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@@ -0,0 +1,1930 @@
+1
+00:00:00,910 --> 00:00:06,310
+الرحيم أهلا وسهلا بكم طلابي الأعزاء في فيديو رقم
+
+2
+00:00:06,310 --> 00:00:11,070
+14. بدي أتكلم في هذا الفيديو عن موضوع اسمه الـ
+
+3
+00:00:11,070 --> 00:00:16,030
+postural drainage. هذا الموضوع هو مكمل للمحاضرة أو
+
+4
+00:00:16,030 --> 00:00:18,550
+الفيديوهات السابقة في الـ physical intervention
+
+5
+00:00:18,550 --> 00:00:22,710
+طبعا احنا أخذنا اللي هو بداية بالـ physical
+
+6
+00:00:22,710 --> 00:00:26,950
+intervention to secretion cleanliness عن طريق اللي
+
+7
+00:00:26,950 --> 00:00:29,650
+هي الـ techniques الأخيرة. أخذنا الـ cuffing و الـ
+
+8
+00:00:29,650 --> 00:00:34,170
+huffing. أخذنا اللي هو كيف أنا ممكن أزيل الـ
+
+9
+00:00:34,170 --> 00:00:39,410
+secretion و أأمن ممرات الهواء و تكون بشكل جيد و
+
+10
+00:00:39,410 --> 00:00:44,510
+تعطي فعالية جيدة في عملية التنفس. اليوم هناخد الـ
+
+11
+00:00:44,510 --> 00:00:47,050
+techniques الأخيرة اللي هو الـ postural drainage
+
+12
+00:00:47,050 --> 00:00:52,290
+هأتحدث فيه عن الـ indication و الـ contraindication
+
+13
+00:00:52,290 --> 00:00:57,880
+الـ techniques اللي أنا ممكن أخليها تكون مصاحبة مع
+
+14
+00:00:57,880 --> 00:01:01,520
+الـ Postural Drainage زي اللي هي الـ Manual
+
+15
+00:01:01,520 --> 00:01:07,200
+Treatment أو الـ Manual العربي زي الـ Percussion،
+
+16
+00:01:07,200 --> 00:01:12,060
+الـ Vibration واللي هو الـ Shaking أيضًا. هأتحدث عن
+
+17
+00:01:12,060 --> 00:01:14,980
+الـ Postural Drainage Position. أي وضعية أنا بدي
+
+18
+00:01:14,980 --> 00:01:17,950
+أختار. هل بدي أختاره على الـ Supine Position في الـ
+
+19
+00:01:17,950 --> 00:01:21,230
+Sitting Position أو الـ Prone Position. كل هذا
+
+20
+00:01:21,230 --> 00:01:24,090
+الشيء هنتحدث فيه إن شاء الله رب العالمين في هذا
+
+21
+00:01:24,090 --> 00:01:28,310
+الفيديو. إذا بدي أبدأ بداية بتعريف الـ Postural
+
+22
+00:01:28,310 --> 00:01:31,790
+Drainage أو البرونكال دريناج. is another
+
+23
+00:01:31,790 --> 00:01:36,870
+intervention for airway clearness. هي طريقة لتنبيث
+
+24
+00:01:36,870 --> 00:01:42,850
+ممر الهواء بشكل آمن حتى يسمح بعبور الأكسجين وخروج
+
+25
+00:01:42,850 --> 00:01:46,440
+الـ waste product اللي هو الـ CO2. It's the main
+
+26
+00:01:46,440 --> 00:01:49,760
+mobilized secretion in one or more lung segments
+
+27
+00:01:49,760 --> 00:01:52,880
+of the central airway by placing patients in
+
+28
+00:01:52,880 --> 00:01:57,760
+various positions. في مواضع مختلفة. هنا عندي factor
+
+29
+00:01:57,760 --> 00:02:01,400
+مهم هيساعدني في العملية اللي هو عبارة عن
+
+30
+00:02:01,400 --> 00:02:06,880
+الـ Gravity Assistant. تمام، الـ Gravity هتساعدنا في
+
+31
+00:02:06,880 --> 00:02:11,050
+البصرة، الـ drainage في الـ high المرحلة فبالتالي أنا
+
+32
+00:02:11,050 --> 00:02:15,070
+راح أستخدم تعريف البُستُرال دريناج هو عبارة عن إيش؟
+
+33
+00:02:15,070 --> 00:02:19,830
+عملية لإزالة الـ Secretion اللي موقف أو معيق حركة
+
+34
+00:02:19,830 --> 00:02:25,370
+دخول وخروج الهواء بطرق معددة بيكون فيها دور
+
+35
+00:02:25,370 --> 00:02:30,930
+للجاذبية الأرضية. هي زي ما أنتم شايفين بدي بس أراجع
+
+36
+00:02:30,930 --> 00:02:34,550
+مع حضراتكم شوية anatomy. أخذنا فيه اللي هو
+
+37
+00:02:34,550 --> 00:02:39,110
+الـ Trachea اللي هي القصباء الهوائية. بعدين في
+
+38
+00:02:39,110 --> 00:02:43,050
+عندنا البرونكيولز أو ما يسمى فيه اللي هي الشعيبات
+
+39
+00:02:43,050 --> 00:02:46,410
+الهوائية. عندي بالـ right three lobes. في عندنا الـ
+
+40
+00:02:46,410 --> 00:02:50,550
+upper lobe، الـ middle lobe، و اللي هي الـ lower lobe
+
+41
+00:02:50,550 --> 00:02:54,040
+بينما في الـ left I have two lobes: just upper lobe
+
+42
+00:02:54,040 --> 00:02:57,540
+and lower lobe. هذا الشيء مهم جدا عشان أنا بكرة
+
+43
+00:02:57,540 --> 00:03:01,420
+بالـ postural drainage لازم أَحدد في أي segment أنا
+
+44
+00:03:01,420 --> 00:03:06,240
+فيه عندي مشكلة عشان أحتاج أو عشان أحط المريض فيه
+
+45
+00:03:06,240 --> 00:03:12,000
+في position مناسب لهذا الشيء. نيجي نشوف اللي هو لما
+
+46
+00:03:12,000 --> 00:03:15,320
+بيكون في عندنا secretions are moved from smaller
+
+47
+00:03:15,320 --> 00:03:19,500
+to larger airway. they are then cleared by cuffing or
+
+48
+00:03:19,750 --> 00:03:24,110
+endotracheal suction. يعني بعد ما أعمل أنا هذا الشيء
+
+49
+00:03:24,110 --> 00:03:28,070
+أو بعد ما أعمل postural drainage لازم يكون في عندي كذا
+
+50
+00:03:28,070 --> 00:03:32,590
+mechanism حتى تساعد لخروج كمية الـ secretion هاي
+
+51
+00:03:32,590 --> 00:03:35,370
+بالذات أنا بأحكي على الناس بكرة اللي هتشتغلوا معاهم
+
+52
+00:03:35,370 --> 00:03:38,990
+بقسم الصدرية. الـ patients اللي هناك بيكونوا موجودين
+
+53
+00:03:39,240 --> 00:03:43,180
+في عندهم كمية لا بأس بها من الـ Secretion. بيكون
+
+54
+00:03:43,180 --> 00:03:48,220
+كثيف، سميك، بلوكي اللي هو ملتصق بشعيبات الهوائية
+
+55
+00:03:48,220 --> 00:03:52,260
+بيعيق حركة اللي هو الهواء اللي موجود في الـ Alveoli
+
+56
+00:03:52,260 --> 00:03:55,660
+وكل هذه الأمور هتشوفوها بإذن الله تعالى مع
+
+57
+00:03:55,660 --> 00:03:59,320
+الـ resident في قسم الصدرية. الـ Postural Drainage
+
+58
+00:03:59,320 --> 00:04:02,020
+also includes the uses of manual techniques. أنا
+
+59
+00:04:02,020 --> 00:04:04,460
+هأستخدم معاها الـ percussion، الـ shaking و
+
+60
+00:04:04,460 --> 00:04:09,170
+الـ vibration. أيضًا بيكون مع اللي هو الـ postural
+
+61
+00:04:09,170 --> 00:04:12,830
+drainage coupled with voluntary cuffing. طبعًا مع
+
+62
+00:04:12,830 --> 00:04:17,750
+كحة إرادية من المريض نفسه إذا كان conscious. لأ
+
+63
+00:04:17,750 --> 00:04:21,470
+شو أهدافنا أو شو الـ indication تبعتنا؟ لمين أنا بدي
+
+64
+00:04:21,470 --> 00:04:25,470
+أستخدم الـ postural drainage؟  الأهداف مع الـ indication للـ postural drainage
+
+65
+00:04:25,470 --> 00:04:28,830
+أول شيء عندي أنه أنا بعمل postural drainage to
+
+66
+00:04:28,830 --> 00:04:31,290
+prevent accumulation of secretion in patients
+
+67
+00:04:31,290 --> 00:04:35,880
+at risk for pulmonary complications. بدي أمنع أي
+
+68
+00:04:35,880 --> 00:04:38,320
+complications تصير لأي patient سواء كان في الـ
+
+69
+00:04:38,320 --> 00:04:42,220
+inpatient عندي في المستشفى، patient أو أنه موجود في
+
+70
+00:04:42,220 --> 00:04:45,720
+بيتهم برة المستشفى. الـ patient اللي عنده pulmonary
+
+71
+00:04:45,720 --> 00:04:49,280
+disease زي الـ chronic bronchitis. ما حكيت الـ acute
+
+72
+00:04:49,280 --> 00:04:51,660
+حكيت الـ chronic لإن الـ acute ما بيكون فيها
+
+73
+00:04:51,660 --> 00:04:54,200
+secretion كبيرة. أما الـ chronic بيكون فيها
+
+74
+00:04:54,200 --> 00:04:57,820
+secretion وكمية لا بأس بها.  Idiopathic fibrosis،
+
+75
+00:04:57,820 --> 00:05:03,860
+التليف الرئوي. الـ patient who are on prolonged bed
+
+76
+00:05:03,860 --> 00:05:08,640
+rest. الـ patient اللي هو نايم في السرير بشكل دائم.
+
+77
+00:05:08,640 --> 00:05:11,900
+الـ patient اللي أيضًا بيستقبل أو اللي عمل عملية
+
+78
+00:05:11,900 --> 00:05:16,080
+جراحية وأخد كمية لا بأس بها من الـ blood. هدول الناس
+
+79
+00:05:16,080 --> 00:05:19,840
+طبعًا بيحوش عنده كمية من الـ secretion من اللي
+
+80
+00:05:19,840 --> 00:05:23,540
+هو الـ secretion مما يعيق عملية الـ breathing
+
+81
+00:05:23,540 --> 00:05:27,140
+و الـ deep coughing. تمام. بس هذا بنسميه
+
+82
+00:05:27,140 --> 00:05:31,880
+conditions. any patient who is volunteer أو any
+
+83
+00:05:31,880 --> 00:05:34,580
+patient who is on ventilator. الـ patients اللي
+
+84
+00:05:34,580 --> 00:05:38,560
+موجودة على تنفس صناعي. if he or she is stable
+
+85
+00:05:38,560 --> 00:05:42,150
+enough to tolerate the treatment. هو قادر على إنه
+
+86
+00:05:42,150 --> 00:05:45,750
+أنا أعمله اللي هي البصرة الـ drainage. لأن معظم
+
+87
+00:05:45,750 --> 00:05:48,770
+المرضى اللي بيكونوا على الـ ventilator تكون حالاتهم
+
+88
+00:05:48,770 --> 00:05:52,190
+حرجة شوية. فأحيانًا ممكن يكون هو contraindication
+
+89
+00:05:52,190 --> 00:05:55,750
+عشان كده أنا ضفتها بالجملة التابعة التالية، إن هو
+
+90
+00:05:55,750 --> 00:06:00,890
+حتى يكون stable enough to tolerate the treatment. هذا أول
+
+91
+00:06:00,890 --> 00:06:04,740
+goal. مع الـ goals الثانية to remove accumulated
+
+92
+00:06:04,740 --> 00:06:09,580
+أمنع أي تجمع لـ secretion في الـ lungs. الـ patient
+
+93
+00:06:09,580 --> 00:06:11,880
+اللي عندهم acute or chronic lung disease زي
+
+94
+00:06:11,880 --> 00:06:15,960
+الالتهاب الرئوي، زي الـ atelectasis، acute lung infections، COPD
+
+95
+00:06:15,960 --> 00:06:20,600
+وهي الأمراض. الـ patient اللي who are generally very
+
+96
+00:06:20,600 --> 00:06:24,340
+weak are generally. الناس اللي بتكون مش قادرة على
+
+97
+00:06:24,340 --> 00:06:29,280
+أنها تُخرج هذا الـ secretion برة. الـ patient اللي
+
+98
+00:06:29,280 --> 00:06:34,730
+أيضًا أستخدمه مع الـ patient اللي أيضًا في عندهم
+
+99
+00:06:34,730 --> 00:06:38,470
+artificial airway زي الـ Endotracheal tube زي اللي
+
+100
+00:06:38,470 --> 00:06:43,250
+هو الـ Tracheostomy. كل الأمور هذه أستخدمها مع هدول
+
+101
+00:06:43,250 --> 00:06:47,470
+الناس. لكن أنا في عندي contraindication. في عندي
+
+102
+00:06:47,470 --> 00:06:52,930
+ناس ممنوعة أنا أشتغل معاها postural drainage. حالات الـ
+
+103
+00:06:52,930 --> 00:06:56,740
+severe hemoptysis. يعني الحالات اللي هو بيكون فيه
+
+104
+00:06:56,740 --> 00:07:00,820
+خروج دم كتيرة أو كمية كبيرة من الدم أثناء الـ
+
+105
+00:07:00,820 --> 00:07:04,340
+cuffing. على سبيل المثال الـ untreated acute
+
+106
+00:07:04,340 --> 00:07:08,060
+conditions. ليه؟ لأنه ما بيكون لسه اتكون في هذه
+
+107
+00:07:08,060 --> 00:07:11,800
+الحالات. يعني أنا اليوم لو أنا على سبيل المثال صار
+
+108
+00:07:11,800 --> 00:07:16,020
+في عندي high fever لأي طفل وكان في عنده bronchitis
+
+109
+00:07:16,020 --> 00:07:19,920
+بسميها في بداية مراحلها acute bronchitis. ما هيكون
+
+110
+00:07:19,920 --> 00:07:23,480
+عند هذا الطفل secretion في الـ coughing. لأ، هتكون
+
+111
+00:07:23,480 --> 00:07:28,400
+كحة ناشفة أو بنسميها الكحة الجافة. بعد ما يتحول بعد
+
+112
+00:07:28,400 --> 00:07:33,240
+شوية إلى اللي هو chronic بيصير في عنده اللي هو
+
+113
+00:07:33,240 --> 00:07:38,290
+secretion. في حالات pulmonary edema. في حالات
+
+114
+00:07:38,290 --> 00:07:41,530
+الـ pulmonary edema ما أستخدم معاهم postural drainage. في
+
+115
+00:07:41,530 --> 00:07:44,490
+حالات الـ congestive heart failure لأنه بأخاف عليه
+
+116
+00:07:44,490 --> 00:07:47,950
+في حالات الـ large pleural effusion. في حالات
+
+117
+00:07:47,950 --> 00:07:50,910
+الـ pulmonary embolism لأنه ممكن مع الـ postural drainage
+
+118
+00:07:50,910 --> 00:07:53,750
+تتحرك عندي هاي الـ embolism أو هاي الـ thrombus
+
+119
+00:07:53,750 --> 00:07:58,070
+وتسبب لي على سبيل المثال اللي هي جلطة رئوية أو
+
+120
+00:07:58,070 --> 00:08:02,310
+جلطة دماغية. إذا اتحركت. في حالات الـ pneumothorax، في حالات الـ
+
+121
+00:08:02,310 --> 00:08:06,150
+Cardiovascular instability لأنه بأخاف إيش يصير عندي
+
+122
+00:08:06,150 --> 00:08:10,570
+في الدورة الدموية. Cardiac arrhythmia، severe hypo أو
+
+123
+00:08:10,570 --> 00:08:14,590
+hypertension. كمان أنا بأخاف منها في حالات recent
+
+124
+00:08:14,590 --> 00:08:18,170
+myocardial infarction لأنه المريض unstable يعني
+
+125
+00:08:18,170 --> 00:08:23,470
+أُصيب بنوبة قلبية بس هو لسه unstable يعني مش مستقر
+
+126
+00:08:23,470 --> 00:08:27,320
+تمامًا. الـ unstable angina أيضًا. اللي هي الـ recent
+
+127
+00:08:27,320 --> 00:08:32,520
+neurosurgery. مريض عامل اللي هو عملية في اللي هو
+
+128
+00:08:32,520 --> 00:08:36,720
+الـ nervous system ومازال حديث عهد بالعملية
+
+129
+00:08:36,720 --> 00:08:41,040
+ما بأجي بأحطه على سبيل المثال في وضع اللي هو prone
+
+130
+00:08:41,040 --> 00:08:45,080
+position و head down ليه؟ لأنه هيزيد الـ
+
+131
+00:08:45,080 --> 00:08:49,520
+intracranial pressure وهذا مش صحيح. هي الـ contra
+
+132
+00:08:49,520 --> 00:08:52,710
+indication. شو هي بعض الـ techniques اللي في الـ
+
+133
+00:08:52,710 --> 00:08:56,470
+manual therapy أنا ممكن أستخدمها مع البصرة الـ
+
+134
+00:08:56,470 --> 00:09:00,210
+drainage؟ أول شيء هأخذ الـ percussion وبعده هأخذ الـ
+
+135
+00:09:00,210 --> 00:09:04,750
+vibration وبعدين رقم تلاتة الـ shaking. تقريبًا كل
+
+136
+00:09:04,750 --> 00:09:08,970
+هاي الحركات أخذناها في معاملنا في معمل اللي هو
+
+137
+00:09:08,970 --> 00:09:12,990
+الـ manual therapy أو معمل المساج بالعربي. الـ percussion
+
+138
+00:09:12,990 --> 00:09:16,650
+كنا بنستخدم الـ percussion mechanically to dislodge
+
+139
+00:09:16,650 --> 00:09:21,790
+viscous أو adherent mucus from airway. أنا أستخدم
+
+140
+00:09:21,790 --> 00:09:27,550
+الـ percussion حتى أَفصل أو أجزء هذا الـ secretion اللي هو
+
+141
+00:09:27,550 --> 00:09:32,490
+viscous أو adherent ملتصق في الـ mucus في الـ airway.
+
+142
+00:09:32,670 --> 00:09:35,830
+Performed with cupped hand، بنعملها بالإيد على شكل
+
+143
+00:09:35,830 --> 00:09:39,930
+الكباية. طبعًا over the lung segment. beginning trend
+
+144
+00:09:39,930 --> 00:09:43,930
+لازم أنا أَحدد بالضبط أنا في أي lobe هأشتغل أو في أي
+
+145
+00:09:43,930 --> 00:09:47,990
+segment من الـ lung هأشتغل. Therapist should try to keep
+
+146
+00:09:47,990 --> 00:09:53,690
+shoulder, elbow and wrist loose and mobile during
+
+147
+00:09:53,690 --> 00:09:57,970
+maneuver. طبعًا هاي مهارة من مهارات المساج إنه أنا
+
+148
+00:09:57,970 --> 00:10:00,930
+لازم أحافظ على الـ shoulder و الـ elbow و الـ wrist
+
+149
+00:10:00,930 --> 00:10:05,350
+إنها تكون flexible، مرنة خلال عملية اللي هي الـ
+
+150
+00:10:05,350 --> 00:10:08,910
+percussion. The percussion is continued for several
+
+151
+00:10:08,910 --> 00:10:13,610
+minutes until the patient needs to alter position
+
+152
+00:10:13,610 --> 00:10:17,320
+to cough. يعني بدي أقدر إني أشتغل الـ percussion
+
+153
+00:10:17,320 --> 00:10:22,500
+لحد ما تيجي الكحة. ساعتها أنا ببقى في عملية الـ
+
+154
+00:10:22,500 --> 00:10:26,260
+percussion على أساس إنه يعمل coughing وبعدين يعمل
+
+155
+00:10:26,260 --> 00:10:31,120
+اللي هو خروج لهذا الـ secretion. This procedure should
+
+156
+00:10:31,120 --> 00:10:35,930
+not be painful and uncomfortable. يعني مش لازم أكون
+
+157
+00:10:35,930 --> 00:10:41,890
+ضارب ولا أكون طبعًا قاسي على جسم المريض. يعني لا
+
+158
+00:10:41,890 --> 00:10:46,230
+لازم يكون مؤذي ولا لازم يكون اللي هو خفيف بحيث إنه
+
+159
+00:10:46,230 --> 00:10:51,310
+لا يؤدي الغرض. هي من مهارات المساج أو اللي هو
+
+160
+00:10:51,310 --> 00:10:55,250
+الـ therapist الشاطرة. هي الـ cupped mechanism اللي أنا
+
+161
+00:10:55,250 --> 00:11:00,110
+حكيت عليها أو الـ cupping أنه على شكل الكباية. حكينا
+
+162
+00:11:00,110 --> 00:11:03,630
+في المهارات لازم الـ therapist يكون شغال الـ
+
+163
+00:11:03,630 --> 00:11:07,630
+shoulder و الـ elbow و الـ wrist لازم تكون بوضعية
+
+164
+00:11:07,630 --> 00:11:13,320
+ممتازة. هي الوضع اللي هو في الـ prone position. حطينا
+
+165
+00:11:13,320 --> 00:11:17,360
+pillow under the abdomen وبلشنا الـ cupping
+
+166
+00:11:17,360 --> 00:11:21,200
+mechanism. الآن الـ congested bronchial walls بيكون
+
+167
+00:11:21,200 --> 00:11:26,870
+في عندنا اللي هو تم إغلاق اللي هي الـ Bronchi أو الـ
+
+168
+00:11:26,870 --> 00:11:29,030
+mini Bronchi بهذا الـ secretion. زي ما أنتم
+
+169
+00:11:29,030 --> 00:11:32,230
+شايفينه. بعد الـ percussion و الـ cuffing اللي صار من
+
+170
+00:11:32,230 --> 00:11:35,870
+الـ patient صار في عندنا dislodgement انفصال لهذا
+
+171
+00:11:35,870 --> 00:11:40,730
+اللي هو الـ secretion ولكن لم يتم تنظيفه بشكل جيد
+
+172
+00:11:40,730 --> 00:11:44,910
+لأنه بعد هيك حكينا لازم الـ patient تبعه يتبعه بـ
+
+173
+00:11:44,910 --> 00:11:51,510
+cuffing voluntary كحة إرادية حتى تشفط هذا
+
+174
+00:11:51,510 --> 00:11:56,750
+secretion ويطلعه لبره. للأسف من الناس اللي أنا ممنوع
+
+175
+00:11:56,750 --> 00:12:01,470
+أشتغل عليها percussion مع الـ Postural Drainage اللي
+
+176
+00:12:01,470 --> 00:12:05,330
+هو ممنوع أشتغلوا هذا الـ percussion فوق الـ bony
+
+177
+00:12:05,330 --> 00:12:07,970
+prominences. ممنوع أشتغله في الـ breast tissue in
+
+178
+00:12:07,970 --> 00:12:11,730
+women. ممنوع أشتغله مع الـ fractures أو الـ spinal
+
+179
+00:12:11,730 --> 00:12:15,510
+fusion أو حالات الـ osteoporosis. ممنوع أشتغله في
+
+180
+00:12:15,510 --> 00:12:20,350
+الـ tumor area. if patient has pulmonary embolism، إذا
+
+181
+00:12:20,350 --> 
+
+223
+00:15:06,270 --> 00:15:09,670
+للpatient's skin and fingers warped around the chest
+
+224
+00:15:09,670 --> 00:15:13,290
+wall محيطة بالchest wall وأبدأ أعمل اللي هي الشاكن
+
+225
+00:15:13,290 --> 00:15:18,870
+The therapist طبعا بالتزامن مع اللي هو الcompress
+
+226
+00:15:18,870 --> 00:15:24,570
+لازم يكون شاكن للchest wall. الآن شو هي المواضع، حكينا
+
+227
+00:15:24,570 --> 00:15:28,830
+عن الtechniques وخلصنا منهم، هنحكي على المواضع في
+
+228
+00:15:28,830 --> 00:15:31,850
+الpostural drainage position، الpostural drainage
+
+229
+00:15:31,850 --> 00:15:36,530
+position. في عندي مواضع متعددة، أهم شيء أنه أنا أعرف
+
+230
+00:15:36,530 --> 00:15:40,830
+وين مكان secretion، إيش أنا بعرف فيه secretion، الـ
+
+231
+00:15:40,830 --> 00:15:45,130
+positions are based on the anatomy of the lungs and the
+
+232
+00:15:45,130 --> 00:15:49,130
+tracheobronchial tree. Each segment of each lobe is
+
+233
+00:15:49,130 --> 00:15:54,290
+drained using the position. إذا بحدد بالظبط أنا وين
+
+234
+00:15:54,290 --> 00:15:57,670
+طبعا هذا عن طريق السماعة. احنا يا طلاب الأعزاء و
+
+235
+00:15:57,670 --> 00:16:01,310
+طالباتي، بنستخدم اللي هو اكتشاف وين الsecretion
+
+236
+00:16:01,310 --> 00:16:05,630
+بالظبط. إذا patient may be positioned on a tilt drainage
+
+237
+00:16:05,630 --> 00:16:10,150
+table. ممكن أحطه على الطاولة، tilt drainage table.
+
+238
+00:16:10,150 --> 00:16:14,930
+زي ما أنتو شايفينه، reinforced bed table with lift.
+
+239
+00:16:14,930 --> 00:16:18,970
+طبعا أو الhospital bed، أو الsmall child اللي هم
+
+240
+00:16:18,970 --> 00:16:22,930
+حالة خاصة، أنه أنا ممكن أجعدهم بيه، اللي هو بحضني أو
+
+241
+00:16:22,930 --> 00:16:26,810
+حضن أحد الأبوين. تمام، هاي الpositions اللي أنا
+
+242
+00:16:26,810 --> 00:16:30,350
+ممكن أحط عليها الpatient وأعمل postural drainage.
+
+243
+00:16:30,350 --> 00:16:33,550
+شوفوا كيف هنا بالsitting position، كيف المريض قاعد.
+
+244
+00:16:33,550 --> 00:16:35,370
+ليه هاي الوضعية القاعد؟ إذا أنا بدي أشتغل على الـ
+
+245
+00:16:35,370 --> 00:16:39,110
+anterior apical segment. أما هنا على الposterior
+
+246
+00:16:39,110 --> 00:16:43,070
+apical segment، لأنه lean forward sitting، قاعد ليه؟
+
+247
+00:16:43,200 --> 00:16:47,200
+فبالتالي هنا بستخدم الpercussion طبعاً على الـ
+
+248
+00:16:47,200 --> 00:16:50,180
+scapula. Your fingers curve over the top of the
+
+249
+00:16:50,180 --> 00:16:53,820
+shoulders، لفوق من الshoulder. فبالتالي هنا هذا الـ
+
+250
+00:16:53,820 --> 00:16:57,160
+posterior apical segment لحالة اللي هي الـ
+
+251
+00:16:57,160 --> 00:17:00,640
+posterior اللي هو secretion متكونة في الapical
+
+252
+00:17:00,640 --> 00:17:04,540
+posterior، الupper lobe. في الanterior هنا في
+
+253
+00:17:04,540 --> 00:17:07,860
+وضعية الsupine position. طبعاً هنا الpercussion
+
+254
+00:17:07,860 --> 00:17:10,380
+هنا هيحددنا بعض الصور للpercussion واللي أنا
+
+255
+00:17:10,380 --> 00:17:13,900
+لازم أعمله في الupper lobe، الposterior segment
+
+256
+00:17:13,900 --> 00:17:19,000
+للright lobe، حوالي turn 45 درجة، وبحط pillow ورا
+
+257
+00:17:19,000 --> 00:17:22,400
+ظهره وتحت بطنيه، يعني هو لا هو جاي prone
+
+258
+00:17:22,400 --> 00:17:26,420
+position ولا جاي supine position، ما بين الاثنين، الـ
+
+259
+00:17:26,420 --> 00:17:29,420
+angular، اللي هي عبارة عن إيش؟ هذا الوضع يسمى
+
+260
+00:17:29,420 --> 00:17:34,840
+الangular، إنه الhead down والfeet up وجاي
+
+261
+00:17:34,840 --> 00:17:39,360
+بوضعية اللي هي لا هو supine ولا هو prone، الـ
+
+262
+00:17:39,360 --> 00:17:44,850
+patient lies in a one-quarter turned position، جايين بربع
+
+263
+00:17:44,850 --> 00:17:48,430
+دائرة، right side، support للpillow ثلاثين درجة، head
+
+264
+00:17:48,430 --> 00:17:51,590
+down position، والpercussion applied under the
+
+265
+00:17:51,590 --> 00:17:55,530
+left breast، لأنه في الanterior زي ما أنتو شايفين
+
+266
+00:17:55,530 --> 00:17:59,790
+هي secretion في الanterior، تمام، هذا الposition
+
+267
+00:17:59,790 --> 00:18:04,070
+ما بنستخدمه نهائياً مع حالات الhead injury، على سبيل
+
+268
+00:18:04,070 --> 00:18:08,670
+المثال. لأ، الmiddle lobes، الmiddle lobes اللي هي
+
+269
+00:18:09,580 --> 00:18:14,380
+الإصابة، الإصابة بتكون في اللي هي الlung أو متوسط
+
+270
+00:18:14,380 --> 00:18:17,480
+الlung. الpatient كمان في الone-quarter turn
+
+271
+00:18:17,480 --> 00:18:21,800
+from spine for the left side زي ما أنتو شايفين،
+
+272
+00:18:21,800 --> 00:18:26,560
+قاعد من خمسة عشر إلى ثلاثين.  الlower lobe، الـ
+
+273
+00:18:26,560 --> 00:18:31,460
+patient في اللي هو الprone position، جاية اللي هي
+
+274
+00:18:31,460 --> 00:18:35,140
+secretion في الlower lobe أو الbasal lobe، هذه
+
+275
+00:18:35,140 --> 00:18:38,840
+طبعاً من الحاجات الصعبة إني أنا أخرجها، لأنها جاية في
+
+276
+00:18:38,840 --> 00:18:42,320
+القاعدة تحت في الlungs، فبالتالي في مسافة طويلة
+
+277
+00:18:42,320 --> 00:18:46,640
+لحد ما أطلعها على الairway. أيضاً هنا في اللي هي
+
+278
+00:18:46,640 --> 00:18:49,740
+الanterior segment، بس أيضاً في الlower lobe، في
+
+279
+00:18:49,740 --> 00:18:52,500
+الanterior segment للlower lobe، برضه نفس
+
+280
+00:18:52,500 --> 00:18:56,780
+الكلام، اللي هو الhead down والfeet up والـ
+
+281
+00:18:56,780 --> 00:19:00,900
+position هذا، عشان أنا إيش أعمل؟ اللي هو خروج للـ
+
+282
+00:19:00,900 --> 00:19:04,800
+secretion. هنا في الposterior segment أيضاً بالـ
+
+283
+00:19:04,800 --> 00:19:08,760
+lower lobe. ما زلنا مستمرين على الlower lobe
+
+284
+00:19:08,760 --> 00:19:13,840
+laterally، اللي هو جاي على الجنب، للlower lobe
+
+285
+00:19:13,840 --> 00:19:18,900
+laterally للright، وأنا متأكدة أن هذا الشيء كله
+
+286
+00:19:18,900 --> 00:19:25,040
+أخذته بالمعمل بشكل أفضل وأكثر مناسبة. هنا جمع كل اللي هو
+
+287
+00:19:25,040 --> 00:19:30,980
+الsegments داخل هاي الslide. شو الguidelines
+
+288
+00:19:30,980 --> 00:19:35,200
+تابعتنا؟ أول شيء في عندي general considerations، بدي
+
+289
+00:19:35,200 --> 00:19:39,040
+أعرف كم مرة أنا بدي أعمل postural drainage، إيش بدي
+
+290
+00:19:39,040 --> 00:19:43,980
+أعرف الtime of day، من أفضل وقت، بدي أعرف كمية
+
+291
+00:19:43,980 --> 00:19:46,860
+الجلسة أو كم هي كمية الجلسات للpostural drainage، إيش
+
+292
+00:19:46,860 --> 00:19:50,720
+هبدأ بالبداية، بالgeneral considerations، time
+
+293
+00:19:50,720 --> 00:19:53,530
+of day. Never administrated post-rehydration،
+
+294
+00:19:53,530 --> 00:19:57,870
+directly after a meal، ولا حتى الmassage كنا بنعمله بعد
+
+295
+00:19:57,870 --> 00:20:02,930
+اللي هي جلسة، أو بعد وجبة من الغذاء. Coordinate the
+
+296
+00:20:02,930 --> 00:20:07,230
+treatment with arousal therapy. لازم أناسق مابيني وما
+
+297
+00:20:07,230 --> 00:20:10,850
+بين استخدام المريض للبخاخة أو التبخير، على سبيل
+
+298
+00:20:10,850 --> 00:20:14,680
+المثال. Some therapists believe arousal therapy
+
+299
+00:20:14,680 --> 00:20:19,040
+مع الhumidification، وأنا بهمني كمية الـ
+
+300
+00:20:19,040 --> 00:20:23,360
+humidification، لأنه هتسهل لي عملية الseparation
+
+301
+00:20:23,360 --> 00:20:30,460
+أو تفتيت السكريشن إذا كان سميك وكثيف. طبعاً للي هو
+
+302
+00:20:30,460 --> 00:20:33,160
+قبل الpostural drainage. بعض الأخصائيين بيقول لك: لأ، أنا
+
+303
+00:20:33,160 --> 00:20:39,080
+لازم في البداية أشرب مريض أنا حاجة دافية بالإضافة للي
+
+304
+00:20:39,080 --> 00:20:44,260
+هو ياخد تبخيرة، على سبيل المثال. هذا بيزيد اللي هو
+
+305
+00:20:44,260 --> 00:20:46,960
+أو بيساعد في الloosening للsecretion،
+
+306
+00:20:46,960 --> 00:20:50,220
+وincreasing للlikelihood، اللي هو productivity،
+
+307
+00:20:50,220 --> 00:20:53,160
+بيساعد طبعاً في إنتاج، إنه الcoughing تكون
+
+308
+00:20:53,160 --> 00:20:57,680
+productive، يعني مُقشع، يعني فيها بلغم، على سبيل
+
+309
+00:20:57,680 --> 00:21:01,500
+المثال. إنه بيصير سهل جداً خروج هذا الwaste
+
+310
+00:21:01,500 --> 00:21:04,650
+product. Others believe arousal therapy is best
+
+311
+00:21:04,650 --> 00:21:08,630
+after postural drainage. لكن بعض الأخصائيين على سبيل
+
+312
+00:21:08,630 --> 00:21:12,690
+المثال بقول لك: لأ، احنا ما بنعمله بعد اللي هو الـ
+
+313
+00:21:12,690 --> 00:21:16,130
+postural drainage، when patient's lungs are clear and
+
+314
+00:21:16,130 --> 00:21:18,770
+maximal benefit can be gained with medication as
+
+315
+00:21:18,770 --> 00:21:21,770
+needed to cough. Arousal therapy. Choose the time
+
+316
+00:21:22,130 --> 00:21:25,770
+of day. The most benefit for the patient. أنت
+
+317
+00:21:25,770 --> 00:21:30,710
+شوف اختيارك للوقت، أو اختيارك لتوقيت اللي هو الـ
+
+318
+00:21:30,710 --> 00:21:34,690
+humidification، بيتمد حسب الحالة، أو حسب ما أنت مرتاح
+
+319
+00:21:34,690 --> 00:21:38,510
+في الحالة، أو حسب اللي هي الحالة وما تستطيعين في ذلك.
+
+320
+00:21:38,510 --> 00:21:42,570
+The patient can tend to be highly productive in early
+
+321
+00:21:42,570 --> 00:21:46,970
+morning because of accumulation of secretions from the
+
+322
+00:21:46,970 --> 00:21:52,350
+night before. طبعاً أفضل شيء أنه أنا الpatient تبعي
+
+323
+00:21:52,350 --> 00:21:56,390
+يكون، أو يعمل الجلسة، يعني بالعادة كنا في المستشفى
+
+324
+00:21:56,390 --> 00:22:00,770
+في قسم الصدرية بنعملها باكراً بالصباح. ليش؟ لأن
+
+325
+00:22:00,770 --> 00:22:04,350
+سبحان الله، كل الsecretion بيبقى طالع لفوق، يعني
+
+326
+00:22:04,350 --> 00:22:07,750
+حتى اللي في الbasal، حتى اللي هو في الmiddle lobe،
+
+327
+00:22:07,750 --> 00:22:10,750
+كله بيكون طالع على الupper respiratory tract.
+
+328
+00:22:10,750 --> 00:22:14,190
+فبتلاقي المريض، سبحان الله، بيقول لك: أنا مخنوق، ليش؟
+
+329
+00:22:14,190 --> 00:22:17,770
+لأنه في عنده secretion وفي عنده blocking في الـ
+
+330
+00:22:17,770 --> 00:22:20,270
+airway. فبالتالي هنا أنا لو عملت postural drainage،
+
+331
+00:22:20,270 --> 00:22:24,170
+هيكون سهل جداً أن المريض يعملي coughing ويطلع هذا
+
+332
+00:22:24,170 --> 00:22:27,610
+secretion.  الpostural drainage in early evening
+
+333
+00:22:27,610 --> 00:22:31,530
+كمان مهم جداً، يعني في بداية الصباح وفي بداية المساء.
+
+334
+00:22:31,840 --> 00:22:35,760
+ليه؟ حتى ينام ليلته جيداً، لأنه طبعاً لو كان فيه
+
+335
+00:22:35,760 --> 00:22:39,100
+secretion وسعال، مازال، بيخلي الطفل ما حيعرف ينام
+
+336
+00:22:39,100 --> 00:22:44,940
+منيح. okay، سواء للكبار أو الصغار. الآن أخذنا الtime.
+
+337
+00:22:44,940 --> 00:22:51,700
+بدي آخذ الfrequency of treatment، كام مرة؟ الآن هذا
+
+338
+00:22:51,700 --> 00:22:56,020
+بيعتمد على اللي هو الtype and severity of patient's
+
+339
+00:22:56,020 --> 00:23:01,920
+pathology، تبعات المريض، كم هي حدة الحالة؟ جدّاً
+
+340
+00:23:01,920 --> 00:23:08,240
+أنا عندي secretion، هل هو few؟ هل هو lot؟ كيف وضعه؟
+
+341
+00:23:08,240 --> 00:23:13,080
+فبالتالي أنه هيكون هذا بيعتمد حسب الحالة. If
+
+342
+00:23:13,080 --> 00:23:16,360
+secretions are thick and copious، طبعاً إذا كان
+
+343
+00:23:16,360 --> 00:23:20,780
+الsecretion سميك وكثيف، من مرتين لأربع مرات
+
+344
+00:23:20,780 --> 00:23:25,320
+بستخدمه خلال اليوم، may be necessary until lungs are
+
+345
+00:23:25,320 --> 00:23:29,530
+clear. If patient is on a maintenance program، الـ
+
+346
+00:23:29,530 --> 00:23:33,470
+frequency is less. اللي كان المريض يعني ما عنده كتير
+
+347
+00:23:33,470 --> 00:23:36,650
+secretion، إيش أنا أعمل أربع مرات؟ لأ، بعمل أقل من هيك.
+
+348
+00:23:36,650 --> 00:23:42,670
+Perhaps once a day or only a few days a week, okay?
+
+349
+00:23:42,670 --> 00:23:47,010
+لأن الpreparation للpostural drainage، تحضيرنا لمريضنا
+
+350
+00:23:47,010 --> 00:23:52,090
+قبل الpostural drainage، loosening لأي tight أو اللي هي
+
+351
+00:23:52,090 --> 00:23:55,830
+bulky clothes، عشان أعرف أشتغل اللي هو الmanual
+
+352
+00:23:55,830 --> 00:23:58,980
+therapy، على سبيل المثال. It is not necessary to
+
+353
+00:23:58,980 --> 00:24:03,200
+expose the skin، ولكن مش بدليل أني أعري كل شيء
+
+354
+00:24:03,200 --> 00:24:06,520
+حتى أوصل للskin. Have absorbent cuffs or tissues
+
+355
+00:24:06,520 --> 00:24:11,950
+available. Have sufficient pillows. بدي وضع مخدات، ممكن
+
+356
+00:24:11,950 --> 00:24:15,130
+أحتاجهم تحت الabdomen، أو إذا أنا بدي أعمل الone
+
+357
+00:24:15,130 --> 00:24:18,770
+quarter، إني أحط شيء ورا ظهره، وشيء من ناحية
+
+358
+00:24:18,770 --> 00:24:21,970
+الأمام، anterior. Explain the treatment procedure
+
+359
+00:24:21,970 --> 00:24:26,870
+for the patient. طبعاً لأي technique بدي أعمله، لازم
+
+360
+00:24:26,870 --> 00:24:30,050
+أشرحه للpatient، ويا حبذا إذا فيه exercises أنا
+
+361
+00:24:30,050 --> 00:24:34,370
+بعملها، وأوريهم إياها، يتعلموها للبيت.  Deep
+
+362
+00:24:34,370 --> 00:24:40,110
+breathing and coughing قبل الpostural drainage، لأنه يعملهم بعد
+
+363
+00:24:40,110 --> 00:24:49,070
+الpostural drainage، لأنه يعملهم
+
+364
+00:24:49,070 --> 00:24:51,710
+بعد الpostural drainage، لأنه يعملهم بعد الpostural drainage، لأنه يعملهم بعد
+
+365
+00:24:51,710 --> 00:24:52,870
+الpostural drainage، لأنه يعملهم بعد الpostural drainage، لأنه يعملهم بعد
+
+366
+00:24:52,870 --> 00:24:53,250
+الpostural drainage، لأنه يعملهم بعد الpostural drainage، لأنه يعملهم بعد
+
+367
+00:24:53,250 --> 00:24:54,010
+الpostural drainage، لأنه يعملهم بعد الpostural drainage، لأنه يعملهم بعد
+
+368
+00:24:54,010 --> 00:24:57,570
+الpostural drainage، لأنه يعملهم بعد الpostural drainage، لأنه يعملهم بعد
+
+369
+00:24:57,570 --> 00:25:03,640
+الpostural drainage، لأنه يعملهم. لكن إذا كان مش قادر يعملهم
+
+370
+00:25:03,640 --> 00:25:06,840
+voluntarily، فأنا بستخدم اللي هو suction machine،
+
+371
+00:25:06,840 --> 00:25:12,540
+وبحاول أشفط له من اللي هو الsecretion اللي تحللت أو
+
+372
+00:25:12,540 --> 00:25:17,980
+اللي طلع على الbronchi. Make any adjustment to
+
+373
+00:25:17,980 --> 00:25:21,840
+tubes. طبعاً إذا كان أنا مريضي طبعاً في الICU على
+
+374
+00:25:21,840 --> 00:25:25,800
+سبيل المثال، وفي عندنا wires وفي عندنا tubes، وفي
+
+375
+00:25:25,800 --> 00:25:31,440
+عندنا ECG electrodes، وهذه الأمور لازم أنا أشوف
+
+376
+00:25:31,440 --> 00:25:35,500
+طريقة إنه أنا أعدل، أعمل adjustable، إنه أنا أكون
+
+377
+00:25:35,500 --> 00:25:39,580
+طبعاً قابلة للتعديل في اللي هو الposition تبعي
+
+378
+00:25:39,580 --> 00:25:44,990
+اللي مع المريض. الanxious sequences، بدي أستخدم
+
+379
+00:25:44,990 --> 00:25:48,190
+which segment of the lung should be determined. مش أنا
+
+380
+00:25:48,190 --> 00:25:53,410
+بدي أشتغل على أي وضع، على أي مكان، لأ، أنا لازم أشتغل
+
+381
+00:25:53,410 --> 00:25:58,030
+وين أنا بالذات عندي فيه secretion. Some patients
+
+382
+00:25:58,030 --> 00:26:00,810
+with chronic lung disease such as cystic fibrosis
+
+383
+00:26:00,810 --> 00:26:04,850
+need to drain all positions، لأن هاي الناس في cystic
+
+384
+00:26:04,850 --> 00:26:09,850
+fibrosis عندها كمية لابأس بها من اللي هو secretion.
+
+385
+00:26:09,850 --> 00:26:13,450
+Other patients may require drainage of only a few
+
+386
+00:26:13,450 --> 00:26:16,430
+segments in which secretions have accumulated.
+
+387
+00:26:16,430 --> 00:26:20,870
+Check the patient's vital signs، لازم آخذ الvital
+
+388
+00:26:20,870 --> 00:26:26,410
+signs قبل اللي هو الpostural drainage للpatient،
+
+389
+00:26:26,410 --> 00:26:30,390
+حتى أشوف أنا شغالة صح ولا مش صح، خصوصاً الـ
+
+390
+00:26:30,390 --> 00:26:33,890
+breathing sounds، لازم أشوفه تحسن ولا ما تحسنش.
+
+391
+00:26:34,370 --> 00:26:37,090
+أيضاً بدي أشوف الpatient التابع، إذا كان
+
+392
+00:26:37,090 --> 00:26:39,910
+comfortable أو relaxed، comfortable وrelaxed، ولا
+
+393
+00:26:39,910 --> 00:26:43,710
+لأ. Stand in front of the patient، عشان أشوف إذا لسمح
+
+394
+00:26:43,710 --> 00:26:47,750
+الله في اختناق أو فيش اختناق، أو أشوف اللي هو الـ
+
+395
+00:26:47,750 --> 00:26:51,470
+facial expression. طبعاً وإحنا عارفين هذا الحكي
+
+396
+00:26:51,470 --> 00:26:55,710
+جيداً. Maintain each position for five to ten
+
+397
+00:26:55,710 --> 00:27:00,690
+minutes if the patient is tolerant. إذا استمر معانا الوضع،
+
+398
+00:27:00,690 --> 00:27:05,710
+أو إذا استحمل أو تحمل الpatient، فإحنا سليم. أما
+
+399
+00:27:05,710 --> 00:27:09,210
+إذا لأ
+
+445
+00:30:14,380 --> 00:30:18,490
+may be productive بعد اللي هو session تبعتي يعني
+
+446
+00:30:18,490 --> 00:30:21,230
+إذا ما قدر يعمل cuffing ويطلع ال secretion خلال
+
+447
+00:30:21,230 --> 00:30:25,530
+البصرة للدرناج ممكن يعمله خلال اللي هو ال cuffing
+
+448
+00:30:25,530 --> 00:30:31,590
+بعد الجلسة بدقائق أو فترة معينة، طبعا أنا كي بدي
+
+449
+00:30:31,590 --> 00:30:35,170
+أقيم فعالية اللي هي الجلسة تبعتي عن طريق الـ
+
+450
+00:30:35,170 --> 00:30:37,590
+Breathing Sound كنا حكينا عليه في البداية تبع
+
+451
+00:30:37,590 --> 00:30:41,810
+الجلسة أنه أنا بسمع اللي هو هل فيه crackles هل فيه
+
+452
+00:30:41,810 --> 00:30:45,170
+secretion ما زال عندي مسموع، لأ، إذا كان أنا
+
+453
+00:30:45,170 --> 00:30:49,330
+بالبداية كنت سمعها كويس، وبعد ال session باجي بحط
+
+454
+00:30:49,330 --> 00:30:53,210
+بالسمعة وبسمع ال Breathing Sound، إذا كان ما زال
+
+455
+00:30:53,210 --> 00:30:56,570
+موجود معناته أنا ما طلع المريض عندي شيء والجلسة
+
+456
+00:30:56,570 --> 00:31:00,950
+تقيمها ليس بجيد، ولكن إذا كان الصوت واضح وإنه ما في
+
+457
+00:31:00,950 --> 00:31:07,070
+شيء والـ Airway Clearance فأنا وصلت لهدفي الآن
+
+458
+00:31:07,070 --> 00:31:10,570
+الـ Type والـ Color والـ Consistency تبعته الـ
+
+459
+00:31:10,570 --> 00:31:14,570
+Secretion والـ Amount مهمة جداً إنه أنا عارفها
+
+460
+00:31:15,250 --> 00:31:18,410
+check up لل patient vital signs after treatment
+
+461
+00:31:18,410 --> 00:31:22,510
+and note how patient tolerate the treatment كمان
+
+462
+00:31:22,510 --> 00:31:25,970
+هاي مهمة حتى أشوف قد إيش ال tolerance تبع ال patient
+
+463
+00:31:25,970 --> 00:31:32,010
+اللي أنا شغالة معاه، في عندي مواضيع اللي هو ال
+
+464
+00:31:32,010 --> 00:31:36,390
+modifications، إنه أنا على سبيل المثال بتأقلم مع
+
+465
+00:31:36,390 --> 00:31:39,990
+الوضعية اللي أنا فيها، إذا كان المريض تبعي في عنده
+
+466
+00:31:39,990 --> 00:31:45,470
+على سبيل المثال مريض بيكون في عنده مضاعفات صعبة جداً إنه
+
+467
+00:31:45,470 --> 00:31:51,210
+أنا أحطه في الـ semisupine أو الـ prone position
+
+468
+00:31:51,210 --> 00:31:55,870
+فبالتالي أنا هنا لازم أعمله adjustable أو أخليه
+
+469
+00:31:55,870 --> 00:31:59,470
+أعمله adjusting للي هو ال position، okay، for
+
+470
+00:31:59,470 --> 00:32:01,830
+example، ال patient with congestive heart failure
+
+471
+00:32:01,830 --> 00:32:06,360
+ما يكونش indicated of orthopenia، طبعا لإنه
+
+472
+00:32:06,360 --> 00:32:09,200
+congestive heart failure after neurosurgery
+
+473
+00:32:09,200 --> 00:32:12,260
+patient كمان may not be allowed to assume head down
+
+474
+00:32:12,260 --> 00:32:15,840
+زي ما حكينا في بداية الفيديو إنه أنا صعب جداً إنه
+
+475
+00:32:15,840 --> 00:32:18,680
+أنا أحط هاي الناس في وضع Trendelenburg position
+
+476
+00:32:18,680 --> 00:32:23,120
+ليه؟ لإنه بيزيد ال intracranial pressure في هاي
+
+477
+00:32:23,120 --> 00:32:26,940
+الوضعية، وبالتالي أنا لازم أشوف اللي هو وضعية أخرى
+
+478
+00:32:26,940 --> 00:32:31,600
+هذا هو Trendelenburg اللي هو position، هذا ال
+
+479
+00:32:31,600 --> 00:32:35,310
+position صعب على الحالة التالية after thoracic
+
+480
+00:32:35,310 --> 00:32:38,570
+surgery، ال patient may have chest tube، في عندنا ال
+
+481
+00:32:38,570 --> 00:32:41,430
+monitoring wires، في عندنا بعض الأشياء اللي بتكون
+
+482
+00:32:41,430 --> 00:32:44,370
+على المريض، هنا لازم أنا آخذ بالي من هنا كويس
+
+483
+00:32:44,370 --> 00:32:47,710
+under the circumstances and other positioning خلال
+
+484
+00:32:47,710 --> 00:32:51,050
+postural drainage must be modified, the position in
+
+485
+00:32:51,050 --> 00:32:53,270
+which postural drainage is undertaken
+
+486
+00:32:53,270 --> 00:32:56,570
+modification، هذه الأمور لازم أنا آخذها بعين
+
+487
+00:32:56,570 --> 00:33:02,600
+الاعتبار، وأعدل من الوضعية مع المريض، ال home program لأن
+
+488
+00:33:02,600 --> 00:33:05,160
+أنا عملت الجلسة عندي في المستشفى، وتمام تمام، و
+
+489
+00:33:05,160 --> 00:33:08,820
+لازم أعلم ال patient كيف يعمل اللي هو ال home
+
+490
+00:33:08,820 --> 00:33:12,240
+program تبعته، البصر، the home program may have carried out
+
+491
+00:33:12,240 --> 00:33:15,280
+regularly basis لل home patient in chronic disease
+
+492
+00:33:16,060 --> 00:33:19,880
+كتير كويس أنا أعلم الأم إذا كان طفلها بيعاني من
+
+493
+00:33:19,880 --> 00:33:23,680
+اللي هو الـChronic Bronchitis إن هي كمان تعمل
+
+494
+00:33:23,680 --> 00:33:27,420
+الـCuffing أو تعمل الـPostural drainage في البيت، و
+
+495
+00:33:27,420 --> 00:33:31,220
+أعطيها الـHome Program، the patient needs to be shown
+
+496
+00:33:31,220 --> 00:33:35,220
+how to position themselves using inexpensive aids
+
+497
+00:33:35,220 --> 00:33:38,560
+كمان إحنا لو علمنا المريض بعض الـ exercises أو بعض
+
+498
+00:33:38,560 --> 00:33:41,880
+الـ positions إنه يشتغلها في البيت وتكون طبعا
+
+499
+00:33:41,880 --> 00:33:47,520
+freely، an adult may place a pillow طبعا أو أي شيء
+
+500
+00:33:47,520 --> 00:33:51,220
+ممكن يشتغل فيها، the patient also lean chestward
+
+501
+00:33:51,220 --> 00:33:55,680
+لل bed and resting with arms, chair or stool، من أي
+
+502
+00:33:55,680 --> 00:33:59,940
+شيء من البيت، أنا ممكن أخلي الأم تصنع اللي هو roll
+
+503
+00:33:59,940 --> 00:34:05,200
+تصنع بعض ال pillows اللي هتكون مساعدة لاستخدامها
+
+504
+00:34:08,090 --> 00:34:11,650
+الاطفال، positions تبعهم أو وضعيات الأطفال، in
+
+505
+00:34:11,650 --> 00:34:16,090
+ironing board, proper against sofa or heavy chairs
+
+506
+00:34:16,090 --> 00:34:20,590
+يا بحطهم على الكنبة أو بحطهم على كرسي بيكون شوية
+
+507
+00:34:20,590 --> 00:34:25,210
+ثقيل، family members often family members often
+
+508
+00:34:25,210 --> 00:34:28,430
+must do proper positioning، ال percussion والـ
+
+509
+00:34:28,430 --> 00:34:32,250
+shaking، والتكنيكس، ممكن أعلمهم، يعني بنعلم الأم
+
+510
+00:34:32,250 --> 00:34:35,790
+يا بنعلم أي حد من ال caregiver إنه يشتغل ال manual
+
+511
+00:34:35,790 --> 00:34:39,330
+therapy، Guidelines and Percussions to assist
+
+512
+00:34:39,330 --> 00:34:43,370
+لل patient، previously discussed، و should be اللي هو
+
+513
+00:34:43,370 --> 00:34:46,950
+طبعا بعض ال guidelines وبعض ال percussions أنا
+
+514
+00:34:46,950 --> 00:34:51,250
+لازم أتبعهم وأعلمهم لل patient، وإنه دائماً يكون
+
+515
+00:34:51,250 --> 00:34:54,570
+حذر في التعامل في الوضعيات، خصوصاً إذا كان
+
+516
+00:34:54,570 --> 00:35:00,830
+neurosurgery، أو إذا كان أي حد بيعمل اللي هو الجلسة
+
+517
+00:35:02,490 --> 00:35:06,970
+امتى أنا لازم أقطع اللي هي جلسة البصرة؟ يا دكتور، متى
+
+518
+00:35:06,970 --> 00:35:11,850
+if chest radiograph is relatively clear، خلصنا كده
+
+519
+00:35:11,850 --> 00:35:14,830
+ال patient تبعي تمام تمام، وال breathing sound
+
+520
+00:35:14,830 --> 00:35:22,010
+عنده سليم، if patient afebrile، هذا مهم جداً إذا كان
+
+521
+00:35:22,010 --> 00:35:28,490
+مريضي afebrile من 24 ل 48 ساعة، if normal or near
+
+522
+00:35:28,490 --> 00:35:33,450
+normal breath sounds are heard with escalations، إذا
+
+523
+00:35:33,450 --> 00:35:38,450
+كان قريب أو شبه قريب في اللي هو سماعي لصوت
+
+524
+00:35:38,450 --> 00:35:43,270
+الـ breathing تبعه، الآن هأتحدث أيضاً عن اللي هي
+
+525
+00:35:43,270 --> 00:35:46,550
+الـImproving Exercise Tolerance، الـ Exercise
+
+526
+00:35:46,550 --> 00:35:49,850
+Tolerance اللي هي عبارة عن قابلية تبع ال patient
+
+527
+00:35:49,850 --> 00:35:53,070
+إنه يعمل الـ exercise، طبعاً الـ muscle weakness
+
+528
+00:35:53,070 --> 00:35:56,590
+وال skeletal involuntary وال skeletal involuntary muscle
+
+529
+00:35:56,590 --> 00:36:00,350
+is common في الـ COPD patients، لازم أعمله
+
+530
+00:36:00,350 --> 00:36:03,610
+strengthening exercises، هنا هأتكلم عن chest mobility
+
+531
+00:36:03,610 --> 00:36:07,330
+وهأتحدث عن بعض ال exercises to strengthening
+
+532
+00:36:07,330 --> 00:36:12,270
+exercises، ال exercises، ال mobilization chest اللي هو
+
+533
+00:36:12,270 --> 00:36:15,730
+ليه؟ حتى أنا تكون عندي ال respiratory muscles، و
+
+534
+00:36:15,730 --> 00:36:18,570
+تكون عندي مش بس ال mainly muscles اللي أنا شغالة
+
+535
+00:36:18,570 --> 00:36:21,050
+عليها، أيضاً شغالة على كل ال respiratory muscles، و
+
+536
+00:36:21,050 --> 00:36:24,750
+ال trunk وال shoulder girdle وكل ال upper ال
+
+537
+00:36:24,750 --> 00:36:28,790
+trunk أنا بدي يكون good، فبالتالي، على سبيل المثال
+
+538
+00:36:28,790 --> 00:36:31,690
+الـ patient with hypomobility لـ  thoracic muscle
+
+539
+00:36:31,690 --> 00:36:34,870
+site to the bed does not expand the part of chest
+
+540
+00:36:34,870 --> 00:36:38,630
+fully during inspiration، أنا بهمني اللي هو الـ
+
+541
+00:36:38,630 --> 00:36:42,310
+full expiration والـ full inspiration اللي هيصير
+
+542
+00:36:42,310 --> 00:36:46,180
+في عمليات ال respiratory system، ال exercises
+
+543
+00:36:46,180 --> 00:36:49,880
+combined with stretching، مهم جداً إنه أنا أساعد
+
+544
+00:36:49,880 --> 00:36:52,960
+المرضى تبعيني في ال range of motion exercises
+
+545
+00:36:52,960 --> 00:36:56,760
+بالإضافة لل stretching exercises، أيضاً أبقى أساعد
+
+546
+00:36:56,760 --> 00:36:59,580
+اللي هو ال patient في ال reinforcing لل expiration
+
+547
+00:36:59,580 --> 00:37:04,000
+leaning forward لل hips and flexing supine، أو اللي
+
+548
+00:37:04,000 --> 00:37:07,460
+هي breathe out، this pushing out viscera superiorly
+
+549
+00:37:07,460 --> 00:37:11,300
+and into diaphragm، زي ما حكيت، الحدث من هذا ال
+
+550
+00:37:11,300 --> 00:37:14,600
+exercise كله إنه أعمل strengthening and
+
+551
+00:37:14,600 --> 00:37:18,580
+mobilization ل chest عند ال patient اللي في قسم
+
+552
+00:37:18,580 --> 00:37:22,540
+الصدرية، بعض ال techniques اللي أنا ببدأ أستخدمهم
+
+553
+00:37:22,540 --> 00:37:28,090
+اللي هي mobilize one side of chest، الآن في عندي كذا
+
+554
+00:37:28,090 --> 00:37:32,130
+mobilization أو كذا position أنا هستخدمه، زي ما
+
+555
+00:37:32,130 --> 00:37:35,310
+هتشوفوه في الصور، هنا عندي two chest mobilizations
+
+556
+00:37:35,310 --> 00:37:39,130
+inspiration and expiration، أيضاً بأعمل laterally
+
+557
+00:37:39,130 --> 00:37:44,410
+اللي هي mobilization، bend from side to side، هذا مهم
+
+558
+00:37:44,410 --> 00:37:47,630
+جداً، to mobilize ال upper chest وال pectoralis
+
+559
+00:37:47,630 --> 00:37:52,870
+muscles، وإحنا عارفين كده، مهم جداً عمل وأهمية ال
+
+560
+00:37:52,870 --> 00:37:56,190
+pectoralis muscles سواء ال major أو ال minor، while
+
+561
+00:37:56,190 --> 00:38:00,110
+patient in sitting position، وبخليه يعمل اللي هي
+
+562
+00:38:00,110 --> 00:38:03,930
+auto exercise أو self exercise في ال range of
+
+563
+00:38:03,930 --> 00:38:08,530
+motion exercises، كما هو موضح بالصور، تموباليز ال
+
+564
+00:38:08,530 --> 00:38:12,150
+upper chest and shoulder، طبعا زي ما أنتم شايفين
+
+565
+00:38:12,150 --> 00:38:20,470
+هنا بيعمل اللي هو انثناء flexion لـ ال lumbar area
+
+566
+00:38:20,470 --> 00:38:24,410
+وهنا بيعمل اللي هو full stretching في حالة اللي
+
+567
+00:38:24,410 --> 00:38:29,990
+هي ال shoulder joint، و upright position لـ ال back
+
+568
+00:38:29,990 --> 00:38:37,810
+وب هيك بيكون انتهى هذا الفصل، ويعطيكم ألف
+
+569
+00:38:37,810 --> 00:38:40,230
+عافية بإذن الله تعالى
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/-e-mevs23fQ_postprocess.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/-e-mevs23fQ_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..5f81082d8dc2b6eae60506952b47c5987a8f28ae
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/-e-mevs23fQ_postprocess.srt
@@ -0,0 +1,2276 @@
+1
+00:00:00,910 --> 00:00:06,310
+الرحيم أهلا وسهلا فيكم طلابي الأعزاء في فيديو رقم
+
+2
+00:00:06,310 --> 00:00:11,070
+14 بدي أتكلم في هذا الفيديو عن موضوع اسمه الـ
+
+3
+00:00:11,070 --> 00:00:16,030
+postural drainage هذا الموضوع هو مكمل للمحاضرة أو
+
+4
+00:00:16,030 --> 00:00:18,550
+الفيديوهات السابقة في ال physical intervention
+
+5
+00:00:18,550 --> 00:00:22,710
+طبعا احنا أخدنا اللي هو بداية بال physical
+
+6
+00:00:22,710 --> 00:00:26,950
+intervention to secretion cleanlinessعن طريق اللي
+
+7
+00:00:26,950 --> 00:00:29,650
+هي ال techniques الأخيرة أخدنا ال cuffing و ال
+
+8
+00:00:29,650 --> 00:00:34,170
+huffing أخدنا اللي هو كيف أنا ممكن أزيل ال
+
+9
+00:00:34,170 --> 00:00:39,410
+secretion و أأمن ممرات الهواء و تكون بشكل جيد و
+
+10
+00:00:39,410 --> 00:00:44,510
+تعطي فعالية جيدة في عملية التنفس اليوم هناخد ال
+
+11
+00:00:44,510 --> 00:00:47,050
+techniques الأخير اللي هو ال postural drainage
+
+12
+00:00:47,050 --> 00:00:52,290
+هتحدث فيه عن ال indication و ال contra indication
+
+13
+00:00:52,290 --> 00:00:57,880
+ال techniques اللي أنا ممكنأخليها تكون مصاحبة مع
+
+14
+00:00:57,880 --> 00:01:01,520
+الـ Postural Drainage زي اللي هي الـ Manual
+
+15
+00:01:01,520 --> 00:01:07,200
+Treatment أو الـ Manual العربي زي الـ Percussion،
+
+16
+00:01:07,200 --> 00:01:12,060
+الـ Vibration واللي هو الـ Shaking أيضًا هتحدث عن
+
+17
+00:01:12,060 --> 00:01:14,980
+الـ Postural Drainage Position أي وضعية أنا بدي
+
+18
+00:01:14,980 --> 00:01:17,950
+أختار هل بدي أختاره على الـ Sublime Positionفي الـ
+
+19
+00:01:17,950 --> 00:01:21,230
+Sitting Position أو الـ Prone Position كل هذا
+
+20
+00:01:21,230 --> 00:01:24,090
+الاشي هنتحدث فيه إن شاء الله رب العالمين في هذا
+
+21
+00:01:24,090 --> 00:01:28,310
+الفيديو إذا بدي أبدأ بداية بتعريف الـ Postural
+
+22
+00:01:28,310 --> 00:01:31,790
+Drainage أو البرونكال دريناج is another
+
+23
+00:01:31,790 --> 00:01:36,870
+intervention for airway clearness هي طريقة لتنبيث
+
+24
+00:01:36,870 --> 00:01:42,850
+ممر الهواء بشكل آمن حتى يسمح بعبور الأكسجين وخروج
+
+25
+00:01:42,850 --> 00:01:46,440
+ال waste product اللي هو الـ CO2It's the main
+
+26
+00:01:46,440 --> 00:01:49,760
+mobilized secretion in one or more lung segments
+
+27
+00:01:49,760 --> 00:01:52,880
+of the central airway by placing patients in
+
+28
+00:01:52,880 --> 00:01:57,760
+various positions في مواضع مختلفة هنا عندي factor
+
+29
+00:01:57,760 --> 00:02:01,400
+مهم هيساعدني في العملية اللي هو عبارة عن
+
+30
+00:02:01,400 --> 00:02:06,880
+الـGravity Assistant تمام، الـGravity هتساعدنا في
+
+31
+00:02:06,880 --> 00:02:11,050
+البصرة، الـdrainage في highالمرحلة فبالتالي انا
+
+32
+00:02:11,050 --> 00:02:15,070
+راح استخدم تعريف البُس رازناش هو عبارة عن إيش
+
+33
+00:02:15,070 --> 00:02:19,830
+عملية لإزالة الـ Secretion اللي موقف أو معيق حركة
+
+34
+00:02:19,830 --> 00:02:25,370
+دخول وخروج الهواء بطرق معددة بيكون فيها دور
+
+35
+00:02:25,370 --> 00:02:30,930
+للجاذبية الأرضيةهي زي ما انتوا شايفين بدي بس اراجع
+
+36
+00:02:30,930 --> 00:02:34,550
+مع حضراتكم شوية anatomy أخدنا فيه اللي هو
+
+37
+00:02:34,550 --> 00:02:39,110
+الـmannebranche اللي هي القصباء الهوائية بعدين في
+
+38
+00:02:39,110 --> 00:02:43,050
+عندنا البرنكوليوز أو ما يسمى فيه اللي هي الشعيبات
+
+39
+00:02:43,050 --> 00:02:46,410
+الهوائية عندي بالright three loops في عندنا ال
+
+40
+00:02:46,410 --> 00:02:50,550
+upper loops ال middle loop و اللي هي ال lower loop
+
+41
+00:02:50,550 --> 00:02:54,040
+بينما في ال left I have two loops justupper loop
+
+42
+00:02:54,040 --> 00:02:57,540
+and lower loop هذا الاشي مهم جدا عشان انا بكرا
+
+43
+00:02:57,540 --> 00:03:01,420
+بالـ postural drainage لازم احدد في اي segment انا
+
+44
+00:03:01,420 --> 00:03:06,240
+فيه عندي مشكلة عشان احتاج او عشان احط المريض فيه
+
+45
+00:03:06,240 --> 00:03:12,000
+في position مناسب لهذا الاشي نيجي نشوف اللي هو لما
+
+46
+00:03:12,000 --> 00:03:15,320
+بيكون في عندنا secretions are moved from smaller
+
+47
+00:03:15,320 --> 00:03:19,500
+to larger airway they are then cleared cuffing or
+
+48
+00:03:19,750 --> 00:03:24,110
+Indotracial suction يعني بعد ما اعمل انا هذا الاشي
+
+49
+00:03:24,110 --> 00:03:28,070
+او بعد ما اعمل بصرا لدرناج لازم يكون في عندي كذا
+
+50
+00:03:28,070 --> 00:03:32,590
+mechanism حتى تساعد لخروج كمية ال secretion هاي
+
+51
+00:03:32,590 --> 00:03:35,370
+بالذات انا بحكي على الناس بكرا اللي هتشتغلوا معاهم
+
+52
+00:03:35,370 --> 00:03:38,990
+بقسم الصدرية ال patience اللي هناك بيكونوا موجودين
+
+53
+00:03:39,240 --> 00:03:43,180
+في عندهم كمية لا بأس بها من الـSecretion بيكون
+
+54
+00:03:43,180 --> 00:03:48,220
+كثيف، سميك، بلوكز اللي هو ملتصق بشعيبات الهوائية
+
+55
+00:03:48,220 --> 00:03:52,260
+بيعيق حركة اللي هو الهواء اللي موجود في الـAlveoli
+
+56
+00:03:52,260 --> 00:03:55,660
+وكل هذه الأمور هتشوفوها بإذن الله تعالى مع
+
+57
+00:03:55,660 --> 00:03:59,320
+الـRechant في قسم الصدرية الـPosterior Drainage
+
+58
+00:03:59,320 --> 00:04:02,020
+also includes the uses of manual technique أنا
+
+59
+00:04:02,020 --> 00:04:04,460
+هستخدم معاها الـpercussion الـshaking و
+
+60
+00:04:04,460 --> 00:04:09,170
+الـvibrationأيضًا بيكون مع اللي هو البوصة
+
+61
+00:04:09,170 --> 00:04:12,830
+للإدرانياج coupled with voluntary cuffing طبعًا مع
+
+62
+00:04:12,830 --> 00:04:17,750
+كحق إرادية برأة المريض نفسه إذا كان conscious لأ
+
+63
+00:04:17,750 --> 00:04:21,470
+شو أهدافنا أو شو ال indication تبعتنا لمين أنا بدي
+
+64
+00:04:21,470 --> 00:04:25,470
+أستخدم الأهداف مع ال indication للبوصة للإدرانياج
+
+65
+00:04:25,470 --> 00:04:28,830
+أول إشي عندي أنه أنا بعمل بوصة للإدرانياج to
+
+66
+00:04:28,830 --> 00:04:31,290
+prevent a communication of secretion in patients
+
+67
+00:04:31,290 --> 00:04:35,880
+at risk for pulmonary complicationبدي أمنع أي
+
+68
+00:04:35,880 --> 00:04:38,320
+complications تصير لأي patient سواء كان في الـ
+
+69
+00:04:38,320 --> 00:04:42,220
+inpatient عندى في المستشفى بايت أو أنه موجود في
+
+70
+00:04:42,220 --> 00:04:45,720
+بيتهم برا المستشفى ال patient اللى عنده pulmonary
+
+71
+00:04:45,720 --> 00:04:49,280
+disease زي الـ chronic bronchitisما حكيت ال acute
+
+72
+00:04:49,280 --> 00:04:51,660
+حكيت ال chronic لإن ال acute ما بيكون فيها
+
+73
+00:04:51,660 --> 00:04:54,200
+secretion كبيرة أما ال chronic بيكون فيها
+
+74
+00:04:54,200 --> 00:04:57,820
+secretion وكمية لا بأس بها Ancestic fibrosis
+
+75
+00:04:57,820 --> 00:05:03,860
+التليف الرئوي ال patient who are on prolonged bed
+
+76
+00:05:03,860 --> 00:05:08,640
+rest ال patient اللي هو نايم في السرير بشكل دائم
+
+77
+00:05:08,640 --> 00:05:11,900
+ال patient اللي أيضا بيستقبل أو اللي عمل عملية
+
+78
+00:05:11,900 --> 00:05:16,080
+جراحية و أخد كمية لا بأس بها من ال bingeهدول الناس
+
+79
+00:05:16,080 --> 00:05:19,840
+طبعاً بيحوش عنده كمية من الـ «breathing» من اللي
+
+80
+00:05:19,840 --> 00:05:23,540
+هو الـ «secretion» مما يعيق عملية الـ «breathing»
+
+81
+00:05:23,540 --> 00:05:27,140
+و الـ «deep coughing» تمام بس أب هذا بنسميه
+
+82
+00:05:27,140 --> 00:05:31,880
+conditions any patient who is volunteer أو any
+
+83
+00:05:31,880 --> 00:05:34,580
+patient who is in ventilator ال patients اللي
+
+84
+00:05:34,580 --> 00:05:38,560
+موجودة على تنفس صناعي if he or she is stable
+
+85
+00:05:38,560 --> 00:05:42,150
+enoughto tolerate the treatment هو قادر على إنه
+
+86
+00:05:42,150 --> 00:05:45,750
+أنا أعمله اللي هي البصرة ال drainage لأن معظم
+
+87
+00:05:45,750 --> 00:05:48,770
+المرضى اللي بيكونوا على ال ventilator تكون حالاتهم
+
+88
+00:05:48,770 --> 00:05:52,190
+حرجة شوية فأحيانا ممكن يكون هو contra indication
+
+89
+00:05:52,190 --> 00:05:55,750
+عشان كده أنا صاحبتها بالجملة التابعة تلاحقة إن هو
+
+90
+00:05:55,750 --> 00:06:00,890
+حتى يكون enough to tolerate the treatment هذا أول
+
+91
+00:06:00,890 --> 00:06:04,740
+goal معيالـ goals التاني to remove accumulated
+
+92
+00:06:04,740 --> 00:06:09,580
+أمنع أي تجمع لsecretion في ال lungs ال patient
+
+93
+00:06:09,580 --> 00:06:11,880
+اللي عندهم acute or chronic lung disease زي
+
+94
+00:06:11,880 --> 00:06:15,960
+النمونيا زي ال atlaxis acute lung infections COPD
+
+95
+00:06:15,960 --> 00:06:20,600
+وهي الأمراض ال patient اللي who are generally very
+
+96
+00:06:20,600 --> 00:06:24,340
+weak are generally الناس اللي بتكون مش قادرة على
+
+97
+00:06:24,340 --> 00:06:29,280
+أنهي تخرج هذا ال secretion لبرا ال patient اللي
+
+98
+00:06:29,280 --> 00:06:34,730
+أيضابأستخدمه مع ال patient اللي أيضا في عندهم
+
+99
+00:06:34,730 --> 00:06:38,470
+artificial airway زي الـ Endotracheal tube زي اللي
+
+100
+00:06:38,470 --> 00:06:43,250
+هو الـ Tracheostomy كل الأمور هذه بستخدمها مع هدول
+
+101
+00:06:43,250 --> 00:06:47,470
+الناس لكن أنا في عندي contra indication في عندي
+
+102
+00:06:47,470 --> 00:06:52,930
+ناس ممنوعة أنا أشتغل معاها بصرا لدرنيج حالات الـ
+
+103
+00:06:52,930 --> 00:06:56,740
+severe hematopoiesisيعني الحالات اللي هو بيكون فيه
+
+104
+00:06:56,740 --> 00:07:00,820
+خروج دم كتيرة أو كمية كبيرة من الدم أثناء ال
+
+105
+00:07:00,820 --> 00:07:04,340
+cuffing على سبيل المثال ال untreated acute
+
+106
+00:07:04,340 --> 00:07:08,060
+conditions ليه؟ لأنه ما بيكون لسه اتكون في هذه
+
+107
+00:07:08,060 --> 00:07:11,800
+الحالات يعني أنا اليوملو أنا على سبيل المثال صار
+
+108
+00:07:11,800 --> 00:07:16,020
+في عندي high fever لأي طفل وكان في عنده bronchites
+
+109
+00:07:16,020 --> 00:07:19,920
+بسميها في بداية مراحلها acute bronchites ما هيكون
+
+110
+00:07:19,920 --> 00:07:23,480
+عند هذا الطفل secretion في الـ coughing لأ هتكون
+
+111
+00:07:23,480 --> 00:07:28,400
+كحة ناشفة أو بنسميها الكحة الجافة بعد ما يتحول بعد
+
+112
+00:07:28,400 --> 00:07:33,240
+شوية إلى اللي هو chronic بيصير في عنده اللي هو
+
+113
+00:07:33,240 --> 00:07:38,290
+secretionفي المكان تفير بلمونري إديمة في حالات
+
+114
+00:07:38,290 --> 00:07:41,530
+البلمونري إديمة ما بستخدم معاهم بوسترالدرنيج في
+
+115
+00:07:41,530 --> 00:07:44,490
+حالات ال congestive heart failure لأنه بخاف عليه
+
+116
+00:07:44,490 --> 00:07:47,950
+في حالات ال large bladdler effusion في حالات
+
+117
+00:07:47,950 --> 00:07:50,910
+البلمونري embolism لأنه ممكن مع ال بوسترالدرنيج
+
+118
+00:07:50,910 --> 00:07:53,750
+تتحرك عندي هاي ال embolism أو هاي ال basis
+
+119
+00:07:53,750 --> 00:07:58,070
+واتسببلي على سبيل المثال اللي هي جلطة رأوية أو
+
+120
+00:07:58,070 --> 00:08:02,310
+جلطة دماغية إذا اتحركت ال nemothoraxفي حالات الـ
+
+121
+00:08:02,310 --> 00:08:06,150
+Cardiovascular Instability لأنه بخاف إيش يصير عندي
+
+122
+00:08:06,150 --> 00:08:10,570
+في الدورة الدموية Cardic Arrhythmia Severe Hypo أو
+
+123
+00:08:10,570 --> 00:08:14,590
+Hypertension كمان أنا بخاف منها في حالات recent
+
+124
+00:08:14,590 --> 00:08:18,170
+myocardial infarction لأنه المريض unstable يعني
+
+125
+00:08:18,170 --> 00:08:23,470
+إجت وذبح قلبه بس هو لساته unstable يعني مش مستقر
+
+126
+00:08:23,470 --> 00:08:27,320
+تماماالـ Unstable Angina أيضًا اللي هي الـ Recent
+
+127
+00:08:27,320 --> 00:08:32,520
+Neurosurgery مريض عامل اللي هو عملية فيه اللي هو
+
+128
+00:08:32,520 --> 00:08:36,720
+الـ Nervous System وما زال حديث لسه العهد بالعملية
+
+129
+00:08:36,720 --> 00:08:41,040
+ما باجي بحطه على سبيل المثال في وضع اللي هو Prone
+
+130
+00:08:41,040 --> 00:08:45,080
+Position وRecline والرأس لتحت ليه؟ لأنه هيزيد الـ
+
+131
+00:08:45,080 --> 00:08:49,520
+Intercranial Pressure وهذا مش صحيح، هي الـ Contra
+
+132
+00:08:49,520 --> 00:08:52,710
+Indicationشو هي بعض ال techniques اللي في ال
+
+133
+00:08:52,710 --> 00:08:56,470
+manual therapy أنا ممكن استخدمها مع البصرة ال
+
+134
+00:08:56,470 --> 00:09:00,210
+drainage أول إشي هاخد ال percussion و بعده هاخد ال
+
+135
+00:09:00,210 --> 00:09:04,750
+vibration و بعدي رقم تلاتة ال shacking تقريبا كل
+
+136
+00:09:04,750 --> 00:09:08,970
+هاي الحركات الطرقنالها في معاملنا في معمل اللي هو
+
+137
+00:09:08,970 --> 00:09:12,990
+ال manual therapy أو معمل المساج بالعربيالبركاشن
+
+138
+00:09:12,990 --> 00:09:16,650
+كنا بنستخدم البركاشن ميكنيكالي ‏to disloading
+
+139
+00:09:16,650 --> 00:09:21,790
+vacas أو adherent ميوكاس from airway أنا بستخدم
+
+140
+00:09:21,790 --> 00:09:27,550
+البركاشن حتى أفصل أو أجزء هذا الـsecretion اللي هو
+
+141
+00:09:27,550 --> 00:09:32,490
+vacas أو adherent ملتصق في الـmucus في الـairway
+
+142
+00:09:32,670 --> 00:09:35,830
+Performed with cup hand، بنعملها الإيدة على شكل
+
+143
+00:09:35,830 --> 00:09:39,930
+الكباية طبعا over the lung segment beginning trend
+
+144
+00:09:39,930 --> 00:09:43,930
+لازم أنا أحدد بالظبط أنا في أي loop هشتغل أو في أي
+
+145
+00:09:43,930 --> 00:09:47,990
+segment من ال lung هشتغل Therapist should try keep
+
+146
+00:09:47,990 --> 00:09:53,690
+shoulder, elbow and wrist loose and mobileduring
+
+147
+00:09:53,690 --> 00:09:57,970
+maneuver طبعا اهاي مهارة من مهارات المساج انه انا
+
+148
+00:09:57,970 --> 00:10:00,930
+لازم احافظ على ال shoulder و ال elbow و ال wrist
+
+149
+00:10:00,930 --> 00:10:05,350
+انها تكون flexible مرنة خلال عملية اللي هي ال
+
+150
+00:10:05,350 --> 00:10:08,910
+cupping ال percussion is continued for several
+
+151
+00:10:08,910 --> 00:10:13,610
+minutes until the patient need to alert position
+
+152
+00:10:13,610 --> 00:10:17,320
+to coughيعني بدي أقدر أني أشتغل ال law percussion
+
+153
+00:10:17,320 --> 00:10:22,500
+لحد ما تيجي الكحة ساعتها أنا ببقى في عملية ال
+
+154
+00:10:22,500 --> 00:10:26,260
+percussion على أساس إنه يعمل coughing و بعدين يعمل
+
+155
+00:10:26,260 --> 00:10:31,120
+اللي هو خروج لهذا secretion this procedure should
+
+156
+00:10:31,120 --> 00:10:35,930
+not painful and uncomfortableيعني مش لازم أكون
+
+157
+00:10:35,930 --> 00:10:41,890
+drill ولا أكون طبعا فراشة على جسم المريض يعني لا
+
+158
+00:10:41,890 --> 00:10:46,230
+لازم يكون مؤذى ولا لازم يكون اللى هو خفيف بحيث أنه
+
+159
+00:10:46,230 --> 00:10:51,310
+لا يؤدي الغرض هى من مهارات المساج أو اللى هو
+
+160
+00:10:51,310 --> 00:10:55,250
+الـtherapist الشاطرهي ال cup ميكانيزم اللي أنا
+
+161
+00:10:55,250 --> 00:11:00,110
+حكيت عليها أو ال cupping أنه على شكل الكباية حكينا
+
+162
+00:11:00,110 --> 00:11:03,630
+في المهارات لازم ال therapist يكون شغال ال
+
+163
+00:11:03,630 --> 00:11:07,630
+shoulder و ال elbow و ال rest لازم تكون بوضعية
+
+164
+00:11:07,630 --> 00:11:13,320
+ممتازةهي الوضع اللي هو في الـ prone position حطينا
+
+165
+00:11:13,320 --> 00:11:17,360
+pillow under the abdomen وبلشنا ال cubbing
+
+166
+00:11:17,360 --> 00:11:21,200
+mechanism الآن ال congestive bronchial walls بيكون
+
+167
+00:11:21,200 --> 00:11:26,870
+في عنا اللي هو تم إغلاق اللي هيالـ Bronchi أو الـ
+
+168
+00:11:26,870 --> 00:11:29,030
+Mini Bronchi بهذا الـ Secretion زي ما انتوا
+
+169
+00:11:29,030 --> 00:11:32,230
+شايفينه بعد ال percussion و ال cuffing اللي صار من
+
+170
+00:11:32,230 --> 00:11:35,870
+ال patient صار في عندنا disloading انفصال لهذا
+
+171
+00:11:35,870 --> 00:11:40,730
+اللي هو ال secretion و لكن لم يتم تنظيفه بشكل جيد
+
+172
+00:11:40,730 --> 00:11:44,910
+لأنه بعد هيك حكينا لازم ال patient تبع يتبعه ب
+
+173
+00:11:44,910 --> 00:11:51,510
+cuffing voluntary كحة إرادية حتى تشفط هذا
+
+174
+00:11:51,510 --> 00:11:56,750
+secretion و يطلعه لبرهاللأ من الناس اللي أنا ممنوع
+
+175
+00:11:56,750 --> 00:12:01,470
+أشتغللها percussion مع الـPosterior Drainage اللي
+
+176
+00:12:01,470 --> 00:12:05,330
+هو ممنوع أشتغلوا هذا الـpercussion فوق الـbony
+
+177
+00:12:05,330 --> 00:12:07,970
+promenades ممنوع أشتغله في الـbreast tissue in
+
+178
+00:12:07,970 --> 00:12:11,730
+woman ممنوع أشتغله مع الـfractures أو الـspinal
+
+179
+00:12:11,730 --> 00:12:15,510
+fusion أو حالات الـosteoporosis ممنوع أشتغله في
+
+180
+00:12:15,510 --> 00:12:20,350
+الـtumour area if patient hasبلمونري إمبولاص، إذا
+
+181
+00:12:20,350 --> 00:12:23,190
+كان عندهم بلمونري إمبوليزم if patient has
+
+182
+00:12:23,190 --> 00:12:26,530
+condition in which hemorrhage could easily occurs
+
+183
+00:12:26,530 --> 00:12:29,530
+الpatient اللي سهل أن يصير فيه عندهم hemorrhagic
+
+184
+00:12:29,530 --> 00:12:33,990
+if patient has unstable angina عندهم الـmyocardial
+
+185
+00:12:33,990 --> 00:12:38,370
+angina أو عندهم الـmyocardial unstable بخاف عليهم
+
+186
+00:12:38,370 --> 00:12:42,310
+من اللي هو الـpercussion if patient has shift pain
+
+187
+00:12:42,310 --> 00:12:46,450
+بعد الـthoracic surgeryعلى سبيل المثال عمل Open
+
+188
+00:12:46,450 --> 00:12:50,810
+Heart Surgery وفي عندنا اللي هو Thoracic Surgery
+
+189
+00:12:50,810 --> 00:12:55,130
+هنا مش بالصح أنه أنا أشتغل عليه Percussion تمانية
+
+190
+00:12:55,130 --> 00:12:58,470
+Contraindication لـ Percussion with Postural
+
+191
+00:12:58,470 --> 00:13:03,230
+Drainageأجي أشوف التكنيك التاني second techniques
+
+192
+00:13:03,230 --> 00:13:06,250
+اللي هو ال vibration is used to in conjunction
+
+193
+00:13:06,250 --> 00:13:11,170
+with طبعا ال percussion to help move secretion إذا
+
+194
+00:13:11,170 --> 00:13:15,190
+ال vibration و ال percussion بيساعدوا على إنه
+
+195
+00:13:15,190 --> 00:13:18,870
+يعملوا move لل secretion in larger airways حتى
+
+196
+00:13:18,870 --> 00:13:22,570
+يطلعوا فيها على ال upper respiratory tract يطلعوا
+
+197
+00:13:22,570 --> 00:13:27,010
+فيها لبره بعد شوية is appliedonly during
+
+198
+00:13:27,010 --> 00:13:32,030
+expiratory phase هنا مهم جدا إنه أنا أعرفهذا الشيء
+
+199
+00:13:32,030 --> 00:13:35,910
+أو هذه التقنيك اللي لازم أعمله في الـExpiratory
+
+200
+00:13:35,910 --> 00:13:39,370
+يعني في الـExhale Inpatient with deep breathing
+
+201
+00:13:39,370 --> 00:13:42,950
+الـ Vibration is applied خلال الـ Placing both
+
+202
+00:13:42,950 --> 00:13:45,890
+hands ممكن أنا عشان أزود اللي هي كمية الـ
+
+203
+00:13:45,890 --> 00:13:50,390
+Vibration أحط اللي هو إيديا فوق بعض عشان أزيد ال
+
+204
+00:13:50,390 --> 00:13:54,350
+pressure في اللي هو chest wall and compressing
+
+205
+00:13:54,350 --> 00:13:57,530
+طبعا و نعمل ضغط رابط ليه Vibrating ال chest wall
+
+206
+00:13:57,530 --> 00:14:02,340
+Inpatient in Breathing outهذا اللي هو التكنيكي
+
+207
+00:14:02,340 --> 00:14:07,740
+التاني الـ pressure is applied in same direction
+
+208
+00:14:07,740 --> 00:14:11,880
+as chest moving نشتغلش اشي عكس اشي لأ way together
+
+209
+00:14:11,880 --> 00:14:15,800
+ايضا ال vibration action is achieved by therapist
+
+210
+00:14:15,800 --> 00:14:19,320
+isometrically contracting in muscles upper
+
+211
+00:14:19,320 --> 00:14:22,380
+extremity and shoulder hands كويس انه انا كمان
+
+212
+00:14:22,380 --> 00:14:26,080
+اعمل عدو هناخد في هذا الفيديو هتشوفوا كيف انا ممكن
+
+213
+00:14:26,080 --> 00:14:31,430
+اعمل chest mobilization بشكل عامThere are
+
+214
+00:14:31,430 --> 00:14:34,970
+techniques اللي احنا هنصاحبه with postural
+
+215
+00:14:34,970 --> 00:14:39,690
+drainage اللي هو حاجة اسمها Shaking هو لاقى
+
+216
+00:14:39,690 --> 00:14:43,730
+الـVagrus from vibration أقوى من الـvibration خلال
+
+217
+00:14:43,730 --> 00:14:49,470
+الـexhale أو خلال الـexpiratory facing طبعا
+
+218
+00:14:49,470 --> 00:14:52,490
+بستخدمه intermittent bouncing maneuver coupled
+
+219
+00:14:52,490 --> 00:14:56,290
+with wide movement of therapist hand هلأ
+
+220
+00:14:56,290 --> 00:14:59,570
+الtherapist كيف بدنا نعمل الشاكينج؟ حكينا الشاكنج
+
+221
+00:14:59,570 --> 00:15:03,310
+side to sideاللي هو therapist's thumb are locked
+
+222
+00:15:03,310 --> 00:15:06,270
+with together and opened and placed directly
+
+223
+00:15:06,270 --> 00:15:09,670
+للpatient's skin and finger warped around chest
+
+224
+00:15:09,670 --> 00:15:13,290
+wall محيطة بالchest wall وأبدأ أعمل اللي هي الشاكن
+
+225
+00:15:13,290 --> 00:15:18,870
+The therapist طبعا بالتزامن مع اللي هو ال compress
+
+226
+00:15:18,870 --> 00:15:24,570
+لازم يكون شاكن لchest wallالان شو هي المواضع حكينا
+
+227
+00:15:24,570 --> 00:15:28,830
+عن ال techniques و خلصنا منهم هنحكي على المواضع في
+
+228
+00:15:28,830 --> 00:15:31,850
+ال postural drainage position ال postural drainage
+
+229
+00:15:31,850 --> 00:15:36,530
+position في عندي مواضع متعددة أهم شي انه انا اعرف
+
+230
+00:15:36,530 --> 00:15:40,830
+وين مكان secretion ايش انا بعرف في secretion ال
+
+231
+00:15:40,830 --> 00:15:45,130
+position are based on the anatomy of lungs and the
+
+232
+00:15:45,130 --> 00:15:49,130
+trachelobroncal tree each segment of each loop is
+
+233
+00:15:49,130 --> 00:15:54,290
+drainedusing لل position اذا بحدد بالظبط انا وين
+
+234
+00:15:54,290 --> 00:15:57,670
+طبعا هذا عن طريق السماعة احنا يا طلاب الأعزاء و
+
+235
+00:15:57,670 --> 00:16:01,310
+طالباتي بنستخدم اللي هو اكتشاف وين ال secretion
+
+236
+00:16:01,310 --> 00:16:05,630
+بالظبط اذا patient may positioned on بصرة لدرناج
+
+237
+00:16:05,630 --> 00:16:10,150
+تابل ممكن احطه على الطاولة لبصرة لدرناج tilt table
+
+238
+00:16:10,150 --> 00:16:14,930
+زي ما انتوا شايفينه reinforced bedTable with lift
+
+239
+00:16:14,930 --> 00:16:18,970
+طبعا او ال hospital bed او ال small child اللي هم
+
+240
+00:16:18,970 --> 00:16:22,930
+حالة خاصة انه انا ممكن اجعدهم بيه اللي هو بحضني او
+
+241
+00:16:22,930 --> 00:16:26,810
+حضن احد الأبواين تمام هاي ال position اللي انا
+
+242
+00:16:26,810 --> 00:16:30,350
+ممكن احط عليها ال patient و اعمل بشرة الدراجة
+
+243
+00:16:30,350 --> 00:16:33,550
+شوفوا كيف هنا بال sitting position كيف المريض جاعد
+
+244
+00:16:33,550 --> 00:16:35,370
+ليه هاي اللي جاعدها اذا انا بدأش اشتغل على ال
+
+245
+00:16:35,370 --> 00:16:39,110
+anterior apical segment اما هنا على ال posterior
+
+246
+00:16:39,110 --> 00:16:43,070
+apical segment لأنه lean forward sitting جاعد ليه؟
+
+247
+00:16:43,200 --> 00:16:47,200
+فبالتالي هنا بستخدم الـ percussion طبعاً على الـ
+
+248
+00:16:47,200 --> 00:16:50,180
+scapula your fingers curve over the top of
+
+249
+00:16:50,180 --> 00:16:53,820
+shoulders لفوق من الشoulder فبالتالي هنا هذا ال
+
+250
+00:16:53,820 --> 00:16:57,160
+posterior apical segment لحالة اللي هي ال
+
+251
+00:16:57,160 --> 00:17:00,640
+posterior اللي هو secretion متكونة في الapical
+
+252
+00:17:00,640 --> 00:17:04,540
+posterior ال upper loop في ال anterior هنا في
+
+253
+00:17:04,540 --> 00:17:07,860
+وضعية ال supine position طبعاً هنا ال percussion
+
+254
+00:17:07,860 --> 00:17:10,380
+هنا هيحددنا بعض الصور لل percussion و اللي أنا
+
+255
+00:17:10,380 --> 00:17:13,900
+لازم أعمله في ال upper loopالـ posterior segment
+
+256
+00:17:13,900 --> 00:17:19,000
+للـ right loops حوالي turn 45 و بحط pillow ورا
+
+257
+00:17:19,000 --> 00:17:22,400
+دهره و تحت بطنيه يعني هو لا هو جايني brawn
+
+258
+00:17:22,400 --> 00:17:26,420
+position ولا جاي subine position ما بين البينين ال
+
+259
+00:17:26,420 --> 00:17:29,420
+angular اللي هي عبارة عن إيش هذا الوضعي هذا يسميها
+
+260
+00:17:29,420 --> 00:17:34,840
+ال angular إنه ال head down و ال feet up و جايني
+
+261
+00:17:34,840 --> 00:17:39,360
+بوضعية اللي هي لا هو subine ولا هو brawn ال
+
+262
+00:17:39,360 --> 00:17:44,850
+patientlies in one quarter turned جايين بربع نصف
+
+263
+00:17:44,850 --> 00:17:48,430
+بعين right side support للبلو تلاتين درجة head
+
+264
+00:17:48,430 --> 00:17:51,590
+down position و ال percussion applied under the
+
+265
+00:17:51,590 --> 00:17:55,530
+left breast لأنه في ال anterior زي ما انتوا شايفين
+
+266
+00:17:55,530 --> 00:17:59,790
+هي secretion في ال anterior تمام هذا ال position
+
+267
+00:17:59,790 --> 00:18:04,070
+ما بستخدمه نهائي مع حالات ال head injury على سبيل
+
+268
+00:18:04,070 --> 00:18:08,670
+المثال لأ ال middle lobes ال middle lobes اللي هي
+
+269
+00:18:09,580 --> 00:18:14,380
+الإصابة، الإصابة بتكون في اللي هي الـlung أو متوسط
+
+270
+00:18:14,380 --> 00:18:17,480
+الـlung ال patient كمان في الـone quarter turn
+
+271
+00:18:17,480 --> 00:18:21,800
+from spine for the left side زي ما أنتوا شايفين،
+
+272
+00:18:21,800 --> 00:18:26,560
+قبعالي من خمس عشر إلى تلاتينالـ lower lobe الـ
+
+273
+00:18:26,560 --> 00:18:31,460
+patient في اللي هو الـ brawn position جاية اللي هي
+
+274
+00:18:31,460 --> 00:18:35,140
+secretion في الـ lower lobe أو الـ basal lobe هذه
+
+275
+00:18:35,140 --> 00:18:38,840
+طبعا من الحاجات الصعبة إن أنا أخرجها لأنها جاية في
+
+276
+00:18:38,840 --> 00:18:42,320
+القاعدة تحت في الـ lungs فبالتالي في مسافة طويلة
+
+277
+00:18:42,320 --> 00:18:46,640
+لحد ما أطلعلي على الـ airway أيضا هنا في اللي هي
+
+278
+00:18:46,640 --> 00:18:49,740
+الـ anterior segment بس أيضا في الـ lower lobe في
+
+279
+00:18:49,740 --> 00:18:52,500
+الـ anterior segment للـ lower lobe برضه نفس
+
+280
+00:18:52,500 --> 00:18:56,780
+الكلاماللي هو ال head down و ال feet up و ال
+
+281
+00:18:56,780 --> 00:19:00,900
+position هذا عشان أنا إيش أعمل اللي هو خروج لل
+
+282
+00:19:00,900 --> 00:19:04,800
+secretion هنا في ال posterior segment أيضا بال
+
+283
+00:19:04,800 --> 00:19:08,760
+lower loop ما زلنا مستمرين على ال lower loop
+
+284
+00:19:08,760 --> 00:19:13,840
+laterally اللي هو جالي على الجنب لل lower loop
+
+285
+00:19:13,840 --> 00:19:18,900
+laterally لل right و أنا متأكدة أن هذا الأشي كله
+
+286
+00:19:18,900 --> 00:19:25,040
+أخدته بالمعمل بشكل أفضل ومناسب هناجمع كل اللي هو
+
+287
+00:19:25,040 --> 00:19:30,980
+الـ Segments داخل هاي الـ Slide شو الـ Guidelines
+
+288
+00:19:30,980 --> 00:19:35,200
+تبعتنا؟ أول إشي في عندي General Consideration بدي
+
+289
+00:19:35,200 --> 00:19:39,040
+أعرف كم مرة أنا بدي أعمل بصرا، لا أدرين إيش بدي
+
+290
+00:19:39,040 --> 00:19:43,980
+أعرف الـ Time of Day، من أفضل وقت بدي أعرف كمية
+
+291
+00:19:43,980 --> 00:19:46,860
+الجلسة أو كم هي كمية الجلسة لـ البصرا، لا أدرين
+
+292
+00:19:46,860 --> 00:19:50,720
+إيش هبدأ بالبداية بالـ General Consideration Time
+
+293
+00:19:50,720 --> 00:19:53,530
+of Daynever administrated post-rehydration
+
+294
+00:19:53,530 --> 00:19:57,870
+directly after meal ولا حتى المساج كنا بنعمله بعد
+
+295
+00:19:57,870 --> 00:20:02,930
+اللي هي جلسة أو بعد وجبة من الغذاء coordinate لل
+
+296
+00:20:02,930 --> 00:20:07,230
+treatment with arousal therapy لازم أناسق مابيني و
+
+297
+00:20:07,230 --> 00:20:10,850
+مابين استخدام المريض للبخاخة أو التبخير على سبيل
+
+298
+00:20:10,850 --> 00:20:14,680
+المثال some therapists believeالـ Arousal Therapy
+
+299
+00:20:14,680 --> 00:20:19,040
+مع الـ Humidification وانا بهمني كمية الـ
+
+300
+00:20:19,040 --> 00:20:23,360
+Humidification لأنه هتسهللي عملية الـ Separation
+
+301
+00:20:23,360 --> 00:20:30,460
+أو تفتيت السكريشن إذا كان سميك وكثيف طبعا للي هو
+
+302
+00:20:30,460 --> 00:20:33,160
+قبل البصرة لدرنيش بعض الأخصائيين بيقولك لأ أنا
+
+303
+00:20:33,160 --> 00:20:39,080
+لازم في البدايةأشرب مريضي حاجة دافية بالإضافة للي
+
+304
+00:20:39,080 --> 00:20:44,260
+هو ياخد تبخيرة على سبيل المثال هذا بيزيد اللي هو
+
+305
+00:20:44,260 --> 00:20:46,960
+أو بيساعد في ال «losing» للـ «secretion»
+
+306
+00:20:46,960 --> 00:20:50,220
+و«increasing» للـ «likehood» اللي هو productivity
+
+307
+00:20:50,220 --> 00:20:53,160
+بيساعد طبعا في إنتاج إنه الـ «cuffing» تكون
+
+308
+00:20:53,160 --> 00:20:57,680
+productive يعني مقشعة يعني فيها بلغا على سبيل
+
+309
+00:20:57,680 --> 00:21:01,500
+المثال إنه بيصير سهل جدا خروج هذا ال «waste
+
+310
+00:21:01,500 --> 00:21:04,650
+product»Other believes arousal therapy is the best
+
+311
+00:21:04,650 --> 00:21:08,630
+after posture drainage لكن بعض الأخصائيين على سبيل
+
+312
+00:21:08,630 --> 00:21:12,690
+المثال بقول لك لأ احنا لأ نعمله بعد اللي هو الـ
+
+313
+00:21:12,690 --> 00:21:16,130
+posture drainage when patient lungs are clear and
+
+314
+00:21:16,130 --> 00:21:18,770
+maximal benefit can again with medication as
+
+315
+00:21:18,770 --> 00:21:21,770
+inserted to cuff arousal therapy choose the time
+
+316
+00:21:22,130 --> 00:21:25,770
+and daily life may be most benefit of patient انت
+
+317
+00:21:25,770 --> 00:21:30,710
+شوف اختيارك للوقت او اختيارك لتوقيت اللي هو ال
+
+318
+00:21:30,710 --> 00:21:34,690
+humidification بيتمد حسب الحالة او حسب ما انت تريح
+
+319
+00:21:34,690 --> 00:21:38,510
+في الحالة او حسب اللي هي الحالة وما تستطيعي في ذلك
+
+320
+00:21:38,510 --> 00:21:42,570
+ال patient can tend highly productive in early
+
+321
+00:21:42,570 --> 00:21:46,970
+morningbecause a communication of secretion from
+
+322
+00:21:46,970 --> 00:21:52,350
+night before طبعا أفضل إشي أنه أنا ال patient تبعي
+
+323
+00:21:52,350 --> 00:21:56,390
+يكون أو يعمل الجلسة يعني بالعادة كنا في المستشفى
+
+324
+00:21:56,390 --> 00:22:00,770
+في قسم الصدرية بنعملها باكرا بالصباح ليش؟ لأن
+
+325
+00:22:00,770 --> 00:22:04,350
+سبحان الله كل ال secretion بيبقى طالع لفوق يعني
+
+326
+00:22:04,350 --> 00:22:07,750
+حتى اللي في ال basal حتى اللي هوفي الـ middle loop
+
+327
+00:22:07,750 --> 00:22:10,750
+كله بيكون طالع على الـ upper respiratory tract
+
+328
+00:22:10,750 --> 00:22:14,190
+فبتلاقي المريض سبحان الله بيقولك أنا مخنوق، ليش؟
+
+329
+00:22:14,190 --> 00:22:17,770
+لأنه في عنده secretion وفي عنده blocking في الـ
+
+330
+00:22:17,770 --> 00:22:20,270
+airway فبالتالي هنا أنا لو عملت postural drainage
+
+331
+00:22:20,270 --> 00:22:24,170
+هيكون سهل جدا أن المريض يعملي cuffing ويطلع هذا
+
+332
+00:22:24,170 --> 00:22:27,610
+secretion الـ postural drainage in early evening
+
+333
+00:22:27,610 --> 00:22:31,530
+كمان مهم جدا يعني في بداية الصباح وفي بداية المساء
+
+334
+00:22:31,840 --> 00:22:35,760
+ليه؟ حتى ينام ليلته جيدا لإنه طبعا لو كان فيه
+
+335
+00:22:35,760 --> 00:22:39,100
+secretion و سدره مازال بيجعلها الطفل ماحيعرف ينام
+
+336
+00:22:39,100 --> 00:22:44,940
+منيح okay سواء للكبار أو الصغار الآن أخدنا ال time
+
+337
+00:22:44,940 --> 00:22:51,700
+بدي أخد ال frequency of treatment كام مرة الآن هذا
+
+338
+00:22:51,700 --> 00:22:56,020
+بيعتمد على اللي هو ال type and severity of patient
+
+339
+00:22:56,020 --> 00:23:01,920
+في ال pathology تبعات المريضكم هي حدة الحالة جدّي
+
+340
+00:23:01,920 --> 00:23:08,240
+أنا عندي secretion هل هو few؟ هل هو lot؟ كيف وضعه؟
+
+341
+00:23:08,240 --> 00:23:13,080
+فبالتالي أنه هيكون هذا بيعتمد حسب الحالة if
+
+342
+00:23:13,080 --> 00:23:16,360
+secretions are thick and compressed طبعا إذا كان
+
+343
+00:23:16,360 --> 00:23:20,780
+ال secretion سميك وكثيف من مرتين لأربع مرات
+
+344
+00:23:20,780 --> 00:23:25,320
+بستخدمه خلال اليوم may necessary until lungs are
+
+345
+00:23:25,320 --> 00:23:29,530
+clear if patient is on maintenance programالـ
+
+346
+00:23:29,530 --> 00:23:33,470
+frequency is less اللي كان المريض يعني ماعنده كتير
+
+347
+00:23:33,470 --> 00:23:36,650
+على إيش أنا أعمل أربع مرات لأ بعمل أقل من هيك
+
+348
+00:23:36,650 --> 00:23:42,670
+perhaps once a day or only few days a week okay
+
+349
+00:23:42,670 --> 00:23:47,010
+لأن ال preparation للبصرة للدرناج تحضيرنا لمريضنا
+
+350
+00:23:47,010 --> 00:23:52,090
+قبل البصرة للدرناج losing لأي tight أو اللي هي
+
+351
+00:23:52,090 --> 00:23:55,830
+bulky clothes عشان أعرف أشتغل اللي هو ال manual
+
+352
+00:23:55,830 --> 00:23:58,980
+therapy على سبيل المثالIt is not necessary to
+
+353
+00:23:58,980 --> 00:24:03,200
+expose the skin ولكن مش بدلولة ان انا اعري لكل شي
+
+354
+00:24:03,200 --> 00:24:06,520
+حتى اوصل ال skin Have sebutum cuff or tissue
+
+355
+00:24:06,520 --> 00:24:11,950
+available Have sufficient belowبدي وضع مخدات ممكن
+
+356
+00:24:11,950 --> 00:24:15,130
+احتجهم تحت الابدومين او اذا انا بدي اعمل ال one
+
+357
+00:24:15,130 --> 00:24:18,770
+quarter اني احط اشي ورا الظاهر واشي من ناحية
+
+358
+00:24:18,770 --> 00:24:21,970
+الامام الانتريال explain لل treatment procedure
+
+359
+00:24:21,970 --> 00:24:26,870
+for patient طبعا لأي انا تقنيك بدي اعمله لازم
+
+360
+00:24:26,870 --> 00:24:30,050
+اشرحه لل patient ويا حبة ده اذا فيه exercise انا
+
+361
+00:24:30,050 --> 00:24:34,370
+بعملهم لحالي و بوريهمياتعلم للبيتشان Deep
+
+362
+00:24:34,370 --> 00:24:40,110
+Breathing وCoughing قبل البصرة لانه يعملهم بعد
+
+363
+00:24:40,110 --> 00:24:49,070
+البصرة لانه يعملهم
+
+364
+00:24:49,070 --> 00:24:51,710
+بعد البصرة لانه يعملهم بعد البصرة لانه يعملهم بعد
+
+365
+00:24:51,710 --> 00:24:52,870
+البصرة لانه يعملهم بعد البصرة لانه يعملهم بعد
+
+366
+00:24:52,870 --> 00:24:53,250
+البصرة لانه يعملهم بعد البصرة لانه يعملهم بعد
+
+367
+00:24:53,250 --> 00:24:54,010
+البصرة لانه يعملهم بعد البصرة لانه يعملهم بعد
+
+368
+00:24:54,010 --> 00:24:57,570
+البصرة لانه يعملهم بعد البصرة لانه يعملهم بعد
+
+369
+00:24:57,570 --> 00:25:03,640
+البصرة لانه يعملهملكن إذا كان مش جادر يعملها
+
+370
+00:25:03,640 --> 00:25:06,840
+voluntary فأنا بستخدم اللي هو section machine
+
+371
+00:25:06,840 --> 00:25:12,540
+وبحاول أشفطله من اللي هو الـsebutam اللي تحلل أو
+
+372
+00:25:12,540 --> 00:25:17,980
+اللي طلع على الأبار«برونكاي» «make any adjustment
+
+373
+00:25:17,980 --> 00:25:21,840
+tube» طبعا إذا كان أنا مريضي طبعا في ال ICU على
+
+374
+00:25:21,840 --> 00:25:25,800
+سبيل المثال وفي عندنا wires وفي عندنا tubes وفي
+
+375
+00:25:25,800 --> 00:25:31,440
+عندنا ECG electrodes وهذه الأمور لازم أنا أشوف
+
+376
+00:25:31,440 --> 00:25:35,500
+طريقة إنه أنا أعدل أعمل adjustable إنه أنا أكون
+
+377
+00:25:35,500 --> 00:25:39,580
+طبعا قابلة للتعديل في اللي هو ال position تبعي
+
+378
+00:25:39,580 --> 00:25:44,990
+اللي مع المريضالـ Anxious Sequences بدي استخدم
+
+379
+00:25:44,990 --> 00:25:48,190
+which segment للـ lung should be determined مش أنا
+
+380
+00:25:48,190 --> 00:25:53,410
+بدي أشتغل على أي وضع على أي مكان لأ أنا لازم أشتغل
+
+381
+00:25:53,410 --> 00:25:58,030
+وين أنا بالذات عندي فيه secretion some patients
+
+382
+00:25:58,030 --> 00:26:00,810
+with chronic lung disease such as cystic fibrosis
+
+383
+00:26:00,810 --> 00:26:04,850
+need to drain all position لأن هاي الناس في cystic
+
+384
+00:26:04,850 --> 00:26:09,850
+fibrosis عندها كمية لبأس بيها من اللي هو secretion
+
+385
+00:26:09,850 --> 00:26:13,450
+other patients may requiredDrainage of only few
+
+386
+00:26:13,450 --> 00:26:16,430
+segments in which secretions have communicated
+
+387
+00:26:16,430 --> 00:26:20,870
+«Check للبيشانت vital signs» لازم أاخد الـ «vital
+
+388
+00:26:20,870 --> 00:26:26,410
+signs» قبل اللي هو الـ «patient drainage» للبيشانت
+
+389
+00:26:26,410 --> 00:26:30,390
+حتى أشوف أنا شغالة صح ولا مش صح خصوصا الـ
+
+390
+00:26:30,390 --> 00:26:33,890
+«breathing sound» لازم أشوفه اتحسن ولا ما اتحسنش
+
+391
+00:26:34,370 --> 00:26:37,090
+أيضا بدي أشوف ال patient التبعي إذا كان
+
+392
+00:26:37,090 --> 00:26:39,910
+comfortable أو relaxed comfortable و relaxed ولا
+
+393
+00:26:39,910 --> 00:26:43,710
+لأ stand in front of patient عشان أشوف إذا لا سمح
+
+394
+00:26:43,710 --> 00:26:47,750
+الله في اختناق أو فيش اختناق أو أشوف اللي هو ال
+
+395
+00:26:47,750 --> 00:26:51,470
+facial expression طبعا و احنا عارفين هذا الحكي
+
+396
+00:26:51,470 --> 00:26:55,710
+جيدا ال maintain each position من خمسة لعشرة
+
+397
+00:26:55,710 --> 00:27:00,690
+minutes if patient tolerant إذا استمرمعانا الوضع
+
+398
+00:27:00,690 --> 00:27:05,710
+أو إذا استحمل أو تحمل ال patient فإحنا سليم أما
+
+399
+00:27:05,710 --> 00:27:09,210
+إذا لأ وبينت عندي بعض العلامات اللي هو ال facial
+
+400
+00:27:09,210 --> 00:27:12,410
+expression كانت لتوحي إنه بخير على طول نعمل
+
+401
+00:27:12,410 --> 00:27:16,830
+stopping لل exercise ونوقف التدريب have لل patient
+
+402
+00:27:16,830 --> 00:27:19,710
+breathing deeply during a drainage but don't allow
+
+403
+00:27:19,710 --> 00:27:23,790
+لل patient hyperventilating في أي موقع في أي مكان
+
+404
+00:27:23,790 --> 00:27:27,990
+بمنع ال hyperventilationor become short of
+
+405
+00:27:27,990 --> 00:27:31,150
+breathing هذا الأشياء أنا بمنعه okay أنا طلبت منه
+
+406
+00:27:31,150 --> 00:27:33,890
+في الـ postural drainage أنه okay اعمل ليه دي ب
+
+407
+00:27:33,890 --> 00:27:38,150
+breathing ولكن ما توصل لمرحلة الـ hyperventilation
+
+408
+00:27:38,150 --> 00:27:42,530
+ال bears live مهم جدا ال breathing من أنواع ال
+
+409
+00:27:42,530 --> 00:27:45,470
+breathing exercise أخذناها is sometimes used
+
+410
+00:27:45,470 --> 00:27:49,850
+بستخدمها في اللي هو خلال ال postural adrenage
+
+411
+00:27:49,850 --> 00:27:55,880
+apply percussionطبعا طبق الـ percussions خلال الـ
+
+412
+00:27:55,880 --> 00:27:58,680
+segment أو خلال اللي هو why ال patient in correct
+
+413
+00:27:58,680 --> 00:28:02,820
+position encourage لل patient to take deep sharp
+
+414
+00:28:02,820 --> 00:28:08,400
+double cuffing طبعا whenever necessary it may more
+
+415
+00:28:08,400 --> 00:28:12,500
+comfortable for patient to point really assume
+
+416
+00:28:12,500 --> 00:28:16,660
+semi upright position أحطله تلت أربع مخدات ورا
+
+417
+00:28:16,660 --> 00:28:20,840
+دهره ويكون في ال semi upright position if patient
+
+418
+00:28:20,840 --> 00:28:25,060
+does not cuffفبتناصلي during positioning with
+
+419
+00:28:25,060 --> 00:28:27,880
+percussion instruct لل patient take several deep
+
+420
+00:28:27,880 --> 00:28:31,560
+breathing and then huffing هو مش قادر يعطيني
+
+421
+00:28:31,560 --> 00:28:34,960
+cuffing فبالتالي بخليه يعمل كذا مرة deep breathing
+
+422
+00:28:34,960 --> 00:28:40,700
+ويتبعها بال huffing وهذا بيقدي الغرض بعد طبعا هيك
+
+423
+00:28:40,700 --> 00:28:44,520
+لازم انا اجيب suction machine خلال ال expiration
+
+424
+00:28:44,520 --> 00:28:49,280
+this may help to elicit cuffing ممكن بعد شوية هذا
+
+425
+00:28:49,280 --> 00:28:53,920
+يعمل stimulation لعمليات ال cuffingIf patient
+
+426
+00:28:53,920 --> 00:28:57,300
+cough is not productive after 5 to 10 minutes، ال
+
+427
+00:28:57,300 --> 00:29:00,120
+position go to the next position، شوف ال position
+
+428
+00:29:00,120 --> 00:29:04,060
+التاني Secretions that have been mobilized during
+
+429
+00:29:04,060 --> 00:29:09,760
+treatment may not cough up until 30 minutes to one
+
+430
+00:29:09,760 --> 00:29:14,350
+hour after treatmentخلال الـ duration high أي
+
+431
+00:29:14,350 --> 00:29:18,410
+treatment should not exceed مش لازم ازديد نهائي عن
+
+432
+00:29:18,410 --> 00:29:24,230
+45 ل 60 دقيقة يعني أنا ما أبالغ في ال exercise as
+
+433
+00:29:24,230 --> 00:29:28,250
+procedures is quite fatiguing for patient لأن هذا
+
+434
+00:29:28,250 --> 00:29:33,090
+هيرهق المريض شوفوا لو كان elderly أو لو كان post
+
+435
+00:29:33,090 --> 00:29:39,450
+-operative فالأمر هيكون متعب لهذه الناسالان ختم
+
+436
+00:29:39,450 --> 00:29:42,550
+الجلسة أو ختم جلسة العلاج Concluding لل treatment
+
+437
+00:29:42,550 --> 00:29:46,850
+Have the patient sit up slowly طبعا أنا كنت حاطة
+
+438
+00:29:46,850 --> 00:29:49,590
+ال patient في وضعيت subine او prone او one quarter
+
+439
+00:29:49,590 --> 00:29:53,150
+فبالتالي انا هخاف عليه من ال hypertension اللي هو
+
+440
+00:29:53,150 --> 00:29:58,140
+البشر ال hypertension فانا لازم احطهبشواش أو
+
+441
+00:29:58,140 --> 00:30:01,900
+بوضعية هادئة جدا في اللي هو الـ sitting position
+
+442
+00:30:01,900 --> 00:30:07,240
+بعدين أبدأ بالتدريج أنه أنا أخلي في ال stand
+
+443
+00:30:07,240 --> 00:30:10,420
+position أو وضعيات أخرى advice لل patient that
+
+444
+00:30:10,420 --> 00:30:14,380
+even if cough was not productive خلال treatment it
+
+445
+00:30:14,380 --> 00:30:18,490
+may be productive بعد اللي هو session تبعتييعني
+
+446
+00:30:18,490 --> 00:30:21,230
+إذا ما جدر يعمل cuffing و يطلع ال secretion خلال
+
+447
+00:30:21,230 --> 00:30:25,530
+البصرة للدرناج ممكن يعمله خلال اللي هو ال cuffing
+
+448
+00:30:25,530 --> 00:30:31,590
+بعد الجلسة بدقائق أو فترة معينةطبعا أنا كي بدي
+
+449
+00:30:31,590 --> 00:30:35,170
+أقيم فعالية اللي هي الجلسة تبعتي عن طريق الـ
+
+450
+00:30:35,170 --> 00:30:37,590
+Breathing Sound كنا حكينا عليه في البداية تبع
+
+451
+00:30:37,590 --> 00:30:41,810
+الجلسة أنه أنا بسمع اللي هو هل فيه Krebitas هل فيه
+
+452
+00:30:41,810 --> 00:30:45,170
+secretion ما زال عندي مسموع لأ إذا كان أنا
+
+453
+00:30:45,170 --> 00:30:49,330
+بالبداية كنت سمعها كويس و بعد ال session باجي بحط
+
+454
+00:30:49,330 --> 00:30:53,210
+بالسمعة و بسمع ال Breathing Soundإذا كان ما زال
+
+455
+00:30:53,210 --> 00:30:56,570
+موجود معناته أنا ما طلع المريض عندي إشي و الجلسة
+
+456
+00:30:56,570 --> 00:31:00,950
+تقيمها ليس بجيد ولكن إذا كان الصوت واضح وإنه مافي
+
+457
+00:31:00,950 --> 00:31:07,070
+إشي و الـ Airway Clearance فأنا وصلت لهدفي الآن
+
+458
+00:31:07,070 --> 00:31:10,570
+الـ Type و الـ Color و الـ Consistency تبعته الـ
+
+459
+00:31:10,570 --> 00:31:14,570
+Secretion و الـ Amount مهمة جدا إنه أنا عارفها
+
+460
+00:31:15,250 --> 00:31:18,410
+check up لل patient vital signs after treatment
+
+461
+00:31:18,410 --> 00:31:22,510
+and note how patient tolerate لل treatment كمان
+
+462
+00:31:22,510 --> 00:31:25,970
+هاي مهمة حتى أشوف قداش ال tolerance تبع ال patient
+
+463
+00:31:25,970 --> 00:31:32,010
+اللي أنا شغالة معاه في أنا عندي مواضيع اللي هو ال
+
+464
+00:31:32,010 --> 00:31:36,390
+modifications إنه أنا على سبيل المثال بتأقلم مع
+
+465
+00:31:36,390 --> 00:31:39,990
+الوضعية اللي أنا فيها إذا كان المريض تبعي في عنده
+
+466
+00:31:39,990 --> 00:31:45,470
+على سبيل المثال مريضبيكون في مضاعية صعبة جدا إنه
+
+467
+00:31:45,470 --> 00:31:51,210
+أنا أحطه في الـ semisubine أو الـ prone position
+
+468
+00:31:51,210 --> 00:31:55,870
+فبالتالي أنا هنا لازم أعمله adjustable أو أخليه
+
+469
+00:31:55,870 --> 00:31:59,470
+أعمله adjusting للي هو ال position okay for
+
+470
+00:31:59,470 --> 00:32:01,830
+example ال patient with congestive heart failure
+
+471
+00:32:01,830 --> 00:32:06,360
+مايكسبتindicated of orthopenia طبعا لإنه
+
+472
+00:32:06,360 --> 00:32:09,200
+congestive heart failure after neurosurgery
+
+473
+00:32:09,200 --> 00:32:12,260
+patient كمان may not allowed to assume head down
+
+474
+00:32:12,260 --> 00:32:15,840
+زي ما حكينا في بداية الفيديو إنه أنا صعب جدا إنه
+
+475
+00:32:15,840 --> 00:32:18,680
+أنا أحط هاي الناس في وضع لتريندلينبيرج position
+
+476
+00:32:18,680 --> 00:32:23,120
+ليه لإنه بزيد ال inter cranial pressure في هاي
+
+477
+00:32:23,120 --> 00:32:26,940
+الوضعية وبالتالي أنا لازم أشوف اللي هو وضعية أخرى
+
+478
+00:32:26,940 --> 00:32:31,600
+هذا هو لتريندلينبيرج اللي هو position هذا ال
+
+479
+00:32:31,600 --> 00:32:35,310
+positionصعب على الحالة التالية after thoracic
+
+480
+00:32:35,310 --> 00:32:38,570
+surgery ال patient may have chest tube في عندنا ال
+
+481
+00:32:38,570 --> 00:32:41,430
+monitoring wires في عندنا بعض الأشياء اللي بتكون
+
+482
+00:32:41,430 --> 00:32:44,370
+على المريض هنا لازم انا اخد بالي من هنا بكويس
+
+483
+00:32:44,370 --> 00:32:47,710
+under the circumstances and other positioning خلال
+
+484
+00:32:47,710 --> 00:32:51,050
+postural drainage must be modified the position in
+
+485
+00:32:51,050 --> 00:32:53,270
+which postural drainage is undertaking
+
+486
+00:32:53,270 --> 00:32:56,570
+modification هذه الأمور لازم انا اخدها بعين
+
+487
+00:32:56,570 --> 00:33:02,600
+الاعتبار و اعدل من الوضعية مع المريض الhomogramلأن
+
+488
+00:33:02,600 --> 00:33:05,160
+أنا عملت الجلسة عندي في المستشفى و تمام التمام و
+
+489
+00:33:05,160 --> 00:33:08,820
+لازم أعلم ال patient كيف يعمل اللي هو ال home
+
+490
+00:33:08,820 --> 00:33:12,240
+program تبعته البصر ال DNA may have carried out
+
+491
+00:33:12,240 --> 00:33:15,280
+regular basis لل home patient in chronic disease
+
+492
+00:33:16,060 --> 00:33:19,880
+كتير كويس أنا أعلم الأم إذا كان طفلها بيعاني من
+
+493
+00:33:19,880 --> 00:33:23,680
+اللي هو الـChronic Bronchitis إن هي كمان تعمل
+
+494
+00:33:23,680 --> 00:33:27,420
+الـCuffing أو تعمل الـPost-rehydration في البيت و
+
+495
+00:33:27,420 --> 00:33:31,220
+أعطيها الـHome Program الـpatient need to be shown
+
+496
+00:33:31,220 --> 00:33:35,220
+how to position themselves using inexpensive aids
+
+497
+00:33:35,220 --> 00:33:38,560
+كمان إحنا لو علمنا المريض بعض الـexercise أو بعض
+
+498
+00:33:38,560 --> 00:33:41,880
+الـposition إنه يشتغلها في البيت و تكون طبعا
+
+499
+00:33:41,880 --> 00:33:47,520
+freelyإن adult may place pillow طبعا أو أي واج
+
+500
+00:33:47,520 --> 00:33:51,220
+ممكن يشتغل فيها ال patient also lean to chestward
+
+501
+00:33:51,220 --> 00:33:55,680
+للbed and resting with arms, chair or stool من أي
+
+502
+00:33:55,680 --> 00:33:59,940
+شيء من البيت أنا ممكن أخلي الأم تصنع اللي هو roll
+
+503
+00:33:59,940 --> 00:34:05,200
+تصنع بعض ال pillow اللي هتكون مساعدة لاستخدامها
+
+504
+00:34:08,090 --> 00:34:11,650
+الاطفال position تبعهم أو وضعيات الأطفال in
+
+505
+00:34:11,650 --> 00:34:16,090
+ironing board proper against sofa or heavy chairs
+
+506
+00:34:16,090 --> 00:34:20,590
+يا بحطهم على الكنابة أو بحطهم على كرسي بيكون شوية
+
+507
+00:34:20,590 --> 00:34:25,210
+دبيل family members often family members often
+
+508
+00:34:25,210 --> 00:34:28,430
+must do proper positioning ال percussion و ال
+
+509
+00:34:28,430 --> 00:34:32,250
+shaking و التكنيكس ممكن أعلمهميا يعني بنعلم الام
+
+510
+00:34:32,250 --> 00:34:35,790
+يا بنعلم أي حد من ال caregiver انه يشتغل ال manual
+
+511
+00:34:35,790 --> 00:34:39,330
+therapyGuidelines and Percussions to assist
+
+512
+00:34:39,330 --> 00:34:43,370
+للpatient previously discussed و should be اللي هو
+
+513
+00:34:43,370 --> 00:34:46,950
+طبعا بعض ال guidelines و بعض ال percussions أنا
+
+514
+00:34:46,950 --> 00:34:51,250
+لازم أتبعهم و أعلمهم لل patient و إنه دائما يكون
+
+515
+00:34:51,250 --> 00:34:54,570
+حذر في التعامل في الوضعيات خصوص إذا كان
+
+516
+00:34:54,570 --> 00:35:00,830
+neurosurgery أو إذا كان أي حد اعمله اللي هو الجلسة
+
+517
+00:35:02,490 --> 00:35:06,970
+وقتاش انا لازم اقطع اللي هي جلسة البصرة يا دلنياش
+
+518
+00:35:06,970 --> 00:35:11,850
+if chest radiograph is relatively clear خلصنا كده
+
+519
+00:35:11,850 --> 00:35:14,830
+ال patient تبعي تمام تمام و ال breathing sound
+
+520
+00:35:14,830 --> 00:35:22,010
+عنده سليم if patient ephebrial هذا مهم جدا إذا كان
+
+521
+00:35:22,010 --> 00:35:28,490
+مريضي ephebrial من 24 ل 48 ساعة if normal or near
+
+522
+00:35:28,490 --> 00:35:33,450
+normal breathe sound are heardwith escalations إذا
+
+523
+00:35:33,450 --> 00:35:38,450
+كان قريب أو شبه قريب في اللي هو سماعي لصوت
+
+524
+00:35:38,450 --> 00:35:43,270
+الـbreathing تبعه الآن هتحدث أيضًا عن اللي هي
+
+525
+00:35:43,270 --> 00:35:46,550
+الـImproving Exercise Tolerance الـExercise
+
+526
+00:35:46,550 --> 00:35:49,850
+Tolerance اللي هي عبارة عن القابلة تبع الpatient
+
+527
+00:35:49,850 --> 00:35:53,070
+إنه يعمل الـexercise طبعًا الـmuscle weakness
+
+528
+00:35:53,070 --> 00:35:56,590
+والسكلتل involuntary والسكلتل involuntary muscle
+
+529
+00:35:56,590 --> 00:36:00,350
+is common في الـCOPD patientلازم اعمله
+
+530
+00:36:00,350 --> 00:36:03,610
+strengthening exercise هنا هتكلم عن chest mobility
+
+531
+00:36:03,610 --> 00:36:07,330
+و هتحدث عن بعض ال exercise to strengthening
+
+532
+00:36:07,330 --> 00:36:12,270
+exercise ال exercise ال mobilization chest اللي هو
+
+533
+00:36:12,270 --> 00:36:15,730
+ليش حتى انا تكون عندي ال respiratory muscles و
+
+534
+00:36:15,730 --> 00:36:18,570
+تكون عندي مش بس ال mainly muscles اللي انا شغالة
+
+535
+00:36:18,570 --> 00:36:21,050
+عليها ايضا شغالة على كل ال respiratory muscles و
+
+536
+00:36:21,050 --> 00:36:24,750
+ال trunk و ال shoulder girdle و كل ال upper ال
+
+537
+00:36:24,750 --> 00:36:28,790
+trunk انا بديه يكون goodفبالتالي على سبيل المثال
+
+538
+00:36:28,790 --> 00:36:31,690
+الـ patient with hypomobility لـ tranquil muscle
+
+539
+00:36:31,690 --> 00:36:34,870
+site to the bed does not expand the part of chest
+
+540
+00:36:34,870 --> 00:36:38,630
+fully during inspiration أنا بهمني اللي هو الـ
+
+541
+00:36:38,630 --> 00:36:42,310
+full expiration و الـ full inspiration اللي هيصير
+
+542
+00:36:42,310 --> 00:36:46,180
+في عمليات ال respiratory systemالـ exercise
+
+543
+00:36:46,180 --> 00:36:49,880
+combined with stretching مهم جدا أنه أنا أساعد
+
+544
+00:36:49,880 --> 00:36:52,960
+المرضى تبعيني في ال range of motion exercise
+
+545
+00:36:52,960 --> 00:36:56,760
+بالإضافة لل stretching exercise أيضا أبقى ساعد
+
+546
+00:36:56,760 --> 00:36:59,580
+اللي هو ال patient في ال reinforcing لل expiration
+
+547
+00:36:59,580 --> 00:37:04,000
+leaning forward لل hips and flexing supine أو اللي
+
+548
+00:37:04,000 --> 00:37:07,460
+هي breathe out this pushing out viscera superiorly
+
+549
+00:37:07,460 --> 00:37:11,300
+and into diaphragmزي ما حكيت الحدث من هذا ال
+
+550
+00:37:11,300 --> 00:37:14,600
+exercise كله إنه أعمل strengthening and
+
+551
+00:37:14,600 --> 00:37:18,580
+mobilization ل chest عند ال patient اللي في قسم
+
+552
+00:37:18,580 --> 00:37:22,540
+الصدرية بعض ال techniques اللي أنا بدأ أستخدمهم
+
+553
+00:37:22,540 --> 00:37:28,090
+اللي هي mobilize one side of chestالآن في عندي كذا
+
+554
+00:37:28,090 --> 00:37:32,130
+mobilization أو كذا position أنا هستخدمه زي ما
+
+555
+00:37:32,130 --> 00:37:35,310
+هتشوفوه في الصور هنا عندي two chest mobilization
+
+556
+00:37:35,310 --> 00:37:39,130
+inspiration and expiration أيضا بعمل laterally
+
+557
+00:37:39,130 --> 00:37:44,410
+اللي هي mobilization bend from side to sideهذا مهم
+
+558
+00:37:44,410 --> 00:37:47,630
+جدا ت mobilize ال upper chest و ال pectoralis
+
+559
+00:37:47,630 --> 00:37:52,870
+muscles و احنا عارفين كده مهم جدا عمل و اهمية ال
+
+560
+00:37:52,870 --> 00:37:56,190
+pectoralis muscles سواء ال major او ال minor while
+
+561
+00:37:56,190 --> 00:38:00,110
+patient in sitting position و بخليه يعمل اللي هي
+
+562
+00:38:00,110 --> 00:38:03,930
+auto exercise او auto self exercise في ال range of
+
+563
+00:38:03,930 --> 00:38:08,530
+motion exerciseكما هو موضح بالصور تموباليز ال
+
+564
+00:38:08,530 --> 00:38:12,150
+upper chest and shoulder طبعا زي ما انتوا شايفين
+
+565
+00:38:12,150 --> 00:38:20,470
+هنا بيعمل اللي هو انثناء flex ل ال lumber area
+
+566
+00:38:20,470 --> 00:38:24,410
+و هنا بيعمل اللي هو full stretching في حالة اللي
+
+567
+00:38:24,410 --> 00:38:29,990
+هي ال shoulder joint و upright position ل ال back
+
+568
+00:38:29,990 --> 00:38:37,810
+و بهيك بيكون أن هنا مساقنالهذا الفصل ويعطيك ألف
+
+569
+00:38:37,810 --> 00:38:40,230
+عافية بإذن الله تعالى
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/-e-mevs23fQ_raw.json b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/-e-mevs23fQ_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..9c4b98784728f9761709af1e22ea1f63a579d6dc
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/-e-mevs23fQ_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 2573, "start": 0.91, "end": 25.73, "text": "الرحيم أهلا وسهلا فيكم طلابي الأعزاء في فيديو رقم 14 بدي أتكلم في هذا الفيديو عن موضوع اسمه الـ postural drainage هذا الموضوع هو مكمل للمحاضرة أو الفيديوهات السابقة في ال physical intervention طبعا احنا أخدنا اللي هو بداية بال physical intervention to secretion cleanliness", "tokens": [6027, 2288, 5016, 32640, 5551, 3224, 15040, 46952, 3224, 15040, 8978, 24793, 23032, 15040, 21292, 16247, 3615, 11622, 16606, 8978, 8978, 16254, 2407, 12602, 4587, 2304, 3499, 4724, 16254, 5551, 2655, 4117, 19528, 8978, 23758, 27188, 1829, 16254, 2407, 18871, 3714, 2407, 11242, 45367, 24525, 2304, 3224, 2423, 39184, 2183, 1807, 32973, 23758, 9673, 2407, 11242, 45367, 31439, 3714, 24793, 1211, 5296, 19528, 5016, 46958, 25720, 34051, 27188, 1829, 16254, 2407, 3224, 9307, 21136, 16758, 28671, 8978, 2423, 4001, 13176, 23032, 3555, 3615, 995, 1975, 5016, 8315, 5551, 9778, 3215, 8315, 13672, 1829, 31439, 4724, 28259, 10632, 20666, 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"word": " بدي", "probability": 0.713623046875}, {"start": 8.11, "end": 8.53, "word": " أتكلم", "probability": 0.9429931640625}, {"start": 8.53, "end": 8.71, "word": " في", "probability": 0.984375}, {"start": 8.71, "end": 8.95, "word": " هذا", "probability": 0.904296875}, {"start": 8.95, "end": 9.53, "word": " الفيديو", "probability": 0.9139404296875}, {"start": 9.53, "end": 9.73, "word": " عن", "probability": 0.98583984375}, {"start": 9.73, "end": 10.19, "word": " موضوع", "probability": 0.9940185546875}, {"start": 10.19, "end": 10.77, "word": " اسمه", "probability": 0.9703776041666666}, {"start": 10.77, "end": 11.07, "word": " الـ", "probability": 0.71630859375}, {"start": 11.07, "end": 11.59, "word": " postural", "probability": 0.55438232421875}, {"start": 11.59, "end": 12.33, "word": " drainage", "probability": 0.94921875}, {"start": 12.33, "end": 13.15, "word": " هذا", "probability": 0.90478515625}, {"start": 13.15, "end": 13.85, "word": " الموضوع", "probability": 0.9990234375}, 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" لدرنيش", "probability": 0.6088623046875}, {"start": 1231.64, "end": 1231.94, "word": " بعض", "probability": 0.890625}, {"start": 1231.94, "end": 1232.6, "word": " الأخصائيين", "probability": 0.8802490234375}, {"start": 1232.6, "end": 1232.88, "word": " بيقولك", "probability": 0.7642822265625}, {"start": 1232.88, "end": 1233.02, "word": " لأ", "probability": 0.875244140625}, {"start": 1233.02, "end": 1233.16, "word": " أنا", "probability": 0.806640625}, {"start": 1233.16, "end": 1233.4, "word": " لازم", "probability": 0.9982096354166666}, {"start": 1233.4, "end": 1233.54, "word": " في", "probability": 0.9423828125}, {"start": 1233.54, "end": 1234.08, "word": " البداية", "probability": 0.982421875}], "temperature": 1.0}, {"id": 53, "seek": 126218, "start": 1234.52, "end": 1262.18, "text": "أشرب مريضي حاجة دافية بالإضافة للي هو ياخد تبخيرة على سبيل المثال هذا بيزيد اللي هو أو بيساعد في ال «losing» للـ «secretion» و«increasing» للـ «likehood» اللي هو productivity بيساعد طبعا في إنتاج إنه الـ «cuffing» تكون productive يعني مقشعة يعني فيها بلغا على سبيل المثال إنه بيصير سهل جدا خروج هذا ال «waste product»", "tokens": [10721, 8592, 25513, 3714, 16572, 11242, 1829, 11331, 26108, 3660, 11778, 31845, 10632, 20666, 28814, 11242, 31845, 3660, 5296, 20292, 31439, 7251, 47283, 3215, 6055, 3555, 9778, 48923, 15844, 8608, 21292, 1211, 9673, 12984, 6027, 23758, 4724, 1829, 11622, 25708, 13672, 1829, 31439, 34051, 4724, 1829, 3794, 995, 22488, 8978, 2423, 4657, 75, 6110, 5933, 24976, 39184, 4657, 8159, 1505, 313, 5933, 4032, 36784, 4647, 265, 3349, 5933, 24976, 39184, 4657, 4092, 3809, 5933, 13672, 1829, 31439, 15604, 4724, 1829, 3794, 995, 22488, 23032, 3555, 3615, 995, 8978, 11933, 29399, 26108, 36145, 3224, 2423, 39184, 4657, 66, 1245, 278, 5933, 6055, 30544, 13304, 37495, 22653, 3714, 4587, 8592, 27884, 37495, 22653, 8978, 11296, 4724, 1211, 17082, 995, 15844, 8608, 21292, 1211, 9673, 12984, 6027, 36145, 3224, 4724, 1829, 9381, 13546, 8608, 3224, 1211, 10874, 28259, 16490, 2288, 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226298, "start": 2246.21, "end": 2262.99, "text": "الآن في عندي كذا mobilization أو كذا position أنا هستخدمه زي ما هتشوفوه في الصور هنا عندي two chest mobilization inspiration and expiration أيضا بعمل laterally اللي هي mobilization bend from side to side", "tokens": [6027, 148, 48506, 8978, 18871, 16254, 9122, 15730, 15891, 2144, 34051, 9122, 15730, 2535, 41850, 8032, 14851, 9778, 40448, 3224, 30767, 1829, 19446, 8032, 2655, 8592, 38688, 2407, 3224, 8978, 31767, 13063, 34105, 18871, 16254, 732, 7443, 15891, 2144, 10249, 293, 39657, 36632, 11242, 995, 4724, 25957, 1211, 1780, 379, 13672, 1829, 39896, 15891, 2144, 11229, 490, 1252, 281, 1252], "avg_logprob": -0.24474897834121204, "compression_ratio": 1.5340909090909092, "no_speech_prob": 0.0, "words": [{"start": 2246.21, "end": 2246.85, "word": "الآن", "probability": 0.6625162760416666}, {"start": 2246.85, "end": 2247.27, "word": " في", "probability": 0.411376953125}, {"start": 2247.27, "end": 2247.67, "word": " عندي", "probability": 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0.916748046875}, {"start": 2253.05, "end": 2253.29, "word": " هنا", "probability": 0.814453125}, {"start": 2253.29, "end": 2253.71, "word": " عندي", "probability": 0.802001953125}, {"start": 2253.71, "end": 2254.31, "word": " two", "probability": 0.44384765625}, {"start": 2254.31, "end": 2254.61, "word": " chest", "probability": 0.56103515625}, {"start": 2254.61, "end": 2255.31, "word": " mobilization", "probability": 0.906005859375}, {"start": 2255.31, "end": 2255.97, "word": " inspiration", "probability": 0.58349609375}, {"start": 2255.97, "end": 2256.31, "word": " and", "probability": 0.9365234375}, {"start": 2256.31, "end": 2257.07, "word": " expiration", "probability": 0.93017578125}, {"start": 2257.07, "end": 2257.85, "word": " أيضا", "probability": 0.7996419270833334}, {"start": 2257.85, "end": 2258.27, "word": " بعمل", "probability": 0.9300130208333334}, {"start": 2258.27, "end": 2259.13, "word": " laterally", "probability": 0.75927734375}, {"start": 2259.13, "end": 2259.75, 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mobilize", "probability": 0.1365966796875}, {"start": 2265.53, "end": 2265.89, "word": " ال", "probability": 0.8623046875}, {"start": 2265.89, "end": 2266.27, "word": " upper", "probability": 0.77099609375}, {"start": 2266.27, "end": 2266.77, "word": " chest", "probability": 0.9111328125}, {"start": 2266.77, "end": 2266.93, "word": " و", "probability": 0.481201171875}, {"start": 2266.93, "end": 2267.01, "word": " ال", "probability": 0.6982421875}, {"start": 2267.01, "end": 2267.63, "word": " pectoralis", "probability": 0.6941731770833334}, {"start": 2267.63, "end": 2268.09, "word": " muscles", "probability": 0.8583984375}, {"start": 2268.09, "end": 2268.59, "word": " و", "probability": 0.66455078125}, {"start": 2268.59, "end": 2268.73, "word": " احنا", "probability": 0.84033203125}, {"start": 2268.73, "end": 2269.09, "word": " عارفين", "probability": 0.9881591796875}, {"start": 2269.09, "end": 2269.35, "word": " كده", "probability": 0.7711588541666666}, {"start": 2269.35, "end": 2269.71, "word": " مهم", "probability": 0.9873046875}, {"start": 2269.71, "end": 2270.11, "word": " جدا", "probability": 0.983154296875}, {"start": 2270.11, "end": 2271.87, "word": " عمل", "probability": 0.843994140625}, {"start": 2271.87, "end": 2272.15, "word": " و", "probability": 0.85595703125}, {"start": 2272.15, "end": 2272.73, "word": " اهمية", "probability": 0.869140625}, {"start": 2272.73, "end": 2272.87, "word": " ال", "probability": 0.97705078125}, {"start": 2272.87, "end": 2273.57, "word": " pectoralis", "probability": 0.9558919270833334}, {"start": 2273.57, "end": 2274.19, "word": " muscles", "probability": 0.76708984375}, {"start": 2274.19, "end": 2274.43, "word": " سواء", "probability": 0.9860026041666666}, {"start": 2274.43, "end": 2274.59, "word": " ال", "probability": 0.62646484375}, {"start": 2274.59, "end": 2274.81, "word": " major", "probability": 0.95654296875}, {"start": 2274.81, "end": 2274.99, "word": " او", "probability": 0.77197265625}, {"start": 2274.99, "end": 2275.11, "word": " ال", "probability": 0.87548828125}, {"start": 2275.11, "end": 2275.43, "word": " minor", "probability": 0.9931640625}, {"start": 2275.43, "end": 2276.19, "word": " while", "probability": 0.76513671875}, {"start": 2276.19, "end": 2276.59, "word": " patient", "probability": 0.91455078125}, {"start": 2276.59, "end": 2276.83, "word": " in", "probability": 0.69970703125}, {"start": 2276.83, "end": 2277.09, "word": " sitting", "probability": 0.78955078125}, {"start": 2277.09, "end": 2277.67, "word": " position", "probability": 0.96826171875}, {"start": 2277.67, "end": 2278.27, "word": " و", "probability": 0.8095703125}, {"start": 2278.27, "end": 2278.89, "word": " بخليه", "probability": 0.8369140625}, {"start": 2278.89, "end": 2279.29, "word": " يعمل", "probability": 0.97119140625}, {"start": 2279.29, "end": 2279.75, "word": " اللي", "probability": 0.624755859375}, {"start": 2279.75, "end": 2280.11, "word": " هي", "probability": 0.430419921875}, {"start": 2280.11, 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{"id": 97, "seek": 231471, "start": 2285.75, "end": 2314.71, "text": "كما هو موضح بالصور تموباليز ال upper chest and shoulder طبعا زي ما انتوا شايفين هنا بيعمل اللي هو انثناء flex ل ال lumber area و هنا بيعمل اللي هو full stretching في حالة اللي هي ال shoulder joint و upright position ل ال back و بهيك بيكون أن هنا مساقنا", "tokens": [4117, 15042, 31439, 3714, 2407, 11242, 5016, 20666, 9381, 13063, 6055, 2304, 37746, 6027, 1829, 11622, 2423, 6597, 7443, 293, 7948, 23032, 3555, 3615, 995, 30767, 1829, 19446, 16472, 2655, 14407, 13412, 995, 33911, 9957, 34105, 4724, 1829, 25957, 1211, 13672, 1829, 31439, 16472, 12984, 1863, 16606, 5896, 5296, 2423, 41686, 1859, 4032, 34105, 4724, 1829, 25957, 1211, 13672, 1829, 31439, 1577, 19632, 8978, 11331, 6027, 3660, 13672, 1829, 39896, 2423, 7948, 7225, 4032, 27405, 2535, 5296, 2423, 646, 4032, 39627, 1829, 4117, 4724, 1829, 30544, 14739, 34105, 47524, 995, 4587, 8315], "avg_logprob": -0.22345430492072976, "compression_ratio": 1.6504424778761062, "no_speech_prob": 5.7220458984375e-06, "words": [{"start": 2285.75, "end": 2286.09, "word": "كما", "probability": 0.741455078125}, {"start": 2286.09, "end": 2286.27, "word": " هو", "probability": 0.95751953125}, {"start": 2286.27, "end": 2286.65, "word": " موضح", "probability": 0.9677734375}, {"start": 2286.65, "end": 2287.21, "word": " بالصور", "probability": 0.947265625}, {"start": 2287.21, "end": 2288.39, "word": " تموباليز", "probability": 0.5666097005208334}, {"start": 2288.39, "end": 2288.53, "word": " ال", "probability": 0.658203125}, {"start": 2288.53, "end": 2288.77, "word": " upper", "probability": 0.433837890625}, {"start": 2288.77, "end": 2289.15, "word": " chest", "probability": 0.9228515625}, {"start": 2289.15, "end": 2289.33, "word": " and", "probability": 0.73974609375}, {"start": 2289.33, "end": 2289.85, "word": " shoulder", "probability": 0.8310546875}, {"start": 2289.85, "end": 2290.91, "word": " طبعا", "probability": 0.947021484375}, {"start": 2290.91, "end": 2291.45, "word": " زي", "probability": 0.70947265625}, {"start": 2291.45, "end": 2291.53, "word": " ما", "probability": 0.9697265625}, {"start": 2291.53, "end": 2291.77, "word": " انتوا", "probability": 0.80712890625}, {"start": 2291.77, "end": 2292.15, "word": " شايفين", "probability": 0.9832763671875}, {"start": 2292.15, "end": 2292.41, "word": " هنا", "probability": 0.89599609375}, {"start": 2292.41, "end": 2293.03, "word": " بيعمل", "probability": 0.976318359375}, {"start": 2293.03, "end": 2293.27, "word": " اللي", "probability": 0.890380859375}, {"start": 2293.27, "end": 2293.79, "word": " هو", "probability": 0.92333984375}, {"start": 2293.79, "end": 2294.79, "word": " انثناء", "probability": 0.58685302734375}, {"start": 2294.79, "end": 2295.15, "word": " flex", "probability": 0.45068359375}, {"start": 2295.15, "end": 2295.49, "word": " ل", "probability": 0.41552734375}, {"start": 2295.49, "end": 2296.49, "word": " ال", "probability": 0.56884765625}, {"start": 2296.49, "end": 2297.01, "word": " lumber", "probability": 0.52685546875}, {"start": 2297.01, "end": 2300.47, "word": " area", "probability": 0.5908203125}, {"start": 2300.47, "end": 2300.97, "word": " و", "probability": 0.4716796875}, {"start": 2300.97, "end": 2301.31, "word": " هنا", "probability": 0.75}, {"start": 2301.31, "end": 2301.83, "word": " بيعمل", "probability": 0.9864501953125}, {"start": 2301.83, "end": 2302.01, "word": " اللي", "probability": 0.958251953125}, {"start": 2302.01, "end": 2302.19, "word": " هو", "probability": 0.98779296875}, {"start": 2302.19, "end": 2302.45, "word": " full", "probability": 0.85986328125}, {"start": 2302.45, "end": 2303.11, "word": " stretching", "probability": 0.8623046875}, {"start": 2303.11, "end": 2303.71, "word": " في", "probability": 0.86376953125}, {"start": 2303.71, "end": 2304.23, "word": " حالة", "probability": 0.9931640625}, {"start": 2304.23, "end": 2304.41, "word": " اللي", "probability": 0.98828125}, {"start": 2304.41, "end": 2304.85, "word": " هي", "probability": 0.939453125}, {"start": 2304.85, "end": 2305.61, "word": " ال", "probability": 0.7265625}, {"start": 2305.61, "end": 2306.25, "word": " shoulder", "probability": 0.939453125}, {"start": 2306.25, "end": 2306.85, "word": " joint", "probability": 0.9404296875}, {"start": 2306.85, "end": 2307.27, "word": " و", "probability": 0.98193359375}, {"start": 2307.27, "end": 2308.11, "word": " upright", "probability": 0.57373046875}, {"start": 2308.11, "end": 2308.75, "word": " position", "probability": 0.98193359375}, {"start": 2308.75, "end": 2309.25, "word": " ل", "probability": 0.734375}, {"start": 2309.25, "end": 2309.61, "word": " ال", "probability": 0.466552734375}, {"start": 2309.61, "end": 2309.99, "word": " back", "probability": 0.88916015625}, {"start": 2309.99, "end": 2311.57, "word": " و", "probability": 0.62353515625}, {"start": 2311.57, "end": 2312.29, "word": " بهيك", "probability": 0.9114583333333334}, {"start": 2312.29, "end": 2312.85, "word": " بيكون", "probability": 0.962890625}, {"start": 2312.85, "end": 2313.53, "word": " أن", "probability": 0.72119140625}, {"start": 2313.53, "end": 2313.89, "word": " هنا", "probability": 0.60009765625}, {"start": 2313.89, "end": 2314.71, "word": " مساقنا", "probability": 0.9434814453125}], "temperature": 1.0}, {"id": 98, "seek": 232023, "start": 2315.05, "end": 2320.23, "text": "لهذا الفصل ويعطيك ألف عافية بإذن الله تعالى", "tokens": [43761, 15730, 27188, 36520, 4032, 40228, 9566, 1829, 4117, 5551, 46538, 6225, 31845, 10632, 4724, 28814, 8848, 1863, 21984, 37279, 6027, 7578], "avg_logprob": -0.14062500129575314, "compression_ratio": 1.1126760563380282, "no_speech_prob": 5.0067901611328125e-06, "words": [{"start": 2315.05, "end": 2315.75, "word": "لهذا", "probability": 0.784912109375}, {"start": 2315.75, "end": 2316.47, "word": " الفصل", "probability": 0.96484375}, {"start": 2316.47, "end": 2317.49, "word": " ويعطيك", "probability": 0.8833984375}, {"start": 2317.49, "end": 2317.81, "word": " ألف", "probability": 0.6107177734375}, {"start": 2317.81, "end": 2318.47, "word": " عافية", "probability": 0.97998046875}, {"start": 2318.47, "end": 2319.45, "word": " بإذن", "probability": 0.9833984375}, {"start": 2319.45, "end": 2319.69, "word": " الله", "probability": 0.9521484375}, {"start": 2319.69, "end": 2320.23, "word": " تعالى", "probability": 0.9820963541666666}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 2327.475375, "duration_after_vad": 2294.593124999993}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/-e-mevs23fQ_raw.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/-e-mevs23fQ_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..29c8fd98fbbf9cdc366b52e4bd5a373f541e6d2f
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/-e-mevs23fQ_raw.srt
@@ -0,0 +1,2288 @@
+1
+00:00:00,910 --> 00:00:06,310
+الرحيم أهلا وسهلا فيكم طلابي الأعزاء في فيديو رقم
+
+2
+00:00:06,310 --> 00:00:11,070
+14 بدي أتكلم في هذا الفيديو عن موضوع اسمه الـ
+
+3
+00:00:11,070 --> 00:00:16,030
+postural drainage هذا الموضوع هو مكمل للمحاضرة أو
+
+4
+00:00:16,030 --> 00:00:18,550
+الفيديوهات السابقة في ال physical intervention
+
+5
+00:00:18,550 --> 00:00:22,710
+طبعا احنا أخدنا اللي هو بداية بال physical
+
+6
+00:00:22,710 --> 00:00:26,950
+intervention to secretion cleanlinessعن طريق اللي
+
+7
+00:00:26,950 --> 00:00:29,650
+هي ال techniques الأخيرة أخدنا ال cuffing و ال
+
+8
+00:00:29,650 --> 00:00:34,170
+huffing أخدنا اللي هو كيف أنا ممكن أزيل ال
+
+9
+00:00:34,170 --> 00:00:39,410
+secretion و أأمن ممرات الهواء و تكون بشكل جيد و
+
+10
+00:00:39,410 --> 00:00:44,510
+تعطي فعالية جيدة في عملية التنفس اليوم هناخد ال
+
+11
+00:00:44,510 --> 00:00:47,050
+techniques الأخير اللي هو ال postural drainage
+
+12
+00:00:47,050 --> 00:00:52,290
+هتحدث فيه عن ال indication و ال contra indication
+
+13
+00:00:52,290 --> 00:00:57,880
+ال techniques اللي أنا ممكنأخليها تكون مصاحبة مع
+
+14
+00:00:57,880 --> 00:01:01,520
+الـ Postural Drainage زي اللي هي الـ Manual
+
+15
+00:01:01,520 --> 00:01:07,200
+Treatment أو الـ Manual العربي زي الـ Percussion،
+
+16
+00:01:07,200 --> 00:01:12,060
+الـ Vibration واللي هو الـ Shaking أيضًا هتحدث عن
+
+17
+00:01:12,060 --> 00:01:14,980
+الـ Postural Drainage Position أي وضعية أنا بدي
+
+18
+00:01:14,980 --> 00:01:17,950
+أختار هل بدي أختاره على الـ Sublime Positionفي الـ
+
+19
+00:01:17,950 --> 00:01:21,230
+Sitting Position أو الـ Prone Position كل هذا
+
+20
+00:01:21,230 --> 00:01:24,090
+الاشي هنتحدث فيه إن شاء الله رب العالمين في هذا
+
+21
+00:01:24,090 --> 00:01:28,310
+الفيديو إذا بدي أبدأ بداية بتعريف الـ Postural
+
+22
+00:01:28,310 --> 00:01:31,790
+Drainage أو البرونكال دريناج is another
+
+23
+00:01:31,790 --> 00:01:36,870
+intervention for airway clearness هي طريقة لتنبيث
+
+24
+00:01:36,870 --> 00:01:42,850
+ممر الهواء بشكل آمن حتى يسمح بعبور الأكسجين وخروج
+
+25
+00:01:42,850 --> 00:01:46,440
+ال waste product اللي هو الـ CO2It's the main
+
+26
+00:01:46,440 --> 00:01:49,760
+mobilized secretion in one or more lung segments
+
+27
+00:01:49,760 --> 00:01:52,880
+of the central airway by placing patients in
+
+28
+00:01:52,880 --> 00:01:57,760
+various positions في مواضع مختلفة هنا عندي factor
+
+29
+00:01:57,760 --> 00:02:01,400
+مهم هيساعدني في العملية اللي هو عبارة عن
+
+30
+00:02:01,400 --> 00:02:06,880
+الـGravity Assistant تمام، الـGravity هتساعدنا في
+
+31
+00:02:06,880 --> 00:02:11,050
+البصرة، الـdrainage في highالمرحلة فبالتالي انا
+
+32
+00:02:11,050 --> 00:02:15,070
+راح استخدم تعريف البُس رازناش هو عبارة عن إيش
+
+33
+00:02:15,070 --> 00:02:19,830
+عملية لإزالة الـ Secretion اللي موقف أو معيق حركة
+
+34
+00:02:19,830 --> 00:02:25,370
+دخول وخروج الهواء بطرق معددة بيكون فيها دور
+
+35
+00:02:25,370 --> 00:02:30,930
+للجاذبية الأرضيةهي زي ما انتوا شايفين بدي بس اراجع
+
+36
+00:02:30,930 --> 00:02:34,550
+مع حضراتكم شوية anatomy أخدنا فيه اللي هو
+
+37
+00:02:34,550 --> 00:02:39,110
+الـmannebranche اللي هي القصباء الهوائية بعدين في
+
+38
+00:02:39,110 --> 00:02:43,050
+عندنا البرنكوليوز أو ما يسمى فيه اللي هي الشعيبات
+
+39
+00:02:43,050 --> 00:02:46,410
+الهوائية عندي بالright three loops في عندنا ال
+
+40
+00:02:46,410 --> 00:02:50,550
+upper loops ال middle loop و اللي هي ال lower loop
+
+41
+00:02:50,550 --> 00:02:54,040
+بينما في ال left I have two loops justupper loop
+
+42
+00:02:54,040 --> 00:02:57,540
+and lower loop هذا الاشي مهم جدا عشان انا بكرا
+
+43
+00:02:57,540 --> 00:03:01,420
+بالـ postural drainage لازم احدد في اي segment انا
+
+44
+00:03:01,420 --> 00:03:06,240
+فيه عندي مشكلة عشان احتاج او عشان احط المريض فيه
+
+45
+00:03:06,240 --> 00:03:12,000
+في position مناسب لهذا الاشي نيجي نشوف اللي هو لما
+
+46
+00:03:12,000 --> 00:03:15,320
+بيكون في عندنا secretions are moved from smaller
+
+47
+00:03:15,320 --> 00:03:19,500
+to larger airway they are then cleared cuffing or
+
+48
+00:03:19,750 --> 00:03:24,110
+Indotracial suction يعني بعد ما اعمل انا هذا الاشي
+
+49
+00:03:24,110 --> 00:03:28,070
+او بعد ما اعمل بصرا لدرناج لازم يكون في عندي كذا
+
+50
+00:03:28,070 --> 00:03:32,590
+mechanism حتى تساعد لخروج كمية ال secretion هاي
+
+51
+00:03:32,590 --> 00:03:35,370
+بالذات انا بحكي على الناس بكرا اللي هتشتغلوا معاهم
+
+52
+00:03:35,370 --> 00:03:38,990
+بقسم الصدرية ال patience اللي هناك بيكونوا موجودين
+
+53
+00:03:39,240 --> 00:03:43,180
+في عندهم كمية لا بأس بها من الـSecretion بيكون
+
+54
+00:03:43,180 --> 00:03:48,220
+كثيف، سميك، بلوكز اللي هو ملتصق بشعيبات الهوائية
+
+55
+00:03:48,220 --> 00:03:52,260
+بيعيق حركة اللي هو الهواء اللي موجود في الـAlveoli
+
+56
+00:03:52,260 --> 00:03:55,660
+وكل هذه الأمور هتشوفوها بإذن الله تعالى مع
+
+57
+00:03:55,660 --> 00:03:59,320
+الـRechant في قسم الصدرية الـPosterior Drainage
+
+58
+00:03:59,320 --> 00:04:02,020
+also includes the uses of manual technique أنا
+
+59
+00:04:02,020 --> 00:04:04,460
+هستخدم معاها الـpercussion الـshaking و
+
+60
+00:04:04,460 --> 00:04:09,170
+الـvibrationأيضًا بيكون مع اللي هو البوصة
+
+61
+00:04:09,170 --> 00:04:12,830
+للإدرانياج coupled with voluntary cuffing طبعًا مع
+
+62
+00:04:12,830 --> 00:04:17,750
+كحق إرادية برأة المريض نفسه إذا كان conscious لأ
+
+63
+00:04:17,750 --> 00:04:21,470
+شو أهدافنا أو شو ال indication تبعتنا لمين أنا بدي
+
+64
+00:04:21,470 --> 00:04:25,470
+أستخدم الأهداف مع ال indication للبوصة للإدرانياج
+
+65
+00:04:25,470 --> 00:04:28,830
+أول إشي عندي أنه أنا بعمل بوصة للإدرانياج to
+
+66
+00:04:28,830 --> 00:04:31,290
+prevent a communication of secretion in patients
+
+67
+00:04:31,290 --> 00:04:35,880
+at risk for pulmonary complicationبدي أمنع أي
+
+68
+00:04:35,880 --> 00:04:38,320
+complications تصير لأي patient سواء كان في الـ
+
+69
+00:04:38,320 --> 00:04:42,220
+inpatient عندى في المستشفى بايت أو أنه موجود في
+
+70
+00:04:42,220 --> 00:04:45,720
+بيتهم برا المستشفى ال patient اللى عنده pulmonary
+
+71
+00:04:45,720 --> 00:04:49,280
+disease زي الـ chronic bronchitisما حكيت ال acute
+
+72
+00:04:49,280 --> 00:04:51,660
+حكيت ال chronic لإن ال acute ما بيكون فيها
+
+73
+00:04:51,660 --> 00:04:54,200
+secretion كبيرة أما ال chronic بيكون فيها
+
+74
+00:04:54,200 --> 00:04:57,820
+secretion وكمية لا بأس بها Ancestic fibrosis
+
+75
+00:04:57,820 --> 00:05:03,860
+التليف الرئوي ال patient who are on prolonged bed
+
+76
+00:05:03,860 --> 00:05:08,640
+rest ال patient اللي هو نايم في السرير بشكل دائم
+
+77
+00:05:08,640 --> 00:05:11,900
+ال patient اللي أيضا بيستقبل أو اللي عمل عملية
+
+78
+00:05:11,900 --> 00:05:16,080
+جراحية و أخد كمية لا بأس بها من ال bingeهدول الناس
+
+79
+00:05:16,080 --> 00:05:19,840
+طبعاً بيحوش عنده كمية من الـ «breathing» من اللي
+
+80
+00:05:19,840 --> 00:05:23,540
+هو الـ «secretion» مما يعيق عملية الـ «breathing»
+
+81
+00:05:23,540 --> 00:05:27,140
+و الـ «deep coughing» تمام بس أب هذا بنسميه
+
+82
+00:05:27,140 --> 00:05:31,880
+conditions any patient who is volunteer أو any
+
+83
+00:05:31,880 --> 00:05:34,580
+patient who is in ventilator ال patients اللي
+
+84
+00:05:34,580 --> 00:05:38,560
+موجودة على تنفس صناعي if he or she is stable
+
+85
+00:05:38,560 --> 00:05:42,150
+enoughto tolerate the treatment هو قادر على إنه
+
+86
+00:05:42,150 --> 00:05:45,750
+أنا أعمله اللي هي البصرة ال drainage لأن معظم
+
+87
+00:05:45,750 --> 00:05:48,770
+المرضى اللي بيكونوا على ال ventilator تكون حالاتهم
+
+88
+00:05:48,770 --> 00:05:52,190
+حرجة شوية فأحيانا ممكن يكون هو contra indication
+
+89
+00:05:52,190 --> 00:05:55,750
+عشان كده أنا صاحبتها بالجملة التابعة تلاحقة إن هو
+
+90
+00:05:55,750 --> 00:06:00,890
+حتى يكون enough to tolerate the treatment هذا أول
+
+91
+00:06:00,890 --> 00:06:04,740
+goal معيالـ goals التاني to remove accumulated
+
+92
+00:06:04,740 --> 00:06:09,580
+أمنع أي تجمع لsecretion في ال lungs ال patient
+
+93
+00:06:09,580 --> 00:06:11,880
+اللي عندهم acute or chronic lung disease زي
+
+94
+00:06:11,880 --> 00:06:15,960
+النمونيا زي ال atlaxis acute lung infections COPD
+
+95
+00:06:15,960 --> 00:06:20,600
+وهي الأمراض ال patient اللي who are generally very
+
+96
+00:06:20,600 --> 00:06:24,340
+weak are generally الناس اللي بتكون مش قادرة على
+
+97
+00:06:24,340 --> 00:06:29,280
+أنهي تخرج هذا ال secretion لبرا ال patient اللي
+
+98
+00:06:29,280 --> 00:06:34,730
+أيضابأستخدمه مع ال patient اللي أيضا في عندهم
+
+99
+00:06:34,730 --> 00:06:38,470
+artificial airway زي الـ Endotracheal tube زي اللي
+
+100
+00:06:38,470 --> 00:06:43,250
+هو الـ Tracheostomy كل الأمور هذه بستخدمها مع هدول
+
+101
+00:06:43,250 --> 00:06:47,470
+الناس لكن أنا في عندي contra indication في عندي
+
+102
+00:06:47,470 --> 00:06:52,930
+ناس ممنوعة أنا أشتغل معاها بصرا لدرنيج حالات الـ
+
+103
+00:06:52,930 --> 00:06:56,740
+severe hematopoiesisيعني الحالات اللي هو بيكون فيه
+
+104
+00:06:56,740 --> 00:07:00,820
+خروج دم كتيرة أو كمية كبيرة من الدم أثناء ال
+
+105
+00:07:00,820 --> 00:07:04,340
+cuffing على سبيل المثال ال untreated acute
+
+106
+00:07:04,340 --> 00:07:08,060
+conditions ليه؟ لأنه ما بيكون لسه اتكون في هذه
+
+107
+00:07:08,060 --> 00:07:11,800
+الحالات يعني أنا اليوملو أنا على سبيل المثال صار
+
+108
+00:07:11,800 --> 00:07:16,020
+في عندي high fever لأي طفل وكان في عنده bronchites
+
+109
+00:07:16,020 --> 00:07:19,920
+بسميها في بداية مراحلها acute bronchites ما هيكون
+
+110
+00:07:19,920 --> 00:07:23,480
+عند هذا الطفل secretion في الـ coughing لأ هتكون
+
+111
+00:07:23,480 --> 00:07:28,400
+كحة ناشفة أو بنسميها الكحة الجافة بعد ما يتحول بعد
+
+112
+00:07:28,400 --> 00:07:33,240
+شوية إلى اللي هو chronic بيصير في عنده اللي هو
+
+113
+00:07:33,240 --> 00:07:38,290
+secretionفي المكان تفير بلمونري إديمة في حالات
+
+114
+00:07:38,290 --> 00:07:41,530
+البلمونري إديمة ما بستخدم معاهم بوسترالدرنيج في
+
+115
+00:07:41,530 --> 00:07:44,490
+حالات ال congestive heart failure لأنه بخاف عليه
+
+116
+00:07:44,490 --> 00:07:47,950
+في حالات ال large bladdler effusion في حالات
+
+117
+00:07:47,950 --> 00:07:50,910
+البلمونري embolism لأنه ممكن مع ال بوسترالدرنيج
+
+118
+00:07:50,910 --> 00:07:53,750
+تتحرك عندي هاي ال embolism أو هاي ال basis
+
+119
+00:07:53,750 --> 00:07:58,070
+واتسببلي على سبيل المثال اللي هي جلطة رأوية أو
+
+120
+00:07:58,070 --> 00:08:02,310
+جلطة دماغية إذا اتحركت ال nemothoraxفي حالات الـ
+
+121
+00:08:02,310 --> 00:08:06,150
+Cardiovascular Instability لأنه بخاف إيش يصير عندي
+
+122
+00:08:06,150 --> 00:08:10,570
+في الدورة الدموية Cardic Arrhythmia Severe Hypo أو
+
+123
+00:08:10,570 --> 00:08:14,590
+Hypertension كمان أنا بخاف منها في حالات recent
+
+124
+00:08:14,590 --> 00:08:18,170
+myocardial infarction لأنه المريض unstable يعني
+
+125
+00:08:18,170 --> 00:08:23,470
+إجت وذبح قلبه بس هو لساته unstable يعني مش مستقر
+
+126
+00:08:23,470 --> 00:08:27,320
+تماماالـ Unstable Angina أيضًا اللي هي الـ Recent
+
+127
+00:08:27,320 --> 00:08:32,520
+Neurosurgery مريض عامل اللي هو عملية فيه اللي هو
+
+128
+00:08:32,520 --> 00:08:36,720
+الـ Nervous System وما زال حديث لسه العهد بالعملية
+
+129
+00:08:36,720 --> 00:08:41,040
+ما باجي بحطه على سبيل المثال في وضع اللي هو Prone
+
+130
+00:08:41,040 --> 00:08:45,080
+Position وRecline والرأس لتحت ليه؟ لأنه هيزيد الـ
+
+131
+00:08:45,080 --> 00:08:49,520
+Intercranial Pressure وهذا مش صحيح، هي الـ Contra
+
+132
+00:08:49,520 --> 00:08:52,710
+Indicationشو هي بعض ال techniques اللي في ال
+
+133
+00:08:52,710 --> 00:08:56,470
+manual therapy أنا ممكن استخدمها مع البصرة ال
+
+134
+00:08:56,470 --> 00:09:00,210
+drainage أول إشي هاخد ال percussion و بعده هاخد ال
+
+135
+00:09:00,210 --> 00:09:04,750
+vibration و بعدي رقم تلاتة ال shacking تقريبا كل
+
+136
+00:09:04,750 --> 00:09:08,970
+هاي الحركات الطرقنالها في معاملنا في معمل اللي هو
+
+137
+00:09:08,970 --> 00:09:12,990
+ال manual therapy أو معمل المساج بالعربيالبركاشن
+
+138
+00:09:12,990 --> 00:09:16,650
+كنا بنستخدم البركاشن ميكنيكالي ‏to disloading
+
+139
+00:09:16,650 --> 00:09:21,790
+vacas أو adherent ميوكاس from airway أنا بستخدم
+
+140
+00:09:21,790 --> 00:09:27,550
+البركاشن حتى أفصل أو أجزء هذا الـsecretion اللي هو
+
+141
+00:09:27,550 --> 00:09:32,490
+vacas أو adherent ملتصق في الـmucus في الـairway
+
+142
+00:09:32,670 --> 00:09:35,830
+Performed with cup hand، بنعملها الإيدة على شكل
+
+143
+00:09:35,830 --> 00:09:39,930
+الكباية طبعا over the lung segment beginning trend
+
+144
+00:09:39,930 --> 00:09:43,930
+لازم أنا أحدد بالظبط أنا في أي loop هشتغل أو في أي
+
+145
+00:09:43,930 --> 00:09:47,990
+segment من ال lung هشتغل Therapist should try keep
+
+146
+00:09:47,990 --> 00:09:53,690
+shoulder, elbow and wrist loose and mobileduring
+
+147
+00:09:53,690 --> 00:09:57,970
+maneuver طبعا اهاي مهارة من مهارات المساج انه انا
+
+148
+00:09:57,970 --> 00:10:00,930
+لازم احافظ على ال shoulder و ال elbow و ال wrist
+
+149
+00:10:00,930 --> 00:10:05,350
+انها تكون flexible مرنة خلال عملية اللي هي ال
+
+150
+00:10:05,350 --> 00:10:08,910
+cupping ال percussion is continued for several
+
+151
+00:10:08,910 --> 00:10:13,610
+minutes until the patient need to alert position
+
+152
+00:10:13,610 --> 00:10:17,320
+to coughيعني بدي أقدر أني أشتغل ال law percussion
+
+153
+00:10:17,320 --> 00:10:22,500
+لحد ما تيجي الكحة ساعتها أنا ببقى في عملية ال
+
+154
+00:10:22,500 --> 00:10:26,260
+percussion على أساس إنه يعمل coughing و بعدين يعمل
+
+155
+00:10:26,260 --> 00:10:31,120
+اللي هو خروج لهذا secretion this procedure should
+
+156
+00:10:31,120 --> 00:10:35,930
+not painful and uncomfortableيعني مش لازم أكون
+
+157
+00:10:35,930 --> 00:10:41,890
+drill ولا أكون طبعا فراشة على جسم المريض يعني لا
+
+158
+00:10:41,890 --> 00:10:46,230
+لازم يكون مؤذى ولا لازم يكون اللى هو خفيف بحيث أنه
+
+159
+00:10:46,230 --> 00:10:51,310
+لا يؤدي الغرض هى من مهارات المساج أو اللى هو
+
+160
+00:10:51,310 --> 00:10:55,250
+الـtherapist الشاطرهي ال cup ميكانيزم اللي أنا
+
+161
+00:10:55,250 --> 00:11:00,110
+حكيت عليها أو ال cupping أنه على شكل الكباية حكينا
+
+162
+00:11:00,110 --> 00:11:03,630
+في المهارات لازم ال therapist يكون شغال ال
+
+163
+00:11:03,630 --> 00:11:07,630
+shoulder و ال elbow و ال rest لازم تكون بوضعية
+
+164
+00:11:07,630 --> 00:11:13,320
+ممتازةهي الوضع اللي هو في الـ prone position حطينا
+
+165
+00:11:13,320 --> 00:11:17,360
+pillow under the abdomen وبلشنا ال cubbing
+
+166
+00:11:17,360 --> 00:11:21,200
+mechanism الآن ال congestive bronchial walls بيكون
+
+167
+00:11:21,200 --> 00:11:26,870
+في عنا اللي هو تم إغلاق اللي هيالـ Bronchi أو الـ
+
+168
+00:11:26,870 --> 00:11:29,030
+Mini Bronchi بهذا الـ Secretion زي ما انتوا
+
+169
+00:11:29,030 --> 00:11:32,230
+شايفينه بعد ال percussion و ال cuffing اللي صار من
+
+170
+00:11:32,230 --> 00:11:35,870
+ال patient صار في عندنا disloading انفصال لهذا
+
+171
+00:11:35,870 --> 00:11:40,730
+اللي هو ال secretion و لكن لم يتم تنظيفه بشكل جيد
+
+172
+00:11:40,730 --> 00:11:44,910
+لأنه بعد هيك حكينا لازم ال patient تبع يتبعه ب
+
+173
+00:11:44,910 --> 00:11:51,510
+cuffing voluntary كحة إرادية حتى تشفط هذا
+
+174
+00:11:51,510 --> 00:11:56,750
+secretion و يطلعه لبرهاللأ من الناس اللي أنا ممنوع
+
+175
+00:11:56,750 --> 00:12:01,470
+أشتغللها percussion مع الـPosterior Drainage اللي
+
+176
+00:12:01,470 --> 00:12:05,330
+هو ممنوع أشتغلوا هذا الـpercussion فوق الـbony
+
+177
+00:12:05,330 --> 00:12:07,970
+promenades ممنوع أشتغله في الـbreast tissue in
+
+178
+00:12:07,970 --> 00:12:11,730
+woman ممنوع أشتغله مع الـfractures أو الـspinal
+
+179
+00:12:11,730 --> 00:12:15,510
+fusion أو حالات الـosteoporosis ممنوع أشتغله في
+
+180
+00:12:15,510 --> 00:12:20,350
+الـtumour area if patient hasبلمونري إمبولاص، إذا
+
+181
+00:12:20,350 --> 00:12:23,190
+كان عندهم بلمونري إمبوليزم if patient has
+
+182
+00:12:23,190 --> 00:12:26,530
+condition in which hemorrhage could easily occurs
+
+183
+00:12:26,530 --> 00:12:29,530
+الpatient اللي سهل أن يصير فيه عندهم hemorrhagic
+
+184
+00:12:29,530 --> 00:12:33,990
+if patient has unstable angina عندهم الـmyocardial
+
+185
+00:12:33,990 --> 00:12:38,370
+angina أو عندهم الـmyocardial unstable بخاف عليهم
+
+186
+00:12:38,370 --> 00:12:42,310
+من اللي هو الـpercussion if patient has shift pain
+
+187
+00:12:42,310 --> 00:12:46,450
+بعد الـthoracic surgeryعلى سبيل المثال عمل Open
+
+188
+00:12:46,450 --> 00:12:50,810
+Heart Surgery وفي عندنا اللي هو Thoracic Surgery
+
+189
+00:12:50,810 --> 00:12:55,130
+هنا مش بالصح أنه أنا أشتغل عليه Percussion تمانية
+
+190
+00:12:55,130 --> 00:12:58,470
+Contraindication لـ Percussion with Postural
+
+191
+00:12:58,470 --> 00:13:03,230
+Drainageأجي أشوف التكنيك التاني second techniques
+
+192
+00:13:03,230 --> 00:13:06,250
+اللي هو ال vibration is used to in conjunction
+
+193
+00:13:06,250 --> 00:13:11,170
+with طبعا ال percussion to help move secretion إذا
+
+194
+00:13:11,170 --> 00:13:15,190
+ال vibration و ال percussion بيساعدوا على إنه
+
+195
+00:13:15,190 --> 00:13:18,870
+يعملوا move لل secretion in larger airways حتى
+
+196
+00:13:18,870 --> 00:13:22,570
+يطلعوا فيها على ال upper respiratory tract يطلعوا
+
+197
+00:13:22,570 --> 00:13:27,010
+فيها لبره بعد شوية is appliedonly during
+
+198
+00:13:27,010 --> 00:13:32,030
+expiratory phase هنا مهم جدا إنه أنا أعرفهذا الشيء
+
+199
+00:13:32,030 --> 00:13:35,910
+أو هذه التقنيك اللي لازم أعمله في الـExpiratory
+
+200
+00:13:35,910 --> 00:13:39,370
+يعني في الـExhale Inpatient with deep breathing
+
+201
+00:13:39,370 --> 00:13:42,950
+الـ Vibration is applied خلال الـ Placing both
+
+202
+00:13:42,950 --> 00:13:45,890
+hands ممكن أنا عشان أزود اللي هي كمية الـ
+
+203
+00:13:45,890 --> 00:13:50,390
+Vibration أحط اللي هو إيديا فوق بعض عشان أزيد ال
+
+204
+00:13:50,390 --> 00:13:54,350
+pressure في اللي هو chest wall and compressing
+
+205
+00:13:54,350 --> 00:13:57,530
+طبعا و نعمل ضغط رابط ليه Vibrating ال chest wall
+
+206
+00:13:57,530 --> 00:14:02,340
+Inpatient in Breathing outهذا اللي هو التكنيكي
+
+207
+00:14:02,340 --> 00:14:07,740
+التاني الـ pressure is applied in same direction
+
+208
+00:14:07,740 --> 00:14:11,880
+as chest moving نشتغلش اشي عكس اشي لأ way together
+
+209
+00:14:11,880 --> 00:14:15,800
+ايضا ال vibration action is achieved by therapist
+
+210
+00:14:15,800 --> 00:14:19,320
+isometrically contracting in muscles upper
+
+211
+00:14:19,320 --> 00:14:22,380
+extremity and shoulder hands كويس انه انا كمان
+
+212
+00:14:22,380 --> 00:14:26,080
+اعمل عدو هناخد في هذا الفيديو هتشوفوا كيف انا ممكن
+
+213
+00:14:26,080 --> 00:14:31,430
+اعمل chest mobilization بشكل عامThere are
+
+214
+00:14:31,430 --> 00:14:34,970
+techniques اللي احنا هنصاحبه with postural
+
+215
+00:14:34,970 --> 00:14:39,690
+drainage اللي هو حاجة اسمها Shaking هو لاقى
+
+216
+00:14:39,690 --> 00:14:43,730
+الـVagrus from vibration أقوى من الـvibration خلال
+
+217
+00:14:43,730 --> 00:14:49,470
+الـexhale أو خلال الـexpiratory facing طبعا
+
+218
+00:14:49,470 --> 00:14:52,490
+بستخدمه intermittent bouncing maneuver coupled
+
+219
+00:14:52,490 --> 00:14:56,290
+with wide movement of therapist hand هلأ
+
+220
+00:14:56,290 --> 00:14:59,570
+الtherapist كيف بدنا نعمل الشاكينج؟ حكينا الشاكنج
+
+221
+00:14:59,570 --> 00:15:03,310
+side to sideاللي هو therapist's thumb are locked
+
+222
+00:15:03,310 --> 00:15:06,270
+with together and opened and placed directly
+
+223
+00:15:06,270 --> 00:15:09,670
+للpatient's skin and finger warped around chest
+
+224
+00:15:09,670 --> 00:15:13,290
+wall محيطة بالchest wall وأبدأ أعمل اللي هي الشاكن
+
+225
+00:15:13,290 --> 00:15:18,870
+The therapist طبعا بالتزامن مع اللي هو ال compress
+
+226
+00:15:18,870 --> 00:15:24,570
+لازم يكون شاكن لchest wallالان شو هي المواضع حكينا
+
+227
+00:15:24,570 --> 00:15:28,830
+عن ال techniques و خلصنا منهم هنحكي على المواضع في
+
+228
+00:15:28,830 --> 00:15:31,850
+ال postural drainage position ال postural drainage
+
+229
+00:15:31,850 --> 00:15:36,530
+position في عندي مواضع متعددة أهم شي انه انا اعرف
+
+230
+00:15:36,530 --> 00:15:40,830
+وين مكان secretion ايش انا بعرف في secretion ال
+
+231
+00:15:40,830 --> 00:15:45,130
+position are based on the anatomy of lungs and the
+
+232
+00:15:45,130 --> 00:15:49,130
+trachelobroncal tree each segment of each loop is
+
+233
+00:15:49,130 --> 00:15:54,290
+drainedusing لل position اذا بحدد بالظبط انا وين
+
+234
+00:15:54,290 --> 00:15:57,670
+طبعا هذا عن طريق السماعة احنا يا طلاب الأعزاء و
+
+235
+00:15:57,670 --> 00:16:01,310
+طالباتي بنستخدم اللي هو اكتشاف وين ال secretion
+
+236
+00:16:01,310 --> 00:16:05,630
+بالظبط اذا patient may positioned on بصرة لدرناج
+
+237
+00:16:05,630 --> 00:16:10,150
+تابل ممكن احطه على الطاولة لبصرة لدرناج tilt table
+
+238
+00:16:10,150 --> 00:16:14,930
+زي ما انتوا شايفينه reinforced bedTable with lift
+
+239
+00:16:14,930 --> 00:16:18,970
+طبعا او ال hospital bed او ال small child اللي هم
+
+240
+00:16:18,970 --> 00:16:22,930
+حالة خاصة انه انا ممكن اجعدهم بيه اللي هو بحضني او
+
+241
+00:16:22,930 --> 00:16:26,810
+حضن احد الأبواين تمام هاي ال position اللي انا
+
+242
+00:16:26,810 --> 00:16:30,350
+ممكن احط عليها ال patient و اعمل بشرة الدراجة
+
+243
+00:16:30,350 --> 00:16:33,550
+شوفوا كيف هنا بال sitting position كيف المريض جاعد
+
+244
+00:16:33,550 --> 00:16:35,370
+ليه هاي اللي جاعدها اذا انا بدأش اشتغل على ال
+
+245
+00:16:35,370 --> 00:16:39,110
+anterior apical segment اما هنا على ال posterior
+
+246
+00:16:39,110 --> 00:16:43,070
+apical segment لأنه lean forward sitting جاعد ليه؟
+
+247
+00:16:43,200 --> 00:16:47,200
+فبالتالي هنا بستخدم الـ percussion طبعاً على الـ
+
+248
+00:16:47,200 --> 00:16:50,180
+scapula your fingers curve over the top of
+
+249
+00:16:50,180 --> 00:16:53,820
+shoulders لفوق من الشoulder فبالتالي هنا هذا ال
+
+250
+00:16:53,820 --> 00:16:57,160
+posterior apical segment لحالة اللي هي ال
+
+251
+00:16:57,160 --> 00:17:00,640
+posterior اللي هو secretion متكونة في الapical
+
+252
+00:17:00,640 --> 00:17:04,540
+posterior ال upper loop في ال anterior هنا في
+
+253
+00:17:04,540 --> 00:17:07,860
+وضعية ال supine position طبعاً هنا ال percussion
+
+254
+00:17:07,860 --> 00:17:10,380
+هنا هيحددنا بعض الصور لل percussion و اللي أنا
+
+255
+00:17:10,380 --> 00:17:13,900
+لازم أعمله في ال upper loopالـ posterior segment
+
+256
+00:17:13,900 --> 00:17:19,000
+للـ right loops حوالي turn 45 و بحط pillow ورا
+
+257
+00:17:19,000 --> 00:17:22,400
+دهره و تحت بطنيه يعني هو لا هو جايني brawn
+
+258
+00:17:22,400 --> 00:17:26,420
+position ولا جاي subine position ما بين البينين ال
+
+259
+00:17:26,420 --> 00:17:29,420
+angular اللي هي عبارة عن إيش هذا الوضعي هذا يسميها
+
+260
+00:17:29,420 --> 00:17:34,840
+ال angular إنه ال head down و ال feet up و جايني
+
+261
+00:17:34,840 --> 00:17:39,360
+بوضعية اللي هي لا هو subine ولا هو brawn ال
+
+262
+00:17:39,360 --> 00:17:44,850
+patientlies in one quarter turned جايين بربع نصف
+
+263
+00:17:44,850 --> 00:17:48,430
+بعين right side support للبلو تلاتين درجة head
+
+264
+00:17:48,430 --> 00:17:51,590
+down position و ال percussion applied under the
+
+265
+00:17:51,590 --> 00:17:55,530
+left breast لأنه في ال anterior زي ما انتوا شايفين
+
+266
+00:17:55,530 --> 00:17:59,790
+هي secretion في ال anterior تمام هذا ال position
+
+267
+00:17:59,790 --> 00:18:04,070
+ما بستخدمه نهائي مع حالات ال head injury على سبيل
+
+268
+00:18:04,070 --> 00:18:08,670
+المثال لأ ال middle lobes ال middle lobes اللي هي
+
+269
+00:18:09,580 --> 00:18:14,380
+الإصابة، الإصابة بتكون في اللي هي الـlung أو متوسط
+
+270
+00:18:14,380 --> 00:18:17,480
+الـlung ال patient كمان في الـone quarter turn
+
+271
+00:18:17,480 --> 00:18:21,800
+from spine for the left side زي ما أنتوا شايفين،
+
+272
+00:18:21,800 --> 00:18:26,560
+قبعالي من خمس عشر إلى تلاتينالـ lower lobe الـ
+
+273
+00:18:26,560 --> 00:18:31,460
+patient في اللي هو الـ brawn position جاية اللي هي
+
+274
+00:18:31,460 --> 00:18:35,140
+secretion في الـ lower lobe أو الـ basal lobe هذه
+
+275
+00:18:35,140 --> 00:18:38,840
+طبعا من الحاجات الصعبة إن أنا أخرجها لأنها جاية في
+
+276
+00:18:38,840 --> 00:18:42,320
+القاعدة تحت في الـ lungs فبالتالي في مسافة طويلة
+
+277
+00:18:42,320 --> 00:18:46,640
+لحد ما أطلعلي على الـ airway أيضا هنا في اللي هي
+
+278
+00:18:46,640 --> 00:18:49,740
+الـ anterior segment بس أيضا في الـ lower lobe في
+
+279
+00:18:49,740 --> 00:18:52,500
+الـ anterior segment للـ lower lobe برضه نفس
+
+280
+00:18:52,500 --> 00:18:56,780
+الكلاماللي هو ال head down و ال feet up و ال
+
+281
+00:18:56,780 --> 00:19:00,900
+position هذا عشان أنا إيش أعمل اللي هو خروج لل
+
+282
+00:19:00,900 --> 00:19:04,800
+secretion هنا في ال posterior segment أيضا بال
+
+283
+00:19:04,800 --> 00:19:08,760
+lower loop ما زلنا مستمرين على ال lower loop
+
+284
+00:19:08,760 --> 00:19:13,840
+laterally اللي هو جالي على الجنب لل lower loop
+
+285
+00:19:13,840 --> 00:19:18,900
+laterally لل right و أنا متأكدة أن هذا الأشي كله
+
+286
+00:19:18,900 --> 00:19:25,040
+أخدته بالمعمل بشكل أفضل ومناسب هناجمع كل اللي هو
+
+287
+00:19:25,040 --> 00:19:30,980
+الـ Segments داخل هاي الـ Slide شو الـ Guidelines
+
+288
+00:19:30,980 --> 00:19:35,200
+تبعتنا؟ أول إشي في عندي General Consideration بدي
+
+289
+00:19:35,200 --> 00:19:39,040
+أعرف كم مرة أنا بدي أعمل بصرا، لا أدرين إيش بدي
+
+290
+00:19:39,040 --> 00:19:43,980
+أعرف الـ Time of Day، من أفضل وقت بدي أعرف كمية
+
+291
+00:19:43,980 --> 00:19:46,860
+الجلسة أو كم هي كمية الجلسة لـ البصرا، لا أدرين
+
+292
+00:19:46,860 --> 00:19:50,720
+إيش هبدأ بالبداية بالـ General Consideration Time
+
+293
+00:19:50,720 --> 00:19:53,530
+of Daynever administrated post-rehydration
+
+294
+00:19:53,530 --> 00:19:57,870
+directly after meal ولا حتى المساج كنا بنعمله بعد
+
+295
+00:19:57,870 --> 00:20:02,930
+اللي هي جلسة أو بعد وجبة من الغذاء coordinate لل
+
+296
+00:20:02,930 --> 00:20:07,230
+treatment with arousal therapy لازم أناسق مابيني و
+
+297
+00:20:07,230 --> 00:20:10,850
+مابين استخدام المريض للبخاخة أو التبخير على سبيل
+
+298
+00:20:10,850 --> 00:20:14,680
+المثال some therapists believeالـ Arousal Therapy
+
+299
+00:20:14,680 --> 00:20:19,040
+مع الـ Humidification وانا بهمني كمية الـ
+
+300
+00:20:19,040 --> 00:20:23,360
+Humidification لأنه هتسهللي عملية الـ Separation
+
+301
+00:20:23,360 --> 00:20:30,460
+أو تفتيت السكريشن إذا كان سميك وكثيف طبعا للي هو
+
+302
+00:20:30,460 --> 00:20:33,160
+قبل البصرة لدرنيش بعض الأخصائيين بيقولك لأ أنا
+
+303
+00:20:33,160 --> 00:20:39,080
+لازم في البدايةأشرب مريضي حاجة دافية بالإضافة للي
+
+304
+00:20:39,080 --> 00:20:44,260
+هو ياخد تبخيرة على سبيل المثال هذا بيزيد اللي هو
+
+305
+00:20:44,260 --> 00:20:46,960
+أو بيساعد في ال «losing» للـ «secretion»
+
+306
+00:20:46,960 --> 00:20:50,220
+و«increasing» للـ «likehood» اللي هو productivity
+
+307
+00:20:50,220 --> 00:20:53,160
+بيساعد طبعا في إنتاج إنه الـ «cuffing» تكون
+
+308
+00:20:53,160 --> 00:20:57,680
+productive يعني مقشعة يعني فيها بلغا على سبيل
+
+309
+00:20:57,680 --> 00:21:01,500
+المثال إنه بيصير سهل جدا خروج هذا ال «waste
+
+310
+00:21:01,500 --> 00:21:04,650
+product»Other believes arousal therapy is the best
+
+311
+00:21:04,650 --> 00:21:08,630
+after posture drainage لكن بعض الأخصائيين على سبيل
+
+312
+00:21:08,630 --> 00:21:12,690
+المثال بقول لك لأ احنا لأ نعمله بعد اللي هو الـ
+
+313
+00:21:12,690 --> 00:21:16,130
+posture drainage when patient lungs are clear and
+
+314
+00:21:16,130 --> 00:21:18,770
+maximal benefit can again with medication as
+
+315
+00:21:18,770 --> 00:21:21,770
+inserted to cuff arousal therapy choose the time
+
+316
+00:21:22,130 --> 00:21:25,770
+and daily life may be most benefit of patient انت
+
+317
+00:21:25,770 --> 00:21:30,710
+شوف اختيارك للوقت او اختيارك لتوقيت اللي هو ال
+
+318
+00:21:30,710 --> 00:21:34,690
+humidification بيتمد حسب الحالة او حسب ما انت تريح
+
+319
+00:21:34,690 --> 00:21:38,510
+في الحالة او حسب اللي هي الحالة وما تستطيعي في ذلك
+
+320
+00:21:38,510 --> 00:21:42,570
+ال patient can tend highly productive in early
+
+321
+00:21:42,570 --> 00:21:46,970
+morningbecause a communication of secretion from
+
+322
+00:21:46,970 --> 00:21:52,350
+night before طبعا أفضل إشي أنه أنا ال patient تبعي
+
+323
+00:21:52,350 --> 00:21:56,390
+يكون أو يعمل الجلسة يعني بالعادة كنا في المستشفى
+
+324
+00:21:56,390 --> 00:22:00,770
+في قسم الصدرية بنعملها باكرا بالصباح ليش؟ لأن
+
+325
+00:22:00,770 --> 00:22:04,350
+سبحان الله كل ال secretion بيبقى طالع لفوق يعني
+
+326
+00:22:04,350 --> 00:22:07,750
+حتى اللي في ال basal حتى اللي هوفي الـ middle loop
+
+327
+00:22:07,750 --> 00:22:10,750
+كله بيكون طالع على الـ upper respiratory tract
+
+328
+00:22:10,750 --> 00:22:14,190
+فبتلاقي المريض سبحان الله بيقولك أنا مخنوق، ليش؟
+
+329
+00:22:14,190 --> 00:22:17,770
+لأنه في عنده secretion وفي عنده blocking في الـ
+
+330
+00:22:17,770 --> 00:22:20,270
+airway فبالتالي هنا أنا لو عملت postural drainage
+
+331
+00:22:20,270 --> 00:22:24,170
+هيكون سهل جدا أن المريض يعملي cuffing ويطلع هذا
+
+332
+00:22:24,170 --> 00:22:27,610
+secretion الـ postural drainage in early evening
+
+333
+00:22:27,610 --> 00:22:31,530
+كمان مهم جدا يعني في بداية الصباح وفي بداية المساء
+
+334
+00:22:31,840 --> 00:22:35,760
+ليه؟ حتى ينام ليلته جيدا لإنه طبعا لو كان فيه
+
+335
+00:22:35,760 --> 00:22:39,100
+secretion و سدره مازال بيجعلها الطفل ماحيعرف ينام
+
+336
+00:22:39,100 --> 00:22:44,940
+منيح okay سواء للكبار أو الصغار الآن أخدنا ال time
+
+337
+00:22:44,940 --> 00:22:51,700
+بدي أخد ال frequency of treatment كام مرة الآن هذا
+
+338
+00:22:51,700 --> 00:22:56,020
+بيعتمد على اللي هو ال type and severity of patient
+
+339
+00:22:56,020 --> 00:23:01,920
+في ال pathology تبعات المريضكم هي حدة الحالة جدّي
+
+340
+00:23:01,920 --> 00:23:08,240
+أنا عندي secretion هل هو few؟ هل هو lot؟ كيف وضعه؟
+
+341
+00:23:08,240 --> 00:23:13,080
+فبالتالي أنه هيكون هذا بيعتمد حسب الحالة if
+
+342
+00:23:13,080 --> 00:23:16,360
+secretions are thick and compressed طبعا إذا كان
+
+343
+00:23:16,360 --> 00:23:20,780
+ال secretion سميك وكثيف من مرتين لأربع مرات
+
+344
+00:23:20,780 --> 00:23:25,320
+بستخدمه خلال اليوم may necessary until lungs are
+
+345
+00:23:25,320 --> 00:23:29,530
+clear if patient is on maintenance programالـ
+
+346
+00:23:29,530 --> 00:23:33,470
+frequency is less اللي كان المريض يعني ماعنده كتير
+
+347
+00:23:33,470 --> 00:23:36,650
+على إيش أنا أعمل أربع مرات لأ بعمل أقل من هيك
+
+348
+00:23:36,650 --> 00:23:42,670
+perhaps once a day or only few days a week okay
+
+349
+00:23:42,670 --> 00:23:47,010
+لأن ال preparation للبصرة للدرناج تحضيرنا لمريضنا
+
+350
+00:23:47,010 --> 00:23:52,090
+قبل البصرة للدرناج losing لأي tight أو اللي هي
+
+351
+00:23:52,090 --> 00:23:55,830
+bulky clothes عشان أعرف أشتغل اللي هو ال manual
+
+352
+00:23:55,830 --> 00:23:58,980
+therapy على سبيل المثالIt is not necessary to
+
+353
+00:23:58,980 --> 00:24:03,200
+expose the skin ولكن مش بدلولة ان انا اعري لكل شي
+
+354
+00:24:03,200 --> 00:24:06,520
+حتى اوصل ال skin Have sebutum cuff or tissue
+
+355
+00:24:06,520 --> 00:24:11,950
+available Have sufficient belowبدي وضع مخدات ممكن
+
+356
+00:24:11,950 --> 00:24:15,130
+احتجهم تحت الابدومين او اذا انا بدي اعمل ال one
+
+357
+00:24:15,130 --> 00:24:18,770
+quarter اني احط اشي ورا الظاهر واشي من ناحية
+
+358
+00:24:18,770 --> 00:24:21,970
+الامام الانتريال explain لل treatment procedure
+
+359
+00:24:21,970 --> 00:24:26,870
+for patient طبعا لأي انا تقنيك بدي اعمله لازم
+
+360
+00:24:26,870 --> 00:24:30,050
+اشرحه لل patient ويا حبة ده اذا فيه exercise انا
+
+361
+00:24:30,050 --> 00:24:34,370
+بعملهم لحالي و بوريهمياتعلم للبيتشان Deep
+
+362
+00:24:34,370 --> 00:24:40,110
+Breathing وCoughing قبل البصرة لانه يعملهم بعد
+
+363
+00:24:40,110 --> 00:24:49,070
+البصرة لانه يعملهم
+
+364
+00:24:49,070 --> 00:24:51,710
+بعد البصرة لانه يعملهم بعد البصرة لانه يعملهم بعد
+
+365
+00:24:51,710 --> 00:24:52,870
+البصرة لانه يعملهم بعد البصرة لانه يعملهم بعد
+
+366
+00:24:52,870 --> 00:24:53,250
+البصرة لانه يعملهم بعد البصرة لانه يعملهم بعد
+
+367
+00:24:53,250 --> 00:24:53,250
+البصرة لانه يعملهم بعد البصرة لانه يعملهم بعد
+
+368
+00:24:53,250 --> 00:24:53,250
+البصرة لانه يعملهم بعد البصرة لانه يعملهم بعد
+
+369
+00:24:53,250 --> 00:24:53,250
+البصرة لانه يعملهم بعد البصرة لانه يعملهم بعد
+
+370
+00:24:53,250 --> 00:24:54,010
+البصرة لانه يعملهم بعد البصرة لانه يعملهم بعد
+
+371
+00:24:54,010 --> 00:24:57,570
+البصرة لانه يعملهم بعد البصرة لانه يعملهم بعد
+
+372
+00:24:57,570 --> 00:25:03,640
+البصرة لانه يعملهملكن إذا كان مش جادر يعملها
+
+373
+00:25:03,640 --> 00:25:06,840
+voluntary فأنا بستخدم اللي هو section machine
+
+374
+00:25:06,840 --> 00:25:12,540
+وبحاول أشفطله من اللي هو الـsebutam اللي تحلل أو
+
+375
+00:25:12,540 --> 00:25:17,980
+اللي طلع على الأبار«برونكاي» «make any adjustment
+
+376
+00:25:17,980 --> 00:25:21,840
+tube» طبعا إذا كان أنا مريضي طبعا في ال ICU على
+
+377
+00:25:21,840 --> 00:25:25,800
+سبيل المثال وفي عندنا wires وفي عندنا tubes وفي
+
+378
+00:25:25,800 --> 00:25:31,440
+عندنا ECG electrodes وهذه الأمور لازم أنا أشوف
+
+379
+00:25:31,440 --> 00:25:35,500
+طريقة إنه أنا أعدل أعمل adjustable إنه أنا أكون
+
+380
+00:25:35,500 --> 00:25:39,580
+طبعا قابلة للتعديل في اللي هو ال position تبعي
+
+381
+00:25:39,580 --> 00:25:44,990
+اللي مع المريضالـ Anxious Sequences بدي استخدم
+
+382
+00:25:44,990 --> 00:25:48,190
+which segment للـ lung should be determined مش أنا
+
+383
+00:25:48,190 --> 00:25:53,410
+بدي أشتغل على أي وضع على أي مكان لأ أنا لازم أشتغل
+
+384
+00:25:53,410 --> 00:25:58,030
+وين أنا بالذات عندي فيه secretion some patients
+
+385
+00:25:58,030 --> 00:26:00,810
+with chronic lung disease such as cystic fibrosis
+
+386
+00:26:00,810 --> 00:26:04,850
+need to drain all position لأن هاي الناس في cystic
+
+387
+00:26:04,850 --> 00:26:09,850
+fibrosis عندها كمية لبأس بيها من اللي هو secretion
+
+388
+00:26:09,850 --> 00:26:13,450
+other patients may requiredDrainage of only few
+
+389
+00:26:13,450 --> 00:26:16,430
+segments in which secretions have communicated
+
+390
+00:26:16,430 --> 00:26:20,870
+«Check للبيشانت vital signs» لازم أاخد الـ «vital
+
+391
+00:26:20,870 --> 00:26:26,410
+signs» قبل اللي هو الـ «patient drainage» للبيشانت
+
+392
+00:26:26,410 --> 00:26:30,390
+حتى أشوف أنا شغالة صح ولا مش صح خصوصا الـ
+
+393
+00:26:30,390 --> 00:26:33,890
+«breathing sound» لازم أشوفه اتحسن ولا ما اتحسنش
+
+394
+00:26:34,370 --> 00:26:37,090
+أيضا بدي أشوف ال patient التبعي إذا كان
+
+395
+00:26:37,090 --> 00:26:39,910
+comfortable أو relaxed comfortable و relaxed ولا
+
+396
+00:26:39,910 --> 00:26:43,710
+لأ stand in front of patient عشان أشوف إذا لا سمح
+
+397
+00:26:43,710 --> 00:26:47,750
+الله في اختناق أو فيش اختناق أو أشوف اللي هو ال
+
+398
+00:26:47,750 --> 00:26:51,470
+facial expression طبعا و احنا عارفين هذا الحكي
+
+399
+00:26:51,470 --> 00:26:55,710
+جيدا ال maintain each position من خمسة لعشرة
+
+400
+00:26:55,710 --> 00:27:00,690
+minutes if patient tolerant إذا استمرمعانا الوضع
+
+401
+00:27:00,690 --> 00:27:05,710
+أو إذا استحمل أو تحمل ال patient فإحنا سليم أما
+
+402
+00:27:05,710 --> 00:27:09,210
+إذا لأ وبينت عندي بعض العلامات اللي هو ال facial
+
+403
+00:27:09,210 --> 00:27:12,410
+expression كانت لتوحي إنه بخير على طول نعمل
+
+404
+00:27:12,410 --> 00:27:16,830
+stopping لل exercise ونوقف التدريب have لل patient
+
+405
+00:27:16,830 --> 00:27:19,710
+breathing deeply during a drainage but don't allow
+
+406
+00:27:19,710 --> 00:27:23,790
+لل patient hyperventilating في أي موقع في أي مكان
+
+407
+00:27:23,790 --> 00:27:27,990
+بمنع ال hyperventilationor become short of
+
+408
+00:27:27,990 --> 00:27:31,150
+breathing هذا الأشياء أنا بمنعه okay أنا طلبت منه
+
+409
+00:27:31,150 --> 00:27:33,890
+في الـ postural drainage أنه okay اعمل ليه دي ب
+
+410
+00:27:33,890 --> 00:27:38,150
+breathing ولكن ما توصل لمرحلة الـ hyperventilation
+
+411
+00:27:38,150 --> 00:27:42,530
+ال bears live مهم جدا ال breathing من أنواع ال
+
+412
+00:27:42,530 --> 00:27:45,470
+breathing exercise أخذناها is sometimes used
+
+413
+00:27:45,470 --> 00:27:49,850
+بستخدمها في اللي هو خلال ال postural adrenage
+
+414
+00:27:49,850 --> 00:27:55,880
+apply percussionطبعا طبق الـ percussions خلال الـ
+
+415
+00:27:55,880 --> 00:27:58,680
+segment أو خلال اللي هو why ال patient in correct
+
+416
+00:27:58,680 --> 00:28:02,820
+position encourage لل patient to take deep sharp
+
+417
+00:28:02,820 --> 00:28:08,400
+double cuffing طبعا whenever necessary it may more
+
+418
+00:28:08,400 --> 00:28:12,500
+comfortable for patient to point really assume
+
+419
+00:28:12,500 --> 00:28:16,660
+semi upright position أحطله تلت أربع مخدات ورا
+
+420
+00:28:16,660 --> 00:28:20,840
+دهره ويكون في ال semi upright position if patient
+
+421
+00:28:20,840 --> 00:28:25,060
+does not cuffفبتناصلي during positioning with
+
+422
+00:28:25,060 --> 00:28:27,880
+percussion instruct لل patient take several deep
+
+423
+00:28:27,880 --> 00:28:31,560
+breathing and then huffing هو مش قادر يعطيني
+
+424
+00:28:31,560 --> 00:28:34,960
+cuffing فبالتالي بخليه يعمل كذا مرة deep breathing
+
+425
+00:28:34,960 --> 00:28:40,700
+ويتبعها بال huffing وهذا بيقدي الغرض بعد طبعا هيك
+
+426
+00:28:40,700 --> 00:28:44,520
+لازم انا اجيب suction machine خلال ال expiration
+
+427
+00:28:44,520 --> 00:28:49,280
+this may help to elicit cuffing ممكن بعد شوية هذا
+
+428
+00:28:49,280 --> 00:28:53,920
+يعمل stimulation لعمليات ال cuffingIf patient
+
+429
+00:28:53,920 --> 00:28:57,300
+cough is not productive after 5 to 10 minutes، ال
+
+430
+00:28:57,300 --> 00:29:00,120
+position go to the next position، شوف ال position
+
+431
+00:29:00,120 --> 00:29:04,060
+التاني Secretions that have been mobilized during
+
+432
+00:29:04,060 --> 00:29:09,760
+treatment may not cough up until 30 minutes to one
+
+433
+00:29:09,760 --> 00:29:14,350
+hour after treatmentخلال الـ duration high أي
+
+434
+00:29:14,350 --> 00:29:18,410
+treatment should not exceed مش لازم ازديد نهائي عن
+
+435
+00:29:18,410 --> 00:29:24,230
+45 ل 60 دقيقة يعني أنا ما أبالغ في ال exercise as
+
+436
+00:29:24,230 --> 00:29:28,250
+procedures is quite fatiguing for patient لأن هذا
+
+437
+00:29:28,250 --> 00:29:33,090
+هيرهق المريض شوفوا لو كان elderly أو لو كان post
+
+438
+00:29:33,090 --> 00:29:39,450
+-operative فالأمر هيكون متعب لهذه الناسالان ختم
+
+439
+00:29:39,450 --> 00:29:42,550
+الجلسة أو ختم جلسة العلاج Concluding لل treatment
+
+440
+00:29:42,550 --> 00:29:46,850
+Have the patient sit up slowly طبعا أنا كنت حاطة
+
+441
+00:29:46,850 --> 00:29:49,590
+ال patient في وضعيت subine او prone او one quarter
+
+442
+00:29:49,590 --> 00:29:53,150
+فبالتالي انا هخاف عليه من ال hypertension اللي هو
+
+443
+00:29:53,150 --> 00:29:58,140
+البشر ال hypertension فانا لازم احطهبشواش أو
+
+444
+00:29:58,140 --> 00:30:01,900
+بوضعية هادئة جدا في اللي هو الـ sitting position
+
+445
+00:30:01,900 --> 00:30:07,240
+بعدين أبدأ بالتدريج أنه أنا أخلي في ال stand
+
+446
+00:30:07,240 --> 00:30:10,420
+position أو وضعيات أخرى advice لل patient that
+
+447
+00:30:10,420 --> 00:30:14,380
+even if cough was not productive خلال treatment it
+
+448
+00:30:14,380 --> 00:30:18,490
+may be productive بعد اللي هو session تبعتييعني
+
+449
+00:30:18,490 --> 00:30:21,230
+إذا ما جدر يعمل cuffing و يطلع ال secretion خلال
+
+450
+00:30:21,230 --> 00:30:25,530
+البصرة للدرناج ممكن يعمله خلال اللي هو ال cuffing
+
+451
+00:30:25,530 --> 00:30:31,590
+بعد الجلسة بدقائق أو فترة معينةطبعا أنا كي بدي
+
+452
+00:30:31,590 --> 00:30:35,170
+أقيم فعالية اللي هي الجلسة تبعتي عن طريق الـ
+
+453
+00:30:35,170 --> 00:30:37,590
+Breathing Sound كنا حكينا عليه في البداية تبع
+
+454
+00:30:37,590 --> 00:30:41,810
+الجلسة أنه أنا بسمع اللي هو هل فيه Krebitas هل فيه
+
+455
+00:30:41,810 --> 00:30:45,170
+secretion ما زال عندي مسموع لأ إذا كان أنا
+
+456
+00:30:45,170 --> 00:30:49,330
+بالبداية كنت سمعها كويس و بعد ال session باجي بحط
+
+457
+00:30:49,330 --> 00:30:53,210
+بالسمعة و بسمع ال Breathing Soundإذا كان ما زال
+
+458
+00:30:53,210 --> 00:30:56,570
+موجود معناته أنا ما طلع المريض عندي إشي و الجلسة
+
+459
+00:30:56,570 --> 00:31:00,950
+تقيمها ليس بجيد ولكن إذا كان الصوت واضح وإنه مافي
+
+460
+00:31:00,950 --> 00:31:07,070
+إشي و الـ Airway Clearance فأنا وصلت لهدفي الآن
+
+461
+00:31:07,070 --> 00:31:10,570
+الـ Type و الـ Color و الـ Consistency تبعته الـ
+
+462
+00:31:10,570 --> 00:31:14,570
+Secretion و الـ Amount مهمة جدا إنه أنا عارفها
+
+463
+00:31:15,250 --> 00:31:18,410
+check up لل patient vital signs after treatment
+
+464
+00:31:18,410 --> 00:31:22,510
+and note how patient tolerate لل treatment كمان
+
+465
+00:31:22,510 --> 00:31:25,970
+هاي مهمة حتى أشوف قداش ال tolerance تبع ال patient
+
+466
+00:31:25,970 --> 00:31:32,010
+اللي أنا شغالة معاه في أنا عندي مواضيع اللي هو ال
+
+467
+00:31:32,010 --> 00:31:36,390
+modifications إنه أنا على سبيل المثال بتأقلم مع
+
+468
+00:31:36,390 --> 00:31:39,990
+الوضعية اللي أنا فيها إذا كان المريض تبعي في عنده
+
+469
+00:31:39,990 --> 00:31:45,470
+على سبيل المثال مريضبيكون في مضاعية صعبة جدا إنه
+
+470
+00:31:45,470 --> 00:31:51,210
+أنا أحطه في الـ semisubine أو الـ prone position
+
+471
+00:31:51,210 --> 00:31:55,870
+فبالتالي أنا هنا لازم أعمله adjustable أو أخليه
+
+472
+00:31:55,870 --> 00:31:59,470
+أعمله adjusting للي هو ال position okay for
+
+473
+00:31:59,470 --> 00:32:01,830
+example ال patient with congestive heart failure
+
+474
+00:32:01,830 --> 00:32:06,360
+مايكسبتindicated of orthopenia طبعا لإنه
+
+475
+00:32:06,360 --> 00:32:09,200
+congestive heart failure after neurosurgery
+
+476
+00:32:09,200 --> 00:32:12,260
+patient كمان may not allowed to assume head down
+
+477
+00:32:12,260 --> 00:32:15,840
+زي ما حكينا في بداية الفيديو إنه أنا صعب جدا إنه
+
+478
+00:32:15,840 --> 00:32:18,680
+أنا أحط هاي الناس في وضع لتريندلينبيرج position
+
+479
+00:32:18,680 --> 00:32:23,120
+ليه لإنه بزيد ال inter cranial pressure في هاي
+
+480
+00:32:23,120 --> 00:32:26,940
+الوضعية وبالتالي أنا لازم أشوف اللي هو وضعية أخرى
+
+481
+00:32:26,940 --> 00:32:31,600
+هذا هو لتريندلينبيرج اللي هو position هذا ال
+
+482
+00:32:31,600 --> 00:32:35,310
+positionصعب على الحالة التالية after thoracic
+
+483
+00:32:35,310 --> 00:32:38,570
+surgery ال patient may have chest tube في عندنا ال
+
+484
+00:32:38,570 --> 00:32:41,430
+monitoring wires في عندنا بعض الأشياء اللي بتكون
+
+485
+00:32:41,430 --> 00:32:44,370
+على المريض هنا لازم انا اخد بالي من هنا بكويس
+
+486
+00:32:44,370 --> 00:32:47,710
+under the circumstances and other positioning خلال
+
+487
+00:32:47,710 --> 00:32:51,050
+postural drainage must be modified the position in
+
+488
+00:32:51,050 --> 00:32:53,270
+which postural drainage is undertaking
+
+489
+00:32:53,270 --> 00:32:56,570
+modification هذه الأمور لازم انا اخدها بعين
+
+490
+00:32:56,570 --> 00:33:02,600
+الاعتبار و اعدل من الوضعية مع المريض الhomogramلأن
+
+491
+00:33:02,600 --> 00:33:05,160
+أنا عملت الجلسة عندي في المستشفى و تمام التمام و
+
+492
+00:33:05,160 --> 00:33:08,820
+لازم أعلم ال patient كيف يعمل اللي هو ال home
+
+493
+00:33:08,820 --> 00:33:12,240
+program تبعته البصر ال DNA may have carried out
+
+494
+00:33:12,240 --> 00:33:15,280
+regular basis لل home patient in chronic disease
+
+495
+00:33:16,060 --> 00:33:19,880
+كتير كويس أنا أعلم الأم إذا كان طفلها بيعاني من
+
+496
+00:33:19,880 --> 00:33:23,680
+اللي هو الـChronic Bronchitis إن هي كمان تعمل
+
+497
+00:33:23,680 --> 00:33:27,420
+الـCuffing أو تعمل الـPost-rehydration في البيت و
+
+498
+00:33:27,420 --> 00:33:31,220
+أعطيها الـHome Program الـpatient need to be shown
+
+499
+00:33:31,220 --> 00:33:35,220
+how to position themselves using inexpensive aids
+
+500
+00:33:35,220 --> 00:33:38,560
+كمان إحنا لو علمنا المريض بعض الـexercise أو بعض
+
+501
+00:33:38,560 --> 00:33:41,880
+الـposition إنه يشتغلها في البيت و تكون طبعا
+
+502
+00:33:41,880 --> 00:33:47,520
+freelyإن adult may place pillow طبعا أو أي واج
+
+503
+00:33:47,520 --> 00:33:51,220
+ممكن يشتغل فيها ال patient also lean to chestward
+
+504
+00:33:51,220 --> 00:33:55,680
+للbed and resting with arms, chair or stool من أي
+
+505
+00:33:55,680 --> 00:33:59,940
+شيء من البيت أنا ممكن أخلي الأم تصنع اللي هو roll
+
+506
+00:33:59,940 --> 00:34:05,200
+تصنع بعض ال pillow اللي هتكون مساعدة لاستخدامها
+
+507
+00:34:08,090 --> 00:34:11,650
+الاطفال position تبعهم أو وضعيات الأطفال in
+
+508
+00:34:11,650 --> 00:34:16,090
+ironing board proper against sofa or heavy chairs
+
+509
+00:34:16,090 --> 00:34:20,590
+يا بحطهم على الكنابة أو بحطهم على كرسي بيكون شوية
+
+510
+00:34:20,590 --> 00:34:25,210
+دبيل family members often family members often
+
+511
+00:34:25,210 --> 00:34:28,430
+must do proper positioning ال percussion و ال
+
+512
+00:34:28,430 --> 00:34:32,250
+shaking و التكنيكس ممكن أعلمهميا يعني بنعلم الام
+
+513
+00:34:32,250 --> 00:34:35,790
+يا بنعلم أي حد من ال caregiver انه يشتغل ال manual
+
+514
+00:34:35,790 --> 00:34:39,330
+therapyGuidelines and Percussions to assist
+
+515
+00:34:39,330 --> 00:34:43,370
+للpatient previously discussed و should be اللي هو
+
+516
+00:34:43,370 --> 00:34:46,950
+طبعا بعض ال guidelines و بعض ال percussions أنا
+
+517
+00:34:46,950 --> 00:34:51,250
+لازم أتبعهم و أعلمهم لل patient و إنه دائما يكون
+
+518
+00:34:51,250 --> 00:34:54,570
+حذر في التعامل في الوضعيات خصوص إذا كان
+
+519
+00:34:54,570 --> 00:35:00,830
+neurosurgery أو إذا كان أي حد اعمله اللي هو الجلسة
+
+520
+00:35:02,490 --> 00:35:06,970
+وقتاش انا لازم اقطع اللي هي جلسة البصرة يا دلنياش
+
+521
+00:35:06,970 --> 00:35:11,850
+if chest radiograph is relatively clear خلصنا كده
+
+522
+00:35:11,850 --> 00:35:14,830
+ال patient تبعي تمام تمام و ال breathing sound
+
+523
+00:35:14,830 --> 00:35:22,010
+عنده سليم if patient ephebrial هذا مهم جدا إذا كان
+
+524
+00:35:22,010 --> 00:35:28,490
+مريضي ephebrial من 24 ل 48 ساعة if normal or near
+
+525
+00:35:28,490 --> 00:35:33,450
+normal breathe sound are heardwith escalations إذا
+
+526
+00:35:33,450 --> 00:35:38,450
+كان قريب أو شبه قريب في اللي هو سماعي لصوت
+
+527
+00:35:38,450 --> 00:35:43,270
+الـbreathing تبعه الآن هتحدث أيضًا عن اللي هي
+
+528
+00:35:43,270 --> 00:35:46,550
+الـImproving Exercise Tolerance الـExercise
+
+529
+00:35:46,550 --> 00:35:49,850
+Tolerance اللي هي عبارة عن القابلة تبع الpatient
+
+530
+00:35:49,850 --> 00:35:53,070
+إنه يعمل الـexercise طبعًا الـmuscle weakness
+
+531
+00:35:53,070 --> 00:35:56,590
+والسكلتل involuntary والسكلتل involuntary muscle
+
+532
+00:35:56,590 --> 00:36:00,350
+is common في الـCOPD patientلازم اعمله
+
+533
+00:36:00,350 --> 00:36:03,610
+strengthening exercise هنا هتكلم عن chest mobility
+
+534
+00:36:03,610 --> 00:36:07,330
+و هتحدث عن بعض ال exercise to strengthening
+
+535
+00:36:07,330 --> 00:36:12,270
+exercise ال exercise ال mobilization chest اللي هو
+
+536
+00:36:12,270 --> 00:36:15,730
+ليش حتى انا تكون عندي ال respiratory muscles و
+
+537
+00:36:15,730 --> 00:36:18,570
+تكون عندي مش بس ال mainly muscles اللي انا شغالة
+
+538
+00:36:18,570 --> 00:36:21,050
+عليها ايضا شغالة على كل ال respiratory muscles و
+
+539
+00:36:21,050 --> 00:36:24,750
+ال trunk و ال shoulder girdle و كل ال upper ال
+
+540
+00:36:24,750 --> 00:36:28,790
+trunk انا بديه يكون goodفبالتالي على سبيل المثال
+
+541
+00:36:28,790 --> 00:36:31,690
+الـ patient with hypomobility لـ tranquil muscle
+
+542
+00:36:31,690 --> 00:36:34,870
+site to the bed does not expand the part of chest
+
+543
+00:36:34,870 --> 00:36:38,630
+fully during inspiration أنا بهمني اللي هو الـ
+
+544
+00:36:38,630 --> 00:36:42,310
+full expiration و الـ full inspiration اللي هيصير
+
+545
+00:36:42,310 --> 00:36:46,180
+في عمليات ال respiratory systemالـ exercise
+
+546
+00:36:46,180 --> 00:36:49,880
+combined with stretching مهم جدا أنه أنا أساعد
+
+547
+00:36:49,880 --> 00:36:52,960
+المرضى تبعيني في ال range of motion exercise
+
+548
+00:36:52,960 --> 00:36:56,760
+بالإضافة لل stretching exercise أيضا أبقى ساعد
+
+549
+00:36:56,760 --> 00:36:59,580
+اللي هو ال patient في ال reinforcing لل expiration
+
+550
+00:36:59,580 --> 00:37:04,000
+leaning forward لل hips and flexing supine أو اللي
+
+551
+00:37:04,000 --> 00:37:07,460
+هي breathe out this pushing out viscera superiorly
+
+552
+00:37:07,460 --> 00:37:11,300
+and into diaphragmزي ما حكيت الحدث من هذا ال
+
+553
+00:37:11,300 --> 00:37:14,600
+exercise كله إنه أعمل strengthening and
+
+554
+00:37:14,600 --> 00:37:18,580
+mobilization ل chest عند ال patient اللي في قسم
+
+555
+00:37:18,580 --> 00:37:22,540
+الصدرية بعض ال techniques اللي أنا بدأ أستخدمهم
+
+556
+00:37:22,540 --> 00:37:28,090
+اللي هي mobilize one side of chestالآن في عندي كذا
+
+557
+00:37:28,090 --> 00:37:32,130
+mobilization أو كذا position أنا هستخدمه زي ما
+
+558
+00:37:32,130 --> 00:37:35,310
+هتشوفوه في الصور هنا عندي two chest mobilization
+
+559
+00:37:35,310 --> 00:37:39,130
+inspiration and expiration أيضا بعمل laterally
+
+560
+00:37:39,130 --> 00:37:44,410
+اللي هي mobilization bend from side to sideهذا مهم
+
+561
+00:37:44,410 --> 00:37:47,630
+جدا ت mobilize ال upper chest و ال pectoralis
+
+562
+00:37:47,630 --> 00:37:52,870
+muscles و احنا عارفين كده مهم جدا عمل و اهمية ال
+
+563
+00:37:52,870 --> 00:37:56,190
+pectoralis muscles سواء ال major او ال minor while
+
+564
+00:37:56,190 --> 00:38:00,110
+patient in sitting position و بخليه يعمل اللي هي
+
+565
+00:38:00,110 --> 00:38:03,930
+auto exercise او auto self exercise في ال range of
+
+566
+00:38:03,930 --> 00:38:08,530
+motion exerciseكما هو موضح بالصور تموباليز ال
+
+567
+00:38:08,530 --> 00:38:12,150
+upper chest and shoulder طبعا زي ما انتوا شايفين
+
+568
+00:38:12,150 --> 00:38:20,470
+هنا بيعمل اللي هو انثناء flex ل ال lumber area
+
+569
+00:38:20,470 --> 00:38:24,410
+و هنا بيعمل اللي هو full stretching في حالة اللي
+
+570
+00:38:24,410 --> 00:38:29,990
+هي ال shoulder joint و upright position ل ال back
+
+571
+00:38:29,990 --> 00:38:37,810
+و بهيك بيكون أن هنا مساقنالهذا الفصل ويعطيك ألف
+
+572
+00:38:37,810 --> 00:38:40,230
+عافية بإذن الله تعالى
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/15HwhIYihT4.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/15HwhIYihT4.srt
new file mode 100644
index 0000000000000000000000000000000000000000..aa1270b1bd4817a9f633ce4530db6b57a6571d23
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/15HwhIYihT4.srt
@@ -0,0 +1,1182 @@
+1
+00:00:01,110 --> 00:00:04,690
+بسم الله الرحمن الرحيم صلى الله عليه وعلى محمد
+
+2
+00:00:04,690 --> 00:00:08,530
+وعلى آله وصحبه أجمعين. راح أدخل اليوم في chapter
+
+3
+00:00:08,530 --> 00:00:12,350
+اسمه الـComplication اللي مفعّلة عند عملية الـ
+
+4
+00:00:12,350 --> 00:00:16,210
+cardiothoracic surgery. أخذنا في الـ chapter السابق
+
+5
+00:00:16,210 --> 00:00:21,150
+عن الـ role of physiotherapy أثناء اللي هي pre-
+
+6
+00:00:21,150 --> 00:00:24,410
+operative و post-operative. هنا هنشوف إذا المريض
+
+7
+00:00:24,410 --> 00:00:27,610
+تبعنا هيدخل فيه complication وإيش هي الـ
+
+8
+00:00:27,610 --> 00:00:30,390
+complication وإيش الـ role of physiotherapy
+
+9
+00:00:30,390 --> 00:00:35,030
+أثناءها. نبدأ على بركة الله. الـ role of
+
+10
+00:00:35,030 --> 00:00:38,840
+physiotherapy أثناء الـ complication. في البداية، إيش
+
+11
+00:00:38,840 --> 00:00:43,600
+هي الـ factors اللي ممكن تزيد أو تساهم معايا في الـ
+
+12
+00:00:43,600 --> 00:00:47,600
+postoperative complication؟ أول عامل اللي هو الـ
+
+13
+00:00:47,600 --> 00:00:51,260
+general anesthesia. إشي طبيعي، تعرفوا الـ patient
+
+14
+00:00:51,260 --> 00:00:54,740
+هيدخل open heart surgery، معناة الكلام إنه أنا
+
+15
+00:00:54,740 --> 00:00:59,490
+هخدر وأبنش كل الجسم. هذا هيعمل إيه؟ Decrease
+
+16
+00:00:59,490 --> 00:01:04,190
+للـ Normal Ciliary Actions of Tracheobronchial Tree.
+
+17
+00:01:04,190 --> 00:01:10,330
+الـ Lung نفسها هيصير فيها Decreasing للـ Normal
+
+18
+00:01:10,330 --> 00:01:15,730
+Capacity. Decreasing. ليش؟ لأنه صار فيها إشي جديد دخل
+
+19
+00:01:15,730 --> 00:01:21,650
+على الجسم. أدى لإيش؟ لـ Lung Collapse. لـ Collection
+
+20
+00:01:21,650 --> 00:01:25,090
+of Secretions. كل الأمور هذه بتعيق اللي هي الـ
+
+21
+00:01:25,090 --> 00:01:27,070
+ventilation. أيضا
+
+22
+00:01:29,260 --> 00:01:33,860
+هذا الفنش اللي أخده الـ patient عمل على decrease of
+
+23
+00:01:33,860 --> 00:01:37,640
+respiratory center in central nervous system. كلنا
+
+24
+00:01:37,640 --> 00:01:41,020
+بنعرف إن الـ center of respiratory system موجود
+
+25
+00:01:41,020 --> 00:01:45,080
+داخل الـ central nervous system. بيؤدي لإنه يصير
+
+26
+00:01:45,080 --> 00:01:47,920
+التنفس shallow. Shallow breathing أو shallow
+
+27
+00:01:47,920 --> 00:01:52,380
+respiration. معناته هذا هيقلل اتساع الـ volume
+
+28
+00:01:52,380 --> 00:01:57,020
+اللي هو الـ volume تبع الـ air اللي بتحرك in و out
+
+29
+00:01:57,360 --> 00:02:00,920
+للـ lungs. خلال الـ quality أو الـ quiet of
+
+30
+00:02:00,920 --> 00:02:05,500
+breathing. إذا نتيجة لإن أنا هنا اشتغلت على الـ
+
+31
+00:02:05,500 --> 00:02:10,160
+central nervous system. إن أنا أدخلت المريض في حالة
+
+32
+00:02:10,160 --> 00:02:13,620
+من الكوما أو حالة من الـ unconsciousness. فبالتالي
+
+33
+00:02:13,620 --> 00:02:17,080
+هنا أنا اشتغلت على مستوى عالي في الأجهزة. معناة
+
+34
+00:02:17,080 --> 00:02:21,120
+الكلام إن في عندي shallow respiration. صارت هذه الـ
+
+35
+00:02:21,120 --> 00:02:24,720
+shallow respiration قدّت لقلة في اتساع volume.
+
+36
+00:02:25,340 --> 00:02:29,440
+وأرفنا شو يعني هو اتساع الـ volume. الـ second factor
+
+37
+00:02:29,440 --> 00:02:34,700
+الـ intubation. أكيد طبعا دخل المريض العمليات معناته
+
+38
+00:02:34,700 --> 00:02:40,040
+أنا هحط أو الـ nurse هم اللي هيحطوا tube داخل الفم
+
+39
+00:02:40,040 --> 00:02:44,120
+أو ممكن يكون في tracheostomy اللي هو قطع في
+
+40
+00:02:44,120 --> 00:02:49,680
+التريكيا نفسها وندخل في اللي هو التراكيستومي. الآن
+
+41
+00:02:49,680 --> 00:02:54,300
+الـ intubation هو insertion للـ endotracheal أو
+
+42
+00:02:54,300 --> 00:02:58,580
+nasogastric tube اللي هو الـ NG Tube. احنا
+
+43
+00:02:58,580 --> 00:03:03,920
+بنختصره، تمام؟ إذا زرع أو وضع endotracheal tube
+
+44
+00:03:03,920 --> 00:03:09,280
+بدأ يفوت من الفم للتريكيا مباشرة أو من اللي هو
+
+45
+00:03:09,280 --> 00:03:15,700
+بنسميه الأنبوب المعدي الأنفي اللي هو Nasogastric
+
+46
+00:03:15,700 --> 00:03:20,520
+Tube. الـ irritation. أول Complication هيصير معايا
+
+47
+00:03:20,520 --> 00:03:26,770
+طبعا إشي طبيعي، لأن في زرع هذا الجهاز داخل الجسم
+
+48
+00:03:26,770 --> 00:03:33,290
+هيصير في عندي عملية تهيج في العينّة اللي بتتاخد في
+
+49
+00:03:33,290 --> 00:03:37,410
+الناس اللي شاكين فيهم أن يكونوا عندهم COVID-19
+
+50
+00:03:37,410 --> 00:03:41,150
+لحظوا كيف بتكون مؤلمة. يعني إذا شفتوا كذا فيديو أو
+
+51
+00:03:41,150 --> 00:03:45,030
+شفتوا إشي، فليه؟ لأنه صار في عندنا irritation. صار
+
+52
+00:03:45,030 --> 00:03:49,050
+في عندنا عملية تهييج للـ mucous membrane اللي موجود
+
+53
+00:03:49,050 --> 00:03:53,330
+في اللي هو التريكيا أو في كل الـ respiratory system.
+
+54
+00:03:53,730 --> 00:03:57,410
+إذا الـ intubation هو عبارة عن أول عامل أو أول
+
+55
+00:03:57,410 --> 00:04:01,230
+factors من الـ complications. منها اللي هو الـ mucous
+
+56
+00:04:01,230 --> 00:04:04,750
+lining تبع الـ tracheobronchial tree which causes
+
+57
+00:04:04,750 --> 00:04:08,670
+increasing the mucous production. معناة الكلام، هذا
+
+58
+00:04:08,670 --> 00:04:13,790
+هيزيد من اللي هو الـ mucous production. فبالتالي،
+
+59
+00:04:13,790 --> 00:04:16,830
+decrease للـ Normal Action of Cilia in Pulmonary
+
+60
+00:04:16,830 --> 00:04:21,730
+Tract. هيقلل العمل الأهداب الموجودة في الـ
+
+61
+00:04:21,730 --> 00:04:25,850
+Respiratory System. طبعاً، which lead to pooling of
+
+62
+00:04:25,850 --> 00:04:30,010
+secretion. معناة الكلام، المنطقة كلها هتمتلأ،
+
+63
+00:04:30,010 --> 00:04:34,670
+ليش؟ بإن هو المخاط أو الـ secretion هاي. ليه؟ لأنه
+
+64
+00:04:34,670 --> 00:04:38,630
+دخل عندنا تيوب. لاحظوا التيوب هذا بيكون كتير رفيع
+
+65
+00:04:38,630 --> 00:04:47,540
+ولكن بيعمل تهيج لهذه المنطقة. الانسداد بين الألم
+
+66
+00:04:47,540 --> 00:04:51,000
+المنتج عن العملية نفسه. هذا بيسبب للـ patient أنه
+
+67
+00:04:51,000 --> 00:04:55,140
+يتنفس بشكل سطحي. ليه؟ عشان هو خايف إذا أخد نفس عميق
+
+68
+00:04:55,140 --> 00:05:00,240
+أن هذا يأثر على العملية. lung expansion is
+
+69
+00:05:00,240 --> 00:05:03,060
+restricted and secretions are not adequately
+
+70
+00:05:03,060 --> 00:05:07,660
+mobilized. نفسها الرئة نفسها. تمدد الرئة ما هيكون
+
+71
+00:05:07,660 --> 00:05:12,840
+بشكل أو إنه يتم باريحية. لأ، هيكون restricted.
+
+72
+00:05:12,840 --> 00:05:17,320
+محدود. ليه؟ لأن الـ secretion دا اللي صار، عملتلي
+
+73
+00:05:17,320 --> 00:05:21,360
+not adequately mobilized. مش سهل إن هو يتحرك،
+
+74
+00:05:21,360 --> 00:05:26,120
+أيضاً. Restricted deep effective cough. The patient is
+
+75
+00:05:26,120 --> 00:05:29,700
+usually has shallow coughing that does not
+
+76
+00:05:29,700 --> 00:05:33,980
+effectively mobilize secretion. الآن الـ shallow
+
+77
+00:05:33,980 --> 00:05:37,720
+coughing أو الكحة العادية ما بتعمل على الـ remove للـ
+
+78
+00:05:37,720 --> 00:05:40,480
+secretion اللي متجمع مثلاً في الـ lower lobe تبع الـ
+
+79
+00:05:40,480 --> 00:05:44,860
+lungs. لأ بتخليه مكانه. فبالتالي هذا ناتج عن إيش؟ هو
+
+80
+00:05:44,860 --> 00:05:48,600
+المريض أصلاً عنده كحة جافة وكحة سطحيّة.
+
+81
+00:05:48,600 --> 00:05:54,190
+ليه؟ لأن هو خايف من الألم اللي هيصير في منطقة
+
+82
+00:05:54,190 --> 00:06:00,150
+العملية. الـ brain medication. تمام.
+
+83
+00:06:00,150 --> 00:06:03,170
+على الرغم من أن الـ brain medication administrated
+
+84
+00:06:03,170 --> 00:06:07,090
+postoperatively. طبعاً بالرغم من أنسجة الـ brain
+
+85
+00:06:07,090 --> 00:06:10,950
+it also depresses الـ respiratory system. ناتج عن
+
+86
+00:06:10,950 --> 00:06:14,350
+اللي هو الـ depression اللي صار في الـ respiratory
+
+87
+00:06:14,350 --> 00:06:18,190
+center اللي هو موجود في الـ brain. طبعاً أيضاً
+
+88
+00:06:18,190 --> 00:06:21,350
+decreased الـ normal ciliary action in bronchial
+
+89
+00:06:21,350 --> 00:06:25,350
+tract. والعاملين هذول احنا أخذناهم في البداية إن هو
+
+90
+00:06:25,350 --> 00:06:29,650
+بيقلل اللي هو respiratory center sensitivity وكمان
+
+91
+00:06:29,650 --> 00:06:32,890
+بتقل اللي هي الـ normal ciliary action. نتيجة
+
+92
+00:06:32,890 --> 00:06:37,710
+لزيادة كميات اللي هو الـ secretion أو الـ mucus
+
+93
+00:06:37,710 --> 00:06:43,130
+للمخاط نفسه. المخاط نفسه ما بيزيد. فبالتالي بتبطل
+
+94
+00:06:43,130 --> 00:06:47,690
+الاهداب اللي هي الأهداب  اللي هي بتشتغل بشكل فعال.
+
+95
+00:06:47,690 --> 00:06:52,570
+الـ factor الخامس عندنا الـ general inactivity. بحد
+
+96
+00:06:52,570 --> 00:06:57,670
+ذاته هي هذه المشكلة. إن هو مازال بدردان ومازال على
+
+97
+00:06:57,670 --> 00:07:01,430
+السرير. معناته هذا بتسبب لعدة مضاعفات. it causes
+
+98
+00:07:01,430 --> 00:07:04,930
+secretion to build particularly طبعاً posterior
+
+99
+00:07:04,930 --> 00:07:10,270
+basal segment of the lower lobes. هذا بيخلي أن كل
+
+100
+00:07:10,270 --> 00:07:14,110
+الـ secretion يتجمع في الـ posterior basal segment
+
+101
+00:07:14,110 --> 00:07:18,090
+اللي هو في الـ lower lobe تحت. generally weakness
+
+102
+00:07:18,090 --> 00:07:24,170
+and fatigue. طبعاً ليه؟ لأنه ما بيحرك حاله. مافي أي
+
+103
+00:07:24,170 --> 00:07:28,130
+activity. الـ muscles صارت weak. كمان هو نفسه صار
+
+104
+00:07:28,130 --> 00:07:32,870
+fatigue. نتيجة اللي هو الـ bedridden اللي هو فيه.
+
+105
+00:07:32,870 --> 00:07:37,130
+هذا بيقلل اللي هو الـ effectiveness. فعالية
+
+106
+00:07:37,130 --> 00:07:40,710
+الـ coughing. وأنا ما بدي فعالية الـ coughing أصلاً تقل
+
+107
+00:07:40,710 --> 00:07:44,510
+لأن هي الأساس اللي موجود عندي عشان تعمل remove للـ
+
+108
+00:07:44,510 --> 00:07:49,070
+secretion. خليني أعدد شو الـ complications الـ
+
+109
+00:07:49,070 --> 00:07:52,330
+complications لمريض الـ cardiothoracic surgery. أول
+
+110
+00:07:52,330 --> 00:07:54,810
+إشي في عندي complications على مستوى الـ respiratory
+
+111
+00:07:54,810 --> 00:07:59,810
+system. على الـ cardiac، thrombosis و DVT. الـ
+
+112
+00:07:59,810 --> 00:08:04,630
+hemorrhagic، الـ wound infection. وهذه حدث ولا حرج. لـ
+
+113
+00:08:04,630 --> 00:08:08,410
+pressure sores. نتيجة للـ bedridden أو إنه كان مثلاً على
+
+114
+00:08:08,410 --> 00:08:12,310
+سبيل المثال دخل في غيبوبة. ناتجة عن اللي هو
+
+115
+00:08:12,310 --> 00:08:17,070
+something wrong. بعدين دخول فيه pressure sores. الـ
+
+116
+00:08:17,070 --> 00:08:20,310
+muscle wasting and impairment of function. طبعاً الـ
+
+117
+00:08:20,310 --> 00:08:23,150
+impairment of function. ناتج عن الـ muscle function
+
+118
+00:08:23,150 --> 00:08:26,490
+هاي الـ total of complications. مجموعة الـ
+
+119
+00:08:26,490 --> 00:08:29,590
+complications اللي صارت. نيجي نشوف الـ respiratory
+
+120
+00:08:29,590 --> 00:08:35,190
+problems. الـ atelectasis. طبعاً إيش هو؟ هو عبارة عن عدم
+
+121
+00:08:35,190 --> 00:08:42,250
+تمدد بشكل كافي للرئة. نتيجة الـ collapse الدموي أو
+
+122
+00:08:42,250 --> 00:08:47,450
+الضيق اللي صار للـ alveoli. hypoventilation is the
+
+123
+00:08:47,450 --> 00:08:51,170
+most common postoperative cause. بدخل المريض
+
+124
+00:08:51,170 --> 00:08:55,510
+عندنا في hypoventilation. على طول طبعاً بيرجعوا يرجعونه على
+
+125
+00:08:55,510 --> 00:08:58,250
+mechanical ventilation أو artificial
+
+126
+00:08:58,250 --> 00:09:05,610
+ventilation. الـ postoperative pneumonia due to
+
+127
+00:09:05,610 --> 00:09:08,970
+infection or accumulation of secretion present two or
+
+128
+00:09:08,970 --> 00:09:12,130
+three days postoperative. نمونيا هنا معناته
+
+129
+00:09:12,130 --> 00:09:15,980
+inflammation للـ lung tissue. تمام. أنا صار في عندي
+
+130
+00:09:15,980 --> 00:09:20,640
+التهاب في أنسجة الرئة نفسها. هذا ناتج عن أي
+
+131
+00:09:20,640 --> 00:09:24,220
+infection. صار للمريض. ممكن يأخذ العدوى من أي حد. ممكن
+
+132
+00:09:24,220 --> 00:09:28,620
+نتيجة لزرع الـ tube هذا. سواءً إن كانت الـ NG tube أو
+
+133
+00:09:28,620 --> 00:09:33,120
+أي tube أنا حاطيته. كان في infection وقدّت لوجود
+
+134
+00:09:33,120 --> 00:09:39,940
+pneumonia. pneumothorax is a complication of gas or
+
+135
+00:09:39,940 --> 00:09:45,140
+air in thoracic cavity. نيمو معناته air. تمام.
+
+136
+00:09:45,140 --> 00:09:51,060
+thoracic. هواء صدر. إذا هو هواء في الصدر. تجمع للغاز
+
+137
+00:09:51,060 --> 00:09:56,440
+داخل التجويف الصدري. فهذا هيعمل على restriction للـ
+
+138
+00:09:56,440 --> 00:10:00,060
+lung movement. تمام. it can be therapeutically
+
+139
+00:10:00,060 --> 00:10:04,500
+because what they are traumatic. ممكن يكون اللي هو
+
+140
+00:10:04,500 --> 00:10:11,200
+صار أثناء العملية أو بعد العملية. وهكذا. Pulmonary
+
+141
+00:10:11,200 --> 00:10:17,620
+embolism. طبعاً أي DVT صارت. ممكن تنتقل. والمصيبة إذا
+
+142
+00:10:17,620 --> 00:10:21,720
+إيش وصلت للـ lungs. هذا هيعمل فيها عندنا pulmonary
+
+143
+00:10:21,720 --> 00:10:25,920
+embolism. its obstruction للـ pulmonary artery in one
+
+144
+00:10:25,920 --> 00:10:31,870
+of its branches. طبعاً by clot arises اللي هو arises
+
+145
+00:10:31,870 --> 00:10:36,830
+from DVT. الآن زي ما حكينا في البداية أنه أنا ممكن
+
+146
+00:10:36,830 --> 00:10:41,890
+يكون عندي صار DVT. نتيجة لـ bedridden. نتيجة للـ blood
+
+147
+00:10:41,890 --> 00:10:47,070
+coagulation. اتحولت هذه القطعة وانتقلت إلى الـ
+
+148
+00:10:47,070 --> 00:10:51,590
+pulmonary artery. عملت لي pulmonary embolism. هي من
+
+149
+00:10:51,590 --> 00:10:55,610
+أسوأ الـ complications اللي ممكن أنا أشوفها. Hypoxia
+
+150
+00:10:56,270 --> 00:11:00,430
+low of oxygen content within tissues of body. وهذا
+
+151
+00:11:00,430 --> 00:11:05,410
+اللي بيصير مع مرضى COVID-19. طلاب الأعزاء. أسوأ شيء
+
+152
+00:11:05,410 --> 00:11:09,170
+اللي هو الـ oxygen saturation in the blood يكون
+
+153
+00:11:09,170 --> 00:11:14,930
+بنسب قليلة جداً في الدم. ليه؟ لأن هذا بيؤدي لموت بعض
+
+154
+00:11:14,930 --> 00:11:18,230
+الأنسجة فيما بعد. وخصوصاً تأثيره على الـ brain بيكون
+
+155
+00:11:18,230 --> 00:11:18,770
+فعال.
+
+156
+00:11:21,390 --> 00:11:26,490
+الـ complications هنا عظيمة وكبيرة جداً. خليني أشوف
+
+157
+00:11:26,490 --> 00:11:30,570
+كمان الـ role of physiotherapy في هذه الحالات. في الـ
+
+158
+00:11:30,570 --> 00:11:33,510
+respiratory complications. احنا هندخل في قسم كبير من
+
+159
+00:11:33,510 --> 00:11:37,710
+الطب الصدرية هنا. هاخد اللي هو الإشي اللي بخصني أنا مع
+
+160
+00:11:37,710 --> 00:11:40,650
+مريض القلب. أهدافي أنا في الـ respiratory
+
+161
+00:11:40,650 --> 00:11:45,230
+complications لمريض القلب is to regain the normal
+
+162
+00:11:45,230 --> 00:11:51,140
+vital capacity. بدي أعيد الرئة أن ترجع لـ vital
+
+163
+00:11:51,140 --> 00:11:54,640
+capacity اللي هي طبيعية. أو إنه يصير في عندنا lung
+
+164
+00:11:54,640 --> 00:11:58,960
+expansion طبيعي. to stimulate coughing. إنه أنا
+
+165
+00:11:58,960 --> 00:12:02,720
+أحاول أخلي يحفظ موضوع الـ coughing. عشان أقدر أعمل
+
+166
+00:12:02,720 --> 00:12:07,200
+removal of secretion. الهدف الثالث to encourage the
+
+167
+00:12:07,200 --> 00:12:10,560
+full use of lungs. إن هو يحاول يستخدم الـ lungs
+
+168
+00:12:10,560 --> 00:12:14,920
+بتاعته عشان ترجع لوضعها الطبيعي. بنبدأ اللي هو
+
+169
+00:12:14,920 --> 00:12:19,140
+بنسميه إحنا الـ weaning from mechanical ventilation أو
+
+170
+00:12:19,140 --> 00:12:22,280
+الـ artificial ventilation. بالتدريج. تمام؟ هذا
+
+171
+00:12:22,280 --> 00:12:26,420
+هتشوفونه شغل  مهم جداً في المعامل. فبالتالي هيكون
+
+172
+00:12:26,420 --> 00:12:30,260
+الإشي إنه أنا بدي أعمل على تشجيع إن المريض يستخدم
+
+173
+00:12:30,260 --> 00:12:33,300
+الـ lungs. عشان ما يصير بعد هيك فيها collapse و
+
+174
+00:12:33,300 --> 00:12:38,560
+infection و increasing لـ secretion. عن طريق إيش؟
+
+175
+00:12:38,560 --> 00:12:41,700
+breathing exercises. وأنا أخدت نوعين من أنواع الـ
+
+176
+00:12:41,700 --> 00:12:44,180
+breathing exercises. فيه عندنا الـ diaphragmatic
+
+177
+00:12:44,180 --> 00:12:47,060
+breathing. وفيه عندنا الـ lateral costal breathing.
+
+178
+00:12:48,320 --> 00:12:52,520
+طبعاً الإشي هذا لازم يكون taught preoperatively و
+
+179
+00:12:52,520 --> 00:12:56,860
+لازم أنا أحافظ على اللي هو الـ deep inspiration
+
+180
+00:12:56,860 --> 00:13:02,740
+followed by اللي هو relaxed expiration. أيضاً بالـ
+
+181
+00:13:02,740 --> 00:13:
+
+223
+00:15:57,820 --> 00:16:01,580
+الفيزيوتيرابي contraindicated في هذه الحالة
+
+224
+00:16:01,580 --> 00:16:06,020
+لأنّه نخاف على الـ patients تبعنا لاحظوا هنا
+
+225
+00:16:06,020 --> 00:16:11,120
+جديش في عندي fluid طبعًا نتيجة اللي هو بيعمل لي ضغط
+
+226
+00:16:11,120 --> 00:16:16,130
+على التنبونات طبعًا بيعملي ضغط على تجمع ثوائل في
+
+227
+00:16:16,130 --> 00:16:22,070
+اللي هي الـ pericardial أو الـ pericardium sac
+
+228
+00:16:22,070 --> 00:16:27,250
+pericardium sac، pericardium sac معناه الكلام أن
+
+229
+00:16:27,250 --> 00:16:33,190
+هو بيعمل overload على الـ heart اللي موجود، يعني الـ
+
+230
+00:16:33,190 --> 00:16:37,270
+cardiogenic shock، الصدمة result from diminished
+
+231
+00:16:37,270 --> 00:16:41,910
+cardiac output، بتأثر في أن هو الـ cardiac output
+
+232
+00:16:41,910 --> 00:16:46,430
+اللي هو كمية ضخ الدم اللي ناتجة عنه الـ cardiac
+
+233
+00:16:46,430 --> 00:16:50,710
+output may fall very low immediately، طبعًا بتقل
+
+234
+00:16:50,710 --> 00:16:54,850
+after cardiac damage، فيزيوتيرابي هنا أيضًا contra
+
+235
+00:16:54,850 --> 00:16:57,670
+indicated لأنّ هذه من الـ complications الصعبة اللي
+
+236
+00:16:57,670 --> 00:17:03,550
+بتصير مع مريض القلب، الـ complication الثالثة، احنا
+
+237
+00:17:03,550 --> 00:17:06,610
+أخذنا complication على مستوى الـ respiratory،
+
+238
+00:17:06,610 --> 00:17:10,150
+خليني أعمل summary، و complication على مستوى الـ
+
+239
+00:17:10,150 --> 00:17:12,890
+heart، هنا بدي أخد الـ complication الثالثة، اللي
+
+240
+00:17:12,890 --> 00:17:15,910
+هي على مستوى الـ circulation أو الـ DVT in
+
+241
+00:17:15,910 --> 00:17:23,470
+general، تمام؟ is a coagulation or clotting
+
+242
+00:17:23,470 --> 00:17:26,790
+bleeding، تمام؟ و clot blood، بيصير في clotting
+
+243
+00:17:26,790 --> 00:17:33,270
+للدم، تمام؟ اللي هو بيصير في عندنا تجلط للدم أو أنّه
+
+244
+00:17:33,270 --> 00:17:36,850
+صار في عندنا خسارة دموية، thrombosis if they attaches
+
+245
+00:17:36,850 --> 00:17:40,630
+the clot can cause pulmonary embolism، شرحنا عنها
+
+246
+00:17:40,630 --> 00:17:44,170
+في الـ pulmonary embolism، أنّه لو صار أنا في عندي
+
+247
+00:17:44,170 --> 00:17:50,370
+مشكلة في اللي هو هاي الخسارة الدموية حتنتقل و تفوت
+
+248
+00:17:50,370 --> 00:17:55,770
+على اللي هو الـ pulmonary artery، فبالتالي
+
+249
+00:17:55,770 --> 00:18:00,070
+بتسبب pulmonary embolism، الفيزيوتيرابي prevention
+
+250
+00:18:00,070 --> 00:18:04,570
+طبعًا أهم شيء أنا أمنع السبب، ليش أنا أخلي يصير في
+
+251
+00:18:04,570 --> 00:18:08,350
+عندي DVT عن طريق الـ active leg exercise، الـ deep
+
+252
+00:18:08,350 --> 00:18:13,180
+breathing exercise على الأقل خمس دقائق في اللي هو
+
+253
+00:18:13,180 --> 00:18:17,840
+كل ساعة، الـ early postoperative leg mobilization
+
+254
+00:18:17,840 --> 00:18:21,740
+أنّه يعمل pumping exercise عشان أنا أمنع الـ DVT
+
+255
+00:18:21,740 --> 00:18:25,560
+مش وقت حدوثها، أنا بدي أمنعها، لأنّ هي لما بتحدث وبتخلص
+
+256
+00:18:25,560 --> 00:18:29,960
+أنا ممنوع أشتغل، لكن أنا بأمنعها في اللي هو قبل ما
+
+257
+00:18:29,960 --> 00:18:41,740
+يحدث الـ DVT، عندما يتطور الـ DVT، في حالة
+
+258
+00:18:41,740 --> 00:18:45,460
+الـ acute، physiotherapy is contraindicated، ممنوع
+
+259
+00:18:45,460 --> 00:18:49,080
+من  عمومًا أن أشتغل، لأنّ بأي exercise أعمل دي
+
+260
+00:18:49,080 --> 00:18:53,180
+detaches، انفصال لهاي الخسارة الدموية وتتحرك عبر الـ
+
+261
+00:18:53,180 --> 00:18:59,640
+bloodstream، في حالة الـ chronic cases اللي applied
+
+262
+00:18:59,640 --> 00:19:03,120
+to deep breathing exercise، active exercise and
+
+263
+00:19:03,120 --> 00:19:07,280
+mobilization، و الـ elastic bandage مهم جدًا اللي هو
+
+264
+00:19:07,280 --> 00:19:10,560
+الـ aid figure بدي أعمله to control swelling and
+
+265
+00:19:10,560 --> 00:19:14,340
+venous return، تمام، إذا في الـ acute لسة المرحلة
+
+266
+00:19:14,340 --> 00:19:19,560
+جديدة والحالة طور عندها DVT جديدة، ممنوع أشتغل
+
+267
+00:19:19,560 --> 00:19:22,660
+معاها، contraindication، لكن في الـ chronic بشتغل
+
+268
+00:19:22,660 --> 00:19:26,160
+range of motion exercise، breathing exercise، و الـ
+
+269
+00:19:26,160 --> 00:19:32,010
+elastic كمان شغالة، لازم تكون موجودة، الـ wound
+
+270
+00:19:32,010 --> 00:19:35,810
+infection، ما شاء الله، حدث ولا حرج، عادةً على طول
+
+271
+00:19:35,810 --> 00:19:41,090
+بيصير عندنا اللي هو الالتهابات ناتجة بعد العملية، الـ
+
+272
+00:19:41,090 --> 00:19:44,530
+infected، ليه؟ لأنّ احنا بيئة طبعًا رطبة، فبالتالي
+
+273
+00:19:44,530 --> 00:19:49,950
+بتطور، أو ممكن الشخص نفسه بتكون اللي هو نوع جسمه ما
+
+274
+00:19:49,950 --> 00:19:53,970
+بيعمل good healing، خصوصًا إذا كان  مريض سكري
+
+275
+00:19:53,970 --> 00:19:57,070
+accumulation تبعنا، بيكون في عندهم poor healing زي
+
+276
+00:19:57,070 --> 00:19:59,750
+ما أخذنا، فبالتالي الـ infected بيكون أو الـ
+
+277
+00:19:59,750 --> 00:20:04,670
+infection بيكون وارد، ليه بيصير الـ patient عندنا
+
+278
+00:20:04,670 --> 00:20:07,170
+عن الـ signs و الـ symptoms تبعية الـ infection
+
+279
+00:20:07,170 --> 00:20:11,970
+hotness، و redness، و edematous، حول الـ sutures طبعًا
+
+280
+00:20:11,970 --> 00:20:16,770
+وارمة، هذه الغرز، و cut and through خلال الـ tissue
+
+281
+00:20:16,770 --> 00:20:20,470
+and the wound may gap either long or long haul
+
+282
+00:20:20,470 --> 00:20:23,930
+length between the sutures، بتبدأ اللي هي نتيجة
+
+283
+00:20:23,930 --> 00:20:29,110
+الممكن، لو كان كمان في عندها صديد، بصير في الـ wound
+
+284
+00:20:29,110 --> 00:20:33,870
+نفسها أنّها بتحلل هذه الـ wound وبتبعد عن بعضها البعض
+
+285
+00:20:33,870 --> 00:20:38,330
+الفيزيوتيرابي، clean wound can receive superficial
+
+286
+00:20:38,330 --> 00:20:42,410
+heat، زي الـ infrared، لأنّه نعرف الـ infrared هي عبارة
+
+287
+00:20:42,410 --> 00:20:47,770
+عن شيء anti-biotic، بتشتغل في superficial wound، الـ
+
+288
+00:20:47,770 --> 00:20:52,530
+ultrasonic كمان بيشتغل فيها في الـ heart scars اللي هو
+
+289
+00:20:52,530 --> 00:20:56,390
+لو صار في عندي scar tissue، الـ paraffin wax طبعًا
+
+290
+00:20:56,390 --> 00:20:59,990
+حتشتغل، كيف أنّ البرافين wax أنا بدي أشتغلها في الـ
+
+291
+00:20:59,990 --> 00:21:04,230
+open heart surgery، بجيب باللي هو الـ tongue
+
+292
+00:21:04,230 --> 00:21:08,170
+depressors اللي هي اللي بيفحص فيها الدكتور اللي
+
+293
+00:21:08,170 --> 00:21:13,530
+هو، وبحط عليها شوية wax وبحطها على مكان العملية
+
+294
+00:21:13,530 --> 00:21:17,930
+عشان اللي هو أعمل softening لـ scar tissue اللي
+
+295
+00:21:17,930 --> 00:21:20,990
+صارت، اللي كانت بالأصل هي infected وأدت إلى وجود
+
+296
+00:21:20,990 --> 00:21:26,070
+scar tissue كبيرة، لازم أنا أبدأ أقلل منها، هذا
+
+297
+00:21:26,070 --> 00:21:29,910
+بالنسبة للـ wound infection اللي هو الـ
+
+298
+00:21:29,910 --> 00:21:34,050
+complication الرابع، الـ pressure source اللي أنا
+
+299
+00:21:34,050 --> 00:21:39,710
+حكيت عليه اليوم، هذا الـ patient عندي طور من حالته و
+
+300
+00:21:39,710 --> 00:21:42,910
+طورّت حالته للأسوأ، صار في عنده pressure source
+
+301
+00:21:42,910 --> 00:21:48,490
+ناتجة عن العجز أو اللي هو الـ immobility، prevent by
+
+302
+00:21:48,490 --> 00:21:51,390
+frequently changing patient postural، لازم الـ
+
+303
+00:21:51,390 --> 00:21:54,590
+position تبع الـ patient أغيره كل ساعتين في هذه
+
+304
+00:21:54,590 --> 00:21:59,090
+الحالة، وهذا طبعًا بمساعدة التمريض، frequently
+
+305
+00:21:59,090 --> 00:22:04,030
+check للـ integrity of skin and area of redness، بدأ
+
+306
+00:22:04,030 --> 00:22:08,610
+أتأكد من سلامة الجلد، دائماً أتفحص الـ back، الـ
+
+307
+00:22:08,610 --> 00:22:11,990
+scapula، الـ calcaneus،
+
+308
+00:22:13,780 --> 00:22:17,440
+كل الـ bony prominence اللي أنا عاملة عليها
+
+309
+00:22:17,440 --> 00:22:21,820
+pressure، عشان ما يصير في عندنا بعد هيك pressure source
+
+310
+00:22:21,820 --> 00:22:26,340
+الـ ultraviolet هنا كتير مهمة، جهازنا الـ ultraviolet
+
+311
+00:22:26,340 --> 00:22:30,320
+كتير مهم وكويس، لأنه بيشتغل as antibiotic
+
+312
+00:22:30,320 --> 00:22:35,760
+apparatus، تمام، الـ neurological damage، بعض الأحيان
+
+313
+00:22:35,760 --> 00:22:39,540
+مرض القلب بيطوروا مشاكل أو بيطوروا مشاكل اللي لها
+
+314
+00:22:39,540 --> 00:22:44,200
+علاقة بالـ neurological system، خلال الـ .. الـ .. هو
+
+315
+00:22:44,200 --> 00:22:46,920
+الـ incision، على سبيل المثال، الـ brain may damaged
+
+316
+00:22:46,920 --> 00:22:50,800
+تمام؟ وممكن كمان الـ brain يصير فيه damage نتيجة
+
+317
+00:22:50,800 --> 00:22:54,340
+الـ embolism، لأنّه حكينا إذا هذه الخثرة الدموية
+
+318
+00:22:54,340 --> 00:22:57,420
+صار لها detach، يا إمّا حتعدي على الـ lung يا إمّا
+
+319
+00:22:57,420 --> 00:23:00,620
+حتعدي على الـ brain، إذا عدت على الـ lung معناه بتصير
+
+320
+00:23:00,620 --> 00:23:03,660
+عندنا pulmonary embolism، إذا عدت على الـ brain صار
+
+321
+00:23:03,660 --> 00:23:10,370
+stroke، تمام؟ الفيزيوتيرابي  مستهدفته from paralysis
+
+322
+00:23:10,370 --> 00:23:15,110
+that occurs، إذا صار والله عندنا stroke ناتجة عن
+
+323
+00:23:15,110 --> 00:23:19,730
+الـ embolism، معناه الكلام حيصير في عندنا مثلًا اللي هو
+
+324
+00:23:19,730 --> 00:23:23,970
+right hemiplegia، حأعالج أنا، حأدخل بجانب إلى أنّه
+
+325
+00:23:23,970 --> 00:23:28,730
+المريض تبعي cardiac حيكون اللي هو neuro obviously،
+
+326
+00:23:28,730 --> 00:23:31,610
+the patient cardiac state may limit from
+
+327
+00:23:31,610 --> 00:23:37,420
+rehabilitation to some extent، to some extent معناه
+
+328
+00:23:37,420 --> 00:23:43,720
+الكلام بشكل واضح أنّ أنا الـ
+
+329
+00:23:43,720 --> 00:23:49,060
+cardiac patient state may limit from
+
+330
+00:23:49,060 --> 00:23:58,120
+rehabilitation to some extent، طبعًا obviously
+
+331
+00:23:58,120 --> 00:24:03,810
+the patient cardiac state may limit، الـ cardiac
+
+332
+00:24:03,810 --> 00:24:07,790
+patient may limit the from rehabilitation to some
+
+333
+00:24:07,790 --> 00:24:10,970
+extent، بعض الأحيان ممكن أنا حاجات أطور الحالة مع
+
+334
+00:24:10,970 --> 00:24:15,390
+المريض أو أنّه أنا أغيّر في الخطة تبعي حسب حالة الـ
+
+335
+00:24:15,390 --> 00:24:19,510
+patient، إذا هيك أنا أخذت ستة complications تابعين
+
+336
+00:24:19,510 --> 00:24:26,630
+لمريض القلب، تمام؟ وبهيك أنا أنهيت هذا الـ chapter
+
+337
+00:24:26,630 --> 00:24:28,730
+ويعطيكم العافية
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/15HwhIYihT4_postprocess.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/15HwhIYihT4_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..5ecf9ce6cf6115a74d5e9ce5c0bc4660603448e5
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/15HwhIYihT4_postprocess.srt
@@ -0,0 +1,1348 @@
+1
+00:00:01,110 --> 00:00:04,690
+بسم الله الرحمن الرحيم صلى الله عليه وعلى محمد
+
+2
+00:00:04,690 --> 00:00:08,530
+وعلى آله وصحبه أجمعين راح أدخل اليوم في chapter
+
+3
+00:00:08,530 --> 00:00:12,350
+اسمه الـ Complication اللي مفعلة عند عملية ال
+
+4
+00:00:12,350 --> 00:00:16,210
+cardio thoracic surgeryأخدنا في ال chapter السابق
+
+5
+00:00:16,210 --> 00:00:21,150
+عن ال role of physiotherapy أثناء اللي هي pre
+
+6
+00:00:21,150 --> 00:00:24,410
+-operative و post-operative هنا هنشوف إذا المريض
+
+7
+00:00:24,410 --> 00:00:27,610
+تبعنا هيدخل فيه complication و إيش هي ال
+
+8
+00:00:27,610 --> 00:00:30,390
+complication و إيش ال role of physiotherapy
+
+9
+00:00:30,390 --> 00:00:35,030
+أثناءها نبدأ على بركة الله ال role of
+
+10
+00:00:35,030 --> 00:00:38,840
+physiotherapy أثناء ال complicationفي البداية، إيش
+
+11
+00:00:38,840 --> 00:00:43,600
+هي ال factors اللي ممكن تزيد أو تساهم معايا في ال
+
+12
+00:00:43,600 --> 00:00:47,600
+postoperative communication؟ أول عامل اللي هو ال
+
+13
+00:00:47,600 --> 00:00:51,260
+general anesthesia، إشي طبيعي، تعرفوا ال patient
+
+14
+00:00:51,260 --> 00:00:54,740
+هيدخل open heart surgery، معناة الكلام إنه أنا
+
+15
+00:00:54,740 --> 00:00:59,490
+هخدر وأبنش كل الجسمهذا هيعمل ايه؟ Decrease
+
+16
+00:00:59,490 --> 00:01:04,190
+للـNormal Cleary Actions of Tracheobronchial Atria
+
+17
+00:01:04,190 --> 00:01:10,330
+الـ Lung نفسها هيصير فيها Decreasing للـ Normal
+
+18
+00:01:10,330 --> 00:01:15,730
+Capacity Decreasing ليش؟ لأنه صار فيها إش جديد دخل
+
+19
+00:01:15,730 --> 00:01:21,650
+على الجسم أدى لإيش؟ لـ Lung Collapse لـ Collection
+
+20
+00:01:21,650 --> 00:01:25,090
+of Secretions كل الأمور هذه بتعيق اللي هي ال
+
+21
+00:01:25,090 --> 00:01:27,070
+ventilation أيضا
+
+22
+00:01:29,260 --> 00:01:33,860
+هذا الفنش اللي أخده ال patient عمل على decrease of
+
+23
+00:01:33,860 --> 00:01:37,640
+respiratory center in central nervous system كلنا
+
+24
+00:01:37,640 --> 00:01:41,020
+بنعرف إن ال center of respiratory system موجود
+
+25
+00:01:41,020 --> 00:01:45,080
+داخل ال central nervous system بيؤدي لإنه يصير
+
+26
+00:01:45,080 --> 00:01:47,920
+التنفس shallow shallow breathing أو shallow
+
+27
+00:01:47,920 --> 00:01:52,380
+respiratory system معناته هذا هيقلل اتدة ال volume
+
+28
+00:01:52,380 --> 00:01:57,020
+اللي هو ال volume تبع ال air اللي بتحرك in و out
+
+29
+00:01:57,360 --> 00:02:00,920
+للـ lungs خلال الـ quality أو الـ quiet of
+
+30
+00:02:00,920 --> 00:02:05,500
+breathing إذا نتيجة لإن أنا هنا اشتغلت على الـ
+
+31
+00:02:05,500 --> 00:02:10,160
+central nervous system إن أنا أدخلت المريض في حالة
+
+32
+00:02:10,160 --> 00:02:13,620
+من الكومة أو حالة من ال unconsciousness فبالتالي
+
+33
+00:02:13,620 --> 00:02:17,080
+هنا أنا اشتغلت على مستوى عالي في الأجهزة معناة
+
+34
+00:02:17,080 --> 00:02:21,120
+الكلام إن في عندي shallow respiration صارت هذه الـ
+
+35
+00:02:21,120 --> 00:02:24,720
+shallow respiration قدّت لقلة في إتدال volume
+
+36
+00:02:25,340 --> 00:02:29,440
+وارفنا شو يعني هو اتد ال volume ال second factor
+
+37
+00:02:29,440 --> 00:02:34,700
+ال intubation أكيد طبعا دخل المريض العمليات معناته
+
+38
+00:02:34,700 --> 00:02:40,040
+انا هححط او ال nurse هم اللي هيحطوا tube داخل الفم
+
+39
+00:02:40,040 --> 00:02:44,120
+او ممكن يكون في tracheostomy اللي هو قطع في
+
+40
+00:02:44,120 --> 00:02:49,680
+التراكيه نفسها وندخل في اللي هو التراكيستومي الآن
+
+41
+00:02:49,680 --> 00:02:54,300
+ال intubation هو insertion لل endotracheal او
+
+42
+00:02:54,300 --> 00:02:58,580
+nasalGastric Tube اللي هو الـ NG Tube احنا
+
+43
+00:02:58,580 --> 00:03:03,920
+بنختصره، تمام؟ اذا زرع او وضع اندوتراكيا لـ tube
+
+44
+00:03:03,920 --> 00:03:09,280
+بدى يفوت من الفم للتراكيا مباشرة او من اللي هو
+
+45
+00:03:09,280 --> 00:03:15,700
+بنسمي الانفل بالعوم المعدي اللي هو Nasogastric
+
+46
+00:03:15,700 --> 00:03:20,520
+Tube ال irritation اول complication هيصير معايا
+
+47
+00:03:20,520 --> 00:03:26,770
+طبعا اشي طبيعىلأن في ذرع هذا الجهاز داخل الجسم
+
+48
+00:03:26,770 --> 00:03:33,290
+هيصير في عندي عملية تهيجفي العينة اللي بتتاخد في
+
+49
+00:03:33,290 --> 00:03:37,410
+الناس اللي شاكين فيهم ان يكونوا عندهم COVID-19
+
+50
+00:03:37,410 --> 00:03:41,150
+لحظوا كيف بتكون مؤلمة يعني إذا شفتوا كذا فيديو أو
+
+51
+00:03:41,150 --> 00:03:45,030
+شفتوا إشي فليه؟ لأنه صار في عندنا irritation صار
+
+52
+00:03:45,030 --> 00:03:49,050
+في عندنا عملية تهييج لـmucous membrane اللي موجود
+
+53
+00:03:49,050 --> 00:03:53,330
+في اللي هو التراكيا أو في كل ال respiratory system
+
+54
+00:03:53,730 --> 00:03:57,410
+إذا الـ rotation هو عبارة عن أول عامل أو أول
+
+55
+00:03:57,410 --> 00:04:01,230
+factors من الcomplication منها اللي هو الـmucous
+
+56
+00:04:01,230 --> 00:04:04,750
+lining تبع الـtracheobronchial tree which causes
+
+57
+00:04:04,750 --> 00:04:08,670
+increasing the mucous production معناة الكلام، هذا
+
+58
+00:04:08,670 --> 00:04:13,790
+هيزيد من اللي هو الـmucous productionفبالتالي،
+
+59
+00:04:13,790 --> 00:04:16,830
+decrease للـ Normal Action of Cilia in Pulmonary
+
+60
+00:04:16,830 --> 00:04:21,730
+Tract هيقلل العمل الأهداف الموجودة في الـ
+
+61
+00:04:21,730 --> 00:04:25,850
+Respiratory System طبعاً، which lead to bowling of
+
+62
+00:04:25,850 --> 00:04:30,010
+secretion معناة الكلام، المنطقة كلها هتم تلقى،
+
+63
+00:04:30,010 --> 00:04:34,670
+ليش؟ بإن هو المخاطر أو الـ Secretion هاي ليه؟ لأنه
+
+64
+00:04:34,670 --> 00:04:38,630
+دخل عندنا تيوب، لاحظوا التيوب هذابكون كتير رفيع
+
+65
+00:04:38,630 --> 00:04:47,540
+ولكن بيعمل ليهيجان لهذه المنطقةالانسيشال بين الألم
+
+66
+00:04:47,540 --> 00:04:51,000
+المنتج عن العملية نفسه هذا بيسبب لل patient أنه
+
+67
+00:04:51,000 --> 00:04:55,140
+يتنفس بشكل سفحي ليه؟ عشان هو خايف إذا أخد نفس عميق
+
+68
+00:04:55,140 --> 00:05:00,240
+أن هذا يأثر على العملية long expansion is
+
+69
+00:05:00,240 --> 00:05:03,060
+restricted and secretions are not adequately
+
+70
+00:05:03,060 --> 00:05:07,660
+mobilized نفسها الرقى نفسها تمدد الرقى ما هيكون
+
+71
+00:05:07,660 --> 00:05:12,840
+بشكلأو إنه يتم بأرياحية، لأ، هيكون Restricted
+
+72
+00:05:12,840 --> 00:05:17,320
+محدد، ليه؟ لأن الـSecretion دا اللي صار، عملتلي
+
+73
+00:05:17,320 --> 00:05:21,360
+Not Educatedly mobilized، مش سهل إن هو يتحرك،
+
+74
+00:05:21,360 --> 00:05:26,120
+أيضًا Restricted DeepEffective Cuff The patient is
+
+75
+00:05:26,120 --> 00:05:29,700
+usually have shallow cuffing that does not
+
+76
+00:05:29,700 --> 00:05:33,980
+effectively to mobilize secretion الآن ال shallow
+
+77
+00:05:33,980 --> 00:05:37,720
+cuffing أو الكحة العادية ما بتعمل على ال remove لل
+
+78
+00:05:37,720 --> 00:05:40,480
+secretion اللي متجمع مثلا في ال lower loop تبع ال
+
+79
+00:05:40,480 --> 00:05:44,860
+lungs لأ بتخليه مكانه فبالتالي هذا ناتج عن إيش؟ هو
+
+80
+00:05:44,860 --> 00:05:48,600
+المريض أصلا مكاني كحة عندي كحة جافة وكحة صفحية
+
+81
+00:05:48,600 --> 00:05:54,190
+ليه؟ لأن هو خايف من البعن اللي هيصير في المكان
+
+82
+00:05:54,190 --> 00:06:00,150
+العملية الـ brain medication تمام
+
+83
+00:06:00,150 --> 00:06:03,170
+على الرغم من أن ال brain medication administrated
+
+84
+00:06:03,170 --> 00:06:07,090
+postoperatively تند طبعا بالرغم من انسجة ال brain
+
+85
+00:06:07,090 --> 00:06:10,950
+it also depressed ال respiratory system ناتج عن
+
+86
+00:06:10,950 --> 00:06:14,350
+اللي هو ال depression اللي صار في ال respiratory
+
+87
+00:06:14,350 --> 00:06:18,190
+center اللي هو موجود في ال brain تند أيضا
+
+88
+00:06:18,190 --> 00:06:21,350
+decreased ال normal cellular reaction in bronchial
+
+89
+00:06:21,350 --> 00:06:25,350
+tractوالعاملين هذول احنا أخدناهم في البداية إن هو
+
+90
+00:06:25,350 --> 00:06:29,650
+بقل اللي هو respiratory center specificity وكمان
+
+91
+00:06:29,650 --> 00:06:32,890
+بتقل اللي هي ال normal cellular reaction نتيجة
+
+92
+00:06:32,890 --> 00:06:37,710
+لزياد بتكميات اللي هو ال secretion أو ال mucus
+
+93
+00:06:37,710 --> 00:06:43,130
+للمخات نفسها المخات نفسها ما بتزيد فبالتالي بتبطل
+
+94
+00:06:43,130 --> 00:06:47,690
+السلية اللي هي السلية الأحداث إنه تشتغل بشكل فعال
+
+95
+00:06:47,690 --> 00:06:52,570
+ال factors الخامس عنا ال general inactivityبحد
+
+96
+00:06:52,570 --> 00:06:57,670
+ذاتها هي هذه الممرضة ان هو مازال بدردان ومازال على
+
+97
+00:06:57,670 --> 00:07:01,430
+السرير معناته هذا بتسبب لعدة مضاعفات it causes
+
+98
+00:07:01,430 --> 00:07:04,930
+secretion to build particularly طبعا posterior
+
+99
+00:07:04,930 --> 00:07:10,270
+basal segment of the lower lobes هذا بيخلي ان كل
+
+100
+00:07:10,270 --> 00:07:14,110
+ال secretion يتجمع في ال posterior basal segment
+
+101
+00:07:14,110 --> 00:07:18,090
+اللي هو في ال lower loop تحت generally ال weakness
+
+102
+00:07:18,090 --> 00:07:24,170
+and fatigue طبعا ليه؟ لأن هوما بيحرك حاله مافي اي
+
+103
+00:07:24,170 --> 00:07:28,130
+activity ال muscle صارت weak كمان هو نفسه صار
+
+104
+00:07:28,130 --> 00:07:32,870
+fatigue نتيجة اللي هو ال bedridden اللي هو فيه
+
+105
+00:07:32,870 --> 00:07:37,130
+decrease هذا بيقلل اللي هو ال effectiveness فعالية
+
+106
+00:07:37,130 --> 00:07:40,710
+ال cuffing وانا مابدي فعالية ال cuffing أصلا اتقل
+
+107
+00:07:40,710 --> 00:07:44,510
+لإن هي الأساس اللي موجود عندى عشان تعمل remove لا
+
+108
+00:07:44,510 --> 00:07:49,070
+secretion خليني أعدد شو ال complicationالـ
+
+109
+00:07:49,070 --> 00:07:52,330
+Complication لمريد الـ Cardiothoracic Surgery أول
+
+110
+00:07:52,330 --> 00:07:54,810
+إشي في عندي Complication على مستوى ال respiratory
+
+111
+00:07:54,810 --> 00:07:59,810
+system على ال cardiac، thrombosis و DVT ال
+
+112
+00:07:59,810 --> 00:08:04,630
+hemorrhagic، ال wound infection وهذه حدث ولا حرج ل
+
+113
+00:08:04,630 --> 00:08:08,410
+pressure source نتيجة للبدردن أو إنه كان مثلا على
+
+114
+00:08:08,410 --> 00:08:12,310
+سبيل المثال دخل في غيبوبة ناتجة عن اللي هو
+
+115
+00:08:12,310 --> 00:08:17,070
+something wrong بعدين دخلي فيه pressure sourceالـ
+
+116
+00:08:17,070 --> 00:08:20,310
+muscle wasting and impairment of function طبعا ال
+
+117
+00:08:20,310 --> 00:08:23,150
+environment of function ناتج عن ال muscle function
+
+118
+00:08:23,150 --> 00:08:26,490
+هاي ال total of complication مجموعة ال
+
+119
+00:08:26,490 --> 00:08:29,590
+complications اللي صارت نيجي نشوف ال respiratory
+
+120
+00:08:29,590 --> 00:08:35,190
+problems ال atlases طبعا إيش هو؟ هو عبارة عن عدم
+
+121
+00:08:35,190 --> 00:08:42,250
+تمدد بشكل كافي للرئة نتيجة ال collapse الدمور أو
+
+122
+00:08:42,250 --> 00:08:47,450
+الضيق اللي صارللـ Alveoli, hypoventilation is the
+
+123
+00:08:47,450 --> 00:08:51,170
+most common postoperative cause بديدخل المريض
+
+124
+00:08:51,170 --> 00:08:55,510
+عندنا في hypoventilation على طول طبعا بيرجعون نيرس
+
+125
+00:08:55,510 --> 00:08:58,250
+على mechanical ventilation أو artificial
+
+126
+00:08:58,250 --> 00:09:05,610
+ventilation ال postoperative pneumonia due to
+
+127
+00:09:05,610 --> 00:09:08,970
+infection or akin to secretion present two or
+
+128
+00:09:08,970 --> 00:09:12,130
+three days postoperative نمونيا هنا معناتها
+
+129
+00:09:12,130 --> 00:09:15,980
+inflammation للـ lung tissueتمام انا صار في عندي
+
+130
+00:09:15,980 --> 00:09:20,640
+التهاب في انسجة الرئة نفسها هذا ناتج عن اي
+
+131
+00:09:20,640 --> 00:09:24,220
+infection صار للمريض ممكن اخد العدوى من اي حد ممكن
+
+132
+00:09:24,220 --> 00:09:28,620
+نتيجة لزرع ال tube هادي توا ان كانت ال ng tube او
+
+133
+00:09:28,620 --> 00:09:33,120
+اي tube انا حاطيته كان في infection و قدت الى وجود
+
+134
+00:09:33,120 --> 00:09:39,940
+pneumonia pneumothorax is a complication of gas or
+
+135
+00:09:39,940 --> 00:09:45,140
+air in thoracic cavity نيمو لحالهاتعني air تمام
+
+136
+00:09:45,140 --> 00:09:51,060
+thoracic هواء صدر إذا هو هواء في الصدر تجمع للغاز
+
+137
+00:09:51,060 --> 00:09:56,440
+داخل التجويز الصدري فهذا هيعمل على restriction لل
+
+138
+00:09:56,440 --> 00:10:00,060
+lung movement تمام it can be therapeutically
+
+139
+00:10:00,060 --> 00:10:04,500
+because what they are traumatic ممكن يكون اللي هو
+
+140
+00:10:04,500 --> 00:10:11,200
+صار أثناء العملية أو بعد العملية و هكذا Balmonary
+
+141
+00:10:11,200 --> 00:10:17,620
+embolismطبعا أي DVT صارت ممكن تنتقل والمصيبة إذا
+
+142
+00:10:17,620 --> 00:10:21,720
+إياش وصلت لـ lungs هذا هيمل فيها عنا بالمونري
+
+143
+00:10:21,720 --> 00:10:25,920
+أمبوليزم its abstraction للبلمونري artery in one
+
+144
+00:10:25,920 --> 00:10:31,870
+of its bronchusطبعا by clot arses اللي هو arreses
+
+145
+00:10:31,870 --> 00:10:36,830
+from DVT الآن زى ما حكينا فى البداية أنه انا ممكن
+
+146
+00:10:36,830 --> 00:10:41,890
+يكون عندي صار DVT نتيجة لبدردن نتيجة لل blood
+
+147
+00:10:41,890 --> 00:10:47,070
+coagulation اتحولت هذه القطعة وانتقلت الى ال
+
+148
+00:10:47,070 --> 00:10:51,590
+pulmonary artery عملتني pulmonary embolism هى من
+
+149
+00:10:51,590 --> 00:10:55,610
+أسوأ ال complication اللى ممكن انا اشوفها Hypoxia
+
+150
+00:10:56,270 --> 00:11:00,430
+law of oxygen content with tissue of body وهذا
+
+151
+00:11:00,430 --> 00:11:05,410
+اللي بيصير مع مرضى COVID-19 طلاب الأعزاء أسوأ شيء
+
+152
+00:11:05,410 --> 00:11:09,170
+اللي هو ال oxygen saturation in the blood يكون
+
+153
+00:11:09,170 --> 00:11:14,930
+بنسب قليلة جدا في الدم ليه؟ لأن هذا بيأدى لموت بعض
+
+154
+00:11:14,930 --> 00:11:18,230
+الأنسجة فيما بعد وخصوصا تأثيره على ال brain بيكون
+
+155
+00:11:18,230 --> 00:11:18,770
+فعال
+
+156
+00:11:21,390 --> 00:11:26,490
+الـ complication هنا عظيمة و كبيرة جدا خليني أشوف
+
+157
+00:11:26,490 --> 00:11:30,570
+كمان ال role of physiotherapy في هذه الحالات في ال
+
+158
+00:11:30,570 --> 00:11:33,510
+respiratory complication احنا هندخل في قسم كبير من
+
+159
+00:11:33,510 --> 00:11:37,710
+الصدرية هنا هاخد اللي هو الاشي اللي بخصني أنا مع
+
+160
+00:11:37,710 --> 00:11:40,650
+مريض القلب أهدافي انا في ال respiratory
+
+161
+00:11:40,650 --> 00:11:45,230
+complication لمريد القلب is to regain the normal
+
+162
+00:11:45,230 --> 00:11:51,140
+vital capacity بدي أعيد الرئة أنهترجع لـVocal
+
+163
+00:11:51,140 --> 00:11:54,640
+Capacity اللي هي طبيعية أو إنه يصير في عندنا lung
+
+164
+00:11:54,640 --> 00:11:58,960
+expansion طبيعي to stimulated coughing إنه أنا
+
+165
+00:11:58,960 --> 00:12:02,720
+أحاول أخلي يحفظ موضوع ال coughing عشان أقدر أعمل
+
+166
+00:12:02,720 --> 00:12:07,200
+removal of secretionالهدف الثالث to encourage the
+
+167
+00:12:07,200 --> 00:12:10,560
+full uses of lungs إن هو يحاول يستخدم ال lungs
+
+168
+00:12:10,560 --> 00:12:14,920
+بتبعته عشان ترجع لوضعها الطبيعي بنبدأ اللي هو
+
+169
+00:12:14,920 --> 00:12:19,140
+بنسميه إحنا الفيطام لـ mechanical ventilation أو
+
+170
+00:12:19,140 --> 00:12:22,280
+الـ artificial ventilation بالتدريج تمام؟ هذا
+
+171
+00:12:22,280 --> 00:12:26,420
+هتشوفون شغل ضرب عالمي في المعامل فبالتالي هيكون
+
+172
+00:12:26,420 --> 00:12:30,260
+الاشي إنه أنا بدي أعمل على تشجيع إن المريض يستخدم
+
+173
+00:12:30,260 --> 00:12:33,300
+ال lungsعشان مايصير بعد هيك فيها collapse و
+
+174
+00:12:33,300 --> 00:12:38,560
+infection و increasing لـsecretion عن طريق إيش؟
+
+175
+00:12:38,560 --> 00:12:41,700
+breathing exercise و أنا أخدت نوعين من أنواع ال
+
+176
+00:12:41,700 --> 00:12:44,180
+breathing exercise فيه عندنا الـ diaphragmatic
+
+177
+00:12:44,180 --> 00:12:47,060
+breathing و فيه عندنا ال lateral costal breathing
+
+178
+00:12:48,320 --> 00:12:52,520
+طبعا الاشي هذا لازم يكون tough preoperatively و
+
+179
+00:12:52,520 --> 00:12:56,860
+لازم انا احافظ على اللي هو الـ deep inspiration
+
+180
+00:12:56,860 --> 00:13:02,740
+followed by اللي هو relax expiration ايضا بال
+
+181
+00:13:02,740 --> 00:13:06,340
+effectiveness لل cuffingعن طريق اللي هو ال cuff
+
+182
+00:13:06,340 --> 00:13:09,140
+should be effective لصبان و ال patient should be
+
+183
+00:13:09,140 --> 00:13:14,500
+support ل ال incision area عن طريق اللي هو أنه
+
+184
+00:13:14,500 --> 00:13:19,780
+يقدم للأمام و يحط طبعا حكينابيلو أو أي إشي support
+
+185
+00:13:19,780 --> 00:13:22,960
+لمنطقة ال incision mechanical assistant for
+
+186
+00:13:22,960 --> 00:13:27,610
+removal secretion أنه أنا ممكن أساعدهبإنه أنا أعمل
+
+187
+00:13:27,610 --> 00:13:31,130
+حاجات الـ suction ممكن أعمل ال percussion أو اللي
+
+188
+00:13:31,130 --> 00:13:35,250
+هي ال clubbing massage طبعا عشان أعمل اللي هو
+
+189
+00:13:35,250 --> 00:13:39,250
+remove لل secretion to ال deep breathing exercise
+
+190
+00:13:39,250 --> 00:13:43,730
+و ال vibration أيضا البصرة للدرناج هو هذا موضوع
+
+191
+00:13:43,730 --> 00:13:46,810
+كبير هناخده ان شاء الله رب العالمين في الصدرية انه
+
+192
+00:13:46,810 --> 00:13:50,390
+أنا أخلي ال patient في وضعيات حتى يتم remove لل
+
+193
+00:13:50,390 --> 00:13:56,710
+secretionنازو فرنجيل سكشن هذا الاشي اللى انا حكيت
+
+194
+00:13:56,710 --> 00:13:59,650
+عليه بال chapter السابق انه انا لو ماقدر ال
+
+195
+00:13:59,650 --> 00:14:03,410
+patient يشيل او يطلع هذا ال secretion لوحده بال
+
+196
+00:14:03,410 --> 00:14:07,930
+coffin انا بفوت جهاز اسمه suction machine طبعا عن
+
+197
+00:14:07,930 --> 00:14:11,010
+طريق ال tube زى ما انتوا شايفين هنا بالصورة في
+
+198
+00:14:11,010 --> 00:14:17,610
+اللى هو نازو فرنجيل machine طبعا هو مؤلم جدا في
+
+199
+00:14:17,610 --> 00:14:21,010
+أسوأ الحالات بنحطه لل patient هنا زى ما هو مضحك
+
+200
+00:14:21,010 --> 00:14:27,260
+بالصورةاللي هو الـ secretion عن طريق هذا الـ tube
+
+201
+00:14:27,260 --> 00:14:30,900
+many patients necessary in some circumstances
+
+202
+00:14:30,900 --> 00:14:35,160
+where the patient is unable to cough up secretion
+
+203
+00:14:36,300 --> 00:14:39,720
+بس تبدلوا بال assistant و بس تبدلوا بال machine
+
+204
+00:14:39,720 --> 00:14:44,240
+هذه اللي احنا حكينا عليها هذا كله لال respiratory
+
+205
+00:14:44,240 --> 00:14:48,560
+complication هاخد ايضا cardiac complication ال
+
+206
+00:14:48,560 --> 00:14:51,860
+cardiac Arrhythmia ال cardiac Arrhythmia اللي هي
+
+207
+00:14:51,860 --> 00:14:56,440
+عبارة عن عدم انتظام لدقات القلب في هذا المريض اللي
+
+208
+00:14:56,440 --> 00:15:00,280
+هو our variation from normal rhythm to the heart
+
+209
+00:15:00,280 --> 00:15:05,170
+لحظة معايا التخطيط هنا هذا ال normalوهذا الـ
+
+210
+00:15:05,170 --> 00:15:09,250
+Atrial Fibrillation تمام؟ فى عنا مشكلة معناته
+
+211
+00:15:09,250 --> 00:15:12,830
+بسميها Arthrosia اللى هى عبارة عن عدم انتظام
+
+212
+00:15:12,830 --> 00:15:17,390
+لطبقات القلب فى ايضا ال cardiac Tombolade اللى هى
+
+213
+00:15:17,390 --> 00:15:21,150
+ال limitation لل ventricular تعرف فى عنا ال
+
+214
+00:15:21,150 --> 00:15:25,800
+ventricle و ال atriumالبوتينين والأوذينين زي ما
+
+215
+00:15:25,800 --> 00:15:29,140
+أخدتها في ال Anatomy طبعا ال filling during distal
+
+216
+00:15:29,140 --> 00:15:33,540
+خلال الإنقباض والانبساط بيصير فيه عندنا because of
+
+217
+00:15:33,540 --> 00:15:37,120
+fluid collection within the precardial sac خليني
+
+218
+00:15:37,120 --> 00:15:39,380
+أشوف شو يعني ال tombolence هو عبارة عن ال
+
+219
+00:15:39,380 --> 00:15:44,160
+limitation اللي صار بال ventricle اللي هو بيهخلال
+
+220
+00:15:44,160 --> 00:15:47,520
+ال filling during the stall بي cause ال fluid ال
+
+221
+00:15:47,520 --> 00:15:51,520
+fluid collection خلال ال pericardiac sac اللي هو
+
+222
+00:15:51,520 --> 00:15:57,820
+ال breast الغشاء أو تيمور بنسميه ال pericardium
+
+223
+00:15:57,820 --> 00:16:01,580
+الفيزيوثرابي مايcontra indicated في هذه الحالة
+
+224
+00:16:01,580 --> 00:16:06,020
+نائش لإنه بنخاف على ال patients تبعنا لاحظوا هنا
+
+225
+00:16:06,020 --> 00:16:11,120
+جديش في عندي fluid طبعا نتيجة اللي هو بيعمللي ضغط
+
+226
+00:16:11,120 --> 00:16:16,130
+علىالتنبونات طبعا بيعملي ضغط على تجمّر ثوائل في
+
+227
+00:16:16,130 --> 00:16:22,070
+اللي هي ال بريكارديال أو ال بريكارديام ساك لل
+
+228
+00:16:22,070 --> 00:16:27,250
+بريكارديام ساك ال بريكارديام ساك معناة الكلام ان
+
+229
+00:16:27,250 --> 00:16:33,190
+هو بيعملي overload على ال heart اللي موجوديعني الـ
+
+230
+00:16:33,190 --> 00:16:37,270
+cardiogenic shock الصدمة result from diminishes
+
+231
+00:16:37,270 --> 00:16:41,910
+cardiac output بتأثر في ان هو ال cardiac output
+
+232
+00:16:41,910 --> 00:16:46,430
+اللي هو كمية ضخ الدم اللي ناتجة عنه ال cardiac
+
+233
+00:16:46,430 --> 00:16:50,710
+output may fall very low immediately طبعا بتقل
+
+234
+00:16:50,710 --> 00:16:54,850
+after cardiac damage فيزي ثerapy هنا أيضا contra
+
+235
+00:16:54,850 --> 00:16:57,670
+indicated لإن هاي من ال complications صعبة اللي
+
+236
+00:16:57,670 --> 00:17:03,550
+بتصير مع مريض القلبالـ Complication التالتة، احنا
+
+237
+00:17:03,550 --> 00:17:06,610
+أخدنا Complication على مستوى الـ Respiratory،
+
+238
+00:17:06,610 --> 00:17:10,150
+خليني أعمل summary، وComplication على مستوى الـ
+
+239
+00:17:10,150 --> 00:17:12,890
+Heart، هنا بدي أخد الـ Complication التالتة، اللي
+
+240
+00:17:12,890 --> 00:17:15,910
+هي على مستوى الـ circulation أو الـ DVT in
+
+241
+00:17:15,910 --> 00:17:23,470
+general، تمام؟ is a coagulation or clotting
+
+242
+00:17:23,470 --> 00:17:26,790
+blooding، تمام؟ و clot blood، بيصير في clotting
+
+243
+00:17:26,790 --> 00:17:33,270
+للبلد،تمام اللى هو بيصير في عندنا تجلط للتم او انه
+
+244
+00:17:33,270 --> 00:17:36,850
+صار في عندنا خسرة دموية Trombosis if they attaches
+
+245
+00:17:36,850 --> 00:17:40,630
+the clot can cause pulmonary embolism شرحنا عنها
+
+246
+00:17:40,630 --> 00:17:44,170
+في ال pulmonary embolism انه لو صار انا في عندى
+
+247
+00:17:44,170 --> 00:17:50,370
+مشكلة في اللى هو هاي الخسرة الدموية هتنتقل و تفوت
+
+248
+00:17:50,370 --> 00:17:55,770
+علىاللي هو الـ Artery البلمونري Artery فبالتالي
+
+249
+00:17:55,770 --> 00:18:00,070
+بتسبب بلمونري Embolism الفيزيوثيرابي Prevention
+
+250
+00:18:00,070 --> 00:18:04,570
+طبعا أهم إشي أنا أمنع السبب ليش أنا أخلي يصير في
+
+251
+00:18:04,570 --> 00:18:08,350
+عندي DVT عن طريق الـ Active Leg Exercise الـ Deep
+
+252
+00:18:08,350 --> 00:18:13,180
+Breathing Exercise على الأقل الخمسدقائق في اللي هو
+
+253
+00:18:13,180 --> 00:18:17,840
+كل ساعة الـ Early Postoperative Leg Mobilization
+
+254
+00:18:17,840 --> 00:18:21,740
+إن هو يعمل pumping exercise عشان أنا أمنع الـ DVT
+
+255
+00:18:21,740 --> 00:18:25,560
+مش وقت حدثة أنا بدي أمنعها لأ هي لما بتحدث و بتخلص
+
+256
+00:18:25,560 --> 00:18:29,960
+أنا ممنوع أشتغل لكن أنا بامنعها في اللي هو قبل ما
+
+257
+00:18:29,960 --> 00:18:41,740
+يحدث الـ DVTعندما يتطور الـ DVT، في حالة
+
+258
+00:18:41,740 --> 00:18:45,460
+الـ acute physiotherapy is contraindicated ممنوع
+
+259
+00:18:45,460 --> 00:18:49,080
+من عامة أن أشتغل، لأن بأي exercise أعمل دي
+
+260
+00:18:49,080 --> 00:18:53,180
+attaches انفصال لهادي الخسر الدموية وتتحرك عبر الـ
+
+261
+00:18:53,180 --> 00:18:59,640
+bloodstream في حالة الـ chronic casesاللي applied
+
+262
+00:18:59,640 --> 00:19:03,120
+to deep breathing exercise active exercise and
+
+263
+00:19:03,120 --> 00:19:07,280
+mobilization و ال elastic bandage مهم جدا اللي هو
+
+264
+00:19:07,280 --> 00:19:10,560
+ال aid figure بدي أعمله to control swelling and
+
+265
+00:19:10,560 --> 00:19:14,340
+venous return تمام، إذا في ال acute لسه المرحلة
+
+266
+00:19:14,340 --> 00:19:19,560
+جديدة و الحالة طور عندها DVT جديدة ممنوع أشتغل
+
+267
+00:19:19,560 --> 00:19:22,660
+معاها contraindication لكن في ال chronic بشتغل
+
+268
+00:19:22,660 --> 00:19:26,160
+range of motion exercise breathing exercise و ال
+
+269
+00:19:26,160 --> 00:19:32,010
+elastic كمان شغالةلازم تكون موجودة الـ wound
+
+270
+00:19:32,010 --> 00:19:35,810
+infection ما شاء الله حدث ولا حرج علنا على طول
+
+271
+00:19:35,810 --> 00:19:41,090
+بيصير علنا اللي هو التهابات ناتجة بعد العمليةالـ
+
+272
+00:19:41,090 --> 00:19:44,530
+infected ليه؟ لإن أحنا بيئة طبعا رطبة فبالتالي
+
+273
+00:19:44,530 --> 00:19:49,950
+بتطور أو ممكن الشخص نفسه بتكون اللي هو نوع جسمه ما
+
+274
+00:19:49,950 --> 00:19:53,970
+بيعمل good healing خصوصا إذا كان ضيابة
+
+275
+00:19:53,970 --> 00:19:57,070
+accumulation تبعنا، بيكون في عندهم poor healing زي
+
+276
+00:19:57,070 --> 00:19:59,750
+ما أخدنا فبالتالي ال infected بيكون أو ال
+
+277
+00:19:59,750 --> 00:20:04,670
+infection one بيكون واردليه بيصير ال patient عندنا
+
+278
+00:20:04,670 --> 00:20:07,170
+عن ال signs و ال symptoms تبعية ال infection
+
+279
+00:20:07,170 --> 00:20:11,970
+hotness و redness و edematous دل ال sutures طبعا
+
+280
+00:20:11,970 --> 00:20:16,770
+وارمة هذه الغرز و cut and through خلال ال tissue
+
+281
+00:20:16,770 --> 00:20:20,470
+and the wound may gap either long or long haul
+
+282
+00:20:20,470 --> 00:20:23,930
+length between the sutures بتبدأ اللي هي نتيجة
+
+283
+00:20:23,930 --> 00:20:29,110
+الممكن لو كان كمان في عنها صديد بس صار في ال wound
+
+284
+00:20:29,110 --> 00:20:33,870
+نفسها انه بتحلل هذه ال wound و بتبعد عن بعضهاالبعض
+
+285
+00:20:33,870 --> 00:20:38,330
+الفيزيو ثيرابي clean wand can receive superficial
+
+286
+00:20:38,330 --> 00:20:42,410
+heat زي ال infrared لأنه نعرف ال infrared هي عبارة
+
+287
+00:20:42,410 --> 00:20:47,770
+عن اشي انتيبايتك بتشتغل في superficial wand ال
+
+288
+00:20:47,770 --> 00:20:52,530
+ultrasonic كمان بيشتغلها في ال heart scars اللي هو
+
+289
+00:20:52,530 --> 00:20:56,390
+لو صار في عندي scar tissue ال paraffin waxطبعا
+
+290
+00:20:56,390 --> 00:20:59,990
+هتشتغل بكيف أن البرافين واكس أنا بدي أشتغلها في ال
+
+291
+00:20:59,990 --> 00:21:04,230
+open heart surgery بجيب باللي هو ال tongue
+
+292
+00:21:04,230 --> 00:21:08,170
+depressors اللي هي اللي بيفحص فيها الدكتور اللي
+
+293
+00:21:08,170 --> 00:21:13,530
+was و بحط عليها شوية wax و بحطها على مكان العملية
+
+294
+00:21:13,530 --> 00:21:17,930
+عشان اللي هو أعمل softening لـscar tissue اللي
+
+295
+00:21:17,930 --> 00:21:20,990
+صارت اللي كانت بالأصل هي infected و أدت إلى وجود
+
+296
+00:21:20,990 --> 00:21:26,070
+scar tissue كبيرة لازم أنا أبدأ أقلر منهاهذا
+
+297
+00:21:26,070 --> 00:21:29,910
+بالنسبة للـ wound infection اللي هو الـ
+
+298
+00:21:29,910 --> 00:21:34,050
+complication الرابع ال pressure source اللي أنا
+
+299
+00:21:34,050 --> 00:21:39,710
+حكيت عليه اليوم هذا ال patient عندي طور من حاله و
+
+300
+00:21:39,710 --> 00:21:42,910
+طورت حالته للأسواق صار في عنده pressure source
+
+301
+00:21:42,910 --> 00:21:48,490
+ناتجة عن العدم أو اللي هو ال immobilityPrevent by
+
+302
+00:21:48,490 --> 00:21:51,390
+frequently changing patient postural لازم ال
+
+303
+00:21:51,390 --> 00:21:54,590
+position تبع ال patient أغيره كل ساعتين في هذه
+
+304
+00:21:54,590 --> 00:21:59,090
+الحالة وهذا طبعا بالمساعدة دور التمريد Frequently
+
+305
+00:21:59,090 --> 00:22:04,030
+check لل integrity of skin and area of redness بدأ
+
+306
+00:22:04,030 --> 00:22:08,610
+أتأكد من سلامة الجلب دائما أتفحص ال back ال
+
+307
+00:22:08,610 --> 00:22:11,990
+scapula ال calcaneus
+
+308
+00:22:13,780 --> 00:22:17,440
+كل الـ bony prominence اللي أنا عاملة عليها
+
+309
+00:22:17,440 --> 00:22:21,820
+pressure عشان مايصير في عندنا بعد هيك pit source
+
+310
+00:22:21,820 --> 00:22:26,340
+ال ultraviolet هنا كتير مهمة جهازنا ال ultraviolet
+
+311
+00:22:26,340 --> 00:22:30,320
+كتير مهم و كويس لأنه بيشتغل as antibiotic
+
+312
+00:22:30,320 --> 00:22:35,760
+apparatus تمام ال neurological damage بعض الأحيان
+
+313
+00:22:35,760 --> 00:22:39,540
+مرض القلب بيطوروا مشاكل أو بيطوروا مشاكل اللي لها
+
+314
+00:22:39,540 --> 00:22:44,200
+علاقة بال neurological systemخلال ال .. ال .. هو
+
+315
+00:22:44,200 --> 00:22:46,920
+الانسيزي على سبيل المثال ال brain may damaged
+
+316
+00:22:46,920 --> 00:22:50,800
+تمام؟ و ممكن كمان ال brain يصير في ال damage نتيجة
+
+317
+00:22:50,800 --> 00:22:54,340
+ال embolism لأنه حكينا إذا هذه الخطرة الدموية
+
+318
+00:22:54,340 --> 00:22:57,420
+صارها دي attached يا إما هتعدي على ال lung يا إما
+
+319
+00:22:57,420 --> 00:23:00,620
+هتعدي على ال brain إذا عدت على ال lung معناه تصار
+
+320
+00:23:00,620 --> 00:23:03,660
+عنها preliminary embolism إذا عدت على ال brain صار
+
+321
+00:23:03,660 --> 00:23:10,370
+stroke تمام؟الفيزيوثرابي مستتريته from paralysis
+
+322
+00:23:10,370 --> 00:23:15,110
+that occurs إذا صار والله عندنا stroke ناتجة عن
+
+323
+00:23:15,110 --> 00:23:19,730
+الembolism معناة الكلام هيصير في عنا مثلا اللي هو
+
+324
+00:23:19,730 --> 00:23:23,970
+right hemibalgia هعالج أنا هدخل بجانب إلى إنه
+
+325
+00:23:23,970 --> 00:23:28,730
+المريض تبعي cardiac هيكون اللي هو neuro obviously
+
+326
+00:23:28,730 --> 00:23:31,610
+the patient cardiac state may limit from
+
+327
+00:23:31,610 --> 00:23:37,420
+rehabilitation some extentto some extent معناك
+
+328
+00:23:37,420 --> 00:23:43,720
+الكلام بشكل واضح أنه أنا ال
+
+329
+00:23:43,720 --> 00:23:49,060
+cardiac patient stated may limit from
+
+330
+00:23:49,060 --> 00:23:58,120
+rehabilitation to some extent طبعا obviously
+
+331
+00:23:58,120 --> 00:24:03,810
+the patient cardiac state may limitالـ Cardiac
+
+332
+00:24:03,810 --> 00:24:07,790
+patient may limit the form rehabilitation to some
+
+333
+00:24:07,790 --> 00:24:10,970
+extent بعض الأحيان ممكن أنا حاجات أطور الحالة مع
+
+334
+00:24:10,970 --> 00:24:15,390
+المريض أو أنه أنا أغير في الخطة تبعتي حسب حالة ال
+
+335
+00:24:15,390 --> 00:24:19,510
+patient إذا هيك أنا أخدت ستة complications تابعين
+
+336
+00:24:19,510 --> 00:24:26,630
+لمريض القلب تمام؟ وبهيك أنا أنهيت هذا ال chapter
+
+337
+00:24:26,630 --> 00:24:28,730
+ويعطيكم العافية
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/15HwhIYihT4_raw.json b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/15HwhIYihT4_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..0f7b5aa577aaed2ade85909655b421d1b4016e35
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/15HwhIYihT4_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 1383, "start": 1.11, "end": 13.83, "text": "بسم الله الرحمن الرحيم صلى الله عليه وعلى محمد وعلى آله وصحبه أجمعين راح أدخل اليوم في chapter اسمه الـ Complication اللي مفعلة عند عملية ال cardio thoracic surgery", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 20328, 23942, 21984, 47356, 4032, 3615, 23942, 3714, 35571, 3215, 4032, 3615, 23942, 19753, 43761, 4032, 9381, 5016, 3555, 3224, 5551, 7435, 2304, 3615, 9957, 12602, 39319, 5551, 3215, 9778, 1211, 45595, 20498, 8978, 7187, 24525, 2304, 3224, 2423, 39184, 2432, 4770, 399, 13672, 1829, 3714, 5172, 30241, 3660, 43242, 6225, 42213, 10632, 2423, 34274, 11588, 326, 299, 7930], "avg_logprob": -0.2091259014779243, "compression_ratio": 1.4772727272727273, "no_speech_prob": 5.364418029785156e-07, "words": [{"start": 1.11, "end": 1.41, "word": "بسم", "probability": 0.847412109375}, {"start": 1.41, "end": 1.69, "word": " الله", "probability": 0.9609375}, {"start": 1.69, "end": 2.11, 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\ No newline at end of file
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/15HwhIYihT4_raw.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/15HwhIYihT4_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..5ecf9ce6cf6115a74d5e9ce5c0bc4660603448e5
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/15HwhIYihT4_raw.srt
@@ -0,0 +1,1348 @@
+1
+00:00:01,110 --> 00:00:04,690
+بسم الله الرحمن الرحيم صلى الله عليه وعلى محمد
+
+2
+00:00:04,690 --> 00:00:08,530
+وعلى آله وصحبه أجمعين راح أدخل اليوم في chapter
+
+3
+00:00:08,530 --> 00:00:12,350
+اسمه الـ Complication اللي مفعلة عند عملية ال
+
+4
+00:00:12,350 --> 00:00:16,210
+cardio thoracic surgeryأخدنا في ال chapter السابق
+
+5
+00:00:16,210 --> 00:00:21,150
+عن ال role of physiotherapy أثناء اللي هي pre
+
+6
+00:00:21,150 --> 00:00:24,410
+-operative و post-operative هنا هنشوف إذا المريض
+
+7
+00:00:24,410 --> 00:00:27,610
+تبعنا هيدخل فيه complication و إيش هي ال
+
+8
+00:00:27,610 --> 00:00:30,390
+complication و إيش ال role of physiotherapy
+
+9
+00:00:30,390 --> 00:00:35,030
+أثناءها نبدأ على بركة الله ال role of
+
+10
+00:00:35,030 --> 00:00:38,840
+physiotherapy أثناء ال complicationفي البداية، إيش
+
+11
+00:00:38,840 --> 00:00:43,600
+هي ال factors اللي ممكن تزيد أو تساهم معايا في ال
+
+12
+00:00:43,600 --> 00:00:47,600
+postoperative communication؟ أول عامل اللي هو ال
+
+13
+00:00:47,600 --> 00:00:51,260
+general anesthesia، إشي طبيعي، تعرفوا ال patient
+
+14
+00:00:51,260 --> 00:00:54,740
+هيدخل open heart surgery، معناة الكلام إنه أنا
+
+15
+00:00:54,740 --> 00:00:59,490
+هخدر وأبنش كل الجسمهذا هيعمل ايه؟ Decrease
+
+16
+00:00:59,490 --> 00:01:04,190
+للـNormal Cleary Actions of Tracheobronchial Atria
+
+17
+00:01:04,190 --> 00:01:10,330
+الـ Lung نفسها هيصير فيها Decreasing للـ Normal
+
+18
+00:01:10,330 --> 00:01:15,730
+Capacity Decreasing ليش؟ لأنه صار فيها إش جديد دخل
+
+19
+00:01:15,730 --> 00:01:21,650
+على الجسم أدى لإيش؟ لـ Lung Collapse لـ Collection
+
+20
+00:01:21,650 --> 00:01:25,090
+of Secretions كل الأمور هذه بتعيق اللي هي ال
+
+21
+00:01:25,090 --> 00:01:27,070
+ventilation أيضا
+
+22
+00:01:29,260 --> 00:01:33,860
+هذا الفنش اللي أخده ال patient عمل على decrease of
+
+23
+00:01:33,860 --> 00:01:37,640
+respiratory center in central nervous system كلنا
+
+24
+00:01:37,640 --> 00:01:41,020
+بنعرف إن ال center of respiratory system موجود
+
+25
+00:01:41,020 --> 00:01:45,080
+داخل ال central nervous system بيؤدي لإنه يصير
+
+26
+00:01:45,080 --> 00:01:47,920
+التنفس shallow shallow breathing أو shallow
+
+27
+00:01:47,920 --> 00:01:52,380
+respiratory system معناته هذا هيقلل اتدة ال volume
+
+28
+00:01:52,380 --> 00:01:57,020
+اللي هو ال volume تبع ال air اللي بتحرك in و out
+
+29
+00:01:57,360 --> 00:02:00,920
+للـ lungs خلال الـ quality أو الـ quiet of
+
+30
+00:02:00,920 --> 00:02:05,500
+breathing إذا نتيجة لإن أنا هنا اشتغلت على الـ
+
+31
+00:02:05,500 --> 00:02:10,160
+central nervous system إن أنا أدخلت المريض في حالة
+
+32
+00:02:10,160 --> 00:02:13,620
+من الكومة أو حالة من ال unconsciousness فبالتالي
+
+33
+00:02:13,620 --> 00:02:17,080
+هنا أنا اشتغلت على مستوى عالي في الأجهزة معناة
+
+34
+00:02:17,080 --> 00:02:21,120
+الكلام إن في عندي shallow respiration صارت هذه الـ
+
+35
+00:02:21,120 --> 00:02:24,720
+shallow respiration قدّت لقلة في إتدال volume
+
+36
+00:02:25,340 --> 00:02:29,440
+وارفنا شو يعني هو اتد ال volume ال second factor
+
+37
+00:02:29,440 --> 00:02:34,700
+ال intubation أكيد طبعا دخل المريض العمليات معناته
+
+38
+00:02:34,700 --> 00:02:40,040
+انا هححط او ال nurse هم اللي هيحطوا tube داخل الفم
+
+39
+00:02:40,040 --> 00:02:44,120
+او ممكن يكون في tracheostomy اللي هو قطع في
+
+40
+00:02:44,120 --> 00:02:49,680
+التراكيه نفسها وندخل في اللي هو التراكيستومي الآن
+
+41
+00:02:49,680 --> 00:02:54,300
+ال intubation هو insertion لل endotracheal او
+
+42
+00:02:54,300 --> 00:02:58,580
+nasalGastric Tube اللي هو الـ NG Tube احنا
+
+43
+00:02:58,580 --> 00:03:03,920
+بنختصره، تمام؟ اذا زرع او وضع اندوتراكيا لـ tube
+
+44
+00:03:03,920 --> 00:03:09,280
+بدى يفوت من الفم للتراكيا مباشرة او من اللي هو
+
+45
+00:03:09,280 --> 00:03:15,700
+بنسمي الانفل بالعوم المعدي اللي هو Nasogastric
+
+46
+00:03:15,700 --> 00:03:20,520
+Tube ال irritation اول complication هيصير معايا
+
+47
+00:03:20,520 --> 00:03:26,770
+طبعا اشي طبيعىلأن في ذرع هذا الجهاز داخل الجسم
+
+48
+00:03:26,770 --> 00:03:33,290
+هيصير في عندي عملية تهيجفي العينة اللي بتتاخد في
+
+49
+00:03:33,290 --> 00:03:37,410
+الناس اللي شاكين فيهم ان يكونوا عندهم COVID-19
+
+50
+00:03:37,410 --> 00:03:41,150
+لحظوا كيف بتكون مؤلمة يعني إذا شفتوا كذا فيديو أو
+
+51
+00:03:41,150 --> 00:03:45,030
+شفتوا إشي فليه؟ لأنه صار في عندنا irritation صار
+
+52
+00:03:45,030 --> 00:03:49,050
+في عندنا عملية تهييج لـmucous membrane اللي موجود
+
+53
+00:03:49,050 --> 00:03:53,330
+في اللي هو التراكيا أو في كل ال respiratory system
+
+54
+00:03:53,730 --> 00:03:57,410
+إذا الـ rotation هو عبارة عن أول عامل أو أول
+
+55
+00:03:57,410 --> 00:04:01,230
+factors من الcomplication منها اللي هو الـmucous
+
+56
+00:04:01,230 --> 00:04:04,750
+lining تبع الـtracheobronchial tree which causes
+
+57
+00:04:04,750 --> 00:04:08,670
+increasing the mucous production معناة الكلام، هذا
+
+58
+00:04:08,670 --> 00:04:13,790
+هيزيد من اللي هو الـmucous productionفبالتالي،
+
+59
+00:04:13,790 --> 00:04:16,830
+decrease للـ Normal Action of Cilia in Pulmonary
+
+60
+00:04:16,830 --> 00:04:21,730
+Tract هيقلل العمل الأهداف الموجودة في الـ
+
+61
+00:04:21,730 --> 00:04:25,850
+Respiratory System طبعاً، which lead to bowling of
+
+62
+00:04:25,850 --> 00:04:30,010
+secretion معناة الكلام، المنطقة كلها هتم تلقى،
+
+63
+00:04:30,010 --> 00:04:34,670
+ليش؟ بإن هو المخاطر أو الـ Secretion هاي ليه؟ لأنه
+
+64
+00:04:34,670 --> 00:04:38,630
+دخل عندنا تيوب، لاحظوا التيوب هذابكون كتير رفيع
+
+65
+00:04:38,630 --> 00:04:47,540
+ولكن بيعمل ليهيجان لهذه المنطقةالانسيشال بين الألم
+
+66
+00:04:47,540 --> 00:04:51,000
+المنتج عن العملية نفسه هذا بيسبب لل patient أنه
+
+67
+00:04:51,000 --> 00:04:55,140
+يتنفس بشكل سفحي ليه؟ عشان هو خايف إذا أخد نفس عميق
+
+68
+00:04:55,140 --> 00:05:00,240
+أن هذا يأثر على العملية long expansion is
+
+69
+00:05:00,240 --> 00:05:03,060
+restricted and secretions are not adequately
+
+70
+00:05:03,060 --> 00:05:07,660
+mobilized نفسها الرقى نفسها تمدد الرقى ما هيكون
+
+71
+00:05:07,660 --> 00:05:12,840
+بشكلأو إنه يتم بأرياحية، لأ، هيكون Restricted
+
+72
+00:05:12,840 --> 00:05:17,320
+محدد، ليه؟ لأن الـSecretion دا اللي صار، عملتلي
+
+73
+00:05:17,320 --> 00:05:21,360
+Not Educatedly mobilized، مش سهل إن هو يتحرك،
+
+74
+00:05:21,360 --> 00:05:26,120
+أيضًا Restricted DeepEffective Cuff The patient is
+
+75
+00:05:26,120 --> 00:05:29,700
+usually have shallow cuffing that does not
+
+76
+00:05:29,700 --> 00:05:33,980
+effectively to mobilize secretion الآن ال shallow
+
+77
+00:05:33,980 --> 00:05:37,720
+cuffing أو الكحة العادية ما بتعمل على ال remove لل
+
+78
+00:05:37,720 --> 00:05:40,480
+secretion اللي متجمع مثلا في ال lower loop تبع ال
+
+79
+00:05:40,480 --> 00:05:44,860
+lungs لأ بتخليه مكانه فبالتالي هذا ناتج عن إيش؟ هو
+
+80
+00:05:44,860 --> 00:05:48,600
+المريض أصلا مكاني كحة عندي كحة جافة وكحة صفحية
+
+81
+00:05:48,600 --> 00:05:54,190
+ليه؟ لأن هو خايف من البعن اللي هيصير في المكان
+
+82
+00:05:54,190 --> 00:06:00,150
+العملية الـ brain medication تمام
+
+83
+00:06:00,150 --> 00:06:03,170
+على الرغم من أن ال brain medication administrated
+
+84
+00:06:03,170 --> 00:06:07,090
+postoperatively تند طبعا بالرغم من انسجة ال brain
+
+85
+00:06:07,090 --> 00:06:10,950
+it also depressed ال respiratory system ناتج عن
+
+86
+00:06:10,950 --> 00:06:14,350
+اللي هو ال depression اللي صار في ال respiratory
+
+87
+00:06:14,350 --> 00:06:18,190
+center اللي هو موجود في ال brain تند أيضا
+
+88
+00:06:18,190 --> 00:06:21,350
+decreased ال normal cellular reaction in bronchial
+
+89
+00:06:21,350 --> 00:06:25,350
+tractوالعاملين هذول احنا أخدناهم في البداية إن هو
+
+90
+00:06:25,350 --> 00:06:29,650
+بقل اللي هو respiratory center specificity وكمان
+
+91
+00:06:29,650 --> 00:06:32,890
+بتقل اللي هي ال normal cellular reaction نتيجة
+
+92
+00:06:32,890 --> 00:06:37,710
+لزياد بتكميات اللي هو ال secretion أو ال mucus
+
+93
+00:06:37,710 --> 00:06:43,130
+للمخات نفسها المخات نفسها ما بتزيد فبالتالي بتبطل
+
+94
+00:06:43,130 --> 00:06:47,690
+السلية اللي هي السلية الأحداث إنه تشتغل بشكل فعال
+
+95
+00:06:47,690 --> 00:06:52,570
+ال factors الخامس عنا ال general inactivityبحد
+
+96
+00:06:52,570 --> 00:06:57,670
+ذاتها هي هذه الممرضة ان هو مازال بدردان ومازال على
+
+97
+00:06:57,670 --> 00:07:01,430
+السرير معناته هذا بتسبب لعدة مضاعفات it causes
+
+98
+00:07:01,430 --> 00:07:04,930
+secretion to build particularly طبعا posterior
+
+99
+00:07:04,930 --> 00:07:10,270
+basal segment of the lower lobes هذا بيخلي ان كل
+
+100
+00:07:10,270 --> 00:07:14,110
+ال secretion يتجمع في ال posterior basal segment
+
+101
+00:07:14,110 --> 00:07:18,090
+اللي هو في ال lower loop تحت generally ال weakness
+
+102
+00:07:18,090 --> 00:07:24,170
+and fatigue طبعا ليه؟ لأن هوما بيحرك حاله مافي اي
+
+103
+00:07:24,170 --> 00:07:28,130
+activity ال muscle صارت weak كمان هو نفسه صار
+
+104
+00:07:28,130 --> 00:07:32,870
+fatigue نتيجة اللي هو ال bedridden اللي هو فيه
+
+105
+00:07:32,870 --> 00:07:37,130
+decrease هذا بيقلل اللي هو ال effectiveness فعالية
+
+106
+00:07:37,130 --> 00:07:40,710
+ال cuffing وانا مابدي فعالية ال cuffing أصلا اتقل
+
+107
+00:07:40,710 --> 00:07:44,510
+لإن هي الأساس اللي موجود عندى عشان تعمل remove لا
+
+108
+00:07:44,510 --> 00:07:49,070
+secretion خليني أعدد شو ال complicationالـ
+
+109
+00:07:49,070 --> 00:07:52,330
+Complication لمريد الـ Cardiothoracic Surgery أول
+
+110
+00:07:52,330 --> 00:07:54,810
+إشي في عندي Complication على مستوى ال respiratory
+
+111
+00:07:54,810 --> 00:07:59,810
+system على ال cardiac، thrombosis و DVT ال
+
+112
+00:07:59,810 --> 00:08:04,630
+hemorrhagic، ال wound infection وهذه حدث ولا حرج ل
+
+113
+00:08:04,630 --> 00:08:08,410
+pressure source نتيجة للبدردن أو إنه كان مثلا على
+
+114
+00:08:08,410 --> 00:08:12,310
+سبيل المثال دخل في غيبوبة ناتجة عن اللي هو
+
+115
+00:08:12,310 --> 00:08:17,070
+something wrong بعدين دخلي فيه pressure sourceالـ
+
+116
+00:08:17,070 --> 00:08:20,310
+muscle wasting and impairment of function طبعا ال
+
+117
+00:08:20,310 --> 00:08:23,150
+environment of function ناتج عن ال muscle function
+
+118
+00:08:23,150 --> 00:08:26,490
+هاي ال total of complication مجموعة ال
+
+119
+00:08:26,490 --> 00:08:29,590
+complications اللي صارت نيجي نشوف ال respiratory
+
+120
+00:08:29,590 --> 00:08:35,190
+problems ال atlases طبعا إيش هو؟ هو عبارة عن عدم
+
+121
+00:08:35,190 --> 00:08:42,250
+تمدد بشكل كافي للرئة نتيجة ال collapse الدمور أو
+
+122
+00:08:42,250 --> 00:08:47,450
+الضيق اللي صارللـ Alveoli, hypoventilation is the
+
+123
+00:08:47,450 --> 00:08:51,170
+most common postoperative cause بديدخل المريض
+
+124
+00:08:51,170 --> 00:08:55,510
+عندنا في hypoventilation على طول طبعا بيرجعون نيرس
+
+125
+00:08:55,510 --> 00:08:58,250
+على mechanical ventilation أو artificial
+
+126
+00:08:58,250 --> 00:09:05,610
+ventilation ال postoperative pneumonia due to
+
+127
+00:09:05,610 --> 00:09:08,970
+infection or akin to secretion present two or
+
+128
+00:09:08,970 --> 00:09:12,130
+three days postoperative نمونيا هنا معناتها
+
+129
+00:09:12,130 --> 00:09:15,980
+inflammation للـ lung tissueتمام انا صار في عندي
+
+130
+00:09:15,980 --> 00:09:20,640
+التهاب في انسجة الرئة نفسها هذا ناتج عن اي
+
+131
+00:09:20,640 --> 00:09:24,220
+infection صار للمريض ممكن اخد العدوى من اي حد ممكن
+
+132
+00:09:24,220 --> 00:09:28,620
+نتيجة لزرع ال tube هادي توا ان كانت ال ng tube او
+
+133
+00:09:28,620 --> 00:09:33,120
+اي tube انا حاطيته كان في infection و قدت الى وجود
+
+134
+00:09:33,120 --> 00:09:39,940
+pneumonia pneumothorax is a complication of gas or
+
+135
+00:09:39,940 --> 00:09:45,140
+air in thoracic cavity نيمو لحالهاتعني air تمام
+
+136
+00:09:45,140 --> 00:09:51,060
+thoracic هواء صدر إذا هو هواء في الصدر تجمع للغاز
+
+137
+00:09:51,060 --> 00:09:56,440
+داخل التجويز الصدري فهذا هيعمل على restriction لل
+
+138
+00:09:56,440 --> 00:10:00,060
+lung movement تمام it can be therapeutically
+
+139
+00:10:00,060 --> 00:10:04,500
+because what they are traumatic ممكن يكون اللي هو
+
+140
+00:10:04,500 --> 00:10:11,200
+صار أثناء العملية أو بعد العملية و هكذا Balmonary
+
+141
+00:10:11,200 --> 00:10:17,620
+embolismطبعا أي DVT صارت ممكن تنتقل والمصيبة إذا
+
+142
+00:10:17,620 --> 00:10:21,720
+إياش وصلت لـ lungs هذا هيمل فيها عنا بالمونري
+
+143
+00:10:21,720 --> 00:10:25,920
+أمبوليزم its abstraction للبلمونري artery in one
+
+144
+00:10:25,920 --> 00:10:31,870
+of its bronchusطبعا by clot arses اللي هو arreses
+
+145
+00:10:31,870 --> 00:10:36,830
+from DVT الآن زى ما حكينا فى البداية أنه انا ممكن
+
+146
+00:10:36,830 --> 00:10:41,890
+يكون عندي صار DVT نتيجة لبدردن نتيجة لل blood
+
+147
+00:10:41,890 --> 00:10:47,070
+coagulation اتحولت هذه القطعة وانتقلت الى ال
+
+148
+00:10:47,070 --> 00:10:51,590
+pulmonary artery عملتني pulmonary embolism هى من
+
+149
+00:10:51,590 --> 00:10:55,610
+أسوأ ال complication اللى ممكن انا اشوفها Hypoxia
+
+150
+00:10:56,270 --> 00:11:00,430
+law of oxygen content with tissue of body وهذا
+
+151
+00:11:00,430 --> 00:11:05,410
+اللي بيصير مع مرضى COVID-19 طلاب الأعزاء أسوأ شيء
+
+152
+00:11:05,410 --> 00:11:09,170
+اللي هو ال oxygen saturation in the blood يكون
+
+153
+00:11:09,170 --> 00:11:14,930
+بنسب قليلة جدا في الدم ليه؟ لأن هذا بيأدى لموت بعض
+
+154
+00:11:14,930 --> 00:11:18,230
+الأنسجة فيما بعد وخصوصا تأثيره على ال brain بيكون
+
+155
+00:11:18,230 --> 00:11:18,770
+فعال
+
+156
+00:11:21,390 --> 00:11:26,490
+الـ complication هنا عظيمة و كبيرة جدا خليني أشوف
+
+157
+00:11:26,490 --> 00:11:30,570
+كمان ال role of physiotherapy في هذه الحالات في ال
+
+158
+00:11:30,570 --> 00:11:33,510
+respiratory complication احنا هندخل في قسم كبير من
+
+159
+00:11:33,510 --> 00:11:37,710
+الصدرية هنا هاخد اللي هو الاشي اللي بخصني أنا مع
+
+160
+00:11:37,710 --> 00:11:40,650
+مريض القلب أهدافي انا في ال respiratory
+
+161
+00:11:40,650 --> 00:11:45,230
+complication لمريد القلب is to regain the normal
+
+162
+00:11:45,230 --> 00:11:51,140
+vital capacity بدي أعيد الرئة أنهترجع لـVocal
+
+163
+00:11:51,140 --> 00:11:54,640
+Capacity اللي هي طبيعية أو إنه يصير في عندنا lung
+
+164
+00:11:54,640 --> 00:11:58,960
+expansion طبيعي to stimulated coughing إنه أنا
+
+165
+00:11:58,960 --> 00:12:02,720
+أحاول أخلي يحفظ موضوع ال coughing عشان أقدر أعمل
+
+166
+00:12:02,720 --> 00:12:07,200
+removal of secretionالهدف الثالث to encourage the
+
+167
+00:12:07,200 --> 00:12:10,560
+full uses of lungs إن هو يحاول يستخدم ال lungs
+
+168
+00:12:10,560 --> 00:12:14,920
+بتبعته عشان ترجع لوضعها الطبيعي بنبدأ اللي هو
+
+169
+00:12:14,920 --> 00:12:19,140
+بنسميه إحنا الفيطام لـ mechanical ventilation أو
+
+170
+00:12:19,140 --> 00:12:22,280
+الـ artificial ventilation بالتدريج تمام؟ هذا
+
+171
+00:12:22,280 --> 00:12:26,420
+هتشوفون شغل ضرب عالمي في المعامل فبالتالي هيكون
+
+172
+00:12:26,420 --> 00:12:30,260
+الاشي إنه أنا بدي أعمل على تشجيع إن المريض يستخدم
+
+173
+00:12:30,260 --> 00:12:33,300
+ال lungsعشان مايصير بعد هيك فيها collapse و
+
+174
+00:12:33,300 --> 00:12:38,560
+infection و increasing لـsecretion عن طريق إيش؟
+
+175
+00:12:38,560 --> 00:12:41,700
+breathing exercise و أنا أخدت نوعين من أنواع ال
+
+176
+00:12:41,700 --> 00:12:44,180
+breathing exercise فيه عندنا الـ diaphragmatic
+
+177
+00:12:44,180 --> 00:12:47,060
+breathing و فيه عندنا ال lateral costal breathing
+
+178
+00:12:48,320 --> 00:12:52,520
+طبعا الاشي هذا لازم يكون tough preoperatively و
+
+179
+00:12:52,520 --> 00:12:56,860
+لازم انا احافظ على اللي هو الـ deep inspiration
+
+180
+00:12:56,860 --> 00:13:02,740
+followed by اللي هو relax expiration ايضا بال
+
+181
+00:13:02,740 --> 00:13:06,340
+effectiveness لل cuffingعن طريق اللي هو ال cuff
+
+182
+00:13:06,340 --> 00:13:09,140
+should be effective لصبان و ال patient should be
+
+183
+00:13:09,140 --> 00:13:14,500
+support ل ال incision area عن طريق اللي هو أنه
+
+184
+00:13:14,500 --> 00:13:19,780
+يقدم للأمام و يحط طبعا حكينابيلو أو أي إشي support
+
+185
+00:13:19,780 --> 00:13:22,960
+لمنطقة ال incision mechanical assistant for
+
+186
+00:13:22,960 --> 00:13:27,610
+removal secretion أنه أنا ممكن أساعدهبإنه أنا أعمل
+
+187
+00:13:27,610 --> 00:13:31,130
+حاجات الـ suction ممكن أعمل ال percussion أو اللي
+
+188
+00:13:31,130 --> 00:13:35,250
+هي ال clubbing massage طبعا عشان أعمل اللي هو
+
+189
+00:13:35,250 --> 00:13:39,250
+remove لل secretion to ال deep breathing exercise
+
+190
+00:13:39,250 --> 00:13:43,730
+و ال vibration أيضا البصرة للدرناج هو هذا موضوع
+
+191
+00:13:43,730 --> 00:13:46,810
+كبير هناخده ان شاء الله رب العالمين في الصدرية انه
+
+192
+00:13:46,810 --> 00:13:50,390
+أنا أخلي ال patient في وضعيات حتى يتم remove لل
+
+193
+00:13:50,390 --> 00:13:56,710
+secretionنازو فرنجيل سكشن هذا الاشي اللى انا حكيت
+
+194
+00:13:56,710 --> 00:13:59,650
+عليه بال chapter السابق انه انا لو ماقدر ال
+
+195
+00:13:59,650 --> 00:14:03,410
+patient يشيل او يطلع هذا ال secretion لوحده بال
+
+196
+00:14:03,410 --> 00:14:07,930
+coffin انا بفوت جهاز اسمه suction machine طبعا عن
+
+197
+00:14:07,930 --> 00:14:11,010
+طريق ال tube زى ما انتوا شايفين هنا بالصورة في
+
+198
+00:14:11,010 --> 00:14:17,610
+اللى هو نازو فرنجيل machine طبعا هو مؤلم جدا في
+
+199
+00:14:17,610 --> 00:14:21,010
+أسوأ الحالات بنحطه لل patient هنا زى ما هو مضحك
+
+200
+00:14:21,010 --> 00:14:27,260
+بالصورةاللي هو الـ secretion عن طريق هذا الـ tube
+
+201
+00:14:27,260 --> 00:14:30,900
+many patients necessary in some circumstances
+
+202
+00:14:30,900 --> 00:14:35,160
+where the patient is unable to cough up secretion
+
+203
+00:14:36,300 --> 00:14:39,720
+بس تبدلوا بال assistant و بس تبدلوا بال machine
+
+204
+00:14:39,720 --> 00:14:44,240
+هذه اللي احنا حكينا عليها هذا كله لال respiratory
+
+205
+00:14:44,240 --> 00:14:48,560
+complication هاخد ايضا cardiac complication ال
+
+206
+00:14:48,560 --> 00:14:51,860
+cardiac Arrhythmia ال cardiac Arrhythmia اللي هي
+
+207
+00:14:51,860 --> 00:14:56,440
+عبارة عن عدم انتظام لدقات القلب في هذا المريض اللي
+
+208
+00:14:56,440 --> 00:15:00,280
+هو our variation from normal rhythm to the heart
+
+209
+00:15:00,280 --> 00:15:05,170
+لحظة معايا التخطيط هنا هذا ال normalوهذا الـ
+
+210
+00:15:05,170 --> 00:15:09,250
+Atrial Fibrillation تمام؟ فى عنا مشكلة معناته
+
+211
+00:15:09,250 --> 00:15:12,830
+بسميها Arthrosia اللى هى عبارة عن عدم انتظام
+
+212
+00:15:12,830 --> 00:15:17,390
+لطبقات القلب فى ايضا ال cardiac Tombolade اللى هى
+
+213
+00:15:17,390 --> 00:15:21,150
+ال limitation لل ventricular تعرف فى عنا ال
+
+214
+00:15:21,150 --> 00:15:25,800
+ventricle و ال atriumالبوتينين والأوذينين زي ما
+
+215
+00:15:25,800 --> 00:15:29,140
+أخدتها في ال Anatomy طبعا ال filling during distal
+
+216
+00:15:29,140 --> 00:15:33,540
+خلال الإنقباض والانبساط بيصير فيه عندنا because of
+
+217
+00:15:33,540 --> 00:15:37,120
+fluid collection within the precardial sac خليني
+
+218
+00:15:37,120 --> 00:15:39,380
+أشوف شو يعني ال tombolence هو عبارة عن ال
+
+219
+00:15:39,380 --> 00:15:44,160
+limitation اللي صار بال ventricle اللي هو بيهخلال
+
+220
+00:15:44,160 --> 00:15:47,520
+ال filling during the stall بي cause ال fluid ال
+
+221
+00:15:47,520 --> 00:15:51,520
+fluid collection خلال ال pericardiac sac اللي هو
+
+222
+00:15:51,520 --> 00:15:57,820
+ال breast الغشاء أو تيمور بنسميه ال pericardium
+
+223
+00:15:57,820 --> 00:16:01,580
+الفيزيوثرابي مايcontra indicated في هذه الحالة
+
+224
+00:16:01,580 --> 00:16:06,020
+نائش لإنه بنخاف على ال patients تبعنا لاحظوا هنا
+
+225
+00:16:06,020 --> 00:16:11,120
+جديش في عندي fluid طبعا نتيجة اللي هو بيعمللي ضغط
+
+226
+00:16:11,120 --> 00:16:16,130
+علىالتنبونات طبعا بيعملي ضغط على تجمّر ثوائل في
+
+227
+00:16:16,130 --> 00:16:22,070
+اللي هي ال بريكارديال أو ال بريكارديام ساك لل
+
+228
+00:16:22,070 --> 00:16:27,250
+بريكارديام ساك ال بريكارديام ساك معناة الكلام ان
+
+229
+00:16:27,250 --> 00:16:33,190
+هو بيعملي overload على ال heart اللي موجوديعني الـ
+
+230
+00:16:33,190 --> 00:16:37,270
+cardiogenic shock الصدمة result from diminishes
+
+231
+00:16:37,270 --> 00:16:41,910
+cardiac output بتأثر في ان هو ال cardiac output
+
+232
+00:16:41,910 --> 00:16:46,430
+اللي هو كمية ضخ الدم اللي ناتجة عنه ال cardiac
+
+233
+00:16:46,430 --> 00:16:50,710
+output may fall very low immediately طبعا بتقل
+
+234
+00:16:50,710 --> 00:16:54,850
+after cardiac damage فيزي ثerapy هنا أيضا contra
+
+235
+00:16:54,850 --> 00:16:57,670
+indicated لإن هاي من ال complications صعبة اللي
+
+236
+00:16:57,670 --> 00:17:03,550
+بتصير مع مريض القلبالـ Complication التالتة، احنا
+
+237
+00:17:03,550 --> 00:17:06,610
+أخدنا Complication على مستوى الـ Respiratory،
+
+238
+00:17:06,610 --> 00:17:10,150
+خليني أعمل summary، وComplication على مستوى الـ
+
+239
+00:17:10,150 --> 00:17:12,890
+Heart، هنا بدي أخد الـ Complication التالتة، اللي
+
+240
+00:17:12,890 --> 00:17:15,910
+هي على مستوى الـ circulation أو الـ DVT in
+
+241
+00:17:15,910 --> 00:17:23,470
+general، تمام؟ is a coagulation or clotting
+
+242
+00:17:23,470 --> 00:17:26,790
+blooding، تمام؟ و clot blood، بيصير في clotting
+
+243
+00:17:26,790 --> 00:17:33,270
+للبلد،تمام اللى هو بيصير في عندنا تجلط للتم او انه
+
+244
+00:17:33,270 --> 00:17:36,850
+صار في عندنا خسرة دموية Trombosis if they attaches
+
+245
+00:17:36,850 --> 00:17:40,630
+the clot can cause pulmonary embolism شرحنا عنها
+
+246
+00:17:40,630 --> 00:17:44,170
+في ال pulmonary embolism انه لو صار انا في عندى
+
+247
+00:17:44,170 --> 00:17:50,370
+مشكلة في اللى هو هاي الخسرة الدموية هتنتقل و تفوت
+
+248
+00:17:50,370 --> 00:17:55,770
+علىاللي هو الـ Artery البلمونري Artery فبالتالي
+
+249
+00:17:55,770 --> 00:18:00,070
+بتسبب بلمونري Embolism الفيزيوثيرابي Prevention
+
+250
+00:18:00,070 --> 00:18:04,570
+طبعا أهم إشي أنا أمنع السبب ليش أنا أخلي يصير في
+
+251
+00:18:04,570 --> 00:18:08,350
+عندي DVT عن طريق الـ Active Leg Exercise الـ Deep
+
+252
+00:18:08,350 --> 00:18:13,180
+Breathing Exercise على الأقل الخمسدقائق في اللي هو
+
+253
+00:18:13,180 --> 00:18:17,840
+كل ساعة الـ Early Postoperative Leg Mobilization
+
+254
+00:18:17,840 --> 00:18:21,740
+إن هو يعمل pumping exercise عشان أنا أمنع الـ DVT
+
+255
+00:18:21,740 --> 00:18:25,560
+مش وقت حدثة أنا بدي أمنعها لأ هي لما بتحدث و بتخلص
+
+256
+00:18:25,560 --> 00:18:29,960
+أنا ممنوع أشتغل لكن أنا بامنعها في اللي هو قبل ما
+
+257
+00:18:29,960 --> 00:18:41,740
+يحدث الـ DVTعندما يتطور الـ DVT، في حالة
+
+258
+00:18:41,740 --> 00:18:45,460
+الـ acute physiotherapy is contraindicated ممنوع
+
+259
+00:18:45,460 --> 00:18:49,080
+من عامة أن أشتغل، لأن بأي exercise أعمل دي
+
+260
+00:18:49,080 --> 00:18:53,180
+attaches انفصال لهادي الخسر الدموية وتتحرك عبر الـ
+
+261
+00:18:53,180 --> 00:18:59,640
+bloodstream في حالة الـ chronic casesاللي applied
+
+262
+00:18:59,640 --> 00:19:03,120
+to deep breathing exercise active exercise and
+
+263
+00:19:03,120 --> 00:19:07,280
+mobilization و ال elastic bandage مهم جدا اللي هو
+
+264
+00:19:07,280 --> 00:19:10,560
+ال aid figure بدي أعمله to control swelling and
+
+265
+00:19:10,560 --> 00:19:14,340
+venous return تمام، إذا في ال acute لسه المرحلة
+
+266
+00:19:14,340 --> 00:19:19,560
+جديدة و الحالة طور عندها DVT جديدة ممنوع أشتغل
+
+267
+00:19:19,560 --> 00:19:22,660
+معاها contraindication لكن في ال chronic بشتغل
+
+268
+00:19:22,660 --> 00:19:26,160
+range of motion exercise breathing exercise و ال
+
+269
+00:19:26,160 --> 00:19:32,010
+elastic كمان شغالةلازم تكون موجودة الـ wound
+
+270
+00:19:32,010 --> 00:19:35,810
+infection ما شاء الله حدث ولا حرج علنا على طول
+
+271
+00:19:35,810 --> 00:19:41,090
+بيصير علنا اللي هو التهابات ناتجة بعد العمليةالـ
+
+272
+00:19:41,090 --> 00:19:44,530
+infected ليه؟ لإن أحنا بيئة طبعا رطبة فبالتالي
+
+273
+00:19:44,530 --> 00:19:49,950
+بتطور أو ممكن الشخص نفسه بتكون اللي هو نوع جسمه ما
+
+274
+00:19:49,950 --> 00:19:53,970
+بيعمل good healing خصوصا إذا كان ضيابة
+
+275
+00:19:53,970 --> 00:19:57,070
+accumulation تبعنا، بيكون في عندهم poor healing زي
+
+276
+00:19:57,070 --> 00:19:59,750
+ما أخدنا فبالتالي ال infected بيكون أو ال
+
+277
+00:19:59,750 --> 00:20:04,670
+infection one بيكون واردليه بيصير ال patient عندنا
+
+278
+00:20:04,670 --> 00:20:07,170
+عن ال signs و ال symptoms تبعية ال infection
+
+279
+00:20:07,170 --> 00:20:11,970
+hotness و redness و edematous دل ال sutures طبعا
+
+280
+00:20:11,970 --> 00:20:16,770
+وارمة هذه الغرز و cut and through خلال ال tissue
+
+281
+00:20:16,770 --> 00:20:20,470
+and the wound may gap either long or long haul
+
+282
+00:20:20,470 --> 00:20:23,930
+length between the sutures بتبدأ اللي هي نتيجة
+
+283
+00:20:23,930 --> 00:20:29,110
+الممكن لو كان كمان في عنها صديد بس صار في ال wound
+
+284
+00:20:29,110 --> 00:20:33,870
+نفسها انه بتحلل هذه ال wound و بتبعد عن بعضهاالبعض
+
+285
+00:20:33,870 --> 00:20:38,330
+الفيزيو ثيرابي clean wand can receive superficial
+
+286
+00:20:38,330 --> 00:20:42,410
+heat زي ال infrared لأنه نعرف ال infrared هي عبارة
+
+287
+00:20:42,410 --> 00:20:47,770
+عن اشي انتيبايتك بتشتغل في superficial wand ال
+
+288
+00:20:47,770 --> 00:20:52,530
+ultrasonic كمان بيشتغلها في ال heart scars اللي هو
+
+289
+00:20:52,530 --> 00:20:56,390
+لو صار في عندي scar tissue ال paraffin waxطبعا
+
+290
+00:20:56,390 --> 00:20:59,990
+هتشتغل بكيف أن البرافين واكس أنا بدي أشتغلها في ال
+
+291
+00:20:59,990 --> 00:21:04,230
+open heart surgery بجيب باللي هو ال tongue
+
+292
+00:21:04,230 --> 00:21:08,170
+depressors اللي هي اللي بيفحص فيها الدكتور اللي
+
+293
+00:21:08,170 --> 00:21:13,530
+was و بحط عليها شوية wax و بحطها على مكان العملية
+
+294
+00:21:13,530 --> 00:21:17,930
+عشان اللي هو أعمل softening لـscar tissue اللي
+
+295
+00:21:17,930 --> 00:21:20,990
+صارت اللي كانت بالأصل هي infected و أدت إلى وجود
+
+296
+00:21:20,990 --> 00:21:26,070
+scar tissue كبيرة لازم أنا أبدأ أقلر منهاهذا
+
+297
+00:21:26,070 --> 00:21:29,910
+بالنسبة للـ wound infection اللي هو الـ
+
+298
+00:21:29,910 --> 00:21:34,050
+complication الرابع ال pressure source اللي أنا
+
+299
+00:21:34,050 --> 00:21:39,710
+حكيت عليه اليوم هذا ال patient عندي طور من حاله و
+
+300
+00:21:39,710 --> 00:21:42,910
+طورت حالته للأسواق صار في عنده pressure source
+
+301
+00:21:42,910 --> 00:21:48,490
+ناتجة عن العدم أو اللي هو ال immobilityPrevent by
+
+302
+00:21:48,490 --> 00:21:51,390
+frequently changing patient postural لازم ال
+
+303
+00:21:51,390 --> 00:21:54,590
+position تبع ال patient أغيره كل ساعتين في هذه
+
+304
+00:21:54,590 --> 00:21:59,090
+الحالة وهذا طبعا بالمساعدة دور التمريد Frequently
+
+305
+00:21:59,090 --> 00:22:04,030
+check لل integrity of skin and area of redness بدأ
+
+306
+00:22:04,030 --> 00:22:08,610
+أتأكد من سلامة الجلب دائما أتفحص ال back ال
+
+307
+00:22:08,610 --> 00:22:11,990
+scapula ال calcaneus
+
+308
+00:22:13,780 --> 00:22:17,440
+كل الـ bony prominence اللي أنا عاملة عليها
+
+309
+00:22:17,440 --> 00:22:21,820
+pressure عشان مايصير في عندنا بعد هيك pit source
+
+310
+00:22:21,820 --> 00:22:26,340
+ال ultraviolet هنا كتير مهمة جهازنا ال ultraviolet
+
+311
+00:22:26,340 --> 00:22:30,320
+كتير مهم و كويس لأنه بيشتغل as antibiotic
+
+312
+00:22:30,320 --> 00:22:35,760
+apparatus تمام ال neurological damage بعض الأحيان
+
+313
+00:22:35,760 --> 00:22:39,540
+مرض القلب بيطوروا مشاكل أو بيطوروا مشاكل اللي لها
+
+314
+00:22:39,540 --> 00:22:44,200
+علاقة بال neurological systemخلال ال .. ال .. هو
+
+315
+00:22:44,200 --> 00:22:46,920
+الانسيزي على سبيل المثال ال brain may damaged
+
+316
+00:22:46,920 --> 00:22:50,800
+تمام؟ و ممكن كمان ال brain يصير في ال damage نتيجة
+
+317
+00:22:50,800 --> 00:22:54,340
+ال embolism لأنه حكينا إذا هذه الخطرة الدموية
+
+318
+00:22:54,340 --> 00:22:57,420
+صارها دي attached يا إما هتعدي على ال lung يا إما
+
+319
+00:22:57,420 --> 00:23:00,620
+هتعدي على ال brain إذا عدت على ال lung معناه تصار
+
+320
+00:23:00,620 --> 00:23:03,660
+عنها preliminary embolism إذا عدت على ال brain صار
+
+321
+00:23:03,660 --> 00:23:10,370
+stroke تمام؟الفيزيوثرابي مستتريته from paralysis
+
+322
+00:23:10,370 --> 00:23:15,110
+that occurs إذا صار والله عندنا stroke ناتجة عن
+
+323
+00:23:15,110 --> 00:23:19,730
+الembolism معناة الكلام هيصير في عنا مثلا اللي هو
+
+324
+00:23:19,730 --> 00:23:23,970
+right hemibalgia هعالج أنا هدخل بجانب إلى إنه
+
+325
+00:23:23,970 --> 00:23:28,730
+المريض تبعي cardiac هيكون اللي هو neuro obviously
+
+326
+00:23:28,730 --> 00:23:31,610
+the patient cardiac state may limit from
+
+327
+00:23:31,610 --> 00:23:37,420
+rehabilitation some extentto some extent معناك
+
+328
+00:23:37,420 --> 00:23:43,720
+الكلام بشكل واضح أنه أنا ال
+
+329
+00:23:43,720 --> 00:23:49,060
+cardiac patient stated may limit from
+
+330
+00:23:49,060 --> 00:23:58,120
+rehabilitation to some extent طبعا obviously
+
+331
+00:23:58,120 --> 00:24:03,810
+the patient cardiac state may limitالـ Cardiac
+
+332
+00:24:03,810 --> 00:24:07,790
+patient may limit the form rehabilitation to some
+
+333
+00:24:07,790 --> 00:24:10,970
+extent بعض الأحيان ممكن أنا حاجات أطور الحالة مع
+
+334
+00:24:10,970 --> 00:24:15,390
+المريض أو أنه أنا أغير في الخطة تبعتي حسب حالة ال
+
+335
+00:24:15,390 --> 00:24:19,510
+patient إذا هيك أنا أخدت ستة complications تابعين
+
+336
+00:24:19,510 --> 00:24:26,630
+لمريض القلب تمام؟ وبهيك أنا أنهيت هذا ال chapter
+
+337
+00:24:26,630 --> 00:24:28,730
+ويعطيكم العافية
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/2gNE9xFg7iE.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/2gNE9xFg7iE.srt
new file mode 100644
index 0000000000000000000000000000000000000000..682acc7132112e5486f9d65512a3815da83e6bd1
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/2gNE9xFg7iE.srt
@@ -0,0 +1,1171 @@
+1
+00:00:01,010 --> 00:00:04,830
+هي مصلحة والسلام على أشرف الأنبياء والمرسلين، نكمل
+
+2
+00:00:04,830 --> 00:00:08,630
+معاكم إن شاء الله في هذا الفيديو رقم 11 لـ
+
+3
+00:00:08,630 --> 00:00:12,110
+Assessments في حالات البلغمية، الآن تكلمنا في
+
+4
+00:00:12,110 --> 00:00:15,330
+الجزئية الأولى عن الأهداف، عن من الذي يحتاج إلى
+
+5
+00:00:15,330 --> 00:00:19,610
+الـ Physiotherapy Program، وتحدثنا عن الـ Abnormal
+
+6
+00:00:19,610 --> 00:00:25,350
+في كل شيء، في اللي هو أمراض الصدر، خليني آخذ اليوم
+
+7
+00:00:25,350 --> 00:00:30,710
+إن شاء الله، الـ part الثاني، وفي فيديو رقم 11، سنرى
+
+8
+00:00:30,710 --> 00:00:34,870
+إن شاء الله بعض الـ abnormal breathing أو بعض الـ
+
+9
+00:00:34,870 --> 00:00:39,810
+abnormal patterns، بأصح أو أفضل عبارة، وهي بداية
+
+10
+00:00:39,810 --> 00:00:43,970
+سنحكي عن dyspnea، dyspnea، أنا آتي بالـ Latin words
+
+11
+00:00:43,970 --> 00:00:47,090
+بجُزْئَيْها، من القسمين، القسم الأول dys بتعني difficulty
+
+12
+00:00:47,090 --> 00:00:51,790
+تمامًا، نية،  التي هي breathing distressed and labored
+
+13
+00:00:51,790 --> 00:00:55,250
+breathing as a result of shortness of breath
+
+14
+00:00:55,250 --> 00:01:00,950
+تمام، هو عبارة عن صعوبة في التنفس وقصر في النفس
+
+15
+00:01:00,950 --> 00:01:07,170
+Tachypnea، tachy تعني rapid أو fast، فبالتالي هي
+
+16
+00:01:07,170 --> 00:01:11,390
+ستكون rapid shallow breathing، هنا عبارة عن مصطلحات
+
+17
+00:01:11,390 --> 00:01:14,290
+لازم نكون عارفينها في الفيزيو ثيرابي، يعني لما يجيء
+
+18
+00:01:14,290 --> 00:01:16,690
+الدكتور ويحكي لنا هذا المريض عنده تاكيبنيا
+
+19
+00:01:16,690 --> 00:01:21,370
+معناه الكلام هو rapid and shallow breathing، و
+
+20
+00:01:21,370 --> 00:01:25,950
+decrease في tidal volume، شو هو tidal volume أو TV؟
+
+21
+00:01:25,950 --> 00:01:31,270
+الذي هو عبارة عن كمية الهواء التي يتم تبادلها
+
+22
+00:01:31,270 --> 00:01:35,290
+أثناء الاستنشاق الذي هو الاستنشاق متبوعًا بانتهاء
+
+23
+00:01:35,290 --> 00:01:40,890
+الزفير، يعني الشهيق متبوع بالزفير، تكون كمية
+
+24
+00:01:40,890 --> 00:01:44,830
+الهواء هذه تُسمى tidal volume، but increase rate
+
+25
+00:01:44,830 --> 00:01:48,230
+بزيادة السرعة تبعها، associated with restrictive
+
+26
+00:01:48,230 --> 00:01:52,750
+or obstructive lung disease، TOD على سبيل المثال
+
+27
+00:01:53,010 --> 00:01:56,430
+and use of accessory muscles، لا يستخدم الـ main
+
+28
+00:01:56,430 --> 00:02:00,310
+muscles، هنا يستخدم المريض الـ accessory muscles في
+
+29
+00:02:00,310 --> 00:02:04,430
+الـ inspiration، is defined as respiratory rate
+
+30
+00:02:04,430 --> 00:02:10,050
+greater than أعلى من عشرين نفسًا في كل دقيقة، and can
+
+31
+00:02:10,050 --> 00:02:13,430
+be seen in from lung in form of lung disease
+
+32
+00:02:13,430 --> 00:02:19,030
+تمام، ويكون أقل شيء طبعًا، نلاقيه طبعًا أكثر شيء في
+
+33
+00:02:19,030 --> 00:02:24,690
+حالات التي هي أمراض الرئة، البرادينيا هي عبارة عن
+
+34
+00:02:24,690 --> 00:02:28,870
+البرادى تعني slow، عكس تاكيبنيا، low rate with
+
+35
+00:02:28,870 --> 00:02:32,890
+shallow breathing in normal depth and regular is
+
+36
+00:02:32,890 --> 00:02:39,470
+defined as يُعرف على أنه البرادينيا على أنه معدل
+
+37
+00:02:39,470 --> 00:02:44,890
+التنفس أقل من عشرة breaths في الدقيقة الواحدة، هناك
+
+38
+00:02:44,890 --> 00:02:51,010
+حكينا أقل من عشرين نفسة أو من عشرين نفسًا، تمام، في كل
+
+39
+00:02:51,010 --> 00:02:57,110
+دقيقة، أما هنا عبارة عن عشرة breaths لكل minute، it's
+
+40
+00:02:57,110 --> 00:03:01,850
+an uncommon finding، هي عبارة عن نتائج غير متوقعة
+
+41
+00:03:01,850 --> 00:03:04,790
+and it's usually due to central nervous system
+
+42
+00:03:04,790 --> 00:03:09,150
+depression by narcotics or trauma، أشياء تكون
+
+43
+00:03:09,150 --> 00:03:12,350
+من النتائج التي غير متوقعة، زي حالة TBI على سبيل
+
+44
+00:03:12,350 --> 00:03:16,370
+المثال، بيكون في عندنا مشكلة آثار بالـ central
+
+45
+00:03:16,370 --> 00:03:20,420
+nervous system، Hyperventilation، Deep، Rapid
+
+46
+00:03:20,420 --> 00:03:23,800
+Inspiration أو Rapid Respiration بشكل عام، and
+
+47
+00:03:23,800 --> 00:03:27,880
+increase tidal volume، كمية الهواء المتبادلة سواء
+
+48
+00:03:27,880 --> 00:03:32,740
+كانت بالشهيق والزفير، الـ inspiration والـ expiration
+
+49
+00:03:32,740 --> 00:03:36,760
+بتكون زيادة في الـ TV، and increase the rate of
+
+50
+00:03:36,760 --> 00:03:41,400
+respiration، وزيادة في سرعة ومعدل التنفس، with
+
+51
+00:03:41,400 --> 00:03:47,890
+regularity، بنغمات متماثلة أو منتظمة، في الـ hyper
+
+52
+00:03:47,890 --> 00:03:52,370
+ventilation، hyper سهم لفوق، زيادة، تمام، rapid
+
+53
+00:03:54,270 --> 00:03:57,610
+الأورثوبينيا، ortho لحالها difficulty في الـ
+
+54
+00:03:57,610 --> 00:04:01,270
+breathing in supine position، يعني بيجينا المريض قبل
+
+55
+00:04:01,270 --> 00:04:05,030
+ودخلنا قسم الصدرية، بيقول لك أستاذ، الحاجة الكبيرة أنه
+
+56
+00:04:05,030 --> 00:04:08,750
+أنا لست قادرة على أخذ نفس لما أنام على ظهري، لكن لو
+
+57
+00:04:08,750 --> 00:04:13,950
+أخذنا  وعملنا لها تقريبًا 45 درجة، semi-sitting position
+
+58
+00:04:13,950 --> 00:04:17,810
+بيقول لك أصبحت أفضل،  ضعوا مخدتين تحت ظهري، أصبحت أفضل
+
+59
+00:04:17,810 --> 00:04:22,830
+في النفس، هذه تُسمى الحالة أورثوبينيا، الأبينيا كلمة
+
+60
+00:04:22,830 --> 00:04:26,610
+A أو حرف الـ A لما يسبق الكلمة، معناه ينفيها
+
+61
+00:04:26,610 --> 00:04:31,830
+تمامًا، معناه انقطاع للنفس، في حالة الـ Expiratory
+
+62
+00:04:31,830 --> 00:04:35,770
+phase، الـ Expiratory هنا أريد أن أركز وأضع على الـ X
+
+63
+00:04:35,770 --> 00:04:41,330
+-piratory phase، الـ Apnea، انقطاع للنفس في الـ N
+
+64
+00:04:41,330 --> 00:04:46,250
+-piratory، تمام؟ إذًا، لازم أفرق بين المصطلحين Apnea و
+
+65
+00:04:46,250 --> 00:04:50,510
+Apneosis، الأبينيا انقطاع النفس خلال مراحل الـ
+
+66
+00:04:50,510 --> 00:04:54,670
+expiratory، أما الـ Apneosis انقطاع النفس خلال
+
+67
+00:04:54,670 --> 00:04:57,850
+مرحلة الـ inspiration، في المراحل التي هي الـ
+
+68
+00:04:57,850 --> 00:05:01,870
+expiratory phase بشكل عام، وهنا مهم جدًا أنا أكون
+
+69
+00:05:01,870 --> 00:05:07,080
+عارف كفزيوتيرابي هذه المصطلحات، tidal volume هو
+
+70
+00:05:07,080 --> 00:05:12,240
+عبارة عن كمية الهواء المتبادلة خلال مرحلة الـ
+
+71
+00:05:12,240 --> 00:05:17,840
+inspiration followed by relaxed expiration، هو بقي
+
+72
+00:05:17,840 --> 00:05:22,720
+أختصره بالـ TV، تمام؟ إذًا، كمية الهواء المتبادلة في
+
+73
+00:05:22,720 --> 00:05:30,530
+مرحلة الشهيق، يتبعها الذي هو relaxed expiration، في
+
+74
+00:05:30,530 --> 00:05:34,410
+الـ healthy young adult، الـ TV approximately حوالي
+
+75
+00:05:34,410 --> 00:05:40,570
+خمسمئة ملليلتر لكل inspiration، تمام، هذا في الـ
+
+76
+00:05:40,570 --> 00:05:45,270
+normal adult، أو الذين هم الناس الذين ليس لديهم أي
+
+77
+00:05:45,270 --> 00:05:51,350
+respiratory problems، أيضًا أريد أن أكمل أو أريد أن أرى بعض
+
+78
+00:05:51,350 --> 00:05:54,730
+الحاجات في الـ assessment تبعي، في عندي Kussmaul
+
+79
+00:05:54,730 --> 00:05:57,810
+Kussmaul هي عبارة عن ماذا؟ cycles gradually
+
+80
+00:05:57,810 --> 00:06:02,220
+increasing في tidal volume، followed by series of
+
+81
+00:06:02,220 --> 00:06:05,440
+gradually decreasing tidal volume، and then a
+
+82
+00:06:05,440 --> 00:06:08,920
+period of apnea، بيصير في عندنا انقطاع في النفس
+
+83
+00:06:08,920 --> 00:06:14,420
+زيادة في tidal volume، يتبعها زيادة series of
+
+84
+00:06:14,420 --> 00:06:17,660
+gradually decreasing tidal volume، and then period
+
+85
+00:06:17,660 --> 00:06:22,840
+of apnea، سرعة tidal volume كانت كميتها عالية جدًا،
+
+86
+00:06:23,740 --> 00:06:28,380
+بعدها مباشرة قلت tidal volume، بزيادة أو مصاحبة
+
+87
+00:06:28,380 --> 00:06:33,120
+الذي هو apnea، انقطاع النفس، this is sometimes seen
+
+88
+00:06:33,120 --> 00:06:37,280
+in patients with severe head injury، طبعًا تصير في
+
+89
+00:06:37,280 --> 00:06:41,380
+حالات الـ TBI أو traumatic brain injury التي أنا
+
+90
+00:06:41,380 --> 00:06:45,640
+أسميها head injury، Kussmaul breathing، هذا النوع من
+
+91
+00:06:45,640 --> 00:06:48,620
+أنواع التنفس، rapid breathing followed by
+
+92
+00:06:48,620 --> 00:06:53,670
+apnea، بالمختصر هو عبارة عن سرعة في النفس على طول
+
+93
+00:06:53,670 --> 00:06:57,630
+with followed by apnea، شوفوا كيف هنا irregular
+
+94
+00:06:57,630 --> 00:07:03,830
+respiration، انقطاع الذي هي الـ apnea، بعدين مرحلة أو
+
+95
+00:07:03,830 --> 00:07:09,340
+cycle جديدة،  الـ anemia، بعض المرضى لاجئين في عندهم
+
+96
+00:07:09,340 --> 00:07:12,820
+if patient appears pale، شاحب، and has high
+
+97
+00:07:12,820 --> 00:07:17,360
+hemoglobin or low hemoglobin، this maybe have short
+
+98
+00:07:17,360 --> 00:07:21,940
+breathing، هذا الشخص أنا أشعر به طبعًا وأحكي عنه أنه هو
+
+99
+00:07:21,940 --> 00:07:27,700
+في عنده short breathing، يعني قصر في التنفس، ثانوثز
+
+100
+00:07:27,700 --> 00:07:32,700
+ثانوثز، عندنا الازرقاق، وهي حالة مهمة جدًا وظاهرة
+
+101
+00:07:32,700 --> 00:07:37,720
+لازم نحن نكون عارفينها سواء في الـ young أو في الـ
+
+102
+00:07:37,720 --> 00:07:42,830
+old، طبعًا، الذين هم الـ geriatric، يعني الـ cyanosis أو
+
+103
+00:07:42,830 --> 00:07:46,110
+الازرقاق، ينقسم لمرحلتين أو لنوعين، في عندنا
+
+104
+00:07:46,110 --> 00:07:49,870
+centrally، وفي عندنا peripherally، الـ centrally هذا
+
+105
+00:07:49,870 --> 00:07:53,090
+مهم جدًا لماذا؟ لأنه بيكون ناتج عن pulmonary disease
+
+106
+00:07:53,090 --> 00:07:59,330
+ويظهر على فم المريض وشفتيه، وكذلك لسانه بيكون
+
+107
+00:07:59,330 --> 00:08:04,130
+أزرق، وأيضًا ممكن يكون واضح تمامًا على الـ peripheral
+
+108
+00:08:04,130 --> 00:08:08,430
+في الـ fingers والـ toes، which will warm due to
+
+109
+00:08:08,430 --> 00:08:14,610
+circulation of blood، هذا ناتج عن ركود الدم، النوع
+
+110
+00:08:14,610 --> 00:08:17,870
+الثاني الذي هو الـ peripherally، هذا بيكون فقط
+
+111
+00:08:17,870 --> 00:08:23,150
+الازرقاق في داخل الذين هم الـ peripheral joints أو
+
+112
+00:08:23,150 --> 00:08:27,090
+الـ peripheral limbs، أما الـ centrally مهم جدًا أن
+
+113
+00:08:27,090 --> 00:08:31,830
+أنا أعرفه، نجد شفتي المريض، ولسانه، ووجهه أيضًا
+
+114
+00:08:31,830 --> 00:08:35,350
+أزرق، في المولود، مهم جدًا أنا أكون عارف الـ
+
+115
+00:08:35,350 --> 00:08:38,510
+central cyanosis، ناتج عن ماذا؟ ممكن يكون ناتج عن
+
+116
+00:08:38,510 --> 00:08:42,770
+الذي هو loss of oxygen أو deficiency of oxygen
+
+117
+00:08:42,770 --> 00:08:45,750
+supply، فبالتالي مهم جدًا هنا أنا أقيم الـ central
+
+118
+00:08:45,750 --> 00:08:50,370
+nervous system، بعد هذا الذي صار معهم، سأقول في
+
+119
+00:08:50,370 --> 00:08:54,170
+عندنا الأديمة أيضًا، لازم أنا أقيمها، هنا مفرق لي ما
+
+120
+00:08:54,170 --> 00:08:57,610
+بين الذي هو الـ cyanosis centrally
+
+121
+00:08:57,610 --> 00:09:02,020
+و peripherally، Central الذي هو بيكون الشيء واضح
+
+122
+00:09:02,020 --> 00:09:06,080
+على الجلد والـ mucous membrane بسبب الذي هو
+
+123
+00:09:06,080 --> 00:09:10,480
+decrease في  الـ oxygen saturation، قلة في
+
+124
+00:09:10,480 --> 00:09:15,800
+كمية تركيز الـ oxygen الذي هو في الشريان أو
+
+125
+00:09:15,800 --> 00:09:19,560
+abnormal hemoglobin، نتيجة لأنه صار في عندنا على
+
+126
+00:09:19,560 --> 00:09:23,900
+سبيل المثال أنيميا، صار في عندنا ازرقاق، exposed للـ
+
+127
+00:09:23,900 --> 00:09:27,680
+area warm، طبعًا الحالة تبعنا إن نحن نفحص المريض
+
+128
+00:09:27,990 --> 00:09:30,750
+الـ clubbing fingers، الذي هو أنا آتي، أنظر على
+
+129
+00:09:30,750 --> 00:09:33,310
+أضافر المريض، أجدها على شكل club، عاملة زي
+
+130
+00:09:33,310 --> 00:09:36,330
+clubbing، لما كنا نعمل clubbing في المساج، بيكون الذي
+
+131
+00:09:36,330 --> 00:09:41,270
+هو الـ fingers أو الـ fingers عامل زي الـ clubbing، هنا
+
+132
+00:09:41,270 --> 00:09:44,290
+بيكون present، موجود، يعني هذا يبين لي أن هنا فعلاً
+
+133
+00:09:44,290 --> 00:09:48,810
+الذي هو المشكلة أو الـ cyanosis centrally سببه
+
+134
+00:09:48,810 --> 00:09:52,760
+centrally، أما إذا كان peripherally، معناته بيكون أن
+
+135
+00:09:52,760 --> 00:09:55,480
+الـ peripherally exposed to skin only، لاحظ في
+
+136
+00:09:55,480 --> 00:09:59,220
+عندنا فرق ما بين الـ central، هنا skin and mucus، هنا
+
+137
+00:09:59,220 --> 00:10:02,100
+peripherally exposed للـ skin بسبب
+
+138
+00:10:02,100 --> 00:10:06,660
+vasoconstriction، صار في عندنا قلة في الـ blood flow
+
+139
+00:10:06,660 --> 00:10:11,500
+للـ peripheral area، طبعًا exposed to area لأنها
+
+140
+00:10:11,500 --> 00:10:19,820
+تعرضت للذي هو cold، مساج ممكن أحل المشكلة الذي هو
+
+141
+00:10:19,820 --> 00:10:25,520
+بالمساج، بالـ warming، هنا زي التي هي خلينا نحكي
+
+142
+00:10:25,520 --> 00:10:28,860
+ظاهرة التي هي Raynaud's phenomenon، الذي هو ممكن يكون في
+
+143
+00:10:28,860 --> 00:10:32,800
+vasoconstriction و constriction للـ artery، طبعًا بيصير الذي
+
+144
+00:10:32,800 --> 00:10:37,740
+هو الأصابع عند السيدات على سبيل المثال، لونها على dark
+
+145
+00:10:37,740 --> 00:10:41,860
+blue أو أسود، خليني أحكي، فبالتالي ممكن أنا أستخدم
+
+146
+00:10:41,860 --> 00:10:46,100
+معها الـ contrast bath وأكون حليت معها شوية شوية
+
+147
+00:10:46,100 --> 00:10:50,540
+في المشكلة، طبعًا هي ستأخذوها في التي هي بعض
+
+148
+00:10:50,540 --> 00:10:54,310
+المساقات، أو ممكن مرت عليكم، هنا ما أجد في عندي
+
+149
+00:10:54,310 --> 00:10:58,270
+clubbing fingers، لأ، الـ fingers طبيعية، وتمام، تمام، و
+
+150
+00:10:58,270 --> 00:11:02,270
+ما في عندنا أي مشكلة، بهكذا بيكون أنا فرقت ما بين الـ
+
+151
+00:11:02,270 --> 00:11:13,010
+central cyanosis والـ peripheral cyanosis، آه
+
+152
+00:11:13,010 --> 00:11:19,600
+هنا سيفتح لي على الموقع، وهي الـ clubbing fingers، طبعًا
+
+153
+00:11:19,600 --> 00:11:24,560
+وهذه التي هي الـ cyanosis التي أريد أن يكون في الذي هو
+
+154
+00:11:24,560 --> 00:11:27,940
+الشفتين والـ tongue والـ face، بيكون في عندنا
+
+155
+00:11:27,940 --> 00:11:32,460
+cyanosis، طبعًا واضحة جدًا، هاي الـ clubbing fingers
+
+156
+00:11:32,460 --> 00:11:37,120
+التي أنتم شايفينها، في عندي بعض القياسات أنا لازم
+
+157
+00:11:37,120 --> 00:11:40,100
+آخذها في الـ chest expansion، عن طريق الـ tape
+
+158
+00:11:40,100 --> 00:11:44,020
+measurement using، للذي هو tape measurement، أريد
+
+159
+00:11:44,020 --> 00:11:46,820
+أن أستخدم  tape flat، should be placed around the
+
+160
+00:11:46,820 --> 00:11:50,930
+chest، لازم يكون مشدود بشكل جيد، عشان أنا أعرف مقدار
+
+161
+00:11:50,930 --> 00:11:54,030
+الـ diameter الذي أنا ممكن آخذه، أسأل المريض أن
+
+162
+00:11:54,030 --> 00:11:57,070
+يتنفس deeply as possible، at the same time along to
+
+163
+00:11:57,070 --> 00:12:00,650
+tape measurement، two measurements are recorded، أنا
+
+164
+00:12:00,650 --> 00:12:06,910
+لازم أسجل القياسين قبل النفس وبعد النفس، وآخذ الفرق
+
+165
+00:12:06,910 --> 00:12:12,430
+بينهم، الآن في عندي three levels، أنا سأقيس من ثلاثة
+
+166
+00:12:12,430 --> 00:12:17,070
+مستويات، الـ level الأول سيكون من الـ fourth costal
+
+167
+00:12:17,070 --> 00:12:22,370
+cartilage، هي الـ first، second، third، هنا الـ fourth
+
+168
+00:12:22,370 --> 00:12:27,570
+وأبدأ أقيس، الطريقة الثانية أو level الثاني من الـ
+
+169
+00:12:27,570 --> 00:12:33,530
+xiphoid process، التي هي نهاية الـ sternum، هي الـ sternum
+
+170
+00:12:33,530 --> 00:12:38,090
+فوق المنبري،  الـ body، وهنا عندنا الـ xiphoid process
+
+171
+00:12:38,090 --> 00:12:43,890
+الطريقة الثالثة أو level الثالث من الـ anterior end
+
+172
+00:12:43,890 --> 00:12:51,790
+للـ costal رقم تسعة، طبعًا من تحت تقريبًا، ونقيس فيه
+
+173
+00:12:51,790 --> 00:12:55,890
+إذًا، أول قياس من الـ fourth، بعدين من الـ xiphoid، by the
+
+174
+00:12:55,890 --> 00:13:01,470
+xiphoid process، بعدين عندي التي هي رقم تسعة، من أو رقم
+
+175
+00:13:01,470 --> 00:13:07,670
+ثلاثة، من الذي هو الـ ninth costal cartilage، وهي
+
+176
+00:13:07,670 --> 00:13:13,390
+القياسات، زي ما حكينا، نأخذ القياس في بداية التي هي
+
+177
+00:13:13,390 --> 00:13:19,190
+النفس وبعد أخذ النفس، chest expansion measures
+
+223
+00:16:14,220 --> 00:16:17,560
+Check up لل lower lobes، احنا الآن في الـ right
+
+224
+00:16:17,560 --> 00:16:22,520
+lungs، في عندي upper، middle، lower lobes، تمام، حاجة
+
+225
+00:16:22,520 --> 00:16:26,410
+أحط اللي هو tip of fingers أو الـ Thumb على اللي هو
+
+226
+00:16:26,410 --> 00:16:29,010
+الـ Spinal Processes اللي هو عُرْتَبَة الـ Thoracic
+
+227
+00:16:29,010 --> 00:16:33,410
+Level، والإيدين هيكونوا حوالين الـ ribs اللي هو
+
+228
+00:16:33,410 --> 00:16:38,070
+بشكل Lateral، وبنسأل الـ patient طبعاً هنا هذه من الـ
+
+229
+00:16:38,070 --> 00:16:41,850
+posterior view، هذا اللي أنتم شايفينه، مش لسترنم هو
+
+230
+00:16:41,850 --> 00:16:45,190
+عبارة عن الـ vertebral column، شوف وين جاي على
+
+231
+00:16:45,190 --> 00:16:47,370
+Spinal Processes تقريباً
+
+232
+00:16:49,560 --> 00:16:54,480
+اللي بتكون هنا و laterally اللي هي بدها تكون طبعاً
+
+233
+00:16:54,480 --> 00:16:58,860
+الـ... الـ fingers جاية على الـ lateral ribs، وبنسأل
+
+234
+00:16:58,860 --> 00:17:02,860
+الـ patient يأخذ عنها deep breathing، واللي هو deep
+
+235
+00:17:02,860 --> 00:17:07,780
+inspiration، و then deep expiration، الآن هتكلم عن
+
+236
+00:17:07,780 --> 00:17:11,800
+الـ tactile أو اللي هو ما يسمى باللي هو الـ vocal
+
+237
+00:17:11,800 --> 00:17:16,850
+fremitus test، اللي هو خفقان الصدر أثناء الكلام، it's
+
+238
+00:17:16,850 --> 00:17:20,490
+a vibration while palpating over chest wall as
+
+239
+00:17:20,490 --> 00:17:25,850
+patient speaks، خفقان الصدر أثناء الكلام بيكون يحكي
+
+240
+00:17:25,850 --> 00:17:29,290
+الـ patient، فبالتالي بنلاقي أنه في صرف، يعاني اللي
+
+241
+00:17:29,290 --> 00:17:34,730
+هو خفقان للصدر، please، أو أضع الـ palm بتاعتك على الـ
+
+242
+00:17:34,730 --> 00:17:37,970
+hands tightly chest wall and then ask the patient
+
+243
+00:17:37,970 --> 00:17:42,690
+to say few words repeated "nineteen nineteen" several times normally
+
+244
+00:17:42,690 --> 00:17:46,670
+fremitus is felt informally، طبعاً بيكون بشكل مش
+
+245
+00:17:46,670 --> 00:17:51,070
+منتظم لـ Chest Wall، الـ Fremitus تزداد في حالة
+
+246
+00:17:51,070 --> 00:17:55,010
+زيادة الـ Secretion، لماذا؟ لأن المريض، خصوصاً احنا
+
+247
+00:17:55,010 --> 00:17:58,730
+بـ COVID-19 الآن، فبالتالي هذا الشيء احنا كنا
+
+248
+00:17:58,730 --> 00:18:03,610
+نلاحظه أو مما كانوا اللي هم الزملاء اللي بيشتغلوا
+
+249
+00:18:03,610 --> 00:18:06,850
+مع الحالات كانوا بيقولوا لنا أنه فعلاً في عندنا الـ
+
+250
+00:18:06,850 --> 00:18:10,570
+Tactile fremitus، الـ Fremitus بتزداد اللي هو في حالة
+
+251
+00:18:10,570 --> 00:18:14,950
+وجود increasing لـ Secretion and Airway، طبعاً تزداد
+
+252
+00:18:14,950 --> 00:18:17,970
+للـ Absence اللي هي خلال Result Obstructive Airway
+
+253
+00:18:18,150 --> 00:18:22,510
+طبعاً لما بيقل اللي هو أو بيصير في عندنا stopping أو
+
+254
+00:18:22,510 --> 00:18:26,790
+obstruction للـ airway، بيصير في عندنا زيادة في لفة
+
+255
+00:18:26,790 --> 00:18:32,310
+متصلة، تمام؟ الآن بالسماعة، هجيس أنا أو هسمع
+
+256
+00:18:32,310 --> 00:18:35,150
+الـ breathing sounds، هشوف في تقييمي أو في خلال
+
+257
+00:18:35,150 --> 00:18:39,210
+الـ assessment اللي أنا ما زلت مستمرة فيه إنه أنا
+
+258
+00:18:39,210 --> 00:18:43,390
+هل هذا النفس normal ولا abnormal؟ شو تعريفنا للـ
+
+259
+00:18:43,390 --> 00:18:46,230
+auscultation of breath sounds؟ هي عبارة عن الـ
+
+260
+00:18:46,230 --> 00:18:48,710
+process of listening to sound within the body
+
+261
+00:18:48,710 --> 00:18:52,450
+specifically to breath sounds during examination
+
+262
+00:18:52,450 --> 00:18:57,090
+of lung، تمام، لفحص اللي هي الرئة، الـ breath sounds
+
+263
+00:18:57,090 --> 00:19:01,430
+occurs because of movement of air in
+
+264
+00:19:01,430 --> 00:19:05,210
+airways during inspiration and expiration، بيجي
+
+265
+00:19:05,210 --> 00:19:08,940
+الدكتور أو أنت مثلاً بتحط السماعة على اللي هو مثلاً
+
+266
+00:19:08,940 --> 00:19:13,020
+منطقة الـ back أو منطقة اللي هو الـ chest، وتأخذ نفس
+
+267
+00:19:13,020 --> 00:19:19,300
+عميق وبتسمع اللي هي النفس، a stethoscope is used to
+
+268
+00:19:19,300 --> 00:19:23,920
+magnify an abnormal breath sound، أي شيء غريب في
+
+269
+00:19:23,920 --> 00:19:27,220
+اللي هو الـ breathing pattern، أنا ممكن أسمع
+
+270
+00:19:27,220 --> 00:19:31,320
+بالسماعة، الآن الـ breathing should be assessed
+
+271
+00:19:31,320 --> 00:19:35,170
+to identify الـ area of lungs، وين المكان بالضبط اللي
+
+272
+00:19:35,170 --> 00:19:39,270
+أنا بدي فيه طبعاً الـ wheezes، congestions، وين الاحتقال
+
+273
+00:19:39,270 --> 00:19:42,990
+موجود، وين فيه عندنا airway obstruction، وين فيه عندنا
+
+274
+00:19:42,990 --> 00:19:46,770
+مشكلة، أنا بدي من عندها determine the
+
+275
+00:19:46,770 --> 00:19:50,530
+effectiveness، بيحدد لي، طبعاً لازم هيحدد لي الـ
+
+276
+00:19:50,530 --> 00:19:53,750
+effectiveness للـ Airway Intervention، هل أنا بحاجة
+
+277
+00:19:53,750 --> 00:20:00,590
+على سبيل المثال لـ Clearness؟ هل أنا بحاجة لـ بصر
+
+278
+00:20:00,590 --> 00:20:04,150
+الدرينج؟ وأين بالضبط التحديد؟ هذا هيحدد لي الـ
+
+279
+00:20:04,150 --> 00:20:07,950
+breath sounds، determine whether lungs are clear or
+
+280
+00:20:07,950 --> 00:20:11,110
+whether intervention should be discontinued، هل أنه
+
+281
+00:20:11,110 --> 00:20:15,530
+أنا الـ lung صارت كويسة ومنيحة، وبعدين ما أنا لازم
+
+282
+00:20:15,530 --> 00:20:19,290
+أدخل ولا لسه أنا بحاجة لإني أنا أدخل بالـ
+
+283
+00:20:19,290 --> 00:20:22,830
+physiotherapy program، تابع، الآن هي بعض الـ patterns
+
+284
+00:20:22,830 --> 00:20:26,450
+لـ Thoracic Landmark Auscultations، والمحل اللي هو
+
+285
+00:20:26,450 --> 00:20:30,190
+السماعة هنا من الـ anterior aspect، وهنا من الـ
+
+286
+00:20:30,190 --> 00:20:34,990
+posterior view، كيف أنا ممكن أشوف مواقع اللي هي
+
+287
+00:20:34,990 --> 00:20:40,160
+السماعة، الـ exercise capacity for complete
+
+288
+00:20:40,160 --> 00:20:43,120
+assessment، عشان أنا أكمل الـ assessment تبعي الـ
+
+289
+00:20:43,120 --> 00:20:47,180
+respiratory system، exercise capacity should also
+
+290
+00:20:47,180 --> 00:20:51,140
+be measured، هل هو عنده الـ endurance كويس ولا مش كويس
+
+291
+00:20:51,140 --> 00:20:55,010
+the most method used to assess patients، طبعاً الـ
+
+292
+00:20:55,010 --> 00:20:59,670
+six-minute walk test، ست دقائق من المشي، ده
+
+293
+00:20:59,670 --> 00:21:04,130
+shuttle walk test، اللي هو طبعاً، جدية هل هو قادر
+
+294
+00:21:04,130 --> 00:21:07,990
+هيكمل معايا هذا المشوار لست دقائق ولا أنه خلاص مش
+
+295
+00:21:07,990 --> 00:21:11,290
+قادر، وبعد هيك أstop، وتقريباً في عنده انقطاع في
+
+296
+00:21:11,290 --> 00:21:15,970
+النفس، الـ  patient's Medical Investigation، الآن
+
+297
+00:21:15,970 --> 00:21:21,050
+الـ Inspiration، خلالها هي أخذ حماس النفس الـ patient
+
+298
+00:21:21,050 --> 00:21:23,750
+file should be reviewed، the current pulmonary
+
+299
+00:21:23,750 --> 00:21:27,210
+diagnosis، عشان أنا بدي أعرف الـ diagnosis، قول لي برضو
+
+300
+00:21:27,750 --> 00:21:32,470
+الـ testing، لازم أكون عارفة إياها، الـ MRI، الصور الـ X-
+
+301
+00:21:32,470 --> 00:21:35,510
+ray، كل شيء لازم أكون عارفة إياه في اللي هو الـ medical
+
+302
+00:21:35,510 --> 00:21:39,910
+file تبعه، this may include but it is not limited to
+
+303
+00:21:39,910 --> 00:21:43,570
+هذا الشيء طبعاً مش هيحد من اللي هي preliminary
+
+304
+00:21:43,570 --> 00:21:47,120
+function tests، الـ Chest X-ray، القطر، البلد، الجاذبية
+
+305
+00:21:47,120 --> 00:21:50,720
+الاناليسيس، طبعاً الـ saturation مهم جداً للأكسجين، الـ
+
+306
+00:21:50,720 --> 00:21:54,460
+ECG، الـ blood count اللي هي الـ CBC، والأمور اللي زي
+
+307
+00:21:54,460 --> 00:21:58,960
+هااي كمان، الـ blood chemistry مهم جداً أنه يكون عندي
+
+308
+00:21:58,960 --> 00:22:03,560
+في file الـ patient، هذه الشغلات طبعاً، هااي بعض اللي
+
+309
+00:22:03,560 --> 00:22:07,000
+هي الـ medical analysis أو الـ investigations بشكل
+
+310
+00:22:07,000 --> 00:22:11,750
+عام، اللي بتكون موجودة، في عند الـ musculoskeletal
+
+311
+00:22:11,750 --> 00:22:14,350
+and integumentary evaluation should include the
+
+312
+00:22:14,350 --> 00:22:18,270
+following، لازم أقيس الـ joint range of motion، gross
+
+313
+00:22:18,270 --> 00:22:22,610
+strength assessment، extremity، الـ postural، الـ gait،
+
+314
+00:22:22,610 --> 00:22:26,990
+الـ skin inspections، و الـ edema inspections، طبعاً كل
+
+315
+00:22:26,990 --> 00:22:31,870
+هذه الأمور مهمة جداً أنه أنا لازم أحددها أو لازم
+
+316
+00:22:31,870 --> 00:22:34,770
+أفحصها في الـ musculoskeletal، الـ functional
+
+317
+00:22:34,770 --> 00:22:38,850
+evaluation، كمان مهمة جداً عندي أنه أنا لازم أفحص الـ
+
+318
+00:22:38,850 --> 00:22:42,690
+ADL، الـ Activities of Daily Living، هل إنه هذا الشيء
+
+319
+00:22:42,690 --> 00:22:47,810
+بيأثر عليه، على سبيل المثال، كان يمشي مشوار، sport
+
+320
+00:22:47,810 --> 00:22:50,750
+يعمل، فبالتالي إنه هذا حد من الـ sport اللي هو
+
+321
+00:22:50,750 --> 00:22:54,190
+بيشتغلها، الـ balance، و الـ gait assessment، طبعاً شيء
+
+322
+00:22:54,190 --> 00:22:58,590
+طبيعي لو كان عنده على سبيل المثال، sprain، بيأثر عنده
+
+323
+00:22:58,590 --> 00:23:01,040
+على الـ balance و الـ gait assessment، الـ superior
+
+324
+00:23:01,040 --> 00:23:05,420
+level function، اللي هو كيف كان زمان يقدر وظائفه، هل
+
+325
+00:23:05,420 --> 00:23:07,980
+بعد الـ disease أو بعد المرض ده، على سبيل المثال
+
+326
+00:23:07,980 --> 00:23:12,440
+ضاِل مستمر ولا بحاجة إلى assistant، الـ need للـ
+
+327
+00:23:12,440 --> 00:23:17,420
+adaptive equipment، هل هو بحاجة لـ، على سبيل المثال
+
+328
+00:23:17,420 --> 00:23:24,200
+oxygen، هل هو بحاجة لـ oxygen، على سبيل المثال، أي
+
+329
+00:23:24,200 --> 00:23:29,380
+جهاز بحاجة له، الـ fall risk، هل هو بدي أقيم هالـ
+
+330
+00:23:29,380 --> 00:23:33,380
+مخاطر اللي هو السقوط، هل هو مثلاً على سبيل المثال
+
+331
+00:23:33,380 --> 00:23:36,260
+fully concentrated أو fully conscious، أنه يكون مثلاً
+
+332
+00:23:36,260 --> 00:23:39,480
+على سبيل المثال قادر على اللي هو الاستمرار في
+
+333
+00:23:39,480 --> 00:23:42,900
+الـ مشي من غير ما يصير فيه أي سقوط، الـ leisure و الـ
+
+334
+00:23:42,900 --> 00:23:47,280
+social activity، كمان مهمة جداً هاي بالنسبة له اللي
+
+335
+00:23:47,280 --> 00:23:51,180
+هو الـ functional evaluation اللي عند المريض تبعنا
+
+336
+00:23:51,760 --> 00:23:55,500
+وبـ هيك بكون أنا خلصت الـ part اللي هو الثاني، فيديو
+
+337
+00:23:55,500 --> 00:24:00,200
+رقم 11، لـ Pulmonary Assessment، ويعطيكم ألف عافية
+
+338
+00:24:00,200 --> 00:24:01,240
+على بركة الله
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/2gNE9xFg7iE_postprocess.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/2gNE9xFg7iE_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..4233e8aab09e08bc403025c3d5b97a4afb65f871
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/2gNE9xFg7iE_postprocess.srt
@@ -0,0 +1,1352 @@
+1
+00:00:01,010 --> 00:00:04,830
+هي مصلة والسلام على أشرف الأنبياء والوصليين نكمل
+
+2
+00:00:04,830 --> 00:00:08,630
+معاكم إن شاء الله في هذا الفيديو رقم 11 لـ
+
+3
+00:00:08,630 --> 00:00:12,110
+Assessments في حالات البلغنارية الآن تكلمنا في
+
+4
+00:00:12,110 --> 00:00:15,330
+الجزئية الأولى عن الأهداف عن مين اللي بحاجة إلى
+
+5
+00:00:15,330 --> 00:00:19,610
+الـ Physotherapy Program واتحدثنا عن الـ Abnormal
+
+6
+00:00:19,610 --> 00:00:25,350
+في كل شيء في اللي هو أمراض الصدر خليني أخد اليوم
+
+7
+00:00:25,350 --> 00:00:30,710
+إن شاء الله ال part التاني وفي فيديو رقم 11هنشوف
+
+8
+00:00:30,710 --> 00:00:34,870
+ان شاء الله بعض ال abnormal breathing او بعض ال
+
+9
+00:00:34,870 --> 00:00:39,810
+abnormal patterns بأصح أو أفضل عبارة اللي هي بداية
+
+10
+00:00:39,810 --> 00:00:43,970
+هنحكي عن dyspnea dyspnea أنا باجي بال Latin words
+
+11
+00:00:43,970 --> 00:00:47,090
+بجسمها من القسمين القسم الأول dys بتعني difficulty
+
+12
+00:00:47,090 --> 00:00:51,790
+تمام نية اللي هي breathing distressed and labored
+
+13
+00:00:51,790 --> 00:00:55,250
+breathing as a result of shorting of breathing
+
+14
+00:00:55,250 --> 00:01:00,950
+تمام هو عبارة عن صعوبة في التنفس وقصر في النفس
+
+15
+00:01:00,950 --> 00:01:07,170
+تاكيبنيا تاكيبت تعني rapid أو fast فبالتالي هي
+
+16
+00:01:07,170 --> 00:01:11,390
+هتكون rapid shallow breathing هنا عبارة عن مصطلحات
+
+17
+00:01:11,390 --> 00:01:14,290
+لازم نكون عارفينها بالفيزي ثيرابي يعني لما ييجي
+
+18
+00:01:14,290 --> 00:01:16,690
+الدكتور يحكي لنا هذا ال patient عنده تاكيبنية
+
+19
+00:01:16,690 --> 00:01:21,370
+معناه الكلام هو rapid and shallow breathing و
+
+20
+00:01:21,370 --> 00:01:25,950
+decrease في تد ال volume شو هو تد ال volume او TV
+
+21
+00:01:25,950 --> 00:01:31,270
+اللي هو عبارة عن ايشكمية الهواء اللى بيتم تبادلها
+
+22
+00:01:31,270 --> 00:01:35,290
+أثناء استنشاق اللى هو الاستنشاق مطبوع بانتهاء
+
+23
+00:01:35,290 --> 00:01:40,890
+الزفير يعني الشهيق مطبوع بيه الزفير بتكون كمية
+
+24
+00:01:40,890 --> 00:01:44,830
+الهواء هذا بيسميها tidal volume but increase rate
+
+25
+00:01:44,830 --> 00:01:48,230
+بزيادة السرعة تبعتها associated with restrictive
+
+26
+00:01:48,230 --> 00:01:52,750
+or obstructive لل lung disease TOD على سبيل المثال
+
+27
+00:01:53,010 --> 00:01:56,430
+and use of accessory muscles بستخدمش ال main
+
+28
+00:01:56,430 --> 00:02:00,310
+muscles هنا بستخدم للمريض ال accessory muscles في
+
+29
+00:02:00,310 --> 00:02:04,430
+ال inspiration is defined as respiratory rate
+
+30
+00:02:04,430 --> 00:02:10,050
+greater than أعلى من عشرين نفس في كل دقيقة and can
+
+31
+00:02:10,050 --> 00:02:13,430
+be seen in from lung in form of the lung disease
+
+32
+00:02:13,430 --> 00:02:19,030
+تمام وبيكون أقل إشي طبعا بنلاقيه طبعا أكتر إشي في
+
+33
+00:02:19,030 --> 00:02:24,690
+حالات اللي هي أمراض الرئامالبراديبنية هي عبارة عن
+
+34
+00:02:24,690 --> 00:02:28,870
+البرادي تعني slow عكس تاكيبنية low rate with
+
+35
+00:02:28,870 --> 00:02:32,890
+shallow breathing in normal depth and regular is
+
+36
+00:02:32,890 --> 00:02:39,470
+defined as يعرف على أنه البراديبنية على أنه معدل
+
+37
+00:02:39,470 --> 00:02:44,890
+التنفس أقل من عشرة breath ل ال minute الواحدة هناك
+
+38
+00:02:44,890 --> 00:02:51,010
+حكينا أقل من عشرين واحدة أو من عشرين نفس تمامفي كل
+
+39
+00:02:51,010 --> 00:02:57,110
+دقيقة أما هنا عبارة عن عشرة breath لكل minute it's
+
+40
+00:02:57,110 --> 00:03:01,850
+an uncommon findings هي عبارة عن نتائج غير متوقعة
+
+41
+00:03:01,850 --> 00:03:04,790
+and it's usually due to central nervous system
+
+42
+00:03:04,790 --> 00:03:09,150
+depression by narcotics or ال trauma حاجات بتكون
+
+43
+00:03:09,150 --> 00:03:12,350
+من النتائج اللي غير متوقعة زي حالة TBI على سبيل
+
+44
+00:03:12,350 --> 00:03:16,370
+المثال بيكون في عندنا مشكلة أثار بال central
+
+45
+00:03:16,370 --> 00:03:20,420
+nervous systemHyperventilation Deep Rapid
+
+46
+00:03:20,420 --> 00:03:23,800
+Inspiration أو Rapid Respiration بشكل عام and
+
+47
+00:03:23,800 --> 00:03:27,880
+increase رتب ال volume كمية الهواء المتبادلة سواء
+
+48
+00:03:27,880 --> 00:03:32,740
+كانت بالشهيق والزفير الinspiration والexpiration
+
+49
+00:03:32,740 --> 00:03:36,760
+بتكون زيادة في ال TV and increase ال rate of
+
+50
+00:03:36,760 --> 00:03:41,400
+respiration وزيادة في سرعة ومعدل التنفس with
+
+51
+00:03:41,400 --> 00:03:47,890
+regularism بنغمات متماثلة أو منتظمةفي الـ hyper
+
+52
+00:03:47,890 --> 00:03:52,370
+ventilation hyper سهم لفوق زيادة تمام رابد
+
+53
+00:03:54,270 --> 00:03:57,610
+الأورثوبينيا أورثو لحالها difficulty في ال
+
+54
+00:03:57,610 --> 00:04:01,270
+breathing in spine position يعني بيجينا المريض قبل
+
+55
+00:04:01,270 --> 00:04:05,030
+ودخلنا قسم الصدرية بيقولك أستاذ الحاجة الكبيرة أنه
+
+56
+00:04:05,030 --> 00:04:08,750
+أنا مش قادرة أخد نفس لما بنام على دهري لكن لو
+
+57
+00:04:08,750 --> 00:04:13,950
+أجينا عضلناها تقريبا 45 درجة semi sitting position
+
+58
+00:04:13,950 --> 00:04:17,810
+بيقولك أفضل بصير حطولي مخدتين تحت دهري بصير أفضل
+
+59
+00:04:17,810 --> 00:04:22,830
+في النفس هذه بسميها الحالة أورثوبينيا الأبينياكلمة
+
+60
+00:04:22,830 --> 00:04:26,610
+A أو حرف الـ A لما بسبق الكلمة معناته بينفيها
+
+61
+00:04:26,610 --> 00:04:31,830
+تماما معناته انقطاع للنفس في حالة ال X-Piratory
+
+62
+00:04:31,830 --> 00:04:35,770
+phase ال X-Piratory هنا بدي أركز و أحط على ال X
+
+63
+00:04:35,770 --> 00:04:41,330
+-Piratory phase الaponeosis انقطاع للنفس في ال N
+
+64
+00:04:41,330 --> 00:04:46,250
+-Piratoryتمام؟ إذا لازم أفرق بين المصطلحين Apnea و
+
+65
+00:04:46,250 --> 00:04:50,510
+Apneosis الأبينيا انقطاع للنفس خلال مرحلات الـ
+
+66
+00:04:50,510 --> 00:04:54,670
+exploratory أما الـ Apneosis انقطاع للنفس خلال
+
+67
+00:04:54,670 --> 00:04:57,850
+مرحلة ال inspiration في مرحلات اللي هي ال
+
+68
+00:04:57,850 --> 00:05:01,870
+exploratory phase بشكل عام وهنا مهم جدا أنا أكون
+
+69
+00:05:01,870 --> 00:05:07,080
+عارف كفيزيسرا بي هذه المصطلحات ألا أتد ال volumeهو
+
+70
+00:05:07,080 --> 00:05:12,240
+عبارة عن كمية الهواء المتبادلة خلال مرحلة الـ
+
+71
+00:05:12,240 --> 00:05:17,840
+Inspiration followed by Relaxed Expiration هو بقى
+
+72
+00:05:17,840 --> 00:05:22,720
+اختصره بالـ TV تمام؟ إذا كمية الهواء المتبادلة في
+
+73
+00:05:22,720 --> 00:05:30,530
+مرحلة الشهيق يتبعها اللي هو Relaxed Expirationفي
+
+74
+00:05:30,530 --> 00:05:34,410
+الـ Healthy Young Adult الـ TV approximately حوالي
+
+75
+00:05:34,410 --> 00:05:40,570
+خمسمية ملي لتر لكل inspiration تمام هذا في الـ
+
+76
+00:05:40,570 --> 00:05:45,270
+Normal Adult أو اللي هم الناس اللي ما عندهم اي
+
+77
+00:05:45,270 --> 00:05:51,350
+respiratory problems ايضا بدي اكمل او بدي اشوف بعض
+
+78
+00:05:51,350 --> 00:05:54,730
+الحاجات في ال assessment تبعي في عندي Kinestox
+
+79
+00:05:54,730 --> 00:05:57,810
+Kinestox هي عبارة عن ايش؟ Cycles gradually
+
+80
+00:05:57,810 --> 00:06:02,220
+increasing في تد ال volumeFollowed by serious
+
+81
+00:06:02,220 --> 00:06:05,440
+gradually decreasing lethal volume and then a
+
+82
+00:06:05,440 --> 00:06:08,920
+period of apnea بيصير في عندنا انقطاع في النفس
+
+83
+00:06:08,920 --> 00:06:14,420
+زيادة في lethal volume بيتبعوا زيادة serious
+
+84
+00:06:14,420 --> 00:06:17,660
+gradually decreasing lethal volume and then period
+
+85
+00:06:17,660 --> 00:06:22,840
+of apnea سرعة lethal volume كانت كميةها عالية جدا
+
+86
+00:06:23,740 --> 00:06:28,380
+بعدها مباشرة قلّت تد ال volume بزيادة او مصاحبة
+
+87
+00:06:28,380 --> 00:06:33,120
+اللي هو لابينيا انقطاع النفس this sometimes seen
+
+88
+00:06:33,120 --> 00:06:37,280
+in patient with severe head injury طبعا بتصير في
+
+89
+00:06:37,280 --> 00:06:41,380
+حالات ال TBI او traumatic brain injury اللي انا
+
+90
+00:06:41,380 --> 00:06:45,640
+بسميها head injury kinestox breathing هذا النوع من
+
+91
+00:06:45,640 --> 00:06:48,620
+انواع ال breathing rapid breathing followed by
+
+92
+00:06:48,620 --> 00:06:53,670
+apnea بالمختصر هو عيبان عن سرعة في النفسعلى طول
+
+93
+00:06:53,670 --> 00:06:57,630
+with followed by apnea شوفوا كيف هنا irregular
+
+94
+00:06:57,630 --> 00:07:03,830
+respiration انقطاع اللي هي ال apnea بعدين مرحلة او
+
+95
+00:07:03,830 --> 00:07:09,340
+cycle جديدة ال anemiaبعض المرضى باللاجئ في عندهم
+
+96
+00:07:09,340 --> 00:07:12,820
+if patient appears pale شاحب and has high
+
+97
+00:07:12,820 --> 00:07:17,360
+homoglobin or low homoglobin this maybe have short
+
+98
+00:07:17,360 --> 00:07:21,940
+breathing هذا الشخص أنا بحسه طبعا وبحكي عنه ان هو
+
+99
+00:07:21,940 --> 00:07:27,700
+في عنده short breathing يعني قصر في التنفسثانوثز
+
+100
+00:07:27,700 --> 00:07:32,700
+ثانوثز عندنا الإذرقاق وهي حالة مهمة جدا وظاهرة
+
+101
+00:07:32,700 --> 00:07:37,720
+لازم احنا نكون عارفينها سواء في ال young أو في ال
+
+102
+00:07:37,720 --> 00:07:42,830
+old طبعااللي هم ال geriatric يعني ال cyanosis أو
+
+103
+00:07:42,830 --> 00:07:46,110
+الإذرقاق بينقسم لمرحلتين أو لنوعين في عندنا
+
+104
+00:07:46,110 --> 00:07:49,870
+centrally و في عندنا peripherally ال centrally هذا
+
+105
+00:07:49,870 --> 00:07:53,090
+مهم جدا ليه؟ لأنه بيكون ناتج عن بالموناري disease
+
+106
+00:07:53,090 --> 00:07:59,330
+و بيظهر على الفم المريض و شفته و كذلك لسانه بيكون
+
+107
+00:07:59,330 --> 00:08:04,130
+أزرق و أيضا ممكن يكون واضح تماما على ال peripheral
+
+108
+00:08:04,130 --> 00:08:08,430
+في ال finger و ال toeswhich will warm due to
+
+109
+00:08:08,430 --> 00:08:14,610
+circulation of blood هذا ناتج عن ركود الدم النوع
+
+110
+00:08:14,610 --> 00:08:17,870
+التاني اللي هو ال peripherally هذا بيكون بس
+
+111
+00:08:17,870 --> 00:08:23,150
+الازرقاق في داخل اللي هم ال peripherally joints او
+
+112
+00:08:23,150 --> 00:08:27,090
+ال peripherally limbs اما ال centrally مهم جدا ان
+
+113
+00:08:27,090 --> 00:08:31,830
+انا اعرفه بنلاقي الشفتين المريض وثمه ووجهه كمان
+
+114
+00:08:31,830 --> 00:08:35,350
+ازرقافي الموليد مهم جدا أنا أكون عارفة الـ
+
+115
+00:08:35,350 --> 00:08:38,510
+«central cyanosis» ناتج عن إيش ممكن يكون ناتج عن
+
+116
+00:08:38,510 --> 00:08:42,770
+اللي هو «loss of oxygen» أو «deficiency of oxygen
+
+117
+00:08:42,770 --> 00:08:45,750
+supply» فبالتالي مهم جدا هنا أنا أقيم الـ «central
+
+118
+00:08:45,750 --> 00:08:50,370
+nervous system» بعد هذا اللي صار معاهم هقول في
+
+119
+00:08:50,370 --> 00:08:54,170
+عندنا الأديمة أيضا لازم أنا أقيمها هنا مفرقلي ما
+
+120
+00:08:54,170 --> 00:08:57,610
+بين اللي هو الـ «cyanosis» «centrally»
+
+121
+00:08:57,610 --> 00:09:02,020
+و«peripherally»Central اللي هو بيكون الاشي واضح
+
+122
+00:09:02,020 --> 00:09:06,080
+على ال skin و ال mucous membrane بسبب اللي هو
+
+123
+00:09:06,080 --> 00:09:10,480
+decrease في القطرية ال oxygen saturation قلة في
+
+124
+00:09:10,480 --> 00:09:15,800
+كمية تركيز ال oxygen اللي هو في الشريان أو
+
+125
+00:09:15,800 --> 00:09:19,560
+abnormal hemoglobin نتيجة لإنه صار في عندنا على
+
+126
+00:09:19,560 --> 00:09:23,900
+سبيل المثال أنميا صار في عندنا إذرقاق Exposed لل
+
+127
+00:09:23,900 --> 00:09:27,680
+area warm طبعا الحالة تبعنا إن أحنا بندفق المريض
+
+128
+00:09:27,990 --> 00:09:30,750
+الـ clubbing finger اللي هو أنا باجي بتطلع على
+
+129
+00:09:30,750 --> 00:09:33,310
+أضافر المريض بلاجيها على شكل ال club عاملة زي
+
+130
+00:09:33,310 --> 00:09:36,330
+cubbing لما كنا نعمل cubbing في المساج بيكون اللي
+
+131
+00:09:36,330 --> 00:09:41,270
+هو الأدفر أو ال fingers عامل زي ال cubbing هنا
+
+132
+00:09:41,270 --> 00:09:44,290
+بيكون present موجود يعني هذا بيبين لي أن هنا فعلا
+
+133
+00:09:44,290 --> 00:09:48,810
+اللي هو المشكلة أو ال cyanosis centrally سببه
+
+134
+00:09:48,810 --> 00:09:52,760
+centrallyأما إذا كان peripherally معناته بيكون ان
+
+135
+00:09:52,760 --> 00:09:55,480
+الـ peripherally exposed to skin only لاحظ في
+
+136
+00:09:55,480 --> 00:09:59,220
+عندنا فرق ما بين ال central هنا skin و mucus هنا
+
+137
+00:09:59,220 --> 00:10:02,100
+peripherally exposed ل ال skin بسبب
+
+138
+00:10:02,100 --> 00:10:06,660
+vasoconstriction صار في عندنا قلة في ال blood flow
+
+139
+00:10:06,660 --> 00:10:11,500
+ل ال peripheral area طبعا exposed to area لأنها
+
+140
+00:10:11,500 --> 00:10:19,820
+تعرضت ل اللي هوCold مساج ممكن أحل المشكلة اللي هو
+
+141
+00:10:19,820 --> 00:10:25,520
+بالمساج بال warming هنا زي اللي هي خلينا نحكي
+
+142
+00:10:25,520 --> 00:10:28,860
+ظاهرة اللي هي راندس فلومينااللي هو ممكن يكون في
+
+143
+00:10:28,860 --> 00:10:32,800
+أنافاز و construction للـ artery طبعا بيصير اللي
+
+144
+00:10:32,800 --> 00:10:37,740
+هو الأصابع عند الست على سبيل المثال لونها على dark
+
+145
+00:10:37,740 --> 00:10:41,860
+blue أو أسود خليني أحكي فبالتالي ممكن أنا أستخدم
+
+146
+00:10:41,860 --> 00:10:46,100
+معاها ال contrast path و أكون حليت معاها شوية شوية
+
+147
+00:10:46,100 --> 00:10:50,540
+في المشكلة طبعا هي هتاخدوها في اللي هي بعض
+
+148
+00:10:50,540 --> 00:10:54,310
+المساقات أو ممكن مرت عليكمهنا ما بلاقي في عندي
+
+149
+00:10:54,310 --> 00:10:58,270
+clubbing finger لأ ال fingers طبيعية و تمام تمام و
+
+150
+00:10:58,270 --> 00:11:02,270
+مافي عندنا اي مشكلة بهيك بيكون انا فرقت ما بين ال
+
+151
+00:11:02,270 --> 00:11:13,010
+central cyanosis و ال peripheral cyanosis اه
+
+152
+00:11:13,010 --> 00:11:19,600
+هنا هيفتحلي على الموقع وهي ال clubbing fingerطبعا
+
+153
+00:11:19,600 --> 00:11:24,560
+و هذه اللي هي ال cyanosis اللي بدى يكون في اللي هو
+
+154
+00:11:24,560 --> 00:11:27,940
+اللابس و ال tongue و ال face بيكون في عندنا
+
+155
+00:11:27,940 --> 00:11:32,460
+cyanosis طبعا واضحة جدا هاي ال clubbing fingers
+
+156
+00:11:32,460 --> 00:11:37,120
+اللي انتوا شايفينها في عندي بعض القياسات انا لازم
+
+157
+00:11:37,120 --> 00:11:40,100
+اخدها في ال chest expansion عن طريق ال tab
+
+158
+00:11:40,100 --> 00:11:44,020
+measurement using ل اللي هو tab measurement بدي
+
+159
+00:11:44,020 --> 00:11:46,820
+استخدم ل flat tab should be placed around to the
+
+160
+00:11:46,820 --> 00:11:50,930
+chestلازم يكون مشدود بشكل جيد عشان انا اعرف قداش
+
+161
+00:11:50,930 --> 00:11:54,030
+الـ Diameter اللى انا ممكن اخده بسأل المريض ان
+
+162
+00:11:54,030 --> 00:11:57,070
+يتنفس deeply as possible at the same time along to
+
+163
+00:11:57,070 --> 00:12:00,650
+tab measurement two measurements are recorded انا
+
+164
+00:12:00,650 --> 00:12:06,910
+لازم اسجل القياسين قبل النفس وبعد النفس واخد الفرق
+
+165
+00:12:06,910 --> 00:12:12,430
+بينهم الان في عندي three levels انا هقيس من تلاتة
+
+166
+00:12:12,430 --> 00:12:17,070
+مستويات ال level الأول هيكون من ال fourthcostal
+
+167
+00:12:17,070 --> 00:12:22,370
+cartilage هى ال first second third هنا ال fourth
+
+168
+00:12:22,370 --> 00:12:27,570
+وابدأ اقيص الطريقة الثانية او level التانى من ال
+
+169
+00:12:27,570 --> 00:12:33,530
+X5 process اللى هى نهاية ال sternum هى ال sternum
+
+170
+00:12:33,530 --> 00:12:38,090
+فوق المنبريام ال body وهنا عندنا ال X5 process
+
+171
+00:12:38,090 --> 00:12:43,890
+الطريقة الثالثة او level الثالث من ال anterior end
+
+172
+00:12:43,890 --> 00:12:51,790
+لالكوستال رقم تسعة طبعا من تحت تقريبا وبنجز فيه
+
+173
+00:12:51,790 --> 00:12:55,890
+اذا اول قياس من ال fourth بعدين من ال X by the
+
+174
+00:12:55,890 --> 00:13:01,470
+braces بعدين عندي اللي هي رقم تسعة من اللي او رقم
+
+175
+00:13:01,470 --> 00:13:07,670
+تلاتة من اللي هو ال ninth costal cartilage وهي
+
+176
+00:13:07,670 --> 00:13:13,390
+القياسات زي ما حكينا بناخد القياس في بداية اللي هي
+
+177
+00:13:13,390 --> 00:13:19,190
+النفسوبعد أخذ النفس chest expansion measures a
+
+178
+00:13:19,190 --> 00:13:22,730
+difference between maximum inspiration and maximum
+
+179
+00:13:22,730 --> 00:13:25,790
+force في ال expiration in the fourth intercourse
+
+180
+00:13:25,790 --> 00:13:30,230
+space للمال or just below breast تحت اللي هو الصدر
+
+181
+00:13:30,230 --> 00:13:35,510
+عند الفيميل normal chest expansion لازم يكون طبعا
+
+182
+00:13:35,510 --> 00:13:42,070
+أكثر من اللي هو أو يساوي خمسة centimeter تمام؟اللي
+
+183
+00:13:42,070 --> 00:13:46,070
+هو بدي يكونها طبعا لل level رقم أربعة أو عند ال
+
+184
+00:13:46,070 --> 00:13:48,710
+course ال cartridge أربعةالـ symmetry of the chest
+
+185
+00:13:48,710 --> 00:13:52,690
+movement Analysis of symmetry طبعاً للـ moving of
+
+186
+00:13:52,690 --> 00:13:54,410
+the chest during a breathing gives therapists
+
+187
+00:13:54,410 --> 00:13:58,470
+information about the mobility of thoracic إنه أنا
+
+188
+00:13:58,470 --> 00:14:02,210
+أشوف الـ symmetry تماثل اللي هو القفص الصدري بشكل
+
+189
+00:14:02,210 --> 00:14:07,390
+جيد هذا هيعطيني معلومات على اللي هو ال mobility في
+
+190
+00:14:07,390 --> 00:14:10,390
+ال thoracic and indicated indirectly towards the
+
+191
+00:14:10,390 --> 00:14:14,350
+area lungs may or may not responding على سبيل
+
+192
+00:14:14,350 --> 00:14:17,550
+المثال في بعض الأحيان ممكن يكونالجهة اليمين فيها
+
+193
+00:14:17,550 --> 00:14:22,430
+depressed والجهة اليسار لأ تمام وكويسة ومافيها
+
+194
+00:14:22,430 --> 00:14:25,810
+مشكلة هذا بيكتشفلي أو هذا بيعطيني معلومات أنه أنا
+
+195
+00:14:25,810 --> 00:14:29,370
+في عندى مشكلة في هاي ال lung بالتحديد فبالتالي
+
+196
+00:14:29,370 --> 00:14:35,060
+مافي عندنا full expansion لال lungالـ procedures
+
+197
+00:14:35,060 --> 00:14:37,440
+طبعاً في كتير حاجات من الـ procedures أنا هنا
+
+198
+00:14:37,440 --> 00:14:41,740
+حولتها للعملي و اللي هو أنا بهمني هنا أنت في النظر
+
+199
+00:14:41,740 --> 00:14:45,960
+تكون عارف أيش الطريقة بالذات لحاجات معينة place
+
+200
+00:14:45,960 --> 00:14:48,520
+your hand in patient's chest and assist لل
+
+201
+00:14:48,520 --> 00:14:51,260
+extrusion of each side of thoracic during
+
+202
+00:14:51,260 --> 00:14:54,900
+inspiration and expiration كل مرة بنحكي الكلام هذا
+
+203
+00:14:54,900 --> 00:14:58,440
+أنه أنا لازم أاخد القياسات في ال inspiration و ال
+
+204
+00:14:58,440 --> 00:15:02,440
+expiration each three labor areas can be checked
+
+205
+00:15:03,010 --> 00:15:08,070
+ثلاث loops لازم انا اقيسهم to check upper loops
+
+206
+00:15:08,070 --> 00:15:12,290
+لقياس الجزء الاعلى من ال lung ال face of patient
+
+207
+00:15:12,290 --> 00:15:15,710
+طبعا place the tip of your thumbs in the mid
+
+208
+00:15:15,710 --> 00:15:19,230
+external line حطها على ال mid external line او ال
+
+209
+00:15:19,230 --> 00:15:22,390
+external notch extend your finger above the
+
+210
+00:15:22,390 --> 00:15:26,150
+clavicle افضل كمان شوية الصورة ببين معانا and the
+
+211
+00:15:26,150 --> 00:15:29,910
+patient full exhaled and then inhaled deeply خد
+
+212
+00:15:29,910 --> 00:15:35,680
+نفس عميق وطلع النفس العميق شوفوا كيف الإيدان هى
+
+213
+00:15:35,680 --> 00:15:39,260
+هنا حط ال thumb على اللى هى ال external notch و
+
+214
+00:15:39,260 --> 00:15:43,100
+اللى هو ال fingers باقي ال fingers على الcostal
+
+215
+00:15:43,100 --> 00:15:47,740
+cartilage و دفع فيهم باتجاه اللى هى الclevica
+
+216
+00:15:47,740 --> 00:15:50,680
+continue لل face of patient place the tip of your
+
+217
+00:15:50,680 --> 00:15:53,720
+thumb in X for the process طبعا هنا أنا بدى أقيس
+
+218
+00:15:53,720 --> 00:15:57,980
+هنا اللى هى ال middle loopهيكون في عندنا في ال X
+
+219
+00:15:57,980 --> 00:16:01,180
+-point البرودس جاية الصمب عليها و ال fingers على
+
+220
+00:16:01,180 --> 00:16:03,900
+ال lateral around ribs او ال around costal
+
+221
+00:16:03,900 --> 00:16:07,640
+cartilage اسقلال باشان deep inspiration and then
+
+222
+00:16:07,640 --> 00:16:14,220
+deep expiration متتابعين ورا بعض الآن لما بدى اعمل
+
+223
+00:16:14,220 --> 00:16:17,560
+check up لل lower lobes احنا الآن في ال right
+
+224
+00:16:17,560 --> 00:16:22,520
+lungs فى عندي upper middle lower lobes تمام حاجة
+
+225
+00:16:22,520 --> 00:16:26,410
+احط اللى هو tip of fingersأو الـ Thumb على اللي هو
+
+226
+00:16:26,410 --> 00:16:29,010
+الـ Spinal Sebrosis اللي هو عرتبة الـ Thoracic
+
+227
+00:16:29,010 --> 00:16:33,410
+Level و الإيدين هيكونوا حوالين ال ribs اللي هو
+
+228
+00:16:33,410 --> 00:16:38,070
+بشكل Lateral و بنسأل ال patient طبعا هنا هذه من ال
+
+229
+00:16:38,070 --> 00:16:41,850
+posterior view هذا اللي أنتوا شايفينه مش لسترنم هو
+
+230
+00:16:41,850 --> 00:16:45,190
+عبارة عن ال vertebral column شوف وين جاي على
+
+231
+00:16:45,190 --> 00:16:47,370
+Spinal Sebrosis تقريبا
+
+232
+00:16:49,560 --> 00:16:54,480
+اللي بتكون هنا و laterally اللي هي بدها تكون طبعا
+
+233
+00:16:54,480 --> 00:16:58,860
+ال .. ال fingers جاية على ال lateral ribs و بنسأل
+
+234
+00:16:58,860 --> 00:17:02,860
+ال patient ياخد عنها deep breathing و اللي هو deep
+
+235
+00:17:02,860 --> 00:17:07,780
+inspiration و then deep expiration الآن هتكلم عن
+
+236
+00:17:07,780 --> 00:17:11,800
+ال textile أو اللي هو ما يسمى باللي هو ال vocal
+
+237
+00:17:11,800 --> 00:17:16,850
+fremitus test اللي هو خفقان الصدر أثناء الكلامit's
+
+238
+00:17:16,850 --> 00:17:20,490
+a vibration while palpating over chest wall as
+
+239
+00:17:20,490 --> 00:17:25,850
+patient speaks خفقان الصدر أثناء الكلام بيكون يحكي
+
+240
+00:17:25,850 --> 00:17:29,290
+ال patient فبالتالي بنلاقي أنه في صرف يعانى اللى
+
+241
+00:17:29,290 --> 00:17:34,730
+هو خفقان للصدر please أو اضع ال palm تبعتك على ال
+
+242
+00:17:34,730 --> 00:17:37,970
+hands tightly chest wall and then ask the patient
+
+243
+00:17:37,970 --> 00:17:42,690
+to few words repeated 1919 several times normally
+
+244
+00:17:42,690 --> 00:17:46,670
+phrimitus is felt informallyطبعاً بيكون بشكل مش
+
+245
+00:17:46,670 --> 00:17:51,070
+منتظم لـ Chest Wallالـ Prematase تزداد في حالة
+
+246
+00:17:51,070 --> 00:17:55,010
+زيادة الـ Secretion لماذا؟ لأن المريض خصوصا احنا
+
+247
+00:17:55,010 --> 00:17:58,730
+بـ COVID-19 الآن فبالتالي هذا الاشي احنا كنا
+
+248
+00:17:58,730 --> 00:18:03,610
+نلاحظه او مما كانوا اللي هم الزملاء اللي بيشتغلوا
+
+249
+00:18:03,610 --> 00:18:06,850
+مع الحالات كانوا بيحكولنا انه فعلا في عندنا الـ
+
+250
+00:18:06,850 --> 00:18:10,570
+Tectal volume الـ Prematase بتزداد اللي هو في حالة
+
+251
+00:18:10,570 --> 00:18:14,950
+وجود increasing لـ Secretion and Airway طبعا تزداد
+
+252
+00:18:14,950 --> 00:18:17,970
+للـ Absence اللي هي خلال Result Obstructive Airway
+
+253
+00:18:18,150 --> 00:18:22,510
+طبعاً لما بيقل اللي هو أو بيصير في عنا stopping أو
+
+254
+00:18:22,510 --> 00:18:26,790
+abstractive للـairway بيصير في عنا زيادة في لفة
+
+255
+00:18:26,790 --> 00:18:32,310
+متاصلة، تمام؟ الآن بالسماعة هجيس أنا أو هسمع
+
+256
+00:18:32,310 --> 00:18:35,150
+الـbreathing sound، هشوف في تقييمي أو في خلال
+
+257
+00:18:35,150 --> 00:18:39,210
+الـassessment اللي أنا ما زلت مستمرة فيه إنه أنا
+
+258
+00:18:39,210 --> 00:18:43,390
+هل هذا النفس normal ولا abnormal؟شو تعريفنا للـ
+
+259
+00:18:43,390 --> 00:18:46,230
+escalations of breath sounds؟ هي عبارة عن الـ
+
+260
+00:18:46,230 --> 00:18:48,710
+process of listening to sound within the body
+
+261
+00:18:48,710 --> 00:18:52,450
+specifically to breathe sounds during examination
+
+262
+00:18:52,450 --> 00:18:57,090
+of lung تمام، لفحص اللي هي الرأى ال breath sound
+
+263
+00:18:57,090 --> 00:19:01,430
+occurs for movement because of movement of air in
+
+264
+00:19:01,430 --> 00:19:05,210
+airways during inspiration and expiration بيجي
+
+265
+00:19:05,210 --> 00:19:08,940
+الدكتور أو أنت مثلا بتحط السماعةعلى اللي هو مثلا
+
+266
+00:19:08,940 --> 00:19:13,020
+منطقة الـ back أو منطقة اللي هو ال chest وخد نفس
+
+267
+00:19:13,020 --> 00:19:19,300
+عميق و بتسمع اللي هي النفس ال Ciscope is used to
+
+268
+00:19:19,300 --> 00:19:23,920
+magnify an abnormal breath sound أي إشي غريب في
+
+269
+00:19:23,920 --> 00:19:27,220
+اللي هو ال breathing pattern أنا ممكن أسمع
+
+270
+00:19:27,220 --> 00:19:31,320
+بالسماعة الأن ال breathing should be assessed
+
+271
+00:19:31,320 --> 00:19:35,170
+identify ال area of lungsوين المكان بالظبط اللي
+
+272
+00:19:35,170 --> 00:19:39,270
+أنا بديه طبعا الـ waste congestions وين الاحتقال
+
+273
+00:19:39,270 --> 00:19:42,990
+موجود وين فيه عنا airway obstructive وين فيه عنا
+
+274
+00:19:42,990 --> 00:19:46,770
+مشكلة أنا بغيز من عندها determine the
+
+275
+00:19:46,770 --> 00:19:50,530
+effectiveness بيحدد ليهطبعاً لازم هيحدد لي الـ
+
+276
+00:19:50,530 --> 00:19:53,750
+Effectiveness للـ Airway Intervention هل أنا بحاجة
+
+277
+00:19:53,750 --> 00:20:00,590
+على سبيل المثال لـ Clearness؟ هل أنا بحاجة لبصر
+
+278
+00:20:00,590 --> 00:20:04,150
+الدرناج؟ و أين بالظبط التحديد؟ هذا هيحدد لي الـ
+
+279
+00:20:04,150 --> 00:20:07,950
+Breath Sounddetermine whether lungs are clear or
+
+280
+00:20:07,950 --> 00:20:11,110
+whether intervention should be discontinued هل أنه
+
+281
+00:20:11,110 --> 00:20:15,530
+أنا ال lung صارت كويسة ومنيحة وبعد كده مانا لازم
+
+282
+00:20:15,530 --> 00:20:19,290
+أدخل ولا لسه أنا بحاجة لإنه أنا أدخل بال
+
+283
+00:20:19,290 --> 00:20:22,830
+physiotherapy program تابعيالان هي بعض الـ Pattern
+
+284
+00:20:22,830 --> 00:20:26,450
+لـ Thoracic Landmark Escalations والمحل اللي هو
+
+285
+00:20:26,450 --> 00:20:30,190
+السماعة هنا من الـ anterior aspect و هنا من ال
+
+286
+00:20:30,190 --> 00:20:34,990
+posterior view كيف انا ممكن اشوف مواقع اللي هي
+
+287
+00:20:34,990 --> 00:20:40,160
+السماعةالـ exercise capacity for complete
+
+288
+00:20:40,160 --> 00:20:43,120
+assessment عشان أنا أكمل الـ assessment تبعي ال
+
+289
+00:20:43,120 --> 00:20:47,180
+respiratory system exercise capacity should also
+
+290
+00:20:47,180 --> 00:20:51,140
+measured هل هو عنده ال endurance كويس ولا مش كويس
+
+291
+00:20:51,140 --> 00:20:55,010
+to the most method used to assist patientsطبعا ال
+
+292
+00:20:55,010 --> 00:20:59,670
+six minutes اللي هي walking ست دقائق من المشي ده
+
+293
+00:20:59,670 --> 00:21:04,130
+shuttle walking test اللي هو طبعا جدية هل هو جادر
+
+294
+00:21:04,130 --> 00:21:07,990
+هيكمل معايا هذا المشور لست دقائق ولا انه خلاص مش
+
+295
+00:21:07,990 --> 00:21:11,290
+جادر و بعد هيك أ stop و تقري في عنده انقطاع في
+
+296
+00:21:11,290 --> 00:21:15,970
+النفسالـ Inspiration Medical Investigation الآن
+
+297
+00:21:15,970 --> 00:21:21,050
+الـ Inspiration خلال هي أخد حماء النفس ال patient
+
+298
+00:21:21,050 --> 00:21:23,750
+file should be reviewed the current pulmonary
+
+299
+00:21:23,750 --> 00:21:27,210
+diagnosis عشان أنا بدي أعرف ال diagnosis قول لبرتي
+
+300
+00:21:27,750 --> 00:21:32,470
+الـ testing لازم أكون عارفاها ال MRI الصور ال X
+
+301
+00:21:32,470 --> 00:21:35,510
+-Ray كل إشي لازم أكون عارفاه في اللي هو ال medical
+
+302
+00:21:35,510 --> 00:21:39,910
+file تبعه this may include but it's not limited to
+
+303
+00:21:39,910 --> 00:21:43,570
+هذا الإشي طبعا مش هيحد من اللي هي preliminary
+
+304
+00:21:43,570 --> 00:21:47,120
+function testالـ Chest X-ray القطر البلد الجاذبية
+
+305
+00:21:47,120 --> 00:21:50,720
+الاناليسية طبعا ال saturation مهم جدا للأكسجين ال
+
+306
+00:21:50,720 --> 00:21:54,460
+ECG ال blood count اللي هي ال CBC و الأمور اللي زي
+
+307
+00:21:54,460 --> 00:21:58,960
+هاي كمان ال blood chemistry مهم جدا أنه يكون عندي
+
+308
+00:21:58,960 --> 00:22:03,560
+في file ال patient هذه الشغلات طبعا هاي بعض اللي
+
+309
+00:22:03,560 --> 00:22:07,000
+هي ال medical analysis أو ال investigation بشكل
+
+310
+00:22:07,000 --> 00:22:11,750
+عام اللي بتكون موجودةفي عند الـ musculoskeletal
+
+311
+00:22:11,750 --> 00:22:14,350
+and integumentary evaluation should include the
+
+312
+00:22:14,350 --> 00:22:18,270
+following لازم أقيس ال joint range of motion gross
+
+313
+00:22:18,270 --> 00:22:22,610
+strength assessment extremity ال postural ال gate
+
+314
+00:22:22,610 --> 00:22:26,990
+ال skin inspections و ال edema inspections طبعا كل
+
+315
+00:22:26,990 --> 00:22:31,870
+هذه الأمور مهمة جدا أنه أنا لازم أحددها أو لازم
+
+316
+00:22:31,870 --> 00:22:34,770
+أفحصها في ال musculoskeletal ال functional
+
+317
+00:22:34,770 --> 00:22:38,850
+evaluation كمان مهمة جدا عندي أنه أنا لازم أفحص ال
+
+318
+00:22:38,850 --> 00:22:42,690
+ADLالـ Activity Daily Living هل إنه هذا الإشي
+
+319
+00:22:42,690 --> 00:22:47,810
+بيأثر عليه على سبيل المثال كان يمشي مشوار sport
+
+320
+00:22:47,810 --> 00:22:50,750
+يعمل فبالتالي إنه هذا حد من ال sport اللي هو
+
+321
+00:22:50,750 --> 00:22:54,190
+بيشتغلها ال balance و ال gate assessment طبعا إشي
+
+322
+00:22:54,190 --> 00:22:58,590
+طبيعي لو كان عنده على سبيل المثال سبنيا بيأثر عنده
+
+323
+00:22:58,590 --> 00:23:01,040
+على ال balance و ال gate assessmentالـ superior
+
+324
+00:23:01,040 --> 00:23:05,420
+level function اللي هو كيف كان زمان يقدي وظائفه هل
+
+325
+00:23:05,420 --> 00:23:07,980
+بعد ال disease أو بعد السؤوب دي على سبيل المثال
+
+326
+00:23:07,980 --> 00:23:12,440
+ضال مستمر ولا بحاجة إلى assistant الـ need للـ
+
+327
+00:23:12,440 --> 00:23:17,420
+adaptive equipment هل هو بحاجة ل على سبيل المثال
+
+328
+00:23:17,420 --> 00:23:24,200
+inspiration هل هو بحاجة ل oxygenعلى سبيل المثال أي
+
+329
+00:23:24,200 --> 00:23:29,380
+جهاز بحاجة له الـ full risk هل هو بدي أقيم هال
+
+330
+00:23:29,380 --> 00:23:33,380
+مخاطر اللي هو السقوط هل هو مثلا على سبيل المثال
+
+331
+00:23:33,380 --> 00:23:36,260
+full concentrated أو full conscious أنه يكون مثلا
+
+332
+00:23:36,260 --> 00:23:39,480
+على سبيل المثال قادر على اللي هو الاستمرار في
+
+333
+00:23:39,480 --> 00:23:42,900
+الماشي من غير ما يصير فيه أي سقوط ال leisure و ال
+
+334
+00:23:42,900 --> 00:23:47,280
+social activity كمان مهمة جداً هاي بالنسبة له اللي
+
+335
+00:23:47,280 --> 00:23:51,180
+هو ال functional evaluation اللي عند المريض تبعنا
+
+336
+00:23:51,760 --> 00:23:55,500
+وبهيك بيكون أنا خلصت ال part اللي هو التاني فيديو
+
+337
+00:23:55,500 --> 00:24:00,200
+رقم 11 لـ Pulmonary Assessment ويعطيكوا ألف عافية
+
+338
+00:24:00,200 --> 00:24:01,240
+على بركة النعم
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/2gNE9xFg7iE_raw.json b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/2gNE9xFg7iE_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..8f4d296ec2291edfd30a73a284373b4645adf4ae
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/2gNE9xFg7iE_raw.json
@@ -0,0 +1 @@
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"word": " kinestox", "probability": 0.5786844889322916}, {"start": 404.38, "end": 404.9, "word": " breathing", "probability": 0.479736328125}, {"start": 404.9, "end": 405.18, "word": " هذا", "probability": 0.75390625}, {"start": 405.18, "end": 405.46, "word": " النوع", "probability": 0.9580078125}, {"start": 405.46, "end": 405.64, "word": " من", "probability": 0.994140625}, {"start": 405.64, "end": 406.06, "word": " انواع", "probability": 0.8304036458333334}, {"start": 406.06, "end": 406.2, "word": " ال", "probability": 0.97900390625}, {"start": 406.2, "end": 406.64, "word": " breathing", "probability": 0.802734375}, {"start": 406.64, "end": 407.28, "word": " rapid", "probability": 0.681640625}, {"start": 407.28, "end": 407.84, "word": " breathing", "probability": 0.9228515625}, {"start": 407.84, "end": 408.32, "word": " followed", "probability": 0.8603515625}, {"start": 408.32, "end": 408.62, "word": " by", "probability": 0.98291015625}, {"start": 408.62, "end": 409.08, "word": " apnea", "probability": 0.5953369140625}, {"start": 409.08, "end": 410.32, "word": " بالمختصر", "probability": 0.95107421875}, {"start": 410.32, "end": 410.84, "word": " هو", "probability": 0.81884765625}, {"start": 410.84, "end": 411.3, "word": " عيبان", "probability": 0.6705322265625}, {"start": 411.3, "end": 411.46, "word": " عن", "probability": 0.6884765625}, {"start": 411.46, "end": 411.78, "word": " سرعة", "probability": 0.9671223958333334}, {"start": 411.78, "end": 411.96, "word": " في", "probability": 0.89501953125}, {"start": 411.96, "end": 412.24, "word": " النفس", "probability": 0.95947265625}], "temperature": 1.0}, {"id": 17, "seek": 42695, "start": 413.05, "end": 426.95, "text": "على طول with followed by apnea شوفوا كيف هنا irregular respiration انقطاع اللي هي ال apnea بعدين مرحلة او cycle جديدة ال anemia", "tokens": [3615, 23942, 23032, 12610, 365, 6263, 538, 1882, 22160, 13412, 38688, 14407, 9122, 33911, 34105, 29349, 1597, 7611, 16472, 47432, 45761, 13672, 1829, 39896, 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"text": "الجهة اليمين فيها depressed والجهة اليسار لأ تمام وكويسة ومافيها مشكلة هذا بيكتشفلي أو هذا بيعطيني معلومات أنه أنا في عندى مشكلة في هاي ال lung بالتحديد فبالتالي مافي عندنا full expansion لال lung", "tokens": [6027, 7435, 3224, 3660, 2423, 32640, 9957, 8978, 11296, 18713, 16070, 7435, 3224, 3660, 45595, 3794, 9640, 5296, 10721, 46811, 10943, 4032, 4117, 45865, 3794, 3660, 4032, 15042, 41185, 11296, 37893, 28820, 3660, 23758, 4724, 1829, 4117, 2655, 8592, 5172, 20292, 34051, 23758, 4724, 40228, 9566, 1829, 22653, 20449, 1211, 20498, 9307, 14739, 3224, 41850, 8978, 43242, 7578, 37893, 28820, 3660, 8978, 8032, 47302, 2423, 16730, 20666, 2655, 5016, 16254, 3215, 6156, 3555, 6027, 2655, 6027, 1829, 19446, 41185, 43242, 8315, 1577, 11260, 5296, 6027, 16730], "avg_logprob": -0.18498563937757206, "compression_ratio": 1.75, "no_speech_prob": 1.1324882507324219e-06, "words": [{"start": 856.51, "end": 856.91, "word": "الجهة", "probability": 0.9736328125}, {"start": 856.91, "end": 857.29, 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inspiration and expiration كل مرة بنحكي الكلام هذا أنه أنا لازم أاخد القياسات في ال inspiration و ال expiration each three labor areas can be checked", "tokens": [6027, 39184, 13846, 23032, 3555, 3615, 995, 14111, 8978, 9122, 2655, 13546, 11331, 26108, 9307, 9154, 2423, 39184, 13846, 41850, 34105, 11331, 12610, 2655, 11296, 24976, 25957, 20292, 4032, 13672, 1829, 31439, 41850, 4724, 16095, 22653, 34105, 14739, 2655, 8978, 28239, 19913, 2288, 6055, 30544, 6225, 9640, 5172, 36632, 8592, 41950, 16572, 28671, 20666, 8848, 9307, 5296, 5016, 26108, 9307, 20449, 9957, 3660, 1081, 428, 1011, 294, 4537, 311, 7443, 293, 4255, 24976, 16455, 5704, 295, 1184, 1252, 295, 11588, 326, 299, 1830, 10249, 293, 39657, 28242, 3714, 25720, 44945, 5016, 4117, 1829, 2423, 28820, 10943, 23758, 14739, 3224, 41850, 5296, 31377, 2304, 5551, 47283, 3215, 25062, 25528, 3794, 9307, 8978, 2423, 10249, 4032, 2423, 39657, 1184, 1045, 5938, 3179, 393, 312, 10033], "avg_logprob": -0.20778729237856403, 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"end": 1031.1, "word": " هو", "probability": 0.98291015625}, {"start": 1031.1, "end": 1031.42, "word": " ال", "probability": 0.89453125}, {"start": 1031.42, "end": 1031.8, "word": " vocal", "probability": 0.9599609375}, {"start": 1031.8, "end": 1032.46, "word": " fremitus", "probability": 0.794921875}, {"start": 1032.46, "end": 1033.2, "word": " test", "probability": 0.9521484375}, {"start": 1033.2, "end": 1033.7, "word": " اللي", "probability": 0.977783203125}, {"start": 1033.7, "end": 1033.94, "word": " هو", "probability": 0.990234375}, {"start": 1033.94, "end": 1034.56, "word": " خفقان", "probability": 0.9906005859375}, {"start": 1034.56, "end": 1034.96, "word": " الصدر", "probability": 0.9466145833333334}, {"start": 1034.96, "end": 1035.48, "word": " أثناء", "probability": 0.9749755859375}, {"start": 1035.48, "end": 1036.04, "word": " الكلام", "probability": 0.9440104166666666}], "temperature": 1.0}, {"id": 43, "seek": 106499, "start": 1036.49, "end": 1064.99, "text": "it's a vibration while palpating over chest wall as patient speaks خفقان الصدر أثناء الكلام بيكون يحكي ال patient فبالتالي بنلاقي أنه في صرف يعانى اللى هو خفقان للصدر please أو اضع ال palm تبعتك على ال hands tightly chest wall and then ask the patient to few words repeated 1919 several times normally phrimitus is felt informally", "tokens": [270, 311, 257, 20006, 1339, 3984, 79, 990, 670, 7443, 2929, 382, 4537, 10789, 16490, 5172, 4587, 7649, 31767, 3215, 2288, 5551, 12984, 1863, 16606, 2423, 28820, 10943, 4724, 1829, 30544, 7251, 5016, 4117, 1829, 2423, 4537, 6156, 3555, 6027, 2655, 6027, 1829, 44945, 15040, 38436, 14739, 3224, 8978, 20328, 28480, 37495, 7649, 7578, 13672, 7578, 31439, 16490, 5172, 4587, 7649, 24976, 9381, 3215, 2288, 1767, 34051, 1975, 11242, 3615, 2423, 17018, 6055, 3555, 34268, 4117, 15844, 2423, 2377, 21952, 7443, 2929, 293, 550, 1029, 264, 4537, 281, 1326, 2283, 10477, 46484, 2940, 1413, 5646, 903, 5565, 30973, 307, 2762, 1356, 379], "avg_logprob": -0.22178397566369437, 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"probability": 0.87548828125}, {"start": 1047.71, "end": 1048.07, "word": " صرف", "probability": 0.967041015625}, {"start": 1048.07, "end": 1048.79, "word": " يعانى", "probability": 0.6138509114583334}, {"start": 1048.79, "end": 1049.29, "word": " اللى", "probability": 0.9091796875}, {"start": 1049.29, "end": 1049.57, "word": " هو", "probability": 0.92333984375}, {"start": 1049.57, "end": 1050.19, "word": " خفقان", "probability": 0.9888916015625}, {"start": 1050.19, "end": 1050.97, "word": " للصدر", "probability": 0.83990478515625}, {"start": 1050.97, "end": 1051.71, "word": " please", "probability": 0.476806640625}, {"start": 1051.71, "end": 1052.21, "word": " أو", "probability": 0.73095703125}, {"start": 1052.21, "end": 1052.85, "word": " اضع", "probability": 0.6991373697916666}, {"start": 1052.85, "end": 1053.07, "word": " ال", "probability": 0.382568359375}, {"start": 1053.07, "end": 1053.35, "word": " palm", "probability": 0.796875}, {"start": 1053.35, "end": 1054.01, "word": " تبعتك", "probability": 0.9512939453125}, {"start": 1054.01, "end": 1054.35, "word": " على", "probability": 0.88427734375}, {"start": 1054.35, "end": 1054.73, "word": " ال", "probability": 0.92626953125}, {"start": 1054.73, "end": 1055.11, "word": " hands", "probability": 0.9052734375}, {"start": 1055.11, "end": 1055.55, "word": " tightly", "probability": 0.64794921875}, {"start": 1055.55, "end": 1055.89, "word": " chest", "probability": 0.77685546875}, {"start": 1055.89, "end": 1056.29, "word": " wall", "probability": 0.86083984375}, {"start": 1056.29, "end": 1056.91, "word": " and", "probability": 0.9248046875}, {"start": 1056.91, "end": 1057.13, "word": " then", "probability": 0.90234375}, {"start": 1057.13, "end": 1057.49, "word": " ask", "probability": 0.94775390625}, {"start": 1057.49, "end": 1057.65, "word": " the", "probability": 0.90087890625}, {"start": 1057.65, "end": 1057.97, "word": " patient", "probability": 0.92822265625}, {"start": 1057.97, "end": 1058.23, "word": " to", "probability": 0.92578125}, {"start": 1058.23, "end": 1058.47, "word": " few", "probability": 0.7919921875}, {"start": 1058.47, "end": 1058.91, "word": " words", "probability": 0.91015625}, {"start": 1058.91, "end": 1059.39, "word": " repeated", "probability": 0.91650390625}, {"start": 1059.39, "end": 1060.35, "word": " 1919", "probability": 0.25244140625}, {"start": 1060.35, "end": 1061.27, "word": " several", "probability": 0.83251953125}, {"start": 1061.27, "end": 1061.75, "word": " times", "probability": 0.62158203125}, {"start": 1061.75, "end": 1062.69, "word": " normally", "probability": 0.80419921875}, {"start": 1062.69, "end": 1063.35, "word": " phrimitus", "probability": 0.3871256510416667}, {"start": 1063.35, "end": 1063.73, "word": " is", "probability": 0.9609375}, {"start": 1063.73, "end": 1064.07, "word": " felt", "probability": 0.476318359375}, {"start": 1064.07, "end": 1064.99, "word": " informally", "probability": 0.64306640625}], "temperature": 1.0}, {"id": 44, "seek": 106784, "start": 1065.35, "end": 1067.85, "text": "طبعاً بيكون بشكل مش منتظم لـ Chest Wall", "tokens": [9566, 3555, 3615, 995, 14111, 4724, 1829, 30544, 4724, 8592, 28820, 37893, 9154, 2655, 19913, 2304, 5296, 39184, 47981, 9551], "avg_logprob": -0.15541295210520426, "compression_ratio": 0.8985507246376812, "no_speech_prob": 0.0, "words": [{"start": 1065.35, "end": 1065.67, "word": "طبعاً", "probability": 0.87861328125}, {"start": 1065.67, "end": 1065.99, "word": " بيكون", "probability": 0.9578450520833334}, {"start": 1065.99, "end": 1066.43, "word": " بشكل", "probability": 0.9646809895833334}, {"start": 1066.43, "end": 1066.67, "word": " مش", "probability": 0.9931640625}, {"start": 1066.67, "end": 1067.25, "word": " منتظم", "probability": 0.9696044921875}, {"start": 1067.25, "end": 1067.43, "word": " لـ", "probability": 0.6444091796875}, {"start": 1067.43, "end": 1067.61, "word": " Chest", "probability": 0.397705078125}, {"start": 1067.61, "end": 1067.85, "word": " Wall", "probability": 0.68603515625}], "temperature": 1.0}, {"id": 45, "seek": 109797, "start": 1068.15, "end": 1097.97, "text": "الـ Prematase تزداد في حالة زيادة الـ Secretion لماذا؟ لأن المريض خصوصا احنا بـ COVID-19 الآن فبالتالي هذا الاشي احنا كنا نلاحظه او مما كانوا اللي هم الزملاء اللي بيشتغلوا مع الحالات كانوا بيحكولنا انه فعلا في عندنا الـ Tectal volume الـ Prematase بتزداد اللي هو في حالة وجود increasing لـ Secretion and Airway طبعا تزداد للـ Absence اللي هي خلال Result Obstructive Airway", "tokens": [6027, 39184, 13011, 267, 651, 6055, 11622, 3215, 18513, 8978, 11331, 6027, 3660, 30767, 1829, 18513, 3660, 2423, 39184, 7400, 313, 32767, 45636, 995, 22807, 5296, 33456, 9673, 16572, 11242, 16490, 9381, 2407, 9381, 995, 1975, 5016, 8315, 4724, 39184, 4566, 12, 3405, 6024, 48506, 6156, 3555, 6027, 2655, 6027, 1829, 23758, 2423, 33599, 1829, 1975, 5016, 8315, 9122, 8315, 8717, 15040, 5016, 19913, 3224, 1975, 2407, 3714, 15042, 25961, 14407, 13672, 1829, 8032, 2304, 6024, 110, 42213, 16606, 13672, 1829, 4724, 1829, 8592, 2655, 17082, 1211, 14407, 20449, 21542, 6027, 9307, 25961, 14407, 4724, 1829, 5016, 4117, 12610, 8315, 16472, 3224, 6156, 3615, 15040, 8978, 43242, 8315, 2423, 39184, 314, 557, 304, 5523, 2423, 39184, 13011, 267, 651, 39894, 11622, 3215, 18513, 13672, 1829, 31439, 8978, 11331, 6027, 3660, 49610, 23328, 5662, 5296, 39184, 7400, 313, 293, 5774, 676, 23032, 3555, 3615, 995, 6055, 11622, 3215, 18513, 24976, 39184, 5813, 655, 13672, 1829, 39896, 16490, 1211, 6027, 5015, 723, 4075, 372, 21673, 5774, 676], "avg_logprob": -0.2767319304038243, "compression_ratio": 1.7668711656441718, "no_speech_prob": 0.1214599609375, "words": [{"start": 1068.15, "end": 1068.43, "word": "الـ", "probability": 0.45611572265625}, {"start": 1068.43, "end": 1068.87, "word": " Prematase", "probability": 0.372802734375}, {"start": 1068.87, "end": 1069.73, "word": " تزداد", "probability": 0.60302734375}, {"start": 1069.73, "end": 1070.27, "word": " في", "probability": 0.904296875}, {"start": 1070.27, "end": 1071.07, "word": " حالة", "probability": 0.9856770833333334}, {"start": 1071.07, "end": 1071.95, "word": " زيادة", "probability": 0.98681640625}, {"start": 1071.95, "end": 1072.13, "word": " الـ", "probability": 0.5999755859375}, {"start": 1072.13, "end": 1072.77, "word": " Secretion", "probability": 0.6656494140625}, {"start": 1072.77, "end": 1073.71, "word": " لماذا؟", "probability": 0.74615478515625}, {"start": 1073.71, "end": 1074.01, "word": " لأن", "probability": 0.93994140625}, {"start": 1074.01, "end": 1074.39, "word": " المريض", "probability": 0.9425455729166666}, {"start": 1074.39, "end": 1074.79, "word": " خصوصا", "probability": 0.92119140625}, {"start": 1074.79, "end": 1075.01, "word": " احنا", "probability": 0.739990234375}, {"start": 1075.01, "end": 1075.19, "word": " بـ", "probability": 0.81494140625}, {"start": 1075.19, "end": 1075.45, "word": " COVID", "probability": 0.51708984375}, {"start": 1075.45, "end": 1075.95, "word": "-19", "probability": 0.863525390625}, {"start": 1075.95, "end": 1076.47, "word": " الآن", "probability": 0.647216796875}, {"start": 1076.47, "end": 1077.45, "word": " فبالتالي", "probability": 0.9798990885416666}, {"start": 1077.45, "end": 1077.77, "word": " هذا", "probability": 0.82373046875}, {"start": 1077.77, "end": 1078.29, "word": " الاشي", "probability": 0.826171875}, {"start": 1078.29, "end": 1078.49, "word": " احنا", "probability": 0.7725423177083334}, {"start": 1078.49, "end": 1078.73, "word": " كنا", "probability": 0.98095703125}, {"start": 1078.73, "end": 1079.35, "word": " نلاحظه", "probability": 0.9228515625}, {"start": 1079.35, "end": 1080.01, "word": " او", "probability": 0.785400390625}, {"start": 1080.01, "end": 1081.29, "word": " مما", "probability": 0.628173828125}, {"start": 1081.29, "end": 1082.31, "word": " كانوا", "probability": 0.972900390625}, {"start": 1082.31, "end": 1082.45, "word": " اللي", "probability": 0.726806640625}, {"start": 1082.45, "end": 1082.61, "word": " هم", "probability": 0.872314453125}, {"start": 1082.61, "end": 1082.97, "word": " الزملاء", "probability": 0.892822265625}, {"start": 1082.97, "end": 1083.11, "word": " اللي", "probability": 0.986572265625}, {"start": 1083.11, "end": 1083.61, "word": " بيشتغلوا", "probability": 0.9875837053571429}, {"start": 1083.61, "end": 1083.81, "word": " مع", "probability": 0.9873046875}, {"start": 1083.81, "end": 1084.51, "word": " الحالات", "probability": 0.92919921875}, {"start": 1084.51, "end": 1085.03, "word": " كانوا", "probability": 0.9677734375}, {"start": 1085.03, "end": 1085.39, "word": " بيحكولنا", "probability": 0.89453125}, {"start": 1085.39, "end": 1085.61, "word": " انه", "probability": 0.6171875}, {"start": 1085.61, "end": 1085.91, "word": " فعلا", "probability": 0.9178059895833334}, {"start": 1085.91, "end": 1086.19, "word": " في", "probability": 0.81005859375}, {"start": 1086.19, "end": 1086.65, "word": " عندنا", "probability": 0.8642578125}, {"start": 1086.65, "end": 1086.85, "word": " الـ", "probability": 0.633544921875}, {"start": 1086.85, "end": 1087.13, "word": " Tectal", "probability": 0.4755859375}, {"start": 1087.13, "end": 1087.55, "word": " volume", "probability": 0.2347412109375}, {"start": 1087.55, "end": 1088.11, "word": " الـ", "probability": 0.28326416015625}, {"start": 1088.11, "end": 1088.55, "word": " Prematase", "probability": 0.8704427083333334}, {"start": 1088.55, "end": 1089.39, "word": " بتزداد", "probability": 0.834228515625}, {"start": 1089.39, "end": 1089.63, "word": " اللي", "probability": 0.879150390625}, {"start": 1089.63, "end": 1089.89, "word": " هو", "probability": 0.9794921875}, {"start": 1089.89, "end": 1090.13, "word": " في", "probability": 0.9765625}, {"start": 1090.13, "end": 1090.57, "word": " حالة", "probability": 0.9972330729166666}, {"start": 1090.57, "end": 1090.91, "word": " وجود", "probability": 0.979248046875}, {"start": 1090.91, "end": 1091.47, "word": " increasing", "probability": 0.49072265625}, 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1387.98, "word": " المثال", "probability": 0.9920247395833334}, {"start": 1387.98, "end": 1388.26, "word": " ضال", "probability": 0.6973876953125}, {"start": 1388.26, "end": 1388.8, "word": " مستمر", "probability": 0.90771484375}, {"start": 1388.8, "end": 1389.44, "word": " ولا", "probability": 0.79541015625}, {"start": 1389.44, "end": 1390.08, "word": " بحاجة", "probability": 0.9937744140625}, {"start": 1390.08, "end": 1390.36, "word": " إلى", "probability": 0.67431640625}, {"start": 1390.36, "end": 1391.02, "word": " assistant", "probability": 0.72119140625}, {"start": 1391.02, "end": 1392.04, "word": " الـ", "probability": 0.674560546875}, {"start": 1392.04, "end": 1392.22, "word": " need", "probability": 0.76318359375}, {"start": 1392.22, "end": 1392.44, "word": " للـ", "probability": 0.498779296875}, {"start": 1392.44, "end": 1392.88, "word": " adaptive", "probability": 0.859375}, {"start": 1392.88, "end": 1393.66, "word": " equipment", "probability": 0.8564453125}, {"start": 1393.66, "end": 1393.96, "word": " هل", "probability": 0.904296875}, {"start": 1393.96, "end": 1394.18, "word": " هو", "probability": 0.9912109375}, {"start": 1394.18, "end": 1395.1, "word": " بحاجة", "probability": 0.9957275390625}, {"start": 1395.1, "end": 1395.34, "word": " ل", "probability": 0.61767578125}, {"start": 1395.34, "end": 1396.3, "word": " على", "probability": 0.27685546875}, {"start": 1396.3, "end": 1396.74, "word": " سبيل", "probability": 0.9930013020833334}, {"start": 1396.74, "end": 1397.42, "word": " المثال", "probability": 0.9708658854166666}, {"start": 1397.42, "end": 1398.42, "word": " inspiration", "probability": 0.78076171875}, {"start": 1398.42, "end": 1399.0, "word": " هل", "probability": 0.84912109375}, {"start": 1399.0, "end": 1399.12, "word": " هو", "probability": 0.99267578125}, {"start": 1399.12, "end": 1399.64, "word": " بحاجة", "probability": 0.995361328125}, {"start": 1399.64, "end": 1399.92, "word": " ل", "probability": 0.8828125}, {"start": 1399.92, "end": 1400.62, "word": " oxygen", "probability": 0.54833984375}], "temperature": 1.0}, {"id": 61, "seek": 143118, "start": 1402.1, "end": 1431.18, "text": "على سبيل المثال أي جهاز بحاجة له الـ full risk هل هو بدي أقيم هال مخاطر اللي هو السقوط هل هو مثلا على سبيل المثال full concentrated أو full conscious أنه يكون مثلا على سبيل المثال قادر على اللي هو الاستمرار في الماشي من غير ما يصير فيه أي سقوط ال leisure و ال social activity كمان مهمة جداً هاي بالنسبة له اللي هو ال functional evaluation اللي عند المريض تبعنا", "tokens": [3615, 23942, 8608, 21292, 1211, 9673, 12984, 6027, 36632, 10874, 3224, 31377, 4724, 5016, 26108, 3660, 46740, 2423, 39184, 1577, 3148, 8032, 1211, 31439, 4724, 16254, 5551, 4587, 32640, 8032, 6027, 3714, 9778, 41193, 2288, 13672, 1829, 31439, 21136, 4587, 2407, 9566, 8032, 1211, 31439, 50113, 15040, 15844, 8608, 21292, 1211, 9673, 12984, 6027, 1577, 21321, 34051, 1577, 6648, 14739, 3224, 7251, 30544, 50113, 15040, 15844, 8608, 21292, 1211, 9673, 12984, 6027, 12174, 18513, 2288, 15844, 13672, 1829, 31439, 42963, 14851, 29973, 9640, 8978, 9673, 33599, 1829, 9154, 32771, 13546, 19446, 7251, 9381, 13546, 8978, 3224, 36632, 8608, 4587, 2407, 9566, 2423, 31339, 4032, 2423, 2093, 5191, 9122, 2304, 7649, 3714, 16095, 3660, 10874, 28259, 14111, 8032, 47302, 20666, 1863, 35457, 3660, 46740, 13672, 1829, 31439, 2423, 11745, 13344, 13672, 1829, 43242, 9673, 16572, 11242, 6055, 3555, 3615, 8315], "avg_logprob": -0.14464285639779909, "compression_ratio": 1.9522184300341296, "no_speech_prob": 7.021427154541016e-05, "words": [{"start": 1402.1, "end": 1402.78, "word": "على", "probability": 0.921875}, {"start": 1402.78, "end": 1403.1, "word": " سبيل", "probability": 0.99169921875}, {"start": 1403.1, "end": 1403.58, "word": " المثال", "probability": 0.9928385416666666}, {"start": 1403.58, "end": 1404.2, "word": " أي", "probability": 0.68408203125}, {"start": 1404.2, "end": 1404.84, "word": " جهاز", "probability": 0.9970703125}, {"start": 1404.84, "end": 1405.72, "word": " بحاجة", "probability": 0.8699951171875}, {"start": 1405.72, "end": 1405.94, "word": " له", "probability": 0.419677734375}, {"start": 1405.94, "end": 1406.48, "word": " الـ", "probability": 0.775634765625}, {"start": 1406.48, "end": 1406.62, "word": " full", "probability": 0.26904296875}, {"start": 1406.62, "end": 1406.96, "word": " risk", "probability": 0.826171875}, {"start": 1406.96, "end": 1407.26, "word": " هل", "probability": 0.832763671875}, {"start": 1407.26, "end": 1407.72, "word": " هو", "probability": 0.98583984375}, {"start": 1407.72, "end": 1408.44, "word": " بدي", "probability": 0.6263427734375}, {"start": 1408.44, "end": 1408.88, "word": " أقيم", "probability": 0.7882486979166666}, {"start": 1408.88, "end": 1409.38, "word": " هال", "probability": 0.54931640625}, {"start": 1409.38, "end": 1410.06, "word": " مخاطر", "probability": 0.885986328125}, {"start": 1410.06, "end": 1410.26, "word": " اللي", "probability": 0.873291015625}, {"start": 1410.26, "end": 1410.72, "word": " هو", "probability": 0.927734375}, {"start": 1410.72, "end": 1411.5, "word": " السقوط", "probability": 0.9776611328125}, {"start": 1411.5, "end": 1411.98, "word": " هل", "probability": 0.88671875}, {"start": 1411.98, "end": 1412.2, "word": " هو", "probability": 0.9951171875}, {"start": 1412.2, "end": 1412.6, "word": " مثلا", "probability": 0.88525390625}, {"start": 1412.6, "end": 1412.8, "word": " على", "probability": 0.84521484375}, {"start": 1412.8, "end": 1413.04, "word": " سبيل", "probability": 0.98974609375}, {"start": 1413.04, "end": 1413.38, "word": " المثال", "probability": 0.9978841145833334}, {"start": 1413.38, "end": 1413.6, "word": " full", "probability": 0.7421875}, {"start": 1413.6, "end": 1414.34, "word": " concentrated", "probability": 0.85009765625}, {"start": 1414.34, "end": 1414.62, "word": " أو", "probability": 0.84814453125}, {"start": 1414.62, "end": 1414.88, "word": " full", "probability": 0.9189453125}, {"start": 1414.88, "end": 1415.3, "word": " conscious", "probability": 0.90234375}, {"start": 1415.3, "end": 1415.62, "word": " أنه", "probability": 0.76806640625}, {"start": 1415.62, "end": 1415.92, "word": " يكون", "probability": 0.99072265625}, {"start": 1415.92, "end": 1416.26, "word": " مثلا", "probability": 0.982177734375}, {"start": 1416.26, "end": 1416.44, "word": " على", "probability": 0.83740234375}, {"start": 1416.44, "end": 1416.58, "word": " سبيل", "probability": 0.9915364583333334}, {"start": 1416.58, "end": 1416.92, "word": " المثال", "probability": 0.9990234375}, {"start": 1416.92, "end": 1417.42, "word": " قادر", "probability": 0.982421875}, {"start": 1417.42, "end": 1417.76, "word": " على", "probability": 0.90087890625}, {"start": 1417.76, "end": 1418.48, "word": " اللي", "probability": 0.958740234375}, {"start": 1418.48, "end": 1418.7, "word": " هو", "probability": 0.9921875}, {"start": 1418.7, "end": 1419.32, "word": " الاستمرار", "probability": 0.9434814453125}, {"start": 1419.32, "end": 1419.48, "word": " في", "probability": 0.97607421875}, {"start": 1419.48, "end": 1419.84, "word": " الماشي", "probability": 0.9347330729166666}, {"start": 1419.84, "end": 1420.02, "word": " من", "probability": 0.9775390625}, {"start": 1420.02, "end": 1420.26, "word": " غير", "probability": 0.996826171875}, {"start": 1420.26, "end": 1420.4, "word": " ما", "probability": 0.9716796875}, {"start": 1420.4, "end": 1420.72, "word": " يصير", "probability": 0.8185221354166666}, {"start": 1420.72, "end": 1420.98, "word": " فيه", "probability": 0.89892578125}, {"start": 1420.98, "end": 1421.12, "word": " أي", "probability": 0.53662109375}, {"start": 1421.12, "end": 1422.06, "word": " سقوط", "probability": 0.9835205078125}, {"start": 1422.06, "end": 1422.42, "word": " ال", "probability": 0.94189453125}, {"start": 1422.42, "end": 1422.64, "word": " leisure", "probability": 0.60888671875}, {"start": 1422.64, "end": 1422.84, "word": " و", "probability": 0.505859375}, {"start": 1422.84, "end": 1422.9, "word": " ال", "probability": 0.97314453125}, {"start": 1422.9, "end": 1423.2, "word": " social", "probability": 0.92626953125}, {"start": 1423.2, "end": 1423.86, "word": " activity", "probability": 0.95556640625}, {"start": 1423.86, "end": 1424.28, "word": " كمان", "probability": 0.9695638020833334}, {"start": 1424.28, "end": 1424.76, "word": " مهمة", "probability": 0.970703125}, {"start": 1424.76, "end": 1425.52, "word": " جداً", "probability": 0.75927734375}, {"start": 1425.52, "end": 1425.76, "word": " هاي", "probability": 0.54486083984375}, {"start": 1425.76, "end": 1426.4, "word": " بالنسبة", "probability": 0.9842529296875}, {"start": 1426.4, "end": 1426.62, "word": " له", "probability": 0.309814453125}, {"start": 1426.62, "end": 1427.28, "word": " اللي", "probability": 0.9609375}, {"start": 1427.28, "end": 1427.48, "word": " هو", "probability": 0.9921875}, {"start": 1427.48, "end": 1427.66, "word": " ال", "probability": 0.95458984375}, {"start": 1427.66, "end": 1428.1, "word": " functional", "probability": 0.9091796875}, {"start": 1428.1, "end": 1429.02, "word": " evaluation", "probability": 0.9853515625}, {"start": 1429.02, "end": 1429.86, "word": " اللي", "probability": 0.97705078125}, {"start": 1429.86, "end": 1430.2, "word": " عند", "probability": 0.986328125}, {"start": 1430.2, "end": 1430.72, "word": " المريض", "probability": 0.9498697916666666}, {"start": 1430.72, "end": 1431.18, "word": " تبعنا", "probability": 0.93212890625}], "temperature": 1.0}, {"id": 62, "seek": 144124, "start": 1431.76, "end": 1441.24, "text": "وبهيك بيكون أنا خلصت ال part اللي هو التاني فيديو رقم 11 لـ Pulmonary Assessment ويعطيكوا ألف عافية على بركة النعم", "tokens": [37746, 3224, 1829, 4117, 4724, 1829, 30544, 41850, 16490, 1211, 9381, 2655, 2423, 644, 13672, 1829, 31439, 16712, 7649, 1829, 8978, 16254, 2407, 12602, 4587, 2304, 2975, 5296, 39184, 35568, 46386, 47643, 4032, 40228, 9566, 1829, 4117, 14407, 5551, 46538, 6225, 31845, 10632, 15844, 4724, 31747, 3660, 28239, 25957], "avg_logprob": -0.25656250178813933, "compression_ratio": 1.2364864864864864, "no_speech_prob": 0.0, "words": [{"start": 1431.76, "end": 1432.4, "word": "وبهيك", "probability": 0.71221923828125}, {"start": 1432.4, "end": 1432.72, "word": " بيكون", "probability": 0.6949869791666666}, {"start": 1432.72, "end": 1432.96, "word": " أنا", "probability": 0.57080078125}, {"start": 1432.96, "end": 1433.48, "word": " خلصت", "probability": 0.9735107421875}, {"start": 1433.48, "end": 1433.6, "word": " ال", "probability": 0.818359375}, {"start": 1433.6, "end": 1433.86, "word": " part", "probability": 0.849609375}, {"start": 1433.86, "end": 1434.16, "word": " اللي", "probability": 0.75}, {"start": 1434.16, "end": 1434.48, "word": " هو", "probability": 0.974609375}, {"start": 1434.48, "end": 1435.12, "word": " التاني", "probability": 0.90966796875}, {"start": 1435.12, "end": 1435.5, "word": " فيديو", "probability": 0.83544921875}, {"start": 1435.5, "end": 1435.8, "word": " رقم", "probability": 0.94677734375}, {"start": 1435.8, "end": 1436.34, "word": " 11", "probability": 0.88671875}, {"start": 1436.34, "end": 1436.82, "word": " لـ", "probability": 0.5511474609375}, {"start": 1436.82, "end": 1437.24, "word": " Pulmonary", "probability": 0.521575927734375}, {"start": 1437.24, "end": 1437.9, "word": " Assessment", "probability": 0.87158203125}, {"start": 1437.9, "end": 1438.96, "word": " ويعطيكوا", "probability": 0.7972005208333334}, {"start": 1438.96, "end": 1439.2, "word": " ألف", "probability": 0.806396484375}, {"start": 1439.2, "end": 1440.2, "word": " عافية", "probability": 0.9777018229166666}, {"start": 1440.2, "end": 1440.46, "word": " على", "probability": 0.86083984375}, {"start": 1440.46, "end": 1440.88, "word": " بركة", "probability": 0.9773763020833334}, {"start": 1440.88, "end": 1441.24, "word": " النعم", "probability": 0.5714111328125}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1455.937625, "duration_after_vad": 1423.1931249999996}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/6mkP1pYJbBs.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/6mkP1pYJbBs.srt
new file mode 100644
index 0000000000000000000000000000000000000000..1105c74c499d6deea815fbba27346f6915ca47d5
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/6mkP1pYJbBs.srt
@@ -0,0 +1,1433 @@
+1
+00:00:01,250 --> 00:00:05,290
+بيبين الله تعالى اليوم راح أكمل معاكم الـ part
+
+2
+00:00:05,290 --> 00:00:08,850
+التاني من الـ physical therapy intervention اللي هو
+
+3
+00:00:08,850 --> 00:00:14,870
+هيتحدث ويكمل عامة سبق ما شرحنا في الـ part واحد
+
+4
+00:00:14,870 --> 00:00:18,530
+تحدثنا في الـ part واحد عن الـ breathing exercise،
+
+5
+00:00:18,530 --> 00:00:20,570
+الـ indication و الـ contraindication و الـ
+
+6
+00:00:20,570 --> 00:00:23,990
+repercussions، كمان تحدثنا عن أنواع الـ breathing
+
+7
+00:00:23,990 --> 00:00:29,370
+exercise اللي أنا ممكن أشتغلهم مع مريض اللي هو في
+
+8
+00:00:29,370 --> 00:00:33,870
+قسم الصدرية. في هذا الفيديو بإذن الله تعالى هنتحدث
+
+9
+00:00:33,870 --> 00:00:37,470
+عن اللي هو الـ Airway Clearance عن طريق الـ
+
+10
+00:00:37,470 --> 00:00:41,130
+Cuffing و الـ Huffing، و هنتبعه بفيديو آخر لـ
+
+11
+00:00:41,130 --> 00:00:44,130
+Postural Drainage. هنا هنتحدث عن الـ Physical
+
+12
+00:00:44,130 --> 00:00:48,490
+Intervention لحالات، على سبيل المثال، الـ COPD أو
+
+13
+00:00:48,490 --> 00:00:53,330
+الحالات اللي هي ممكن أن أجدها في قسم الصدرية. خلينا
+
+14
+00:00:53,330 --> 00:00:58,630
+نشوف اللي هو بداية أول حالة معانا اللي هي عبارة عن
+
+15
+00:00:59,250 --> 00:01:04,050
+Preventing and Relieving  لـ Dyspnea اللي هي الـ
+
+16
+00:01:04,050 --> 00:01:06,990
+Dyspnea. كنا عرفنا الـ Dyspnea، الـ Dyspnea
+
+17
+00:01:06,990 --> 00:01:10,570
+هي عبارة عن difficulty to breathing في اللي هو
+
+18
+00:01:10,570 --> 00:01:14,790
+أوضاع مختلفة. A patient with COPD على سبيل
+
+19
+00:01:14,790 --> 00:01:19,000
+المثال، فيها أنيميا انفعالية، and may suffer from
+
+20
+00:01:19,000 --> 00:01:23,840
+periodic episodes. بيعانوا بعض الأحيان من نوبات من
+
+21
+00:01:23,840 --> 00:01:28,320
+الـ dyspnea، من نوبات هي عبارة عن قصر في النفس
+
+22
+00:01:28,320 --> 00:01:34,960
+خصوصا في اللي هو بعد جهد معين أو وجود مثير، على
+
+23
+00:01:34,960 --> 00:01:42,220
+سبيل المثال، معطر، أي شيء يلوث هواء بالجو، فبنلاقي
+
+24
+00:01:42,220 --> 00:01:47,880
+الربيع مثلاً، أو أزهار، اللي هي سقوط أوراق الشجر في
+
+25
+00:01:47,880 --> 00:01:52,220
+الخريف. كل هذه المؤثرات بتأثر على هؤلاء المرضى
+
+26
+00:01:58,550 --> 00:02:02,870
+بالتالي بيصير فيه مشكلة فيه، أنه هو نمط تبع تنفس
+
+27
+00:02:02,870 --> 00:02:06,890
+هذا المريض. To prevent this attack، حتى أنا أمنع هذه
+
+28
+00:02:06,890 --> 00:02:09,770
+الـ attack، لازم يكون عندي Control Breathing و
+
+29
+00:02:09,770 --> 00:02:13,630
+becoming aware of the activity situation
+
+30
+00:02:13,630 --> 00:02:18,310
+and participate in these cases؟ هو المريض نفسه أو هي
+
+31
+00:02:18,310 --> 00:02:23,010
+الأم نفسها بتكون على وعي، أنه على سبيل المثال هذا
+
+32
+00:02:23,010 --> 00:02:27,810
+الشيء بيزيد من الأزمة أو بيزيد من اللي هو dyspnea
+
+33
+00:02:27,810 --> 00:02:32,600
+للبني. وبالتالي ما بحط له على الغسيل اللي هو معطر
+
+34
+00:02:32,600 --> 00:02:37,380
+ملابس بيكون قوي جداً، لأ أستغني عنه مثلاً، لا يصح
+
+35
+00:02:37,380 --> 00:02:41,440
+أن أنا أخد هذا المريض وأطلع فيه في جو يكون فيه
+
+36
+00:02:41,440 --> 00:02:45,900
+غبار أو جو يكون بارد جداً، حتى أنا ما أعرض هذا الطفل
+
+37
+00:02:45,900 --> 00:02:51,080
+أو هذا المريض لمشاكل. الـ Control of Breathing
+
+38
+00:02:51,080 --> 00:02:54,980
+and Reduction of Expiratory Rate، عن طريق بيرز الـ
+
+39
+00:02:54,980 --> 00:02:57,880
+BLB، اللي هو أخذناه من أنواع الـ Breathing
+
+40
+00:02:57,880 --> 00:03:02,360
+Exercise. بيرز الـ Breathing خلال الـ expiration في
+
+41
+00:03:02,360 --> 00:03:06,260
+عملية اللي هي الـ "Have a patient assume
+
+42
+00:03:06,260 --> 00:03:10,580
+a relaxed forward bend". أيه نيحة له لقدام. طبعاً الـ
+
+43
+00:03:10,580 --> 00:03:13,620
+forward bend position stimulating لديه fragmentary
+
+44
+00:03:13,620 --> 00:03:17,280
+breathing. هذه مميزاته، إذا أنا بفضل هذا الـ
+
+45
+00:03:17,280 --> 00:03:20,940
+position، إن المريض يتني حاله لقدام، ليه؟ هذا بيحفظ
+
+46
+00:03:20,940 --> 00:03:24,680
+إنه دافع يشتغل، طبعاً هو mainly muscles، have
+
+47
+00:03:24,680 --> 00:03:28,620
+the patient focus on the expiratory phase، breathing while
+
+48
+00:03:28,620 --> 00:03:33,190
+being sure to avoid possibly forceful expiration. في كل
+
+49
+00:03:33,190 --> 00:03:35,890
+breathing exercise اللي أنا بشتغلها، ممنوع المريض
+
+50
+00:03:35,890 --> 00:03:41,530
+التابعي يحاول أن هو يخرج الهواء بقوة وصعوبة، تمام؟
+
+51
+00:03:41,530 --> 00:03:43,870
+خلينا كمان شوية، هنشوف كمان في الـ Cuffing نفس
+
+52
+00:03:43,870 --> 00:03:47,070
+الكلام. Have the patient remain in a forward position
+
+53
+00:03:47,070 --> 00:03:50,710
+postural and continue breathing in a slow controlled
+
+54
+00:03:50,710 --> 00:03:55,030
+manner until the episode of dyspnea subsides، اللي هو
+
+55
+00:03:55,030 --> 00:03:59,740
+لحد ما تروح هي الـ attack معانا. أول position عندنا
+
+56
+00:03:59,740 --> 00:04:02,940
+relaxed position، طبعاً اللي هو أنا أخلي المريض في
+
+57
+00:04:02,940 --> 00:04:06,220
+وضع relaxation position. First step towards self-
+
+58
+00:04:06,220 --> 00:04:09,040
+help positioning. It's an effective technique to
+
+59
+00:04:09,040 --> 00:04:13,800
+reduce both symptoms and improve breathing. إذا أنا خليته
+
+60
+00:04:13,800 --> 00:04:17,140
+اللي هو في وضع يكون مرتاح فيه، مش أجبره أنه يبقى
+
+61
+00:04:17,140 --> 00:04:21,540
+احنا طبعاً نكون قلقين ونسوي زعر حواليه، لأ ده هيزيد
+
+62
+00:04:21,540 --> 00:04:23,860
+من صعوبة التنفس. أدي المريض، لأ بالعكس أنا هنا
+
+63
+00:04:23,860 --> 00:04:26,860
+أكون في وضع relaxed position. كمان أحط الـ patient
+
+64
+00:04:26,860 --> 00:04:29,690
+تبعي في relaxed position. Neck and Shoulder & Garter
+
+65
+00:04:29,690 --> 00:04:34,050
+relaxation should be done. لازم أنا كل يوم أعلّم
+
+66
+00:04:34,050 --> 00:04:36,710
+المريض تبعي كيف يعمل اللي هو relaxation exercise.
+
+67
+00:04:36,710 --> 00:04:41,270
+مهم جداً في هذه الحالات الـ upper chest relaxation
+
+68
+00:04:41,270 --> 00:04:45,030
+together with controlled breathing is needed. في عندي five
+
+69
+00:04:45,030 --> 00:04:49,350
+practices اللي هو different ways. أول position الـ
+
+70
+00:04:49,350 --> 00:04:53,150
+high side lying. كله هنشوفه بالصور. الـ free arm
+
+71
+00:04:53,150 --> 00:04:57,010
+support on table و الـ free arm support on thigh
+
+72
+00:04:57,440 --> 00:05:01,600
+و الـ back support against wall و الـ forearm
+
+73
+00:05:01,600 --> 00:05:06,000
+support forward. خليني أشوف كل وضعية من الـ
+
+74
+00:05:06,000 --> 00:05:09,840
+relaxation positions together. أول position
+
+75
+00:05:09,840 --> 00:05:14,980
+اللي هو الـ high side lying، forearm. شايفين هذا
+
+76
+00:05:14,980 --> 00:05:21,140
+الوضعية، حاطة كذا مخدة، وهو عبارة عن high lying، high
+
+77
+00:05:21,140 --> 00:05:24,140
+side lying breathing. الـ position هذا to reduce
+
+78
+00:05:24,140 --> 00:05:27,640
+shortness of breath. تمام. هاي أول وضعية. الوضعية
+
+79
+00:05:27,640 --> 00:05:31,880
+التانية، الـ free arm support on table. هو four بنات
+
+80
+00:05:31,880 --> 00:05:36,340
+للأمام، lean forward. تمام، واللي هو sitting
+
+81
+00:05:36,340 --> 00:05:40,260
+position، وحاطة مخدتين. معناه الكلام to reduce
+
+82
+00:05:40,260 --> 00:05:43,800
+shortness of breath. الـ position التالت في
+
+83
+00:05:43,800 --> 00:05:48,420
+sitting position و الـ free arm supporting on his
+
+84
+00:05:48,420 --> 00:05:51,990
+thigh. تمام؟ يعني قريب من الـ fourth lean sitting
+
+85
+00:05:51,990 --> 00:05:55,390
+position. الـ position الرابع اللي هو الـ patient
+
+86
+00:05:55,390 --> 00:05:59,730
+تبعنا against the wall. هنا يسند نفسه على حائط. هذا
+
+87
+00:05:59,730 --> 00:06:04,070
+الحائط relaxed position، حتى أنا أعمل على تحفيز
+
+88
+00:06:04,070 --> 00:06:08,230
+اللي هو shortness of breath. الـ Upper Chest
+
+89
+00:06:08,230 --> 00:06:11,750
+Relaxation with Together. الـ position الخامس الـ
+
+90
+00:06:11,750 --> 00:06:15,490
+forearm supporting on the table. تمام. هنا في وضع
+
+91
+00:06:15,490 --> 00:06:18,570
+اللي هو standing position. هذه الـ five positions
+
+92
+00:06:18,570 --> 00:06:22,090
+اللي أنا حكيت عليها to Relaxation، حتى أنا أعمل
+
+93
+00:06:22,090 --> 00:06:26,890
+Controlled Breathing في خلال اللي هي الأزمة أو خلال
+
+94
+00:06:26,890 --> 00:06:31,500
+الـ dyspnea اللي صارت. كمان الـ position هذا اللي
+
+95
+00:06:31,500 --> 00:06:35,000
+هو عبارة عن الـ high lying position أو اللي هو الـ
+
+96
+00:06:35,000 --> 00:06:38,900
+hook lying position اللي هو below at the knee و
+
+97
+00:06:38,900 --> 00:06:42,580
+below at the neck. فبالتالي هنا أنا بعمل relaxation
+
+98
+00:06:42,580 --> 00:06:46,640
+position. هنا الـ muscles back و الأضلع اللي هي
+
+99
+00:06:46,640 --> 00:06:51,380
+relaxed بتكون في هذه الوضعية. هنا الموضوع الـ
+
+100
+00:06:51,380 --> 00:06:55,400
+Secretion أو الـ Airway Clearance. الـ Airway زي ما
+
+101
+00:06:55,400 --> 00:06:59,120
+احنا عارفينه. هنا كمان هنحكي عليه في موضوع الـ Post
+
+102
+00:06:59,120 --> 00:07:01,160
+traumatic stress disorder. فيه أخذنا كمان الـ
+
+103
+00:07:01,160 --> 00:07:05,220
+segmental اللي هو Clearance في المحاضرة أو في
+
+104
+00:07:05,220 --> 00:07:09,540
+الفيديو السابق. زي ما أنتم شايفينه، وين أنا بالظبط
+
+105
+00:07:09,540 --> 00:07:13,960
+بعرف في عندي Secretion. بحط الـ patient تبعي في
+
+106
+00:07:13,960 --> 00:07:19,560
+وضعية مناسبة. الآن هستخدم ثلاث طرق أساسية لـ Secretion
+
+107
+00:07:19,560 --> 00:07:23,060
+Clearance. الطريقة الأولى والثانية هاخدهم في هذا
+
+108
+00:07:23,060 --> 00:07:26,320
+الفيديو، أما الطريقة الثالثة وهي الـ postural drainage
+
+109
+00:07:26,320 --> 00:07:30,840
+هاخدها في الفيديو اللاحق إن شاء الله. الـ Cuffing و
+
+110
+00:07:30,840 --> 00:07:34,160
+الـ Huffing هما تكنيكين، احنا هناخدهم بإذن الله في
+
+111
+00:07:34,160 --> 00:07:39,100
+هذا الفيديو ونبدأ فيهم على بركة الله. هشوف المريض
+
+112
+00:07:39,100 --> 00:07:42,580
+تبعي في الـ Cuffing. Ineffectiveness، شو الـ Cuffing
+
+113
+00:07:42,580 --> 00:07:47,770
+هي عبارة عن عملية مهمة جداً لإزالة الـ secretion اللي
+
+114
+00:07:47,770 --> 00:07:51,890
+مغلقة لي أو اللي مسددة الـ airway. And effective
+
+115
+00:07:51,890 --> 00:07:55,310
+cough is necessary to eliminate respiratory
+
+116
+00:07:55,310 --> 00:07:59,450
+obstruction and keep the lungs clear. أهم شيء أنا عندي
+
+117
+00:07:59,450 --> 00:08:04,340
+الـ lungs تكون clear to exchange gas. تمام. الـ Airway
+
+118
+00:08:04,340 --> 00:08:07,480
+Clearance is an important part to manage patients with
+
+119
+00:08:07,480 --> 00:08:11,000
+acute and chronic respiratory conditions. مهم جداً أن أنا
+
+120
+00:08:11,000 --> 00:08:15,740
+أحافظ على الـ Airway كلها تكون clear. يقدر اللي
+
+121
+00:08:15,740 --> 00:08:19,540
+هو يستطيع الهواء الدخول وخروج الـ waste products
+
+122
+00:08:19,540 --> 00:08:25,580
+بشكل منتظم وثابت. الـ Cuff mechanism كيف هتكون؟ بدي
+
+123
+00:08:25,580 --> 00:08:28,580
+يكون في البداية عندنا deep inspiration زي ما احنا
+
+124
+00:08:28,580 --> 00:08:32,500
+شايفين في هذه الصورة. طبعاً هنا بالبداية صار في عندنا
+
+125
+00:08:32,500 --> 00:08:36,780
+irritation، حدوث اللي هو مثير ومحفز، ومن ثم الـ
+
+126
+00:08:36,780 --> 00:08:41,360
+inspiration. في هذه الحالة الـ glottis طبعاً closed
+
+127
+00:08:41,360 --> 00:08:45,420
+and the vocal cord tightness. الحبل الصوتي أو
+
+128
+00:08:45,420 --> 00:08:49,440
+الأحبال الصوتية مغلقة، مشدودة، وكذلك لسان المزمار
+
+129
+00:08:49,440 --> 00:08:55,910
+مغلق. الـ abdominal muscles طبعاً، و diaphragm elevated. الـ
+
+130
+00:08:55,910 --> 00:09:00,350
+abdominal contract، اشتغلت الـ diaphragm، ارتفع على
+
+131
+00:09:00,350 --> 00:09:07,830
+الأعلى، مما يزيد من الـ intrathoracic and intraabdominal
+
+132
+00:09:07,830 --> 00:09:10,410
+pressure. Intraabdominal pressure and intrathoracic
+
+133
+00:09:10,410 --> 00:09:14,250
+pressure. فبالتالي بعد شوية هتلاقي أنه صار في عندنا
+
+134
+00:09:14,250 --> 00:09:17,790
+اللي هي الـ compression، الضغط اللي دخل هنا. لاحظوا
+
+135
+00:09:17,790 --> 00:09:22,350
+معايا هنا اللي هو الـ diaphragm ارتفع لفوق. تمام. صار
+
+136
+00:09:22,350 --> 00:09:25,850
+في عندنا زيادة في الـ intrathoracic و الـ intra-
+
+137
+00:09:25,850 --> 00:09:29,070
+abdominal pressure. بعد شوية هيصير في عندنا forceful
+
+138
+00:09:29,330 --> 00:09:33,310
+explosive اللي هو الـ expiration طبعاً، وبيصير
+
+139
+00:09:33,310 --> 00:09:36,510
+في عندنا الـ exhaling أو الـ expiration of process.
+
+140
+00:09:36,510 --> 00:09:40,830
+هاي عبارة عن عملية الـ Cuff mechanism. في عندنا five
+
+141
+00:09:40,830 --> 00:09:44,330
+stages لعملية الـ Cuff. أول شيء الـ deep inspiration
+
+142
+00:09:44,330 --> 00:09:49,190
+بعدين الـ glottis closes. بعدين الـ abdominal هو اللي
+
+143
+00:09:49,190 --> 00:09:53,130
+هو الـ pragmatic muscles، و الـ glottis opens. رقم
+
+144
+00:09:53,130 --> 00:09:56,250
+أربعة، بعد شوية اللي هي الـ last stage اللي هي الـ
+
+145
+00:09:56,250 --> 00:10:01,220
+explosive expiration. الآن في عندي حاجة اسمها normal
+
+146
+00:10:01,220 --> 00:10:05,040
+cough pumping. هي عبارة عن ايش؟ الـ cough pumping إما بيكون
+
+147
+00:10:05,040 --> 00:10:10,030
+عنه reflexes أو voluntary. في الأطفال بالعادة بيكون
+
+148
+00:10:10,030 --> 00:10:14,970
+اللي هو الشيء أو الموضوع مش فعّال، يعني الموضوع الـ
+
+149
+00:10:14,970 --> 00:10:17,490
+cuffing عند الأطفال مش موجود، يعني هو عند البالغين،
+
+150
+00:10:17,490 --> 00:10:20,730
+يعني ما بقدر أقول للطفل على سبيل المثال، ابن سنة أو
+
+151
+00:10:20,730 --> 00:10:25,130
+أقل مثلاً، أنه يلا كح، لأ ما بقدر، فبالتالي هو مش
+
+152
+00:10:25,130 --> 00:10:28,010
+voluntary عند هذول الأطفال، بروح أنا وأنا أعمله
+
+153
+00:10:28,010 --> 00:10:31,130
+stimulation بأي شيء، هناخذها الطرق هاي عندهم كمان،
+
+154
+00:10:31,130 --> 00:10:35,190
+كام slides. فبالتالي عند الكبار ممكن يكون voluntary.
+
+155
+00:10:35,190 --> 00:10:39,950
+الـ normal individual cough pump is effective في
+
+156
+00:10:39,950 --> 00:10:43,810
+اللي هو الـ generation السابع. ف أنا عندي برونشيات
+
+157
+00:10:43,810 --> 00:10:48,550
+23 generation اللي مسؤولة عن الـ cough pumping اللي
+
+158
+00:10:48,550 --> 00:10:53,860
+هو رقم 7. طبعاً زي ما أنتم شايفينها هنا تحت
+
+159
+00:10:53,860 --> 00:10:58,100
+المايكروسكوب، هي عبارة عن epithelial cells، و isolated
+
+160
+00:10:58,100 --> 00:11:02,520
+يعني مهدبة أو فيها أهداب. هي موجودة حتى تعمل على الـ
+
+161
+00:11:02,520 --> 00:11:05,980
+movement لـ secretion. Large airway، absent of
+
+162
+00:11:05,980 --> 00:11:10,700
+pathology. طبعاً وجودها هي نعمة من الله سبحانه
+
+163
+00:11:10,700 --> 00:11:13,620
+وتعالى حتى تعمل movement للـ secretion، أنه يطلع على
+
+164
+00:11:13,620 --> 00:11:17,460
+الـ upper respiratory tract حتى احنا نقدر أو نستطيع
+
+165
+00:11:17,460 --> 00:11:21,470
+أن احنا نتخلص منه. هذه الـ generation اللي أنا حكيت
+
+166
+00:11:21,470 --> 00:11:25,850
+عليها، هما 23 generation للبرونكي والمسؤولة عن الـ
+
+167
+00:11:25,850 --> 00:11:29,590
+pumping أو الـ cough pumping اللي هو رقم 7. الـ
+
+168
+00:11:29,590 --> 00:11:34,130
+factors اللي بتقلل effectiveness لـ cough mechanism في
+
+169
+00:11:34,130 --> 00:11:37,870
+عندي كذا factors بتقلل عملية الـ Cuffing. أول شيء
+
+170
+00:11:37,870 --> 00:11:42,780
+اللي بتقلل الـ inspiratory capacity: يا إما الـ  MLB يا إما
+
+171
+00:11:42,780 --> 00:11:45,200
+الـ weakness of diaphragm، يا إما الـ post-
+
+172
+00:11:45,200 --> 00:11:49,120
+operative. خليني أشوف اللي هو الـ pain. إذا كان في
+
+173
+00:11:49,120 --> 00:11:53,420
+عندي ألم، خصوصاً في الـ lung diseases، وفي مرحلة الـ
+
+174
+00:11:53,420 --> 00:11:56,700
+acute، الـ rib fractures، الـ trauma، الـ chest
+
+175
+00:11:56,700 --> 00:12:01,180
+surgery،  abdominal surgery. هذه الألم الناتجة عن
+
+176
+00:12:01,180 --> 00:12:04,640
+هذه الأمراض أو عن هذه الأحداث بتقلل من الـ
+
+177
+00:12:04,640 --> 00:12:09,320
+inspiratory capacity. تمام؟ وهذا هيقلل بحد ذاته من
+
+178
+00:12:09,320 --> 00:12:13,100
+عملية الـ coughing. فيه هنا الـ weakness للـ diaphragm،
+
+179
+00:12:13,100 --> 00:12:17,100
+ضعف عضلة الـ diaphragm. هذا مهم جداً، إنه لو صار
+
+180
+00:12:17,100 --> 00:12:20,240
+
+223
+00:15:07,140 --> 00:15:10,420
+في Thickness of the Mucus هلأ هذا الـ Mucus اللي أنا
+
+224
+00:15:10,420 --> 00:15:14,440
+بدي أطلعه من تحت من الـ Basal Lung وأطلعه على الـ
+
+225
+00:15:14,440 --> 00:15:19,340
+Upper Respiratory Tract بيكون لزج أو كثيف، فصعب أنه
+
+226
+00:15:19,340 --> 00:15:22,600
+يطلع معايا للأعلى، فبالتالي زي على سبيل المثال CF
+
+227
+00:15:22,600 --> 00:15:26,520
+أو Cystic Fibrosis، هو عبارة عن Chronic Bronchitis
+
+228
+00:15:26,520 --> 00:15:30,860
+and Pulmonary Infection، طبعاً  (Pneumonia)، ووجود هذه
+
+229
+00:15:30,860 --> 00:15:33,420
+الأمراض زي الـ cystic fibrosis والـ Chronic
+
+230
+00:15:33,420 --> 00:15:37,800
+bronchitis، وأيضاً وجود الـ Pneumonia، هذه الحالات صعب
+
+231
+00:15:37,800 --> 00:15:41,900
+ميوكاسها يطلع بسرعة، فبالتالي بتقلل من عملية الـ
+
+232
+00:15:41,900 --> 00:15:45,240
+Cough Pumping، الـ Intubation Irritates the Lumina of the
+
+233
+00:15:45,240 --> 00:15:48,280
+Airway and Causes Increased Mucus
+
+234
+00:15:48,280 --> 00:15:51,420
+Production، طبعاً والـ Dehydration اللي هو
+
+235
+00:15:51,420 --> 00:15:53,860
+فبالتالي هنا في هذه الحالات أنا ممكن أعمل
+
+236
+00:15:53,860 --> 00:15:58,800
+humidification، بالتبخيرة، لو كان كبير شوية بنشربه
+
+237
+00:15:58,800 --> 00:16:02,780
+بعض السوائل الدافئة عشان تعملي ترطيب لهذا السائل
+
+238
+00:16:02,780 --> 00:16:08,200
+وبعد شوية يصير له Exhalable out of the body، هاي
+
+239
+00:16:08,200 --> 00:16:12,500
+أربع أسباب عندنا بتخفف أو بتقلل من عمل الـ Cough Pumping، خليني أشوف اللي هو بعض الـ effective للـ
+
+240
+00:16:12,500 --> 00:16:16,040
+Cuffing، هنا إشي practical سيبته أنا للجزء العملي
+
+241
+00:16:16,040 --> 00:16:19,900
+وننتقل لجزئية ثانية، هي الـ precautions اللي بتاعت لـ
+
+242
+00:16:19,900 --> 00:16:25,040
+treating and effective Cuffing، ممنوع أنا أسمح لأي
+
+243
+00:16:25,040 --> 00:16:29,280
+مريض to gasp، gasp، يعني يتنفس بشدة أو يعمل expel
+
+244
+00:16:29,280 --> 00:16:32,980
+the air، إيه؟ بسبب إزالة العمل وإستفادة الطاقة من
+
+245
+00:16:32,980 --> 00:16:37,910
+الـ Breathing، لأنه هيضيع جهده على الفاضي، ما
+
+246
+00:16:37,910 --> 00:16:41,050
+هيستفيد من هذا الجهد، بسبب إنه إيش؟ Causing
+
+247
+00:16:41,050 --> 00:16:44,350
+للpatient fatigue more easily، فبالتالي أنا ما بدي
+
+248
+00:16:47,470 --> 00:16:53,050
+يوصل المريض معايا لمرحلة من الفتيج، رقم 2، Increase
+
+249
+00:16:53,050 --> 00:16:56,730
+Turbulence، the Unresistance of Airway Possibility،
+
+250
+00:16:56,730 --> 00:16:59,330
+leading to increase bronchospasm and further
+
+251
+00:16:59,330 --> 00:17:03,090
+contraction of the Airway، ممنوع أعمل أي إشي يضايق
+
+252
+00:17:03,090 --> 00:17:06,790
+المريض، على سبيل المثال، وهذا الإشي بذاته بيعملي
+
+253
+00:17:06,790 --> 00:17:10,840
+bronchospasm، أحنا بالعكس، معظم الأدوية اللي جايتها
+
+254
+00:17:10,840 --> 00:17:13,520
+في قسم الصدرية كلها بتكون Bronchodilators،
+
+255
+00:17:13,520 --> 00:17:16,860
+يعني أنا بدي أعمل Bronchodilation، أووسع البرونكي
+
+256
+00:17:16,860 --> 00:17:20,540
+والبرونكيولز عشان يطلع منها اللي هو الـ secretion
+
+257
+00:17:20,540 --> 00:17:25,540
+اللي عامل ليه المشاكل، أيضاً may push mucus or
+
+258
+00:17:25,540 --> 00:17:29,140
+foreign body object to deep into the air، بس لازم avoid
+
+259
+00:17:29,140 --> 00:17:34,100
+uncontrolled coughing spasm، اللي هي الـ proximal
+
+260
+00:17:34,100 --> 00:17:38,360
+coughing، Avoid forceful Cuffing if patient have
+
+261
+00:17:38,360 --> 00:17:44,080
+a history of CVA or aneurysm، ممنوع أني أمنع الـ
+
+262
+00:17:44,080 --> 00:17:48,400
+Cuffing القوية في هذه الحالات، Neurologically compromised
+
+263
+00:17:48,400 --> 00:17:52,580
+patients،  Have this patient huff several times to clear her airway
+
+264
+00:17:52,580 --> 00:17:57,120
+rather than Cuffing، في هنا أنا بستبدلها بالـ Huffing،
+
+265
+00:17:57,120 --> 00:18:03,390
+أفضل ليه؟ لأن هي بتكون طبعاً يعني أفضل وأحن، خلينا
+
+266
+00:18:03,390 --> 00:18:07,270
+نحكي على الـ patient تبع اللي هو الـ stroke أو الـ
+
+267
+00:18:07,270 --> 00:18:11,850
+aneurysm، Be sure that the patient coughs while
+
+268
+00:18:11,850 --> 00:18:16,390
+somewhat erect or in a side-lying postural، طبعاً لازم نتأكد
+
+269
+00:18:16,390 --> 00:18:20,630
+من أن هذا المريض أنه بيحاول أنه يعمل إشي في الوضعية
+
+270
+00:18:20,630 --> 00:18:25,130
+الصحيحة في الـ side-lying position، في عندي حوالي أربعة
+
+271
+00:18:25,130 --> 00:18:28,950
+techniques بتساعد اللي هو الشخص اللي بيعمل good
+
+272
+00:18:28,950 --> 00:18:33,130
+Cuffing and improve airway Clearance، أول
+
+273
+00:18:33,130 --> 00:18:37,460
+طريقة اللي هي الـ Manual Assisted، بحاول أنا أعلم
+
+274
+00:18:37,460 --> 00:18:41,360
+المريض إنه هو يساعد نفسه بنفسه، If patient have
+
+275
+00:18:41,360 --> 00:18:43,940
+abdominal weakness، الـ manual pressure على الـ
+
+276
+00:18:43,940 --> 00:18:46,900
+abdominal area assists to develop greater
+
+277
+00:18:46,900 --> 00:18:49,800
+intra-abdominal pressure for more
+
+278
+00:18:49,800 --> 00:18:54,040
+forceful coughing، لأن المريض نفسه هو اللي بيعمل
+
+279
+00:18:54,040 --> 00:18:57,360
+coughing، بنخليه يحط أيديه على بطنه، طبعاً الـ manual
+
+280
+00:18:57,360 --> 00:19:00,780
+assist عنده، هنشوفها بالصور، فبالتالي هنا أنا بزيد
+
+281
+00:19:00,780 --> 00:19:03,400
+الـ intra-abdominal pressure، فممكن يصير في عندنا
+
+282
+00:19:03,400 --> 00:19:07,800
+coughing لهذه الحالة، الـ Manual Pressure، طبعاً الـ
+
+283
+00:19:07,800 --> 00:19:13,020
+Resistance ممكن يعملها الـ patient نفسه إذا كان
+
+284
+00:19:13,020 --> 00:19:16,980
+يستطيع ذلك، ما استطاع بيعملها الـ therapist، هنا إذا
+
+285
+00:19:16,980 --> 00:19:21,180
+يستطيع، يساعدُه طبعاً، وزي ما أنتم شايفين، هو المفروض
+
+286
+00:19:21,180 --> 00:19:22,980
+على الـ Supine Position، والثيرابيست عامل
+
+287
+00:19:22,980 --> 00:19:26,780
+Increasing الـ abdominal pressure، طبعاً على منطقة الـ
+
+288
+00:19:26,780 --> 00:19:30,360
+Xiphoid process، and other hand placed on the first, keeping
+
+289
+00:19:30,360 --> 00:19:34,460
+fingers open, interlocking them، طبعاً هنا بيحاول إنه
+
+290
+00:19:34,460 --> 00:19:37,200
+يعمل stimulation و increase للـ intra-abdominal
+
+291
+00:19:37,200 --> 00:19:41,280
+pressure، عشان هذا المريض يعمل expel to the air
+
+292
+00:19:42,160 --> 00:19:45,780
+after patient inhaled deeply، طبعاً بعد ما ياخد نفس
+
+293
+00:19:45,780 --> 00:19:49,580
+عميق، the therapist manually assists the patient to, or
+
+294
+00:19:49,580 --> 00:19:53,100
+he/she attempts to cough، بيساعده في إنه يحاول
+
+295
+00:19:53,100 --> 00:19:56,700
+يعمل الكحة، the abdomen is compressed and inward
+
+296
+00:19:56,700 --> 00:20:00,680
+upward forcefully، طبعاً which pushes the diaphragm
+
+297
+00:20:00,680 --> 00:20:03,200
+upward, causing a more forceful and effective
+
+298
+00:20:03,200 --> 00:20:08,250
+cough، فبالتالي هنا الضغط على البطن داخل وأعلى
+
+299
+00:20:08,250 --> 00:20:12,090
+لفوق، القوة بتكون اتجاهها in and upwards which
+
+300
+00:20:12,090 --> 00:20:15,630
+pushes the diaphragm، طبعاً هذا بيساعد الـ diaphragm،
+
+301
+00:20:15,630 --> 00:20:18,650
+واحنا حكينا في الـ Cough mechanism، إنه اللي هو من
+
+302
+00:20:18,650 --> 00:20:21,390
+عوامل الـ Cuffing الجيدة أن يكون في عندنا elevation
+
+303
+00:20:21,390 --> 00:20:24,610
+للـ diaphragm، أيضاً increase الـ intrinsic thoracic
+
+304
+00:20:24,610 --> 00:20:27,570
+and intra-abdominal pressure، فبالتالي بيصير في
+
+305
+00:20:27,570 --> 00:20:31,300
+عندنا عملية اللي هي الـ Cuffing، هنا in the same
+
+306
+00:20:31,300 --> 00:20:35,000
+maneuver was performed with patients in a chair،
+
+307
+00:20:35,000 --> 00:20:37,500
+هنا في وضع sitting position، هنا كل اللي شفناها
+
+308
+00:20:37,500 --> 00:20:40,980
+كانت في وضع supine position، هنا هنشوف إيش زي ما
+
+309
+00:20:40,980 --> 00:20:44,400
+أنتم شايفينه في وضع sitting position، هنا المريض
+
+310
+00:20:44,400 --> 00:20:46,540
+قادر يقعد معايا على sitting position، لكن هناك لو
+
+311
+00:20:46,540 --> 00:20:50,560
+كان مش قادر، بنخليه في supine position، Therapist or
+
+312
+00:20:50,560 --> 00:20:53,700
+family members، Therapist أو الـ family members can
+
+313
+00:20:53,700 --> 00:20:56,850
+stand to the back of the patient and apply manual
+
+314
+00:20:56,850 --> 00:21:00,990
+pressure، يطبق معها شوية ضغط خلال الـ Expiration،
+
+315
+00:21:00,990 --> 00:21:05,060
+اللي أمكن المريض نفسه، أحنا كل اللي تحدثنا عليه في
+
+316
+00:21:05,060 --> 00:21:09,440
+الـ slides السابقة كان بالـ patient مع الـ
+
+317
+00:21:09,440 --> 00:21:12,040
+Therapist أو مع حد من الـ Caregivers أو الـ
+
+318
+00:21:12,040 --> 00:21:15,020
+Family Members، اللي قلناه لو المريض نفسه while
+
+319
+00:21:15,020 --> 00:21:17,380
+in sitting position، يعني الـ patient crosses her
+
+320
+00:21:17,380 --> 00:21:20,520
+arms or his arms across the two abdominal places
+
+321
+00:21:20,520 --> 00:21:24,360
+and interlocking hands below xiphoid process، بنفسه،
+
+322
+00:21:24,360 --> 00:21:27,580
+حايحط إيديه التنتين تحت بطنه وعلى منطقة الـ xiphoid
+
+323
+00:21:27,580 --> 00:21:32,040
+process اللي هي sternum، after deep inspiration،
+
+324
+00:21:32,040 --> 00:21:36,380
+الـ patient pushes inward, upward, and the abdominal rest
+
+325
+00:21:36,380 --> 00:21:39,860
+forearms seamlessly lean forward while attempting
+
+326
+00:21:39,860 --> 00:21:43,680
+to cough، فبالتالي هو بيكون قاعد forward عشان
+
+327
+00:21:43,680 --> 00:21:48,960
+يحاول أنه يعمل الـ coughing، أول موضوع الـ manual
+
+328
+00:21:48,960 --> 00:21:53,940
+اللي هو assist، في عندي الـ splinting اللي هي الحاجة
+
+329
+00:21:53,940 --> 00:21:59,530
+التانية، عشان أنا أساعد الـ coughing، لازم إضافة أو
+
+330
+00:21:59,530 --> 00:22:03,070
+recent injury، عاملة عملية قيصرية جديدة للست، فبالتالي هي
+
+331
+00:22:03,070 --> 00:22:07,790
+بحاجة لإشي يمنع أو يقلل من الألم اللي حيصير
+
+332
+00:22:07,790 --> 00:22:12,910
+اللي هو due to coughing، فبالتالي ممكن أنا أسمح
+
+333
+00:22:12,910 --> 00:22:15,930
+لهذا المريض إنه يعمل هذا، the patient to press hand
+
+334
+00:22:15,930 --> 00:22:20,290
+on and below or below the incision، يحط مخدة على الـ abdominal area
+
+335
+00:22:20,290 --> 00:22:23,630
+to firmly over the incision to support the painful
+
+336
+00:22:23,630 --> 00:22:27,610
+area with each cough، if patient cannot reach
+
+337
+00:22:27,610 --> 00:22:31,690
+painful area, the therapist should assist، طبعاً لأنه
+
+338
+00:22:31,690 --> 00:22:35,190
+بتكون الست على سبيل المثال عاملة cesarean، فبالتالي
+
+339
+00:22:35,190 --> 00:22:38,770
+هي بحاجة لإشي يعملها support، زي ما أنتم شايفينه،
+
+340
+00:22:38,770 --> 00:22:42,630
+هنا Splinting over an anterior surgical incision،
+
+341
+00:22:43,210 --> 00:22:47,930
+وهنا طبعاً الـ Splinting خلف اللي هو لأن الـ
+
+342
+00:22:47,930 --> 00:22:50,270
+posterior lateral incision، على سبيل المثال في الـ
+
+343
+00:22:50,270 --> 00:22:53,870
+lung، كان عندنا فيه incision، فبالتالي هنا حطت الإشي
+
+344
+00:22:53,870 --> 00:22:58,590
+أو الـ Splinting posterior lateral، الـ
+
+345
+00:22:58,590 --> 00:23:01,870
+Humidification، العامل الثالث من العوامل اللي بتزيد
+
+346
+00:23:01,870 --> 00:23:05,390
+أو بتساعد في الـ Cough Pumping، اللي هو الـ
+
+347
+00:23:05,390 --> 00:23:08,870
+Humidification، استخدام التبخير، على سبيل المثال، هي
+
+348
+00:23:08,870 --> 00:23:11,630
+بيستخدموها في حالة إذا كان الـ Secretions very
+
+349
+00:23:11,630 --> 00:23:16,290
+thick، والـ mucus مش قادر يطلع معايا لبرا، فبالتالي
+
+350
+00:23:16,290 --> 00:23:19,190
+أنا في البداية بعمل Humidification للـ patient
+
+351
+00:23:19,190 --> 00:23:23,950
+after therapy، ultrasonic، اللي هي الـ ultrasonic
+
+352
+00:23:23,950 --> 00:23:29,070
+nebulizer therapy، but both in which enhance the
+
+353
+00:23:29,070 --> 00:23:31,990
+cellular transport system and facilitate
+
+354
+00:23:31,990 --> 00:23:36,050
+productive coughing، هذا بيساعد في إنه يعمل لي الطفل
+
+355
+00:23:36,050 --> 00:23:39,270
+الصغير الـ Cuffing، زي ما أنتم شايفينها بتكون
+
+356
+00:23:39,270 --> 00:23:43,550
+الـ تبخيرة بتبقى في الأطفال على شكل ألعاب حتى إنه ما
+
+357
+00:23:43,550 --> 00:23:47,190
+يخاف منها، وبتكون على شكل play therapy، يعني هنا أنا
+
+358
+00:23:47,190 --> 00:23:50,890
+بستخدمها مع أطفالي كتير منها زي كده، حاجات بتكون
+
+359
+00:23:50,890 --> 00:23:54,690
+في عليها رسومات، فبالتالي هو الطفل بيكون متفاعل
+
+360
+00:23:54,690 --> 00:23:59,120
+معاها، الطريقة الرابعة اللي هو الـ Tracheal
+
+361
+00:23:59,120 --> 00:24:03,000
+Stimulation، طبعاً لحالات اللي ما بتقدر تعمل
+
+362
+00:24:03,000 --> 00:24:05,920
+Cuffing، الـ Tracheal Stimulation أو الـ
+
+363
+00:24:05,920 --> 00:24:09,600
+Tracheal Tactile may be used in infants، زي ما حكيت لكم
+
+364
+00:24:09,600 --> 00:24:13,540
+في البداية أن هذا الطفل الصغير ما بيقدر إنه يعمل
+
+365
+00:24:13,540 --> 00:24:16,720
+Cuffing، فبالتالي أنا ممكن أعمله stimulation عن
+
+366
+00:24:16,720 --> 00:24:19,940
+طريق اللي هو tongue depressors، for example، أو
+
+367
+00:24:19,940 --> 00:24:24,830
+in unresponsive حالات، الـ unresponsive اللي هم الـ
+
+368
+00:24:24,830 --> 00:24:27,850
+Comatose patients، we cannot cooperate during a
+
+369
+00:24:27,850 --> 00:24:31,070
+treatment، تلاقي كل الـ stimulations in somewhat
+
+370
+00:24:31,070 --> 00:24:37,290
+uncomfortable maneuver، Uncomfortable maneuver، طبعاً
+
+371
+00:24:37,290 --> 00:24:41,950
+اللي حتستمر بس تخلص أنا أو بدي آخذ اللي هو reflexive
+
+372
+00:24:41,950 --> 00:24:46,350
+Coughing حتى أحفز أو أعمل مثير لإن هذا الطفل يعملي
+
+373
+00:24:46,350 --> 00:24:49,940
+Coughing، بتلاقي two fingers at the sternal notch to
+
+374
+00:24:49,940 --> 00:24:53,940
+apply a circular motion، على منطقة الـ sternal notch،
+
+375
+00:24:53,940 --> 00:24:56,920
+which is pressed downward and track the
+
+376
+00:24:56,920 --> 00:25:00,180
+reflexes، يعني ممكن زي ما حكينا هنا بالـ tongue
+
+377
+00:25:00,180 --> 00:25:04,380
+depressors، وممكن كمان أحفز بطريقة أخرى عن طريق
+
+378
+00:25:04,380 --> 00:25:08,700
+اللي هو وضع إيديا التنتين وأعمل حركة دائرية، Circular
+
+379
+00:25:08,700 --> 00:25:13,620
+motions، اللي هو ضغط in a downward direction to facilitate
+
+380
+00:25:13,620 --> 00:25:16,960
+the reflexive
+
+381
+00:25:16,960 --> 00:25:20,580
+Coughing، هيك بيكون أنا أخدت أربع طرق للي هو
+
+382
+00:25:20,580 --> 00:25:24,400
+increase الـ Cough mechanism، اللي هي الـ manual
+
+383
+00:25:24,400 --> 00:25:30,620
+assist، والـ Tracheal Stimulation، وأخذنا الـ
+
+384
+00:25:30,620 --> 00:25:34,080
+Humidification، والطريقة الثالثة اللي هي عبارة عن
+
+385
+00:25:34,080 --> 00:25:39,330
+Splinting، اللي هو الـ Cuff، إذا أخذنا أربع
+
+386
+00:25:39,330 --> 00:25:41,790
+additional techniques to improve airway clearance:
+
+387
+00:25:41,790 --> 00:25:48,190
+الـ manual assist، والـ splinting، وكمان في عندنا
+
+388
+00:25:48,190 --> 00:25:53,190
+اللي هو الـ Humidification، وآخر حاجة أخدناها اللي
+
+389
+00:25:53,190 --> 00:25:58,000
+هو عبارة عن الـ Tracheal Stimulation، الآن هنتحدث عن
+
+390
+00:25:58,000 --> 00:26:02,780
+آخر إشي اللي هو الـ Huffing، لـ Airway Clearance،
+
+391
+00:26:02,780 --> 00:26:07,380
+طبعاً اللي أنا حكيت عليها، الطريقة الثانية بالنسبة
+
+392
+00:26:07,380 --> 00:26:13,020
+لتنظيف أو جعل ممرات الهواء آمنة ونظيفة، الـ Huffing،
+
+393
+00:26:13,020 --> 00:26:16,320
+طبعاً أَحن من الـ Coughing، أحنا بنحكي عليها الـ
+
+394
+00:26:16,320 --> 00:26:21,580
+Huffing، هي تمتاز بأنها forced expiration ولكن ليست
+
+395
+00:26:21,580 --> 00:26:24,340
+بالقوة التي فيها الـ Coughing، a forced expiratory
+
+396
+00:26:24,340 --> 00:26:28,020
+effort made while the glottis remains open، أحنا لأ في الـ
+
+397
+00:26:28,020 --> 00:26:30,300
+Cuffing قلنا اللي glottis بيضل إيش؟ closed، في
+
+398
+00:26:30,300 --> 00:26:33,160
+البداية، and the intrathoracic pressure doesn't
+
+399
+00:26:33,160 --> 00:26:37,990
+raises to such a high level as with coughing، ما بيرتفع عندي
+
+400
+00:26:37,990 --> 00:26:42,750
+اللي هو نتيجة ضغط الـ intrathoracic اللي هو بأعلى
+
+401
+00:26:42,750 --> 00:26:47,450
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/6mkP1pYJbBs_postprocess.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/6mkP1pYJbBs_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..09aa26188bb6668bcecfddcfa56488f08fb7ef7a
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/6mkP1pYJbBs_postprocess.srt
@@ -0,0 +1,1664 @@
+1
+00:00:01,250 --> 00:00:05,290
+بيبن الله تعالى اليوم راح أكمل معاكم ال part
+
+2
+00:00:05,290 --> 00:00:08,850
+التاني من ال physical therapy intervention اللي هو
+
+3
+00:00:08,850 --> 00:00:14,870
+هيتحدث ويكمل عامة سبق ما شرحنا في part واحد
+
+4
+00:00:14,870 --> 00:00:18,530
+اتحدثنا في part واحد عن ال breathing exercise ال
+
+5
+00:00:18,530 --> 00:00:20,570
+indication و ال contra indication و ال
+
+6
+00:00:20,570 --> 00:00:23,990
+repercussions كمان اتحدثنا عن أنواع ال breathing
+
+7
+00:00:23,990 --> 00:00:29,370
+exercise اللي أنا ممكن أشتغلهم مع مريض اللي هو في
+
+8
+00:00:29,370 --> 00:00:33,870
+قسم الصدريةفي هذا الفيديو بإذن الله تعالى هنتحدث
+
+9
+00:00:33,870 --> 00:00:37,470
+عن اللي هو الـ Airway Clearness عن طريق الـ
+
+10
+00:00:37,470 --> 00:00:41,130
+Cuffing و الـ Huffing و هنتبعه بفيديو آخر لـ
+
+11
+00:00:41,130 --> 00:00:44,130
+Postural Adrenalgia هنا هتحدث عن الـ Physical
+
+12
+00:00:44,130 --> 00:00:48,490
+Intervention لحالات على سبيل المثال الـ COPD أو
+
+13
+00:00:48,490 --> 00:00:53,330
+الحالات اللي هي ممكن أن أجدها في قسم الصدرية خلينا
+
+14
+00:00:53,330 --> 00:00:58,630
+نشوف اللي هو بداية أول حالة معانا اللي هي عبارة عن
+
+15
+00:00:59,250 --> 00:01:04,050
+Preventing and Relieving لالـ Disposed اللي هي الـ
+
+16
+00:01:04,050 --> 00:01:06,990
+Discipine كنا عرفنا الـ Discipine، الـ Discipine
+
+17
+00:01:06,990 --> 00:01:10,570
+هي عبارة عن difficulty to breathing في اللي هو
+
+18
+00:01:10,570 --> 00:01:14,790
+أوضاع مختلفة mini patient with COPD على سبيل
+
+19
+00:01:14,790 --> 00:01:19,000
+المثال، فيها أنمي انفظيمة and أسمةmay suffer from
+
+20
+00:01:19,000 --> 00:01:23,840
+periodic episodes بيعانوا بعض الأحيان من نوبات من
+
+21
+00:01:23,840 --> 00:01:28,320
+الـdiscipline من نوبات هي عبارة عن قصر في النفس
+
+22
+00:01:28,320 --> 00:01:34,960
+خصوصا في اللي هو بدل جهد معين أو وجود مثير على
+
+23
+00:01:34,960 --> 00:01:42,220
+سبيل المثالمعطر، أي شيء تلوث هواء بالجو فبنلاقي
+
+24
+00:01:42,220 --> 00:01:47,880
+الربيع مثلا أو أزهار اللي هي سقوط أوراق الشجار في
+
+25
+00:01:47,880 --> 00:01:52,220
+الخريف كل هذه المؤثرات بتأثر على هؤلاء المرضى
+
+26
+00:01:58,550 --> 00:02:02,870
+بالتالي بيصير فيه مشكلة فيه أنه هو نمط تبع تنفس
+
+27
+00:02:02,870 --> 00:02:06,890
+هذا المريض to prevent this attack حتى أنا أمنع هذه
+
+28
+00:02:06,890 --> 00:02:09,770
+ال attack لازم يكون عندي control breathing و
+
+29
+00:02:09,770 --> 00:02:13,630
+becoming awareWhat's the activity situation
+
+30
+00:02:13,630 --> 00:02:18,310
+participate in these cases؟ هو المريض نفسه أو هي
+
+31
+00:02:18,310 --> 00:02:23,010
+الأم نفسها بتكون على وعي أنه على سبيل المثال هذا
+
+32
+00:02:23,010 --> 00:02:27,810
+الاشي بيزيد من الأزمة أو بيزيد من اللي هو dyspnea
+
+33
+00:02:27,810 --> 00:02:32,600
+لإبنيفبالتالي ما بحطله على الغسيل اللي هو معطر
+
+34
+00:02:32,600 --> 00:02:37,380
+ملابس بيكون قوي جدا، لأ أستغني عنه مثلا، لا يصح
+
+35
+00:02:37,380 --> 00:02:41,440
+أنه أنا أخد هذا المريض و أطلع فيه في جو يكون فيه
+
+36
+00:02:41,440 --> 00:02:45,900
+غبار أو جو يكون بارد جدا حتى أنا ما أعرض هذا الطفل
+
+37
+00:02:45,900 --> 00:02:51,080
+أو هذا المريض تبعي لمشاكلالـ «Control of Breathing
+
+38
+00:02:51,080 --> 00:02:54,980
+and Reduction of Expiratory Rate» عن طريق بيرز الـ
+
+39
+00:02:54,980 --> 00:02:57,880
+BLB اللي هو أخدناها من أنواع الـ Breathing
+
+40
+00:02:57,880 --> 00:03:02,360
+Exercise بيرز الـ Breathing خلال الـ expiration في
+
+41
+00:03:02,360 --> 00:03:06,260
+عملية اللي هي الـ «ذافير» «Have a patient assume
+
+42
+00:03:06,260 --> 00:03:10,580
+relaxed forward bend» أيه نيحة له لقدام طبعا الـ
+
+43
+00:03:10,580 --> 00:03:13,620
+forward bend position stimulating لديه fragmentary
+
+44
+00:03:13,620 --> 00:03:17,280
+breathingهذه مميزاته، إذا أنا بفضل هذا الـ
+
+45
+00:03:17,280 --> 00:03:20,940
+position إن المريض يتني حاله لقدام، ليه؟ هذا بيحفظ
+
+46
+00:03:20,940 --> 00:03:24,680
+إنه دافع يشتغل طبعا هو mainly muscles، have
+
+47
+00:03:24,680 --> 00:03:28,620
+للpatient focus expiratory phase، breathing while
+
+48
+00:03:28,620 --> 00:03:33,190
+being sure to avoid possibly expirationفي كل
+
+49
+00:03:33,190 --> 00:03:35,890
+breathing exercise اللي أنا بشتغلها ممنوع المريض
+
+50
+00:03:35,890 --> 00:03:41,530
+التابعي يحاول إن هو يخرج الهواء بقوة وصعوبة، تمام؟
+
+51
+00:03:41,530 --> 00:03:43,870
+قعدوا كمان شوية هنشوف كمان في ال cuffing نفس
+
+52
+00:03:43,870 --> 00:03:47,070
+الكلام Have the patient remain in forward position
+
+53
+00:03:47,070 --> 00:03:50,710
+postural and continue breathing in slow control
+
+54
+00:03:50,710 --> 00:03:55,030
+manner until the episode disabnia suspects اللي هو
+
+55
+00:03:55,030 --> 00:03:59,740
+لحد ما تروح هي ال attack معناأول position عندنا
+
+56
+00:03:59,740 --> 00:04:02,940
+relaxed position طبعا اللي هو أنا أخلي المريض في
+
+57
+00:04:02,940 --> 00:04:06,220
+وضع relaxation position first step towards self
+
+58
+00:04:06,220 --> 00:04:09,040
+-help positioning it's effective technique to
+
+59
+00:04:09,040 --> 00:04:13,800
+reduce both symptoms وwork breathing إذا أنا خليته
+
+60
+00:04:13,800 --> 00:04:17,140
+اللي هو بوضعيا يكون مرتاح فيها مش إجتوا انه بقى
+
+61
+00:04:17,140 --> 00:04:21,540
+احنا طبعا نكون قلقين ونسير الزعر حواليه لأ ده هزيد
+
+62
+00:04:21,540 --> 00:04:23,860
+من الصعوبة التنفس تدى المريض لأ بالعكس أنا هنا
+
+63
+00:04:23,860 --> 00:04:26,860
+أكون في وضع relaxed position كمان أحط ال patient
+
+64
+00:04:26,860 --> 00:04:29,690
+تبعي ب relaxed positionNeck و Shoulder & Garter
+
+65
+00:04:29,690 --> 00:04:34,050
+relaxation should be done لازم انا كل يوم اعلمه
+
+66
+00:04:34,050 --> 00:04:36,710
+للمريض تبعى كيف يعمل اللى هوا relaxation exercise
+
+67
+00:04:36,710 --> 00:04:41,270
+مهم جدا فى هاى الحالات ال upper chest relaxation
+
+68
+00:04:41,270 --> 00:04:45,030
+together with control breathing need فى عندى five
+
+69
+00:04:45,030 --> 00:04:49,350
+practice اللى هوا different way اول position ال
+
+70
+00:04:49,350 --> 00:04:53,150
+high side lying كله هنشوفه بالصور ال free arm
+
+71
+00:04:53,150 --> 00:04:57,010
+support in table و ال free arm support in thigh
+
+72
+00:04:57,440 --> 00:05:01,600
+والـ Back support against wall و الـ Forearm
+
+73
+00:05:01,600 --> 00:05:06,000
+support forward خلّيني أشوف كل وضعية من الـ
+
+74
+00:05:06,000 --> 00:05:09,840
+relaxation position with together أول position
+
+75
+00:05:09,840 --> 00:05:14,980
+اللي هو الـ high side lying forearm شايفين هذا
+
+76
+00:05:14,980 --> 00:05:21,140
+الوضعية حاطة كذا مخدة وهو عبارة عن highlying high
+
+77
+00:05:21,140 --> 00:05:24,140
+side lying breathing ال position هدا to reduce
+
+78
+00:05:24,140 --> 00:05:27,640
+shortening of breathing تمام هاي أول وضعية الوضعية
+
+79
+00:05:27,640 --> 00:05:31,880
+التانية ال furry arm support in table هو four بنات
+
+80
+00:05:31,880 --> 00:05:36,340
+للأمام lean forward تمام و اللي هو sitting
+
+81
+00:05:36,340 --> 00:05:40,260
+position و حاطة مخدتين معناه الكلام to produce
+
+82
+00:05:40,260 --> 00:05:43,800
+shortening of breathing ال position التالت في
+
+83
+00:05:43,800 --> 00:05:48,420
+sitting position و ال furry arm supporting in his
+
+84
+00:05:48,420 --> 00:05:51,990
+thighتمام؟ يعني قريب من الـ fourth lean sitting
+
+85
+00:05:51,990 --> 00:05:55,390
+position ال position الرابع اللي هو ال patient
+
+86
+00:05:55,390 --> 00:05:59,730
+تبعنا against wall هنا سند نفسه على حائط هذا
+
+87
+00:05:59,730 --> 00:06:04,070
+الحائط relaxed position حتى أنا أعمل على تحفيز
+
+88
+00:06:04,070 --> 00:06:08,230
+اللي هو shortening of breathingالـ Upper Chest
+
+89
+00:06:08,230 --> 00:06:11,750
+Relaxation with Together الـ Position الخامس الـ
+
+90
+00:06:11,750 --> 00:06:15,490
+Forearm Supporting على الـ Table تمام هنا في وضع
+
+91
+00:06:15,490 --> 00:06:18,570
+اللي هو Standing Position هذه الـ Five Position
+
+92
+00:06:18,570 --> 00:06:22,090
+اللي أنا حكيت عليها to Relaxation حتى أنا أعمل
+
+93
+00:06:22,090 --> 00:06:26,890
+Control Breathing في خلال اللي هي الأزمة أو خلال
+
+94
+00:06:26,890 --> 00:06:31,500
+الـDiscipline اللي صارتكمان ال position هذا اللي
+
+95
+00:06:31,500 --> 00:06:35,000
+هو عبارة عن ال high lying position أو اللي هو ال
+
+96
+00:06:35,000 --> 00:06:38,900
+crook lying position اللي هو below at the knee و
+
+97
+00:06:38,900 --> 00:06:42,580
+below at the neck فبالتالي هنا أنا بعمل relaxation
+
+98
+00:06:42,580 --> 00:06:46,640
+position هنا ال muscle back و الأبضمن البصل اللي
+
+99
+00:06:46,640 --> 00:06:51,380
+هي relaxed بتكون في هذه الوضعيةهنا الموضوع الـ
+
+100
+00:06:51,380 --> 00:06:55,400
+Secretion أو الـ Airway Clearance الـ Airway زي ما
+
+101
+00:06:55,400 --> 00:06:59,120
+احنا عارفينه هنا كمان هنحكي عليه في موضوع الـ Post
+
+102
+00:06:59,120 --> 00:07:01,160
+-traumatic stress disorder فيه أخدنا كمان الـ
+
+103
+00:07:01,160 --> 00:07:05,220
+Segmentة اللي هو Clearance في المحاضرة أو في
+
+104
+00:07:05,220 --> 00:07:09,540
+الفيديو السابق زي ما انتوا شايفينه وين انا بالظبط
+
+105
+00:07:09,540 --> 00:07:13,960
+بعرف في عندى Secretion بحط ال patient تبعى في
+
+106
+00:07:13,960 --> 00:07:19,560
+وضعية مناسبة الآن هستمد تلات طرق أساسية لSecretion
+
+107
+00:07:19,560 --> 00:07:23,060
+of Clearanceطريقة الأولى والتانى هاخدهم في هذا
+
+108
+00:07:23,060 --> 00:07:26,320
+الفيديو أما الطريقة الثالثة وهى البشري ال adrenage
+
+109
+00:07:26,320 --> 00:07:30,840
+هاخدها في الفيديو اللاحق ان شاء الله ال cuffing و
+
+110
+00:07:30,840 --> 00:07:34,160
+ال huffing هم تكنيكيان احنا هناخدهم بإذن الله في
+
+111
+00:07:34,160 --> 00:07:39,100
+هذا الفيديو ونبدأ فيهم على بركة الله هشوف المريض
+
+112
+00:07:39,100 --> 00:07:42,580
+تبعى في ال cuffing uneffectiveness شوه ال cuffing
+
+113
+00:07:42,580 --> 00:07:47,770
+هى عبارة عن عمليةمهم جدا لإزالة الـ secretion اللي
+
+114
+00:07:47,770 --> 00:07:51,890
+مغلق لي أو اللي مسدد الـ airway and effective
+
+115
+00:07:51,890 --> 00:07:55,310
+cough is necessary to eliminate respiratory
+
+116
+00:07:55,310 --> 00:07:59,450
+obstruction and keep lungs clear أهم إشي أنا عندي
+
+117
+00:07:59,450 --> 00:08:04,340
+ال lungs تكون clear to exchange gasتمام الـ Airway
+
+118
+00:08:04,340 --> 00:08:07,480
+clearness is important part to manage patient with
+
+119
+00:08:07,480 --> 00:08:11,000
+acute chronic respiratory condition مهم جدا ان انا
+
+120
+00:08:11,000 --> 00:08:15,740
+احافظ على الـ Airway كلها تكون clearness يقدر اللي
+
+121
+00:08:15,740 --> 00:08:19,540
+هو يستطيع الهواء الدخول وخروج ال waste product
+
+122
+00:08:19,540 --> 00:08:25,580
+بشكل منتظم وثابت ال cuff mechanism كيف هتكون؟بدي
+
+123
+00:08:25,580 --> 00:08:28,580
+يكون في البداية عنا deep inspiration زي ما احنا
+
+124
+00:08:28,580 --> 00:08:32,500
+شايفين في هذه الصورة طبعا هنا بالبداية صار في عنا
+
+125
+00:08:32,500 --> 00:08:36,780
+irritation حدوث اللي هو مثير ومحفظ ومن ثم ال
+
+126
+00:08:36,780 --> 00:08:41,360
+inspiration في هذه الحالة ال glutes طبعا closed
+
+127
+00:08:41,360 --> 00:08:45,420
+and the vocal cord tightness الحبل الصوتي أو
+
+128
+00:08:45,420 --> 00:08:49,440
+الأحبال الصوتية مغلقة مشدودة وكذلك لسان المزمار
+
+129
+00:08:49,440 --> 00:08:55,910
+مغلق ال abdominal muscles طبعا وادفرام elevatedالـ
+
+130
+00:08:55,910 --> 00:09:00,350
+Abdominal Contract اشتغلت الـ Diaphragm ارتفع على
+
+131
+00:09:00,350 --> 00:09:07,830
+الأعلى مما يزيد من الـ Interthoracic and Abdominal
+
+132
+00:09:07,830 --> 00:09:10,410
+Pressure Interabdominal Pressure and Interthoracic
+
+133
+00:09:10,410 --> 00:09:14,250
+Pressure فبالتالي بعد شوية هتلاقي أنه صار في عنا
+
+134
+00:09:14,250 --> 00:09:17,790
+اللي هي ال compression الضغط اللي دخل هنا لاحظوا
+
+135
+00:09:17,790 --> 00:09:22,350
+معايا هنا اللي هو الـ Diaphragmأرتفع لفوق تمام صار
+
+136
+00:09:22,350 --> 00:09:25,850
+في عنا زيادة في الـ Intrathoracic و الـ Intra
+
+137
+00:09:25,850 --> 00:09:29,070
+-abdominal pressure بعد شوية هيصير في عنا X-belt
+
+138
+00:09:29,330 --> 00:09:33,310
+Explosive لا اللي هو الـ expiration طبعا و بيصير
+
+139
+00:09:33,310 --> 00:09:36,510
+في عندنا ال exhaling أو ال expiration of process
+
+140
+00:09:36,510 --> 00:09:40,830
+هاي عبارة عن عملية ال cuff mechanism في عندنا five
+
+141
+00:09:40,830 --> 00:09:44,330
+stages لعملية ال cuff أول الشيء الديب inspiration
+
+142
+00:09:44,330 --> 00:09:49,190
+بعدين ال glutes closes بعدين ال abdominal هو اللي
+
+143
+00:09:49,190 --> 00:09:53,130
+هو the pragmatic muscles و ال glutes opens رقم
+
+144
+00:09:53,130 --> 00:09:56,250
+أربعة بعد شوية اللي هي ال last stage اللي هي ال
+
+145
+00:09:56,250 --> 00:10:01,220
+explosive expirationالان في عندي حاجة اسمها normal
+
+146
+00:10:01,220 --> 00:10:05,040
+cuff pumping هي عبارة عن إيش القف مابي إما بيكون
+
+147
+00:10:05,040 --> 00:10:10,030
+عنه reflexes أو voluntaryفي الأطفال بالعادة بيكون
+
+148
+00:10:10,030 --> 00:10:14,970
+اللي هو الاشي أو الموضوع مش فعاد، يعني الموضوع الـ
+
+149
+00:10:14,970 --> 00:10:17,490
+cuffing عند الأطفال مش موجود، يعني هو عند البلغين،
+
+150
+00:10:17,490 --> 00:10:20,730
+يعني مابقدر أولى الطفل على سبيل المثال ابن سنة أو
+
+151
+00:10:20,730 --> 00:10:25,130
+أقل مثلا أنه يلا كح، لأ مابستطيع، فبالتالي هو مش
+
+152
+00:10:25,130 --> 00:10:28,010
+voluntary عند هدول الأطفال، بروح أنا و أنا أعمله
+
+153
+00:10:28,010 --> 00:10:31,130
+stimulation بأي إشي، هناخدها الطرق هاي عنده كمان،
+
+154
+00:10:31,130 --> 00:10:35,190
+كام slides، فبالتاليعند الكبار ممكن يكون voluntary
+
+155
+00:10:35,190 --> 00:10:39,950
+الـ normal individual cuff bump is effective في
+
+156
+00:10:39,950 --> 00:10:43,810
+اللي هو ال generation السابع، فانا عندي لبلونكاي
+
+157
+00:10:43,810 --> 00:10:48,550
+23 generation اللي مسؤول عن ال cuff bumping اللي
+
+158
+00:10:48,550 --> 00:10:53,860
+هو رقم 7طبعاً زي ما انتوا شايفينها هنا تحت
+
+159
+00:10:53,860 --> 00:10:58,100
+المايكروسكوب هي عبارة عن أثيليا متشون وisolated
+
+160
+00:10:58,100 --> 00:11:02,520
+يعني مهدبة أو فيها أهداب هي موجودة حتى تعمل على ال
+
+161
+00:11:02,520 --> 00:11:05,980
+movement لsecretion large airway absent of
+
+162
+00:11:05,980 --> 00:11:10,700
+pathology طبعاً الوجودها هي نعمة من الله سبحانه
+
+163
+00:11:10,700 --> 00:11:13,620
+وتعالى حتى تعمل movement لsecretion انه يطلع على
+
+164
+00:11:13,620 --> 00:11:17,460
+ال upper respiratory tract حتى احنا نقدر أو نستطيع
+
+165
+00:11:17,460 --> 00:11:21,470
+ان احنا نتخلص منههذه ال generation اللي أنا حكيت
+
+166
+00:11:21,470 --> 00:11:25,850
+عليها هما 23 generation للبرونكاي والمسئول عن ال
+
+167
+00:11:25,850 --> 00:11:29,590
+pumping أو ال cuff pumping اللي هو رقم 7 ال
+
+168
+00:11:29,590 --> 00:11:34,130
+factors اللي بتقلل effectiveness لكف ميكانيزم في
+
+169
+00:11:34,130 --> 00:11:37,870
+عندي كذا factors بيقلل عملية ال cuffing أول إشي
+
+170
+00:11:37,870 --> 00:11:42,780
+اللي بتقلل ال inspiratory capacity يا MLBيا إما
+
+171
+00:11:42,780 --> 00:11:45,200
+الـ weakness of diaphragm يا إما الـ post
+
+172
+00:11:45,200 --> 00:11:49,120
+-operative خلّيني أشوف اللي هو ال pain إذا كان في
+
+173
+00:11:49,120 --> 00:11:53,420
+عندي ألم خصوصا في ال lung disease وفي مرحلة ال
+
+174
+00:11:53,420 --> 00:11:56,700
+acute ال rib fractures، ال trauma، ال chest
+
+175
+00:11:56,700 --> 00:12:01,180
+resynthetic abdominal surgery هذه الألم الناتجة عن
+
+176
+00:12:01,180 --> 00:12:04,640
+هذه الأمراض أو عن هذه الأحداث بتقلل من ال
+
+177
+00:12:04,640 --> 00:12:09,320
+inspiratory capacity تمام؟ وهذا هيقلل بحد ذاته من
+
+178
+00:12:09,320 --> 00:12:13,100
+عملية ال coughingفيه هنا الـ weakness لـ diaphragm
+
+179
+00:12:13,100 --> 00:12:17,100
+ضعف عضلة الـ diaphragm هذا مهم جدا إنه لو صار
+
+180
+00:12:17,100 --> 00:12:20,240
+بيصير فيه هنا أن ال diaphragm طبعا هو ال mainly
+
+181
+00:12:20,240 --> 00:12:22,860
+muscles فبالتالي إذا كانت weak هيحلم حالها
+
+182
+00:12:22,860 --> 00:12:25,720
+accessory muscles وهذا احنا ما بدناه يعمل result
+
+183
+00:12:25,720 --> 00:12:29,220
+of high spinal cord injury أو ناتجة عن ال
+
+184
+00:12:29,220 --> 00:12:33,020
+neuropathic أو myopathic disease بتقلل قدرة المريض
+
+185
+00:12:33,020 --> 00:12:37,280
+على إنه ياخد دي ب breathing ال postoperatively بعد
+
+186
+00:12:37,280 --> 00:12:41,240
+العملياتده ال respiratory أو اللي هو ال
+
+187
+00:12:41,240 --> 00:12:44,140
+respiratory center made breast as a result of
+
+188
+00:12:44,140 --> 00:12:47,380
+general anaesthesia لإنه أخد ال patient تبعنا
+
+189
+00:12:47,380 --> 00:12:52,780
+general anaesthesia فبالتالي بقل عنده اللي هو أو
+
+190
+00:12:52,780 --> 00:12:56,580
+بخفض شغل ال respiratory center اللي موجود في ال
+
+191
+00:12:56,580 --> 00:13:00,370
+brain stemطبعاً ونتجة الألم ممكن يكون post
+
+192
+00:13:00,370 --> 00:13:03,610
+-operative اللي ناتجة عن الـ post-operative عملية
+
+193
+00:13:03,610 --> 00:13:07,210
+كانت على سبيل المثال صار في عنده عملية open
+
+194
+00:13:07,210 --> 00:13:11,350
+surgery فبالتالي بيصير فيها ban ال medication بعض
+
+195
+00:13:11,350 --> 00:13:15,890
+الأدوية تعمل على تطبيق أو إحباط شغل اللي هو ال
+
+196
+00:13:15,890 --> 00:13:20,650
+respiratory center هذا أول سبب من أسباب العوامل
+
+197
+00:13:20,650 --> 00:13:23,850
+اللي بتقل ال effectiveness لل coughing اللي هو قلة
+
+198
+00:13:23,850 --> 00:13:28,740
+عمل ال respiratory stageفي عندنا الـ Inability to
+
+199
+00:13:28,740 --> 00:13:34,300
+forcibly exhale air عدم قدرته المريض على اللي هو
+
+200
+00:13:34,300 --> 00:13:38,520
+يعمل exhale أو exhale to the air عدم قدرته على دفع
+
+201
+00:13:38,520 --> 00:13:42,300
+الهواء إلى الخارج ناتج الـ Spinal Cord Injury
+
+202
+00:13:42,300 --> 00:13:48,760
+الإصابات كلها اللي فوقabove T12 injury Myopathic
+
+203
+00:13:48,760 --> 00:13:51,940
+disease زي اللي هو الـ muscular dystrophy الـ
+
+204
+00:13:51,940 --> 00:13:54,420
+excessive fatigue a result of a critical illness
+
+205
+00:13:54,420 --> 00:13:57,320
+عن الـ chest و الـ abdominal incision ال patient
+
+206
+00:13:57,320 --> 00:14:01,020
+who have tracheostomy also has difficulty to
+
+207
+00:14:01,020 --> 00:14:04,260
+breathing طبعا ليش؟ لأنه في عندنا فتحة في الـ
+
+208
+00:14:04,260 --> 00:14:08,080
+tracheostomy should be covered عشان يصير أفضل لازم
+
+209
+00:14:08,080 --> 00:14:13,550
+إحنا أيش نغلقها، هذا السبب الثانيالسبب الثالث للي
+
+210
+00:14:13,550 --> 00:14:17,790
+هو قلة عمل أو فشل عمل اللي هي الـ Cuff Mechanism
+
+211
+00:14:17,790 --> 00:14:22,610
+Decrease للـ Action of Sela and Bronchi Tree
+
+212
+00:14:22,610 --> 00:14:27,530
+الأهداف اللي موجودة اللي احنا حكينا عليها موجودة
+
+213
+00:14:27,530 --> 00:14:30,830
+في الـ Bronchi اللي هي وظيفتها تعمل Movement لـ
+
+214
+00:14:30,830 --> 00:14:34,610
+Secretion نتيجة لحدث معين، نتيجة لأي Pathology
+
+215
+00:14:34,610 --> 00:14:38,130
+معين بتقل اللي هو الـ Mechanism تبعتها أو بتقل
+
+216
+00:14:38,130 --> 00:14:41,640
+عملها فبالتالي بتقلل من عملية الـ Cuffingالـ
+
+217
+00:14:41,640 --> 00:14:45,980
+General Anesthesia، الـ Intubation، وجود اللي هو
+
+218
+00:14:45,980 --> 00:14:49,080
+الـ Tracheal Intubation أو أي Intubation إحنا كنا
+
+219
+00:14:49,080 --> 00:14:53,980
+حاطيناه، Pathology زي الـ COPD على سبيل المثال،
+
+220
+00:14:53,980 --> 00:14:58,980
+الـ Smoking أيضًا بيقلل من اللي هو عمل الأهداف
+
+221
+00:14:58,980 --> 00:15:03,940
+اللي موجودة عندىأيضاً فيها السبب الرابع لقلة الـ
+
+222
+00:15:03,940 --> 00:15:07,140
+Cough Mechanism أو الـ Cough Pumping اللي هي زيادة
+
+223
+00:15:07,140 --> 00:15:10,420
+في Thickness of Mucus هلأ هذا الـ Mucus اللي أنا
+
+224
+00:15:10,420 --> 00:15:14,440
+بدي أطلعه من تحت من الـ Basal Lung و أطلعه على ال
+
+225
+00:15:14,440 --> 00:15:19,340
+Upper Respiratory Tract بيكون لزج أو كثيف فصعب أنه
+
+226
+00:15:19,340 --> 00:15:22,600
+يطلع معايا للأعلى فبالتالي زي على سبيل المثال CF
+
+227
+00:15:22,600 --> 00:15:26,520
+أو Cystic Fibrosis هو عبارة عن Chronic Bronchitis
+
+228
+00:15:26,520 --> 00:15:30,860
+and Pulmonary Infection طبعاً نمونياووجود هذه
+
+229
+00:15:30,860 --> 00:15:33,420
+الأمراض زي الـ cystic fibrosis والـChronic
+
+230
+00:15:33,420 --> 00:15:37,800
+bronchitis وأيضا وجود الـPneumoniaهذه الحالات صعب
+
+231
+00:15:37,800 --> 00:15:41,900
+ميوكاسها يطلع بسرعة فبالتالي بتقلل من عملية الـ
+
+232
+00:15:41,900 --> 00:15:45,240
+Cough Pumping الـ Intubation Irritates Lagumina of
+
+233
+00:15:45,240 --> 00:15:48,280
+اللي هي Airway and Causes Increased Mucus
+
+234
+00:15:48,280 --> 00:15:51,420
+Production طبعاً و الـ Dehydration اللي هو
+
+235
+00:15:51,420 --> 00:15:53,860
+فبالتالي هنا في هذه الحالات أنا ممكن أعمل
+
+236
+00:15:53,860 --> 00:15:58,800
+humidification بالتبخيرة لو كان كبير شوية بنشربه
+
+237
+00:15:58,800 --> 00:16:02,780
+بعض السواقل الدافية عشان تعملي ترطيب لهذا السائل
+
+238
+00:16:02,780 --> 00:16:08,200
+وبعد شوية يصير له Exhalable toout of the body هاي
+
+239
+00:16:08,200 --> 00:16:12,500
+أربع أسباب عندنا بتخفف أو بتقلل من عمل ال cuff
+
+240
+00:16:12,500 --> 00:16:16,040
+pumping خليني أشوف اللي هو بعض ال effective لل
+
+241
+00:16:16,040 --> 00:16:19,900
+cuffing هنا إشي practical سيبته أنا للجزء العملي
+
+242
+00:16:19,900 --> 00:16:25,040
+وننتقل لجزئية تانية شهي ال precautions اللي تبعت ل
+
+243
+00:16:25,040 --> 00:16:29,280
+treating and effective cuffing ممنوع أنا أسمح لأي
+
+244
+00:16:29,280 --> 00:16:32,980
+مريض to gasp gasp يعني يتنفس بشدة أو يعمل expel
+
+245
+00:16:32,980 --> 00:16:37,910
+لال airإيه؟ بسبب إزالة العمل وإستفادة الطاقة من
+
+246
+00:16:37,910 --> 00:16:41,050
+الـ Breathing لأنه هيضيع جهده على الفاضي، ما
+
+247
+00:16:41,050 --> 00:16:44,350
+هيستفيد من هذا الجهد بسبب إنه إيش Causing
+
+248
+00:16:44,350 --> 00:16:47,470
+للpatient fatigue more easily فبالتالي أنا مابدى
+
+249
+00:16:47,470 --> 00:16:53,050
+يوصل المريض معايا لمرحلة من الفتيجرقم 2 Increase
+
+250
+00:16:53,050 --> 00:16:56,730
+turbulence لـunresistance of airway possibility
+
+251
+00:16:56,730 --> 00:16:59,330
+leading to increase bronchospasm and further
+
+252
+00:16:59,330 --> 00:17:03,090
+contraction للـairway ممنوع أعمل أي إشي يضايق
+
+253
+00:17:03,090 --> 00:17:06,790
+المريض على سبيل المثال وهذا الإشي بذاته بيعملي
+
+254
+00:17:06,790 --> 00:17:10,840
+bronchospasmأحنا بالعكس معظم الأدوية اللي جاتوها
+
+255
+00:17:10,840 --> 00:17:13,520
+في قسم الصدرية كلها بتكون الـ bronchodilations
+
+256
+00:17:13,520 --> 00:17:16,860
+يعني أنا بدي أعمل bronchodilations أووسع البرونكاي
+
+257
+00:17:16,860 --> 00:17:20,540
+و البرونكليوز عشان يطلع منها اللي هو الـ secretion
+
+258
+00:17:20,540 --> 00:17:25,540
+اللي عامل ليه المشاكل أيضًا may push mucus are
+
+259
+00:17:25,540 --> 00:17:29,140
+foreign body object to deep into air بساش avoid
+
+260
+00:17:29,140 --> 00:17:34,100
+uncontrolled coughing spasm اللي هي البروكزيمال
+
+261
+00:17:34,100 --> 00:17:38,360
+coughingavoid forceful cuffing if patient have
+
+262
+00:17:38,360 --> 00:17:44,080
+history اللي هو CVA or aneurysm ممنوع أن أمنع ال
+
+263
+00:17:44,080 --> 00:17:48,400
+cuffing القوية في هذه الحالات neurologically have
+
+264
+00:17:48,400 --> 00:17:52,580
+this patient huff several times to clear her way
+
+265
+00:17:52,580 --> 00:17:57,120
+rather than cuffing في هنا أنا بستدلها بال huffing
+
+266
+00:17:57,120 --> 00:18:03,390
+أفضل ليه؟ لأن هي بتكون طبعايعني أفضل و أحن خلينا
+
+267
+00:18:03,390 --> 00:18:07,270
+نحكي على ال patient تبع اللي هو ال stroke أو ال
+
+268
+00:18:07,270 --> 00:18:11,850
+aneurysm Be sure that the patient cuffs while
+
+269
+00:18:11,850 --> 00:18:16,390
+somewhat erect side-lying postural طبعا لازم نتأكد
+
+270
+00:18:16,390 --> 00:18:20,630
+من أن هذا المريض أنه أجرب أنه بعمل إشي في الوضعية
+
+271
+00:18:20,630 --> 00:18:25,130
+الصح في ال side-lying position في عندي حوالي أربعة
+
+272
+00:18:25,130 --> 00:18:28,950
+techniques بتساعد اللي هو الشخص اللي بيعمل good
+
+273
+00:18:28,950 --> 00:18:33,130
+cuffing and improve airwayاللي هو Clearance أول
+
+274
+00:18:33,130 --> 00:18:37,460
+طريقة اللي هي الـ Manual Assistedبحاول أنا أعلم
+
+275
+00:18:37,460 --> 00:18:41,360
+المريض إن هو يساعد نفسه بنفسه If patient have
+
+276
+00:18:41,360 --> 00:18:43,940
+abdominal weakness ال manual pressure على ال
+
+277
+00:18:43,940 --> 00:18:46,900
+abdominal area assists to develop greater
+
+278
+00:18:46,900 --> 00:18:49,800
+intrabrain intraabdominal pressure for more
+
+279
+00:18:49,800 --> 00:18:54,040
+forceful coughing لأن المريض نفسه لحد اللي بيعمل
+
+280
+00:18:54,040 --> 00:18:57,360
+coughing بنخليه يحط أيديه على بطنه طبعا ال manual
+
+281
+00:18:57,360 --> 00:19:00,780
+assist عنده هنشوفها بالصور فبالتالي هنا أنا بزيد
+
+282
+00:19:00,780 --> 00:19:03,400
+ال intraabdominal pressure فممكن يصير في عنا
+
+283
+00:19:03,400 --> 00:19:07,800
+coughing لهذه الحالةالـ Manual Pressure طبعا الـ
+
+284
+00:19:07,800 --> 00:19:13,020
+Resistance ممكن يعملها ال patient نفسه إذا كان
+
+285
+00:19:13,020 --> 00:19:16,980
+السيطيع ذلك ما استطاع بيعملها ال therapist هنا إذا
+
+286
+00:19:16,980 --> 00:19:21,180
+السيطيع ساعده طبعا وزي ما انتوا شايفين هو المفروض
+
+287
+00:19:21,180 --> 00:19:22,980
+على الـ Subliminal Position والثيرابيست عامل
+
+288
+00:19:22,980 --> 00:19:26,780
+Increasing ال abdominal pressure طبعا على منطقة ال
+
+289
+00:19:26,780 --> 00:19:30,360
+X Y process and other hand placed to first keeping
+
+290
+00:19:30,360 --> 00:19:34,460
+finger open interlocking themطبعاً هنا بيحاول إنه
+
+291
+00:19:34,460 --> 00:19:37,200
+يعمل stimulation و increase للـ intra-abdominal
+
+292
+00:19:37,200 --> 00:19:41,280
+pressure عشان هذا المريض يعمل expel to the air
+
+293
+00:19:42,160 --> 00:19:45,780
+after patient inhaled deeply طبعا بعد ما ياخد نفس
+
+294
+00:19:45,780 --> 00:19:49,580
+عميق the therapist manually assist patient to or
+
+295
+00:19:49,580 --> 00:19:53,100
+he she attempts to coughing بيساعده في ان يحاول
+
+296
+00:19:53,100 --> 00:19:56,700
+يعمل الكحان the abdomen is compressed and inward
+
+297
+00:19:56,700 --> 00:20:00,680
+upward forcefully طبعا which push the diaphragm
+
+298
+00:20:00,680 --> 00:20:03,200
+upward causes more forcefully and effective
+
+299
+00:20:03,200 --> 00:20:08,250
+coughingفبالتالي هنا الضغط على البطن داخل وأعلى
+
+300
+00:20:08,250 --> 00:20:12,090
+لفوق القوة بتكون اتجاهها in and upwards which
+
+301
+00:20:12,090 --> 00:20:15,630
+pushes the diaphragm طبعاً هذا بيساعد ال diaphragm
+
+302
+00:20:15,630 --> 00:20:18,650
+واحنا حكينا في ال cuff mechanism أنه اللي هو من
+
+303
+00:20:18,650 --> 00:20:21,390
+عوامل ال cuffing الجيدة أن يكون في عندنا elevation
+
+304
+00:20:21,390 --> 00:20:24,610
+للdiaphragm أيضا increase ال intrinsic thoracic
+
+305
+00:20:24,610 --> 00:20:27,570
+and intraabdominal pressure فبالتالي بيصير في
+
+306
+00:20:27,570 --> 00:20:31,300
+عندنا عملية اللي هي ال cuffingهنا in the same
+
+307
+00:20:31,300 --> 00:20:35,000
+maneuver كان performed with patients in a chair
+
+308
+00:20:35,000 --> 00:20:37,500
+هنا في وضع sitting position هنا كل اللي شوفناها
+
+309
+00:20:37,500 --> 00:20:40,980
+كانت في وضع spine position هنا هنشوف ايش زي ما
+
+310
+00:20:40,980 --> 00:20:44,400
+انتوا شايفينه في وضع sitting position هنا المريض
+
+311
+00:20:44,400 --> 00:20:46,540
+جادر يقعد معايا على sitting position لكن هناك لو
+
+312
+00:20:46,540 --> 00:20:50,560
+كان مش جادر بنخليه في spine position Therapist or
+
+313
+00:20:50,560 --> 00:20:53,700
+family members Therapist او ال family members can
+
+314
+00:20:53,700 --> 00:20:56,850
+standto the back of patient and apply manual
+
+315
+00:20:56,850 --> 00:21:00,990
+pressure بيطبق معها شوية ضغط خلال الـ X-Biration
+
+316
+00:21:00,990 --> 00:21:05,060
+اللي أمكن المريض نفسهأحنا كل اللي حدثنا عليه في
+
+317
+00:21:05,060 --> 00:21:09,440
+الـ «سلايدين» السابقين كان بالpatient مع ال
+
+318
+00:21:09,440 --> 00:21:12,040
+«Therapist» أو مع حد من الـ «Caregiver» أو الـ
+
+319
+00:21:12,040 --> 00:21:15,020
+«Family Members» اللي قاله لو المريض نفسه «while
+
+320
+00:21:15,020 --> 00:21:17,380
+in sitting position» يعني ال «patient crosses her
+
+321
+00:21:17,380 --> 00:21:20,520
+arms» أو «his arms» «across two abdominal places
+
+322
+00:21:20,520 --> 00:21:24,360
+and interlocking hands below x-foi debris» بنفسه،
+
+323
+00:21:24,360 --> 00:21:27,580
+حيحط إيدي التنتين تحت بطنه وعلى منطقة الـ «x-foi
+
+324
+00:21:27,580 --> 00:21:32,040
+debris» اللي هي «فيرستيرنا»after deep inspiration
+
+325
+00:21:32,040 --> 00:21:36,380
+ال patient push inward upward and abdominal rest
+
+326
+00:21:36,380 --> 00:21:39,860
+forearms seamlessly lean forward while attempting
+
+327
+00:21:39,860 --> 00:21:43,680
+to coughing فبالتالي هو بيكون قاعد forward عشان
+
+328
+00:21:43,680 --> 00:21:48,960
+يحاول أنه يعمل ال coughing أول موضوع ال manual
+
+329
+00:21:48,960 --> 00:21:53,940
+اللي هو assist في عند ال splitting اللي هي الحاجة
+
+330
+00:21:53,940 --> 00:21:59,530
+التانية عشان أنا أساعد ال coughingلازم اضافة او
+
+331
+00:21:59,530 --> 00:22:03,070
+recent injury عام لسزيريا جديد للست فبالتالي هي
+
+332
+00:22:03,070 --> 00:22:07,790
+بحاجة لأنه اشي يمنع او يقلل من القلم اللي هيصير
+
+333
+00:22:07,790 --> 00:22:12,910
+اللي هو due to coughing فبالتالي ممكن انا اسمح
+
+334
+00:22:12,910 --> 00:22:15,930
+لهذا المريض انه يعمل هذا ال patient to press hand
+
+335
+00:22:15,930 --> 00:22:20,290
+and below or below يحط مخدة على ال abdominal area
+
+336
+00:22:20,290 --> 00:22:23,630
+to firmly over incision to support the painful
+
+337
+00:22:23,630 --> 00:22:27,610
+area withEach coughing if patient cannot reach
+
+338
+00:22:27,610 --> 00:22:31,690
+painful area the therapist should assist طبعا لأنه
+
+339
+00:22:31,690 --> 00:22:35,190
+بتكون السبت على سبيل المثال عاملة cesarea فبالتالي
+
+340
+00:22:35,190 --> 00:22:38,770
+هي بحاجة لإيش يعملها support زي ما انتوا شايفينه
+
+341
+00:22:38,770 --> 00:22:42,630
+هنا Splinting over an anterior surgical incision
+
+342
+00:22:43,210 --> 00:22:47,930
+وهنا طبعا الـ «سبلنتينج» خلف اللي هو لأن الـ
+
+343
+00:22:47,930 --> 00:22:50,270
+posterior lateral incision على سبيل المثال في الـ
+
+344
+00:22:50,270 --> 00:22:53,870
+lung كان عندنا فيه incision فبالتالي هنا حطت الإشي
+
+345
+00:22:53,870 --> 00:22:58,590
+أو الـ «سبلنتينج» posterior lateral الـ
+
+346
+00:22:58,590 --> 00:23:01,870
+homodification العامل التالت من العوامل اللي بتزيد
+
+347
+00:23:01,870 --> 00:23:05,390
+أو بتساعد في ال cuff pumping اللي هو الـ
+
+348
+00:23:05,390 --> 00:23:08,870
+homodification استخدام التبخير على سبيل المثال هي
+
+349
+00:23:08,870 --> 00:23:11,630
+بيستخدمها في حالة إذا كان ال «secretion» very
+
+350
+00:23:11,630 --> 00:23:16,290
+thickوالـ mucus مش جادر يطلع معايا لبرا فبالتالي
+
+351
+00:23:16,290 --> 00:23:19,190
+أنا في البداية بعمل humidification لل patient
+
+352
+00:23:19,190 --> 00:23:23,950
+after therapy، ultrasonic اللي هي الـ ultrasonic
+
+353
+00:23:23,950 --> 00:23:29,070
+الـ nuclear therapy but both in which enhance my
+
+354
+00:23:29,070 --> 00:23:31,990
+cellular transport system and facilitate
+
+355
+00:23:31,990 --> 00:23:36,050
+productive coughingهذا بيساعد في إنه يعمل لي الطفل
+
+356
+00:23:36,050 --> 00:23:39,270
+الصغير ال cuffing زي ما أنتوا شايفينها بتكون
+
+357
+00:23:39,270 --> 00:23:43,550
+التبخيرة تبقى في الأطفال على شكل ألعاب حتى إنه ما
+
+358
+00:23:43,550 --> 00:23:47,190
+يخاف منها و تكون على شكل play therapy يعني هنا أنا
+
+359
+00:23:47,190 --> 00:23:50,890
+بستخدمها مع أطفالي كتير منيها زي كده حاجات بتكون
+
+360
+00:23:50,890 --> 00:23:54,690
+في عليها رسومات فبالتالي هو الطفل بيكون متفاعل
+
+361
+00:23:54,690 --> 00:23:59,120
+معاها الطريقة الرابعة اللي هوالـ tracheal
+
+362
+00:23:59,120 --> 00:24:03,000
+stimulation طبعاً لحالات اللي ما بتقدر تعمل
+
+363
+00:24:03,000 --> 00:24:05,920
+cuffing الـ tracheal stimulation بتحصير أو الـ
+
+364
+00:24:05,920 --> 00:24:09,600
+tracheal tactile may used to infants زي ما حكيتلكم
+
+365
+00:24:09,600 --> 00:24:13,540
+في البداية أن هذا الطفل الصغير ما بيقدر أن يعمل
+
+366
+00:24:13,540 --> 00:24:16,720
+cuffing فبالتالي أنا ممكن أعمله stimulation عن
+
+367
+00:24:16,720 --> 00:24:19,940
+طريق اللي هو tongue depressors for example أو
+
+368
+00:24:19,940 --> 00:24:24,830
+disoriented في الحالات الـ disoriented اللي همالـ
+
+369
+00:24:24,830 --> 00:24:27,850
+Comatose patient «we cannot cooperate during a
+
+370
+00:24:27,850 --> 00:24:31,070
+treatment» تلاقي كل السيمولاتش in somewhat
+
+371
+00:24:31,070 --> 00:24:37,290
+uncomfortable maneuver Uncomfortable maneuver طبعا
+
+372
+00:24:37,290 --> 00:24:41,950
+اللي سيتت بس تخلص انا او بدي اخد اللي هو reflexive
+
+373
+00:24:41,950 --> 00:24:46,350
+cuffing حتى احفظ او اعمل مثير لإن هذا الطفل يعملي
+
+374
+00:24:46,350 --> 00:24:49,940
+cuffingبتلاقي two finger and sternal notch to
+
+375
+00:24:49,940 --> 00:24:53,940
+apply circular motion على منطقة الـ sternal notch
+
+376
+00:24:53,940 --> 00:24:56,920
+which pressure downward and track فسلة الـ
+
+377
+00:24:56,920 --> 00:25:00,180
+reflexes يعني ممكن زي ما حكينا هنا بالـ tongue
+
+378
+00:25:00,180 --> 00:25:04,380
+depressors وممكن كمان أحكي بطريقة أخرى عن طريق
+
+379
+00:25:04,380 --> 00:25:08,700
+اللي هووضع إيديا تنتين وأعمل حركة دائرية Circular
+
+380
+00:25:08,700 --> 00:25:13,620
+motions لاللي هو ضغط in downward and to facilitate
+
+381
+00:25:13,620 --> 00:25:16,960
+لreflexive
+
+382
+00:25:16,960 --> 00:25:20,580
+cuffing هيك بيكون أنا أخدت أربع طرق لاللي هو
+
+383
+00:25:20,580 --> 00:25:24,400
+increase ال cuff mechanism اللي هي ال manual
+
+384
+00:25:24,400 --> 00:25:30,620
+assist و ال trackless stimulation و أخدنا ال
+
+385
+00:25:30,620 --> 00:25:34,080
+humidification و الطريقة التالتة اللي هي عبارة عن
+
+386
+00:25:34,080 --> 00:25:39,330
+supplantingللي هو الـ cuff إذا أخدنا أربع
+
+387
+00:25:39,330 --> 00:25:41,790
+additional technique to improve airway clearness
+
+388
+00:25:41,790 --> 00:25:48,190
+ال manual assist و ال splinting و كمان في عندنا
+
+389
+00:25:48,190 --> 00:25:53,190
+اللي هو ال humidification و آخر حاجة أخدناها اللي
+
+390
+00:25:53,190 --> 00:25:58,000
+هو عبارة عن ال tracheal stimulationالان هحتكدث عن
+
+391
+00:25:58,000 --> 00:26:02,780
+اخر اشي اللى هو الـ Huffing لـ Airway Clearness
+
+392
+00:26:02,780 --> 00:26:07,380
+طبعا اللى انا حكيت عليها الطريقة التانية بالنسبة
+
+393
+00:26:07,380 --> 00:26:13,020
+لتنظيف اوجعل ممرات الهواء آمنة ونظيفة الـ Huffing
+
+394
+00:26:13,020 --> 00:26:16,320
+طبعا أحن من الـ Coughing احنا بنحكي عليها الـ
+
+395
+00:26:16,320 --> 00:26:21,580
+Huffing هي تمتاز بإنها forced expiration ولكن ليست
+
+396
+00:26:21,580 --> 00:26:24,340
+بالقوة اللتي فيها الـ Coughing a forced expiratory
+
+397
+00:26:24,340 --> 00:26:28,020
+effort made glutes remain open احنا لأ في الـ
+
+398
+00:26:28,020 --> 00:26:30,300
+Cuffing قلنا اللي glutes بيضلوا إيش closed في
+
+399
+00:26:30,300 --> 00:26:33,160
+البداية and the intertheracic pressure doesn't
+
+400
+00:26:33,160 --> 00:26:37,990
+raises such high level with coughingما بيرتفع عندي
+
+401
+00:26:37,990 --> 00:26:42,750
+اللي هو نتيجة ضغط الـ Intraturistic اللي هو بأعلى
+
+402
+00:26:42,750 --> 00:26:47,450
+زي اللي وصلته في الـ Cuffing وعلى الرغم من إنه هيك
+
+403
+00:26:47,450 --> 00:26:51,090
+إلا إن هذا الضغط بيعمل زيادة to produce
+
+404
+00:26:51,090 --> 00:26:54,610
+compressions and narrowing للترياكيا ضيق في
+
+405
+00:26:54,610 --> 00:26:59,170
+الترياكيا وللبرونكاي to secretion moved up وبتحرك
+
+406
+00:26:59,170 --> 00:27:04,240
+لبرونكاي الـ Tree وانا هذا اللي بديه أنه أناأعمل
+
+407
+00:27:04,240 --> 00:27:08,640
+على تحويل أو سحب هذا الـ mucus من اللي هو الـ lung
+
+408
+00:27:08,640 --> 00:27:12,960
+tissue أو من أي segment موجود فيه و أطلعه على اللي
+
+409
+00:27:12,960 --> 00:27:18,720
+هو ال bronchial tree عشان أعمل اللي هو remove لهذا
+
+410
+00:27:18,720 --> 00:27:22,680
+ال secretion بهيك مكون أنا حكيت في هذا الفيديو عن
+
+411
+00:27:22,680 --> 00:27:27,070
+ال cuff mechanism عن ال huffingو ان شاء الله رب
+
+412
+00:27:27,070 --> 00:27:30,970
+العالمين هنتحدث في الفيديو السابق الفيديو اللاحق
+
+413
+00:27:30,970 --> 00:27:35,150
+عن ال postural drainage و اللي هو الطريقة الثالثة
+
+414
+00:27:35,150 --> 00:27:41,050
+من ال airway clearness و بهيك يعطيكوا العافية و ان
+
+415
+00:27:41,050 --> 00:27:44,070
+شاء الله رب العالمين تكون سعيدة عليكم بالتعليم
+
+416
+00:27:44,070 --> 00:27:45,010
+الإلكتروني
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/6mkP1pYJbBs_raw.json b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/6mkP1pYJbBs_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..3bb7c656408e77d899e8f2f1fde2df92c180adef
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/6mkP1pYJbBs_raw.json
@@ -0,0 +1 @@
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حتى أنا أمنع هذه ال attack لازم يكون عندي control breathing و becoming aware", "tokens": [3555, 6027, 2655, 6027, 1829, 4724, 1829, 9381, 13546, 8978, 3224, 37893, 28820, 3660, 8978, 3224, 14739, 3224, 31439, 8717, 2304, 9566, 6055, 3555, 3615, 6055, 1863, 36178, 23758, 9673, 16572, 11242, 281, 4871, 341, 2690, 11331, 49975, 41850, 5551, 27842, 3615, 29538, 2423, 2690, 5296, 31377, 2304, 7251, 30544, 18871, 16254, 1969, 9570, 4032, 5617, 3650], "avg_logprob": -0.37149783352325705, "compression_ratio": 1.3546511627906976, "no_speech_prob": 1.1920928955078125e-07, "words": [{"start": 118.55, "end": 119.33, "word": "بالتالي", "probability": 0.6777099609375}, {"start": 119.33, "end": 119.67, "word": " بيصير", "probability": 0.765625}, {"start": 119.67, "end": 119.83, "word": " فيه", "probability": 0.4599609375}, {"start": 119.83, "end": 120.47, "word": " مشكلة", "probability": 0.9168294270833334}, {"start": 120.47, "end": 120.75, "word": " فيه", "probability": 0.658935546875}, {"start": 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لمشاكل", "tokens": [5172, 3555, 6027, 2655, 6027, 1829, 19446, 4724, 5016, 9566, 43761, 15844, 6024, 118, 3794, 26895, 13672, 1829, 31439, 20449, 9566, 2288, 3714, 15040, 3555, 3794, 4724, 1829, 30544, 12174, 45865, 10874, 28259, 12399, 5296, 10721, 5551, 14851, 17082, 22653, 18871, 3224, 50113, 15040, 12399, 20193, 7251, 9381, 5016, 14739, 3224, 41850, 5551, 9778, 3215, 23758, 9673, 16572, 11242, 4032, 5551, 9566, 1211, 3615, 8978, 3224, 8978, 10874, 2407, 7251, 30544, 8978, 3224, 32771, 3555, 9640, 34051, 10874, 2407, 7251, 30544, 4724, 9640, 3215, 10874, 28259, 11331, 49975, 41850, 19446, 5551, 3615, 43042, 23758, 41950, 5172, 1211, 34051, 23758, 9673, 16572, 11242, 6055, 3555, 3615, 1829, 32767, 8592, 995, 28820], "avg_logprob": -0.11620214326424641, "compression_ratio": 1.8916256157635467, "no_speech_prob": 5.185604095458984e-06, "words": [{"start": 148.78, "end": 149.56, "word": "فبالتالي", "probability": 0.9673665364583334}, {"start": 149.56, "end": 149.98, "word": " ما", 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" position", "probability": 0.9833984375}, {"start": 361.41, "end": 362.17, "word": " حتى", "probability": 0.785888671875}, {"start": 362.17, "end": 362.51, "word": " أنا", "probability": 0.6220703125}, {"start": 362.51, "end": 363.39, "word": " أعمل", "probability": 0.9080403645833334}, {"start": 363.39, "end": 363.55, "word": " على", "probability": 0.916015625}, {"start": 363.55, "end": 364.07, "word": " تحفيز", "probability": 0.940185546875}, {"start": 364.07, "end": 364.25, "word": " اللي", "probability": 0.947509765625}, {"start": 364.25, "end": 364.67, "word": " هو", "probability": 0.99365234375}, {"start": 364.67, "end": 365.47, "word": " shortening", "probability": 0.824951171875}, {"start": 365.47, "end": 365.73, "word": " of", "probability": 0.96533203125}, {"start": 365.73, "end": 366.13, "word": " breathing", "probability": 0.86669921875}], "temperature": 1.0}, {"id": 17, "seek": 38915, "start": 366.83, "end": 389.15, "text": "الـ Upper Chest Relaxation with Together الـ 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lying position أو اللي هو ال crook lying position اللي هو below at the knee و below at the neck فبالتالي هنا أنا بعمل relaxation position هنا ال muscle back و الأبضمن البصل اللي هي relaxed بتكون في هذه الوضعية", "tokens": [24793, 7649, 2423, 2535, 23758, 13672, 1829, 31439, 6225, 3555, 9640, 3660, 18871, 2423, 1090, 8493, 2535, 34051, 13672, 1829, 31439, 2423, 4848, 453, 8493, 2535, 13672, 1829, 31439, 2507, 412, 264, 9434, 4032, 2507, 412, 264, 6189, 6156, 3555, 6027, 2655, 6027, 1829, 34105, 41850, 4724, 25957, 1211, 30315, 2535, 34105, 2423, 8679, 646, 4032, 16247, 3555, 11242, 2304, 1863, 29739, 36520, 13672, 1829, 39896, 14628, 39894, 30544, 8978, 29538, 2423, 2407, 11242, 3615, 10632], "avg_logprob": -0.20586444960012065, "compression_ratio": 1.7839195979899498, "no_speech_prob": 4.172325134277344e-07, "words": [{"start": 389.46, "end": 389.9, "word": "كمان", "probability": 0.78271484375}, {"start": 389.9, "end": 390.0, "word": " ال", "probability": 0.802734375}, {"start": 390.0, 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"end": 400.14, "word": " at", "probability": 0.93701171875}, {"start": 400.14, "end": 400.36, "word": " the", "probability": 0.92431640625}, {"start": 400.36, "end": 400.72, "word": " neck", "probability": 0.9697265625}, {"start": 400.72, "end": 401.38, "word": " فبالتالي", "probability": 0.9763997395833334}, {"start": 401.38, "end": 401.6, "word": " هنا", "probability": 0.87890625}, {"start": 401.6, "end": 401.82, "word": " أنا", "probability": 0.71826171875}, {"start": 401.82, "end": 402.18, "word": " بعمل", "probability": 0.95751953125}, {"start": 402.18, "end": 402.58, "word": " relaxation", "probability": 0.91552734375}, {"start": 402.58, "end": 403.64, "word": " position", "probability": 0.9853515625}, {"start": 403.64, "end": 404.18, "word": " هنا", "probability": 0.84326171875}, {"start": 404.18, "end": 404.4, "word": " ال", "probability": 0.9248046875}, {"start": 404.4, "end": 404.62, "word": " muscle", "probability": 0.955078125}, {"start": 404.62, "end": 404.96, "word": " back", "probability": 0.75634765625}, {"start": 404.96, "end": 405.1, "word": " و", "probability": 0.5986328125}, {"start": 405.1, "end": 405.52, "word": " الأبضمن", "probability": 0.577685546875}, {"start": 405.52, "end": 406.02, "word": " البصل", "probability": 0.7607421875}, {"start": 406.02, "end": 406.64, "word": " اللي", "probability": 0.979248046875}, {"start": 406.64, "end": 406.92, "word": " هي", "probability": 0.7783203125}, {"start": 406.92, "end": 407.36, "word": " relaxed", "probability": 0.572265625}, {"start": 407.36, "end": 407.8, "word": " بتكون", "probability": 0.980224609375}, {"start": 407.8, "end": 408.02, "word": " في", "probability": 0.97509765625}, {"start": 408.02, "end": 408.46, "word": " هذه", "probability": 0.46435546875}, {"start": 408.46, "end": 409.2, "word": " الوضعية", "probability": 0.97783203125}], "temperature": 1.0}, {"id": 19, "seek": 44026, "start": 410.6, "end": 440.26, "text": "هنا الموضوع الـ Secretion أو الـ Airway Clearance الـ Airway زي ما احنا عارفينه هنا كمان هنحكي عليه في موضوع الـ Post-traumatic stress disorder فيه أخدنا كمان الـ Segmentة اللي هو Clearance في المحاضرة أو في الفيديو السابق زي ما انتوا شايفينه وين انا بالظبط بعرف في عندى Secretion بحط ال patient تبعى في وضعية مناسبة الآن هستمد تلات طرق أساسية لSecretion of Clearance", "tokens": [3224, 8315, 9673, 2407, 11242, 45367, 2423, 39184, 7400, 313, 34051, 2423, 39184, 5774, 676, 14993, 719, 2423, 39184, 5774, 676, 30767, 1829, 19446, 1975, 5016, 8315, 6225, 9640, 5172, 9957, 3224, 34105, 9122, 2304, 7649, 8032, 1863, 5016, 4117, 1829, 47356, 8978, 3714, 2407, 11242, 45367, 2423, 39184, 10223, 12, 17227, 449, 2399, 4244, 13399, 8978, 3224, 5551, 9778, 3215, 8315, 9122, 2304, 7649, 2423, 39184, 1100, 10433, 3660, 13672, 1829, 31439, 14993, 719, 8978, 9673, 5016, 46958, 25720, 34051, 8978, 27188, 1829, 16254, 2407, 21136, 16758, 4587, 30767, 1829, 19446, 16472, 2655, 14407, 13412, 995, 33911, 9957, 3224, 4032, 9957, 1975, 8315, 20666, 19913, 3555, 9566, 45030, 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\ No newline at end of file
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/6mkP1pYJbBs_raw.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/6mkP1pYJbBs_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..09aa26188bb6668bcecfddcfa56488f08fb7ef7a
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/6mkP1pYJbBs_raw.srt
@@ -0,0 +1,1664 @@
+1
+00:00:01,250 --> 00:00:05,290
+بيبن الله تعالى اليوم راح أكمل معاكم ال part
+
+2
+00:00:05,290 --> 00:00:08,850
+التاني من ال physical therapy intervention اللي هو
+
+3
+00:00:08,850 --> 00:00:14,870
+هيتحدث ويكمل عامة سبق ما شرحنا في part واحد
+
+4
+00:00:14,870 --> 00:00:18,530
+اتحدثنا في part واحد عن ال breathing exercise ال
+
+5
+00:00:18,530 --> 00:00:20,570
+indication و ال contra indication و ال
+
+6
+00:00:20,570 --> 00:00:23,990
+repercussions كمان اتحدثنا عن أنواع ال breathing
+
+7
+00:00:23,990 --> 00:00:29,370
+exercise اللي أنا ممكن أشتغلهم مع مريض اللي هو في
+
+8
+00:00:29,370 --> 00:00:33,870
+قسم الصدريةفي هذا الفيديو بإذن الله تعالى هنتحدث
+
+9
+00:00:33,870 --> 00:00:37,470
+عن اللي هو الـ Airway Clearness عن طريق الـ
+
+10
+00:00:37,470 --> 00:00:41,130
+Cuffing و الـ Huffing و هنتبعه بفيديو آخر لـ
+
+11
+00:00:41,130 --> 00:00:44,130
+Postural Adrenalgia هنا هتحدث عن الـ Physical
+
+12
+00:00:44,130 --> 00:00:48,490
+Intervention لحالات على سبيل المثال الـ COPD أو
+
+13
+00:00:48,490 --> 00:00:53,330
+الحالات اللي هي ممكن أن أجدها في قسم الصدرية خلينا
+
+14
+00:00:53,330 --> 00:00:58,630
+نشوف اللي هو بداية أول حالة معانا اللي هي عبارة عن
+
+15
+00:00:59,250 --> 00:01:04,050
+Preventing and Relieving لالـ Disposed اللي هي الـ
+
+16
+00:01:04,050 --> 00:01:06,990
+Discipine كنا عرفنا الـ Discipine، الـ Discipine
+
+17
+00:01:06,990 --> 00:01:10,570
+هي عبارة عن difficulty to breathing في اللي هو
+
+18
+00:01:10,570 --> 00:01:14,790
+أوضاع مختلفة mini patient with COPD على سبيل
+
+19
+00:01:14,790 --> 00:01:19,000
+المثال، فيها أنمي انفظيمة and أسمةmay suffer from
+
+20
+00:01:19,000 --> 00:01:23,840
+periodic episodes بيعانوا بعض الأحيان من نوبات من
+
+21
+00:01:23,840 --> 00:01:28,320
+الـdiscipline من نوبات هي عبارة عن قصر في النفس
+
+22
+00:01:28,320 --> 00:01:34,960
+خصوصا في اللي هو بدل جهد معين أو وجود مثير على
+
+23
+00:01:34,960 --> 00:01:42,220
+سبيل المثالمعطر، أي شيء تلوث هواء بالجو فبنلاقي
+
+24
+00:01:42,220 --> 00:01:47,880
+الربيع مثلا أو أزهار اللي هي سقوط أوراق الشجار في
+
+25
+00:01:47,880 --> 00:01:52,220
+الخريف كل هذه المؤثرات بتأثر على هؤلاء المرضى
+
+26
+00:01:58,550 --> 00:02:02,870
+بالتالي بيصير فيه مشكلة فيه أنه هو نمط تبع تنفس
+
+27
+00:02:02,870 --> 00:02:06,890
+هذا المريض to prevent this attack حتى أنا أمنع هذه
+
+28
+00:02:06,890 --> 00:02:09,770
+ال attack لازم يكون عندي control breathing و
+
+29
+00:02:09,770 --> 00:02:13,630
+becoming awareWhat's the activity situation
+
+30
+00:02:13,630 --> 00:02:18,310
+participate in these cases؟ هو المريض نفسه أو هي
+
+31
+00:02:18,310 --> 00:02:23,010
+الأم نفسها بتكون على وعي أنه على سبيل المثال هذا
+
+32
+00:02:23,010 --> 00:02:27,810
+الاشي بيزيد من الأزمة أو بيزيد من اللي هو dyspnea
+
+33
+00:02:27,810 --> 00:02:32,600
+لإبنيفبالتالي ما بحطله على الغسيل اللي هو معطر
+
+34
+00:02:32,600 --> 00:02:37,380
+ملابس بيكون قوي جدا، لأ أستغني عنه مثلا، لا يصح
+
+35
+00:02:37,380 --> 00:02:41,440
+أنه أنا أخد هذا المريض و أطلع فيه في جو يكون فيه
+
+36
+00:02:41,440 --> 00:02:45,900
+غبار أو جو يكون بارد جدا حتى أنا ما أعرض هذا الطفل
+
+37
+00:02:45,900 --> 00:02:51,080
+أو هذا المريض تبعي لمشاكلالـ «Control of Breathing
+
+38
+00:02:51,080 --> 00:02:54,980
+and Reduction of Expiratory Rate» عن طريق بيرز الـ
+
+39
+00:02:54,980 --> 00:02:57,880
+BLB اللي هو أخدناها من أنواع الـ Breathing
+
+40
+00:02:57,880 --> 00:03:02,360
+Exercise بيرز الـ Breathing خلال الـ expiration في
+
+41
+00:03:02,360 --> 00:03:06,260
+عملية اللي هي الـ «ذافير» «Have a patient assume
+
+42
+00:03:06,260 --> 00:03:10,580
+relaxed forward bend» أيه نيحة له لقدام طبعا الـ
+
+43
+00:03:10,580 --> 00:03:13,620
+forward bend position stimulating لديه fragmentary
+
+44
+00:03:13,620 --> 00:03:17,280
+breathingهذه مميزاته، إذا أنا بفضل هذا الـ
+
+45
+00:03:17,280 --> 00:03:20,940
+position إن المريض يتني حاله لقدام، ليه؟ هذا بيحفظ
+
+46
+00:03:20,940 --> 00:03:24,680
+إنه دافع يشتغل طبعا هو mainly muscles، have
+
+47
+00:03:24,680 --> 00:03:28,620
+للpatient focus expiratory phase، breathing while
+
+48
+00:03:28,620 --> 00:03:33,190
+being sure to avoid possibly expirationفي كل
+
+49
+00:03:33,190 --> 00:03:35,890
+breathing exercise اللي أنا بشتغلها ممنوع المريض
+
+50
+00:03:35,890 --> 00:03:41,530
+التابعي يحاول إن هو يخرج الهواء بقوة وصعوبة، تمام؟
+
+51
+00:03:41,530 --> 00:03:43,870
+قعدوا كمان شوية هنشوف كمان في ال cuffing نفس
+
+52
+00:03:43,870 --> 00:03:47,070
+الكلام Have the patient remain in forward position
+
+53
+00:03:47,070 --> 00:03:50,710
+postural and continue breathing in slow control
+
+54
+00:03:50,710 --> 00:03:55,030
+manner until the episode disabnia suspects اللي هو
+
+55
+00:03:55,030 --> 00:03:59,740
+لحد ما تروح هي ال attack معناأول position عندنا
+
+56
+00:03:59,740 --> 00:04:02,940
+relaxed position طبعا اللي هو أنا أخلي المريض في
+
+57
+00:04:02,940 --> 00:04:06,220
+وضع relaxation position first step towards self
+
+58
+00:04:06,220 --> 00:04:09,040
+-help positioning it's effective technique to
+
+59
+00:04:09,040 --> 00:04:13,800
+reduce both symptoms وwork breathing إذا أنا خليته
+
+60
+00:04:13,800 --> 00:04:17,140
+اللي هو بوضعيا يكون مرتاح فيها مش إجتوا انه بقى
+
+61
+00:04:17,140 --> 00:04:21,540
+احنا طبعا نكون قلقين ونسير الزعر حواليه لأ ده هزيد
+
+62
+00:04:21,540 --> 00:04:23,860
+من الصعوبة التنفس تدى المريض لأ بالعكس أنا هنا
+
+63
+00:04:23,860 --> 00:04:26,860
+أكون في وضع relaxed position كمان أحط ال patient
+
+64
+00:04:26,860 --> 00:04:29,690
+تبعي ب relaxed positionNeck و Shoulder & Garter
+
+65
+00:04:29,690 --> 00:04:34,050
+relaxation should be done لازم انا كل يوم اعلمه
+
+66
+00:04:34,050 --> 00:04:36,710
+للمريض تبعى كيف يعمل اللى هوا relaxation exercise
+
+67
+00:04:36,710 --> 00:04:41,270
+مهم جدا فى هاى الحالات ال upper chest relaxation
+
+68
+00:04:41,270 --> 00:04:45,030
+together with control breathing need فى عندى five
+
+69
+00:04:45,030 --> 00:04:49,350
+practice اللى هوا different way اول position ال
+
+70
+00:04:49,350 --> 00:04:53,150
+high side lying كله هنشوفه بالصور ال free arm
+
+71
+00:04:53,150 --> 00:04:57,010
+support in table و ال free arm support in thigh
+
+72
+00:04:57,440 --> 00:05:01,600
+والـ Back support against wall و الـ Forearm
+
+73
+00:05:01,600 --> 00:05:06,000
+support forward خلّيني أشوف كل وضعية من الـ
+
+74
+00:05:06,000 --> 00:05:09,840
+relaxation position with together أول position
+
+75
+00:05:09,840 --> 00:05:14,980
+اللي هو الـ high side lying forearm شايفين هذا
+
+76
+00:05:14,980 --> 00:05:21,140
+الوضعية حاطة كذا مخدة وهو عبارة عن highlying high
+
+77
+00:05:21,140 --> 00:05:24,140
+side lying breathing ال position هدا to reduce
+
+78
+00:05:24,140 --> 00:05:27,640
+shortening of breathing تمام هاي أول وضعية الوضعية
+
+79
+00:05:27,640 --> 00:05:31,880
+التانية ال furry arm support in table هو four بنات
+
+80
+00:05:31,880 --> 00:05:36,340
+للأمام lean forward تمام و اللي هو sitting
+
+81
+00:05:36,340 --> 00:05:40,260
+position و حاطة مخدتين معناه الكلام to produce
+
+82
+00:05:40,260 --> 00:05:43,800
+shortening of breathing ال position التالت في
+
+83
+00:05:43,800 --> 00:05:48,420
+sitting position و ال furry arm supporting in his
+
+84
+00:05:48,420 --> 00:05:51,990
+thighتمام؟ يعني قريب من الـ fourth lean sitting
+
+85
+00:05:51,990 --> 00:05:55,390
+position ال position الرابع اللي هو ال patient
+
+86
+00:05:55,390 --> 00:05:59,730
+تبعنا against wall هنا سند نفسه على حائط هذا
+
+87
+00:05:59,730 --> 00:06:04,070
+الحائط relaxed position حتى أنا أعمل على تحفيز
+
+88
+00:06:04,070 --> 00:06:08,230
+اللي هو shortening of breathingالـ Upper Chest
+
+89
+00:06:08,230 --> 00:06:11,750
+Relaxation with Together الـ Position الخامس الـ
+
+90
+00:06:11,750 --> 00:06:15,490
+Forearm Supporting على الـ Table تمام هنا في وضع
+
+91
+00:06:15,490 --> 00:06:18,570
+اللي هو Standing Position هذه الـ Five Position
+
+92
+00:06:18,570 --> 00:06:22,090
+اللي أنا حكيت عليها to Relaxation حتى أنا أعمل
+
+93
+00:06:22,090 --> 00:06:26,890
+Control Breathing في خلال اللي هي الأزمة أو خلال
+
+94
+00:06:26,890 --> 00:06:31,500
+الـDiscipline اللي صارتكمان ال position هذا اللي
+
+95
+00:06:31,500 --> 00:06:35,000
+هو عبارة عن ال high lying position أو اللي هو ال
+
+96
+00:06:35,000 --> 00:06:38,900
+crook lying position اللي هو below at the knee و
+
+97
+00:06:38,900 --> 00:06:42,580
+below at the neck فبالتالي هنا أنا بعمل relaxation
+
+98
+00:06:42,580 --> 00:06:46,640
+position هنا ال muscle back و الأبضمن البصل اللي
+
+99
+00:06:46,640 --> 00:06:51,380
+هي relaxed بتكون في هذه الوضعيةهنا الموضوع الـ
+
+100
+00:06:51,380 --> 00:06:55,400
+Secretion أو الـ Airway Clearance الـ Airway زي ما
+
+101
+00:06:55,400 --> 00:06:59,120
+احنا عارفينه هنا كمان هنحكي عليه في موضوع الـ Post
+
+102
+00:06:59,120 --> 00:07:01,160
+-traumatic stress disorder فيه أخدنا كمان الـ
+
+103
+00:07:01,160 --> 00:07:05,220
+Segmentة اللي هو Clearance في المحاضرة أو في
+
+104
+00:07:05,220 --> 00:07:09,540
+الفيديو السابق زي ما انتوا شايفينه وين انا بالظبط
+
+105
+00:07:09,540 --> 00:07:13,960
+بعرف في عندى Secretion بحط ال patient تبعى في
+
+106
+00:07:13,960 --> 00:07:19,560
+وضعية مناسبة الآن هستمد تلات طرق أساسية لSecretion
+
+107
+00:07:19,560 --> 00:07:23,060
+of Clearanceطريقة الأولى والتانى هاخدهم في هذا
+
+108
+00:07:23,060 --> 00:07:26,320
+الفيديو أما الطريقة الثالثة وهى البشري ال adrenage
+
+109
+00:07:26,320 --> 00:07:30,840
+هاخدها في الفيديو اللاحق ان شاء الله ال cuffing و
+
+110
+00:07:30,840 --> 00:07:34,160
+ال huffing هم تكنيكيان احنا هناخدهم بإذن الله في
+
+111
+00:07:34,160 --> 00:07:39,100
+هذا الفيديو ونبدأ فيهم على بركة الله هشوف المريض
+
+112
+00:07:39,100 --> 00:07:42,580
+تبعى في ال cuffing uneffectiveness شوه ال cuffing
+
+113
+00:07:42,580 --> 00:07:47,770
+هى عبارة عن عمليةمهم جدا لإزالة الـ secretion اللي
+
+114
+00:07:47,770 --> 00:07:51,890
+مغلق لي أو اللي مسدد الـ airway and effective
+
+115
+00:07:51,890 --> 00:07:55,310
+cough is necessary to eliminate respiratory
+
+116
+00:07:55,310 --> 00:07:59,450
+obstruction and keep lungs clear أهم إشي أنا عندي
+
+117
+00:07:59,450 --> 00:08:04,340
+ال lungs تكون clear to exchange gasتمام الـ Airway
+
+118
+00:08:04,340 --> 00:08:07,480
+clearness is important part to manage patient with
+
+119
+00:08:07,480 --> 00:08:11,000
+acute chronic respiratory condition مهم جدا ان انا
+
+120
+00:08:11,000 --> 00:08:15,740
+احافظ على الـ Airway كلها تكون clearness يقدر اللي
+
+121
+00:08:15,740 --> 00:08:19,540
+هو يستطيع الهواء الدخول وخروج ال waste product
+
+122
+00:08:19,540 --> 00:08:25,580
+بشكل منتظم وثابت ال cuff mechanism كيف هتكون؟بدي
+
+123
+00:08:25,580 --> 00:08:28,580
+يكون في البداية عنا deep inspiration زي ما احنا
+
+124
+00:08:28,580 --> 00:08:32,500
+شايفين في هذه الصورة طبعا هنا بالبداية صار في عنا
+
+125
+00:08:32,500 --> 00:08:36,780
+irritation حدوث اللي هو مثير ومحفظ ومن ثم ال
+
+126
+00:08:36,780 --> 00:08:41,360
+inspiration في هذه الحالة ال glutes طبعا closed
+
+127
+00:08:41,360 --> 00:08:45,420
+and the vocal cord tightness الحبل الصوتي أو
+
+128
+00:08:45,420 --> 00:08:49,440
+الأحبال الصوتية مغلقة مشدودة وكذلك لسان المزمار
+
+129
+00:08:49,440 --> 00:08:55,910
+مغلق ال abdominal muscles طبعا وادفرام elevatedالـ
+
+130
+00:08:55,910 --> 00:09:00,350
+Abdominal Contract اشتغلت الـ Diaphragm ارتفع على
+
+131
+00:09:00,350 --> 00:09:07,830
+الأعلى مما يزيد من الـ Interthoracic and Abdominal
+
+132
+00:09:07,830 --> 00:09:10,410
+Pressure Interabdominal Pressure and Interthoracic
+
+133
+00:09:10,410 --> 00:09:14,250
+Pressure فبالتالي بعد شوية هتلاقي أنه صار في عنا
+
+134
+00:09:14,250 --> 00:09:17,790
+اللي هي ال compression الضغط اللي دخل هنا لاحظوا
+
+135
+00:09:17,790 --> 00:09:22,350
+معايا هنا اللي هو الـ Diaphragmأرتفع لفوق تمام صار
+
+136
+00:09:22,350 --> 00:09:25,850
+في عنا زيادة في الـ Intrathoracic و الـ Intra
+
+137
+00:09:25,850 --> 00:09:29,070
+-abdominal pressure بعد شوية هيصير في عنا X-belt
+
+138
+00:09:29,330 --> 00:09:33,310
+Explosive لا اللي هو الـ expiration طبعا و بيصير
+
+139
+00:09:33,310 --> 00:09:36,510
+في عندنا ال exhaling أو ال expiration of process
+
+140
+00:09:36,510 --> 00:09:40,830
+هاي عبارة عن عملية ال cuff mechanism في عندنا five
+
+141
+00:09:40,830 --> 00:09:44,330
+stages لعملية ال cuff أول الشيء الديب inspiration
+
+142
+00:09:44,330 --> 00:09:49,190
+بعدين ال glutes closes بعدين ال abdominal هو اللي
+
+143
+00:09:49,190 --> 00:09:53,130
+هو the pragmatic muscles و ال glutes opens رقم
+
+144
+00:09:53,130 --> 00:09:56,250
+أربعة بعد شوية اللي هي ال last stage اللي هي ال
+
+145
+00:09:56,250 --> 00:10:01,220
+explosive expirationالان في عندي حاجة اسمها normal
+
+146
+00:10:01,220 --> 00:10:05,040
+cuff pumping هي عبارة عن إيش القف مابي إما بيكون
+
+147
+00:10:05,040 --> 00:10:10,030
+عنه reflexes أو voluntaryفي الأطفال بالعادة بيكون
+
+148
+00:10:10,030 --> 00:10:14,970
+اللي هو الاشي أو الموضوع مش فعاد، يعني الموضوع الـ
+
+149
+00:10:14,970 --> 00:10:17,490
+cuffing عند الأطفال مش موجود، يعني هو عند البلغين،
+
+150
+00:10:17,490 --> 00:10:20,730
+يعني مابقدر أولى الطفل على سبيل المثال ابن سنة أو
+
+151
+00:10:20,730 --> 00:10:25,130
+أقل مثلا أنه يلا كح، لأ مابستطيع، فبالتالي هو مش
+
+152
+00:10:25,130 --> 00:10:28,010
+voluntary عند هدول الأطفال، بروح أنا و أنا أعمله
+
+153
+00:10:28,010 --> 00:10:31,130
+stimulation بأي إشي، هناخدها الطرق هاي عنده كمان،
+
+154
+00:10:31,130 --> 00:10:35,190
+كام slides، فبالتاليعند الكبار ممكن يكون voluntary
+
+155
+00:10:35,190 --> 00:10:39,950
+الـ normal individual cuff bump is effective في
+
+156
+00:10:39,950 --> 00:10:43,810
+اللي هو ال generation السابع، فانا عندي لبلونكاي
+
+157
+00:10:43,810 --> 00:10:48,550
+23 generation اللي مسؤول عن ال cuff bumping اللي
+
+158
+00:10:48,550 --> 00:10:53,860
+هو رقم 7طبعاً زي ما انتوا شايفينها هنا تحت
+
+159
+00:10:53,860 --> 00:10:58,100
+المايكروسكوب هي عبارة عن أثيليا متشون وisolated
+
+160
+00:10:58,100 --> 00:11:02,520
+يعني مهدبة أو فيها أهداب هي موجودة حتى تعمل على ال
+
+161
+00:11:02,520 --> 00:11:05,980
+movement لsecretion large airway absent of
+
+162
+00:11:05,980 --> 00:11:10,700
+pathology طبعاً الوجودها هي نعمة من الله سبحانه
+
+163
+00:11:10,700 --> 00:11:13,620
+وتعالى حتى تعمل movement لsecretion انه يطلع على
+
+164
+00:11:13,620 --> 00:11:17,460
+ال upper respiratory tract حتى احنا نقدر أو نستطيع
+
+165
+00:11:17,460 --> 00:11:21,470
+ان احنا نتخلص منههذه ال generation اللي أنا حكيت
+
+166
+00:11:21,470 --> 00:11:25,850
+عليها هما 23 generation للبرونكاي والمسئول عن ال
+
+167
+00:11:25,850 --> 00:11:29,590
+pumping أو ال cuff pumping اللي هو رقم 7 ال
+
+168
+00:11:29,590 --> 00:11:34,130
+factors اللي بتقلل effectiveness لكف ميكانيزم في
+
+169
+00:11:34,130 --> 00:11:37,870
+عندي كذا factors بيقلل عملية ال cuffing أول إشي
+
+170
+00:11:37,870 --> 00:11:42,780
+اللي بتقلل ال inspiratory capacity يا MLBيا إما
+
+171
+00:11:42,780 --> 00:11:45,200
+الـ weakness of diaphragm يا إما الـ post
+
+172
+00:11:45,200 --> 00:11:49,120
+-operative خلّيني أشوف اللي هو ال pain إذا كان في
+
+173
+00:11:49,120 --> 00:11:53,420
+عندي ألم خصوصا في ال lung disease وفي مرحلة ال
+
+174
+00:11:53,420 --> 00:11:56,700
+acute ال rib fractures، ال trauma، ال chest
+
+175
+00:11:56,700 --> 00:12:01,180
+resynthetic abdominal surgery هذه الألم الناتجة عن
+
+176
+00:12:01,180 --> 00:12:04,640
+هذه الأمراض أو عن هذه الأحداث بتقلل من ال
+
+177
+00:12:04,640 --> 00:12:09,320
+inspiratory capacity تمام؟ وهذا هيقلل بحد ذاته من
+
+178
+00:12:09,320 --> 00:12:13,100
+عملية ال coughingفيه هنا الـ weakness لـ diaphragm
+
+179
+00:12:13,100 --> 00:12:17,100
+ضعف عضلة الـ diaphragm هذا مهم جدا إنه لو صار
+
+180
+00:12:17,100 --> 00:12:20,240
+بيصير فيه هنا أن ال diaphragm طبعا هو ال mainly
+
+181
+00:12:20,240 --> 00:12:22,860
+muscles فبالتالي إذا كانت weak هيحلم حالها
+
+182
+00:12:22,860 --> 00:12:25,720
+accessory muscles وهذا احنا ما بدناه يعمل result
+
+183
+00:12:25,720 --> 00:12:29,220
+of high spinal cord injury أو ناتجة عن ال
+
+184
+00:12:29,220 --> 00:12:33,020
+neuropathic أو myopathic disease بتقلل قدرة المريض
+
+185
+00:12:33,020 --> 00:12:37,280
+على إنه ياخد دي ب breathing ال postoperatively بعد
+
+186
+00:12:37,280 --> 00:12:41,240
+العملياتده ال respiratory أو اللي هو ال
+
+187
+00:12:41,240 --> 00:12:44,140
+respiratory center made breast as a result of
+
+188
+00:12:44,140 --> 00:12:47,380
+general anaesthesia لإنه أخد ال patient تبعنا
+
+189
+00:12:47,380 --> 00:12:52,780
+general anaesthesia فبالتالي بقل عنده اللي هو أو
+
+190
+00:12:52,780 --> 00:12:56,580
+بخفض شغل ال respiratory center اللي موجود في ال
+
+191
+00:12:56,580 --> 00:13:00,370
+brain stemطبعاً ونتجة الألم ممكن يكون post
+
+192
+00:13:00,370 --> 00:13:03,610
+-operative اللي ناتجة عن الـ post-operative عملية
+
+193
+00:13:03,610 --> 00:13:07,210
+كانت على سبيل المثال صار في عنده عملية open
+
+194
+00:13:07,210 --> 00:13:11,350
+surgery فبالتالي بيصير فيها ban ال medication بعض
+
+195
+00:13:11,350 --> 00:13:15,890
+الأدوية تعمل على تطبيق أو إحباط شغل اللي هو ال
+
+196
+00:13:15,890 --> 00:13:20,650
+respiratory center هذا أول سبب من أسباب العوامل
+
+197
+00:13:20,650 --> 00:13:23,850
+اللي بتقل ال effectiveness لل coughing اللي هو قلة
+
+198
+00:13:23,850 --> 00:13:28,740
+عمل ال respiratory stageفي عندنا الـ Inability to
+
+199
+00:13:28,740 --> 00:13:34,300
+forcibly exhale air عدم قدرته المريض على اللي هو
+
+200
+00:13:34,300 --> 00:13:38,520
+يعمل exhale أو exhale to the air عدم قدرته على دفع
+
+201
+00:13:38,520 --> 00:13:42,300
+الهواء إلى الخارج ناتج الـ Spinal Cord Injury
+
+202
+00:13:42,300 --> 00:13:48,760
+الإصابات كلها اللي فوقabove T12 injury Myopathic
+
+203
+00:13:48,760 --> 00:13:51,940
+disease زي اللي هو الـ muscular dystrophy الـ
+
+204
+00:13:51,940 --> 00:13:54,420
+excessive fatigue a result of a critical illness
+
+205
+00:13:54,420 --> 00:13:57,320
+عن الـ chest و الـ abdominal incision ال patient
+
+206
+00:13:57,320 --> 00:14:01,020
+who have tracheostomy also has difficulty to
+
+207
+00:14:01,020 --> 00:14:04,260
+breathing طبعا ليش؟ لأنه في عندنا فتحة في الـ
+
+208
+00:14:04,260 --> 00:14:08,080
+tracheostomy should be covered عشان يصير أفضل لازم
+
+209
+00:14:08,080 --> 00:14:13,550
+إحنا أيش نغلقها، هذا السبب الثانيالسبب الثالث للي
+
+210
+00:14:13,550 --> 00:14:17,790
+هو قلة عمل أو فشل عمل اللي هي الـ Cuff Mechanism
+
+211
+00:14:17,790 --> 00:14:22,610
+Decrease للـ Action of Sela and Bronchi Tree
+
+212
+00:14:22,610 --> 00:14:27,530
+الأهداف اللي موجودة اللي احنا حكينا عليها موجودة
+
+213
+00:14:27,530 --> 00:14:30,830
+في الـ Bronchi اللي هي وظيفتها تعمل Movement لـ
+
+214
+00:14:30,830 --> 00:14:34,610
+Secretion نتيجة لحدث معين، نتيجة لأي Pathology
+
+215
+00:14:34,610 --> 00:14:38,130
+معين بتقل اللي هو الـ Mechanism تبعتها أو بتقل
+
+216
+00:14:38,130 --> 00:14:41,640
+عملها فبالتالي بتقلل من عملية الـ Cuffingالـ
+
+217
+00:14:41,640 --> 00:14:45,980
+General Anesthesia، الـ Intubation، وجود اللي هو
+
+218
+00:14:45,980 --> 00:14:49,080
+الـ Tracheal Intubation أو أي Intubation إحنا كنا
+
+219
+00:14:49,080 --> 00:14:53,980
+حاطيناه، Pathology زي الـ COPD على سبيل المثال،
+
+220
+00:14:53,980 --> 00:14:58,980
+الـ Smoking أيضًا بيقلل من اللي هو عمل الأهداف
+
+221
+00:14:58,980 --> 00:15:03,940
+اللي موجودة عندىأيضاً فيها السبب الرابع لقلة الـ
+
+222
+00:15:03,940 --> 00:15:07,140
+Cough Mechanism أو الـ Cough Pumping اللي هي زيادة
+
+223
+00:15:07,140 --> 00:15:10,420
+في Thickness of Mucus هلأ هذا الـ Mucus اللي أنا
+
+224
+00:15:10,420 --> 00:15:14,440
+بدي أطلعه من تحت من الـ Basal Lung و أطلعه على ال
+
+225
+00:15:14,440 --> 00:15:19,340
+Upper Respiratory Tract بيكون لزج أو كثيف فصعب أنه
+
+226
+00:15:19,340 --> 00:15:22,600
+يطلع معايا للأعلى فبالتالي زي على سبيل المثال CF
+
+227
+00:15:22,600 --> 00:15:26,520
+أو Cystic Fibrosis هو عبارة عن Chronic Bronchitis
+
+228
+00:15:26,520 --> 00:15:30,860
+and Pulmonary Infection طبعاً نمونياووجود هذه
+
+229
+00:15:30,860 --> 00:15:33,420
+الأمراض زي الـ cystic fibrosis والـChronic
+
+230
+00:15:33,420 --> 00:15:37,800
+bronchitis وأيضا وجود الـPneumoniaهذه الحالات صعب
+
+231
+00:15:37,800 --> 00:15:41,900
+ميوكاسها يطلع بسرعة فبالتالي بتقلل من عملية الـ
+
+232
+00:15:41,900 --> 00:15:45,240
+Cough Pumping الـ Intubation Irritates Lagumina of
+
+233
+00:15:45,240 --> 00:15:48,280
+اللي هي Airway and Causes Increased Mucus
+
+234
+00:15:48,280 --> 00:15:51,420
+Production طبعاً و الـ Dehydration اللي هو
+
+235
+00:15:51,420 --> 00:15:53,860
+فبالتالي هنا في هذه الحالات أنا ممكن أعمل
+
+236
+00:15:53,860 --> 00:15:58,800
+humidification بالتبخيرة لو كان كبير شوية بنشربه
+
+237
+00:15:58,800 --> 00:16:02,780
+بعض السواقل الدافية عشان تعملي ترطيب لهذا السائل
+
+238
+00:16:02,780 --> 00:16:08,200
+وبعد شوية يصير له Exhalable toout of the body هاي
+
+239
+00:16:08,200 --> 00:16:12,500
+أربع أسباب عندنا بتخفف أو بتقلل من عمل ال cuff
+
+240
+00:16:12,500 --> 00:16:16,040
+pumping خليني أشوف اللي هو بعض ال effective لل
+
+241
+00:16:16,040 --> 00:16:19,900
+cuffing هنا إشي practical سيبته أنا للجزء العملي
+
+242
+00:16:19,900 --> 00:16:25,040
+وننتقل لجزئية تانية شهي ال precautions اللي تبعت ل
+
+243
+00:16:25,040 --> 00:16:29,280
+treating and effective cuffing ممنوع أنا أسمح لأي
+
+244
+00:16:29,280 --> 00:16:32,980
+مريض to gasp gasp يعني يتنفس بشدة أو يعمل expel
+
+245
+00:16:32,980 --> 00:16:37,910
+لال airإيه؟ بسبب إزالة العمل وإستفادة الطاقة من
+
+246
+00:16:37,910 --> 00:16:41,050
+الـ Breathing لأنه هيضيع جهده على الفاضي، ما
+
+247
+00:16:41,050 --> 00:16:44,350
+هيستفيد من هذا الجهد بسبب إنه إيش Causing
+
+248
+00:16:44,350 --> 00:16:47,470
+للpatient fatigue more easily فبالتالي أنا مابدى
+
+249
+00:16:47,470 --> 00:16:53,050
+يوصل المريض معايا لمرحلة من الفتيجرقم 2 Increase
+
+250
+00:16:53,050 --> 00:16:56,730
+turbulence لـunresistance of airway possibility
+
+251
+00:16:56,730 --> 00:16:59,330
+leading to increase bronchospasm and further
+
+252
+00:16:59,330 --> 00:17:03,090
+contraction للـairway ممنوع أعمل أي إشي يضايق
+
+253
+00:17:03,090 --> 00:17:06,790
+المريض على سبيل المثال وهذا الإشي بذاته بيعملي
+
+254
+00:17:06,790 --> 00:17:10,840
+bronchospasmأحنا بالعكس معظم الأدوية اللي جاتوها
+
+255
+00:17:10,840 --> 00:17:13,520
+في قسم الصدرية كلها بتكون الـ bronchodilations
+
+256
+00:17:13,520 --> 00:17:16,860
+يعني أنا بدي أعمل bronchodilations أووسع البرونكاي
+
+257
+00:17:16,860 --> 00:17:20,540
+و البرونكليوز عشان يطلع منها اللي هو الـ secretion
+
+258
+00:17:20,540 --> 00:17:25,540
+اللي عامل ليه المشاكل أيضًا may push mucus are
+
+259
+00:17:25,540 --> 00:17:29,140
+foreign body object to deep into air بساش avoid
+
+260
+00:17:29,140 --> 00:17:34,100
+uncontrolled coughing spasm اللي هي البروكزيمال
+
+261
+00:17:34,100 --> 00:17:38,360
+coughingavoid forceful cuffing if patient have
+
+262
+00:17:38,360 --> 00:17:44,080
+history اللي هو CVA or aneurysm ممنوع أن أمنع ال
+
+263
+00:17:44,080 --> 00:17:48,400
+cuffing القوية في هذه الحالات neurologically have
+
+264
+00:17:48,400 --> 00:17:52,580
+this patient huff several times to clear her way
+
+265
+00:17:52,580 --> 00:17:57,120
+rather than cuffing في هنا أنا بستدلها بال huffing
+
+266
+00:17:57,120 --> 00:18:03,390
+أفضل ليه؟ لأن هي بتكون طبعايعني أفضل و أحن خلينا
+
+267
+00:18:03,390 --> 00:18:07,270
+نحكي على ال patient تبع اللي هو ال stroke أو ال
+
+268
+00:18:07,270 --> 00:18:11,850
+aneurysm Be sure that the patient cuffs while
+
+269
+00:18:11,850 --> 00:18:16,390
+somewhat erect side-lying postural طبعا لازم نتأكد
+
+270
+00:18:16,390 --> 00:18:20,630
+من أن هذا المريض أنه أجرب أنه بعمل إشي في الوضعية
+
+271
+00:18:20,630 --> 00:18:25,130
+الصح في ال side-lying position في عندي حوالي أربعة
+
+272
+00:18:25,130 --> 00:18:28,950
+techniques بتساعد اللي هو الشخص اللي بيعمل good
+
+273
+00:18:28,950 --> 00:18:33,130
+cuffing and improve airwayاللي هو Clearance أول
+
+274
+00:18:33,130 --> 00:18:37,460
+طريقة اللي هي الـ Manual Assistedبحاول أنا أعلم
+
+275
+00:18:37,460 --> 00:18:41,360
+المريض إن هو يساعد نفسه بنفسه If patient have
+
+276
+00:18:41,360 --> 00:18:43,940
+abdominal weakness ال manual pressure على ال
+
+277
+00:18:43,940 --> 00:18:46,900
+abdominal area assists to develop greater
+
+278
+00:18:46,900 --> 00:18:49,800
+intrabrain intraabdominal pressure for more
+
+279
+00:18:49,800 --> 00:18:54,040
+forceful coughing لأن المريض نفسه لحد اللي بيعمل
+
+280
+00:18:54,040 --> 00:18:57,360
+coughing بنخليه يحط أيديه على بطنه طبعا ال manual
+
+281
+00:18:57,360 --> 00:19:00,780
+assist عنده هنشوفها بالصور فبالتالي هنا أنا بزيد
+
+282
+00:19:00,780 --> 00:19:03,400
+ال intraabdominal pressure فممكن يصير في عنا
+
+283
+00:19:03,400 --> 00:19:07,800
+coughing لهذه الحالةالـ Manual Pressure طبعا الـ
+
+284
+00:19:07,800 --> 00:19:13,020
+Resistance ممكن يعملها ال patient نفسه إذا كان
+
+285
+00:19:13,020 --> 00:19:16,980
+السيطيع ذلك ما استطاع بيعملها ال therapist هنا إذا
+
+286
+00:19:16,980 --> 00:19:21,180
+السيطيع ساعده طبعا وزي ما انتوا شايفين هو المفروض
+
+287
+00:19:21,180 --> 00:19:22,980
+على الـ Subliminal Position والثيرابيست عامل
+
+288
+00:19:22,980 --> 00:19:26,780
+Increasing ال abdominal pressure طبعا على منطقة ال
+
+289
+00:19:26,780 --> 00:19:30,360
+X Y process and other hand placed to first keeping
+
+290
+00:19:30,360 --> 00:19:34,460
+finger open interlocking themطبعاً هنا بيحاول إنه
+
+291
+00:19:34,460 --> 00:19:37,200
+يعمل stimulation و increase للـ intra-abdominal
+
+292
+00:19:37,200 --> 00:19:41,280
+pressure عشان هذا المريض يعمل expel to the air
+
+293
+00:19:42,160 --> 00:19:45,780
+after patient inhaled deeply طبعا بعد ما ياخد نفس
+
+294
+00:19:45,780 --> 00:19:49,580
+عميق the therapist manually assist patient to or
+
+295
+00:19:49,580 --> 00:19:53,100
+he she attempts to coughing بيساعده في ان يحاول
+
+296
+00:19:53,100 --> 00:19:56,700
+يعمل الكحان the abdomen is compressed and inward
+
+297
+00:19:56,700 --> 00:20:00,680
+upward forcefully طبعا which push the diaphragm
+
+298
+00:20:00,680 --> 00:20:03,200
+upward causes more forcefully and effective
+
+299
+00:20:03,200 --> 00:20:08,250
+coughingفبالتالي هنا الضغط على البطن داخل وأعلى
+
+300
+00:20:08,250 --> 00:20:12,090
+لفوق القوة بتكون اتجاهها in and upwards which
+
+301
+00:20:12,090 --> 00:20:15,630
+pushes the diaphragm طبعاً هذا بيساعد ال diaphragm
+
+302
+00:20:15,630 --> 00:20:18,650
+واحنا حكينا في ال cuff mechanism أنه اللي هو من
+
+303
+00:20:18,650 --> 00:20:21,390
+عوامل ال cuffing الجيدة أن يكون في عندنا elevation
+
+304
+00:20:21,390 --> 00:20:24,610
+للdiaphragm أيضا increase ال intrinsic thoracic
+
+305
+00:20:24,610 --> 00:20:27,570
+and intraabdominal pressure فبالتالي بيصير في
+
+306
+00:20:27,570 --> 00:20:31,300
+عندنا عملية اللي هي ال cuffingهنا in the same
+
+307
+00:20:31,300 --> 00:20:35,000
+maneuver كان performed with patients in a chair
+
+308
+00:20:35,000 --> 00:20:37,500
+هنا في وضع sitting position هنا كل اللي شوفناها
+
+309
+00:20:37,500 --> 00:20:40,980
+كانت في وضع spine position هنا هنشوف ايش زي ما
+
+310
+00:20:40,980 --> 00:20:44,400
+انتوا شايفينه في وضع sitting position هنا المريض
+
+311
+00:20:44,400 --> 00:20:46,540
+جادر يقعد معايا على sitting position لكن هناك لو
+
+312
+00:20:46,540 --> 00:20:50,560
+كان مش جادر بنخليه في spine position Therapist or
+
+313
+00:20:50,560 --> 00:20:53,700
+family members Therapist او ال family members can
+
+314
+00:20:53,700 --> 00:20:56,850
+standto the back of patient and apply manual
+
+315
+00:20:56,850 --> 00:21:00,990
+pressure بيطبق معها شوية ضغط خلال الـ X-Biration
+
+316
+00:21:00,990 --> 00:21:05,060
+اللي أمكن المريض نفسهأحنا كل اللي حدثنا عليه في
+
+317
+00:21:05,060 --> 00:21:09,440
+الـ «سلايدين» السابقين كان بالpatient مع ال
+
+318
+00:21:09,440 --> 00:21:12,040
+«Therapist» أو مع حد من الـ «Caregiver» أو الـ
+
+319
+00:21:12,040 --> 00:21:15,020
+«Family Members» اللي قاله لو المريض نفسه «while
+
+320
+00:21:15,020 --> 00:21:17,380
+in sitting position» يعني ال «patient crosses her
+
+321
+00:21:17,380 --> 00:21:20,520
+arms» أو «his arms» «across two abdominal places
+
+322
+00:21:20,520 --> 00:21:24,360
+and interlocking hands below x-foi debris» بنفسه،
+
+323
+00:21:24,360 --> 00:21:27,580
+حيحط إيدي التنتين تحت بطنه وعلى منطقة الـ «x-foi
+
+324
+00:21:27,580 --> 00:21:32,040
+debris» اللي هي «فيرستيرنا»after deep inspiration
+
+325
+00:21:32,040 --> 00:21:36,380
+ال patient push inward upward and abdominal rest
+
+326
+00:21:36,380 --> 00:21:39,860
+forearms seamlessly lean forward while attempting
+
+327
+00:21:39,860 --> 00:21:43,680
+to coughing فبالتالي هو بيكون قاعد forward عشان
+
+328
+00:21:43,680 --> 00:21:48,960
+يحاول أنه يعمل ال coughing أول موضوع ال manual
+
+329
+00:21:48,960 --> 00:21:53,940
+اللي هو assist في عند ال splitting اللي هي الحاجة
+
+330
+00:21:53,940 --> 00:21:59,530
+التانية عشان أنا أساعد ال coughingلازم اضافة او
+
+331
+00:21:59,530 --> 00:22:03,070
+recent injury عام لسزيريا جديد للست فبالتالي هي
+
+332
+00:22:03,070 --> 00:22:07,790
+بحاجة لأنه اشي يمنع او يقلل من القلم اللي هيصير
+
+333
+00:22:07,790 --> 00:22:12,910
+اللي هو due to coughing فبالتالي ممكن انا اسمح
+
+334
+00:22:12,910 --> 00:22:15,930
+لهذا المريض انه يعمل هذا ال patient to press hand
+
+335
+00:22:15,930 --> 00:22:20,290
+and below or below يحط مخدة على ال abdominal area
+
+336
+00:22:20,290 --> 00:22:23,630
+to firmly over incision to support the painful
+
+337
+00:22:23,630 --> 00:22:27,610
+area withEach coughing if patient cannot reach
+
+338
+00:22:27,610 --> 00:22:31,690
+painful area the therapist should assist طبعا لأنه
+
+339
+00:22:31,690 --> 00:22:35,190
+بتكون السبت على سبيل المثال عاملة cesarea فبالتالي
+
+340
+00:22:35,190 --> 00:22:38,770
+هي بحاجة لإيش يعملها support زي ما انتوا شايفينه
+
+341
+00:22:38,770 --> 00:22:42,630
+هنا Splinting over an anterior surgical incision
+
+342
+00:22:43,210 --> 00:22:47,930
+وهنا طبعا الـ «سبلنتينج» خلف اللي هو لأن الـ
+
+343
+00:22:47,930 --> 00:22:50,270
+posterior lateral incision على سبيل المثال في الـ
+
+344
+00:22:50,270 --> 00:22:53,870
+lung كان عندنا فيه incision فبالتالي هنا حطت الإشي
+
+345
+00:22:53,870 --> 00:22:58,590
+أو الـ «سبلنتينج» posterior lateral الـ
+
+346
+00:22:58,590 --> 00:23:01,870
+homodification العامل التالت من العوامل اللي بتزيد
+
+347
+00:23:01,870 --> 00:23:05,390
+أو بتساعد في ال cuff pumping اللي هو الـ
+
+348
+00:23:05,390 --> 00:23:08,870
+homodification استخدام التبخير على سبيل المثال هي
+
+349
+00:23:08,870 --> 00:23:11,630
+بيستخدمها في حالة إذا كان ال «secretion» very
+
+350
+00:23:11,630 --> 00:23:16,290
+thickوالـ mucus مش جادر يطلع معايا لبرا فبالتالي
+
+351
+00:23:16,290 --> 00:23:19,190
+أنا في البداية بعمل humidification لل patient
+
+352
+00:23:19,190 --> 00:23:23,950
+after therapy، ultrasonic اللي هي الـ ultrasonic
+
+353
+00:23:23,950 --> 00:23:29,070
+الـ nuclear therapy but both in which enhance my
+
+354
+00:23:29,070 --> 00:23:31,990
+cellular transport system and facilitate
+
+355
+00:23:31,990 --> 00:23:36,050
+productive coughingهذا بيساعد في إنه يعمل لي الطفل
+
+356
+00:23:36,050 --> 00:23:39,270
+الصغير ال cuffing زي ما أنتوا شايفينها بتكون
+
+357
+00:23:39,270 --> 00:23:43,550
+التبخيرة تبقى في الأطفال على شكل ألعاب حتى إنه ما
+
+358
+00:23:43,550 --> 00:23:47,190
+يخاف منها و تكون على شكل play therapy يعني هنا أنا
+
+359
+00:23:47,190 --> 00:23:50,890
+بستخدمها مع أطفالي كتير منيها زي كده حاجات بتكون
+
+360
+00:23:50,890 --> 00:23:54,690
+في عليها رسومات فبالتالي هو الطفل بيكون متفاعل
+
+361
+00:23:54,690 --> 00:23:59,120
+معاها الطريقة الرابعة اللي هوالـ tracheal
+
+362
+00:23:59,120 --> 00:24:03,000
+stimulation طبعاً لحالات اللي ما بتقدر تعمل
+
+363
+00:24:03,000 --> 00:24:05,920
+cuffing الـ tracheal stimulation بتحصير أو الـ
+
+364
+00:24:05,920 --> 00:24:09,600
+tracheal tactile may used to infants زي ما حكيتلكم
+
+365
+00:24:09,600 --> 00:24:13,540
+في البداية أن هذا الطفل الصغير ما بيقدر أن يعمل
+
+366
+00:24:13,540 --> 00:24:16,720
+cuffing فبالتالي أنا ممكن أعمله stimulation عن
+
+367
+00:24:16,720 --> 00:24:19,940
+طريق اللي هو tongue depressors for example أو
+
+368
+00:24:19,940 --> 00:24:24,830
+disoriented في الحالات الـ disoriented اللي همالـ
+
+369
+00:24:24,830 --> 00:24:27,850
+Comatose patient «we cannot cooperate during a
+
+370
+00:24:27,850 --> 00:24:31,070
+treatment» تلاقي كل السيمولاتش in somewhat
+
+371
+00:24:31,070 --> 00:24:37,290
+uncomfortable maneuver Uncomfortable maneuver طبعا
+
+372
+00:24:37,290 --> 00:24:41,950
+اللي سيتت بس تخلص انا او بدي اخد اللي هو reflexive
+
+373
+00:24:41,950 --> 00:24:46,350
+cuffing حتى احفظ او اعمل مثير لإن هذا الطفل يعملي
+
+374
+00:24:46,350 --> 00:24:49,940
+cuffingبتلاقي two finger and sternal notch to
+
+375
+00:24:49,940 --> 00:24:53,940
+apply circular motion على منطقة الـ sternal notch
+
+376
+00:24:53,940 --> 00:24:56,920
+which pressure downward and track فسلة الـ
+
+377
+00:24:56,920 --> 00:25:00,180
+reflexes يعني ممكن زي ما حكينا هنا بالـ tongue
+
+378
+00:25:00,180 --> 00:25:04,380
+depressors وممكن كمان أحكي بطريقة أخرى عن طريق
+
+379
+00:25:04,380 --> 00:25:08,700
+اللي هووضع إيديا تنتين وأعمل حركة دائرية Circular
+
+380
+00:25:08,700 --> 00:25:13,620
+motions لاللي هو ضغط in downward and to facilitate
+
+381
+00:25:13,620 --> 00:25:16,960
+لreflexive
+
+382
+00:25:16,960 --> 00:25:20,580
+cuffing هيك بيكون أنا أخدت أربع طرق لاللي هو
+
+383
+00:25:20,580 --> 00:25:24,400
+increase ال cuff mechanism اللي هي ال manual
+
+384
+00:25:24,400 --> 00:25:30,620
+assist و ال trackless stimulation و أخدنا ال
+
+385
+00:25:30,620 --> 00:25:34,080
+humidification و الطريقة التالتة اللي هي عبارة عن
+
+386
+00:25:34,080 --> 00:25:39,330
+supplantingللي هو الـ cuff إذا أخدنا أربع
+
+387
+00:25:39,330 --> 00:25:41,790
+additional technique to improve airway clearness
+
+388
+00:25:41,790 --> 00:25:48,190
+ال manual assist و ال splinting و كمان في عندنا
+
+389
+00:25:48,190 --> 00:25:53,190
+اللي هو ال humidification و آخر حاجة أخدناها اللي
+
+390
+00:25:53,190 --> 00:25:58,000
+هو عبارة عن ال tracheal stimulationالان هحتكدث عن
+
+391
+00:25:58,000 --> 00:26:02,780
+اخر اشي اللى هو الـ Huffing لـ Airway Clearness
+
+392
+00:26:02,780 --> 00:26:07,380
+طبعا اللى انا حكيت عليها الطريقة التانية بالنسبة
+
+393
+00:26:07,380 --> 00:26:13,020
+لتنظيف اوجعل ممرات الهواء آمنة ونظيفة الـ Huffing
+
+394
+00:26:13,020 --> 00:26:16,320
+طبعا أحن من الـ Coughing احنا بنحكي عليها الـ
+
+395
+00:26:16,320 --> 00:26:21,580
+Huffing هي تمتاز بإنها forced expiration ولكن ليست
+
+396
+00:26:21,580 --> 00:26:24,340
+بالقوة اللتي فيها الـ Coughing a forced expiratory
+
+397
+00:26:24,340 --> 00:26:28,020
+effort made glutes remain open احنا لأ في الـ
+
+398
+00:26:28,020 --> 00:26:30,300
+Cuffing قلنا اللي glutes بيضلوا إيش closed في
+
+399
+00:26:30,300 --> 00:26:33,160
+البداية and the intertheracic pressure doesn't
+
+400
+00:26:33,160 --> 00:26:37,990
+raises such high level with coughingما بيرتفع عندي
+
+401
+00:26:37,990 --> 00:26:42,750
+اللي هو نتيجة ضغط الـ Intraturistic اللي هو بأعلى
+
+402
+00:26:42,750 --> 00:26:47,450
+زي اللي وصلته في الـ Cuffing وعلى الرغم من إنه هيك
+
+403
+00:26:47,450 --> 00:26:51,090
+إلا إن هذا الضغط بيعمل زيادة to produce
+
+404
+00:26:51,090 --> 00:26:54,610
+compressions and narrowing للترياكيا ضيق في
+
+405
+00:26:54,610 --> 00:26:59,170
+الترياكيا وللبرونكاي to secretion moved up وبتحرك
+
+406
+00:26:59,170 --> 00:27:04,240
+لبرونكاي الـ Tree وانا هذا اللي بديه أنه أناأعمل
+
+407
+00:27:04,240 --> 00:27:08,640
+على تحويل أو سحب هذا الـ mucus من اللي هو الـ lung
+
+408
+00:27:08,640 --> 00:27:12,960
+tissue أو من أي segment موجود فيه و أطلعه على اللي
+
+409
+00:27:12,960 --> 00:27:18,720
+هو ال bronchial tree عشان أعمل اللي هو remove لهذا
+
+410
+00:27:18,720 --> 00:27:22,680
+ال secretion بهيك مكون أنا حكيت في هذا الفيديو عن
+
+411
+00:27:22,680 --> 00:27:27,070
+ال cuff mechanism عن ال huffingو ان شاء الله رب
+
+412
+00:27:27,070 --> 00:27:30,970
+العالمين هنتحدث في الفيديو السابق الفيديو اللاحق
+
+413
+00:27:30,970 --> 00:27:35,150
+عن ال postural drainage و اللي هو الطريقة الثالثة
+
+414
+00:27:35,150 --> 00:27:41,050
+من ال airway clearness و بهيك يعطيكوا العافية و ان
+
+415
+00:27:41,050 --> 00:27:44,070
+شاء الله رب العالمين تكون سعيدة عليكم بالتعليم
+
+416
+00:27:44,070 --> 00:27:45,010
+الإلكتروني
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/K7Fw_5kjBzo.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/K7Fw_5kjBzo.srt
new file mode 100644
index 0000000000000000000000000000000000000000..161122f19be7411385abee26b93c272c6f05f4ae
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/K7Fw_5kjBzo.srt
@@ -0,0 +1,1446 @@
+1
+00:00:00,910 --> 00:00:04,900
+والصلاة والسلام على أشرف الأنبياء والمرسلين، نكمل
+
+2
+00:00:04,900 --> 00:00:08,260
+معاكم إن شاء الله في موضوع اللي هو الـ Cardiac
+
+3
+00:00:08,260 --> 00:00:12,000
+Rehabilitation، الآن هنشوف اللي هي محاضرة الـ
+
+4
+00:00:12,000 --> 00:00:16,120
+Intensive Care Unit، اللي هي الـ ICU، قسمت المحاضرة
+
+5
+00:00:16,120 --> 00:00:21,100
+إلى جزئين، اللي هو فيديو رقم 8 وفيديو رقم 9، في هذا
+
+6
+00:00:21,100 --> 00:00:24,760
+الفيديو الأول هنحكي فيه على مين الأشخاص اللي أنا
+
+7
+00:00:24,760 --> 00:00:28,920
+بدي أتعامل معاهم في الـ ICU، وشو أول هدف إلي كفيزيو
+
+8
+00:00:28,920 --> 00:00:33,240
+ثيرابيست في العناية المركزة، نبدأ على بركة الله
+
+9
+00:00:40,190 --> 00:00:43,150
+الـ patients are admitted to the intensive care unit if
+
+10
+00:00:43,150 --> 00:00:48,270
+they required  الأشخاص اللي أنا بدي أتعامل معاهم في
+
+11
+00:00:48,270 --> 00:00:52,590
+الـ ICU، دخلوا الـ ICU لهدفين، الهدف الأول إما إنهم
+
+12
+00:00:52,590 --> 00:00:57,440
+بحاجة لـ intensive therapy، إلى علاج مكثف، أو بحاجة لـ
+
+13
+00:00:57,440 --> 00:01:01,540
+Intensive Monitoring، مراقبة مشددة، يعني مريض بـ
+
+14
+00:01:01,540 --> 00:01:03,760
+Traumatic Brain Injury، على سبيل المثال، الـ
+
+15
+00:01:03,760 --> 00:01:07,440
+Unconscious، هو بحاجة لـ Intensive Therapy، و بحاجة
+
+16
+00:01:07,440 --> 00:01:10,640
+لـ Intensive Monitoring، فبالتالي هي أهم هدفين
+
+17
+00:01:10,640 --> 00:01:15,240
+لدخول المرضى إلى وحدة العناية المركزة، الـ ICU،
+
+18
+00:01:15,240 --> 00:01:20,670
+بتنقسم إلى أقسام وتفارعات متعددة، كل حالة حسب، أو كل
+
+19
+00:01:20,670 --> 00:01:25,470
+قسم بيرتقي أن هذا المريض بيخصه، على سبيل المثال،
+
+20
+00:01:25,470 --> 00:01:29,090
+الـ Neurosurgery، اللي هم ICU لحالهم، الـ respiratory
+
+21
+00:01:29,090 --> 00:01:34,030
+اللي هم unit لوحدهم، وكذلك الـ cardiac اللي احنا
+
+22
+00:01:34,030 --> 00:01:38,290
+هنتعامل معاه بهذه المحاضرة، اللي هم كمان نفس الشيء،
+
+23
+00:01:38,290 --> 00:01:43,730
+unit لوحدهم، هنشوف شو أهم أهدافنا في العلاج الطبيعي
+
+24
+00:01:43,730 --> 00:01:48,610
+في الـ ICU، أول شيء، وأول هدف عندي اللي هو assist
+
+25
+00:01:48,610 --> 00:01:52,510
+in removing the secretions، بدي أحاول أساعد المريض على
+
+26
+00:01:52,510 --> 00:01:57,550
+إن الـ airway يكون clear، يكون تماماً واضحاً، وتماماً
+
+27
+00:01:57,550 --> 00:02:02,620
+ما فيه أي عوائق لدخول وخروج الهواء، هذا أول هدف، الهدف
+
+28
+00:02:02,620 --> 00:02:06,160
+الثاني improvement of the ventilation of all areas of the
+
+29
+00:02:06,160 --> 00:02:10,200
+lungs، كل الـ lungs، أو الـ composition تبع الـ lungs
+
+30
+00:02:10,200 --> 00:02:14,440
+لازم تكون clear من أي secretion، يعني الـ
+
+31
+00:02:14,440 --> 00:02:18,900
+ventilation فيها هيكون تمام وبخير، maintaining the
+
+32
+00:02:18,900 --> 00:02:22,900
+mobility، بنعرف إن هو بعض الحالات ممكن تكون بدردن،
+
+33
+00:02:22,900 --> 00:02:26,580
+ممكن تكون completely paralysis، فبالتالي أنا بحاجة
+
+34
+00:02:26,580 --> 00:02:29,600
+لأن أنا أحافظ على الـ range of motion في الـ joints،
+
+35
+00:02:29,600 --> 00:02:33,380
+maintain a good posture for the patient، لازم أحافظ على
+
+36
+00:02:33,380 --> 00:02:37,620
+الوضع الصحيح للمرضى، decrease the patient's
+
+37
+00:02:37,620 --> 00:02:43,440
+hospital stay، لأن تقاسمدى نجاح المستشفى لأي مستشفى،
+
+38
+00:02:43,440 --> 00:02:47,440
+سواء كان governmental أو specialized، نجاحه بمدى
+
+39
+00:02:47,440 --> 00:02:51,260
+مكوث المرضى داخله، على سبيل المثال، يعني معظم
+
+40
+00:02:51,260 --> 00:02:55,720
+المستشفيات اللي هي زي مستشفيات داخل الخط الأخضر، أو
+
+41
+00:02:55,720 --> 00:02:59,910
+مستشفيات إسرائيل، بيوصلوا الحالة لحد ما يعرفوا إنه
+
+42
+00:02:59,910 --> 00:03:03,810
+هي على سبيل المثال، وصلت لمرحلة الـ «موت»، فبالتالي
+
+43
+00:03:03,810 --> 00:03:07,710
+بيروحوا هم محاولينها على الشفاء، حتى ما تنحسب عليهم
+
+44
+00:03:07,710 --> 00:03:11,310
+حالة وفاة داخل هذا المستشفى، تمام؟ لأن
+
+45
+00:03:11,310 --> 00:03:15,030
+الـ «Hospital Death Day»، والـ «death» للـ «patient»،
+
+46
+00:03:15,030 --> 00:03:20,150
+هذا بيزيد من سمعة المستشفى اللي هو فيها هذا المريض،
+
+47
+00:03:20,400 --> 00:03:24,340
+فبالتالي أنا كل ما كان إيه لي دور أفضل في الـ ICU،
+
+48
+00:03:24,340 --> 00:03:27,960
+كل ما أنا قللت من الـ hospital stays تبعت للـ
+
+49
+00:03:27,960 --> 00:03:32,760
+patients، فبالتالي هو هدف كثير مهم على صعيد سواء
+
+50
+00:03:32,760 --> 00:03:36,640
+economic، أو على صعيد اللي هو الصّمعة تبعت هذا
+
+51
+00:03:36,640 --> 00:03:39,740
+المستشفى، هلأ شو الـ most common techniques اللي أنا
+
+52
+00:03:39,740 --> 00:03:43,910
+بدي أستخدمهم في الـ intensive care unit؟ فيه حاجة
+
+53
+00:03:43,910 --> 00:03:46,990
+اسمها الـ postural drainage، وهتكلم عنه بشكل كبير،
+
+54
+00:03:46,990 --> 00:03:51,270
+وواضح في ICU 2 أيضاً، اللي هي الـ percussion، والـ
+
+55
+00:03:51,270 --> 00:03:55,990
+vibration to remove secretions، tracheal suction، والـ
+
+56
+00:03:55,990 --> 00:03:59,670
+lavage and cuffing، اللي هو كمان هتكلم على تركيب
+
+57
+00:03:59,670 --> 00:04:03,930
+لـ tubes، وكيف أنا ممكن أتعامل مع هؤلاء المرضى في
+
+58
+00:04:03,930 --> 00:04:07,030
+خلال وجود الـ tubes، الـ mobilization techniques زي
+
+59
+00:04:07,030 --> 00:04:09,430
+الـ passive range of motion، والـ active range of motion،
+
+60
+00:04:09,700 --> 00:04:13,820
+breathing exercises and incentive، اللي هو الـ
+
+61
+00:04:13,820 --> 00:04:16,560
+spirometers، وهو جهاز إن شاء الله رب العالمين
+
+62
+00:04:16,560 --> 00:04:21,560
+هتشوفوه في العملية، الـ methods للـ airway clearance،
+
+63
+00:04:21,560 --> 00:04:27,980
+هتكلم على ست طرق لخلو اللي هو ممرّات الهواء من أيّ
+
+64
+00:04:27,980 --> 00:04:33,880
+secretions تعيق تبادل الغازات، الآن أول طريقة اللي
+
+65
+00:04:33,880 --> 00:04:36,930
+هي عن طريق ciliary action، الـ ancillary action
+
+66
+00:04:36,930 --> 00:04:40,810
+causes a mucous blanket to cover the tracheobronchial
+
+67
+00:04:40,810 --> 00:04:44,690
+epithelia، mobilized، هذه الأهداف اللي
+
+68
+00:04:44,690 --> 00:04:48,700
+موجودة زي ما أنتم شايفينها، هي عبارة عن حركة
+
+69
+00:04:48,700 --> 00:04:52,020
+الأهداب، والـ cilia and villi، اللي هي الـ
+
+70
+00:04:52,020 --> 00:04:55,880
+microvilli، أو بنسميها الخمائل الرقيقة، بتعمل على
+
+71
+00:04:55,880 --> 00:04:59,140
+حركة، هي زي ما أنتم شايفينها تحت المايكروسكوب، هي
+
+72
+00:04:59,140 --> 00:05:03,040
+طبعاً goblet cells، خلايا كأسية، هذه الخلايا الكأسية
+
+73
+00:05:03,040 --> 00:05:07,080
+بتعمل على حركة ودفع اللي هو الـ secretion إلى
+
+74
+00:05:07,080 --> 00:05:10,680
+ممراته العليا، حتى يتم اللي هو عن طريق الـ cuffing
+
+75
+00:05:10,680 --> 00:05:15,290
+إخراجه إلى الخارج، إذن الـ epithelium، أو اللي هو
+
+76
+00:05:15,290 --> 00:05:18,510
+طبعاً من ال simple epithelium tissue to mobilize in
+
+77
+00:05:18,510 --> 00:05:22,390
+continuous motion toward the hilum of the lung، لأن الـ
+
+78
+00:05:22,390 --> 00:05:27,690
+hilum تبع الـ lung، اللي هي المادة أو النسيج
+
+79
+00:05:27,690 --> 00:05:32,280
+الرئوي، اللي هو عبارة عن نسيج هلامي، الـ two larynx،
+
+80
+00:05:32,280 --> 00:05:35,640
+بتتم إخراجه إلى الـ larynx، حتى يتم إخراجه عن طريق
+
+81
+00:05:35,640 --> 00:05:39,520
+البلعوم، إلا إنه يستمر للخروج عن طريق الـ cuffing
+
+82
+00:05:39,520 --> 00:05:44,140
+أو الـ swallowing، وإنه يتم قشعه، أو يتم رميه خارج الجسم،
+
+83
+00:05:44,140 --> 00:05:47,780
+فبالتالي هنا، من لو حكينا أنا بدي أشتغل على الـ
+
+84
+00:05:47,780 --> 00:05:50,540
+lobes اللي هنا، الـ lower lobes، أو في قاع الـ basal
+
+85
+00:05:50,540 --> 00:05:55,010
+lobes، خلينا نحكي القاعدة الأساسية، لأ الـ Lung، بدي يتمّ
+
+86
+00:05:55,010 --> 00:05:58,430
+إخراجه عن طريق السيليا، لكن هذه الأهداب لازم أن
+
+87
+00:05:58,430 --> 00:06:02,770
+تكون بصحة جيدة، وتكون بكفاءة عالية تشتغل، يعني على
+
+88
+00:06:02,770 --> 00:06:06,050
+سبيل المثال، مدخنين، ما هتكون كفائتهم عالية، ولا
+
+89
+00:06:06,050 --> 00:06:08,930
+الناس اللي استخدمت أو عندها lung disease، على سبيل
+
+90
+00:06:08,930 --> 00:06:12,710
+المثال، هيأثر في حركة الأهداب، والأشياء اللي موجودة
+
+91
+00:06:12,710 --> 00:06:16,970
+هنا، خلينا نشوف هذا الـ mucous blanket moves reasonably
+
+92
+00:06:16,970 --> 00:06:22,560
+at a rate of 16 mm per minute، and can completely
+
+93
+00:06:22,560 --> 00:06:25,880
+clean a normal adult lung in less than 20 minutes،
+
+94
+00:06:25,880 --> 00:06:29,740
+بالـ cuffing، أنا بستطيع أنه أنا أخرج هذا الـ secretion،
+
+95
+00:06:29,740 --> 00:06:33,760
+عن طريق الـ mouth، بالـ cuffing، تمام؟ فبالتالي هيك أنا
+
+96
+00:06:33,760 --> 00:06:37,960
+بخلص الجسم، هلأ الـ ciliary activity is impaired with a
+
+97
+00:06:37,960 --> 00:06:41,740
+history of smoking، لسه أنا كنت بحكي أنه أنا ممكن
+
+98
+00:06:42,030 --> 00:06:45,650
+هذه اللي هي الأهداب اللي موجودة عنده داخل
+
+99
+00:06:45,650 --> 00:06:49,930
+الرئتين، أنها تتأثر بالمدخنين، بالـ surgery،
+
+100
+00:06:49,930 --> 00:06:53,710
+anesthesia، طبعاً، للـ trauma، أي إصابة، أي lung
+
+101
+00:06:53,710 --> 00:06:57,890
+disease، على سبيل المثال، pneumonia، bronchitis، أيّ
+
+102
+00:06:57,890 --> 00:07:02,010
+شيء بيأثر في وجود اللي هو أو حركة الأهداب اللي
+
+103
+00:07:02,010 --> 00:07:04,970
+موجودة، الـ pain كمان، والـ obesity، a conventional
+
+104
+00:07:04,970 --> 00:07:08,470
+recovery أيضاً، من العوامل اللي بتأثر في حركة هذه
+
+105
+00:07:08,470 --> 00:07:12,300
+الأهداب،الأساسية techniques للـ Clearance، زي الـ
+
+106
+00:07:12,300 --> 00:07:14,980
+Cuffing، والـ Suction، الـ Cuffing اللي هو طبعاً فيه
+
+107
+00:07:14,980 --> 00:07:17,380
+شيء stimulation، أنا بحفزه عشان المريض يعمل ليه
+
+108
+00:07:17,380 --> 00:07:21,500
+coughing، ويطلع هذا secretion، أما الـ Suction اللي
+
+109
+00:07:21,500 --> 00:07:25,740
+هو بعمله لـ tubes، أو عن طريق machine، طبعاً عشان أنا
+
+110
+00:07:25,740 --> 00:07:29,060
+أعمل اللي هو suction لهذا الـ secretion، وأريح الـ
+
+111
+00:07:29,060 --> 00:07:32,090
+patient، وأخلي الـ airway clear، becoming
+
+112
+00:07:32,090 --> 00:07:35,410
+increasingly important in the prevention of atelectasis
+
+113
+00:07:35,410 --> 00:07:38,890
+and pulmonary infections، لأنه ليش؟ هيكون فيه
+
+114
+00:07:38,890 --> 00:07:42,390
+secretion، وهذا الـ secretion فيه بيروجينات، وفي أمور
+
+115
+00:07:42,390 --> 00:07:49,270
+مش مظبوطة، فبالتالي بتعيق حركة اللي هو الـ airway،
+
+116
+00:07:49,270 --> 00:07:54,160
+العامل الثاني، أو الطريقة الثانية، اللي هي من أحد
+
+117
+00:07:54,160 --> 00:07:57,760
+الطرق اللي احنا حكينا عليها، الـ Cuffing، الـ
+
+118
+00:07:57,760 --> 00:08:00,120
+Cuffing is considered an extremely important
+
+119
+00:08:00,120 --> 00:08:04,220
+mechanism to remove lung secretions، من أهم الطرق،
+
+120
+00:08:04,220 --> 00:08:08,380
+وبنعرف إن الـ center اللي موجود في الـ brain،
+
+121
+00:08:08,380 --> 00:08:11,840
+بستعمل الـ Cuffing، بتحفزه، حتى اللي هو يصير فيه
+
+122
+00:08:11,840 --> 00:08:15,840
+عندنا coughing reflex، فبالتالي الأطفال اللي هم من عمر
+
+123
+00:08:15,840 --> 00:08:19,700
+أشهر لسنة، ما بيكون عندهم شغال الـ Coughing Reflex،
+
+124
+00:08:19,700 --> 00:08:24,700
+لأ، بيصير احنا نعملهم stimulation، حتى إيه ما نفعّل
+
+125
+00:08:24,700 --> 00:08:27,320
+الـ Coughing، يا إما عن طريق الـ Tongue Depressors،
+
+126
+00:08:27,320 --> 00:08:31,500
+أو عن طريق أي شيء، بحيث إنه أنا أحفّزهم، على المساج،
+
+127
+00:08:31,500 --> 00:08:34,380
+اللي هو الـ Vibration، والـ Percussion، حتى أنا
+
+128
+00:08:34,380 --> 00:08:38,720
+أخرج هذا الـ Secretion، بالإضافة لإنه الـ Coughing
+
+129
+00:08:38,720 --> 00:08:42,240
+is a major defense against retained or noisy secretions،
+
+130
+00:08:42,580 --> 00:08:46,080
+بتمّ اللي هو عبارة عن إن الـ Cuffing، ما بتبقى شيء
+
+131
+00:08:46,080 --> 00:08:50,240
+مهم جداً، بنخاف على الأطفال، ليه؟ لأن حكينا ما فيه
+
+132
+00:08:50,240 --> 00:08:53,820
+عندهم أي Reflex للـ Cuffing، فبالتالي أنا
+
+133
+00:08:53,820 --> 00:08:56,680
+ما أقدرش أخليه يعمل Cuffing، يعني ما أقدرش أوصل اللي
+
+134
+00:08:56,680 --> 00:08:59,700
+هو اللي بلعومه لمرحلة، أو عنده اللي بلعومه وأحكيله
+
+135
+00:08:59,700 --> 00:09:04,020
+يلاّ أعمل كحة، لأنه ما حيفهم عليه كمان، فبالتالي
+
+136
+00:09:04,020 --> 00:09:07,440
+إنه هيكون ناجح وفعال الـ Cuffing مع اللي هم الـ
+
+137
+00:09:07,440 --> 00:09:11,590
+Children، أو اللي هم الـ Adults وما بعد ذلك، الـ
+
+138
+00:09:11,590 --> 00:09:14,490
+Cough Mechanism، لازم يكون في عندنا Educate
+
+139
+00:09:14,490 --> 00:09:20,810
+Inspiratory Volume، نفس عميق، Inspiration، بعدين
+
+140
+00:09:20,810 --> 00:09:24,950
+Inspiration، بوقفه، فبالتالي هيك أنا بحبس النفس،
+
+141
+00:09:24,950 --> 00:09:30,590
+بيعمل stimulation لعملية الـ coughing، الآن لسان
+
+142
+00:09:30,590 --> 00:09:34,950
+المزمار مغلق، وكل ما زدت أنا، أو خلقت لسان المزمار،
+
+143
+00:09:34,950 --> 00:09:37,950
+هذا هيعطيني الـ function تبعته، important part في الـ
+
+144
+00:09:37,950 --> 00:09:41,210
+effective cough mechanism، هيعطيني وظيفة مهمة جداً في الـ
+
+145
+00:09:41,210 --> 00:09:44,130
+coughing، increase للـ intra thoracic pressure، إذا
+
+146
+00:09:44,130 --> 00:09:46,570
+أنا زدت الـ intra thoracic pressure، معناه الكلام
+
+147
+00:09:46,570 --> 00:09:51,540
+إني أنا هرفع، اللي هو أزيد كمان الـ intra-abdominal
+
+148
+00:09:51,540 --> 00:09:55,220
+pressure، مما يؤدي إلى رفع، أو يعمل pushing down
+
+149
+00:09:55,220 --> 00:09:58,880
+للديافراغم، واحنا حكينا الديافراغم هي mainly
+
+150
+00:09:58,880 --> 00:10:02,140
+respiratory muscles اللي موجودة في جسم الإنسان،
+
+151
+00:10:02,140 --> 00:10:07,240
+عضلة أساسية للّي هو respiration، طبعاً هذا هيقلل
+
+152
+00:10:07,240 --> 00:10:10,700
+من الـ volume تبع الـ thoracic cavity، هيك العملية
+
+153
+00:10:10,700 --> 00:10:16,710
+بتصير، إذا أنا أغلقت لسان المزمار، الـ glottis closed،
+
+154
+00:10:16,710 --> 00:10:19,550
+هيسير فيه عندنا increase للـ thoracic abdominal،
+
+155
+00:10:19,550 --> 00:10:22,530
+increasing للـ intra-thoracic abdominal pressure،
+
+156
+00:10:22,530 --> 00:10:24,830
+أول شيء الـ thoracic pressure، بعدين الـ intra
+
+157
+00:10:24,830 --> 00:10:29,930
+-abdominal pressure، هيعمل على pushing up، اللي هي
+
+158
+00:10:29,930 --> 00:10:34,610
+diaphragm، upward، then decreasing للـ thoracic cavity،
+
+159
+00:10:34,610 --> 00:10:38,710
+هذا بيخلي اللي هو تحفيز للـ coughing، أنه يصير عند
+
+160
+00:10:38,710 --> 00:10:44,240
+الشخص، بعد هيك هوصل لمرحلة اللي هو إني أنا أفتح لسان
+
+161
+00:10:44,240 --> 00:10:47,020
+المزمار، إذا أنا فتحت لسان المزمار، معناه الحقيقة
+
+162
+00:10:47,020 --> 00:10:51,320
+إني أنا بدي اللي هو إني الـ cough يطلع لبرا، و
+
+163
+00:10:51,320 --> 00:10:55,000
+الهواء يطلع لبرا، فبالتالي بيصاحب خروج الـ secretion،
+
+164
+00:10:55,000 --> 00:10:58,180
+after intra-alveolar pressure increase، the
+
+165
+00:10:58,180 --> 00:11:01,800
+glottis suddenly opens، بيحدث فجأة هذا الانفتاح،
+
+166
+00:11:01,800 --> 00:11:06,160
+بيحدث فجأة للسماح بسرعة عالية لخروج الهواء من الـ
+
+167
+00:11:06,160 --> 00:11:10,630
+lungs، الـ Peak Flow تبعته حوالي 300 لتر لكل دقيقة،
+
+168
+00:11:10,630 --> 00:11:14,790
+لكل ثانية، لكل دقيقة، إذاً أولاً Inspiration، عملنا تحفيز،
+
+169
+00:11:14,790 --> 00:11:19,490
+بدخول الهواء، Inspiration، compression، ضغطه، بعدين
+
+170
+00:11:19,490 --> 00:11:22,250
+صار في عندنا اللي هو الـ Glottis، لما بده يحصل فيه
+
+171
+00:11:22,250 --> 00:11:25,390
+Opening، بده يحصل في عندنا Explosion، خروج الهواء،
+
+172
+00:11:25,390 --> 00:11:31,630
+بشكل قوي جداً، الآن كيف إن هذه الـ Coughing بده
+
+173
+00:11:31,630 --> 00:11:35,350
+يُحصل فيها Suppression، أو عملية كبح، أو عملية عدم
+
+174
+00:11:35,770 --> 00:11:39,390
+اللي هو استمرار الـ Coughing، عن طريقين، أول شيء
+
+175
+00:11:39,390 --> 00:11:43,710
+فيه عندنا involuntary، وفيه عندنا voluntary، الـ involuntary
+
+176
+00:11:43,710 --> 0
+
+223
+00:14:53,850 --> 00:14:56,810
+يعني النفس أخليه من الـ deep breathing فبالتالي بدي
+
+224
+00:14:56,810 --> 00:15:00,550
+أزيد الـ lung volume by achieving by accommodating
+
+225
+00:15:00,550 --> 00:15:02,770
+an inspiratory effect to make more than
+
+226
+00:15:02,770 --> 00:15:07,780
+effectiveness على الـ External Tracheal Stimulation
+
+227
+00:15:07,780 --> 00:15:09,680
+اللي كنت بحكي عليه إنه أنا أعمل .. بدي أعمل
+
+228
+00:15:09,680 --> 00:15:13,460
+Stimulation عشان أحصل على الـ Cuffing. This
+
+229
+00:15:13,460 --> 00:15:17,600
+achieved by applying manual pressure للـ thoracic
+
+230
+00:15:17,600 --> 00:15:23,120
+أو للـ Trachea. أسفة، above Manubrium Notches اللي
+
+231
+00:15:23,120 --> 00:15:26,740
+هو فوق. عدم تلقّاس في عندنا اللي هو مقبض الصدر لو
+
+232
+00:15:26,740 --> 00:15:30,140
+رجعنا شوية Anatomy. فعدم تلقّاس في عندنا فوق اللي هو
+
+233
+00:15:30,140 --> 00:15:33,640
+بدي يكون Manubrium وهنا الـ body و تحت الـ X-fiber
+
+234
+00:15:33,640 --> 00:15:36,860
+process. أنا على الـ Manubrial Notch بدي أضغط عليها
+
+235
+00:15:36,860 --> 00:15:40,420
+فبالتالي أنا بعمل stimulation للـ cuffing this
+
+236
+00:15:40,420 --> 00:15:44,220
+creates partial trachea compression. هذا بيعطينا
+
+237
+00:15:44,220 --> 00:15:47,200
+ضغط على الـ tracheal compression which can cause
+
+238
+00:15:47,200 --> 00:15:50,620
+mechanical stimulation للـ cuff mechanism. كمان عند
+
+239
+00:15:50,620 --> 00:15:53,720
+الأطفال ممكن عن طريق الـ tongue depressors إنه أنا
+
+240
+00:15:53,720 --> 00:15:57,460
+أفوتها في فم الطفل فبالتالي بعمل stimulation للـ
+
+241
+00:15:57,460 --> 00:16:02,060
+cuff. فبيروح الطفل و هو بعد كده بيعمل كحة. عندنا هذه
+
+242
+00:16:02,060 --> 00:16:06,160
+الأربع طرق للـ Cuff Stimulation. تمام. الـ Huffing و
+
+243
+00:16:06,160 --> 00:16:09,640
+أخدنا الـ Deep Breathing و الـ External Tracheal
+
+244
+00:16:09,640 --> 00:16:13,520
+Stimulation و أيضا اللي هي الـ Vibration. أحد طرق
+
+245
+00:16:13,520 --> 00:16:21,300
+المساج. الآن هدخل في الطريقة الخامسة من اللي هو الـ
+
+246
+00:16:21,300 --> 00:16:24,700
+Clearing للـ Airway Stimulation عن طريق الـ
+
+247
+00:16:24,700 --> 00:16:28,000
+Oropharynx with suction catheter. لاحظوا معايا
+
+248
+00:16:28,000 --> 00:16:33,400
+حكينا Oro معناته فموي، هيكون من الفم، هنا Naso إذا
+
+249
+00:16:33,400 --> 00:16:37,120
+كانت الـ tube فايتة من الأنف، Nasopharynx إذا كانت
+
+250
+00:16:37,120 --> 00:16:40,560
+فايتة من الفم، Oropharynx. الـ catheter اللي هي
+
+251
+00:16:40,560 --> 00:16:43,620
+عبارة عن الـ tubes اللي أنا بدي أفوتها داخل جسم
+
+252
+00:16:43,620 --> 00:16:47,120
+الإنسان. و الـ none above method of cough
+
+253
+00:16:47,120 --> 00:16:49,500
+stimulation is successful. وقت إيه أنا بدي
+
+254
+00:16:49,500 --> 00:16:53,740
+أستخدمها؟ في حالة فشل الطرق الأربع اللي أنا حكيت
+
+255
+00:16:53,740 --> 00:16:58,130
+عليهم للـ airway clearance. هدخل في الطريقة الخامسة
+
+256
+00:16:58,130 --> 00:17:02,990
+وهي مؤلمة جدا، وإن فشلت الطريقة الخامسة، هفوت بالـ
+
+257
+00:17:02,990 --> 00:17:05,670
+suction machine على طول، يا إما بدي أفتح
+
+258
+00:17:05,670 --> 00:17:09,670
+Tracheostomy. فتحها في داخل الحلق اللي هي
+
+259
+00:17:09,670 --> 00:17:14,130
+Tracheostomy في داخل القصبة الهوائية أو عن طريق اللي هو
+
+260
+00:17:14,130 --> 00:17:18,110
+الـ mouth و أدخل tube زي ما حكينا Oropharynx و أعمل
+
+261
+00:17:18,110 --> 00:17:23,450
+اللي هو suction. هذه الست طرق للـ airway clearance.
+
+262
+00:17:23,450 --> 00:17:28,480
+تمام؟ هلأ شو الـ complications تبعت الـ cuff؟ أنا ممكن
+
+263
+00:17:28,480 --> 00:17:32,940
+أدخل في complications أو مضاعفات في الـ cuffing على
+
+264
+00:17:32,940 --> 00:17:35,520
+صعيد الـ respiratory system. هيصير في عندنا
+
+265
+00:17:35,520 --> 00:17:39,260
+bronchoconstriction و أنا ما بدي يصير هذا الشيء.
+
+266
+00:17:39,260 --> 00:17:42,860
+لازم يكون عند الـ bronchi بوضعها الطبيعي، الـ normal
+
+267
+00:17:42,860 --> 00:17:47,000
+حتى لو كانت في constriction ممكن أعطيه
+
+268
+00:17:47,000 --> 00:17:50,880
+bronchodilators. موسّع للشعب الهوائي. الـ trauma to
+
+269
+00:17:50,880 --> 00:17:55,570
+airways and larynx. بلا trauma. نيموثوراكس.
+
+270
+00:17:55,570 --> 00:17:59,730
+Interstitial emphysema. هاي كلها بتصير على صعيد الـ
+
+271
+00:17:59,730 --> 00:18:04,210
+respiratory system. hemodynamic، hemoblood، dynamic
+
+272
+00:18:04,210 --> 00:18:09,420
+movement، decrease للـ venous return. تمام، هنا على
+
+273
+00:18:09,420 --> 00:18:12,720
+الصعيد اللي هو الـ vessels و الـ blood و الأمور
+
+274
+00:18:12,720 --> 00:18:16,580
+اللي هي علاقة بالـ circulation. ألثسميا، transit
+
+275
+00:18:16,580 --> 00:18:20,400
+ischemic أو systemic hypertension and hypotension.
+
+276
+00:18:20,400 --> 00:18:23,820
+تمام، هذه أحد الـ complications اللي بتصير على
+
+277
+00:18:23,820 --> 00:18:28,500
+الصعيد أو على مجال اللي هو الـ circulatory، cerebral
+
+278
+00:18:28,940 --> 00:18:33,520
+ممكن يدخل المريض في حالة إغماء أو فقدان للوعي تمام
+
+279
+00:18:33,520 --> 00:18:36,760
+بسبب زيادة في كمية الأكسجين أو نقص في كمية
+
+280
+00:18:36,760 --> 00:18:40,280
+الأكسجين اللي واصلة للدماغ. على صعيد الـ chest
+
+281
+00:18:40,280 --> 00:18:43,420
+wall، ممكن يصير في عندنا rib fractures. مش إحنا حكينا
+
+282
+00:18:43,420 --> 00:18:46,500
+في الـ tracheal stimulation إنه أنا بدي أعمل
+
+283
+00:18:46,500 --> 00:18:49,590
+stimulation في الـ manubrium. فبالتالي ممكن لو كان
+
+284
+00:18:49,590 --> 00:18:52,770
+المريض مصاب بـ osteoporosis على سبيل المثال أو عنده أو أنا
+
+285
+00:18:52,770 --> 00:18:56,310
+إجيت عملت الـ stimulation بطريقة قوية جدا وفي عنده
+
+286
+00:18:56,310 --> 00:18:59,750
+pathological أو شيء مرضي. لأن هذا الشخص، الـ patient
+
+287
+00:18:59,750 --> 00:19:03,790
+ممكن أسبب له fractures أو ممكن يصير في عندي
+
+288
+00:19:03,790 --> 00:19:08,710
+ruptures للـ muscles اللي هي rectus abdominis. أيضا
+
+289
+00:19:08,710 --> 00:19:13,370
+في حاجات ثانية ممكن تصير أو متعلقات أخرى بنسميها
+
+290
+00:19:13,370 --> 00:19:16,550
+زي الـ urinary incontinence. ممكن من الـ complications
+
+291
+00:19:16,550 --> 00:19:21,750
+أو pulmonary emboli اللي هي عبارة عن embolism تمشي
+
+292
+00:19:21,750 --> 00:19:24,450
+مع الـ pulmonary. هذه الخامسة هي عبارة عن
+
+293
+00:19:24,450 --> 00:19:28,750
+complications للـ cuffing اللي أنا هعملها مش بإرادة
+
+294
+00:19:28,750 --> 00:19:32,030
+المريض. الـ cuffing اللي أنا هعملها غصب عن المريض أو
+
+295
+00:19:32,030 --> 00:19:36,240
+هعملها ضد إرادته. شو الـ tracheal suction؟ الـ
+
+296
+00:19:36,240 --> 00:19:40,140
+suction is performed routinely in a tube, yet يعني
+
+297
+00:19:40,140 --> 00:19:44,820
+أنا ببدأ أفوت tube داخل الـ patient to remove and
+
+298
+00:19:44,820 --> 00:19:48,520
+cuffing secretions. عشان أشيل الـ secretions وممكن عشان
+
+299
+00:19:48,520 --> 00:19:52,120
+أعمل cuffing. الـ frequency تبعته determined by
+
+300
+00:19:52,120 --> 00:19:56,640
+quantity of secretion. كم هي كمية الـ secretions؟ هل هو مش
+
+301
+00:19:56,640 --> 00:20:00,380
+قادر يتنفس فعلا من إنه في عندي blocking أو blockage
+
+302
+00:20:00,380 --> 00:20:06,880
+اللي هي انسداد للـ airway بالـ secretions ولا كيف؟ أنا بدي
+
+303
+00:20:06,880 --> 00:20:11,810
+أعمل. تمام؟ الأوروفارينجال زي ما حكينا أورو من الفم
+
+304
+00:20:11,810 --> 00:20:16,530
+و nasal من الأنف. الأوروفارينجال airway بستخدمها للـ
+
+305
+00:20:16,530 --> 00:20:19,490
+unconscious patient. ليه؟ لأن لو استخدمت
+
+306
+00:20:19,490 --> 00:20:23,430
+الأوروفارينجال للـ patient الـ conscious، هذا هيعمل لي
+
+307
+00:20:23,430 --> 00:20:26,150
+اللي هو vomiting. فبالتالي بيصير في عندنا
+
+308
+00:20:26,150 --> 00:20:28,990
+aspiration. عملية الـ aspiration هي عبارة عن عملية
+
+309
+00:20:28,990 --> 00:20:32,910
+الاستنشاق. لأن ممكن يكون الـ patient عندي conscious
+
+310
+00:20:32,910 --> 00:20:36,390
+و واعي و بياكل و أنا أروح أعمله أوروفارينجال، فبالتالي
+
+311
+00:20:36,390 --> 00:20:40,010
+ممكن أفوت اللي هو الـ Digestive System على الـ
+
+312
+00:20:40,010 --> 00:20:43,830
+Respiratory System. مما يؤدي لحدوث اللي هي الـ
+
+313
+00:20:43,830 --> 00:20:47,770
+Aspiration. و أنا هنا هفوت في مشاكل ثانية. هلأ الـ
+
+314
+00:20:47,770 --> 00:20:52,090
+Proper Size. سببها الـ Oropharyngeal تعتمد أو ممكن
+
+315
+00:20:52,090 --> 00:20:56,690
+أنا أقدرها من المسافة الواقعة من اللي هي. Check and
+
+316
+00:20:56,690 --> 00:20:59,910
+Measuring للـ Distance from Corner of Mouth to Ear.
+
+317
+00:21:00,220 --> 00:21:03,540
+من اسمها oro معناه فم. دي المسافة من الأنف إلى
+
+318
+00:21:03,540 --> 00:21:07,040
+الأذن. زي ما أنتم شايفينها من الـ mouth. أسفة، من
+
+319
+00:21:07,040 --> 00:21:12,880
+الفم للأذن. هي بيسميها الـ oropharyngeal. هاي هأعملها
+
+320
+00:21:12,880 --> 00:21:16,960
+هنا بعض الصور. اللي هي هذه المسافة من الـ corner من
+
+321
+00:21:16,960 --> 00:21:23,090
+زاوية الفم لـ اللي هي الأذن. تمام. نيجي نشوف الـ
+
+322
+00:21:23,090 --> 00:21:26,450
+nasopharyngeal. الاستخدامات الـ nasopharyngeal
+
+323
+00:21:26,450 --> 00:21:29,970
+لحالات الـ conscious. ممكن أستخدمها مع الناس اللي هم
+
+324
+00:21:29,970 --> 00:21:34,210
+واعين و okay. لأن ما في عندي مشاكل في اللي هي الـ
+
+325
+00:21:34,210 --> 00:21:38,140
+aspiration. الـ advantage تبعتها، حكينا بنستخدمها مع
+
+326
+00:21:38,140 --> 00:21:41,020
+الـ conscious و الـ semi-conscious كمان. to be air
+
+327
+00:21:41,020 --> 00:21:43,960
+-tolerate. أما الـ proper distance تبعتها هي تكون من
+
+328
+00:21:43,960 --> 00:21:48,320
+الـ tip of the thing في الأنف لحجم توصل الـ air
+
+329
+00:21:48,320 --> 00:21:52,800
+بالإضافة إلى واحد inch. يعني لو كانت المسافة مثلا
+
+330
+00:21:52,800 --> 00:21:57,380
+عشرة سنتي من الأنف لحافة الأذن، بزيد عليها كمان
+
+331
+00:21:57,380 --> 00:22:01,140
+واحد. قبل الـ insertion، اللي هي الـ airway should be
+
+332
+00:22:01,140 --> 00:22:07,460
+lubricated and of water or soluble lubricant. قبل ما
+
+333
+00:22:07,460 --> 00:22:12,460
+أغرس هذا التيوب الصغير. ممكن أنا يا إما بغمسه في
+
+334
+00:22:12,460 --> 00:22:18,800
+ماء أو إنه بحط عليه جل حتى إنه يصير بشكل جيد. تمام؟
+
+335
+00:22:18,800 --> 00:22:21,800
+و يكون سهل اللي هو الـ intubation أو سهل الإدخال
+
+336
+00:22:21,800 --> 00:22:28,110
+تبعه. هاي هو، هيلاحظوا الأنف؟ من اللي هي الأنف لـ
+
+337
+00:22:28,110 --> 00:22:32,670
+mouth بقيس المسافة و بدخل على طول إلى الداخل. تمام.
+
+338
+00:22:32,670 --> 00:22:39,970
+هذه هي. أنا فوته من الأنف و دخل لجوة الـ angiotube
+
+339
+00:22:39,970 --> 00:22:42,650
+اللي هو الـ nasogastric. كمان ممكن، بس هيوصل للـ
+
+340
+00:22:42,650 --> 00:22:46,310
+gastric تحت، للـ abdomen. it's painful, painful,
+
+341
+00:22:46,310 --> 00:22:51,400
+painful. الـ Endotracheal tube كمان نفس الشيء. to
+
+342
+00:22:51,400 --> 00:22:54,860
+prevent airway obstruction. أيضًا من أهدافه تسهيل
+
+343
+00:22:54,860 --> 00:22:58,080
+إجراءات الـ suction و provide mechanical
+
+344
+00:22:58,080 --> 00:23:01,940
+ventilation and protect للـ airway من أي foreign body.
+
+345
+00:23:01,940 --> 00:23:05,860
+تمام؟ الـ Endotracheal tubes، إن أنا دخلت على الـ
+
+346
+00:23:05,860 --> 00:23:10,040
+Endotracheal مصنوع من الـ polyvinyl chloride أو
+
+347
+00:23:10,040 --> 00:23:13,590
+السيليكون. حتى يكون طريًا. لأنه هو rigid لما يكون برا
+
+348
+00:23:13,590 --> 00:23:17,930
+ولكن مع حرارة الجسم بيصير أكثر soft. فبالتالي أنا
+
+349
+00:23:17,930 --> 00:23:20,890
+لما يكون في إيدي rigid لكن لما بدخل داخل جسم
+
+350
+00:23:20,890 --> 00:23:27,170
+الإنسان بيصير أكثر soft مع اللي هو الـ body
+
+351
+00:23:27,170 --> 00:23:32,410
+temperature. الـ polyvinyl chloride does not reach
+
+352
+00:23:32,410 --> 00:23:35,550
+أو does not react with tissue and small to
+
+353
+00:23:35,550 --> 00:23:39,230
+facilitate passage of suction catheter. والتيوب هذا
+
+354
+00:23:40,430 --> 00:23:44,730
+marking to inside diameter and outside diameter in
+
+355
+00:23:44,730 --> 00:23:48,210
+millimeter. إنه بيقيسوا باللي اللي هو بالـ millimeter
+
+356
+00:23:48,210 --> 00:23:51,630
+الـ inside و الـ outside تبعه. فيه طبعًا اللي هو من
+
+357
+00:23:51,630 --> 00:23:54,950
+أجزاء الـ cuff. في الـ endotracheal can be inflated
+
+358
+00:23:54,950 --> 00:23:59,370
+with using اللي هي السرنجة. إنه أنا ممكن أسطحه عن
+
+359
+00:23:59,370 --> 00:24:03,800
+طريق اللي هو السرنجة. الـ Cuff high provide fixation
+
+360
+00:24:03,800 --> 00:24:07,000
+للـ endotracheal tube. وحنشوفها في الصور القادمة. to
+
+361
+00:24:07,000 --> 00:24:10,460
+prevent air leak في التراكيا. to produce minimal
+
+362
+00:24:10,460 --> 00:24:14,320
+pressure on tracheal mucus. حتى تمنع اللي هي
+
+363
+00:24:14,320 --> 00:24:17,040
+للتراكيا الميوكاس. and that's minimal ischemic
+
+364
+00:24:17,040 --> 00:24:22,020
+injury to tracheal wall. هي اللي هي بنحكي عليها هاد
+
+365
+00:24:22,020 --> 00:24:25,240
+التراكيا طبعًا اللي هي الحنجرة. هذا الـ tongue لتحت
+
+366
+00:24:25,240 --> 00:24:28,320
+وهنا الـ endotracheal tube دخل من الداخل
+
+367
+00:24:28,320 --> 00:24:32,700
+endotracheal tube. تمام. وهي الـ cuffing عملنا فيها
+
+368
+00:24:32,700 --> 00:24:36,240
+flattening tube. في الـ flattening اللي هي cuffing
+
+369
+00:24:36,240 --> 00:24:39,780
+وهذا الـ esophagus المريء. هذا اللي هو عبارة عن الـ
+
+370
+00:24:39,780 --> 00:24:45,420
+intubation أو اللي هو الـ endotracheal tube. لأن
+
+371
+00:24:45,420 --> 00:24:49,280
+الطريقة اللي هي لتراكستومي. الـ Tracheostomy طبعًا هي
+
+372
+00:24:49,280 --> 00:24:52,480
+عبارة عن. لتراكيا بدي يصير فيها ectomy with several
+
+373
+00:24:52,480 --> 00:24:56,220
+advantages over للـ oral و للـ nasal و للـ endotracheal tube،
+
+374
+00:24:56,220 --> 00:24:59,080
+اللي لها مميزات كتير منيحة. الـ suction is
+
+375
+00:24:59,080 --> 00:25:01,820
+facilitated and better tolerated by conscious
+
+376
+00:25:01,820 --> 00:25:05,600
+patients. مهم جدًا إنه أنا أتعامل فيها مع الـ
+
+377
+00:25:05,600 --> 00:25:08,460
+conscious patient. «Fixation tube is easier to
+
+378
+00:25:08,460 --> 00:25:12,600
+eating and even speaking are possible». بعض الأحيان
+
+379
+00:25:12,600 --> 00:25:16,240
+ممكن الناس اللي عملوا Tracheostomy يتكلموا، ولكن
+
+380
+00:25:16,240 --> 00:25:20,840
+بتكونش اللي هي الصوت واضح. يعني إلى لما يغلق اللي
+
+381
+00:25:20,840 --> 00:25:24,500
+هي بتركز. to me «and changing tube is easier». سهل
+
+382
+00:25:24,500 --> 00:25:28,450
+إنه يغيرها. الـ Tracheostomy is also used when long
+
+383
+00:25:28,450 --> 00:25:31,290
+term airway is needed. لما بده يكون على المدى
+
+384
+00:25:31,290 --> 00:25:35,330
+البعيد. مش صح إنه أنا أخليه ماشي في الشارع مع اللي
+
+385
+00:25:35,330 --> 00:25:40,410
+هي الـ endotracheal tube أو أي nasal tube أو أي شيء
+
+386
+00:25:40,410 --> 00:25:42,970
+لأ، الـ Tracheostomy بتكون أفضل. يعني هي ممكن تشوفوا
+
+387
+00:25:42,970 --> 00:25:47,030
+ناس ماشية بـ Tracheostomy أو اللي هو مغطيها. الـ
+
+388
+00:25:47,030 --> 00:25:50,430
+airway constant usually after 10 to 14 days
+
+389
+00:25:50,430 --> 00:25:55,710
+intubation. تمام؟ هذه اللي هي التراكستومي اللي موجود
+
+390
+00:25:55,710 --> 00:26:01,650
+عندنا. كيف صار اللي هو cutting للتراكيا و إدخال لـ
+
+391
+00:26:01,650 --> 00:26:06,270
+tubes. من التراكستومي. من هنا طبعًا بتتم عن طريق أو
+
+392
+00:26:06,270 --> 00:26:10,770
+under supervision by doctors. و بداية تمامًا بتكون
+
+393
+00:26:10,770 --> 00:26:13,370
+مع الـ unconscious patient. و بعدين ممكن يتعامل معها
+
+394
+00:26:13,370 --> 00:26:17,030
+و بعدين بصير weaning للـ ventilation. هذا و
+
+395
+00:26:17,030 --> 00:26:22,750
+إغلاقها بالكامل. تمام؟ الـ Basic steps في عندنا بعض
+
+396
+00:26:22,750 --> 00:26:25,950
+الخطوات. أنا حذفتهم. ما بدنا إياهم. في عندنا الـ
+
+397
+00:26:25,950 --> 00:26:29,070
+Basic steps للـ suction procedures. كيف أنا ممكن
+
+398
+00:26:29,070 --> 00:26:31,950
+أتعامل أو أـ suction تلك الـ tiny
+
+445
+00:29:40,570 --> 00:29:46,670
+that turning the head to right, tilting body, lift
+
+446
+00:29:46,670 --> 00:29:49,650
+increase chances of successful cannulation to lift
+
+447
+00:29:49,650 --> 00:29:53,650
+برنقais لحالها بتلف ليه؟ لأنه سهل تفوت على الـ
+
+448
+00:29:53,650 --> 00:29:57,910
+right أكثر من الـ left curved tip أو هذا اللي هو
+
+449
+00:29:57,910 --> 00:30:01,730
+الـ curved tip هذا الـ catheter  خلال to improve
+
+450
+00:30:01,730 --> 00:30:04,410
+the chance of entering the left lung during suction
+
+451
+00:30:04,410 --> 00:30:07,590
+فبالتالي بتفوت معانا على الـ left lung أكثر من
+
+452
+00:30:07,590 --> 00:30:12,610
+اللي هو الـ right lung هذا هي كل ما لدينا في اللي
+
+453
+00:30:12,610 --> 00:30:18,230
+هو intensive care unit. وألقاكم بإذن الله تعالى في
+
+454
+00:30:18,230 --> 00:30:21,630
+intensive care unit part 2. في أمان الله
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/K7Fw_5kjBzo_postprocess.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/K7Fw_5kjBzo_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..92ba06b7fd8c3fdd01a21597329c0e6c4abd3134
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/K7Fw_5kjBzo_postprocess.srt
@@ -0,0 +1,1816 @@
+1
+00:00:00,910 --> 00:00:04,900
+والصلاة والسلام على أشرف الأنبياء والمرسليننكمل
+
+2
+00:00:04,900 --> 00:00:08,260
+معاكم إن شاء الله في موضوع اللي هو الـ Cardiac
+
+3
+00:00:08,260 --> 00:00:12,000
+Rehabilitation الآن هنشوف اللي هي محاضرة الـ
+
+4
+00:00:12,000 --> 00:00:16,120
+Intensive Care Unit اللي هي الـ ICU قسمت المحاضرة
+
+5
+00:00:16,120 --> 00:00:21,100
+إلى جزئين اللي هو فيديو رقم 8 وفيديو رقم 9 في هذا
+
+6
+00:00:21,100 --> 00:00:24,760
+الفيديو الأول هنحكي فيه على مين الأشخاص اللي أنا
+
+7
+00:00:24,760 --> 00:00:28,920
+بدي أتعامل معاهم في الـ ICU وشو أول هدف إلي كفيزيو
+
+8
+00:00:28,920 --> 00:00:33,240
+ثيرابيست في العناية المركزة نبدأ على بركة الله
+
+9
+00:00:40,190 --> 00:00:43,150
+الpatient are admitted on intensive care unit if
+
+10
+00:00:43,150 --> 00:00:48,270
+they required الأشخاص اللي أنا بدي أتعامل معاهم في
+
+11
+00:00:48,270 --> 00:00:52,590
+ال ICU هدخلوا ال ICU لهدفين الهدف الأول إما إنهم
+
+12
+00:00:52,590 --> 00:00:57,440
+بحاجة ل intensive therapyإلى علاج مكثف أو بحاجة لـ
+
+13
+00:00:57,440 --> 00:01:01,540
+Intensive Monitoring مراقبة مشددة يعني مريض بـ
+
+14
+00:01:01,540 --> 00:01:03,760
+Traumatic Brain Injury على سبيل المثال الـ
+
+15
+00:01:03,760 --> 00:01:07,440
+Unconscious هو بحاجة لـ Intensive Therapy و بحاجة
+
+16
+00:01:07,440 --> 00:01:10,640
+لـ Intensive Monitoring فبالتالي هي أهم هدفين
+
+17
+00:01:10,640 --> 00:01:15,240
+لدخول المرضى إلى وحدة العناية المركزة الـ ICU
+
+18
+00:01:15,240 --> 00:01:20,670
+بتنقسمالى أقسام وتفارعات متعددة كل حالة حسب أو كل
+
+19
+00:01:20,670 --> 00:01:25,470
+قسم بيرتقي أن هذا المريض بيخصه على سبيل الإنسان
+
+20
+00:01:25,470 --> 00:01:29,090
+الـ Neurosurgery اللي هم ICU لحالهم ال respiratory
+
+21
+00:01:29,090 --> 00:01:34,030
+اللي هم unit لوحدهم وكذلك ال cardiac اللي احنا
+
+22
+00:01:34,030 --> 00:01:38,290
+هنتعامل معاه بهذه المحاضرة اللي هم كمان نفس الاشي
+
+23
+00:01:38,290 --> 00:01:43,730
+unit لوحدهمهنشوف شو أهم أهدافنا في العلاج الطبيعي
+
+24
+00:01:43,730 --> 00:01:48,610
+في الـ ICU أول أشي و أول هدف عندي اللي هو assist
+
+25
+00:01:48,610 --> 00:01:52,510
+in remove ال secretion بدي أحاول أساعد المريض على
+
+26
+00:01:52,510 --> 00:01:57,550
+إن ال airway يكون clear يكون تماما واضح و تماما
+
+27
+00:01:57,550 --> 00:02:02,620
+مافي أي عوائق لدخول و خروج الهواء هذا أول هدفالهدف
+
+28
+00:02:02,620 --> 00:02:06,160
+الثاني improvement لل ventilation of all areas of
+
+29
+00:02:06,160 --> 00:02:10,200
+lungs كل ال lungs أو ال composition تبع ال lungs
+
+30
+00:02:10,200 --> 00:02:14,440
+لازم تكون clear من أي secretion يعني ال
+
+31
+00:02:14,440 --> 00:02:18,900
+ventilation فيها هيكون تمام و بخير maintaining ال
+
+32
+00:02:18,900 --> 00:02:22,900
+mobilityبنعرف إن هو بعض الحالات ممكن تكون بدردن
+
+33
+00:02:22,900 --> 00:02:26,580
+ممكن تكون completely paralysis فبالتالي أنا بحاجة
+
+34
+00:02:26,580 --> 00:02:29,600
+لإنه أنا أحافظ على ال range of motions في ال joint
+
+35
+00:02:29,600 --> 00:02:33,380
+maintain a good postural of patient لازم أحافظ على
+
+36
+00:02:33,380 --> 00:02:37,620
+القوانين الصحيح للمرضى decrease لل patient's
+
+37
+00:02:37,620 --> 00:02:43,440
+hospital stay لأن تقاسمدى نجاح المستشفى لأي مستشفى
+
+38
+00:02:43,440 --> 00:02:47,440
+سواء كان governmental أو specialized نجاحه بمدى
+
+39
+00:02:47,440 --> 00:02:51,260
+مكوث المرضى داخله على سبيل المثال يعني معظم
+
+40
+00:02:51,260 --> 00:02:55,720
+المستشفيات اللي هي زي مستشفيات داخل الخط الأخضر أو
+
+41
+00:02:55,720 --> 00:02:59,910
+مستشفيات إسرائيلبيوصلوا الحالة لحد ما يعرفوا إنه
+
+42
+00:02:59,910 --> 00:03:03,810
+هي على سبيل المثال وصلت لمرحلة الـ «موت» فبالتالي
+
+43
+00:03:03,810 --> 00:03:07,710
+بيروحوا هم محاولينها على الشفاء حتى ما تنحسب عليهم
+
+44
+00:03:07,710 --> 00:03:11,310
+حالة وفاة داخل هذا المستشفى، تمام؟ لإن
+
+45
+00:03:11,310 --> 00:03:15,030
+الـ«Hospital Death Day» والـ «death» لل«patient»
+
+46
+00:03:15,030 --> 00:03:20,150
+هذا بيزيد من سمعة المستشفى اللي هو فيها هذا المرض
+
+47
+00:03:20,400 --> 00:03:24,340
+فبالتالي أنا كل ما كان إيه لي دور أفضل في ال ICU
+
+48
+00:03:24,340 --> 00:03:27,960
+كل ما أنا قللت من ال hospital stays تبعت لل
+
+49
+00:03:27,960 --> 00:03:32,760
+patient فبالتالي هو هدف كتير مهم على صعيد سواء
+
+50
+00:03:32,760 --> 00:03:36,640
+economic أو على صعيد اللي هو الصمعة تبعت هذا
+
+51
+00:03:36,640 --> 00:03:39,740
+المستشفى هلأ شو ال most common technique اللي أنا
+
+52
+00:03:39,740 --> 00:03:43,910
+بدي أستخدمهم في ال intensive care unit؟فيه أنحاجة
+
+53
+00:03:43,910 --> 00:03:46,990
+اسمها الـ postural drainage و هتكلم عنه بشكل كبير
+
+54
+00:03:46,990 --> 00:03:51,270
+و واضح في ICU 2 أيضا اللي هي ال percussion و ال
+
+55
+00:03:51,270 --> 00:03:55,990
+vibration to remove secretion, tracheal sections و
+
+56
+00:03:55,990 --> 00:03:59,670
+ال lavage and cuffing اللي هو كمان هتكلم على تركيب
+
+57
+00:03:59,670 --> 00:04:03,930
+لـ tubes و كيف أنا ممكن أتعامل مع هؤلاء المرضى في
+
+58
+00:04:03,930 --> 00:04:07,030
+خلال وجود لـ tubes ال mobilization technique زي
+
+59
+00:04:07,030 --> 00:04:09,430
+البث في range of motion و الactive range of motion
+
+60
+00:04:09,700 --> 00:04:13,820
+breathing exercise and incentive اللي هو الـ
+
+61
+00:04:13,820 --> 00:04:16,560
+spirometers وهو جهاز ان شاء الله رب العالمين
+
+62
+00:04:16,560 --> 00:04:21,560
+هتشوفوه في العملية ال methods لل airway clearness
+
+63
+00:04:21,560 --> 00:04:27,980
+هتكلم على ست طرق لخلو اللي هو ممرضات الهواء من أي
+
+64
+00:04:27,980 --> 00:04:33,880
+secretion يعيق تبادل الغازات الآن أول طريقة اللي
+
+65
+00:04:33,880 --> 00:04:36,930
+هي عن طريق stellary actionالـ ancillary action
+
+66
+00:04:36,930 --> 00:04:40,810
+causes a mucous blanket with cover للتركيوب
+
+67
+00:04:40,810 --> 00:04:44,690
+بلانكيلاترية Epithelia mobilized هذه الأهداف اللي
+
+68
+00:04:44,690 --> 00:04:48,700
+موجودة زي ما انتوا شايفينهاهي عبارة عن حركة
+
+69
+00:04:48,700 --> 00:04:52,020
+الأهداب و الـ cilia and villi اللي هي الـ
+
+70
+00:04:52,020 --> 00:04:55,880
+microvilli أو بنسميها الخمائل الرقيقة بتعمل على
+
+71
+00:04:55,880 --> 00:04:59,140
+حركة هي زي ما أنتوا شايفينها تحت المايكروسكوب هي
+
+72
+00:04:59,140 --> 00:05:03,040
+طبعاً globet cells خلايا كأسية هذه الخلايا الكأسية
+
+73
+00:05:03,040 --> 00:05:07,080
+بتعمل على حركة ودفع اللي هو الـ secretion إلى
+
+74
+00:05:07,080 --> 00:05:10,680
+ممراته العليا حتى يتم اللي هو عن طريق الـ cuffing
+
+75
+00:05:10,680 --> 00:05:15,290
+إخراجه إلى الخارجإذن الـ Epithelium أو اللي هو
+
+76
+00:05:15,290 --> 00:05:18,510
+طبعا من السمبل Epithelium tissue to mobilize in
+
+77
+00:05:18,510 --> 00:05:22,390
+continuous motion toward helium of lung لأن ال
+
+78
+00:05:22,390 --> 00:05:27,690
+helium تبع ال lung اللي هي المادة أو النسيج
+
+79
+00:05:27,690 --> 00:05:32,280
+الرئوي اللي هو عبارة عن نسيج هلاميالـ two larynx
+
+80
+00:05:32,280 --> 00:05:35,640
+بتتم إخراجه إلى الـ larynx حتى يتم إخراجه عن طريق
+
+81
+00:05:35,640 --> 00:05:39,520
+البلعوم إلا إنه يستمر للخروج عن طريق الـ cuffing
+
+82
+00:05:39,520 --> 00:05:44,140
+أرثوالود إنه يتم قشعه أو يتم رميه خارج الجسم
+
+83
+00:05:44,140 --> 00:05:47,780
+فبالتالي هنا من لو حكينا أنا بدي أشتغل على ال
+
+84
+00:05:47,780 --> 00:05:50,540
+loops اللي هنا ال lower loops أو في قاع ال basal
+
+85
+00:05:50,540 --> 00:05:55,010
+loop خديني أحكي القاعدة الأساسيةلأ الـ Lung بدي تم
+
+86
+00:05:55,010 --> 00:05:58,430
+إخراجه عن طريق السيليا لكن هذه الأهداب لازم أن
+
+87
+00:05:58,430 --> 00:06:02,770
+تكون بصحة جيدة و تكون بكفاءة عالية تشتغل يعني على
+
+88
+00:06:02,770 --> 00:06:06,050
+سبيل المثال مدخنين ما هتكون كفائتهم عالية ولا
+
+89
+00:06:06,050 --> 00:06:08,930
+الناس اللي استخدمت أو عندها lung disease على سبيل
+
+90
+00:06:08,930 --> 00:06:12,710
+المثال هيأثر في حركة الأهداب و الأصوات اللي موجودة
+
+91
+00:06:12,710 --> 00:06:16,970
+هنا خليني نشوف هذا ال ميوكاس بلانكت موف reasonably
+
+92
+00:06:16,970 --> 00:06:22,560
+غير عدرية 16 ملي متر لكل دقيقةand can completely
+
+93
+00:06:22,560 --> 00:06:25,880
+clean normal adult lung at least than 20 minutes
+
+94
+00:06:25,880 --> 00:06:29,740
+بالكفنج أنا بستطيع أنه أنا أخرج هذا ال secretion
+
+95
+00:06:29,740 --> 00:06:33,760
+عن طريق ال mouse بالكفنج تمام فبالتالي هيك أنا
+
+96
+00:06:33,760 --> 00:06:37,960
+بخلص الجسم هلأ ال slurry activity main paired with
+
+97
+00:06:37,960 --> 00:06:41,740
+history with smoking لسه أنا كنت بحكي أنه أنا ممكن
+
+98
+00:06:42,030 --> 00:06:45,650
+هذه اللي هي الأصوات والأهداب اللي موجودة عنده داخل
+
+99
+00:06:45,650 --> 00:06:49,930
+الرئتين أنها تتأثر بالمدخنين بال surgery
+
+100
+00:06:49,930 --> 00:06:53,710
+anesthesia طبعاً لل trauma أي إصابة أي lung
+
+101
+00:06:53,710 --> 00:06:57,890
+disease على سبيل المثال pneumonia bronchitis أي
+
+102
+00:06:57,890 --> 00:07:02,010
+إشي بيأثر في وجود اللي هو أو حركة الأهداف اللي
+
+103
+00:07:02,010 --> 00:07:04,970
+موجودة ال pain كمان والمبيضة a conventional
+
+104
+00:07:04,970 --> 00:07:08,470
+recovery أيضا من العوامل اللي بتأثر في حركة هذه
+
+105
+00:07:08,470 --> 00:07:12,300
+الأهدافالأسكندرية التكنيكية للـ Clearness زي الـ
+
+106
+00:07:12,300 --> 00:07:14,980
+Cuffing و الـ Suction الـ Cuffing اللي هو طبعا فيه
+
+107
+00:07:14,980 --> 00:07:17,380
+إشي stimulation أنا بحفظ عشان المرض يعمل ليه
+
+108
+00:07:17,380 --> 00:07:21,500
+Cuffing و يطلع هذا Secretion أما الـ Suction اللي
+
+109
+00:07:21,500 --> 00:07:25,740
+هو يعمل ليه Tubes أو عن طريق Machine طبعا عشان أنا
+
+110
+00:07:25,740 --> 00:07:29,060
+أعمل اللي هو Suction لهذا الـ Secretion و أليح ال
+
+111
+00:07:29,060 --> 00:07:32,090
+patient و أخلي الـ Airway Clearnessbecoming
+
+112
+00:07:32,090 --> 00:07:35,410
+increasingly important to prevention of atlases
+
+113
+00:07:35,410 --> 00:07:38,890
+and pulmonary infection لأنه ليش؟ هيكون فيه
+
+114
+00:07:38,890 --> 00:07:42,390
+secretion وهذا ال secretion في بيوثرجين وفي أمور
+
+115
+00:07:42,390 --> 00:07:49,270
+مش مظبوطة فبالتالي بتعيق حركة اللي هو ال «airway»
+
+116
+00:07:49,270 --> 00:07:54,160
+العامل التاني أو الطريقة التانيةاللي هي من أحد
+
+117
+00:07:54,160 --> 00:07:57,760
+الطرق اللي احنا حكينا عليها الـ Cuffing الـ
+
+118
+00:07:57,760 --> 00:08:00,120
+Cuffing is considered extremely important
+
+119
+00:08:00,120 --> 00:08:04,220
+mechanism to remove a lung secretion من أهم الطرق
+
+120
+00:08:04,220 --> 00:08:08,380
+وبنعرف إن الـ center في اللي موجود في الـ brain
+
+121
+00:08:08,380 --> 00:08:11,840
+استملى الـ Cuffing بتبتحفزه حتى اللي هو يصير فيه
+
+122
+00:08:11,840 --> 00:08:15,840
+عنا Cuffing reflexفبالتالي الأطفال اللي هم من عمر
+
+123
+00:08:15,840 --> 00:08:19,700
+أشهر لسنة ما بيكون عندهم شغال الـ Coughing Reflex
+
+124
+00:08:19,700 --> 00:08:24,700
+لأ بيصير إحنا نعملهم stimulation حتى إيه ما نطفى
+
+125
+00:08:24,700 --> 00:08:27,320
+الـ Coughing يا إما عن طريق الـ Tongue Depressors
+
+126
+00:08:27,320 --> 00:08:31,500
+أو عن طريق أي إشي بحيث إنه أنا أحفظهم على المساج
+
+127
+00:08:31,500 --> 00:08:34,380
+اللي هو الـ Vibration و الـ Percussion حتى أنا
+
+128
+00:08:34,380 --> 00:08:38,720
+أخرج هذا الـ Secretion بالإضافة لإنه الـ Coughing
+
+129
+00:08:38,720 --> 00:08:42,240
+is major defense against retained noisy secretions
+
+130
+00:08:42,580 --> 00:08:46,080
+بتم اللي هو عبارة عن إن الـ «cuffing» ماتبقى إشي
+
+131
+00:08:46,080 --> 00:08:50,240
+مهم جدا، بنخاف على الأطفال، ليه؟ لأن حاكينا مافي
+
+132
+00:08:50,240 --> 00:08:53,820
+عندهم أي «reflex» للـ «cuffing»، فبالتالي أنا
+
+133
+00:08:53,820 --> 00:08:56,680
+ماقدرش أخليه يعمل «cuffing»، يعني ماقدرش أوصل اللي
+
+134
+00:08:56,680 --> 00:08:59,700
+هو اللي بلغب لمرحلة أو عنده اللي بلعوم وأحكيله
+
+135
+00:08:59,700 --> 00:09:04,020
+يلّا أعمل كحلقة، لأنه ماحيفهم عليه كمان، فبالتالي
+
+136
+00:09:04,020 --> 00:09:07,440
+إنه هيكون ناجح وفعال الـ «cuffing» مع اللي هم الـ
+
+137
+00:09:07,440 --> 00:09:11,590
+«children» أو اللي هم الـadults وما بعد ذلك،الـ
+
+138
+00:09:11,590 --> 00:09:14,490
+Cuff Mechanism لازم يكون في عندنا Educate
+
+139
+00:09:14,490 --> 00:09:20,810
+Inspiratory Volume نفس عميق Inspiration بعدين
+
+140
+00:09:20,810 --> 00:09:24,950
+Inspiration بوقفه فبالتالي هيك أنا بحبس النفس
+
+141
+00:09:24,950 --> 00:09:30,590
+بيعمل stimulation لعملية ال cuffingالان لسان
+
+142
+00:09:30,590 --> 00:09:34,950
+المزمار مغلق و كل ما زدت انا او خلقت لسان المزمار
+
+143
+00:09:34,950 --> 00:09:37,950
+هذا هيعطيني ال function تبعته important part في ال
+
+144
+00:09:37,950 --> 00:09:41,210
+effect cuff mechanism هيعطيني وظيفة مهمة جدا في ال
+
+145
+00:09:41,210 --> 00:09:44,130
+cuffing increase لل intra thoracic pressure اذا
+
+146
+00:09:44,130 --> 00:09:46,570
+انا زدت ال intra thoracic pressure معناه الكلام
+
+147
+00:09:46,570 --> 00:09:51,540
+انه انا هرفعاللي هو أزيد كمان الـ intra-abdominal
+
+148
+00:09:51,540 --> 00:09:55,220
+pressure مما يؤدي إلى رفع أو يعمل pushing down
+
+149
+00:09:55,220 --> 00:09:58,880
+للديافرام واحنا حكينا الديافرام هي mainly
+
+150
+00:09:58,880 --> 00:10:02,140
+respiratory muscles اللي موجودة في جسم الإنسان
+
+151
+00:10:02,140 --> 00:10:07,240
+عضلة أساسية له اللي هو respiration طبعاً هذا هيقلل
+
+152
+00:10:07,240 --> 00:10:10,700
+من ال volume تبع ال thoracic cavity هيك العملية
+
+153
+00:10:10,700 --> 00:10:16,710
+بتصير إذا أنا أغلقت لسان المزمار ال gluteusClosed،
+
+154
+00:10:16,710 --> 00:10:19,550
+هيصير فيه عنا increase للثراثك abdominal،
+
+155
+00:10:19,550 --> 00:10:22,530
+increasing للـintra-thoracic abdominal pressure،
+
+156
+00:10:22,530 --> 00:10:24,830
+أول أشيه الـthoracic pressure، بعدين الـintra
+
+157
+00:10:24,830 --> 00:10:29,930
+-abdominal pressure، هيعمل على bushing up، اللي هي
+
+158
+00:10:29,930 --> 00:10:34,610
+diaphragm، upward، then decreasing للثراثك cavity،
+
+159
+00:10:34,610 --> 00:10:38,710
+هذا بيخلي اللي هو تحفيز لـcuffing أنه يصير عند
+
+160
+00:10:38,710 --> 00:10:44,240
+الشخصبعد هيك هوصل لمرحلة اللي هو أنه أنا أفتح لسان
+
+161
+00:10:44,240 --> 00:10:47,020
+المزمار إذا أنا فتحت لسان المزمار معناه الحقيقة
+
+162
+00:10:47,020 --> 00:10:51,320
+أنه أنا بدي اللي هو أنه ال cuffing يطلع لبرا و
+
+163
+00:10:51,320 --> 00:10:55,000
+الهواء يطلع لبرا فبالتالي بيصاحب خروج ال secretion
+
+164
+00:10:55,000 --> 00:10:58,180
+after intra-alveolar pressures increase the
+
+165
+00:10:58,180 --> 00:11:01,800
+glottis suddenly opens بيحدث فجأة هذا الانفتاح
+
+166
+00:11:01,800 --> 00:11:06,160
+بيحدث فجأة للسماح بسرعة عالية لخروج الهواء من ال
+
+167
+00:11:06,160 --> 00:11:10,630
+lungsالـ Peak Flow تبعته حوالي 300 لتر لكل دقيقة
+
+168
+00:11:10,630 --> 00:11:14,790
+لكل تاني لكل دقيقة إذاً أولا إرتيشن عملنا تحفيز
+
+169
+00:11:14,790 --> 00:11:19,490
+بدخول الهواء Inspiration compression ضغطه بعدين
+
+170
+00:11:19,490 --> 00:11:22,250
+صار في عندنا اللي هو الـ Glottis لما بده يحصل في
+
+171
+00:11:22,250 --> 00:11:25,390
+Opening بده يحصل في عندنا Explosion خروج الهواء
+
+172
+00:11:25,390 --> 00:11:31,630
+بشكل فريق جداً الآن كيف أن هذه الـ Cuffing بده
+
+173
+00:11:31,630 --> 00:11:35,350
+يحصل فيها Suppressions أو عملية كبح أو عملية عدم
+
+174
+00:11:35,770 --> 00:11:39,390
+اللي هو استمرار الـ Coughing عن طريقين أول شي
+
+175
+00:11:39,390 --> 00:11:43,710
+فيعنا involuntary وفيعنا voluntary ال involuntary
+
+176
+00:11:43,710 --> 00:11:47,850
+معناته الشخص غير متحكم فيها it can result from the
+
+177
+00:11:47,850 --> 00:11:52,350
+following أنه هيكون بسبب decrease لل inspiratory
+
+178
+00:11:52,350 --> 00:11:56,960
+effect as patient with quadriplegiaأو if ability
+
+179
+00:11:56,960 --> 00:12:00,720
+to close and then open glottis واحنا حكينا فتح و
+
+180
+00:12:00,720 --> 00:12:04,160
+أغلق لسان المزمار مهم جدا في الناس اللي عندهم
+
+181
+00:12:04,160 --> 00:12:08,920
+laryngeal palsy أو diminished expiratory effect
+
+182
+00:12:08,920 --> 00:12:12,320
+هنا decrease و diminished هنا للإنسبيراتوري و هنا
+
+183
+00:12:12,320 --> 00:12:16,200
+للإكسبيراتوري as patient with quadriplegia or
+
+184
+00:12:16,200 --> 00:12:20,060
+palipalegia إذا هذا الإشي involuntary صار عندهم
+
+185
+00:12:20,060 --> 00:12:26,450
+صار الإشي عندهم لاشعوري أو لا إرادي تمام؟الـ
+
+186
+00:12:26,450 --> 00:12:29,210
+voluntary زي مين؟ زي الناس اللي صار عندهم control
+
+187
+00:12:29,210 --> 00:12:32,290
+suppression لل cuff reflex is common لل patient
+
+188
+00:12:32,290 --> 00:12:35,310
+لبعد ال surgery هنا voluntary بدي يصير عندهم كبح
+
+189
+00:12:35,310 --> 00:12:40,070
+للكحة أو إن هو خايف من الألم الناتج مثلا زي الست
+
+190
+00:12:40,070 --> 00:12:43,850
+اللي عاملة CS فبالتالي هي بتكون خايفة تعمل cuffing
+
+191
+00:12:43,850 --> 00:12:47,840
+ليه؟ لأنه هيعمل abdominal painالـ fear can be
+
+192
+00:12:47,840 --> 00:12:51,740
+minimized ممكن أنا أخفف هذا الخوف عن طريق ال
+
+193
+00:12:51,740 --> 00:12:54,980
+instruction اللي أنا بدي أعطيه هي preoperative قبل
+
+194
+00:12:54,980 --> 00:12:58,760
+العملية this shot can be general explanation and
+
+195
+00:12:58,760 --> 00:13:02,480
+expected surgery and importance of coughing ال
+
+196
+00:13:02,480 --> 00:13:06,080
+pain after surgery الألم اللي بتصير بعد العملية
+
+197
+00:13:06,080 --> 00:13:10,300
+cannot be eliminatedلا يمكن إنه أنا أزيلها تماما
+
+198
+00:13:10,300 --> 00:13:14,800
+ولكن ممكن أنا أخففها عن طريق المساكنات هذا الإشي
+
+199
+00:13:14,800 --> 00:13:18,000
+بنكون مفاهمينه إحنا للمريض تبعنا ونعطيه التعليمات
+
+200
+00:13:18,000 --> 00:13:23,500
+اللي هي pre-op ما قبل العملية تمام؟ هلأ شو ال
+
+201
+00:13:23,500 --> 00:13:27,480
+methods لل cuff stimulation؟ كيف أنا ممكن أحفظ ال
+
+202
+00:13:27,480 --> 00:13:32,520
+cuff stimulation؟ أول إشي عن طريق ال huffing وهحكي
+
+203
+00:13:32,520 --> 00:13:35,860
+على أربع كومبونز اللي هم أربع عوامل الـ Huffing
+
+204
+00:13:35,860 --> 00:13:40,480
+اللي هو غير الـ Cuffing it is a forced expiratory
+
+205
+00:13:40,480 --> 00:13:45,240
+effort is made by glutes is remained open and
+
+206
+00:13:45,240 --> 00:13:49,640
+intrathoracic pressure هيك مش cuffing بيطلع من جوا
+
+207
+00:13:49,640 --> 00:13:53,120
+لأ هنا بيكون عنا ال glutes أو ما يسمى بلسان
+
+208
+00:13:53,120 --> 00:13:57,000
+المزمار remains open and intrathoracic pressure
+
+209
+00:13:57,000 --> 00:14:01,790
+due to the nut rise ما بيرفعزي ما صار عندنا في الـ
+
+210
+00:14:01,790 --> 00:14:05,870
+Coughing Caused rapid change in air flow طبعاً
+
+211
+00:14:05,870 --> 00:14:09,650
+هيسبب تغيرات في الـ air flow مجال الهواء may
+
+212
+00:14:09,650 --> 00:14:12,310
+result in secretion and hence mechanically
+
+213
+00:14:12,310 --> 00:14:16,410
+stimulated normal coughing هلأ الـ vibration اللي
+
+214
+00:14:16,410 --> 00:14:21,310
+هي من أحد الطرق لتحفيز ال coughing اللي هي its
+
+215
+00:14:21,310 --> 00:14:24,990
+report stimulated continuously coughing as much as
+
+216
+00:14:24,990 --> 00:14:28,330
+same reason huffing هلأ ال vibration over the
+
+217
+00:14:28,330 --> 00:14:34,470
+chestكمان إنه أنا أعمل vibration اللي هي بحركات
+
+218
+00:14:34,470 --> 00:14:38,130
+المساج طبعا expiration causes increased expiratory
+
+219
+00:14:38,130 --> 00:14:41,970
+force may increase coughing effectiveness بتساعد
+
+220
+00:14:41,970 --> 00:14:45,890
+في ال coughing effectiveness طريقة ثالثة لل
+
+221
+00:14:45,890 --> 00:14:48,770
+stimulation في ال coughing اللي هي deep breathing
+
+222
+00:14:48,770 --> 00:14:53,850
+exercise وإنه أنا بدي أعمل deep breathing exercise
+
+223
+00:14:53,850 --> 00:14:56,810
+يعني النفس أخليه من ال deep breathing فبالتالي بدي
+
+224
+00:14:56,810 --> 00:15:00,550
+أزيد ال lung volumeby achieving by accommodating
+
+225
+00:15:00,550 --> 00:15:02,770
+an inspiratory effect to make more than
+
+226
+00:15:02,770 --> 00:15:07,780
+effectivenessعلى الـ External Tracheal Stimulation
+
+227
+00:15:07,780 --> 00:15:09,680
+اللي كنت بحكي عليه إنه أنا أعمل .. بدي أعمل
+
+228
+00:15:09,680 --> 00:15:13,460
+Stimulation عشان أحصل على الـ Cuffing This
+
+229
+00:15:13,460 --> 00:15:17,600
+achieved by applying manual pressure للـ thoracic
+
+230
+00:15:17,600 --> 00:15:23,120
+أو للـ Trachea أسفة above Manipural Notches اللي
+
+231
+00:15:23,120 --> 00:15:26,740
+هو فوق عدم تلقاس في عنا اللي هو مقبض الصيف لو
+
+232
+00:15:26,740 --> 00:15:30,140
+رجعنا شوية Anatomy فعدم تلقاس في عنا فوق اللي هو
+
+233
+00:15:30,140 --> 00:15:33,640
+بدي يكون Maniprium وهنا ال body و تحت ال X-fiber
+
+234
+00:15:33,640 --> 00:15:36,860
+processأنا على الـ Manipal Notch بدي أضغط عليها
+
+235
+00:15:36,860 --> 00:15:40,420
+فبالتالي أنا بعمل stimulation للـ cuffing this
+
+236
+00:15:40,420 --> 00:15:44,220
+creates partial trachea compression هذا بيعطينا
+
+237
+00:15:44,220 --> 00:15:47,200
+ضغط على ال tracheal compression which can cause
+
+238
+00:15:47,200 --> 00:15:50,620
+mechanical stimulation لل cuff mechanism كمان عند
+
+239
+00:15:50,620 --> 00:15:53,720
+الأطفال ممكن عن طريق ال tongue depressors أنه أنا
+
+240
+00:15:53,720 --> 00:15:57,460
+أفوتها في فم الطفل فبالتالي بعمل stimulation لل
+
+241
+00:15:57,460 --> 00:16:02,060
+cuff فبروح الطفل و هو بعد كده أعمل كحة عنديهذه
+
+242
+00:16:02,060 --> 00:16:06,160
+الأربع طرق للـ Cuff Stimulation تمام الـ Huffing و
+
+243
+00:16:06,160 --> 00:16:09,640
+أخدنا الـ Deep Breathing و الـ External Tracheal
+
+244
+00:16:09,640 --> 00:16:13,520
+Stimulation و أيضا اللي هي الـ Vibration أحد طرق
+
+245
+00:16:13,520 --> 00:16:21,300
+المساج الآن هدخل في الطريقة الخامسة من اللي هوالـ
+
+246
+00:16:21,300 --> 00:16:24,700
+Clearing للـ Airway Stimulation عن طريق الـ
+
+247
+00:16:24,700 --> 00:16:28,000
+Oropharynx with suction catheter لاحظوا معايا
+
+248
+00:16:28,000 --> 00:16:33,400
+حكينا Oro معناته فموي، هيكون من الفم، هنا Naso إذا
+
+249
+00:16:33,400 --> 00:16:37,120
+كانت الـ tube فايتة من الأنف، Nasopharynx إذا كانت
+
+250
+00:16:37,120 --> 00:16:40,560
+فايتة من الفم، Oropharynxالـ catheter اللي هي
+
+251
+00:16:40,560 --> 00:16:43,620
+عبارة عن ال tubes اللي أنا بدي أفوتها داخل جسم
+
+252
+00:16:43,620 --> 00:16:47,120
+الإنسان و ال none above method of cough
+
+253
+00:16:47,120 --> 00:16:49,500
+stimulation is successful وقت إيه أنا بدي
+
+254
+00:16:49,500 --> 00:16:53,740
+أستخدمها؟ في حالة فشلة الطرق الأربعة اللي أنا حكيت
+
+255
+00:16:53,740 --> 00:16:58,130
+عليهم لل airway clearnessهدخل فى الطريقة الخامسة
+
+256
+00:16:58,130 --> 00:17:02,990
+وهى مؤلمة جدا وإن فشلت الطريقة الخامسة هفوت بال
+
+257
+00:17:02,990 --> 00:17:05,670
+suction machine على طول يا إما بدي أفتح
+
+258
+00:17:05,670 --> 00:17:09,670
+Tracheostomy فتحها فى داخل الحلق اللى هى
+
+259
+00:17:09,670 --> 00:17:14,130
+Tracheostomy فى داخل الكراكية أو عن طريق اللى هو
+
+260
+00:17:14,130 --> 00:17:18,110
+ال mouse و أدخل tube زى ما حكينا Oropharynx و أعمل
+
+261
+00:17:18,110 --> 00:17:23,450
+اللى هو suction هذه الست طرق لل airway clearness
+
+262
+00:17:23,450 --> 00:17:28,480
+تمام؟هلأ شو ال complication تبعت ال cuff؟ أنا ممكن
+
+263
+00:17:28,480 --> 00:17:32,940
+أدخل في complication أو مضاعفات في ال cuffing على
+
+264
+00:17:32,940 --> 00:17:35,520
+صعيد ال respiratory system هيصير في عالنا
+
+265
+00:17:35,520 --> 00:17:39,260
+bronchoconstriction و أنا مابدي أصير هذا الشيء
+
+266
+00:17:39,260 --> 00:17:42,860
+لازم يكون عند ال bronchi بوضعها الطبيعي ال normal
+
+267
+00:17:42,860 --> 00:17:47,000
+حتى لو كانت في construction ممكن أعطيه
+
+268
+00:17:47,000 --> 00:17:50,880
+bronchodilators موسع للشعب الهوائي ال trauma to
+
+269
+00:17:50,880 --> 00:17:55,570
+airways and larynx بلا traumaنيمو ثوركس
+
+270
+00:17:55,570 --> 00:17:59,730
+Interstitial emphysema هاي كلها بتصير على صعيد ال
+
+271
+00:17:59,730 --> 00:18:04,210
+respiratory system hemodynamic، hemoblood، dynamic
+
+272
+00:18:04,210 --> 00:18:09,420
+movement، decrease للـvenous returnتمام، هنا على
+
+273
+00:18:09,420 --> 00:18:12,720
+الصعيد اللي هو الـ vessels و ال blood و الأمور
+
+274
+00:18:12,720 --> 00:18:16,580
+اللي هي علاقة بالcirculation ألثسميا، transit
+
+275
+00:18:16,580 --> 00:18:20,400
+ischemic أو systemic hypertension and hypotension
+
+276
+00:18:20,400 --> 00:18:23,820
+تمام، هذه أحد ال complications اللي بتصير على
+
+277
+00:18:23,820 --> 00:18:28,500
+الصعيد أو على مجال اللي هو الcirculatory cerebral
+
+278
+00:18:28,940 --> 00:18:33,520
+ممكن يدخل للمريض في حالة أغماء أو فقدر للوعي تام
+
+279
+00:18:33,520 --> 00:18:36,760
+بسبب زيادة في كمية الأكسجين أو نقص في كمية
+
+280
+00:18:36,760 --> 00:18:40,280
+الأكسجين اللي واصلة للدماغ على سعيد ال «chest
+
+281
+00:18:40,280 --> 00:18:43,420
+wall» ممكن يصير في عنا rib fractures مش إحنا حكينا
+
+282
+00:18:43,420 --> 00:18:46,500
+في ال «tracheal stimulation» إنه أنا بدي أعمل
+
+283
+00:18:46,500 --> 00:18:49,590
+simulation في ال «malibrium»فبالتالي ممكن لو كان
+
+284
+00:18:49,590 --> 00:18:52,770
+المرض osteoporosis على سبيل المثال أو عنده أو أنا
+
+285
+00:18:52,770 --> 00:18:56,310
+إجيت عملت ال stimulation بطريقة قوية جدا وفي عنه
+
+286
+00:18:56,310 --> 00:18:59,750
+pathological أو إشي مرضي لأن هذا الشخص ال patient
+
+287
+00:18:59,750 --> 00:19:03,790
+ممكن أسبب في fractures أو ممكن يصير في عندي
+
+288
+00:19:03,790 --> 00:19:08,710
+ruptures لل muscles اللي هي rectus abdominisأيضا
+
+289
+00:19:08,710 --> 00:19:13,370
+في حاجات تانية ممكن تصير أو متعلقات أخرى بنسميها
+
+290
+00:19:13,370 --> 00:19:16,550
+زي ال urinary incontinence ممكن من ال complication
+
+291
+00:19:16,550 --> 00:19:21,750
+أو pulmonary emboli اللي هي عبارة عن embolism تمشي
+
+292
+00:19:21,750 --> 00:19:24,450
+مع ال pulmonary هذه الخامسة هي عبارة عن
+
+293
+00:19:24,450 --> 00:19:28,750
+complication لل cuffing اللي أنا هعملها مش بإيرادة
+
+294
+00:19:28,750 --> 00:19:32,030
+المريض ال cuffing اللي أنا هعملها غصب عن المريض أو
+
+295
+00:19:32,030 --> 00:19:36,240
+هعملها بعدم إيرادته شهو ال tracheal suction؟الـ
+
+296
+00:19:36,240 --> 00:19:40,140
+suction is performed routinely in a tube yet يعني
+
+297
+00:19:40,140 --> 00:19:44,820
+أنا بدأ أفوت لتيوب داخل ال patient to removeand
+
+298
+00:19:44,820 --> 00:19:48,520
+cuffing stimulation عشان أشيل السكريشن وممكن عشان
+
+299
+00:19:48,520 --> 00:19:52,120
+أعمل cuffing ال frequency تبعته determined by
+
+300
+00:19:52,120 --> 00:19:56,640
+quantity of secretion كم هي كمية السكريشن هل هو مش
+
+301
+00:19:56,640 --> 00:20:00,380
+جادر اتنفس فعلا من إنه في أنا blocking أو blockage
+
+302
+00:20:00,380 --> 00:20:06,880
+اللي هي انسداد لل airway بالسكريشن ولا كيف أنا بدي
+
+303
+00:20:06,880 --> 00:20:11,810
+أعمل تمام؟الأوروفرانجيال زى ما حكينا أورو من الفم
+
+304
+00:20:11,810 --> 00:20:16,530
+و nasal من الأنف الأوروفرانجيال airway بستخدمها لل
+
+305
+00:20:16,530 --> 00:20:19,490
+unconscious patient ليه؟ لإن لو استخدمت
+
+306
+00:20:19,490 --> 00:20:23,430
+الأوروفرانجيال لل patient ال conscious هدا هيعمللي
+
+307
+00:20:23,430 --> 00:20:26,150
+اللى هو vomiting فبالتالي بيصير في عندنا
+
+308
+00:20:26,150 --> 00:20:28,990
+aspiration عملية ال aspiration هي عبارة عن عملية
+
+309
+00:20:28,990 --> 00:20:32,910
+الشردقة لإن ممكن يسكن ال patient عندى conscious
+
+310
+00:20:32,910 --> 00:20:36,390
+وواعى وبياكل وانا أروح أعمله أوروفرانجيال فبالتالي
+
+311
+00:20:36,390 --> 00:20:40,010
+ممكن أفوت اللى هوالـ Digestive System على الـ
+
+312
+00:20:40,010 --> 00:20:43,830
+Respiratory System مما يؤدي لحدوث اللي هي الـ
+
+313
+00:20:43,830 --> 00:20:47,770
+Aspiration وأنا هنا هفوت في مشاكل تانية هلأ الـ
+
+314
+00:20:47,770 --> 00:20:52,090
+Proper Size سببها الـ Oropharyngeal تعتمد أو ممكن
+
+315
+00:20:52,090 --> 00:20:56,690
+أنا أقدرها من المسافة الواقعة من اللي هي Check and
+
+316
+00:20:56,690 --> 00:20:59,910
+Measuring للـDistance from Corner of Mouth to Air
+
+317
+00:21:00,220 --> 00:21:03,540
+من اسمها oro معناه تقلب دي المسافة من الأنف إلى
+
+318
+00:21:03,540 --> 00:21:07,040
+الأذن زي ما أنتوا شايفينها من ال mouth أسفة من
+
+319
+00:21:07,040 --> 00:21:12,880
+الفم لأذن هي بيسميها ال oro phalangeal هاي هاعملها
+
+320
+00:21:12,880 --> 00:21:16,960
+هنا بعض الصور اللي هي هذه المسافة من ال corner من
+
+321
+00:21:16,960 --> 00:21:23,090
+زاوية الفم ل اللي هيالأذن تمام نيجي نشوف ال
+
+322
+00:21:23,090 --> 00:21:26,450
+nasopharyngeal الاستخدامات ال nasopharyngeal
+
+323
+00:21:26,450 --> 00:21:29,970
+لحالات ال conscious ممكن استخدمها مع الناس اللي هم
+
+324
+00:21:29,970 --> 00:21:34,210
+وعين و okay لإن مافي عندي مشاكل في اللي هي ال
+
+325
+00:21:34,210 --> 00:21:38,140
+aspirationالـ advantage تبعتها حكينا بستخدمها مع
+
+326
+00:21:38,140 --> 00:21:41,020
+الـ conscious والـ semi-conscious كمان to be air
+
+327
+00:21:41,020 --> 00:21:43,960
+-tolerate أما ال proper distance تبعتها هي تكون من
+
+328
+00:21:43,960 --> 00:21:48,320
+ال tip of thing في north لحجم توصل الـ air
+
+329
+00:21:48,320 --> 00:21:52,800
+بالإضافة إلى واحد inch يعني لو كانت المسافة مثلا
+
+330
+00:21:52,800 --> 00:21:57,380
+عشرة سانتي من الأنف لحافة الأذن بزيد عليها كمان
+
+331
+00:21:57,380 --> 00:22:01,140
+واحد قبل ال insertion اللي هي ال airway should be
+
+332
+00:22:01,140 --> 00:22:07,460
+lubricated andof water or soluble lubricant قبل ما
+
+333
+00:22:07,460 --> 00:22:12,460
+أغرس هذا التيوب الصغير ممكن أنا يا إما بغمسه في
+
+334
+00:22:12,460 --> 00:22:18,800
+ماء أو إنه بحط عليه جل حتى إنه يصير بشكل جيد تمام؟
+
+335
+00:22:18,800 --> 00:22:21,800
+ويكون سهل اللي هو ال intubation أو سهل الإدخال
+
+336
+00:22:21,800 --> 00:22:28,110
+تبعه هاي هو، هيلاحظوا الأنف؟من اللي هي الأنف لـ
+
+337
+00:22:28,110 --> 00:22:32,670
+mouse بقس المسافة و بدخل على طول إلى الداخل تمام
+
+338
+00:22:32,670 --> 00:22:39,970
+هذه هي أنا فوته من الأنف و دخل لجوا الـ angiotube
+
+339
+00:22:39,970 --> 00:22:42,650
+اللي هو الـ nasogastric كمان ممكن بس هيوصل لل
+
+340
+00:22:42,650 --> 00:22:46,310
+gastric تحت لل abdomen it's painful painful
+
+341
+00:22:46,310 --> 00:22:51,400
+painfulالـ Endotracheal tube كمان نفس الاشي to
+
+342
+00:22:51,400 --> 00:22:54,860
+prevent airway obstruction أيضًا من أهدافه تفسّل
+
+343
+00:22:54,860 --> 00:22:58,080
+تاتد من جلال الـ suction وprovide mechanical
+
+344
+00:22:58,080 --> 00:23:01,940
+ventilation and protect للأعلى من أي foreign body
+
+345
+00:23:01,940 --> 00:23:05,860
+تمام؟ الـ Endotracheal tubes إن أنا دخلت على الـ
+
+346
+00:23:05,860 --> 00:23:10,040
+Endotracheal مصنع من الـ polyvinyl chloride أو
+
+347
+00:23:10,040 --> 00:23:13,590
+السيليكون حتى يكون طريقالأن هو rigid لما يكون برا
+
+348
+00:23:13,590 --> 00:23:17,930
+ولكن مع حرارة الجسم بيصير أكثر soft فبالتالي أنا
+
+349
+00:23:17,930 --> 00:23:20,890
+لما أكون في إيدي rigid لكن لما بدخل داخل جسم
+
+350
+00:23:20,890 --> 00:23:27,170
+الإنسان بيصير أكثر soft مع اللي هو الـ body
+
+351
+00:23:27,170 --> 00:23:32,410
+temperature الـ polyvinyl chloride does not reach
+
+352
+00:23:32,410 --> 00:23:35,550
+أو does not react with tissue and small to
+
+353
+00:23:35,550 --> 00:23:39,230
+facilitate passage of suction catheter والتيوب هذا
+
+354
+00:23:40,430 --> 00:23:44,730
+marking to inside diameter and outside diameter in
+
+355
+00:23:44,730 --> 00:23:48,210
+millimeter أنه بيقيصوا باللي اللي هو بالmillimeter
+
+356
+00:23:48,210 --> 00:23:51,630
+ال inside و ال outside تبعه فيه طبعا اللي هو من
+
+357
+00:23:51,630 --> 00:23:54,950
+أجزاء ال cuff في ال endotracheal can be inflated
+
+358
+00:23:54,950 --> 00:23:59,370
+with using اللي هي السرنجة أنه أنا ممكن أسطحه عن
+
+359
+00:23:59,370 --> 00:24:03,800
+طريق اللي هو السرنجةالـ Cuff high provide fixation
+
+360
+00:24:03,800 --> 00:24:07,000
+للـ endotracheal tube وحنشوفها في الصور القادمة to
+
+361
+00:24:07,000 --> 00:24:10,460
+prevent air lack في التراكيا to produce minimal
+
+362
+00:24:10,460 --> 00:24:14,320
+pressure on tracheal mucus حتى تمنع اللي هي
+
+363
+00:24:14,320 --> 00:24:17,040
+لتراكيا الميوكاس and that's minimal ischemic
+
+364
+00:24:17,040 --> 00:24:22,020
+injury to tracheal wallهي اللي هي بنحكي عليها هاد
+
+365
+00:24:22,020 --> 00:24:25,240
+التراكيا طبعا اللي هي الحنجرة هذا ال tongue لتحت
+
+366
+00:24:25,240 --> 00:24:28,320
+وهنا ال endotracheal tube دخل من الداخل
+
+367
+00:24:28,320 --> 00:24:32,700
+endotracheal tube تمام وهي ال cuffing عملنا فيها
+
+368
+00:24:32,700 --> 00:24:36,240
+flattening tube في ال flattening اللي هي cuffing
+
+369
+00:24:36,240 --> 00:24:39,780
+وهذا ال esophagus المريء هذا اللي هو عبارة عن ال
+
+370
+00:24:39,780 --> 00:24:45,420
+intubation أو اللي هو ال endotracheal tube لان
+
+371
+00:24:45,420 --> 00:24:49,280
+الطريقة اللي هي لتركزتميهالـ Tracheostomy طبعا هي
+
+372
+00:24:49,280 --> 00:24:52,480
+عبارة عن لتراكيا بدي يصير فيها ectomy with several
+
+373
+00:24:52,480 --> 00:24:56,220
+advantages over للأورال والنازل اندو تراكيا لتيوب،
+
+374
+00:24:56,220 --> 00:24:59,080
+اللي لها مميزات كتير منيحة ال suction is
+
+375
+00:24:59,080 --> 00:25:01,820
+facilitated and better tolerated by conscious
+
+376
+00:25:01,820 --> 00:25:05,600
+patientsمهم جدا إنه أنا أتعامل فيها مع الـ
+
+377
+00:25:05,600 --> 00:25:08,460
+Conscious Patient «Fixation tube is easier to
+
+378
+00:25:08,460 --> 00:25:12,600
+eating and even speaking are possible» بعض الأحيان
+
+379
+00:25:12,600 --> 00:25:16,240
+ممكن الناس اللي عملوا trackers to me يتكلموا ولكن
+
+380
+00:25:16,240 --> 00:25:20,840
+بتكونش اللي هي الصوت واضح يعني إلى لما يغلق اللي
+
+381
+00:25:20,840 --> 00:25:24,500
+هي بتركز to me «and changing tube is easier» سهل
+
+382
+00:25:24,500 --> 00:25:28,450
+إنه يغيرهاالـ Tracheostomy is also used when long
+
+383
+00:25:28,450 --> 00:25:31,290
+term airway is needed لما بده يهجى على المدى
+
+384
+00:25:31,290 --> 00:25:35,330
+البعيد مش صح إنه أنا أخليه ماشي في الشارع مع اللي
+
+385
+00:25:35,330 --> 00:25:40,410
+هي الـ endotracheal tube أو أي نازو tube أو أي إشي
+
+386
+00:25:40,410 --> 00:25:42,970
+لأ ال Tracheostomy بتكون أفضل يعني هي ممكن تشوفوا
+
+387
+00:25:42,970 --> 00:25:47,030
+ناس ماشية ب Tracheostomy أو اللي هو مغطيها ال
+
+388
+00:25:47,030 --> 00:25:50,430
+airway constant usually after 10 to 14 days
+
+389
+00:25:50,430 --> 00:25:55,710
+intubation تمام؟هذه اللي هي التراكستومي اللي موجود
+
+390
+00:25:55,710 --> 00:26:01,650
+عندنا كيف صار اللي هو cutting لتراكيا و ادخال ل
+
+391
+00:26:01,650 --> 00:26:06,270
+tubes من التراكستومي من هنا طبعا بتتم عن طريق أو
+
+392
+00:26:06,270 --> 00:26:10,770
+under supervision by doctors و بداية تماما بتكون
+
+393
+00:26:10,770 --> 00:26:13,370
+مع ال unconscious patient و بعدين ممكن يتعامل معها
+
+394
+00:26:13,370 --> 00:26:17,030
+و بعدين بصير winning ل ال ventilation هذا و
+
+395
+00:26:17,030 --> 00:26:22,750
+اغلاقها بالكامل تمام؟الـ Basic steps في عندنا بعض
+
+396
+00:26:22,750 --> 00:26:25,950
+الخطوات أنا حذفتهم ما بدنا إياهم في عندنا الـ
+
+397
+00:26:25,950 --> 00:26:29,070
+Basic steps للـ suction procedures كيف أنا ممكن
+
+398
+00:26:29,070 --> 00:26:31,950
+أتعامل أو suction تلك الـ tummy tubes اللي أنا
+
+399
+00:26:31,950 --> 00:26:35,670
+عندي هذا الشخص مثلا في كومة وداخل الـ intensive
+
+400
+00:26:35,670 --> 00:26:39,010
+care unit فبالتالي أنا بدي أعمله suction عشان أعمل
+
+401
+00:26:39,010 --> 00:26:41,780
+removal لل-secretionConnect للـ catheter with
+
+402
+00:26:41,780 --> 00:26:44,800
+suction machine طبعا أهم إشي لازم أنا أعقم ال
+
+403
+00:26:44,800 --> 00:26:48,120
+machine أعقم ال tubes اللي أنا بدي أحطها لإنه
+
+404
+00:26:48,120 --> 00:26:52,360
+المسألة هنا مسألة خطيرة خصوصا إحنا بنحكي على COVID
+
+405
+00:26:52,360 --> 00:26:56,100
+-19 في هذه الأيام فبالتالي ال sterilization مهم
+
+406
+00:26:56,100 --> 00:27:00,080
+جداهذا أول إشي تاني إشي insert للكثيتر proper
+
+407
+00:27:00,080 --> 00:27:04,020
+distance into trachea tube usual length to reach
+
+408
+00:27:04,020 --> 00:27:08,500
+ربع إنش أدخله داخل اللي هي اللي تركز to me و أبدأ
+
+409
+00:27:08,500 --> 00:27:11,800
+أشغل ال machine في اللي هو أنه يبدأ يشفط
+
+410
+00:27:11,800 --> 00:27:15,580
+لـsecretion اللي موجود apply suction putting your
+
+411
+00:27:15,580 --> 00:27:19,280
+thumb over the hall of catheterزي ما انتوا شايفين
+
+412
+00:27:19,280 --> 00:27:24,900
+وضغط عليها وليهنا بيبدأ يحرك فيها عشان تشفط كتير
+
+413
+00:27:24,900 --> 00:27:28,720
+احنا كلنا بنستخدمها في اللي هو ال «inpatient» اللي
+
+414
+00:27:28,720 --> 00:27:31,780
+هم موجودين في ال «ICU» «Gently» ال «catheter»
+
+415
+00:27:31,780 --> 00:27:35,930
+between your thumb and fingertips طبعااللي هو as
+
+416
+00:27:35,930 --> 00:27:38,530
+you pull catheter out زي ما انتوا شايفينه بحرك
+
+417
+00:27:38,530 --> 00:27:41,930
+فيها هاي اللي هي كيف ال suction تركز to me أنا
+
+418
+00:27:41,930 --> 00:27:44,830
+ممكن أعملها وبتجيب معناه نتائج جيدة بس إلها
+
+419
+00:27:44,830 --> 00:27:50,050
+disadvantage إن هو طبعا easy to infected للشخص
+
+420
+00:27:50,050 --> 00:27:54,970
+المصاب يعني مش سهل أنه هو يعني جديد نكون حارسين عن
+
+421
+00:27:54,970 --> 00:27:59,530
+ال sterilization ولكن بيصير في عندنا damage لبعض
+
+422
+00:27:59,530 --> 00:28:03,480
+اللي هوالـ «Tissues» اللي موجودة في التراكيا فهي
+
+423
+00:28:03,480 --> 00:28:09,500
+مش آمنة خالص. هلأ، شو difficulty تبعت ال
+
+424
+00:28:09,500 --> 00:28:13,380
+«cannulation»؟ إنه أنا أعمل «cannula» داخل، إحنا
+
+425
+00:28:13,380 --> 00:28:16,040
+شبهها هنا ب «cannula»، داخل اللي هو
+
+426
+00:28:16,040 --> 00:28:19,220
+الـ«minibronchi» اللي أنتوا شايفين، هذه اللي هي
+
+427
+00:28:19,220 --> 00:28:23,380
+التراكيا، هنا هاي البرونكاي، هاي البرونكوليوز اللي
+
+428
+00:28:23,380 --> 00:28:25,380
+هي البرونكوليوز، اللي هي عبارة عن الشعيبات
+
+429
+00:28:25,380 --> 00:28:28,870
+الهوائيةit's more difficult to pass a suction
+
+430
+00:28:28,870 --> 00:28:33,250
+catheter into left than right لأن حكينا I have two
+
+431
+00:28:33,250 --> 00:28:37,570
+lungs one of them right and one of them left الآن
+
+432
+00:28:37,570 --> 00:28:43,810
+هاي ال right three loops تمام و ال left two loops
+
+433
+00:28:43,810 --> 00:28:49,930
+حكينا ليش لو وجود ال heart ال catheter إنها تمر في
+
+434
+00:28:49,930 --> 00:28:55,760
+خلال اللي هو ال left is difficult than rightطبعاً
+
+435
+00:28:55,760 --> 00:28:59,080
+لأنه في تلاتة loops هيكون صعب أن تفوت في الـ left
+
+436
+00:28:59,080 --> 00:29:04,960
+في ال adult ال right main stem أو اللي هي الشجرة
+
+437
+00:29:04,960 --> 00:29:09,280
+الأساسية تبعتنا Bronchus usually comes off angle
+
+438
+00:29:09,280 --> 00:29:14,540
+about 200 from midline sagittal تبعد حوالي بزاوية
+
+439
+00:29:14,540 --> 00:29:20,230
+200 هذه المد ساجتال من المد ساجتالتمام where is
+
+440
+00:29:20,230 --> 00:29:23,310
+the left اللي هو بده يكون marked angle about
+
+441
+00:29:23,310 --> 00:29:26,850
+تلاتمية وخمسين similar angle في ال biofrictions
+
+442
+00:29:26,850 --> 00:29:29,910
+are noted in النيونيات اللي هم المواليد ميتين
+
+443
+00:29:29,910 --> 00:29:33,430
+واربعين ال right واربعمية واربعين في ال left
+
+444
+00:29:33,430 --> 00:29:40,570
+فبالتالي بيكون صعب دخولها على ال left it suggested
+
+445
+00:29:40,570 --> 00:29:46,670
+that turning the head to rightto tilting body lift
+
+446
+00:29:46,670 --> 00:29:49,650
+increase change in successful cannulation to lift
+
+447
+00:29:49,650 --> 00:29:53,650
+برنقais لحالها بتلف ليه؟ لأنه سهل تفوت على الـ
+
+448
+00:29:53,650 --> 00:29:57,910
+right أكتر من الـ left curved tip أو هذا اللي هو
+
+449
+00:29:57,910 --> 00:30:01,730
+الـ curved cured هذا الـ catheter خلال to improve
+
+450
+00:30:01,730 --> 00:30:04,410
+the chance entering to left lung during suction
+
+451
+00:30:04,410 --> 00:30:07,590
+فبالتالي بتفوت معانا على الـ left lung أكتر من
+
+452
+00:30:07,590 --> 00:30:12,610
+اللي هو الـ right lung هذا هي كل ما لدينا في اللي
+
+453
+00:30:12,610 --> 00:30:18,230
+هو intensive care unitوألقاكم بإذن الله تعالى في
+
+454
+00:30:18,230 --> 00:30:21,630
+intensive care unit part 2 في أمان الله
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/K7Fw_5kjBzo_raw.json b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/K7Fw_5kjBzo_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..eef651c779f18fd3ec0cc115040dbed319c487d5
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/K7Fw_5kjBzo_raw.json
@@ -0,0 +1 @@
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طرق للـ Cuff Stimulation تمام الـ Huffing و أخدنا الـ Deep Breathing و الـ External Tracheal Stimulation و أيضا اللي هي الـ Vibration أحد طرق المساج الآن هدخل في الطريقة الخامسة من اللي هو", "tokens": [3224, 24192, 16247, 25513, 3615, 23032, 2288, 4587, 24976, 39184, 383, 1245, 745, 332, 2776, 46811, 10943, 2423, 39184, 389, 1245, 278, 4032, 5551, 9778, 3215, 8315, 2423, 39184, 14895, 20093, 571, 4032, 2423, 39184, 48277, 1765, 6000, 304, 745, 332, 2776, 4032, 36632, 11242, 995, 13672, 1829, 39896, 2423, 39184, 691, 897, 2405, 5551, 24401, 23032, 2288, 4587, 9673, 3794, 26108, 6024, 48506, 8032, 3215, 9778, 1211, 8978, 41950, 16572, 28671, 33962, 10943, 3794, 3660, 9154, 13672, 1829, 31439], "avg_logprob": -0.18692129923973555, "compression_ratio": 1.5051546391752577, "no_speech_prob": 1.7881393432617188e-07, "words": [{"start": 961.7, "end": 962.06, "word": "هذه", "probability": 0.728271484375}, {"start": 962.06, "end": 962.42, "word": " الأربع", "probability": 0.8551432291666666}, 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{"start": 1721.35, "end": 1722.67, "word": " تمام", "probability": 0.820556640625}, {"start": 1722.67, "end": 1722.83, "word": " و", "probability": 0.4091796875}, {"start": 1722.83, "end": 1722.93, "word": " ال", "probability": 0.52001953125}, {"start": 1722.93, "end": 1723.11, "word": " left", "probability": 0.939453125}, {"start": 1723.11, "end": 1723.41, "word": " two", "probability": 0.92431640625}, {"start": 1723.41, "end": 1723.81, "word": " loops", "probability": 0.947265625}, {"start": 1723.81, "end": 1724.51, "word": " حكينا", "probability": 0.9654541015625}, {"start": 1724.51, "end": 1724.77, "word": " ليش", "probability": 0.950439453125}, {"start": 1724.77, "end": 1724.95, "word": " لو", "probability": 0.6328125}, {"start": 1724.95, "end": 1725.21, "word": " وجود", "probability": 0.954833984375}, {"start": 1725.21, "end": 1725.35, "word": " ال", "probability": 0.8818359375}, {"start": 1725.35, "end": 1725.79, "word": " heart", "probability": 0.90966796875}, {"start": 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"probability": 0.99658203125}, {"start": 1793.05, "end": 1793.37, "word": " تفوت", "probability": 0.94873046875}, {"start": 1793.37, "end": 1793.53, "word": " على", "probability": 0.81396484375}, {"start": 1793.53, "end": 1793.65, "word": " الـ", "probability": 0.726318359375}, {"start": 1793.65, "end": 1793.85, "word": " right", "probability": 0.374267578125}, {"start": 1793.85, "end": 1794.27, "word": " أكتر", "probability": 0.913818359375}, {"start": 1794.27, "end": 1794.43, "word": " من", "probability": 0.99560546875}, {"start": 1794.43, "end": 1794.59, "word": " الـ", "probability": 0.782958984375}, {"start": 1794.59, "end": 1794.87, "word": " left", "probability": 0.93408203125}, {"start": 1794.87, "end": 1795.91, "word": " curved", "probability": 0.5849609375}, {"start": 1795.91, "end": 1796.37, "word": " tip", "probability": 0.36669921875}, {"start": 1796.37, "end": 1796.63, "word": " أو", "probability": 0.8720703125}, {"start": 1796.63, "end": 1797.07, "word": " هذا", 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" الـ", "probability": 0.648193359375}, {"start": 1806.39, "end": 1806.59, "word": " left", "probability": 0.93701171875}, {"start": 1806.59, "end": 1806.89, "word": " lung", "probability": 0.9169921875}, {"start": 1806.89, "end": 1807.29, "word": " أكتر", "probability": 0.99267578125}, {"start": 1807.29, "end": 1807.59, "word": " من", "probability": 0.9921875}, {"start": 1807.59, "end": 1807.89, "word": " اللي", "probability": 0.978759765625}, {"start": 1807.89, "end": 1808.21, "word": " هو", "probability": 0.99462890625}, {"start": 1808.21, "end": 1808.51, "word": " الـ", "probability": 0.76318359375}, {"start": 1808.51, "end": 1808.67, "word": " right", "probability": 0.91455078125}, {"start": 1808.67, "end": 1809.21, "word": " lung", "probability": 0.9140625}, {"start": 1809.21, "end": 1810.43, "word": " هذا", "probability": 0.8037109375}, {"start": 1810.43, "end": 1810.67, "word": " هي", "probability": 0.4287109375}, {"start": 1810.67, "end": 1811.15, "word": " كل", "probability": 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1820.17, "end": 1821.03, "word": " في", "probability": 0.88623046875}, {"start": 1821.03, "end": 1821.37, "word": " أمان", "probability": 0.7237955729166666}, {"start": 1821.37, "end": 1821.63, "word": " الله", "probability": 0.9609375}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1830.1271875, "duration_after_vad": 1792.6174999999957}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/K7Fw_5kjBzo_raw.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/K7Fw_5kjBzo_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..92ba06b7fd8c3fdd01a21597329c0e6c4abd3134
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/K7Fw_5kjBzo_raw.srt
@@ -0,0 +1,1816 @@
+1
+00:00:00,910 --> 00:00:04,900
+والصلاة والسلام على أشرف الأنبياء والمرسليننكمل
+
+2
+00:00:04,900 --> 00:00:08,260
+معاكم إن شاء الله في موضوع اللي هو الـ Cardiac
+
+3
+00:00:08,260 --> 00:00:12,000
+Rehabilitation الآن هنشوف اللي هي محاضرة الـ
+
+4
+00:00:12,000 --> 00:00:16,120
+Intensive Care Unit اللي هي الـ ICU قسمت المحاضرة
+
+5
+00:00:16,120 --> 00:00:21,100
+إلى جزئين اللي هو فيديو رقم 8 وفيديو رقم 9 في هذا
+
+6
+00:00:21,100 --> 00:00:24,760
+الفيديو الأول هنحكي فيه على مين الأشخاص اللي أنا
+
+7
+00:00:24,760 --> 00:00:28,920
+بدي أتعامل معاهم في الـ ICU وشو أول هدف إلي كفيزيو
+
+8
+00:00:28,920 --> 00:00:33,240
+ثيرابيست في العناية المركزة نبدأ على بركة الله
+
+9
+00:00:40,190 --> 00:00:43,150
+الpatient are admitted on intensive care unit if
+
+10
+00:00:43,150 --> 00:00:48,270
+they required الأشخاص اللي أنا بدي أتعامل معاهم في
+
+11
+00:00:48,270 --> 00:00:52,590
+ال ICU هدخلوا ال ICU لهدفين الهدف الأول إما إنهم
+
+12
+00:00:52,590 --> 00:00:57,440
+بحاجة ل intensive therapyإلى علاج مكثف أو بحاجة لـ
+
+13
+00:00:57,440 --> 00:01:01,540
+Intensive Monitoring مراقبة مشددة يعني مريض بـ
+
+14
+00:01:01,540 --> 00:01:03,760
+Traumatic Brain Injury على سبيل المثال الـ
+
+15
+00:01:03,760 --> 00:01:07,440
+Unconscious هو بحاجة لـ Intensive Therapy و بحاجة
+
+16
+00:01:07,440 --> 00:01:10,640
+لـ Intensive Monitoring فبالتالي هي أهم هدفين
+
+17
+00:01:10,640 --> 00:01:15,240
+لدخول المرضى إلى وحدة العناية المركزة الـ ICU
+
+18
+00:01:15,240 --> 00:01:20,670
+بتنقسمالى أقسام وتفارعات متعددة كل حالة حسب أو كل
+
+19
+00:01:20,670 --> 00:01:25,470
+قسم بيرتقي أن هذا المريض بيخصه على سبيل الإنسان
+
+20
+00:01:25,470 --> 00:01:29,090
+الـ Neurosurgery اللي هم ICU لحالهم ال respiratory
+
+21
+00:01:29,090 --> 00:01:34,030
+اللي هم unit لوحدهم وكذلك ال cardiac اللي احنا
+
+22
+00:01:34,030 --> 00:01:38,290
+هنتعامل معاه بهذه المحاضرة اللي هم كمان نفس الاشي
+
+23
+00:01:38,290 --> 00:01:43,730
+unit لوحدهمهنشوف شو أهم أهدافنا في العلاج الطبيعي
+
+24
+00:01:43,730 --> 00:01:48,610
+في الـ ICU أول أشي و أول هدف عندي اللي هو assist
+
+25
+00:01:48,610 --> 00:01:52,510
+in remove ال secretion بدي أحاول أساعد المريض على
+
+26
+00:01:52,510 --> 00:01:57,550
+إن ال airway يكون clear يكون تماما واضح و تماما
+
+27
+00:01:57,550 --> 00:02:02,620
+مافي أي عوائق لدخول و خروج الهواء هذا أول هدفالهدف
+
+28
+00:02:02,620 --> 00:02:06,160
+الثاني improvement لل ventilation of all areas of
+
+29
+00:02:06,160 --> 00:02:10,200
+lungs كل ال lungs أو ال composition تبع ال lungs
+
+30
+00:02:10,200 --> 00:02:14,440
+لازم تكون clear من أي secretion يعني ال
+
+31
+00:02:14,440 --> 00:02:18,900
+ventilation فيها هيكون تمام و بخير maintaining ال
+
+32
+00:02:18,900 --> 00:02:22,900
+mobilityبنعرف إن هو بعض الحالات ممكن تكون بدردن
+
+33
+00:02:22,900 --> 00:02:26,580
+ممكن تكون completely paralysis فبالتالي أنا بحاجة
+
+34
+00:02:26,580 --> 00:02:29,600
+لإنه أنا أحافظ على ال range of motions في ال joint
+
+35
+00:02:29,600 --> 00:02:33,380
+maintain a good postural of patient لازم أحافظ على
+
+36
+00:02:33,380 --> 00:02:37,620
+القوانين الصحيح للمرضى decrease لل patient's
+
+37
+00:02:37,620 --> 00:02:43,440
+hospital stay لأن تقاسمدى نجاح المستشفى لأي مستشفى
+
+38
+00:02:43,440 --> 00:02:47,440
+سواء كان governmental أو specialized نجاحه بمدى
+
+39
+00:02:47,440 --> 00:02:51,260
+مكوث المرضى داخله على سبيل المثال يعني معظم
+
+40
+00:02:51,260 --> 00:02:55,720
+المستشفيات اللي هي زي مستشفيات داخل الخط الأخضر أو
+
+41
+00:02:55,720 --> 00:02:59,910
+مستشفيات إسرائيلبيوصلوا الحالة لحد ما يعرفوا إنه
+
+42
+00:02:59,910 --> 00:03:03,810
+هي على سبيل المثال وصلت لمرحلة الـ «موت» فبالتالي
+
+43
+00:03:03,810 --> 00:03:07,710
+بيروحوا هم محاولينها على الشفاء حتى ما تنحسب عليهم
+
+44
+00:03:07,710 --> 00:03:11,310
+حالة وفاة داخل هذا المستشفى، تمام؟ لإن
+
+45
+00:03:11,310 --> 00:03:15,030
+الـ«Hospital Death Day» والـ «death» لل«patient»
+
+46
+00:03:15,030 --> 00:03:20,150
+هذا بيزيد من سمعة المستشفى اللي هو فيها هذا المرض
+
+47
+00:03:20,400 --> 00:03:24,340
+فبالتالي أنا كل ما كان إيه لي دور أفضل في ال ICU
+
+48
+00:03:24,340 --> 00:03:27,960
+كل ما أنا قللت من ال hospital stays تبعت لل
+
+49
+00:03:27,960 --> 00:03:32,760
+patient فبالتالي هو هدف كتير مهم على صعيد سواء
+
+50
+00:03:32,760 --> 00:03:36,640
+economic أو على صعيد اللي هو الصمعة تبعت هذا
+
+51
+00:03:36,640 --> 00:03:39,740
+المستشفى هلأ شو ال most common technique اللي أنا
+
+52
+00:03:39,740 --> 00:03:43,910
+بدي أستخدمهم في ال intensive care unit؟فيه أنحاجة
+
+53
+00:03:43,910 --> 00:03:46,990
+اسمها الـ postural drainage و هتكلم عنه بشكل كبير
+
+54
+00:03:46,990 --> 00:03:51,270
+و واضح في ICU 2 أيضا اللي هي ال percussion و ال
+
+55
+00:03:51,270 --> 00:03:55,990
+vibration to remove secretion, tracheal sections و
+
+56
+00:03:55,990 --> 00:03:59,670
+ال lavage and cuffing اللي هو كمان هتكلم على تركيب
+
+57
+00:03:59,670 --> 00:04:03,930
+لـ tubes و كيف أنا ممكن أتعامل مع هؤلاء المرضى في
+
+58
+00:04:03,930 --> 00:04:07,030
+خلال وجود لـ tubes ال mobilization technique زي
+
+59
+00:04:07,030 --> 00:04:09,430
+البث في range of motion و الactive range of motion
+
+60
+00:04:09,700 --> 00:04:13,820
+breathing exercise and incentive اللي هو الـ
+
+61
+00:04:13,820 --> 00:04:16,560
+spirometers وهو جهاز ان شاء الله رب العالمين
+
+62
+00:04:16,560 --> 00:04:21,560
+هتشوفوه في العملية ال methods لل airway clearness
+
+63
+00:04:21,560 --> 00:04:27,980
+هتكلم على ست طرق لخلو اللي هو ممرضات الهواء من أي
+
+64
+00:04:27,980 --> 00:04:33,880
+secretion يعيق تبادل الغازات الآن أول طريقة اللي
+
+65
+00:04:33,880 --> 00:04:36,930
+هي عن طريق stellary actionالـ ancillary action
+
+66
+00:04:36,930 --> 00:04:40,810
+causes a mucous blanket with cover للتركيوب
+
+67
+00:04:40,810 --> 00:04:44,690
+بلانكيلاترية Epithelia mobilized هذه الأهداف اللي
+
+68
+00:04:44,690 --> 00:04:48,700
+موجودة زي ما انتوا شايفينهاهي عبارة عن حركة
+
+69
+00:04:48,700 --> 00:04:52,020
+الأهداب و الـ cilia and villi اللي هي الـ
+
+70
+00:04:52,020 --> 00:04:55,880
+microvilli أو بنسميها الخمائل الرقيقة بتعمل على
+
+71
+00:04:55,880 --> 00:04:59,140
+حركة هي زي ما أنتوا شايفينها تحت المايكروسكوب هي
+
+72
+00:04:59,140 --> 00:05:03,040
+طبعاً globet cells خلايا كأسية هذه الخلايا الكأسية
+
+73
+00:05:03,040 --> 00:05:07,080
+بتعمل على حركة ودفع اللي هو الـ secretion إلى
+
+74
+00:05:07,080 --> 00:05:10,680
+ممراته العليا حتى يتم اللي هو عن طريق الـ cuffing
+
+75
+00:05:10,680 --> 00:05:15,290
+إخراجه إلى الخارجإذن الـ Epithelium أو اللي هو
+
+76
+00:05:15,290 --> 00:05:18,510
+طبعا من السمبل Epithelium tissue to mobilize in
+
+77
+00:05:18,510 --> 00:05:22,390
+continuous motion toward helium of lung لأن ال
+
+78
+00:05:22,390 --> 00:05:27,690
+helium تبع ال lung اللي هي المادة أو النسيج
+
+79
+00:05:27,690 --> 00:05:32,280
+الرئوي اللي هو عبارة عن نسيج هلاميالـ two larynx
+
+80
+00:05:32,280 --> 00:05:35,640
+بتتم إخراجه إلى الـ larynx حتى يتم إخراجه عن طريق
+
+81
+00:05:35,640 --> 00:05:39,520
+البلعوم إلا إنه يستمر للخروج عن طريق الـ cuffing
+
+82
+00:05:39,520 --> 00:05:44,140
+أرثوالود إنه يتم قشعه أو يتم رميه خارج الجسم
+
+83
+00:05:44,140 --> 00:05:47,780
+فبالتالي هنا من لو حكينا أنا بدي أشتغل على ال
+
+84
+00:05:47,780 --> 00:05:50,540
+loops اللي هنا ال lower loops أو في قاع ال basal
+
+85
+00:05:50,540 --> 00:05:55,010
+loop خديني أحكي القاعدة الأساسيةلأ الـ Lung بدي تم
+
+86
+00:05:55,010 --> 00:05:58,430
+إخراجه عن طريق السيليا لكن هذه الأهداب لازم أن
+
+87
+00:05:58,430 --> 00:06:02,770
+تكون بصحة جيدة و تكون بكفاءة عالية تشتغل يعني على
+
+88
+00:06:02,770 --> 00:06:06,050
+سبيل المثال مدخنين ما هتكون كفائتهم عالية ولا
+
+89
+00:06:06,050 --> 00:06:08,930
+الناس اللي استخدمت أو عندها lung disease على سبيل
+
+90
+00:06:08,930 --> 00:06:12,710
+المثال هيأثر في حركة الأهداب و الأصوات اللي موجودة
+
+91
+00:06:12,710 --> 00:06:16,970
+هنا خليني نشوف هذا ال ميوكاس بلانكت موف reasonably
+
+92
+00:06:16,970 --> 00:06:22,560
+غير عدرية 16 ملي متر لكل دقيقةand can completely
+
+93
+00:06:22,560 --> 00:06:25,880
+clean normal adult lung at least than 20 minutes
+
+94
+00:06:25,880 --> 00:06:29,740
+بالكفنج أنا بستطيع أنه أنا أخرج هذا ال secretion
+
+95
+00:06:29,740 --> 00:06:33,760
+عن طريق ال mouse بالكفنج تمام فبالتالي هيك أنا
+
+96
+00:06:33,760 --> 00:06:37,960
+بخلص الجسم هلأ ال slurry activity main paired with
+
+97
+00:06:37,960 --> 00:06:41,740
+history with smoking لسه أنا كنت بحكي أنه أنا ممكن
+
+98
+00:06:42,030 --> 00:06:45,650
+هذه اللي هي الأصوات والأهداب اللي موجودة عنده داخل
+
+99
+00:06:45,650 --> 00:06:49,930
+الرئتين أنها تتأثر بالمدخنين بال surgery
+
+100
+00:06:49,930 --> 00:06:53,710
+anesthesia طبعاً لل trauma أي إصابة أي lung
+
+101
+00:06:53,710 --> 00:06:57,890
+disease على سبيل المثال pneumonia bronchitis أي
+
+102
+00:06:57,890 --> 00:07:02,010
+إشي بيأثر في وجود اللي هو أو حركة الأهداف اللي
+
+103
+00:07:02,010 --> 00:07:04,970
+موجودة ال pain كمان والمبيضة a conventional
+
+104
+00:07:04,970 --> 00:07:08,470
+recovery أيضا من العوامل اللي بتأثر في حركة هذه
+
+105
+00:07:08,470 --> 00:07:12,300
+الأهدافالأسكندرية التكنيكية للـ Clearness زي الـ
+
+106
+00:07:12,300 --> 00:07:14,980
+Cuffing و الـ Suction الـ Cuffing اللي هو طبعا فيه
+
+107
+00:07:14,980 --> 00:07:17,380
+إشي stimulation أنا بحفظ عشان المرض يعمل ليه
+
+108
+00:07:17,380 --> 00:07:21,500
+Cuffing و يطلع هذا Secretion أما الـ Suction اللي
+
+109
+00:07:21,500 --> 00:07:25,740
+هو يعمل ليه Tubes أو عن طريق Machine طبعا عشان أنا
+
+110
+00:07:25,740 --> 00:07:29,060
+أعمل اللي هو Suction لهذا الـ Secretion و أليح ال
+
+111
+00:07:29,060 --> 00:07:32,090
+patient و أخلي الـ Airway Clearnessbecoming
+
+112
+00:07:32,090 --> 00:07:35,410
+increasingly important to prevention of atlases
+
+113
+00:07:35,410 --> 00:07:38,890
+and pulmonary infection لأنه ليش؟ هيكون فيه
+
+114
+00:07:38,890 --> 00:07:42,390
+secretion وهذا ال secretion في بيوثرجين وفي أمور
+
+115
+00:07:42,390 --> 00:07:49,270
+مش مظبوطة فبالتالي بتعيق حركة اللي هو ال «airway»
+
+116
+00:07:49,270 --> 00:07:54,160
+العامل التاني أو الطريقة التانيةاللي هي من أحد
+
+117
+00:07:54,160 --> 00:07:57,760
+الطرق اللي احنا حكينا عليها الـ Cuffing الـ
+
+118
+00:07:57,760 --> 00:08:00,120
+Cuffing is considered extremely important
+
+119
+00:08:00,120 --> 00:08:04,220
+mechanism to remove a lung secretion من أهم الطرق
+
+120
+00:08:04,220 --> 00:08:08,380
+وبنعرف إن الـ center في اللي موجود في الـ brain
+
+121
+00:08:08,380 --> 00:08:11,840
+استملى الـ Cuffing بتبتحفزه حتى اللي هو يصير فيه
+
+122
+00:08:11,840 --> 00:08:15,840
+عنا Cuffing reflexفبالتالي الأطفال اللي هم من عمر
+
+123
+00:08:15,840 --> 00:08:19,700
+أشهر لسنة ما بيكون عندهم شغال الـ Coughing Reflex
+
+124
+00:08:19,700 --> 00:08:24,700
+لأ بيصير إحنا نعملهم stimulation حتى إيه ما نطفى
+
+125
+00:08:24,700 --> 00:08:27,320
+الـ Coughing يا إما عن طريق الـ Tongue Depressors
+
+126
+00:08:27,320 --> 00:08:31,500
+أو عن طريق أي إشي بحيث إنه أنا أحفظهم على المساج
+
+127
+00:08:31,500 --> 00:08:34,380
+اللي هو الـ Vibration و الـ Percussion حتى أنا
+
+128
+00:08:34,380 --> 00:08:38,720
+أخرج هذا الـ Secretion بالإضافة لإنه الـ Coughing
+
+129
+00:08:38,720 --> 00:08:42,240
+is major defense against retained noisy secretions
+
+130
+00:08:42,580 --> 00:08:46,080
+بتم اللي هو عبارة عن إن الـ «cuffing» ماتبقى إشي
+
+131
+00:08:46,080 --> 00:08:50,240
+مهم جدا، بنخاف على الأطفال، ليه؟ لأن حاكينا مافي
+
+132
+00:08:50,240 --> 00:08:53,820
+عندهم أي «reflex» للـ «cuffing»، فبالتالي أنا
+
+133
+00:08:53,820 --> 00:08:56,680
+ماقدرش أخليه يعمل «cuffing»، يعني ماقدرش أوصل اللي
+
+134
+00:08:56,680 --> 00:08:59,700
+هو اللي بلغب لمرحلة أو عنده اللي بلعوم وأحكيله
+
+135
+00:08:59,700 --> 00:09:04,020
+يلّا أعمل كحلقة، لأنه ماحيفهم عليه كمان، فبالتالي
+
+136
+00:09:04,020 --> 00:09:07,440
+إنه هيكون ناجح وفعال الـ «cuffing» مع اللي هم الـ
+
+137
+00:09:07,440 --> 00:09:11,590
+«children» أو اللي هم الـadults وما بعد ذلك،الـ
+
+138
+00:09:11,590 --> 00:09:14,490
+Cuff Mechanism لازم يكون في عندنا Educate
+
+139
+00:09:14,490 --> 00:09:20,810
+Inspiratory Volume نفس عميق Inspiration بعدين
+
+140
+00:09:20,810 --> 00:09:24,950
+Inspiration بوقفه فبالتالي هيك أنا بحبس النفس
+
+141
+00:09:24,950 --> 00:09:30,590
+بيعمل stimulation لعملية ال cuffingالان لسان
+
+142
+00:09:30,590 --> 00:09:34,950
+المزمار مغلق و كل ما زدت انا او خلقت لسان المزمار
+
+143
+00:09:34,950 --> 00:09:37,950
+هذا هيعطيني ال function تبعته important part في ال
+
+144
+00:09:37,950 --> 00:09:41,210
+effect cuff mechanism هيعطيني وظيفة مهمة جدا في ال
+
+145
+00:09:41,210 --> 00:09:44,130
+cuffing increase لل intra thoracic pressure اذا
+
+146
+00:09:44,130 --> 00:09:46,570
+انا زدت ال intra thoracic pressure معناه الكلام
+
+147
+00:09:46,570 --> 00:09:51,540
+انه انا هرفعاللي هو أزيد كمان الـ intra-abdominal
+
+148
+00:09:51,540 --> 00:09:55,220
+pressure مما يؤدي إلى رفع أو يعمل pushing down
+
+149
+00:09:55,220 --> 00:09:58,880
+للديافرام واحنا حكينا الديافرام هي mainly
+
+150
+00:09:58,880 --> 00:10:02,140
+respiratory muscles اللي موجودة في جسم الإنسان
+
+151
+00:10:02,140 --> 00:10:07,240
+عضلة أساسية له اللي هو respiration طبعاً هذا هيقلل
+
+152
+00:10:07,240 --> 00:10:10,700
+من ال volume تبع ال thoracic cavity هيك العملية
+
+153
+00:10:10,700 --> 00:10:16,710
+بتصير إذا أنا أغلقت لسان المزمار ال gluteusClosed،
+
+154
+00:10:16,710 --> 00:10:19,550
+هيصير فيه عنا increase للثراثك abdominal،
+
+155
+00:10:19,550 --> 00:10:22,530
+increasing للـintra-thoracic abdominal pressure،
+
+156
+00:10:22,530 --> 00:10:24,830
+أول أشيه الـthoracic pressure، بعدين الـintra
+
+157
+00:10:24,830 --> 00:10:29,930
+-abdominal pressure، هيعمل على bushing up، اللي هي
+
+158
+00:10:29,930 --> 00:10:34,610
+diaphragm، upward، then decreasing للثراثك cavity،
+
+159
+00:10:34,610 --> 00:10:38,710
+هذا بيخلي اللي هو تحفيز لـcuffing أنه يصير عند
+
+160
+00:10:38,710 --> 00:10:44,240
+الشخصبعد هيك هوصل لمرحلة اللي هو أنه أنا أفتح لسان
+
+161
+00:10:44,240 --> 00:10:47,020
+المزمار إذا أنا فتحت لسان المزمار معناه الحقيقة
+
+162
+00:10:47,020 --> 00:10:51,320
+أنه أنا بدي اللي هو أنه ال cuffing يطلع لبرا و
+
+163
+00:10:51,320 --> 00:10:55,000
+الهواء يطلع لبرا فبالتالي بيصاحب خروج ال secretion
+
+164
+00:10:55,000 --> 00:10:58,180
+after intra-alveolar pressures increase the
+
+165
+00:10:58,180 --> 00:11:01,800
+glottis suddenly opens بيحدث فجأة هذا الانفتاح
+
+166
+00:11:01,800 --> 00:11:06,160
+بيحدث فجأة للسماح بسرعة عالية لخروج الهواء من ال
+
+167
+00:11:06,160 --> 00:11:10,630
+lungsالـ Peak Flow تبعته حوالي 300 لتر لكل دقيقة
+
+168
+00:11:10,630 --> 00:11:14,790
+لكل تاني لكل دقيقة إذاً أولا إرتيشن عملنا تحفيز
+
+169
+00:11:14,790 --> 00:11:19,490
+بدخول الهواء Inspiration compression ضغطه بعدين
+
+170
+00:11:19,490 --> 00:11:22,250
+صار في عندنا اللي هو الـ Glottis لما بده يحصل في
+
+171
+00:11:22,250 --> 00:11:25,390
+Opening بده يحصل في عندنا Explosion خروج الهواء
+
+172
+00:11:25,390 --> 00:11:31,630
+بشكل فريق جداً الآن كيف أن هذه الـ Cuffing بده
+
+173
+00:11:31,630 --> 00:11:35,350
+يحصل فيها Suppressions أو عملية كبح أو عملية عدم
+
+174
+00:11:35,770 --> 00:11:39,390
+اللي هو استمرار الـ Coughing عن طريقين أول شي
+
+175
+00:11:39,390 --> 00:11:43,710
+فيعنا involuntary وفيعنا voluntary ال involuntary
+
+176
+00:11:43,710 --> 00:11:47,850
+معناته الشخص غير متحكم فيها it can result from the
+
+177
+00:11:47,850 --> 00:11:52,350
+following أنه هيكون بسبب decrease لل inspiratory
+
+178
+00:11:52,350 --> 00:11:56,960
+effect as patient with quadriplegiaأو if ability
+
+179
+00:11:56,960 --> 00:12:00,720
+to close and then open glottis واحنا حكينا فتح و
+
+180
+00:12:00,720 --> 00:12:04,160
+أغلق لسان المزمار مهم جدا في الناس اللي عندهم
+
+181
+00:12:04,160 --> 00:12:08,920
+laryngeal palsy أو diminished expiratory effect
+
+182
+00:12:08,920 --> 00:12:12,320
+هنا decrease و diminished هنا للإنسبيراتوري و هنا
+
+183
+00:12:12,320 --> 00:12:16,200
+للإكسبيراتوري as patient with quadriplegia or
+
+184
+00:12:16,200 --> 00:12:20,060
+palipalegia إذا هذا الإشي involuntary صار عندهم
+
+185
+00:12:20,060 --> 00:12:26,450
+صار الإشي عندهم لاشعوري أو لا إرادي تمام؟الـ
+
+186
+00:12:26,450 --> 00:12:29,210
+voluntary زي مين؟ زي الناس اللي صار عندهم control
+
+187
+00:12:29,210 --> 00:12:32,290
+suppression لل cuff reflex is common لل patient
+
+188
+00:12:32,290 --> 00:12:35,310
+لبعد ال surgery هنا voluntary بدي يصير عندهم كبح
+
+189
+00:12:35,310 --> 00:12:40,070
+للكحة أو إن هو خايف من الألم الناتج مثلا زي الست
+
+190
+00:12:40,070 --> 00:12:43,850
+اللي عاملة CS فبالتالي هي بتكون خايفة تعمل cuffing
+
+191
+00:12:43,850 --> 00:12:47,840
+ليه؟ لأنه هيعمل abdominal painالـ fear can be
+
+192
+00:12:47,840 --> 00:12:51,740
+minimized ممكن أنا أخفف هذا الخوف عن طريق ال
+
+193
+00:12:51,740 --> 00:12:54,980
+instruction اللي أنا بدي أعطيه هي preoperative قبل
+
+194
+00:12:54,980 --> 00:12:58,760
+العملية this shot can be general explanation and
+
+195
+00:12:58,760 --> 00:13:02,480
+expected surgery and importance of coughing ال
+
+196
+00:13:02,480 --> 00:13:06,080
+pain after surgery الألم اللي بتصير بعد العملية
+
+197
+00:13:06,080 --> 00:13:10,300
+cannot be eliminatedلا يمكن إنه أنا أزيلها تماما
+
+198
+00:13:10,300 --> 00:13:14,800
+ولكن ممكن أنا أخففها عن طريق المساكنات هذا الإشي
+
+199
+00:13:14,800 --> 00:13:18,000
+بنكون مفاهمينه إحنا للمريض تبعنا ونعطيه التعليمات
+
+200
+00:13:18,000 --> 00:13:23,500
+اللي هي pre-op ما قبل العملية تمام؟ هلأ شو ال
+
+201
+00:13:23,500 --> 00:13:27,480
+methods لل cuff stimulation؟ كيف أنا ممكن أحفظ ال
+
+202
+00:13:27,480 --> 00:13:32,520
+cuff stimulation؟ أول إشي عن طريق ال huffing وهحكي
+
+203
+00:13:32,520 --> 00:13:35,860
+على أربع كومبونز اللي هم أربع عوامل الـ Huffing
+
+204
+00:13:35,860 --> 00:13:40,480
+اللي هو غير الـ Cuffing it is a forced expiratory
+
+205
+00:13:40,480 --> 00:13:45,240
+effort is made by glutes is remained open and
+
+206
+00:13:45,240 --> 00:13:49,640
+intrathoracic pressure هيك مش cuffing بيطلع من جوا
+
+207
+00:13:49,640 --> 00:13:53,120
+لأ هنا بيكون عنا ال glutes أو ما يسمى بلسان
+
+208
+00:13:53,120 --> 00:13:57,000
+المزمار remains open and intrathoracic pressure
+
+209
+00:13:57,000 --> 00:14:01,790
+due to the nut rise ما بيرفعزي ما صار عندنا في الـ
+
+210
+00:14:01,790 --> 00:14:05,870
+Coughing Caused rapid change in air flow طبعاً
+
+211
+00:14:05,870 --> 00:14:09,650
+هيسبب تغيرات في الـ air flow مجال الهواء may
+
+212
+00:14:09,650 --> 00:14:12,310
+result in secretion and hence mechanically
+
+213
+00:14:12,310 --> 00:14:16,410
+stimulated normal coughing هلأ الـ vibration اللي
+
+214
+00:14:16,410 --> 00:14:21,310
+هي من أحد الطرق لتحفيز ال coughing اللي هي its
+
+215
+00:14:21,310 --> 00:14:24,990
+report stimulated continuously coughing as much as
+
+216
+00:14:24,990 --> 00:14:28,330
+same reason huffing هلأ ال vibration over the
+
+217
+00:14:28,330 --> 00:14:34,470
+chestكمان إنه أنا أعمل vibration اللي هي بحركات
+
+218
+00:14:34,470 --> 00:14:38,130
+المساج طبعا expiration causes increased expiratory
+
+219
+00:14:38,130 --> 00:14:41,970
+force may increase coughing effectiveness بتساعد
+
+220
+00:14:41,970 --> 00:14:45,890
+في ال coughing effectiveness طريقة ثالثة لل
+
+221
+00:14:45,890 --> 00:14:48,770
+stimulation في ال coughing اللي هي deep breathing
+
+222
+00:14:48,770 --> 00:14:53,850
+exercise وإنه أنا بدي أعمل deep breathing exercise
+
+223
+00:14:53,850 --> 00:14:56,810
+يعني النفس أخليه من ال deep breathing فبالتالي بدي
+
+224
+00:14:56,810 --> 00:15:00,550
+أزيد ال lung volumeby achieving by accommodating
+
+225
+00:15:00,550 --> 00:15:02,770
+an inspiratory effect to make more than
+
+226
+00:15:02,770 --> 00:15:07,780
+effectivenessعلى الـ External Tracheal Stimulation
+
+227
+00:15:07,780 --> 00:15:09,680
+اللي كنت بحكي عليه إنه أنا أعمل .. بدي أعمل
+
+228
+00:15:09,680 --> 00:15:13,460
+Stimulation عشان أحصل على الـ Cuffing This
+
+229
+00:15:13,460 --> 00:15:17,600
+achieved by applying manual pressure للـ thoracic
+
+230
+00:15:17,600 --> 00:15:23,120
+أو للـ Trachea أسفة above Manipural Notches اللي
+
+231
+00:15:23,120 --> 00:15:26,740
+هو فوق عدم تلقاس في عنا اللي هو مقبض الصيف لو
+
+232
+00:15:26,740 --> 00:15:30,140
+رجعنا شوية Anatomy فعدم تلقاس في عنا فوق اللي هو
+
+233
+00:15:30,140 --> 00:15:33,640
+بدي يكون Maniprium وهنا ال body و تحت ال X-fiber
+
+234
+00:15:33,640 --> 00:15:36,860
+processأنا على الـ Manipal Notch بدي أضغط عليها
+
+235
+00:15:36,860 --> 00:15:40,420
+فبالتالي أنا بعمل stimulation للـ cuffing this
+
+236
+00:15:40,420 --> 00:15:44,220
+creates partial trachea compression هذا بيعطينا
+
+237
+00:15:44,220 --> 00:15:47,200
+ضغط على ال tracheal compression which can cause
+
+238
+00:15:47,200 --> 00:15:50,620
+mechanical stimulation لل cuff mechanism كمان عند
+
+239
+00:15:50,620 --> 00:15:53,720
+الأطفال ممكن عن طريق ال tongue depressors أنه أنا
+
+240
+00:15:53,720 --> 00:15:57,460
+أفوتها في فم الطفل فبالتالي بعمل stimulation لل
+
+241
+00:15:57,460 --> 00:16:02,060
+cuff فبروح الطفل و هو بعد كده أعمل كحة عنديهذه
+
+242
+00:16:02,060 --> 00:16:06,160
+الأربع طرق للـ Cuff Stimulation تمام الـ Huffing و
+
+243
+00:16:06,160 --> 00:16:09,640
+أخدنا الـ Deep Breathing و الـ External Tracheal
+
+244
+00:16:09,640 --> 00:16:13,520
+Stimulation و أيضا اللي هي الـ Vibration أحد طرق
+
+245
+00:16:13,520 --> 00:16:21,300
+المساج الآن هدخل في الطريقة الخامسة من اللي هوالـ
+
+246
+00:16:21,300 --> 00:16:24,700
+Clearing للـ Airway Stimulation عن طريق الـ
+
+247
+00:16:24,700 --> 00:16:28,000
+Oropharynx with suction catheter لاحظوا معايا
+
+248
+00:16:28,000 --> 00:16:33,400
+حكينا Oro معناته فموي، هيكون من الفم، هنا Naso إذا
+
+249
+00:16:33,400 --> 00:16:37,120
+كانت الـ tube فايتة من الأنف، Nasopharynx إذا كانت
+
+250
+00:16:37,120 --> 00:16:40,560
+فايتة من الفم، Oropharynxالـ catheter اللي هي
+
+251
+00:16:40,560 --> 00:16:43,620
+عبارة عن ال tubes اللي أنا بدي أفوتها داخل جسم
+
+252
+00:16:43,620 --> 00:16:47,120
+الإنسان و ال none above method of cough
+
+253
+00:16:47,120 --> 00:16:49,500
+stimulation is successful وقت إيه أنا بدي
+
+254
+00:16:49,500 --> 00:16:53,740
+أستخدمها؟ في حالة فشلة الطرق الأربعة اللي أنا حكيت
+
+255
+00:16:53,740 --> 00:16:58,130
+عليهم لل airway clearnessهدخل فى الطريقة الخامسة
+
+256
+00:16:58,130 --> 00:17:02,990
+وهى مؤلمة جدا وإن فشلت الطريقة الخامسة هفوت بال
+
+257
+00:17:02,990 --> 00:17:05,670
+suction machine على طول يا إما بدي أفتح
+
+258
+00:17:05,670 --> 00:17:09,670
+Tracheostomy فتحها فى داخل الحلق اللى هى
+
+259
+00:17:09,670 --> 00:17:14,130
+Tracheostomy فى داخل الكراكية أو عن طريق اللى هو
+
+260
+00:17:14,130 --> 00:17:18,110
+ال mouse و أدخل tube زى ما حكينا Oropharynx و أعمل
+
+261
+00:17:18,110 --> 00:17:23,450
+اللى هو suction هذه الست طرق لل airway clearness
+
+262
+00:17:23,450 --> 00:17:28,480
+تمام؟هلأ شو ال complication تبعت ال cuff؟ أنا ممكن
+
+263
+00:17:28,480 --> 00:17:32,940
+أدخل في complication أو مضاعفات في ال cuffing على
+
+264
+00:17:32,940 --> 00:17:35,520
+صعيد ال respiratory system هيصير في عالنا
+
+265
+00:17:35,520 --> 00:17:39,260
+bronchoconstriction و أنا مابدي أصير هذا الشيء
+
+266
+00:17:39,260 --> 00:17:42,860
+لازم يكون عند ال bronchi بوضعها الطبيعي ال normal
+
+267
+00:17:42,860 --> 00:17:47,000
+حتى لو كانت في construction ممكن أعطيه
+
+268
+00:17:47,000 --> 00:17:50,880
+bronchodilators موسع للشعب الهوائي ال trauma to
+
+269
+00:17:50,880 --> 00:17:55,570
+airways and larynx بلا traumaنيمو ثوركس
+
+270
+00:17:55,570 --> 00:17:59,730
+Interstitial emphysema هاي كلها بتصير على صعيد ال
+
+271
+00:17:59,730 --> 00:18:04,210
+respiratory system hemodynamic، hemoblood، dynamic
+
+272
+00:18:04,210 --> 00:18:09,420
+movement، decrease للـvenous returnتمام، هنا على
+
+273
+00:18:09,420 --> 00:18:12,720
+الصعيد اللي هو الـ vessels و ال blood و الأمور
+
+274
+00:18:12,720 --> 00:18:16,580
+اللي هي علاقة بالcirculation ألثسميا، transit
+
+275
+00:18:16,580 --> 00:18:20,400
+ischemic أو systemic hypertension and hypotension
+
+276
+00:18:20,400 --> 00:18:23,820
+تمام، هذه أحد ال complications اللي بتصير على
+
+277
+00:18:23,820 --> 00:18:28,500
+الصعيد أو على مجال اللي هو الcirculatory cerebral
+
+278
+00:18:28,940 --> 00:18:33,520
+ممكن يدخل للمريض في حالة أغماء أو فقدر للوعي تام
+
+279
+00:18:33,520 --> 00:18:36,760
+بسبب زيادة في كمية الأكسجين أو نقص في كمية
+
+280
+00:18:36,760 --> 00:18:40,280
+الأكسجين اللي واصلة للدماغ على سعيد ال «chest
+
+281
+00:18:40,280 --> 00:18:43,420
+wall» ممكن يصير في عنا rib fractures مش إحنا حكينا
+
+282
+00:18:43,420 --> 00:18:46,500
+في ال «tracheal stimulation» إنه أنا بدي أعمل
+
+283
+00:18:46,500 --> 00:18:49,590
+simulation في ال «malibrium»فبالتالي ممكن لو كان
+
+284
+00:18:49,590 --> 00:18:52,770
+المرض osteoporosis على سبيل المثال أو عنده أو أنا
+
+285
+00:18:52,770 --> 00:18:56,310
+إجيت عملت ال stimulation بطريقة قوية جدا وفي عنه
+
+286
+00:18:56,310 --> 00:18:59,750
+pathological أو إشي مرضي لأن هذا الشخص ال patient
+
+287
+00:18:59,750 --> 00:19:03,790
+ممكن أسبب في fractures أو ممكن يصير في عندي
+
+288
+00:19:03,790 --> 00:19:08,710
+ruptures لل muscles اللي هي rectus abdominisأيضا
+
+289
+00:19:08,710 --> 00:19:13,370
+في حاجات تانية ممكن تصير أو متعلقات أخرى بنسميها
+
+290
+00:19:13,370 --> 00:19:16,550
+زي ال urinary incontinence ممكن من ال complication
+
+291
+00:19:16,550 --> 00:19:21,750
+أو pulmonary emboli اللي هي عبارة عن embolism تمشي
+
+292
+00:19:21,750 --> 00:19:24,450
+مع ال pulmonary هذه الخامسة هي عبارة عن
+
+293
+00:19:24,450 --> 00:19:28,750
+complication لل cuffing اللي أنا هعملها مش بإيرادة
+
+294
+00:19:28,750 --> 00:19:32,030
+المريض ال cuffing اللي أنا هعملها غصب عن المريض أو
+
+295
+00:19:32,030 --> 00:19:36,240
+هعملها بعدم إيرادته شهو ال tracheal suction؟الـ
+
+296
+00:19:36,240 --> 00:19:40,140
+suction is performed routinely in a tube yet يعني
+
+297
+00:19:40,140 --> 00:19:44,820
+أنا بدأ أفوت لتيوب داخل ال patient to removeand
+
+298
+00:19:44,820 --> 00:19:48,520
+cuffing stimulation عشان أشيل السكريشن وممكن عشان
+
+299
+00:19:48,520 --> 00:19:52,120
+أعمل cuffing ال frequency تبعته determined by
+
+300
+00:19:52,120 --> 00:19:56,640
+quantity of secretion كم هي كمية السكريشن هل هو مش
+
+301
+00:19:56,640 --> 00:20:00,380
+جادر اتنفس فعلا من إنه في أنا blocking أو blockage
+
+302
+00:20:00,380 --> 00:20:06,880
+اللي هي انسداد لل airway بالسكريشن ولا كيف أنا بدي
+
+303
+00:20:06,880 --> 00:20:11,810
+أعمل تمام؟الأوروفرانجيال زى ما حكينا أورو من الفم
+
+304
+00:20:11,810 --> 00:20:16,530
+و nasal من الأنف الأوروفرانجيال airway بستخدمها لل
+
+305
+00:20:16,530 --> 00:20:19,490
+unconscious patient ليه؟ لإن لو استخدمت
+
+306
+00:20:19,490 --> 00:20:23,430
+الأوروفرانجيال لل patient ال conscious هدا هيعمللي
+
+307
+00:20:23,430 --> 00:20:26,150
+اللى هو vomiting فبالتالي بيصير في عندنا
+
+308
+00:20:26,150 --> 00:20:28,990
+aspiration عملية ال aspiration هي عبارة عن عملية
+
+309
+00:20:28,990 --> 00:20:32,910
+الشردقة لإن ممكن يسكن ال patient عندى conscious
+
+310
+00:20:32,910 --> 00:20:36,390
+وواعى وبياكل وانا أروح أعمله أوروفرانجيال فبالتالي
+
+311
+00:20:36,390 --> 00:20:40,010
+ممكن أفوت اللى هوالـ Digestive System على الـ
+
+312
+00:20:40,010 --> 00:20:43,830
+Respiratory System مما يؤدي لحدوث اللي هي الـ
+
+313
+00:20:43,830 --> 00:20:47,770
+Aspiration وأنا هنا هفوت في مشاكل تانية هلأ الـ
+
+314
+00:20:47,770 --> 00:20:52,090
+Proper Size سببها الـ Oropharyngeal تعتمد أو ممكن
+
+315
+00:20:52,090 --> 00:20:56,690
+أنا أقدرها من المسافة الواقعة من اللي هي Check and
+
+316
+00:20:56,690 --> 00:20:59,910
+Measuring للـDistance from Corner of Mouth to Air
+
+317
+00:21:00,220 --> 00:21:03,540
+من اسمها oro معناه تقلب دي المسافة من الأنف إلى
+
+318
+00:21:03,540 --> 00:21:07,040
+الأذن زي ما أنتوا شايفينها من ال mouth أسفة من
+
+319
+00:21:07,040 --> 00:21:12,880
+الفم لأذن هي بيسميها ال oro phalangeal هاي هاعملها
+
+320
+00:21:12,880 --> 00:21:16,960
+هنا بعض الصور اللي هي هذه المسافة من ال corner من
+
+321
+00:21:16,960 --> 00:21:23,090
+زاوية الفم ل اللي هيالأذن تمام نيجي نشوف ال
+
+322
+00:21:23,090 --> 00:21:26,450
+nasopharyngeal الاستخدامات ال nasopharyngeal
+
+323
+00:21:26,450 --> 00:21:29,970
+لحالات ال conscious ممكن استخدمها مع الناس اللي هم
+
+324
+00:21:29,970 --> 00:21:34,210
+وعين و okay لإن مافي عندي مشاكل في اللي هي ال
+
+325
+00:21:34,210 --> 00:21:38,140
+aspirationالـ advantage تبعتها حكينا بستخدمها مع
+
+326
+00:21:38,140 --> 00:21:41,020
+الـ conscious والـ semi-conscious كمان to be air
+
+327
+00:21:41,020 --> 00:21:43,960
+-tolerate أما ال proper distance تبعتها هي تكون من
+
+328
+00:21:43,960 --> 00:21:48,320
+ال tip of thing في north لحجم توصل الـ air
+
+329
+00:21:48,320 --> 00:21:52,800
+بالإضافة إلى واحد inch يعني لو كانت المسافة مثلا
+
+330
+00:21:52,800 --> 00:21:57,380
+عشرة سانتي من الأنف لحافة الأذن بزيد عليها كمان
+
+331
+00:21:57,380 --> 00:22:01,140
+واحد قبل ال insertion اللي هي ال airway should be
+
+332
+00:22:01,140 --> 00:22:07,460
+lubricated andof water or soluble lubricant قبل ما
+
+333
+00:22:07,460 --> 00:22:12,460
+أغرس هذا التيوب الصغير ممكن أنا يا إما بغمسه في
+
+334
+00:22:12,460 --> 00:22:18,800
+ماء أو إنه بحط عليه جل حتى إنه يصير بشكل جيد تمام؟
+
+335
+00:22:18,800 --> 00:22:21,800
+ويكون سهل اللي هو ال intubation أو سهل الإدخال
+
+336
+00:22:21,800 --> 00:22:28,110
+تبعه هاي هو، هيلاحظوا الأنف؟من اللي هي الأنف لـ
+
+337
+00:22:28,110 --> 00:22:32,670
+mouse بقس المسافة و بدخل على طول إلى الداخل تمام
+
+338
+00:22:32,670 --> 00:22:39,970
+هذه هي أنا فوته من الأنف و دخل لجوا الـ angiotube
+
+339
+00:22:39,970 --> 00:22:42,650
+اللي هو الـ nasogastric كمان ممكن بس هيوصل لل
+
+340
+00:22:42,650 --> 00:22:46,310
+gastric تحت لل abdomen it's painful painful
+
+341
+00:22:46,310 --> 00:22:51,400
+painfulالـ Endotracheal tube كمان نفس الاشي to
+
+342
+00:22:51,400 --> 00:22:54,860
+prevent airway obstruction أيضًا من أهدافه تفسّل
+
+343
+00:22:54,860 --> 00:22:58,080
+تاتد من جلال الـ suction وprovide mechanical
+
+344
+00:22:58,080 --> 00:23:01,940
+ventilation and protect للأعلى من أي foreign body
+
+345
+00:23:01,940 --> 00:23:05,860
+تمام؟ الـ Endotracheal tubes إن أنا دخلت على الـ
+
+346
+00:23:05,860 --> 00:23:10,040
+Endotracheal مصنع من الـ polyvinyl chloride أو
+
+347
+00:23:10,040 --> 00:23:13,590
+السيليكون حتى يكون طريقالأن هو rigid لما يكون برا
+
+348
+00:23:13,590 --> 00:23:17,930
+ولكن مع حرارة الجسم بيصير أكثر soft فبالتالي أنا
+
+349
+00:23:17,930 --> 00:23:20,890
+لما أكون في إيدي rigid لكن لما بدخل داخل جسم
+
+350
+00:23:20,890 --> 00:23:27,170
+الإنسان بيصير أكثر soft مع اللي هو الـ body
+
+351
+00:23:27,170 --> 00:23:32,410
+temperature الـ polyvinyl chloride does not reach
+
+352
+00:23:32,410 --> 00:23:35,550
+أو does not react with tissue and small to
+
+353
+00:23:35,550 --> 00:23:39,230
+facilitate passage of suction catheter والتيوب هذا
+
+354
+00:23:40,430 --> 00:23:44,730
+marking to inside diameter and outside diameter in
+
+355
+00:23:44,730 --> 00:23:48,210
+millimeter أنه بيقيصوا باللي اللي هو بالmillimeter
+
+356
+00:23:48,210 --> 00:23:51,630
+ال inside و ال outside تبعه فيه طبعا اللي هو من
+
+357
+00:23:51,630 --> 00:23:54,950
+أجزاء ال cuff في ال endotracheal can be inflated
+
+358
+00:23:54,950 --> 00:23:59,370
+with using اللي هي السرنجة أنه أنا ممكن أسطحه عن
+
+359
+00:23:59,370 --> 00:24:03,800
+طريق اللي هو السرنجةالـ Cuff high provide fixation
+
+360
+00:24:03,800 --> 00:24:07,000
+للـ endotracheal tube وحنشوفها في الصور القادمة to
+
+361
+00:24:07,000 --> 00:24:10,460
+prevent air lack في التراكيا to produce minimal
+
+362
+00:24:10,460 --> 00:24:14,320
+pressure on tracheal mucus حتى تمنع اللي هي
+
+363
+00:24:14,320 --> 00:24:17,040
+لتراكيا الميوكاس and that's minimal ischemic
+
+364
+00:24:17,040 --> 00:24:22,020
+injury to tracheal wallهي اللي هي بنحكي عليها هاد
+
+365
+00:24:22,020 --> 00:24:25,240
+التراكيا طبعا اللي هي الحنجرة هذا ال tongue لتحت
+
+366
+00:24:25,240 --> 00:24:28,320
+وهنا ال endotracheal tube دخل من الداخل
+
+367
+00:24:28,320 --> 00:24:32,700
+endotracheal tube تمام وهي ال cuffing عملنا فيها
+
+368
+00:24:32,700 --> 00:24:36,240
+flattening tube في ال flattening اللي هي cuffing
+
+369
+00:24:36,240 --> 00:24:39,780
+وهذا ال esophagus المريء هذا اللي هو عبارة عن ال
+
+370
+00:24:39,780 --> 00:24:45,420
+intubation أو اللي هو ال endotracheal tube لان
+
+371
+00:24:45,420 --> 00:24:49,280
+الطريقة اللي هي لتركزتميهالـ Tracheostomy طبعا هي
+
+372
+00:24:49,280 --> 00:24:52,480
+عبارة عن لتراكيا بدي يصير فيها ectomy with several
+
+373
+00:24:52,480 --> 00:24:56,220
+advantages over للأورال والنازل اندو تراكيا لتيوب،
+
+374
+00:24:56,220 --> 00:24:59,080
+اللي لها مميزات كتير منيحة ال suction is
+
+375
+00:24:59,080 --> 00:25:01,820
+facilitated and better tolerated by conscious
+
+376
+00:25:01,820 --> 00:25:05,600
+patientsمهم جدا إنه أنا أتعامل فيها مع الـ
+
+377
+00:25:05,600 --> 00:25:08,460
+Conscious Patient «Fixation tube is easier to
+
+378
+00:25:08,460 --> 00:25:12,600
+eating and even speaking are possible» بعض الأحيان
+
+379
+00:25:12,600 --> 00:25:16,240
+ممكن الناس اللي عملوا trackers to me يتكلموا ولكن
+
+380
+00:25:16,240 --> 00:25:20,840
+بتكونش اللي هي الصوت واضح يعني إلى لما يغلق اللي
+
+381
+00:25:20,840 --> 00:25:24,500
+هي بتركز to me «and changing tube is easier» سهل
+
+382
+00:25:24,500 --> 00:25:28,450
+إنه يغيرهاالـ Tracheostomy is also used when long
+
+383
+00:25:28,450 --> 00:25:31,290
+term airway is needed لما بده يهجى على المدى
+
+384
+00:25:31,290 --> 00:25:35,330
+البعيد مش صح إنه أنا أخليه ماشي في الشارع مع اللي
+
+385
+00:25:35,330 --> 00:25:40,410
+هي الـ endotracheal tube أو أي نازو tube أو أي إشي
+
+386
+00:25:40,410 --> 00:25:42,970
+لأ ال Tracheostomy بتكون أفضل يعني هي ممكن تشوفوا
+
+387
+00:25:42,970 --> 00:25:47,030
+ناس ماشية ب Tracheostomy أو اللي هو مغطيها ال
+
+388
+00:25:47,030 --> 00:25:50,430
+airway constant usually after 10 to 14 days
+
+389
+00:25:50,430 --> 00:25:55,710
+intubation تمام؟هذه اللي هي التراكستومي اللي موجود
+
+390
+00:25:55,710 --> 00:26:01,650
+عندنا كيف صار اللي هو cutting لتراكيا و ادخال ل
+
+391
+00:26:01,650 --> 00:26:06,270
+tubes من التراكستومي من هنا طبعا بتتم عن طريق أو
+
+392
+00:26:06,270 --> 00:26:10,770
+under supervision by doctors و بداية تماما بتكون
+
+393
+00:26:10,770 --> 00:26:13,370
+مع ال unconscious patient و بعدين ممكن يتعامل معها
+
+394
+00:26:13,370 --> 00:26:17,030
+و بعدين بصير winning ل ال ventilation هذا و
+
+395
+00:26:17,030 --> 00:26:22,750
+اغلاقها بالكامل تمام؟الـ Basic steps في عندنا بعض
+
+396
+00:26:22,750 --> 00:26:25,950
+الخطوات أنا حذفتهم ما بدنا إياهم في عندنا الـ
+
+397
+00:26:25,950 --> 00:26:29,070
+Basic steps للـ suction procedures كيف أنا ممكن
+
+398
+00:26:29,070 --> 00:26:31,950
+أتعامل أو suction تلك الـ tummy tubes اللي أنا
+
+399
+00:26:31,950 --> 00:26:35,670
+عندي هذا الشخص مثلا في كومة وداخل الـ intensive
+
+400
+00:26:35,670 --> 00:26:39,010
+care unit فبالتالي أنا بدي أعمله suction عشان أعمل
+
+401
+00:26:39,010 --> 00:26:41,780
+removal لل-secretionConnect للـ catheter with
+
+402
+00:26:41,780 --> 00:26:44,800
+suction machine طبعا أهم إشي لازم أنا أعقم ال
+
+403
+00:26:44,800 --> 00:26:48,120
+machine أعقم ال tubes اللي أنا بدي أحطها لإنه
+
+404
+00:26:48,120 --> 00:26:52,360
+المسألة هنا مسألة خطيرة خصوصا إحنا بنحكي على COVID
+
+405
+00:26:52,360 --> 00:26:56,100
+-19 في هذه الأيام فبالتالي ال sterilization مهم
+
+406
+00:26:56,100 --> 00:27:00,080
+جداهذا أول إشي تاني إشي insert للكثيتر proper
+
+407
+00:27:00,080 --> 00:27:04,020
+distance into trachea tube usual length to reach
+
+408
+00:27:04,020 --> 00:27:08,500
+ربع إنش أدخله داخل اللي هي اللي تركز to me و أبدأ
+
+409
+00:27:08,500 --> 00:27:11,800
+أشغل ال machine في اللي هو أنه يبدأ يشفط
+
+410
+00:27:11,800 --> 00:27:15,580
+لـsecretion اللي موجود apply suction putting your
+
+411
+00:27:15,580 --> 00:27:19,280
+thumb over the hall of catheterزي ما انتوا شايفين
+
+412
+00:27:19,280 --> 00:27:24,900
+وضغط عليها وليهنا بيبدأ يحرك فيها عشان تشفط كتير
+
+413
+00:27:24,900 --> 00:27:28,720
+احنا كلنا بنستخدمها في اللي هو ال «inpatient» اللي
+
+414
+00:27:28,720 --> 00:27:31,780
+هم موجودين في ال «ICU» «Gently» ال «catheter»
+
+415
+00:27:31,780 --> 00:27:35,930
+between your thumb and fingertips طبعااللي هو as
+
+416
+00:27:35,930 --> 00:27:38,530
+you pull catheter out زي ما انتوا شايفينه بحرك
+
+417
+00:27:38,530 --> 00:27:41,930
+فيها هاي اللي هي كيف ال suction تركز to me أنا
+
+418
+00:27:41,930 --> 00:27:44,830
+ممكن أعملها وبتجيب معناه نتائج جيدة بس إلها
+
+419
+00:27:44,830 --> 00:27:50,050
+disadvantage إن هو طبعا easy to infected للشخص
+
+420
+00:27:50,050 --> 00:27:54,970
+المصاب يعني مش سهل أنه هو يعني جديد نكون حارسين عن
+
+421
+00:27:54,970 --> 00:27:59,530
+ال sterilization ولكن بيصير في عندنا damage لبعض
+
+422
+00:27:59,530 --> 00:28:03,480
+اللي هوالـ «Tissues» اللي موجودة في التراكيا فهي
+
+423
+00:28:03,480 --> 00:28:09,500
+مش آمنة خالص. هلأ، شو difficulty تبعت ال
+
+424
+00:28:09,500 --> 00:28:13,380
+«cannulation»؟ إنه أنا أعمل «cannula» داخل، إحنا
+
+425
+00:28:13,380 --> 00:28:16,040
+شبهها هنا ب «cannula»، داخل اللي هو
+
+426
+00:28:16,040 --> 00:28:19,220
+الـ«minibronchi» اللي أنتوا شايفين، هذه اللي هي
+
+427
+00:28:19,220 --> 00:28:23,380
+التراكيا، هنا هاي البرونكاي، هاي البرونكوليوز اللي
+
+428
+00:28:23,380 --> 00:28:25,380
+هي البرونكوليوز، اللي هي عبارة عن الشعيبات
+
+429
+00:28:25,380 --> 00:28:28,870
+الهوائيةit's more difficult to pass a suction
+
+430
+00:28:28,870 --> 00:28:33,250
+catheter into left than right لأن حكينا I have two
+
+431
+00:28:33,250 --> 00:28:37,570
+lungs one of them right and one of them left الآن
+
+432
+00:28:37,570 --> 00:28:43,810
+هاي ال right three loops تمام و ال left two loops
+
+433
+00:28:43,810 --> 00:28:49,930
+حكينا ليش لو وجود ال heart ال catheter إنها تمر في
+
+434
+00:28:49,930 --> 00:28:55,760
+خلال اللي هو ال left is difficult than rightطبعاً
+
+435
+00:28:55,760 --> 00:28:59,080
+لأنه في تلاتة loops هيكون صعب أن تفوت في الـ left
+
+436
+00:28:59,080 --> 00:29:04,960
+في ال adult ال right main stem أو اللي هي الشجرة
+
+437
+00:29:04,960 --> 00:29:09,280
+الأساسية تبعتنا Bronchus usually comes off angle
+
+438
+00:29:09,280 --> 00:29:14,540
+about 200 from midline sagittal تبعد حوالي بزاوية
+
+439
+00:29:14,540 --> 00:29:20,230
+200 هذه المد ساجتال من المد ساجتالتمام where is
+
+440
+00:29:20,230 --> 00:29:23,310
+the left اللي هو بده يكون marked angle about
+
+441
+00:29:23,310 --> 00:29:26,850
+تلاتمية وخمسين similar angle في ال biofrictions
+
+442
+00:29:26,850 --> 00:29:29,910
+are noted in النيونيات اللي هم المواليد ميتين
+
+443
+00:29:29,910 --> 00:29:33,430
+واربعين ال right واربعمية واربعين في ال left
+
+444
+00:29:33,430 --> 00:29:40,570
+فبالتالي بيكون صعب دخولها على ال left it suggested
+
+445
+00:29:40,570 --> 00:29:46,670
+that turning the head to rightto tilting body lift
+
+446
+00:29:46,670 --> 00:29:49,650
+increase change in successful cannulation to lift
+
+447
+00:29:49,650 --> 00:29:53,650
+برنقais لحالها بتلف ليه؟ لأنه سهل تفوت على الـ
+
+448
+00:29:53,650 --> 00:29:57,910
+right أكتر من الـ left curved tip أو هذا اللي هو
+
+449
+00:29:57,910 --> 00:30:01,730
+الـ curved cured هذا الـ catheter خلال to improve
+
+450
+00:30:01,730 --> 00:30:04,410
+the chance entering to left lung during suction
+
+451
+00:30:04,410 --> 00:30:07,590
+فبالتالي بتفوت معانا على الـ left lung أكتر من
+
+452
+00:30:07,590 --> 00:30:12,610
+اللي هو الـ right lung هذا هي كل ما لدينا في اللي
+
+453
+00:30:12,610 --> 00:30:18,230
+هو intensive care unitوألقاكم بإذن الله تعالى في
+
+454
+00:30:18,230 --> 00:30:21,630
+intensive care unit part 2 في أمان الله
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/MUUknHF3SV4.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/MUUknHF3SV4.srt
new file mode 100644
index 0000000000000000000000000000000000000000..cd4c096557cef343f5c830dc24b3485b753a13b4
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/MUUknHF3SV4.srt
@@ -0,0 +1,1367 @@
+1
+00:00:01,290 --> 00:00:05,050
+والصلاة والسلام علي أشرف الأنبياء والمرسلين إن شاء الله
+
+2
+00:00:05,050 --> 00:00:08,630
+بالعالمين، المحاضرة هذه راح أدخل في الـ chapter
+
+3
+00:00:08,630 --> 00:00:13,770
+الأخير أو الـ part الأخير من هذا المساق، سأتحدث فيه
+
+4
+00:00:13,770 --> 00:00:17,370
+عن الـ Pulmonary Physiotherapy ودور الـ Physiotherapy في
+
+5
+00:00:17,370 --> 00:00:22,430
+كل Chest Disease. نبدأ على بركة الله في فيديو رقم
+
+6
+00:00:22,430 --> 00:00:23,030
+10
+
+7
+00:00:30,370 --> 00:00:35,910
+لأن المعروف أن الـ Respiratory System هو عبارة عن
+
+8
+00:00:35,910 --> 00:00:40,390
+الشيء اللي بيمد الجسم بالـ Oxygen Supply، تمام؟
+
+9
+00:00:40,390 --> 00:00:46,390
+فبالتالي سلامة الـ life هتأدي إلى ضخ كمية ممتازة
+
+10
+00:00:46,390 --> 00:00:51,210
+للخلايا (Cells of a human body) required constant of
+
+11
+00:00:51,210 --> 00:00:55,230
+stream oxygen to stay alive. النظام التنفسى
+
+12
+00:00:55,230 --> 00:01:00,150
+يعطي أكسجين للجسم، وإزالة ما يسمى بالكربون
+
+13
+00:01:00,150 --> 00:01:05,610
+دايأوكسايد، وWaste Product، كـ byproduct ثالث، إذا كان مسموحاً
+
+14
+00:01:05,610 --> 00:01:10,510
+لـAccumulated، أي تراكم أو أي تكون لثاني أكسيد
+
+15
+00:01:10,510 --> 00:01:15,630
+الكربون هذا بيؤدي إلى حالة من اللي هي عدم الايضاب
+
+16
+00:01:15,630 --> 00:01:20,470
+في الجسم، وبالأخر إلى وفاة هذا الشخص. هناك ثلاثة أجزاء
+
+17
+00:01:20,470 --> 00:01:24,420
+مهمة من نظام الجهاز التنفسي. الـ Airway أنا بهمني
+
+18
+00:01:24,420 --> 00:01:27,840
+سلامة الـ Airway. هل فيه أي Obstructions؟ هل فيه أي
+
+19
+00:01:27,840 --> 00:01:32,520
+Secretions؟ هل فيه أي مشكلة بتعيقني؟ الـ Lungs اللي
+
+20
+00:01:32,520 --> 00:01:37,020
+فيها عملية الـ Gas Exchange مهمة جداً أيضاً، بتهمني
+
+21
+00:01:37,020 --> 00:01:40,280
+سلامة الـ Muscles of Respiration سواء اللي هو الـ
+
+22
+00:01:40,280 --> 00:01:44,620
+Mainly Muscle أو الـ Accessory Muscle. كل هذه الثلاث
+
+23
+00:01:44,620 --> 00:01:49,710
+محاور أنا هشتغل عليها بالـ Physiotherapy Program. هدخل
+
+24
+00:01:49,710 --> 00:01:53,870
+مباشرة في الـ Physiotherapy Part و الـ Anatomy وما
+
+25
+00:01:53,870 --> 00:01:58,370
+يتعلق في المقدمة من هذا الـ Chapter، تركته، وهأدخل
+
+26
+00:01:58,370 --> 00:02:02,670
+مباشرة في الـ Physiotherapy Program لأن الـ Aspects
+
+27
+00:02:02,670 --> 00:02:04,950
+of Respiratory Rehabilitation include all of the
+
+28
+00:02:04,950 --> 00:02:07,970
+following: الـ Patient Assessment and Goal Setting،
+
+29
+00:02:07,970 --> 00:02:12,970
+الـ Exercise Training، Self Management Education، و
+
+30
+00:02:12,970 --> 00:02:15,850
+الـ Nutritional Intervention، و الـ Psychosocial
+
+31
+00:02:15,850 --> 00:02:19,690
+Support. هي الـ Aspects اللي أنا هشتغل عليها في الـ
+
+32
+00:02:19,690 --> 00:02:24,510
+Respiratory Rehabilitation، تمام؟ زي أي مريض، بنبدأ
+
+33
+00:02:24,510 --> 00:02:29,350
+بوضع الـ Assessment له، بيشمل كل ما يتعلق في المريض
+
+34
+00:02:29,350 --> 00:02:32,370
+الـ Past History، و الـ Present History، و كل الأمور
+
+35
+00:02:32,370 --> 00:02:35,470
+دي. بعدين أنا بدي أبدأ أضع اللي هو الـ Plan of
+
+36
+00:02:35,470 --> 00:02:38,790
+Treatment. الـ Plan بتاعتي هتشمل طبعاً فيها الـ Goal
+
+37
+00:02:38,790 --> 00:02:42,690
+Setting، الـ Exercise Training، الـ Self Management، الـ
+
+38
+00:02:42,690 --> 00:02:46,910
+Home Program. هل هو مثلاً على سبيل المثال بيصير فيه
+
+39
+00:02:46,910 --> 00:02:50,590
+عنده Difficulty of Breathing في وقت الليل، إن
+
+40
+00:02:50,590 --> 00:02:55,130
+النهار بيكون سليم، كل هذه الأمور أنا هناقشها في
+
+41
+00:02:55,130 --> 00:02:58,230
+محاضرة اليوم بإذن الله تعالى فيما يخص الـ
+
+42
+00:02:58,230 --> 00:03:02,810
+Assessment of Pulmonary Physiotherapy. هأتكلم على
+
+43
+00:03:02,810 --> 00:03:06,790
+ثمانية من الـ Aims of Physical Therapy للـ Pulmonary
+
+44
+00:03:06,790 --> 00:03:11,270
+Disease. أول هدف إلي أنا ببدأ أشتغل عليه مع أي مريض في
+
+45
+00:03:11,270 --> 00:03:15,110
+قسم الصدرية، بدي يكون هدفي الأساسي والأولاني To
+
+46
+00:03:15,110 --> 00:03:18,210
+Prevent Airway Obstruction. أي شيء هيعملي
+
+47
+00:03:18,210 --> 00:03:22,990
+Obstruction لازم أنا أبدأ أتعامل مع الشيء وأشيله
+
+48
+00:03:22,990 --> 00:03:26,680
+سواء كان بالـ Physiotherapy Program أو بمساعدة اللي
+
+49
+00:03:26,680 --> 00:03:30,580
+هو الـ Medication مع الدكتور To Improve Airway
+
+50
+00:03:30,580 --> 00:03:33,740
+Clearness. هذا كمان بيهمني. And Ventilation
+
+51
+00:03:33,740 --> 00:03:37,520
+Through Mobilization and Drainage of Secretion.
+
+52
+00:03:37,520 --> 00:03:41,100
+الآن To Improve للـ Endurance and General Exercise
+
+53
+00:03:41,100 --> 00:03:44,680
+Tolerance and Overall Wellbeing. بيهمني كمان الـ
+
+54
+00:03:44,680 --> 00:03:48,200
+Endurance.  جدي استعداد المريض وقابليته لأداء الـ
+
+55
+00:03:48,200 --> 00:03:52,860
+Exercise. هل عنده Good Tolerance ولا لسه هو Fatigue؟
+
+56
+00:03:52,860 --> 00:03:56,460
+To Reduce للـ Energy Cost During Respiration خلال
+
+57
+00:03:56,460 --> 00:03:59,900
+الـ Breathing Retraining. الآن أنا بدل ما يبدل هذا
+
+58
+00:03:59,900 --> 00:04:04,540
+المجهود ويخلص كل كمية الطاقة عند هذا المريض، لأ، بدي
+
+59
+00:04:04,540 --> 00:04:09,900
+أحاول أقلل أو أخليه يتنفس بـ Pattern معين بحيث أنه
+
+60
+00:04:09,900 --> 00:04:13,420
+ما تنتهي الطاقة عنده اللي هي المفروض أنا أستخدمها
+
+61
+00:04:13,420 --> 00:04:17,520
+بعد هيك فيه أشياء تانية مهمة، تمام؟ أيضاً من الأهداف
+
+62
+00:04:17,520 --> 00:04:21,320
+To Prevent or Correct الـ Postural Deformities. بعض
+
+63
+00:04:21,320 --> 00:04:25,680
+الأحيان بما أنه بيكون على سبيل المثال عنده مشكلة
+
+64
+00:04:25,680 --> 00:04:29,860
+معينة، معاق معينة، بيروح هو واخد وضعية معينة خاطئة على
+
+65
+00:04:29,860 --> 00:04:33,600
+أساس أنه يتحايل على الألم أو أنه يتفادى هذا الألم
+
+66
+00:04:33,850 --> 00:04:38,110
+فبالتالي بتصير هي كانت بمجرد محاولة على ألم، بعد
+
+67
+00:04:38,110 --> 00:04:43,030
+شهر شهرين بتصير عبارة عن عادة وإعاقة مستديمة، معاناة
+
+68
+00:04:43,030 --> 00:04:46,210
+دي، للمثال زي الـ Scoliosis مثلاً، فبالتالي هنا أنا
+
+69
+00:04:46,210 --> 00:04:49,870
+دوري To Prevent أيضاً أو To Correct لأي Potential
+
+70
+00:04:49,870 --> 00:04:54,180
+Deformity. هتصير To Promote Relaxation. إذا أنا عملت
+
+71
+00:04:54,180 --> 00:04:57,320
+Breathing Exercise، خصصتُ بـ Breathing، معناه أن أنا
+
+72
+00:04:57,320 --> 00:05:00,740
+بعمل Relaxation، General Relaxation، To Maintain or
+
+73
+00:05:00,740 --> 00:05:03,880
+Improve the Chest Mobility. مهم جداً إنه أنا أخلي
+
+74
+00:05:03,880 --> 00:05:07,780
+اللي هو يكون في عندي Chest Mobility حتى إنه أنا
+
+75
+00:05:07,780 --> 00:05:11,960
+أترك مجال للـ Lungs تاخد راحتها في الـ Inspiration
+
+76
+00:05:11,960 --> 00:05:15,820
+and then Expiration. To Improve الـ Cough Effectiveness.
+
+77
+00:05:16,460 --> 00:05:20,020
+الـ Cough هنا مجالها واسع وموضوعها مهم جداً، إذا أنا
+
+78
+00:05:20,020 --> 00:05:22,840
+حسّنت من موضوع الـ Coughing، فمعناه الكلام إنه أنا
+
+79
+00:05:22,840 --> 00:05:26,400
+هأعمل Clearness للـ Airway، معناه الكلام إنه أنا
+
+80
+00:05:26,400 --> 00:05:31,200
+هأدخل كمية كويسة من الأكسجين إلى داخل الجسم وأخرج
+
+81
+00:05:31,200 --> 00:05:35,100
+اللي هو الـ Carbondioxide. فبالتالي أنا هنا حسّنت من
+
+82
+00:05:35,100 --> 00:05:39,100
+الـ Lung Functions. هذا المهم في كل الـ Respiratory
+
+83
+00:05:39,100 --> 00:05:44,810
+طبعاً System. الـ Evaluation تبعنا في تقييم المريض، شو
+
+84
+00:05:44,810 --> 00:05:48,090
+أهدافي أنا من هذه الـ Examination؟ إنه أنا أعمل
+
+85
+00:05:48,090 --> 00:05:50,150
+الـ Determine للـ Patient، الـ Primary and
+
+86
+00:05:50,150 --> 00:05:52,710
+Secondary Respiratory and Ventilatory Impairments.
+
+87
+00:05:52,710 --> 00:05:58,460
+بدي أحدد شو المشاكل الأساسية والثانوية. How
+
+88
+00:05:58,460 --> 00:06:00,840
+environmentally limits your physical function؟ هل
+
+89
+00:06:00,840 --> 00:06:04,840
+بتأثر على وظائفه الحيوية؟ على سبيل المثال هو مثلاً
+
+90
+00:06:04,840 --> 00:06:08,060
+تجينا الست بتقول لك أنا بس أطلع الدرج بيصير في عندي
+
+91
+00:06:08,060 --> 00:06:12,860
+اختناق. بدي أشوف هل هي بتأثر عليها ولا لأ. To remind
+
+92
+00:06:12,860 --> 00:06:16,520
+the education. The Ventilatory Pump and Oxygen
+
+93
+00:06:16,520 --> 00:06:21,320
+Uptake طبعاً، وإزالة ثاني أكسيد الكربون To Meet
+
+94
+00:06:21,320 --> 00:06:24,740
+Oxygen Demand During Functional Activities. بدي
+
+95
+00:06:24,740 --> 00:06:28,780
+أحدد اللي هو عملية المدخول في حالة استقطاب
+
+96
+00:06:28,780 --> 00:06:32,780
+الأكسجين أو في حالة استهلاك كمية الأكسجين، وطرد الـ
+
+97
+00:06:32,780 --> 00:06:36,140
+Waste Product. أيضاً بدي أشوف اللي هو To Assess
+
+98
+00:06:36,140 --> 00:06:39,760
+Patient Suitability for Participation in
+
+99
+00:06:39,760 --> 00:06:44,440
+Rehabilitation Programs. بأكد عليه في وجود
+
+100
+00:06:44,440 --> 00:06:47,900
+أو حضوره في المشاركة في عملية الـ Rehabilitation.
+
+101
+00:06:47,900 --> 00:06:53,490
+هل له دور فعال ولا لأ؟ أكبر تطور في تجارب عملية
+
+102
+00:06:53,490 --> 00:06:58,770
+(repeated phrase removed for brevity)
+
+107
+00:07:09,690 --> 00:07:11,030
+(repeated phrase removed for brevity)
+
+108
+00:07:11,030 --> 00:07:20,670
+(repeated phrase removed for brevity)
+
+109
+00:07:20,980 --> 00:07:25,940
+الـ Lung Fibrosis أو عنده اللي هو مشكلة في الـ
+
+110
+00:07:25,940 --> 00:07:29,780
+Lungs. بدي أعرف ليش هو توقف عن البرنامج، معناه
+
+111
+00:07:29,780 --> 00:07:33,260
+الكلام إنه فيه سبب إنه خلاّه يستأمن هذا الوضع
+
+112
+00:07:33,260 --> 00:07:35,860
+فبالتالي ما كمل معايا الـ Breathing Exercise على
+
+113
+00:07:35,860 --> 00:07:39,020
+سبييل المثال و بطل يجي على الجلسة أو بطل يكمل الـ
+
+114
+00:07:39,020 --> 00:07:42,960
+Home Program بتاعه. إذا لازم أنا أبحث في هذا الشيء
+
+115
+00:07:42,960 --> 00:07:48,260
+وأشوف شو المشكلة اللي أدت إلى ذلك. شو الـ Components
+
+116
+00:07:48,260 --> 00:07:51,520
+تبع الـ Initial Patient Assessment؟ الـ Patient
+
+117
+00:07:51,520 --> 00:07:55,200
+Interview، الـ Medical History. هأشوف في الـ Physical
+
+118
+00:07:55,200 --> 00:07:58,680
+Assessment، الـ Review للـ Diagnostic Tests. هأشوف اللي
+
+119
+00:07:58,680 --> 00:08:02,640
+هو تحويله تبع الدكتور و الـ Symptoms Assessment.
+
+120
+00:08:02,640 --> 00:08:05,800
+أيضاً في الـ General Assessment بدي أشوف زي ما أي
+
+121
+00:08:05,800 --> 00:08:08,700
+Assessment بنعمله، الـ Age، و الـ Name، و الـ Sex، و الـ
+
+122
+00:08:08,700 --> 00:08:12,200
+Occupation، و الـ Social History، و كل هذه الأمور. هل
+
+123
+00:08:12,200 --> 00:08:16,980
+هو مدخن ولا مش مدخن؟ بيستخدم أدوية أخرى ولا لأ؟ على
+
+124
+00:08:16,980 --> 00:08:20,980
+سبيل المثال، هل كان يستخدم بخاخة قبل كده ولا لأ؟
+
+125
+00:08:20,980 --> 00:08:24,540
+هل بيستخدم أدوية الـ Bronchodilators أو لأ؟ Usual
+
+126
+00:08:24,540 --> 00:08:28,340
+Activities Level Including Employment. هل هو موظف؟
+
+127
+00:08:28,340 --> 00:08:33,420
+هل هو في البيت؟  ما بيشتغل هذه الست؟ هل هي ربة
+
+128
+00:08:33,420 --> 00:08:36,180
+بيت؟ هل عندها أطفال؟ ما عندها أطفال؟ كل هذه الأمور
+
+129
+00:08:36,180 --> 00:08:41,180
+بتهمني.  Regular Exercise، تمام؟ إذا كان بيعمل
+
+130
+00:08:41,180 --> 00:08:44,720
+تمارين، هل هو منتظم فيها؟ ولا كل أسبوع مرة بيطلع
+
+131
+00:08:44,720 --> 00:08:48,230
+يمشي على سبيل المثال؟ الـ Complaints نفسها، الشكوى،
+
+132
+00:08:48,230 --> 00:08:51,890
+إيش هي؟ اللي هي طبعاً Prescribed with Medication
+
+133
+00:08:51,890 --> 00:08:54,890
+and Treatment. الـ Pain Level مثلاً، عن طريق الـ Pain
+
+134
+00:08:54,890 --> 00:08:59,630
+Scale، أدّيه هو بياخده من عشرة؟ هل هو Painful ولا
+
+135
+00:08:59,630 --> 00:09:05,850
+Less Pain؟ فأنا لازم أعرف كام هي شدة الألم. Support
+
+136
+00:09:05,850 --> 00:09:10,170
+للـ Family and Friends. طبعاً الـ Family مهم جداً خصوصاً
+
+137
+00:09:10,170 --> 00:09:13,530
+إذا كان أنا عندي هذا طفل وبحاجة إلى Caregiver.
+
+138
+00:09:13,530 --> 00:09:17,150
+History of Environmental Exposures and Sensitivity.
+
+139
+00:09:17,150 --> 00:09:24,210
+طبعاً، البيئة اللي هو عايش فيها، هل هو مثلاً Smoker
+
+140
+00:09:24,210 --> 00:09:28,850
+ولا على سبيل المثال في حد ثاني عنده Smoke، تمام؟
+
+141
+00:09:28,850 --> 00:09:31,930
+هذا بيهمني كمان. هل هو مثلاً عايش في منطقة
+
+142
+00:09:31,930 --> 00:09:35,650
+Industrial على سبيل المثال، بيئة مليئة بالمصانع
+
+143
+00:09:35,650 --> 00:09:42,230
+مليئة بالـ Pollutants اللي هي كل الملوثات، فبالتالي
+
+144
+00:09:42,230 --> 00:09:46,470
+أنا لازم هنا أعرف كيف هو عايش أو أين هو يعيش. الـ
+
+145
+00:09:46,470 --> 00:09:49,050
+Goals of Participating in Rehabilitation Programs.
+
+146
+00:09:49,050 --> 00:09:52,410
+Past Medical History. كمان لازم أعرف أي Operation
+
+147
+00:09:52,410 --> 00:09:56,690
+هو عملها، على سبيل المثال Lobotomy أو أي مشكلة أو
+
+148
+00:09:56,690 --> 00:10:00,590
+أي عمليات على القصبة الهوائية، Breathlessness، كل هذه الأمور
+
+149
+00:10:00,590 --> 00:10:04,590
+لازم أعرفها في الـ Past History. أيضاً في عندي
+
+150
+00:10:04,590 --> 00:10:07,550
+Specific Assessment. خليني أشوف الـ Patient بتاعي
+
+151
+00:10:07,550 --> 00:10:11,450
+لازم أنا أسأله عن بعض الـ Symptoms إذا كانت موجودة
+
+152
+00:10:11,450 --> 00:10:14,250
+أو لأ. فيه هنا بعض المصطلحات مهمة جداً.
+
+153
+00:10:14,250 --> 00:10:18,870
+"Dyspnea" معناتها Difficult or Labored
+
+154
+00:10:18,870 --> 00:10:23,130
+Breathing. "Dyspnea" صعوبة في التنفس. الـ BND هي
+
+155
+00:10:23,130 --> 00:10:29,450
+عبارة عن إيش؟ الإحساس بالاختناق أثناء اللي هو الليل
+
+156
+00:10:29,450 --> 00:10:34,150
+بعد ساعة أو ساعتين من النوم. دي يبقى عن Sensation
+
+157
+00:10:34,150 --> 00:10:37,570
+of Breathlessness أو Shortening في الـ Breathing
+
+158
+00:10:37,570 --> 00:10:41,930
+للـ  Weekends، Patient After One or Two Hours of
+
+159
+00:10:41,930 --> 00:10:45,150
+Sleep. بعد ساعة أو ساعتين من النوم، and Usually
+
+160
+00:10:45,150 --> 00:10:48,710
+Relieved When Upright Position. يعني على سبيل
+
+161
+00:10:48,710 --> 00:10:51,670
+المثال، وخصوصاً إذا كانت Obese.  He/She For Example
+
+162
+00:10:51,670 --> 00:10:55,770
+بتقول لي أنا أول الليل بنام، بعد ساعة أو ساعتين بحس
+
+163
+00:10:55,770 --> 00:11:03,110
+بحاجة تخنقني. هنا المشكلة بس بتعدل نفسها أو بالميل
+
+164
+00:11:03,110 --> 00:11:05,730
+لـ Upright Position أو Long Sitting Position
+
+165
+00:11:05,730 --> 00:11:10,650
+بتصير تماماً تماماً. هذه بسميها اللي هو Proximal
+
+166
+00:11:10,650 --> 00:11:15,870
+Nocturnal Dyspnea أو Dyspnea. الـ BND، تمام؟ الـ
+
+167
+00:11:15,870 --> 00:11:19,690
+Orthopnea هي عبارة عن Shortness للـ Breathing أو
+
+168
+00:11:19,690 --> 00:11:23,410
+Dyspnea، بنقص الأكسجين بتصير في الـ Supine Position. إذا
+
+169
+00:11:23,410 --> 00:11:28,610
+فيه فرق بين مصطلح اتنين ومصطلح ثلاثة. الـ Wheezing اللي
+
+170
+00:11:28,610 --> 00:11:32,090
+هو أو الـ Wheeze، الصفير، هو عبارة عن Continuous Coarse
+
+171
+00:11:32,090 --> 00:11:36,410
+Whistling Sound Produced in the Respiratory Airway.
+
+172
+00:11:36,410 --> 00:11:40,490
+تمام؟ في غلال التنفس. في عندنا بعض الأحيان في
+
+173
+00:11:40,490 --> 00:11:45,890
+الأطفال ممكن يصير في عندهم Wheezing. هذا بيكون طبعاً
+
+174
+00:11:45,890 --> 00:11:50,530
+نتيجة لأي مشكلة، نتيجة Lung Disease على سبيل المثال.
+
+175
+00:11:50,820 --> 00:11:54,600
+في بيوتنا، بدي أشوف لونه، بدي أشوف  الـ Viscosity،
+
+176
+00:11:54,600 --> 00:11:59,480
+الـ Quantity، الـ Presence of Blood or Not،
+
+177
+00:11:59,480 --> 00:12:02,480
+كل هذه الأمور بتهمنا. مثلاً لما كنا نحكي على نوع
+
+178
+00:12:02,480 --> 00:12:05,820
+الـ Tubes اللي موجودة عندي في الـ ICU، كل ما كانت
+
+179
+00:12:05,820 --> 00:12:09,440
+شفافة ومرئية، بيكون أفضل حتى أنا ألاحظ كل هذا
+
+180
+00:12:09,440 --> 00:12:13,560
+الأمر. إذن هو عبارة عن Name of Cough up  لـ Mucous
+
+181
+00:12:13,560 --> 00:12:18,250
+Material from the Airways، Trachea and Bronchi. طبعاً
+
+182
+00:12:18,250 --> 00:12:20,810
+بدي أشوف إذا فيه تغيير عندي في الـ Color، في الـ
+
+183
+00:12:20,810 --> 00:12:26,670
+
+223
+00:15:11,050 --> 00:15:14,990
+هذه الحالة fluid retention, chest pain إذا كان ال
+
+224
+00:15:14,990 --> 00:15:17,430
+respiratory system أو الpatient فيه عنده chest
+
+225
+00:15:17,430 --> 00:15:20,250
+pain, معناته هذا سيؤدي إلى أن يكون فيه عندنا muscular
+
+226
+00:15:20,250 --> 00:15:24,230
+skeletal disorders أو البلورة أو في عندنا tracheal
+
+227
+00:15:24,230 --> 00:15:27,370
+inflammation للـ lung, bronchia, أو small airway
+
+228
+00:15:27,370 --> 00:15:31,450
+contains pain fibers, طبعا هنا الشخص سيأخذ وضعية
+
+229
+00:15:31,450 --> 00:15:36,900
+بحيث أنه يحاول يقلل هذا الألم، الincontinence
+
+230
+00:15:36,900 --> 00:15:41,460
+وهذا موضوع كبير, نحن نعاني منه, خصوصا فئات, اللي هو
+
+231
+00:15:41,460 --> 00:15:44,320
+ال female. اليوم, إذا كانت أنا عندي ال female, أنا
+
+232
+00:15:44,320 --> 00:15:47,460
+سأحكي حاجة in general, يعني إذا كان عندي ال female
+
+233
+00:15:47,460 --> 00:15:55,440
+عمرها تجاوز الأربعين و الخمسين, وحوالي عندها ٥ إلى ٦ baby
+
+234
+00:15:55,440 --> 00:15:59,480
+فبالتالي في عندها كمان شيء أهم من هو الـ head,
+
+235
+00:15:59,480 --> 00:16:04,180
+obesity, هذا الشيء كل ما ستعمل cuffing, ال intra
+
+236
+00:16:04,180 --> 00:16:07,840
+-abdominal pressure, كل ما سيصير في عندي فرصة و
+
+237
+00:16:07,840 --> 00:16:10,920
+قابلة للاستعداد أن يصير في عندنا incontinence, لماذا؟
+
+238
+00:16:10,920 --> 00:16:13,480
+لأنه صار في عندي weakness في ال pelvic floor
+
+239
+00:16:13,480 --> 00:16:16,520
+muscles, إن شاء الله رب العالمين سنشرح عنه في المدة
+
+240
+00:16:16,520 --> 00:16:19,690
+القادمة في الفصل القادم, معناته الكلام إذا أنا زاد
+
+241
+00:16:19,690 --> 00:16:22,630
+عندي الـ intra-abdominal pressure, هذا يزيد الـ
+
+242
+00:16:22,630 --> 00:16:26,710
+increasing في اللي هو ال incontinence, طبعا ليس مع
+
+243
+00:16:26,710 --> 00:16:29,590
+كل الستات هذا الأشياء, لأ, الناس اللي عندها weakness
+
+244
+00:16:29,590 --> 00:16:34,170
+في ال pelvic floor muscles, طبعا aggravated, تزيد
+
+245
+00:16:34,170 --> 00:16:38,110
+الحالة سوءًا مع ال chronic coughing, ال coughing and
+
+246
+00:16:38,110 --> 00:16:40,410
+huffing يزيد ال intra-abdominal pressure, طبعا
+
+247
+00:16:40,410 --> 00:16:44,430
+which is my participated, urine leakage, fear of
+
+248
+00:16:44,430 --> 00:16:48,760
+this may influence compliance with physiotherapy.
+
+249
+00:16:48,760 --> 00:16:54,640
+طبعاً هذا الأشياء يؤثر في أثناء اللي هو الجلسة
+
+250
+00:16:54,640 --> 00:17:00,300
+العلاجية, أثناء الآن حسب الجامعية الأمريكية للـ
+
+251
+00:17:00,300 --> 00:17:05,300
+القلب, صنفت إن ال breathlessness according إلى four
+
+252
+00:17:05,300 --> 00:17:08,880
+grades, ال grade الأول أو ال class الأول, no
+
+253
+00:17:08,880 --> 00:17:12,500
+symptoms, مافي أي أعراض, و الordinary activity لل
+
+254
+00:17:12,500 --> 00:17:15,140
+breathlessness only occurring with severe
+
+255
+00:17:15,140 --> 00:17:18,660
+exertion, زي الـ Running, زي اللي هو الـ Fast
+
+256
+00:17:18,660 --> 00:17:21,860
+Bicycling أو الـ Cross Country Skiing, طبعاً هذا
+
+257
+00:17:21,860 --> 00:17:26,080
+شيء بسيط, أنه مافيه symptoms, في ال degree الثاني أو
+
+258
+00:17:26,080 --> 00:17:29,900
+ال class الثاني, في عندنا symptoms مع ال activity
+
+259
+00:17:29,900 --> 00:17:32,960
+الذي سيؤدي هذا الشخص, على سبيل المثال, لما بده
+
+260
+00:17:32,960 --> 00:17:38,200
+يعمل upstairing, اللي هو ال upstairing للدرج, making
+
+261
+00:17:38,200 --> 00:17:42,560
+beds أو carrying large amount of shopping, تمام, هذا
+
+262
+00:17:42,560 --> 00:17:45,970
+ال class الثاني, في عندنا أعراض, Class 3, كل ما لها
+
+263
+00:17:45,970 --> 00:17:49,470
+الأمور تزيد سوءًا, شوفوا class 1, no symptoms, بس
+
+264
+00:17:49,470 --> 00:17:53,030
+class 2, في عندنا symptoms, class 3, وصلنا ل symptoms
+
+265
+00:17:53,030 --> 00:17:58,470
+with mild exertion, مع جهد متوسط, يعني bathing,
+
+266
+00:17:58,870 --> 00:18:02,150
+showering, dressing, أشياء بسيطة جداً, يصير في عندنا
+
+267
+00:18:02,150 --> 00:18:08,820
+symptoms, ومؤشرات لإن في عندي breathlessness, الدرجة
+
+268
+00:18:08,820 --> 00:18:12,920
+الرابعة أو ال class 4, ال symptoms حتى وهو في وضع
+
+269
+00:18:12,920 --> 00:18:16,040
+الراحة أو اللي هو ال bed, يعني نايم على السرير
+
+270
+00:18:16,040 --> 00:18:19,900
+برضه كمان في عندنا short lessons, which of each
+
+271
+00:18:19,900 --> 00:18:23,460
+symptoms in acquiring should be made concerning, أنا
+
+272
+00:18:23,460 --> 00:18:27,100
+لازم أهتم بأشياء, بال duration, absolute time, sense of
+
+273
+00:18:27,100 --> 00:18:30,540
+recognition, the symptoms, month and year, يجب
+
+274
+00:18:30,540 --> 00:18:33,440
+تدوينها بالضبط, الله, the duration of a person's symptoms
+
+275
+00:18:34,240 --> 00:18:38,060
+فترة اللي هو وجود الـ symptoms, هالأيام, أو أسابيع
+
+276
+00:18:38,060 --> 00:18:42,560
+ال severity تبعه, شدته, in absolute terms and
+
+277
+00:18:42,560 --> 00:18:45,520
+relative to recent distance passed, ال pattern
+
+278
+00:18:45,520 --> 00:18:50,000
+seasonal أو daily variations, طبعا هل هو مثلاً في
+
+279
+00:18:50,000 --> 00:18:53,020
+الربيع يزيد؟ هل هو في الخريف يزيد؟ هل في الشتاء
+
+280
+00:18:53,020 --> 00:18:57,760
+الأعراض بتكون more strong؟ كل هذا لازم أعرفه
+
+281
+00:18:57,760 --> 00:19:03,490
+associated factors, including للparticipant
+
+282
+00:19:03,490 --> 00:19:06,870
+relieving factors and associated symptoms, if any.
+
+283
+00:19:06,870 --> 00:19:11,250
+تمام؟ بدي أشوف إذا في عندي عوامل تؤثر, if any
+
+284
+00:19:11,250 --> 00:19:14,290
+chest, طبعا سأشوف ال chest assessment, إذا في أنا
+
+285
+00:19:14,290 --> 00:19:18,430
+عندي أي مشاكل, أي deformities, سألاحظ هنا ال sternum
+
+286
+00:19:18,430 --> 00:19:22,430
+كيف طالعة, طبعا ال chest كيف عاملة عندي؟ في مشكلة؟
+
+287
+00:19:22,430 --> 00:19:26,870
+هل هذه ال deformities  congenital, من لحظة ما
+
+288
+00:19:26,870 --> 00:19:31,240
+انخلق, من لحظة الميلاد,  ولا صارت acquired نتيجة
+
+289
+00:19:31,240 --> 00:19:36,480
+habits خاطئة، نتيجة لعدم الرغبة في التعرض للألم هذا
+
+290
+00:19:36,480 --> 00:19:40,480
+الشخص، سأعمل هذا. في عندنا الـcongenital،
+
+291
+00:19:40,480 --> 00:19:42,840
+بعض الـdeformities الـcongenital، زي شيء اسمه
+
+292
+00:19:42,840 --> 00:19:46,660
+الـpectus carinatum أو بسميها الـpigeon chest، صدر
+
+293
+00:19:46,660 --> 00:19:50,760
+الحمامة. الـsternum ما الذي يميزه؟ إنه الـsternum is
+
+294
+00:19:50,760 --> 00:19:55,700
+prominent and protruded anteriorly. تمام، هذه
+
+295
+00:19:55,700 --> 00:20:00,690
+الوضع. إنه الـ sternum, عظمة القص, تكون بارزة للأمام
+
+296
+00:20:00,690 --> 00:20:07,790
+مثل صدر الحمامة, تمام, ال Pectus Excavatum اللي
+
+297
+00:20:07,790 --> 00:20:13,830
+بنسميها القمع أو اللي هو الصدر القمعي
+
+298
+00:20:13,830 --> 00:20:17,130
+هذا الصدر طبعاً يكون فيه  ال sternum  أو lowered
+
+299
+00:20:17,130 --> 00:20:21,970
+of sternum, is the breast, عكس الأولانية, والـ lower
+
+300
+00:20:21,970 --> 00:20:26,950
+ribs flare out, ونشوف كيف اللي هو الـ lower ribs
+
+301
+00:20:26,950 --> 00:20:30,790
+اللي موجودة هنا تكون flare out, يعني مسطحة إلى
+
+302
+00:20:30,790 --> 00:20:33,450
+الخلف, ال patient with this deformity are
+
+303
+00:20:33,450 --> 00:20:37,690
+diaphragmatic breathers, excessive abdominal
+
+304
+00:20:37,690 --> 00:20:41,470
+protrusion, and little upper chest movement occurs
+
+305
+00:20:41,470 --> 00:20:45,450
+during breathing, لأن هذا الشخص بدنا نلاحظ أنه في
+
+306
+00:20:45,450 --> 00:20:49,910
+ال diaphragmatic عنده deformity, طبعاً حكينا عنها
+
+307
+00:20:49,910 --> 00:20:54,650
+اللي هي Pectus Excavatum, بكترستكسفيتام, أو القمع, أو بالاسم
+
+308
+00:20:54,650 --> 00:20:59,210
+الثاني اللي هو صدر القمع, يتنفس diaphragmatic
+
+309
+00:20:59,210 --> 00:21:03,070
+breathing, excessive abdominal protrusion, ينفخ
+
+310
+00:21:03,070 --> 00:21:06,590
+البطن للأمام, و little في ال upper chest movement
+
+311
+00:21:06,590 --> 00:21:11,370
+هذا بالنسبة للمسكولي سكلتر deformity, أيضاً إذا كانت
+
+312
+00:21:11,370 --> 00:21:15,830
+المشكلة acquired, يعني مكتسبة, فيها نوع اسمه ال
+
+313
+00:21:15,830 --> 00:21:20,160
+barrel chest, اللي هو الصدر البرميلي, anterior
+
+314
+00:21:20,160 --> 00:21:22,760
+-posterior, سيحصل زيادة في القطر
+
+315
+00:21:22,760 --> 00:21:26,180
+من ال anterior-posterior, الآن ال circumference أو
+
+316
+00:21:26,180 --> 00:21:30,120
+القطر تبع ال upper chest appears larger than that
+
+317
+00:21:30,120 --> 00:21:34,980
+lower chest, تمام, الجزئية ال upper أكبر بكثير من
+
+318
+00:21:34,980 --> 00:21:38,920
+الجزئية ال lower, بدنا نلاحظ هنا هذه ال upper أكبر
+
+319
+00:21:38,920 --> 00:21:42,280
+من اللي هي ال lower part, الـ sternum appears
+
+320
+00:21:42,280 --> 00:21:45,320
+prominent and the anteroposterior diameter of chest
+
+321
+00:21:45,320 --> 00:21:48,660
+are greater than normal, أعلى من ال normal أو أكبر
+
+322
+00:21:48,660 --> 00:21:52,780
+من ال normal, with COPD, طبعاً اللي هو هي بالأغلب
+
+323
+00:21:52,780 --> 00:21:56,460
+بتكون ال barrel chest مع مرضى ال COPD اللي هو
+
+324
+00:21:56,460 --> 00:22:02,030
+chronic obstructive pulmonary disease, تمام؟ فيه أيضاً
+
+325
+00:22:02,030 --> 00:22:05,870
+عندي من المشاكل اللي هي شيء اسمه scoliosis, اللي
+
+326
+00:22:05,870 --> 00:22:09,670
+هي lateral curvature للسباين, كما أنتم شايفين
+
+327
+00:22:09,670 --> 00:22:13,490
+lateral curvatures, صار في عندي انحناء جانبي
+
+328
+00:22:13,490 --> 00:22:17,130
+asymmetry due to impaired movement of chest
+
+329
+00:22:17,130 --> 00:22:20,300
+disease, فيه أيضاً عندي شيء اسمه الـ Kyphosis
+
+330
+00:22:20,300 --> 00:22:25,520
+طبعاً اللي هو الحدب أو ما يسمى بالتحدب الأمامي, هذا
+
+331
+00:22:25,520 --> 00:22:29,940
+نتيجة إلى نقص حركة الصدر, chest mobility, سأرى
+
+332
+00:22:29,940 --> 00:22:33,040
+أنا أو في أثناء اللي هو التقييم, سأعمل check لل
+
+333
+00:22:33,040 --> 00:22:36,760
+active movement في كل ال directions, سأحدد ال
+
+334
+00:22:36,760 --> 00:22:40,760
+restricting في أي motions في ال spinal أو ال
+
+335
+00:22:40,760 --> 00:22:46,130
+vertebral column, الآن ال respiratory muscles, سأتحدث
+
+336
+00:22:46,130 --> 00:22:49,070
+على الـ mainly اللي هي الـ diaphragm و الـ
+
+337
+00:22:49,070 --> 00:22:53,130
+accessory muscles, اللي هي between ribs
+
+338
+00:22:53,130 --> 00:22:56,530
+muscular structures, طبعاً سيكون فيه عندنا إما
+
+339
+00:22:56,530 --> 00:23:00,630
+weakness أو hypertrophy, ممكن يعني يكون فيه
+
+340
+00:23:00,630 --> 00:23:05,370
+عندنا weakness وكذلك hypertrophy, ما نوع ال
+
+341
+00:23:05,370 --> 00:23:09,150
+respiratory pattern, اللي هيتنفس فيه, سأقيم أيضاً ال
+
+342
+00:23:09,150 --> 00:23:14,130
+respiratory rate, معدل التنفس, انتظامه, و ال ventilation
+
+343
+00:23:14,130 --> 00:23:18,810
+خلال الراحة أو النشاط, مهم جداً أنا
+
+344
+00:23:18,810 --> 00:23:22,270
+أعرفه, أيضاً ال normal, لأعرف الطبيعي, لأني بعد
+
+345
+00:23:22,270 --> 00:23:25,450
+ذلك سأعرف أن ما رأيته هو ال abnormal, ال normal
+
+346
+00:23:25,450 --> 00:23:30,970
+respiratory rate لل healthy adult من ١٢ إلى ٢٠
+
+347
+00:23:30,970 --> 00:23:36,530
+breath per minute, من ١٢ إلى ٢٠ نفس خلال الدقيقة
+
+348
+00:23:36,530 --> 00:23:38,970
+this is the most accurately determined when
+
+349
+00:23:38,970 --> 00:23:42,870
+patient unaware and the respiratory rate is being
+
+350
+00:23:42,870 --> 00:23:46,590
+measured, and while taking pulse rate, أيضاً ممكن آخذ
+
+351
+00:23:46,590 --> 00:23:50,890
+معه اللي هو ال pulse rate, في هذه الحالة ال
+
+352
+00:23:50,890 --> 00:23:54,310
+normal ratio ما بين الinspiration و ال expiration
+
+353
+00:23:54,310 --> 00:24:00,930
+من ١ إلى ٢ في فترة ال rest, و ١ إلى ١ في فترة ال
+
+354
+00:24:00,930 --> 00:24:05,750
+activity, تمام؟ ال patient اللي عنده COPD, chronic
+
+355
+00:24:05,750 --> 00:24:10,030
+chronic obstructive pulmonary disease may have
+
+356
+00:24:10,030 --> 00:24:14,170
+ratio من ١ إلى ٤ في ال rest, لاحظوا ما هو ال normal؟
+
+357
+00:24:14,170 --> 00:24:17,230
+ال normal إنه يكون من ١ إلى ٢, فبالتالي زاد من ١
+
+358
+00:24:17,230 --> 00:24:21,290
+إلى ٤, and which is reflected in difficulty of
+
+359
+00:24:21,290 --> 00:24:24,410
+expiration phase, نحن نتحدث هنا عن المعادلة أو
+
+360
+00:24:24,410 --> 00:24:28,910
+التناسب سيكون من ال inspiration لل expiration
+
+361
+00:24:28,910 --> 00:24:32,850
+تمام، معناته هنا سألاحظ أن الـ ٤ زادت في ال
+
+362
+00:24:32,850 --> 00:24:37,250
+expiration phase, فبالتالي هو عنده difficulty خلال
+
+363
+00:24:37,250 --> 00:24:41,990
+ال expiratory phase, أيضاً سأكمل اللي هو باقي ال
+
+364
+00:24:41,990 --> 00:24:44,230
+assessment, أنه أنا سأرى في عندنا normal
+
+365
+00:24:44,230 --> 00:24:48,330
+sequences of inspiration at rest, ال diaphragm
+
+366
+00:24:48,330 --> 00:24:51,770
+الـ Contracts and descends, ال abdomen في منطقة
+
+367
+00:24:51,770 --> 00:24:56,570
+الـ epigastric area, طبعاً يحدث ارتفاع, this is
+
+368
+00:24:56,570 --> 00:25:01,470
+followed by lateral costal expansion, سيحدث
+
+369
+00:25:01,470 --> 00:25:06,250
+الـ lateral costal, سيحدث توسع, as the ribs move
+
+370
+00:25:06,250 --> 00:25:10,660
+up and out, and finally the upper chest raises, Neck
+
+371
+00:25:10,660 --> 00:25:13,080
+muscles, مهمة جداً لأنها تعمل معي كـ accessory
+
+372
+00:25:13,080 --> 00:25:16,520
+muscles, واللي هو يجب علي المحافظة عليها
+
+373
+00:25:16,520 --> 00:25:19,960
+و المحافظة على ال muscle power تبعتها, Of inspiration
+
+374
+00:25:19,960 --> 00:25:24,180
+should be inactive, طبعاً خلال ماذا؟ relaxed
+
+375
+00:25:24,180 --> 00:25:30,570
+inspiration, to assist breathing, اللي هو التنفس
+
+376
+00:25:30,570 --> 00:25:33,610
+sequence, لما ابدأ أقيم ال patient, assume comfortable
+
+377
+00:25:33,610 --> 00:25:37,570
+position, semi recline أو sublime position, place
+
+378
+00:25:37,570 --> 00:25:40,330
+your hand, طبعاً سنضع يدنا على منطقة ال patient's
+
+379
+00:25:40,330 --> 00:25:44,050
+epigastric region, أعلى المعدة, and the sternum
+
+380
+00:25:44,050 --> 00:25:47,750
+observe movement of two areas, سأرى أنا واضع
+
+381
+00:25:47,750 --> 00:25:50,630
+يدي كما أنتم شايفين هنا على ال epigastric area
+
+382
+00:25:50,630 --> 00:25:55,490
+أو ال epigastric regions, وسأرى اللي هو المنطقة
+
+383
+00:25:55,490 --> 00:26:00,330
+هنا كيف سيكون النفس فيها, وبهذا نكون قد أنهينا ال
+
+384
+00:26:00,330 --> 00:26:04,330
+part الأول من ال preliminary assessment, ألقاكم
+
+385
+00:26:04,330 --> 00:26:08,350
+بإذن الله تعالى في part الثاني, ويعطيكم العافية
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/MUUknHF3SV4_postprocess.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/MUUknHF3SV4_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..a8799b2cd3f622f0e37ca63924f6a9aa590c475a
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/MUUknHF3SV4_postprocess.srt
@@ -0,0 +1,1540 @@
+1
+00:00:01,290 --> 00:00:05,050
+والصلاة والسلام علي أشرف الأنبياء والمرسلين إن شاء
+
+2
+00:00:05,050 --> 00:00:08,630
+الله بالعالمين المحاضرة هذه راح أدخل في ال chapter
+
+3
+00:00:08,630 --> 00:00:13,770
+الأخير أو ال part الأخير من هذا المساق سأتحدث فيه
+
+4
+00:00:13,770 --> 00:00:17,370
+عن البلمونري فيزيو ثيرابي ودور الفيزيو ثيرابي في
+
+5
+00:00:17,370 --> 00:00:22,430
+كل chest disease نبدأ على بركة الله في فيديو رقم
+
+6
+00:00:22,430 --> 00:00:23,030
+10
+
+7
+00:00:30,370 --> 00:00:35,910
+لأ المعروف إن ال respiratory system هو عبارة عن
+
+8
+00:00:35,910 --> 00:00:40,390
+الاشي اللي بيمد الجسم بال Oxygen supply تمام
+
+9
+00:00:40,390 --> 00:00:46,390
+فبالتالي سلامة ال life هتأدي إلى ضخ كمية ممتازة
+
+10
+00:00:46,390 --> 00:00:51,210
+للخلايا cell of a human body required constant of
+
+11
+00:00:51,210 --> 00:00:55,230
+stream oxygen to stay aliveالنظام الفرسبيراتوري
+
+12
+00:00:55,230 --> 00:01:00,150
+يعطي أكسجين لجسم الجسم لإزالة ما يسمى كالكربون
+
+13
+00:01:00,150 --> 00:01:05,610
+ديكسايد ووست البروداكت ك بي لثالث إذا كان مسموحاً
+
+14
+00:01:05,610 --> 00:01:10,510
+لأكومليكايتد أي تراكم أو أي تكون لثاني أكسجن
+
+15
+00:01:10,510 --> 00:01:15,630
+الكربون هذا بيؤدي إلى حالة من اللي هي عدم الابتذاب
+
+16
+00:01:15,630 --> 00:01:20,470
+في الجسم وبالآخر إلى وفاة هذا الشخص هناك ثلاثة جزء
+
+17
+00:01:20,470 --> 00:01:24,420
+مهمة من نظام الفرسبيراتوريالـ Airway أنا بهمني
+
+18
+00:01:24,420 --> 00:01:27,840
+سلامة الـ Airway هل في أي Obstructions؟ هل في أي
+
+19
+00:01:27,840 --> 00:01:32,520
+Secretions؟ هل في أي مشكلة بتعيقني؟ ال lungs اللي
+
+20
+00:01:32,520 --> 00:01:37,020
+فيها بتن من gas exchange مهمة جدا أيضا بتهمني
+
+21
+00:01:37,020 --> 00:01:40,280
+سلامة ال muscles of respiration سواء اللي هو ال
+
+22
+00:01:40,280 --> 00:01:44,620
+mainly muscle أو ال accessory muscle كل هذه الثلاث
+
+23
+00:01:44,620 --> 00:01:49,710
+محاولة أنا هشتغل عليها بالفيزيotherapy programهدخل
+
+24
+00:01:49,710 --> 00:01:53,870
+مباشرة في الـ Physiotherapy part و ال Anatomy و ما
+
+25
+00:01:53,870 --> 00:01:58,370
+يتعلق في المقدمة من هذا ال chapter تركته و هدخل
+
+26
+00:01:58,370 --> 00:02:02,670
+مباشرة في ال Physiotherapy program لئا ال aspect
+
+27
+00:02:02,670 --> 00:02:04,950
+of respiratory rehabilitation include all of the
+
+28
+00:02:04,950 --> 00:02:07,970
+following ال patient assessment and goal setting
+
+29
+00:02:07,970 --> 00:02:12,970
+ال exercise training self management education و
+
+30
+00:02:12,970 --> 00:02:15,850
+ال nutritional intervention و ال psychosocial
+
+31
+00:02:15,850 --> 00:02:19,690
+supportهي ال aspect اللي أنا هشتغل عليها في ال
+
+32
+00:02:19,690 --> 00:02:24,510
+respiratory rehabilitation تمام؟ زي أي مريض بنبدأ
+
+33
+00:02:24,510 --> 00:02:29,350
+بوضع ال assessment له بيشمل كل ما يتعلق في المريض
+
+34
+00:02:29,350 --> 00:02:32,370
+ال past history و ال present history و كل الأمور
+
+35
+00:02:32,370 --> 00:02:35,470
+هاي بعدين أنا بدي أبدأ أضع اللي هو ال plan of
+
+36
+00:02:35,470 --> 00:02:38,790
+treatment ال plan تبعتي هتشمل طبعا فيها ال goal
+
+37
+00:02:38,790 --> 00:02:42,690
+setting ال exercise training ال self managementالـ
+
+38
+00:02:42,690 --> 00:02:46,910
+Home Program هل هو مثلًا على سبيل المثال بيصير فيه
+
+39
+00:02:46,910 --> 00:02:50,590
+عنده difficulty of breathing في وقت الليل، إن
+
+40
+00:02:50,590 --> 00:02:55,130
+النهار بيكون سليم، كل هذه الأمور أنا هناقشها في
+
+41
+00:02:55,130 --> 00:02:58,230
+محاضرة اليوم بإذن الله تعالى فيما يخص ال
+
+42
+00:02:58,230 --> 00:03:02,810
+assessment of pulmonary physiotherapy هتكلم على
+
+43
+00:03:02,810 --> 00:03:06,790
+ثمانية من ال aims of physical therapy للـpulmonary
+
+44
+00:03:06,790 --> 00:03:11,270
+disease أول هدف إلي أنا ببدأ أشتغل معهأي مريض في
+
+45
+00:03:11,270 --> 00:03:15,110
+قسم الصدرية بدي يكون هدفي الأساسي والأولاني to
+
+46
+00:03:15,110 --> 00:03:18,210
+prevent airway obstruction أي إشي حيعملي
+
+47
+00:03:18,210 --> 00:03:22,990
+obstruction لازم أنا أبدأ أتحيل على الإشي و أشيله
+
+48
+00:03:22,990 --> 00:03:26,680
+سواء كان بالـ Physotherapy Programأو بمساعدة اللي
+
+49
+00:03:26,680 --> 00:03:30,580
+هو الـ medication مع الدكتور to improve airway
+
+50
+00:03:30,580 --> 00:03:33,740
+clearness هذا كمان بيهمني الاشيء and ventilation
+
+51
+00:03:33,740 --> 00:03:37,520
+through mobilization and drainage of secretion
+
+52
+00:03:37,520 --> 00:03:41,100
+الان to improve لل endurance and general exercise
+
+53
+00:03:41,100 --> 00:03:44,680
+tolerance and overall wellbeing بيهمني كمان ال
+
+54
+00:03:44,680 --> 00:03:48,200
+enduranceجدّي استعداد المريض وقابليته لأداء الـ
+
+55
+00:03:48,200 --> 00:03:52,860
+Exercise هل عنده Good Tolerance ولا لسه هو Fatigue
+
+56
+00:03:52,860 --> 00:03:56,460
+Reduce لل energy cost during respiration خلال
+
+57
+00:03:56,460 --> 00:03:59,900
+الbreathing retrainings الآن أنا بدل ما يبدل هذا
+
+58
+00:03:59,900 --> 00:04:04,540
+المجهود ويخلص كل كمية الطاقة عند هذا المريض لأ بدي
+
+59
+00:04:04,540 --> 00:04:09,900
+أحاول أقلل أو أخليه يتنفس بـ pattern معين بحيث أنه
+
+60
+00:04:09,900 --> 00:04:13,420
+ما تنتهي الطاقة عنده اللي هي المفروض أنا أستخدمها
+
+61
+00:04:13,420 --> 00:04:17,520
+بعد هيك في أشياء تانية مهمةتمام؟ أيضًا من الأهداف
+
+62
+00:04:17,520 --> 00:04:21,320
+to prevent or correct الـ postural deformities بعض
+
+63
+00:04:21,320 --> 00:04:25,680
+الأحيان بما أنه بيكون على سبيل المثال عنده مشكلة
+
+64
+00:04:25,680 --> 00:04:29,860
+معاق معينة بيروح هو ماخد وضعية معينة خاطئة على
+
+65
+00:04:29,860 --> 00:04:33,600
+أساس أنه يتحايل على الألم أو أنه يتفادى هذا الألم
+
+66
+00:04:33,850 --> 00:04:38,110
+فبالتالي بتصير هي كانت بمجرد بس محايلة على ألم بعد
+
+67
+00:04:38,110 --> 00:04:43,030
+شهر شهرين بتصير عبارة عن عادة وإعاقة مستديمة معناة
+
+68
+00:04:43,030 --> 00:04:46,210
+دي للمثال زي الـ scoliosis مثلا فبالتالي هنا أنا
+
+69
+00:04:46,210 --> 00:04:49,870
+دوري to prevent أيضا أو correct لأي potential
+
+70
+00:04:49,870 --> 00:04:54,180
+deformity هتصير to promote relaxationإذا أنا عملت
+
+71
+00:04:54,180 --> 00:04:57,320
+breathing exercise خصنتي بـ Breathing معناه أن أنا
+
+72
+00:04:57,320 --> 00:05:00,740
+بعمل relaxation، general relaxation to maintain or
+
+73
+00:05:00,740 --> 00:05:03,880
+improve the chest mobility مهم جدا إنه أنا أخلي
+
+74
+00:05:03,880 --> 00:05:07,780
+اللي هو يكون في عندي chest mobility حتى إنه أنا
+
+75
+00:05:07,780 --> 00:05:11,960
+أترك مجال لل lungs تاخد راحتها في ال inspiration
+
+76
+00:05:11,960 --> 00:05:15,820
+and then expiration to improve القف effectiveness
+
+77
+00:05:16,460 --> 00:05:20,020
+الـ Cuff هنا مجالها واسع وموضوعها مهم جدا إذا أنا
+
+78
+00:05:20,020 --> 00:05:22,840
+حسنت من موضوع الـ Cuffing فمعناة الكلام إنه أنا
+
+79
+00:05:22,840 --> 00:05:26,400
+هعمل Clearness للـ Airway معناة الكلام إنه أنا
+
+80
+00:05:26,400 --> 00:05:31,200
+هفوت كمية كويسة من الأكسجين إلى داخل الجسم و أخرج
+
+81
+00:05:31,200 --> 00:05:35,100
+اللي هو الـ Carbondioxide فبالتالي أنا هنا حسنت من
+
+82
+00:05:35,100 --> 00:05:39,100
+الـ Lung Functions هذا المهم في كل الـ Respiratory
+
+83
+00:05:39,100 --> 00:05:44,810
+طبعا Systemالـ Evaluation تبعنا في تقييم المريض شو
+
+84
+00:05:44,810 --> 00:05:48,090
+أهدافي أنا من هذه الـ Examination؟ إنه أنا أعمل
+
+85
+00:05:48,090 --> 00:05:50,150
+الـ Determine للـ Patient الـ Primary and
+
+86
+00:05:50,150 --> 00:05:52,710
+Secondary Respiratory و Ventilatory Environments
+
+87
+00:05:52,710 --> 00:05:58,460
+بدي أحدد شو المشاكل الأساسية والثانويةHow
+
+88
+00:05:58,460 --> 00:06:00,840
+environmentally limits your physical function؟ هل
+
+89
+00:06:00,840 --> 00:06:04,840
+بتأثر على وظائفه الحيوية؟ على سبيل المثال هو مثلا
+
+90
+00:06:04,840 --> 00:06:08,060
+تجينا الست بقولك أنا بس أطلع الدرج بصير في عندي
+
+91
+00:06:08,060 --> 00:06:12,860
+اختناق بدي أشوف هل هي بتأثر عليها ولا لأ بت remind
+
+92
+00:06:12,860 --> 00:06:16,520
+the educationThe ventilatory pump and oxygen
+
+93
+00:06:16,520 --> 00:06:21,320
+uptake طبعا وإزالة تاني أكسيد الكربون to meet
+
+94
+00:06:21,320 --> 00:06:24,740
+oxygen demand during functional activities بدي
+
+95
+00:06:24,740 --> 00:06:28,780
+أحدد اللي هو عملية المدخّة في حالة استقطاب
+
+96
+00:06:28,780 --> 00:06:32,780
+الأكسجين أو في حالة استهلاك كمية الأكسجين وطارد ال
+
+97
+00:06:32,780 --> 00:06:36,140
+waste product أيضا بدي أشوف اللي هو assistant
+
+98
+00:06:36,140 --> 00:06:39,760
+patient suitability for participant in
+
+99
+00:06:39,760 --> 00:06:44,440
+rehabilitation بالمهنة البروجرامأكد عليه في وجود
+
+100
+00:06:44,440 --> 00:06:47,900
+أو حضوره في المشاركة في عملية الـ Rehabilitation
+
+101
+00:06:47,900 --> 00:06:53,490
+هل له دور فعال ولا لأ؟أكبر تطور في تجارب عملية
+
+102
+00:06:53,490 --> 00:06:58,770
+تجارب عملية تجارب عملية تجارب عملية تجارب عملية
+
+103
+00:06:58,770 --> 00:07:03,930
+تجارب عملية تجارب عملية تجارب عملية تجارب عملية
+
+104
+00:07:03,930 --> 00:07:07,730
+تجارب عملية تجارب عملية تجارب عملية تجارب عملية
+
+105
+00:07:07,730 --> 00:07:09,670
+تجارب عملية تجارب عملية تجارب عملية تجارب عملية
+
+106
+00:07:09,670 --> 00:07:09,690
+تجارب عملية تجارب عملية تجارب عملية تجارب عملية
+
+107
+00:07:09,690 --> 00:07:11,030
+تجارب عملية تجارب عملية تجارب عملية تجارب عملية
+
+108
+00:07:11,030 --> 00:07:20,670
+تجارب عملية تجارب عملية
+
+109
+00:07:20,980 --> 00:07:25,940
+الـ Lung Fibrosis أو عنده اللي هو مشكلة في الـ
+
+110
+00:07:25,940 --> 00:07:29,780
+Lungs بدي أعرف ليش هو توقف عن البرنامج معناة
+
+111
+00:07:29,780 --> 00:07:33,260
+الكلام إنه فيه سبب إنه خلاه يستأمن هذا الوضع
+
+112
+00:07:33,260 --> 00:07:35,860
+فبالتالي ما أكمل معايا الـ Breathing Exercise على
+
+113
+00:07:35,860 --> 00:07:39,020
+سبيل المثال و بطل يجي على الجنسة أو بطل يكمل ال
+
+114
+00:07:39,020 --> 00:07:42,960
+home program تبعهم إذا لازم أنا أبحث في هذا الاشي
+
+115
+00:07:42,960 --> 00:07:48,260
+و أشوف شو المشكلة اللي قدت إلى ذلكشو ال component
+
+116
+00:07:48,260 --> 00:07:51,520
+تبع ال initial patient assessment ال patient
+
+117
+00:07:51,520 --> 00:07:55,200
+interview ال medical history هشوف في ال physical
+
+118
+00:07:55,200 --> 00:07:58,680
+assessment ال review لل diagnostic test هشوف اللي
+
+119
+00:07:58,680 --> 00:08:02,640
+هو تحويله تبع الدكتور و ال symptoms assessment
+
+120
+00:08:02,640 --> 00:08:05,800
+أيضا في ال general assessment بدي أشوف زي ما أي
+
+121
+00:08:05,800 --> 00:08:08,700
+assessment بنعمله ال age و ال name و ال sex و ال
+
+122
+00:08:08,700 --> 00:08:12,200
+occupation و ال social history و كل هذه الأمور هل
+
+123
+00:08:12,200 --> 00:08:16,980
+هو مدخن ولا مش مدخن بيستخدم أدوية أخرى ولا لأعلى
+
+124
+00:08:16,980 --> 00:08:20,980
+سبيل المثال، هل كان يستخدم بخاخة قبل كده ولا لأ؟
+
+125
+00:08:20,980 --> 00:08:24,540
+هل بيستخدم أدوية الـ Bronchodilators أو لأ؟ Usual
+
+126
+00:08:24,540 --> 00:08:28,340
+activities level Including employment، هل هو موظف؟
+
+127
+00:08:28,340 --> 00:08:33,420
+هل هو في البيت؟ ما بيتش تشتغل هذه الست؟ هل هي ربط
+
+128
+00:08:33,420 --> 00:08:36,180
+بيت؟ هل عندها أطفال؟ ما عندها أطفال؟ كل هذه الأمور
+
+129
+00:08:36,180 --> 00:08:41,180
+بتهمني أنا Regular exercise، تمام؟ إذا كان بيعمل
+
+130
+00:08:41,180 --> 00:08:44,720
+تمارين، هل هو منتظم فيها؟ ولا كل أسبوع مرة بيطلع
+
+131
+00:08:44,720 --> 00:08:48,230
+يمشي على سبيل المثال؟الـ Complaints نفسها، الشكوى،
+
+132
+00:08:48,230 --> 00:08:51,890
+إيش هي؟ اللي هي طبعا Prescribed with medication
+
+133
+00:08:51,890 --> 00:08:54,890
+and treatment ال pain level مثلا، عن طريق ال pain
+
+134
+00:08:54,890 --> 00:08:59,630
+scale، أديه هو بياخد من عشرة؟ هل هو painful ولا
+
+135
+00:08:59,630 --> 00:09:05,850
+less pain؟ فأنا لازم أعرف كام هي شدة الألمةSupport
+
+136
+00:09:05,850 --> 00:09:10,170
+لل family and friends طبعا ال family مهم جدا خصوصا
+
+137
+00:09:10,170 --> 00:09:13,530
+إذا كان أنا عندي هذا طفل وبحاجة إلى caregiver
+
+138
+00:09:13,530 --> 00:09:17,150
+History of environmental exposures and sensitivity
+
+139
+00:09:17,150 --> 00:09:24,210
+طبعاالبيئة اللي هو عايش فيها هل هو مثلًا smoker
+
+140
+00:09:24,210 --> 00:09:28,850
+ولا على سبيل المثال في حد تاني عنده smoke تمام؟
+
+141
+00:09:28,850 --> 00:09:31,930
+هذا بيهمني كمان هل هو مثلًا عايش في منطقة
+
+142
+00:09:31,930 --> 00:09:35,650
+industrial على سبيل المثال بيئة مليئة بالمصانع
+
+143
+00:09:35,650 --> 00:09:42,230
+مليئة بال populations اللي هي كل الملوثات فبالتالي
+
+144
+00:09:42,230 --> 00:09:46,470
+أنا لازم هنا أعرفكيف هو عايش أو اين هو يعيش ال
+
+145
+00:09:46,470 --> 00:09:49,050
+goals of participating ل rehabilitation programs
+
+146
+00:09:49,050 --> 00:09:52,410
+باست medical history كمان لازم اعرف اي operation
+
+147
+00:09:52,410 --> 00:09:56,690
+هو عملها على سبيل المثال lobotomy او اي مشكلة او
+
+148
+00:09:56,690 --> 00:10:00,590
+اي الناس على القزمة breathlessness كل هذه الأمور
+
+149
+00:10:00,590 --> 00:10:04,590
+لازم اعرفها في ال past history ايضا في عندي
+
+150
+00:10:04,590 --> 00:10:07,550
+specific assessment خليني اشوف ال patient تبعي
+
+151
+00:10:07,550 --> 00:10:11,450
+لازم انا اسأله عن بعض ال symptoms اذا كانت موجودة
+
+152
+00:10:11,450 --> 00:10:14,250
+او لأفي عند هنا بعض المصطلحات مهمة جدا
+
+153
+00:10:14,250 --> 00:10:18,870
+«discipline» معناتها difficult or labored
+
+154
+00:10:18,870 --> 00:10:23,130
+breathing «discipline» صعوبة في التنفس الـ BND هي
+
+155
+00:10:23,130 --> 00:10:29,450
+عبارة عن إيش الإحساس بالاختناق أثناء اللي هوالليل
+
+156
+00:10:29,450 --> 00:10:34,150
+بعد ساعة أو ساعتين من النوم دي يبقى عن sensation
+
+157
+00:10:34,150 --> 00:10:37,570
+of breathlessness أو shortening في الـ breathing
+
+158
+00:10:37,570 --> 00:10:41,930
+للـ weekends patient after one or two hours of
+
+159
+00:10:41,930 --> 00:10:45,150
+sleep بعد ساعة أو ساعتين من النوم and usually
+
+160
+00:10:45,150 --> 00:10:48,710
+relieved when upright position يعني على سبيل
+
+161
+00:10:48,710 --> 00:10:51,670
+المثال وخصوصا إذا كانت obese هيست for example
+
+162
+00:10:51,670 --> 00:10:55,770
+تقولي أنا أول الليل بنامبعد ساعة أو ساعتين بحس
+
+163
+00:10:55,770 --> 00:11:03,110
+حاجة تخنقني هنا المشكلة بس تعدل نفسها أو من الصبيل
+
+164
+00:11:03,110 --> 00:11:05,730
+ل ال upright position أو long sitting position
+
+165
+00:11:05,730 --> 00:11:10,650
+بتصير تماما تماما هذه بسميها اللي هو proximal
+
+166
+00:11:10,650 --> 00:11:15,870
+nocturnal disease أو dyspnea الـ BNDتمام؟ الـ
+
+167
+00:11:15,870 --> 00:11:19,690
+Orthopenia هي عبارة عن shortness للـ breathing أو
+
+168
+00:11:19,690 --> 00:11:23,410
+discipline بنقصين بتصير في ال sublime position إذا
+
+169
+00:11:23,410 --> 00:11:28,610
+في فرق بين مصطلح اتنين ومصطلح تلاتة الويزنج اللي
+
+170
+00:11:28,610 --> 00:11:32,090
+هو أو الويزن الصفير هو عبارة عن continuous course
+
+171
+00:11:32,090 --> 00:11:36,410
+whistling sound produced in the respiratory airway
+
+172
+00:11:36,410 --> 00:11:40,490
+تمام؟ في غلال التنفسفي عندنا بعض الأحيان في
+
+173
+00:11:40,490 --> 00:11:45,890
+الأطفال ممكن يصير في عندهم wheezing هذا بيكون طبعا
+
+174
+00:11:45,890 --> 00:11:50,530
+نتيجة لأي مشكلة نتيجة lung disease على سبيل المثال
+
+175
+00:11:50,820 --> 00:11:54,600
+في بيوتنا، بدي أشوف لونه، بدي أشوف الفاسقوس
+
+176
+00:11:54,600 --> 00:11:59,480
+السبعته، الـQuantity، الـPresence of blood or not،
+
+177
+00:11:59,480 --> 00:12:02,480
+كل هذه الأمور بيهمنا، مثلًا لما كنا نحكي على نوع
+
+178
+00:12:02,480 --> 00:12:05,820
+الـTubes اللي موجودة عندى في الـICU، كل ما كانت
+
+179
+00:12:05,820 --> 00:12:09,440
+شفافة ومرئية، بيكون أفضل حتى أنا ألاحظ كل هذا
+
+180
+00:12:09,440 --> 00:12:13,560
+الأمر، إذن هو عبارة عن name of coughed up لمucous
+
+181
+00:12:13,560 --> 00:12:18,250
+material from the airways trachea and bronchiطبعا
+
+182
+00:12:18,250 --> 00:12:20,810
+بدي أشوف إذا في تغيير عندي في ال color في ال
+
+183
+00:12:20,810 --> 00:12:26,670
+quantity في ال viscosity ووجود blood or not هذا
+
+184
+00:12:26,670 --> 00:12:30,650
+فيديو بتعلق اللي هو في shorting of breathing
+
+185
+00:12:30,650 --> 00:12:38,950
+لالستات تمام كنت أنا ألحقته بالمحاضرة إذا ال cuff
+
+186
+00:12:38,950 --> 00:12:43,640
+أي change في أنواع الكفكحة ناشفة، كحة لأ فيها
+
+187
+00:12:43,640 --> 00:12:48,920
+secretion، مدتها، ال duration تبعها هل هي بتكون في
+
+188
+00:12:48,920 --> 00:12:52,200
+الليل و النهار نفس الأشي و لا بس بالليل بتزيد طبعا
+
+189
+00:12:52,200 --> 00:12:56,880
+هذا مهم جدا في عندي ال dry cuffing أو ما يسمى اللي
+
+190
+00:12:56,880 --> 00:13:00,440
+هو الكحة الناشفة اللي هي hacking cuff is often
+
+191
+00:13:00,440 --> 00:13:06,040
+caused by infection للأبراطورينطبعا التهاب في مجال
+
+192
+00:13:06,040 --> 00:13:09,800
+التنفس العلوية الـ nose way الصورات طبعا بما أننا
+
+193
+00:13:09,800 --> 00:13:13,760
+في COVID-19 لازم احنا ناخد بالنا منها تمام؟ بيكون
+
+194
+00:13:13,760 --> 00:13:17,600
+الاشي زي cold أو influenza لكن إذا كان في عندي
+
+195
+00:13:17,600 --> 00:13:20,840
+group of cough زي الحرش dry coughing sound similar
+
+196
+00:13:20,840 --> 00:13:25,680
+seal barking اللي هي زي اللي بنسميها نباح الفقمة
+
+197
+00:13:26,180 --> 00:13:30,440
+هذا اللي بيكون هو عبارة عن ليس كحة جافة لأ بتكون
+
+198
+00:13:30,440 --> 00:13:37,960
+مصحوبة باللي هو شحيح أو بحاح أو نبح فيه اللي هو
+
+199
+00:13:37,960 --> 00:13:42,420
+الصوت الـ wet cuffing أو ما يسمى بالكحة اللي هي
+
+200
+00:13:42,420 --> 00:13:45,560
+الرطبة هي عبارة عن إشي بيكون فيه عندنا fluid
+
+201
+00:13:45,560 --> 00:13:49,340
+secretionفي عندي هنا بلغام هذا البلغام لازم انا
+
+202
+00:13:49,340 --> 00:13:52,820
+اشوفه هل في مشكلة او لأ طبعا المشكلة بتكون في
+
+203
+00:13:52,820 --> 00:13:55,240
+اللواريسبيرات والـ retract طالما انا حكيت عن مجال
+
+204
+00:13:55,240 --> 00:13:57,780
+التنفس السفلية معناة الكلام اللي انا بدي اوصل لل
+
+205
+00:13:57,780 --> 00:14:03,760
+lungs windpipe and lungs تمام اللي هو ال bronchus
+
+206
+00:14:03,760 --> 00:14:06,680
+و ال bronchioles و هذه الأمور ال whopping cuffing
+
+207
+00:14:06,680 --> 00:14:11,480
+بسميها ايضا اللي هي او سعالة ديكي خليني اسميه also
+
+208
+00:14:11,480 --> 00:14:15,560
+known as brisites اللي هي عبارة عن القحة اللي
+
+209
+00:14:15,560 --> 00:14:22,200
+بتكونمستمرة ورا بعضها البعض الـ hematopoiesis الـ
+
+210
+00:14:22,200 --> 00:14:25,500
+hemo لحق لها blood وتوبيسيز اللي هي عبارة عن ال
+
+211
+00:14:25,500 --> 00:14:28,700
+cuffing اللي بيكون مسحوب في ال blood it may range
+
+212
+00:14:28,700 --> 00:14:32,280
+slightly streaking of sputum and frank blood بتكون
+
+213
+00:14:32,280 --> 00:14:38,040
+خيوط بسيطة في اللي هو ال sputum أو ال secretion
+
+214
+00:14:38,040 --> 00:14:41,970
+اللي عمله الشخص عن طريق ال cuffingهنا انا بدي اركز
+
+215
+00:14:41,970 --> 00:14:46,510
+ان الاشي بسيط جدا او ال blood مش بكميات كبيرة لو
+
+216
+00:14:46,510 --> 00:14:49,070
+كان في عندى blood بكميات كبيرة معناته انا هنا بحط
+
+217
+00:14:49,070 --> 00:14:52,750
+question mark و بسيبه على جانب لإنه ممكن يكون في
+
+218
+00:14:52,750 --> 00:14:57,190
+عندي TB او ما يسمى بيه السلل الرئوي ال weight if
+
+219
+00:14:57,190 --> 00:14:59,690
+there is an increase in weight it may be
+
+220
+00:14:59,690 --> 00:15:03,270
+associated with fluid retention مهم جدا إذا كان في
+
+221
+00:15:03,270 --> 00:15:07,310
+عنا مشاكل في التنفس خصوصا تسمعوا في الناس اللي
+
+222
+00:15:07,310 --> 00:15:11,050
+ممكن يحكيلك ان هو عنده ميه ع الصدرلأن ممكن يصير في
+
+223
+00:15:11,050 --> 00:15:14,990
+هذه الحالة fluid retention chest pain إذا كان ال
+
+224
+00:15:14,990 --> 00:15:17,430
+respiratory system أو الpatient فيه عنده chest
+
+225
+00:15:17,430 --> 00:15:20,250
+pain معناته هذا هيؤدى لإن يكون فيه عندنا muscular
+
+226
+00:15:20,250 --> 00:15:24,230
+skeletal disorders أو البلورة أو في عندنا tracheal
+
+227
+00:15:24,230 --> 00:15:27,370
+inflammation للـ Lung branchemia أو small airway
+
+228
+00:15:27,370 --> 00:15:31,450
+contains pain fibers طبعا هنا الشخص هياخد وضعية
+
+229
+00:15:31,450 --> 00:15:36,900
+بحيث إن هو يحاول يقلل هذا الألمالـ incontinence
+
+230
+00:15:36,900 --> 00:15:41,460
+وهذا موضوع كبير إحنا بنعاني منه خصوصا فئات اللي هو
+
+231
+00:15:41,460 --> 00:15:44,320
+ال female اليوم إذا كانت أنا عندي ال female أنا
+
+232
+00:15:44,320 --> 00:15:47,460
+هحكي حاجة in general يعني إذا كان عندي ال female
+
+233
+00:15:47,460 --> 00:15:55,440
+عمرها تزاوج تتجاوز لـ 45 و حوالي عندها 5 ل 6 baby
+
+234
+00:15:55,440 --> 00:15:59,480
+headفبالتالي في عندها كمان إشي أهم من هو الـ
+
+235
+00:15:59,480 --> 00:16:04,180
+obesity هذا الإشي كل ما هتعمل cuffing الـ intra
+
+236
+00:16:04,180 --> 00:16:07,840
+-abdominal pressure كل ما هيصير في عندي فرصة و
+
+237
+00:16:07,840 --> 00:16:10,920
+قابلة للاستعداد أن يصير في عندنا incontinence ليش؟
+
+238
+00:16:10,920 --> 00:16:13,480
+لأنه صار في عندي weakness في ال pelvic floor
+
+239
+00:16:13,480 --> 00:16:16,520
+muscles إن شاء الله رب العالمين هنشرح عنه في مدة
+
+240
+00:16:16,520 --> 00:16:19,690
+الجاينة في الفصل الجايمعناة الكلام إذا أنا زاد
+
+241
+00:16:19,690 --> 00:16:22,630
+عندي الـ intra-abdominal pressure هذا بيقدر الـ
+
+242
+00:16:22,630 --> 00:16:26,710
+increasing في اللي هو ال incontinence طبعا مش مع
+
+243
+00:16:26,710 --> 00:16:29,590
+كل الستات هذا الأشياء لأ الناس اللي عندها weakness
+
+244
+00:16:29,590 --> 00:16:34,170
+في ال pelvic floor muscles طبعا aggravated بتزيد
+
+245
+00:16:34,170 --> 00:16:38,110
+الحالة سوء مع ال chronic coughing ال coughing and
+
+246
+00:16:38,110 --> 00:16:40,410
+huffing increase ال intra-abdominal pressure طبعا
+
+247
+00:16:40,410 --> 00:16:44,430
+which is my participated urine leakage fear of
+
+248
+00:16:44,430 --> 00:16:48,760
+this may influence compliancewith physiotherapy
+
+249
+00:16:48,760 --> 00:16:54,640
+طبعاً هذا الأشياء بيأثر في أثناء اللي هو الجلسة
+
+250
+00:16:54,640 --> 00:17:00,300
+تبع أثناء الآن حسب الجامعية الأمريكية لاللي هو
+
+251
+00:17:00,300 --> 00:17:05,300
+القلب صنفت إن ال breathlessness according إلى four
+
+252
+00:17:05,300 --> 00:17:08,880
+grades ال grade الأول أو ال class الأول no
+
+253
+00:17:08,880 --> 00:17:12,500
+symptoms مافي أي أعراض و الordinary activity لل
+
+254
+00:17:12,500 --> 00:17:15,140
+breathlessness only occurring with severe
+
+255
+00:17:15,140 --> 00:17:18,660
+excretionsزي الـ Running زي اللي هو الـ Fast
+
+256
+00:17:18,660 --> 00:17:21,860
+Bicycling أو الـ Cross Country Skiing طبعاً هذا
+
+257
+00:17:21,860 --> 00:17:26,080
+إشي بسيط إنه مافيه symptoms في ال degree التاني أو
+
+258
+00:17:26,080 --> 00:17:29,900
+ال class التاني في عندنا symptoms مع ال activity
+
+259
+00:17:29,900 --> 00:17:32,960
+اللي بده يؤدي هالشخص على سبيل النتال اللي لما بده
+
+260
+00:17:32,960 --> 00:17:38,200
+يعمل upstairing اللي هو ال upstairing للدرج making
+
+261
+00:17:38,200 --> 00:17:42,560
+beds أو carrying large amount of shopping تمام هذا
+
+262
+00:17:42,560 --> 00:17:45,970
+ال class اتنين في عندنا أعراضClass 3 كل ما لها
+
+263
+00:17:45,970 --> 00:17:49,470
+الأمور بتزيد سوءًا شوفوا class 1 no symptoms بس
+
+264
+00:17:49,470 --> 00:17:53,030
+class 2 في عندنا symptoms class 3 وصلنا ل symptoms
+
+265
+00:17:53,030 --> 00:17:58,470
+with mild exceptions مع جهد متوسط يعني bathing,
+
+266
+00:17:58,870 --> 00:18:02,150
+showering, dressing أشياء بسيطة جدا بيصير في عندنا
+
+267
+00:18:02,150 --> 00:18:08,820
+symptoms ومؤشرات لإن في عندي breathlessnessالدرجة
+
+268
+00:18:08,820 --> 00:18:12,920
+الرابعة او ال class 4 ال symptoms حتى و هو في وضع
+
+269
+00:18:12,920 --> 00:18:16,040
+ال rest او اللي هو ال bed يعني نايم على السرير
+
+270
+00:18:16,040 --> 00:18:19,900
+برضه كمان في عندنا short lessons which of each
+
+271
+00:18:19,900 --> 00:18:23,460
+symptoms in acquiring should made concerning انا
+
+272
+00:18:23,460 --> 00:18:27,100
+لازم اهتم باش بال duration absolute time sense of
+
+273
+00:18:27,100 --> 00:18:30,540
+recognitions the symptoms month and year جديهم
+
+274
+00:18:30,540 --> 00:18:33,440
+بالظبط الله the duration of a person's symptoms
+
+275
+00:18:34,240 --> 00:18:38,060
+فترة اللي هو وجود الـ symptoms هالأيام و لا أسابيع
+
+276
+00:18:38,060 --> 00:18:42,560
+ال severity تبعته شدته in absolute terms and
+
+277
+00:18:42,560 --> 00:18:45,520
+relative to recent distance passed ال pattern
+
+278
+00:18:45,520 --> 00:18:50,000
+seasonal أو daily variations طبعا هل هو مثلا في
+
+279
+00:18:50,000 --> 00:18:53,020
+الربيع بزيد؟ هل هو في الخريف بزيد؟ هل في الشتاء
+
+280
+00:18:53,020 --> 00:18:57,760
+القزمة بتكون more strong؟ كل هذا لازم أعرفه
+
+281
+00:18:57,760 --> 00:19:03,490
+associated factorsincluding للparticipant
+
+282
+00:19:03,490 --> 00:19:06,870
+relieving factors and associated symptoms if any
+
+283
+00:19:06,870 --> 00:19:11,250
+تمام؟ بدي أشوف إذا في عندي عوامل بتأثر if any
+
+284
+00:19:11,250 --> 00:19:14,290
+chest طبعا هشوف ال chest assessment إذا في أنا
+
+285
+00:19:14,290 --> 00:19:18,430
+عندي أي مشاكل لل deformities بتلاحظ هنا ال sternum
+
+286
+00:19:18,430 --> 00:19:22,430
+كيف طالعة طبعا ال chest كيف عاملة عندي؟ في مشكلة
+
+287
+00:19:22,430 --> 00:19:26,870
+هلأ هاي ال deformities هل هي congenital من لحظة ما
+
+288
+00:19:26,870 --> 00:19:31,240
+انخلق من لحظة الميلاد ولا صارت acquiredنتيجة
+
+289
+00:19:31,240 --> 00:19:36,480
+habits خاطئة، نتيجة لا يريدوا أن يتعرضوا لألم هذا
+
+290
+00:19:36,480 --> 00:19:40,480
+الشخص، فسأعمل هذه الحاجة. في عندنا الـcongenital،
+
+291
+00:19:40,480 --> 00:19:42,840
+بعض الـdeformities الـcongenital، زي حاجة اسمها
+
+292
+00:19:42,840 --> 00:19:46,660
+الـpictus cartinum أو بسميها الـbicon chest، صدر
+
+293
+00:19:46,660 --> 00:19:50,760
+الحمامة. الـsternum شو مميزته؟ إنه الـsternum is
+
+294
+00:19:50,760 --> 00:19:55,700
+prominent and protruded anteriorly. تمام، هذه
+
+295
+00:19:55,700 --> 00:20:00,690
+الوضع.إنه الـ sternum عظمة القص بتكون بارزة للأمام
+
+296
+00:20:00,690 --> 00:20:07,790
+زي صدر الحمامة تمام ال Bectus X Vetums اللي
+
+297
+00:20:07,790 --> 00:20:13,830
+بنسميها القمع أو اللي هو الصدر القمعي أو القمعي
+
+298
+00:20:13,830 --> 00:20:17,130
+هذا الصدر طبعا بيكون اللي هي ال sternum أو lowered
+
+299
+00:20:17,130 --> 00:20:21,970
+of sternum is the breast عكس الأولانيةوالـ lower
+
+300
+00:20:21,970 --> 00:20:26,950
+ribs flare out ونشوف كيف اللي هو الـ lower ribs
+
+301
+00:20:26,950 --> 00:20:30,790
+اللي موجودة هنا بتكون flare out يعني مسطحة إلى
+
+302
+00:20:30,790 --> 00:20:33,450
+الخلف ال patient with this deformity are
+
+303
+00:20:33,450 --> 00:20:37,690
+diaphragmatic breathers excessive abdominal
+
+304
+00:20:37,690 --> 00:20:41,470
+protrusions and little upper chest movement occurs
+
+305
+00:20:41,470 --> 00:20:45,450
+during breathing لأن هذا الشخص بدنا نلاحظ أنه في
+
+306
+00:20:45,450 --> 00:20:49,910
+ال diaphragmatic عنده deformity طبعا حكينا عنها
+
+307
+00:20:49,910 --> 00:20:54,650
+اللي هي X-fetumبكترستكسفيتام أو القمع أو بالاسم
+
+308
+00:20:54,650 --> 00:20:59,210
+التاني اللي هو صدر القمع بتنفس the pragmatic
+
+309
+00:20:59,210 --> 00:21:03,070
+breathing excessive abdominal protrusion بينفخ
+
+310
+00:21:03,070 --> 00:21:06,590
+البطن الأمام و little في ال upper chest movement
+
+311
+00:21:06,590 --> 00:21:11,370
+هاي بالنسبة للمسكولي سكلتر deformity أيضا إذا كانت
+
+312
+00:21:11,370 --> 00:21:15,830
+المشكلة acquired يعني مكتسبة فيها نهاج اسمه ال
+
+313
+00:21:15,830 --> 00:21:20,160
+parallel chestاللي هو الصدر البرميلي anterior
+
+314
+00:21:20,160 --> 00:21:22,760
+-posterior بدي يحصل في عنا increasing ال diameter
+
+315
+00:21:22,760 --> 00:21:26,180
+من ال anterior-posterior هلأ ال circumference أو
+
+316
+00:21:26,180 --> 00:21:30,120
+القطر تبع ال upper chest appears large than that
+
+317
+00:21:30,120 --> 00:21:34,980
+lower chest تمام الجزئية ال upper أكبر بكتير من
+
+318
+00:21:34,980 --> 00:21:38,920
+الجزئية ال lower بدنا نلاحظ هنا هذه ال upper أكبر
+
+319
+00:21:38,920 --> 00:21:42,280
+من اللي هي ال lower partالـ sternum appears
+
+320
+00:21:42,280 --> 00:21:45,320
+prominent and the anterosterol diameter of chest
+
+321
+00:21:45,320 --> 00:21:48,660
+are greater than normal أعلى من ال normal أو أكبر
+
+322
+00:21:48,660 --> 00:21:52,780
+من ال normal with COPD طبعا اللي هو هي بالأغلب
+
+323
+00:21:52,780 --> 00:21:56,460
+بتكون ال parallel chest مع مرضة ال COPD اللي هو
+
+324
+00:21:56,460 --> 00:22:02,030
+chronic obstructive pulmonary disease تمام؟في ايضا
+
+325
+00:22:02,030 --> 00:22:05,870
+عندي من المشاكل اللي هي حاجة اسمها scoliosis اللي
+
+326
+00:22:05,870 --> 00:22:09,670
+هي lateral curvature للسبين زي ما انتوا شايفينه
+
+327
+00:22:09,670 --> 00:22:13,490
+lateral curvatures صار في عندي انحناء جانبي
+
+328
+00:22:13,490 --> 00:22:17,130
+asymmetry due to impaired movement of chest
+
+329
+00:22:17,130 --> 00:22:20,300
+diseaseفيه أيضًا عندي حاجة اسمها الـ Key Forces
+
+330
+00:22:20,300 --> 00:22:25,520
+طبعًا اللي هو الحدب أو ما يسمى بالتحد بالأمامي هذا
+
+331
+00:22:25,520 --> 00:22:29,940
+نتيجة إيه؟ Chest Divis بكلة ال mobility بدي أشوف
+
+332
+00:22:29,940 --> 00:22:33,040
+أنا أو في أثناء اللي هو التقييم بدي أعمل check لل
+
+333
+00:22:33,040 --> 00:22:36,760
+active movement في كل ال directions identify ال
+
+334
+00:22:36,760 --> 00:22:40,760
+restricting في أي motions في ال spinal أو ال
+
+335
+00:22:40,760 --> 00:22:46,130
+vertebral column الآن ال respiratory muscleهتكلم
+
+336
+00:22:46,130 --> 00:22:49,070
+على الـ mainly اللي هي الـ diaphragm و الـ
+
+337
+00:22:49,070 --> 00:22:53,130
+accessory muscles اللي هي between ribs in his
+
+338
+00:22:53,130 --> 00:22:56,530
+muscular structures طبعا بيكون فيه عنا واسطنغ a
+
+339
+00:22:56,530 --> 00:23:00,630
+weakness and hyper atrophied ممكن يعني يكون فيه
+
+340
+00:23:00,630 --> 00:23:05,370
+عنا weakness و كذلك hyper atrophy شو نوع ال
+
+341
+00:23:05,370 --> 00:23:09,150
+respiratory pattern اللي هتنفس فيه هقيمه أيضا ال
+
+342
+00:23:09,150 --> 00:23:14,130
+system rate معدر التنفسانتظامه و ال ventilation
+
+343
+00:23:14,130 --> 00:23:18,810
+خلال اللي هو ال risk أو ال activity مهم جدا أنا
+
+344
+00:23:18,810 --> 00:23:22,270
+أعرفه كمان ال normal بدي أعرف الطبيعي عشان بعد
+
+345
+00:23:22,270 --> 00:23:25,450
+شوية نعرف أن هو ال abnormal اللي رأيته ال normal
+
+346
+00:23:25,450 --> 00:23:30,970
+respiratory rate لل healthy adultمن 12 إلى 20
+
+347
+00:23:30,970 --> 00:23:36,530
+breathes per minute من 12 إلى 20 نفس خلال الدقيقة
+
+348
+00:23:36,530 --> 00:23:38,970
+this is the most accurately determined when
+
+349
+00:23:38,970 --> 00:23:42,870
+patient unaware and the respiratory rate is being
+
+350
+00:23:42,870 --> 00:23:46,590
+measured and walk taking pulse rate كمان ممكن أخد
+
+351
+00:23:46,590 --> 00:23:50,890
+معاها اللي هو ال pulse rate في هذه الحالة ال
+
+352
+00:23:50,890 --> 00:23:54,310
+normal ratio ما بين الinspiration و ال expiration
+
+353
+00:23:54,310 --> 00:24:00,930
+من 1 إلى 2 في فترة ال restو 1 إلى 1 في فترة ال
+
+354
+00:24:00,930 --> 00:24:05,750
+activity تمام؟ ال patient اللي عنده COPD chronic
+
+355
+00:24:05,750 --> 00:24:10,030
+chronic obstructive pulmonary disease may have
+
+356
+00:24:10,030 --> 00:24:14,170
+ratio من 1 إلى 4 في ال rest شوفتوا إيش ال normal؟
+
+357
+00:24:14,170 --> 00:24:17,230
+ال normal إنه يكون من 1 إلى 2 فبالتالي زاد من 1
+
+358
+00:24:17,230 --> 00:24:21,290
+إلى 4and which is reflected difficulty of
+
+359
+00:24:21,290 --> 00:24:24,410
+expiration phase احنا حاكي هنا المعادلة هنا أو
+
+360
+00:24:24,410 --> 00:24:28,910
+التناسب هيكون من ال inspiration لل expiration
+
+361
+00:24:28,910 --> 00:24:32,850
+تمام، معناته هنا بدي ألاحظ أن الأربعة زادت في ال
+
+362
+00:24:32,850 --> 00:24:37,250
+expiration phase فبالتالي هو عنده difficulty خلال
+
+363
+00:24:37,250 --> 00:24:41,990
+ال expiratory phase أيضا بدي أكمل اللي هو باقي ال
+
+364
+00:24:41,990 --> 00:24:44,230
+assessment أنه أنا بدي أشوف في عندنا normal
+
+365
+00:24:44,230 --> 00:24:48,330
+sequences of inspiration at restالـ Death Fragment
+
+366
+00:24:48,330 --> 00:24:51,770
+الـ Contracts and descending الأبدومين في منطقة
+
+367
+00:24:51,770 --> 00:24:56,570
+الـ epigastric area طبعا راسد ارتفاع، this is
+
+368
+00:24:56,570 --> 00:25:01,470
+followed by lateral costal expansion صار في عندي
+
+369
+00:25:01,470 --> 00:25:06,250
+الـ lateral costal صار فيها توسع as the ribs move
+
+370
+00:25:06,250 --> 00:25:10,660
+up and out and finally the upper chest raisesNeck
+
+371
+00:25:10,660 --> 00:25:13,080
+muscles مهمة جدا لأنها بتشتغل معايا as accessory
+
+372
+00:25:13,080 --> 00:25:16,520
+muscles واللي هو لازم أنا أكون محافظة عليها
+
+373
+00:25:16,520 --> 00:25:19,960
+ومحافظة على ال muscle power تبعتها Of inspiration
+
+374
+00:25:19,960 --> 00:25:24,180
+should be inactive طبعا during إيه اللي هي relaxed
+
+375
+00:25:24,180 --> 00:25:30,570
+inspiration to assist breathing اللي هوبريفينج
+
+376
+00:25:30,570 --> 00:25:33,610
+سيكوانس لما بدأ أقيم ال patient assume comfortable
+
+377
+00:25:33,610 --> 00:25:37,570
+position سيمي recline أو sublime position place
+
+378
+00:25:37,570 --> 00:25:40,330
+your hand طبعا بدنا نحط إيدينا ال patient's
+
+379
+00:25:40,330 --> 00:25:44,050
+iligastric region أعلى المعدة and the sternum
+
+380
+00:25:44,050 --> 00:25:47,750
+observe movement of two areas بدي أشوف أنا حاطة
+
+381
+00:25:47,750 --> 00:25:50,630
+إيدي زي ما أنتوا شايفين هنا على ال iligastric area
+
+382
+00:25:50,630 --> 00:25:55,490
+أو ال iligastric regions وبدي أشوف اللي هو المنطقة
+
+383
+00:25:55,490 --> 00:26:00,330
+هنا كيف بدي يكون النفس فيهاوبهيك بيكون خلصنا ال
+
+384
+00:26:00,330 --> 00:26:04,330
+part الأول من ال preliminary assessment ألقاكم
+
+385
+00:26:04,330 --> 00:26:08,350
+بإذن الله تعالى في part اتنين ويعطيكوا العافية
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/MUUknHF3SV4_raw.json b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/MUUknHF3SV4_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..cef829239e0ed751eddfa2b768e35bec0832a6d0
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/MUUknHF3SV4_raw.json
@@ -0,0 +1 @@
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"text": "في ايضا عندي من المشاكل اللي هي حاجة اسمها scoliosis اللي هي lateral curvature للسبين زي ما انتوا شايفينه lateral curvatures صار في عندي انحناء جانبي asymmetry due to impaired movement of chest disease", "tokens": [41185, 1975, 1829, 11242, 995, 18871, 16254, 9154, 9673, 8592, 995, 28820, 13672, 1829, 39896, 11331, 26108, 3660, 24525, 2304, 11296, 795, 401, 48783, 13672, 1829, 39896, 25128, 37638, 24976, 3794, 3555, 9957, 30767, 1829, 19446, 16472, 2655, 14407, 13412, 995, 33911, 9957, 3224, 25128, 33900, 3377, 20328, 9640, 8978, 18871, 16254, 16472, 5016, 1863, 16606, 10874, 7649, 21292, 37277, 9889, 3462, 281, 36762, 3963, 295, 7443, 4752], "avg_logprob": -0.2282608669737111, "compression_ratio": 1.4894736842105263, "no_speech_prob": 0.0, "words": [{"start": 1321.31, "end": 1321.63, "word": "في", "probability": 0.391357421875}, {"start": 1321.63, "end": 1322.03, "word": " ايضا", "probability": 0.81805419921875}, {"start": 1322.03, "end": 1322.29, "word": " عندي", 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motions في ال spinal أو ال vertebral column الآن ال respiratory muscle", "tokens": [41185, 3224, 36632, 11242, 14111, 995, 18871, 16254, 11331, 26108, 3660, 24525, 2304, 11296, 2423, 39184, 12759, 27445, 23032, 3555, 3615, 14111, 995, 13672, 1829, 31439, 21542, 3215, 3555, 34051, 19446, 7251, 38251, 7578, 20666, 2655, 24401, 20666, 10721, 2304, 10943, 1829, 23758, 8717, 31371, 7435, 3660, 11933, 1829, 3224, 22807, 47981, 9886, 271, 4724, 28820, 3660, 2423, 16199, 4724, 16254, 5551, 8592, 38688, 41850, 34051, 8978, 5551, 12984, 1863, 16606, 13672, 1829, 31439, 16712, 38436, 32640, 4724, 16254, 5551, 25957, 1211, 1520, 24976, 4967, 3963, 8978, 28242, 2423, 11095, 5876, 2423, 1472, 37714, 8978, 36632, 27500, 8978, 2423, 28022, 34051, 2423, 16167, 32728, 1173, 16449, 6024, 48506, 2423, 27038, 8679], "avg_logprob": -0.24260603170841932, "compression_ratio": 1.6344827586206896, "no_speech_prob": 1.7881393432617188e-07, "words": [{"start": 1338.08, "end": 1338.36, "word": "فيه", 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نعرف أن هو ال abnormal اللي رأيته ال normal respiratory rate لل healthy adult", "tokens": [7649, 2655, 19913, 10943, 3224, 4032, 2423, 29553, 16490, 1211, 6027, 13672, 1829, 31439, 2423, 3148, 34051, 2423, 5191, 3714, 16095, 10874, 28259, 41850, 5551, 3615, 28480, 3224, 9122, 2304, 7649, 2423, 2710, 4724, 16254, 5551, 3615, 28480, 41950, 21292, 3615, 1829, 6225, 8592, 7649, 39182, 13412, 2407, 10632, 8717, 3615, 28480, 14739, 31439, 2423, 32847, 13672, 1829, 12602, 10721, 36081, 3224, 2423, 2710, 27038, 3314, 24976, 4627, 5075], "avg_logprob": -0.2114955348627908, "compression_ratio": 1.6, "no_speech_prob": 3.993511199951172e-06, "words": [{"start": 1392.45, "end": 1393.17, "word": "انتظامه", "probability": 0.8283203125}, {"start": 1393.17, "end": 1393.49, "word": " و", "probability": 0.425048828125}, {"start": 1393.49, "end": 1393.57, "word": " ال", "probability": 0.6923828125}, {"start": 1393.57, "end": 1394.13, "word": " ventilation", "probability": 0.5927734375}, {"start": 1394.13, 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"compression_ratio": 1.3211678832116789, "no_speech_prob": 0.0, "words": [{"start": 1558.93, "end": 1559.45, "word": "وبهيك", "probability": 0.8524169921875}, {"start": 1559.45, "end": 1559.73, "word": " بيكون", "probability": 0.787109375}, {"start": 1559.73, "end": 1560.21, "word": " خلصنا", "probability": 0.9757080078125}, {"start": 1560.21, "end": 1560.33, "word": " ال", "probability": 0.9248046875}, {"start": 1560.33, "end": 1560.53, "word": " part", "probability": 0.828125}, {"start": 1560.53, "end": 1561.11, "word": " الأول", "probability": 0.873291015625}, {"start": 1561.11, "end": 1561.57, "word": " من", "probability": 0.9853515625}, {"start": 1561.57, "end": 1561.81, "word": " ال", "probability": 0.84423828125}, {"start": 1561.81, "end": 1562.21, "word": " preliminary", "probability": 0.361083984375}, {"start": 1562.21, "end": 1563.49, "word": " assessment", "probability": 0.9423828125}, {"start": 1563.49, "end": 1564.33, "word": " ألقاكم", "probability": 0.9076171875}, {"start": 1564.33, "end": 1564.67, "word": " بإذن", "probability": 0.98486328125}, {"start": 1564.67, "end": 1564.91, "word": " الله", "probability": 0.94873046875}, {"start": 1564.91, "end": 1565.53, "word": " تعالى", "probability": 0.8626302083333334}, {"start": 1565.53, "end": 1565.83, "word": " في", "probability": 0.95068359375}, {"start": 1565.83, "end": 1566.41, "word": " part", "probability": 0.966796875}, {"start": 1566.41, "end": 1567.29, "word": " اتنين", "probability": 0.81854248046875}, {"start": 1567.29, "end": 1567.89, "word": " ويعطيكوا", "probability": 0.7850748697916666}, {"start": 1567.89, "end": 1568.35, "word": " العافية", "probability": 0.9195963541666666}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1579.189125, "duration_after_vad": 1542.3962499999973}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/MUUknHF3SV4_raw.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/MUUknHF3SV4_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..d2a8dcaf9594514508d02aaebb01f6f2cc58da7a
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/MUUknHF3SV4_raw.srt
@@ -0,0 +1,1544 @@
+1
+00:00:01,290 --> 00:00:05,050
+والصلاة والسلام علي أشرف الأنبياء والمرسلين إن شاء
+
+2
+00:00:05,050 --> 00:00:08,630
+الله بالعالمين المحاضرة هذه راح أدخل في ال chapter
+
+3
+00:00:08,630 --> 00:00:13,770
+الأخير أو ال part الأخير من هذا المساق سأتحدث فيه
+
+4
+00:00:13,770 --> 00:00:17,370
+عن البلمونري فيزيو ثيرابي ودور الفيزيو ثيرابي في
+
+5
+00:00:17,370 --> 00:00:22,430
+كل chest disease نبدأ على بركة الله في فيديو رقم
+
+6
+00:00:22,430 --> 00:00:23,030
+10
+
+7
+00:00:30,370 --> 00:00:35,910
+لأ المعروف إن ال respiratory system هو عبارة عن
+
+8
+00:00:35,910 --> 00:00:40,390
+الاشي اللي بيمد الجسم بال Oxygen supply تمام
+
+9
+00:00:40,390 --> 00:00:46,390
+فبالتالي سلامة ال life هتأدي إلى ضخ كمية ممتازة
+
+10
+00:00:46,390 --> 00:00:51,210
+للخلايا cell of a human body required constant of
+
+11
+00:00:51,210 --> 00:00:55,230
+stream oxygen to stay aliveالنظام الفرسبيراتوري
+
+12
+00:00:55,230 --> 00:01:00,150
+يعطي أكسجين لجسم الجسم لإزالة ما يسمى كالكربون
+
+13
+00:01:00,150 --> 00:01:05,610
+ديكسايد ووست البروداكت ك بي لثالث إذا كان مسموحاً
+
+14
+00:01:05,610 --> 00:01:10,510
+لأكومليكايتد أي تراكم أو أي تكون لثاني أكسجن
+
+15
+00:01:10,510 --> 00:01:15,630
+الكربون هذا بيؤدي إلى حالة من اللي هي عدم الابتذاب
+
+16
+00:01:15,630 --> 00:01:20,470
+في الجسم وبالآخر إلى وفاة هذا الشخص هناك ثلاثة جزء
+
+17
+00:01:20,470 --> 00:01:24,420
+مهمة من نظام الفرسبيراتوريالـ Airway أنا بهمني
+
+18
+00:01:24,420 --> 00:01:27,840
+سلامة الـ Airway هل في أي Obstructions؟ هل في أي
+
+19
+00:01:27,840 --> 00:01:32,520
+Secretions؟ هل في أي مشكلة بتعيقني؟ ال lungs اللي
+
+20
+00:01:32,520 --> 00:01:37,020
+فيها بتن من gas exchange مهمة جدا أيضا بتهمني
+
+21
+00:01:37,020 --> 00:01:40,280
+سلامة ال muscles of respiration سواء اللي هو ال
+
+22
+00:01:40,280 --> 00:01:44,620
+mainly muscle أو ال accessory muscle كل هذه الثلاث
+
+23
+00:01:44,620 --> 00:01:49,710
+محاولة أنا هشتغل عليها بالفيزيotherapy programهدخل
+
+24
+00:01:49,710 --> 00:01:53,870
+مباشرة في الـ Physiotherapy part و ال Anatomy و ما
+
+25
+00:01:53,870 --> 00:01:58,370
+يتعلق في المقدمة من هذا ال chapter تركته و هدخل
+
+26
+00:01:58,370 --> 00:02:02,670
+مباشرة في ال Physiotherapy program لئا ال aspect
+
+27
+00:02:02,670 --> 00:02:04,950
+of respiratory rehabilitation include all of the
+
+28
+00:02:04,950 --> 00:02:07,970
+following ال patient assessment and goal setting
+
+29
+00:02:07,970 --> 00:02:12,970
+ال exercise training self management education و
+
+30
+00:02:12,970 --> 00:02:15,850
+ال nutritional intervention و ال psychosocial
+
+31
+00:02:15,850 --> 00:02:19,690
+supportهي ال aspect اللي أنا هشتغل عليها في ال
+
+32
+00:02:19,690 --> 00:02:24,510
+respiratory rehabilitation تمام؟ زي أي مريض بنبدأ
+
+33
+00:02:24,510 --> 00:02:29,350
+بوضع ال assessment له بيشمل كل ما يتعلق في المريض
+
+34
+00:02:29,350 --> 00:02:32,370
+ال past history و ال present history و كل الأمور
+
+35
+00:02:32,370 --> 00:02:35,470
+هاي بعدين أنا بدي أبدأ أضع اللي هو ال plan of
+
+36
+00:02:35,470 --> 00:02:38,790
+treatment ال plan تبعتي هتشمل طبعا فيها ال goal
+
+37
+00:02:38,790 --> 00:02:42,690
+setting ال exercise training ال self managementالـ
+
+38
+00:02:42,690 --> 00:02:46,910
+Home Program هل هو مثلًا على سبيل المثال بيصير فيه
+
+39
+00:02:46,910 --> 00:02:50,590
+عنده difficulty of breathing في وقت الليل، إن
+
+40
+00:02:50,590 --> 00:02:55,130
+النهار بيكون سليم، كل هذه الأمور أنا هناقشها في
+
+41
+00:02:55,130 --> 00:02:58,230
+محاضرة اليوم بإذن الله تعالى فيما يخص ال
+
+42
+00:02:58,230 --> 00:03:02,810
+assessment of pulmonary physiotherapy هتكلم على
+
+43
+00:03:02,810 --> 00:03:06,790
+ثمانية من ال aims of physical therapy للـpulmonary
+
+44
+00:03:06,790 --> 00:03:11,270
+disease أول هدف إلي أنا ببدأ أشتغل معهأي مريض في
+
+45
+00:03:11,270 --> 00:03:15,110
+قسم الصدرية بدي يكون هدفي الأساسي والأولاني to
+
+46
+00:03:15,110 --> 00:03:18,210
+prevent airway obstruction أي إشي حيعملي
+
+47
+00:03:18,210 --> 00:03:22,990
+obstruction لازم أنا أبدأ أتحيل على الإشي و أشيله
+
+48
+00:03:22,990 --> 00:03:26,680
+سواء كان بالـ Physotherapy Programأو بمساعدة اللي
+
+49
+00:03:26,680 --> 00:03:30,580
+هو الـ medication مع الدكتور to improve airway
+
+50
+00:03:30,580 --> 00:03:33,740
+clearness هذا كمان بيهمني الاشيء and ventilation
+
+51
+00:03:33,740 --> 00:03:37,520
+through mobilization and drainage of secretion
+
+52
+00:03:37,520 --> 00:03:41,100
+الان to improve لل endurance and general exercise
+
+53
+00:03:41,100 --> 00:03:44,680
+tolerance and overall wellbeing بيهمني كمان ال
+
+54
+00:03:44,680 --> 00:03:48,200
+enduranceجدّي استعداد المريض وقابليته لأداء الـ
+
+55
+00:03:48,200 --> 00:03:52,860
+Exercise هل عنده Good Tolerance ولا لسه هو Fatigue
+
+56
+00:03:52,860 --> 00:03:56,460
+Reduce لل energy cost during respiration خلال
+
+57
+00:03:56,460 --> 00:03:59,900
+الbreathing retrainings الآن أنا بدل ما يبدل هذا
+
+58
+00:03:59,900 --> 00:04:04,540
+المجهود ويخلص كل كمية الطاقة عند هذا المريض لأ بدي
+
+59
+00:04:04,540 --> 00:04:09,900
+أحاول أقلل أو أخليه يتنفس بـ pattern معين بحيث أنه
+
+60
+00:04:09,900 --> 00:04:13,420
+ما تنتهي الطاقة عنده اللي هي المفروض أنا أستخدمها
+
+61
+00:04:13,420 --> 00:04:17,520
+بعد هيك في أشياء تانية مهمةتمام؟ أيضًا من الأهداف
+
+62
+00:04:17,520 --> 00:04:21,320
+to prevent or correct الـ postural deformities بعض
+
+63
+00:04:21,320 --> 00:04:25,680
+الأحيان بما أنه بيكون على سبيل المثال عنده مشكلة
+
+64
+00:04:25,680 --> 00:04:29,860
+معاق معينة بيروح هو ماخد وضعية معينة خاطئة على
+
+65
+00:04:29,860 --> 00:04:33,600
+أساس أنه يتحايل على الألم أو أنه يتفادى هذا الألم
+
+66
+00:04:33,850 --> 00:04:38,110
+فبالتالي بتصير هي كانت بمجرد بس محايلة على ألم بعد
+
+67
+00:04:38,110 --> 00:04:43,030
+شهر شهرين بتصير عبارة عن عادة وإعاقة مستديمة معناة
+
+68
+00:04:43,030 --> 00:04:46,210
+دي للمثال زي الـ scoliosis مثلا فبالتالي هنا أنا
+
+69
+00:04:46,210 --> 00:04:49,870
+دوري to prevent أيضا أو correct لأي potential
+
+70
+00:04:49,870 --> 00:04:54,180
+deformity هتصير to promote relaxationإذا أنا عملت
+
+71
+00:04:54,180 --> 00:04:57,320
+breathing exercise خصنتي بـ Breathing معناه أن أنا
+
+72
+00:04:57,320 --> 00:05:00,740
+بعمل relaxation، general relaxation to maintain or
+
+73
+00:05:00,740 --> 00:05:03,880
+improve the chest mobility مهم جدا إنه أنا أخلي
+
+74
+00:05:03,880 --> 00:05:07,780
+اللي هو يكون في عندي chest mobility حتى إنه أنا
+
+75
+00:05:07,780 --> 00:05:11,960
+أترك مجال لل lungs تاخد راحتها في ال inspiration
+
+76
+00:05:11,960 --> 00:05:15,820
+and then expiration to improve القف effectiveness
+
+77
+00:05:16,460 --> 00:05:20,020
+الـ Cuff هنا مجالها واسع وموضوعها مهم جدا إذا أنا
+
+78
+00:05:20,020 --> 00:05:22,840
+حسنت من موضوع الـ Cuffing فمعناة الكلام إنه أنا
+
+79
+00:05:22,840 --> 00:05:26,400
+هعمل Clearness للـ Airway معناة الكلام إنه أنا
+
+80
+00:05:26,400 --> 00:05:31,200
+هفوت كمية كويسة من الأكسجين إلى داخل الجسم و أخرج
+
+81
+00:05:31,200 --> 00:05:35,100
+اللي هو الـ Carbondioxide فبالتالي أنا هنا حسنت من
+
+82
+00:05:35,100 --> 00:05:39,100
+الـ Lung Functions هذا المهم في كل الـ Respiratory
+
+83
+00:05:39,100 --> 00:05:44,810
+طبعا Systemالـ Evaluation تبعنا في تقييم المريض شو
+
+84
+00:05:44,810 --> 00:05:48,090
+أهدافي أنا من هذه الـ Examination؟ إنه أنا أعمل
+
+85
+00:05:48,090 --> 00:05:50,150
+الـ Determine للـ Patient الـ Primary and
+
+86
+00:05:50,150 --> 00:05:52,710
+Secondary Respiratory و Ventilatory Environments
+
+87
+00:05:52,710 --> 00:05:58,460
+بدي أحدد شو المشاكل الأساسية والثانويةHow
+
+88
+00:05:58,460 --> 00:06:00,840
+environmentally limits your physical function؟ هل
+
+89
+00:06:00,840 --> 00:06:04,840
+بتأثر على وظائفه الحيوية؟ على سبيل المثال هو مثلا
+
+90
+00:06:04,840 --> 00:06:08,060
+تجينا الست بقولك أنا بس أطلع الدرج بصير في عندي
+
+91
+00:06:08,060 --> 00:06:12,860
+اختناق بدي أشوف هل هي بتأثر عليها ولا لأ بت remind
+
+92
+00:06:12,860 --> 00:06:16,520
+the educationThe ventilatory pump and oxygen
+
+93
+00:06:16,520 --> 00:06:21,320
+uptake طبعا وإزالة تاني أكسيد الكربون to meet
+
+94
+00:06:21,320 --> 00:06:24,740
+oxygen demand during functional activities بدي
+
+95
+00:06:24,740 --> 00:06:28,780
+أحدد اللي هو عملية المدخّة في حالة استقطاب
+
+96
+00:06:28,780 --> 00:06:32,780
+الأكسجين أو في حالة استهلاك كمية الأكسجين وطارد ال
+
+97
+00:06:32,780 --> 00:06:36,140
+waste product أيضا بدي أشوف اللي هو assistant
+
+98
+00:06:36,140 --> 00:06:39,760
+patient suitability for participant in
+
+99
+00:06:39,760 --> 00:06:44,440
+rehabilitation بالمهنة البروجرامأكد عليه في وجود
+
+100
+00:06:44,440 --> 00:06:47,900
+أو حضوره في المشاركة في عملية الـ Rehabilitation
+
+101
+00:06:47,900 --> 00:06:53,490
+هل له دور فعال ولا لأ؟أكبر تطور في تجارب عملية
+
+102
+00:06:53,490 --> 00:06:58,770
+تجارب عملية تجارب عملية تجارب عملية تجارب عملية
+
+103
+00:06:58,770 --> 00:07:03,930
+تجارب عملية تجارب عملية تجارب عملية تجارب عملية
+
+104
+00:07:03,930 --> 00:07:07,730
+تجارب عملية تجارب عملية تجارب عملية تجارب عملية
+
+105
+00:07:07,730 --> 00:07:09,670
+تجارب عملية تجارب عملية تجارب عملية تجارب عملية
+
+106
+00:07:09,670 --> 00:07:09,670
+تجارب عملية تجارب عملية تجارب عملية تجارب عملية
+
+107
+00:07:09,670 --> 00:07:09,690
+تجارب عملية تجارب عملية تجارب عملية تجارب عملية
+
+108
+00:07:09,690 --> 00:07:11,030
+تجارب عملية تجارب عملية تجارب عملية تجارب عملية
+
+109
+00:07:11,030 --> 00:07:20,670
+تجارب عملية تجارب عملية
+
+110
+00:07:20,980 --> 00:07:25,940
+الـ Lung Fibrosis أو عنده اللي هو مشكلة في الـ
+
+111
+00:07:25,940 --> 00:07:29,780
+Lungs بدي أعرف ليش هو توقف عن البرنامج معناة
+
+112
+00:07:29,780 --> 00:07:33,260
+الكلام إنه فيه سبب إنه خلاه يستأمن هذا الوضع
+
+113
+00:07:33,260 --> 00:07:35,860
+فبالتالي ما أكمل معايا الـ Breathing Exercise على
+
+114
+00:07:35,860 --> 00:07:39,020
+سبيل المثال و بطل يجي على الجنسة أو بطل يكمل ال
+
+115
+00:07:39,020 --> 00:07:42,960
+home program تبعهم إذا لازم أنا أبحث في هذا الاشي
+
+116
+00:07:42,960 --> 00:07:48,260
+و أشوف شو المشكلة اللي قدت إلى ذلكشو ال component
+
+117
+00:07:48,260 --> 00:07:51,520
+تبع ال initial patient assessment ال patient
+
+118
+00:07:51,520 --> 00:07:55,200
+interview ال medical history هشوف في ال physical
+
+119
+00:07:55,200 --> 00:07:58,680
+assessment ال review لل diagnostic test هشوف اللي
+
+120
+00:07:58,680 --> 00:08:02,640
+هو تحويله تبع الدكتور و ال symptoms assessment
+
+121
+00:08:02,640 --> 00:08:05,800
+أيضا في ال general assessment بدي أشوف زي ما أي
+
+122
+00:08:05,800 --> 00:08:08,700
+assessment بنعمله ال age و ال name و ال sex و ال
+
+123
+00:08:08,700 --> 00:08:12,200
+occupation و ال social history و كل هذه الأمور هل
+
+124
+00:08:12,200 --> 00:08:16,980
+هو مدخن ولا مش مدخن بيستخدم أدوية أخرى ولا لأعلى
+
+125
+00:08:16,980 --> 00:08:20,980
+سبيل المثال، هل كان يستخدم بخاخة قبل كده ولا لأ؟
+
+126
+00:08:20,980 --> 00:08:24,540
+هل بيستخدم أدوية الـ Bronchodilators أو لأ؟ Usual
+
+127
+00:08:24,540 --> 00:08:28,340
+activities level Including employment، هل هو موظف؟
+
+128
+00:08:28,340 --> 00:08:33,420
+هل هو في البيت؟ ما بيتش تشتغل هذه الست؟ هل هي ربط
+
+129
+00:08:33,420 --> 00:08:36,180
+بيت؟ هل عندها أطفال؟ ما عندها أطفال؟ كل هذه الأمور
+
+130
+00:08:36,180 --> 00:08:41,180
+بتهمني أنا Regular exercise، تمام؟ إذا كان بيعمل
+
+131
+00:08:41,180 --> 00:08:44,720
+تمارين، هل هو منتظم فيها؟ ولا كل أسبوع مرة بيطلع
+
+132
+00:08:44,720 --> 00:08:48,230
+يمشي على سبيل المثال؟الـ Complaints نفسها، الشكوى،
+
+133
+00:08:48,230 --> 00:08:51,890
+إيش هي؟ اللي هي طبعا Prescribed with medication
+
+134
+00:08:51,890 --> 00:08:54,890
+and treatment ال pain level مثلا، عن طريق ال pain
+
+135
+00:08:54,890 --> 00:08:59,630
+scale، أديه هو بياخد من عشرة؟ هل هو painful ولا
+
+136
+00:08:59,630 --> 00:09:05,850
+less pain؟ فأنا لازم أعرف كام هي شدة الألمةSupport
+
+137
+00:09:05,850 --> 00:09:10,170
+لل family and friends طبعا ال family مهم جدا خصوصا
+
+138
+00:09:10,170 --> 00:09:13,530
+إذا كان أنا عندي هذا طفل وبحاجة إلى caregiver
+
+139
+00:09:13,530 --> 00:09:17,150
+History of environmental exposures and sensitivity
+
+140
+00:09:17,150 --> 00:09:24,210
+طبعاالبيئة اللي هو عايش فيها هل هو مثلًا smoker
+
+141
+00:09:24,210 --> 00:09:28,850
+ولا على سبيل المثال في حد تاني عنده smoke تمام؟
+
+142
+00:09:28,850 --> 00:09:31,930
+هذا بيهمني كمان هل هو مثلًا عايش في منطقة
+
+143
+00:09:31,930 --> 00:09:35,650
+industrial على سبيل المثال بيئة مليئة بالمصانع
+
+144
+00:09:35,650 --> 00:09:42,230
+مليئة بال populations اللي هي كل الملوثات فبالتالي
+
+145
+00:09:42,230 --> 00:09:46,470
+أنا لازم هنا أعرفكيف هو عايش أو اين هو يعيش ال
+
+146
+00:09:46,470 --> 00:09:49,050
+goals of participating ل rehabilitation programs
+
+147
+00:09:49,050 --> 00:09:52,410
+باست medical history كمان لازم اعرف اي operation
+
+148
+00:09:52,410 --> 00:09:56,690
+هو عملها على سبيل المثال lobotomy او اي مشكلة او
+
+149
+00:09:56,690 --> 00:10:00,590
+اي الناس على القزمة breathlessness كل هذه الأمور
+
+150
+00:10:00,590 --> 00:10:04,590
+لازم اعرفها في ال past history ايضا في عندي
+
+151
+00:10:04,590 --> 00:10:07,550
+specific assessment خليني اشوف ال patient تبعي
+
+152
+00:10:07,550 --> 00:10:11,450
+لازم انا اسأله عن بعض ال symptoms اذا كانت موجودة
+
+153
+00:10:11,450 --> 00:10:14,250
+او لأفي عند هنا بعض المصطلحات مهمة جدا
+
+154
+00:10:14,250 --> 00:10:18,870
+«discipline» معناتها difficult or labored
+
+155
+00:10:18,870 --> 00:10:23,130
+breathing «discipline» صعوبة في التنفس الـ BND هي
+
+156
+00:10:23,130 --> 00:10:29,450
+عبارة عن إيش الإحساس بالاختناق أثناء اللي هوالليل
+
+157
+00:10:29,450 --> 00:10:34,150
+بعد ساعة أو ساعتين من النوم دي يبقى عن sensation
+
+158
+00:10:34,150 --> 00:10:37,570
+of breathlessness أو shortening في الـ breathing
+
+159
+00:10:37,570 --> 00:10:41,930
+للـ weekends patient after one or two hours of
+
+160
+00:10:41,930 --> 00:10:45,150
+sleep بعد ساعة أو ساعتين من النوم and usually
+
+161
+00:10:45,150 --> 00:10:48,710
+relieved when upright position يعني على سبيل
+
+162
+00:10:48,710 --> 00:10:51,670
+المثال وخصوصا إذا كانت obese هيست for example
+
+163
+00:10:51,670 --> 00:10:55,770
+تقولي أنا أول الليل بنامبعد ساعة أو ساعتين بحس
+
+164
+00:10:55,770 --> 00:11:03,110
+حاجة تخنقني هنا المشكلة بس تعدل نفسها أو من الصبيل
+
+165
+00:11:03,110 --> 00:11:05,730
+ل ال upright position أو long sitting position
+
+166
+00:11:05,730 --> 00:11:10,650
+بتصير تماما تماما هذه بسميها اللي هو proximal
+
+167
+00:11:10,650 --> 00:11:15,870
+nocturnal disease أو dyspnea الـ BNDتمام؟ الـ
+
+168
+00:11:15,870 --> 00:11:19,690
+Orthopenia هي عبارة عن shortness للـ breathing أو
+
+169
+00:11:19,690 --> 00:11:23,410
+discipline بنقصين بتصير في ال sublime position إذا
+
+170
+00:11:23,410 --> 00:11:28,610
+في فرق بين مصطلح اتنين ومصطلح تلاتة الويزنج اللي
+
+171
+00:11:28,610 --> 00:11:32,090
+هو أو الويزن الصفير هو عبارة عن continuous course
+
+172
+00:11:32,090 --> 00:11:36,410
+whistling sound produced in the respiratory airway
+
+173
+00:11:36,410 --> 00:11:40,490
+تمام؟ في غلال التنفسفي عندنا بعض الأحيان في
+
+174
+00:11:40,490 --> 00:11:45,890
+الأطفال ممكن يصير في عندهم wheezing هذا بيكون طبعا
+
+175
+00:11:45,890 --> 00:11:50,530
+نتيجة لأي مشكلة نتيجة lung disease على سبيل المثال
+
+176
+00:11:50,820 --> 00:11:54,600
+في بيوتنا، بدي أشوف لونه، بدي أشوف الفاسقوس
+
+177
+00:11:54,600 --> 00:11:59,480
+السبعته، الـQuantity، الـPresence of blood or not،
+
+178
+00:11:59,480 --> 00:12:02,480
+كل هذه الأمور بيهمنا، مثلًا لما كنا نحكي على نوع
+
+179
+00:12:02,480 --> 00:12:05,820
+الـTubes اللي موجودة عندى في الـICU، كل ما كانت
+
+180
+00:12:05,820 --> 00:12:09,440
+شفافة ومرئية، بيكون أفضل حتى أنا ألاحظ كل هذا
+
+181
+00:12:09,440 --> 00:12:13,560
+الأمر، إذن هو عبارة عن name of coughed up لمucous
+
+182
+00:12:13,560 --> 00:12:18,250
+material from the airways trachea and bronchiطبعا
+
+183
+00:12:18,250 --> 00:12:20,810
+بدي أشوف إذا في تغيير عندي في ال color في ال
+
+184
+00:12:20,810 --> 00:12:26,670
+quantity في ال viscosity ووجود blood or not هذا
+
+185
+00:12:26,670 --> 00:12:30,650
+فيديو بتعلق اللي هو في shorting of breathing
+
+186
+00:12:30,650 --> 00:12:38,950
+لالستات تمام كنت أنا ألحقته بالمحاضرة إذا ال cuff
+
+187
+00:12:38,950 --> 00:12:43,640
+أي change في أنواع الكفكحة ناشفة، كحة لأ فيها
+
+188
+00:12:43,640 --> 00:12:48,920
+secretion، مدتها، ال duration تبعها هل هي بتكون في
+
+189
+00:12:48,920 --> 00:12:52,200
+الليل و النهار نفس الأشي و لا بس بالليل بتزيد طبعا
+
+190
+00:12:52,200 --> 00:12:56,880
+هذا مهم جدا في عندي ال dry cuffing أو ما يسمى اللي
+
+191
+00:12:56,880 --> 00:13:00,440
+هو الكحة الناشفة اللي هي hacking cuff is often
+
+192
+00:13:00,440 --> 00:13:06,040
+caused by infection للأبراطورينطبعا التهاب في مجال
+
+193
+00:13:06,040 --> 00:13:09,800
+التنفس العلوية الـ nose way الصورات طبعا بما أننا
+
+194
+00:13:09,800 --> 00:13:13,760
+في COVID-19 لازم احنا ناخد بالنا منها تمام؟ بيكون
+
+195
+00:13:13,760 --> 00:13:17,600
+الاشي زي cold أو influenza لكن إذا كان في عندي
+
+196
+00:13:17,600 --> 00:13:20,840
+group of cough زي الحرش dry coughing sound similar
+
+197
+00:13:20,840 --> 00:13:25,680
+seal barking اللي هي زي اللي بنسميها نباح الفقمة
+
+198
+00:13:26,180 --> 00:13:30,440
+هذا اللي بيكون هو عبارة عن ليس كحة جافة لأ بتكون
+
+199
+00:13:30,440 --> 00:13:37,960
+مصحوبة باللي هو شحيح أو بحاح أو نبح فيه اللي هو
+
+200
+00:13:37,960 --> 00:13:42,420
+الصوت الـ wet cuffing أو ما يسمى بالكحة اللي هي
+
+201
+00:13:42,420 --> 00:13:45,560
+الرطبة هي عبارة عن إشي بيكون فيه عندنا fluid
+
+202
+00:13:45,560 --> 00:13:49,340
+secretionفي عندي هنا بلغام هذا البلغام لازم انا
+
+203
+00:13:49,340 --> 00:13:52,820
+اشوفه هل في مشكلة او لأ طبعا المشكلة بتكون في
+
+204
+00:13:52,820 --> 00:13:55,240
+اللواريسبيرات والـ retract طالما انا حكيت عن مجال
+
+205
+00:13:55,240 --> 00:13:57,780
+التنفس السفلية معناة الكلام اللي انا بدي اوصل لل
+
+206
+00:13:57,780 --> 00:14:03,760
+lungs windpipe and lungs تمام اللي هو ال bronchus
+
+207
+00:14:03,760 --> 00:14:06,680
+و ال bronchioles و هذه الأمور ال whopping cuffing
+
+208
+00:14:06,680 --> 00:14:11,480
+بسميها ايضا اللي هي او سعالة ديكي خليني اسميه also
+
+209
+00:14:11,480 --> 00:14:15,560
+known as brisites اللي هي عبارة عن القحة اللي
+
+210
+00:14:15,560 --> 00:14:22,200
+بتكونمستمرة ورا بعضها البعض الـ hematopoiesis الـ
+
+211
+00:14:22,200 --> 00:14:25,500
+hemo لحق لها blood وتوبيسيز اللي هي عبارة عن ال
+
+212
+00:14:25,500 --> 00:14:28,700
+cuffing اللي بيكون مسحوب في ال blood it may range
+
+213
+00:14:28,700 --> 00:14:32,280
+slightly streaking of sputum and frank blood بتكون
+
+214
+00:14:32,280 --> 00:14:38,040
+خيوط بسيطة في اللي هو ال sputum أو ال secretion
+
+215
+00:14:38,040 --> 00:14:41,970
+اللي عمله الشخص عن طريق ال cuffingهنا انا بدي اركز
+
+216
+00:14:41,970 --> 00:14:46,510
+ان الاشي بسيط جدا او ال blood مش بكميات كبيرة لو
+
+217
+00:14:46,510 --> 00:14:49,070
+كان في عندى blood بكميات كبيرة معناته انا هنا بحط
+
+218
+00:14:49,070 --> 00:14:52,750
+question mark و بسيبه على جانب لإنه ممكن يكون في
+
+219
+00:14:52,750 --> 00:14:57,190
+عندي TB او ما يسمى بيه السلل الرئوي ال weight if
+
+220
+00:14:57,190 --> 00:14:59,690
+there is an increase in weight it may be
+
+221
+00:14:59,690 --> 00:15:03,270
+associated with fluid retention مهم جدا إذا كان في
+
+222
+00:15:03,270 --> 00:15:07,310
+عنا مشاكل في التنفس خصوصا تسمعوا في الناس اللي
+
+223
+00:15:07,310 --> 00:15:11,050
+ممكن يحكيلك ان هو عنده ميه ع الصدرلأن ممكن يصير في
+
+224
+00:15:11,050 --> 00:15:14,990
+هذه الحالة fluid retention chest pain إذا كان ال
+
+225
+00:15:14,990 --> 00:15:17,430
+respiratory system أو الpatient فيه عنده chest
+
+226
+00:15:17,430 --> 00:15:20,250
+pain معناته هذا هيؤدى لإن يكون فيه عندنا muscular
+
+227
+00:15:20,250 --> 00:15:24,230
+skeletal disorders أو البلورة أو في عندنا tracheal
+
+228
+00:15:24,230 --> 00:15:27,370
+inflammation للـ Lung branchemia أو small airway
+
+229
+00:15:27,370 --> 00:15:31,450
+contains pain fibers طبعا هنا الشخص هياخد وضعية
+
+230
+00:15:31,450 --> 00:15:36,900
+بحيث إن هو يحاول يقلل هذا الألمالـ incontinence
+
+231
+00:15:36,900 --> 00:15:41,460
+وهذا موضوع كبير إحنا بنعاني منه خصوصا فئات اللي هو
+
+232
+00:15:41,460 --> 00:15:44,320
+ال female اليوم إذا كانت أنا عندي ال female أنا
+
+233
+00:15:44,320 --> 00:15:47,460
+هحكي حاجة in general يعني إذا كان عندي ال female
+
+234
+00:15:47,460 --> 00:15:55,440
+عمرها تزاوج تتجاوز لـ 45 و حوالي عندها 5 ل 6 baby
+
+235
+00:15:55,440 --> 00:15:59,480
+headفبالتالي في عندها كمان إشي أهم من هو الـ
+
+236
+00:15:59,480 --> 00:16:04,180
+obesity هذا الإشي كل ما هتعمل cuffing الـ intra
+
+237
+00:16:04,180 --> 00:16:07,840
+-abdominal pressure كل ما هيصير في عندي فرصة و
+
+238
+00:16:07,840 --> 00:16:10,920
+قابلة للاستعداد أن يصير في عندنا incontinence ليش؟
+
+239
+00:16:10,920 --> 00:16:13,480
+لأنه صار في عندي weakness في ال pelvic floor
+
+240
+00:16:13,480 --> 00:16:16,520
+muscles إن شاء الله رب العالمين هنشرح عنه في مدة
+
+241
+00:16:16,520 --> 00:16:19,690
+الجاينة في الفصل الجايمعناة الكلام إذا أنا زاد
+
+242
+00:16:19,690 --> 00:16:22,630
+عندي الـ intra-abdominal pressure هذا بيقدر الـ
+
+243
+00:16:22,630 --> 00:16:26,710
+increasing في اللي هو ال incontinence طبعا مش مع
+
+244
+00:16:26,710 --> 00:16:29,590
+كل الستات هذا الأشياء لأ الناس اللي عندها weakness
+
+245
+00:16:29,590 --> 00:16:34,170
+في ال pelvic floor muscles طبعا aggravated بتزيد
+
+246
+00:16:34,170 --> 00:16:38,110
+الحالة سوء مع ال chronic coughing ال coughing and
+
+247
+00:16:38,110 --> 00:16:40,410
+huffing increase ال intra-abdominal pressure طبعا
+
+248
+00:16:40,410 --> 00:16:44,430
+which is my participated urine leakage fear of
+
+249
+00:16:44,430 --> 00:16:48,760
+this may influence compliancewith physiotherapy
+
+250
+00:16:48,760 --> 00:16:54,640
+طبعاً هذا الأشياء بيأثر في أثناء اللي هو الجلسة
+
+251
+00:16:54,640 --> 00:17:00,300
+تبع أثناء الآن حسب الجامعية الأمريكية لاللي هو
+
+252
+00:17:00,300 --> 00:17:05,300
+القلب صنفت إن ال breathlessness according إلى four
+
+253
+00:17:05,300 --> 00:17:08,880
+grades ال grade الأول أو ال class الأول no
+
+254
+00:17:08,880 --> 00:17:12,500
+symptoms مافي أي أعراض و الordinary activity لل
+
+255
+00:17:12,500 --> 00:17:15,140
+breathlessness only occurring with severe
+
+256
+00:17:15,140 --> 00:17:18,660
+excretionsزي الـ Running زي اللي هو الـ Fast
+
+257
+00:17:18,660 --> 00:17:21,860
+Bicycling أو الـ Cross Country Skiing طبعاً هذا
+
+258
+00:17:21,860 --> 00:17:26,080
+إشي بسيط إنه مافيه symptoms في ال degree التاني أو
+
+259
+00:17:26,080 --> 00:17:29,900
+ال class التاني في عندنا symptoms مع ال activity
+
+260
+00:17:29,900 --> 00:17:32,960
+اللي بده يؤدي هالشخص على سبيل النتال اللي لما بده
+
+261
+00:17:32,960 --> 00:17:38,200
+يعمل upstairing اللي هو ال upstairing للدرج making
+
+262
+00:17:38,200 --> 00:17:42,560
+beds أو carrying large amount of shopping تمام هذا
+
+263
+00:17:42,560 --> 00:17:45,970
+ال class اتنين في عندنا أعراضClass 3 كل ما لها
+
+264
+00:17:45,970 --> 00:17:49,470
+الأمور بتزيد سوءًا شوفوا class 1 no symptoms بس
+
+265
+00:17:49,470 --> 00:17:53,030
+class 2 في عندنا symptoms class 3 وصلنا ل symptoms
+
+266
+00:17:53,030 --> 00:17:58,470
+with mild exceptions مع جهد متوسط يعني bathing,
+
+267
+00:17:58,870 --> 00:18:02,150
+showering, dressing أشياء بسيطة جدا بيصير في عندنا
+
+268
+00:18:02,150 --> 00:18:08,820
+symptoms ومؤشرات لإن في عندي breathlessnessالدرجة
+
+269
+00:18:08,820 --> 00:18:12,920
+الرابعة او ال class 4 ال symptoms حتى و هو في وضع
+
+270
+00:18:12,920 --> 00:18:16,040
+ال rest او اللي هو ال bed يعني نايم على السرير
+
+271
+00:18:16,040 --> 00:18:19,900
+برضه كمان في عندنا short lessons which of each
+
+272
+00:18:19,900 --> 00:18:23,460
+symptoms in acquiring should made concerning انا
+
+273
+00:18:23,460 --> 00:18:27,100
+لازم اهتم باش بال duration absolute time sense of
+
+274
+00:18:27,100 --> 00:18:30,540
+recognitions the symptoms month and year جديهم
+
+275
+00:18:30,540 --> 00:18:33,440
+بالظبط الله the duration of a person's symptoms
+
+276
+00:18:34,240 --> 00:18:38,060
+فترة اللي هو وجود الـ symptoms هالأيام و لا أسابيع
+
+277
+00:18:38,060 --> 00:18:42,560
+ال severity تبعته شدته in absolute terms and
+
+278
+00:18:42,560 --> 00:18:45,520
+relative to recent distance passed ال pattern
+
+279
+00:18:45,520 --> 00:18:50,000
+seasonal أو daily variations طبعا هل هو مثلا في
+
+280
+00:18:50,000 --> 00:18:53,020
+الربيع بزيد؟ هل هو في الخريف بزيد؟ هل في الشتاء
+
+281
+00:18:53,020 --> 00:18:57,760
+القزمة بتكون more strong؟ كل هذا لازم أعرفه
+
+282
+00:18:57,760 --> 00:19:03,490
+associated factorsincluding للparticipant
+
+283
+00:19:03,490 --> 00:19:06,870
+relieving factors and associated symptoms if any
+
+284
+00:19:06,870 --> 00:19:11,250
+تمام؟ بدي أشوف إذا في عندي عوامل بتأثر if any
+
+285
+00:19:11,250 --> 00:19:14,290
+chest طبعا هشوف ال chest assessment إذا في أنا
+
+286
+00:19:14,290 --> 00:19:18,430
+عندي أي مشاكل لل deformities بتلاحظ هنا ال sternum
+
+287
+00:19:18,430 --> 00:19:22,430
+كيف طالعة طبعا ال chest كيف عاملة عندي؟ في مشكلة
+
+288
+00:19:22,430 --> 00:19:26,870
+هلأ هاي ال deformities هل هي congenital من لحظة ما
+
+289
+00:19:26,870 --> 00:19:31,240
+انخلق من لحظة الميلاد ولا صارت acquiredنتيجة
+
+290
+00:19:31,240 --> 00:19:36,480
+habits خاطئة، نتيجة لا يريدوا أن يتعرضوا لألم هذا
+
+291
+00:19:36,480 --> 00:19:40,480
+الشخص، فسأعمل هذه الحاجة. في عندنا الـcongenital،
+
+292
+00:19:40,480 --> 00:19:42,840
+بعض الـdeformities الـcongenital، زي حاجة اسمها
+
+293
+00:19:42,840 --> 00:19:46,660
+الـpictus cartinum أو بسميها الـbicon chest، صدر
+
+294
+00:19:46,660 --> 00:19:50,760
+الحمامة. الـsternum شو مميزته؟ إنه الـsternum is
+
+295
+00:19:50,760 --> 00:19:55,700
+prominent and protruded anteriorly. تمام، هذه
+
+296
+00:19:55,700 --> 00:20:00,690
+الوضع.إنه الـ sternum عظمة القص بتكون بارزة للأمام
+
+297
+00:20:00,690 --> 00:20:07,790
+زي صدر الحمامة تمام ال Bectus X Vetums اللي
+
+298
+00:20:07,790 --> 00:20:13,830
+بنسميها القمع أو اللي هو الصدر القمعي أو القمعي
+
+299
+00:20:13,830 --> 00:20:17,130
+هذا الصدر طبعا بيكون اللي هي ال sternum أو lowered
+
+300
+00:20:17,130 --> 00:20:21,970
+of sternum is the breast عكس الأولانيةوالـ lower
+
+301
+00:20:21,970 --> 00:20:26,950
+ribs flare out ونشوف كيف اللي هو الـ lower ribs
+
+302
+00:20:26,950 --> 00:20:30,790
+اللي موجودة هنا بتكون flare out يعني مسطحة إلى
+
+303
+00:20:30,790 --> 00:20:33,450
+الخلف ال patient with this deformity are
+
+304
+00:20:33,450 --> 00:20:37,690
+diaphragmatic breathers excessive abdominal
+
+305
+00:20:37,690 --> 00:20:41,470
+protrusions and little upper chest movement occurs
+
+306
+00:20:41,470 --> 00:20:45,450
+during breathing لأن هذا الشخص بدنا نلاحظ أنه في
+
+307
+00:20:45,450 --> 00:20:49,910
+ال diaphragmatic عنده deformity طبعا حكينا عنها
+
+308
+00:20:49,910 --> 00:20:54,650
+اللي هي X-fetumبكترستكسفيتام أو القمع أو بالاسم
+
+309
+00:20:54,650 --> 00:20:59,210
+التاني اللي هو صدر القمع بتنفس the pragmatic
+
+310
+00:20:59,210 --> 00:21:03,070
+breathing excessive abdominal protrusion بينفخ
+
+311
+00:21:03,070 --> 00:21:06,590
+البطن الأمام و little في ال upper chest movement
+
+312
+00:21:06,590 --> 00:21:11,370
+هاي بالنسبة للمسكولي سكلتر deformity أيضا إذا كانت
+
+313
+00:21:11,370 --> 00:21:15,830
+المشكلة acquired يعني مكتسبة فيها نهاج اسمه ال
+
+314
+00:21:15,830 --> 00:21:20,160
+parallel chestاللي هو الصدر البرميلي anterior
+
+315
+00:21:20,160 --> 00:21:22,760
+-posterior بدي يحصل في عنا increasing ال diameter
+
+316
+00:21:22,760 --> 00:21:26,180
+من ال anterior-posterior هلأ ال circumference أو
+
+317
+00:21:26,180 --> 00:21:30,120
+القطر تبع ال upper chest appears large than that
+
+318
+00:21:30,120 --> 00:21:34,980
+lower chest تمام الجزئية ال upper أكبر بكتير من
+
+319
+00:21:34,980 --> 00:21:38,920
+الجزئية ال lower بدنا نلاحظ هنا هذه ال upper أكبر
+
+320
+00:21:38,920 --> 00:21:42,280
+من اللي هي ال lower partالـ sternum appears
+
+321
+00:21:42,280 --> 00:21:45,320
+prominent and the anterosterol diameter of chest
+
+322
+00:21:45,320 --> 00:21:48,660
+are greater than normal أعلى من ال normal أو أكبر
+
+323
+00:21:48,660 --> 00:21:52,780
+من ال normal with COPD طبعا اللي هو هي بالأغلب
+
+324
+00:21:52,780 --> 00:21:56,460
+بتكون ال parallel chest مع مرضة ال COPD اللي هو
+
+325
+00:21:56,460 --> 00:22:02,030
+chronic obstructive pulmonary disease تمام؟في ايضا
+
+326
+00:22:02,030 --> 00:22:05,870
+عندي من المشاكل اللي هي حاجة اسمها scoliosis اللي
+
+327
+00:22:05,870 --> 00:22:09,670
+هي lateral curvature للسبين زي ما انتوا شايفينه
+
+328
+00:22:09,670 --> 00:22:13,490
+lateral curvatures صار في عندي انحناء جانبي
+
+329
+00:22:13,490 --> 00:22:17,130
+asymmetry due to impaired movement of chest
+
+330
+00:22:17,130 --> 00:22:20,300
+diseaseفيه أيضًا عندي حاجة اسمها الـ Key Forces
+
+331
+00:22:20,300 --> 00:22:25,520
+طبعًا اللي هو الحدب أو ما يسمى بالتحد بالأمامي هذا
+
+332
+00:22:25,520 --> 00:22:29,940
+نتيجة إيه؟ Chest Divis بكلة ال mobility بدي أشوف
+
+333
+00:22:29,940 --> 00:22:33,040
+أنا أو في أثناء اللي هو التقييم بدي أعمل check لل
+
+334
+00:22:33,040 --> 00:22:36,760
+active movement في كل ال directions identify ال
+
+335
+00:22:36,760 --> 00:22:40,760
+restricting في أي motions في ال spinal أو ال
+
+336
+00:22:40,760 --> 00:22:46,130
+vertebral column الآن ال respiratory muscleهتكلم
+
+337
+00:22:46,130 --> 00:22:49,070
+على الـ mainly اللي هي الـ diaphragm و الـ
+
+338
+00:22:49,070 --> 00:22:53,130
+accessory muscles اللي هي between ribs in his
+
+339
+00:22:53,130 --> 00:22:56,530
+muscular structures طبعا بيكون فيه عنا واسطنغ a
+
+340
+00:22:56,530 --> 00:23:00,630
+weakness and hyper atrophied ممكن يعني يكون فيه
+
+341
+00:23:00,630 --> 00:23:05,370
+عنا weakness و كذلك hyper atrophy شو نوع ال
+
+342
+00:23:05,370 --> 00:23:09,150
+respiratory pattern اللي هتنفس فيه هقيمه أيضا ال
+
+343
+00:23:09,150 --> 00:23:14,130
+system rate معدر التنفسانتظامه و ال ventilation
+
+344
+00:23:14,130 --> 00:23:18,810
+خلال اللي هو ال risk أو ال activity مهم جدا أنا
+
+345
+00:23:18,810 --> 00:23:22,270
+أعرفه كمان ال normal بدي أعرف الطبيعي عشان بعد
+
+346
+00:23:22,270 --> 00:23:25,450
+شوية نعرف أن هو ال abnormal اللي رأيته ال normal
+
+347
+00:23:25,450 --> 00:23:30,970
+respiratory rate لل healthy adultمن 12 إلى 20
+
+348
+00:23:30,970 --> 00:23:36,530
+breathes per minute من 12 إلى 20 نفس خلال الدقيقة
+
+349
+00:23:36,530 --> 00:23:38,970
+this is the most accurately determined when
+
+350
+00:23:38,970 --> 00:23:42,870
+patient unaware and the respiratory rate is being
+
+351
+00:23:42,870 --> 00:23:46,590
+measured and walk taking pulse rate كمان ممكن أخد
+
+352
+00:23:46,590 --> 00:23:50,890
+معاها اللي هو ال pulse rate في هذه الحالة ال
+
+353
+00:23:50,890 --> 00:23:54,310
+normal ratio ما بين الinspiration و ال expiration
+
+354
+00:23:54,310 --> 00:24:00,930
+من 1 إلى 2 في فترة ال restو 1 إلى 1 في فترة ال
+
+355
+00:24:00,930 --> 00:24:05,750
+activity تمام؟ ال patient اللي عنده COPD chronic
+
+356
+00:24:05,750 --> 00:24:10,030
+chronic obstructive pulmonary disease may have
+
+357
+00:24:10,030 --> 00:24:14,170
+ratio من 1 إلى 4 في ال rest شوفتوا إيش ال normal؟
+
+358
+00:24:14,170 --> 00:24:17,230
+ال normal إنه يكون من 1 إلى 2 فبالتالي زاد من 1
+
+359
+00:24:17,230 --> 00:24:21,290
+إلى 4and which is reflected difficulty of
+
+360
+00:24:21,290 --> 00:24:24,410
+expiration phase احنا حاكي هنا المعادلة هنا أو
+
+361
+00:24:24,410 --> 00:24:28,910
+التناسب هيكون من ال inspiration لل expiration
+
+362
+00:24:28,910 --> 00:24:32,850
+تمام، معناته هنا بدي ألاحظ أن الأربعة زادت في ال
+
+363
+00:24:32,850 --> 00:24:37,250
+expiration phase فبالتالي هو عنده difficulty خلال
+
+364
+00:24:37,250 --> 00:24:41,990
+ال expiratory phase أيضا بدي أكمل اللي هو باقي ال
+
+365
+00:24:41,990 --> 00:24:44,230
+assessment أنه أنا بدي أشوف في عندنا normal
+
+366
+00:24:44,230 --> 00:24:48,330
+sequences of inspiration at restالـ Death Fragment
+
+367
+00:24:48,330 --> 00:24:51,770
+الـ Contracts and descending الأبدومين في منطقة
+
+368
+00:24:51,770 --> 00:24:56,570
+الـ epigastric area طبعا راسد ارتفاع، this is
+
+369
+00:24:56,570 --> 00:25:01,470
+followed by lateral costal expansion صار في عندي
+
+370
+00:25:01,470 --> 00:25:06,250
+الـ lateral costal صار فيها توسع as the ribs move
+
+371
+00:25:06,250 --> 00:25:10,660
+up and out and finally the upper chest raisesNeck
+
+372
+00:25:10,660 --> 00:25:13,080
+muscles مهمة جدا لأنها بتشتغل معايا as accessory
+
+373
+00:25:13,080 --> 00:25:16,520
+muscles واللي هو لازم أنا أكون محافظة عليها
+
+374
+00:25:16,520 --> 00:25:19,960
+ومحافظة على ال muscle power تبعتها Of inspiration
+
+375
+00:25:19,960 --> 00:25:24,180
+should be inactive طبعا during إيه اللي هي relaxed
+
+376
+00:25:24,180 --> 00:25:30,570
+inspiration to assist breathing اللي هوبريفينج
+
+377
+00:25:30,570 --> 00:25:33,610
+سيكوانس لما بدأ أقيم ال patient assume comfortable
+
+378
+00:25:33,610 --> 00:25:37,570
+position سيمي recline أو sublime position place
+
+379
+00:25:37,570 --> 00:25:40,330
+your hand طبعا بدنا نحط إيدينا ال patient's
+
+380
+00:25:40,330 --> 00:25:44,050
+iligastric region أعلى المعدة and the sternum
+
+381
+00:25:44,050 --> 00:25:47,750
+observe movement of two areas بدي أشوف أنا حاطة
+
+382
+00:25:47,750 --> 00:25:50,630
+إيدي زي ما أنتوا شايفين هنا على ال iligastric area
+
+383
+00:25:50,630 --> 00:25:55,490
+أو ال iligastric regions وبدي أشوف اللي هو المنطقة
+
+384
+00:25:55,490 --> 00:26:00,330
+هنا كيف بدي يكون النفس فيهاوبهيك بيكون خلصنا ال
+
+385
+00:26:00,330 --> 00:26:04,330
+part الأول من ال preliminary assessment ألقاكم
+
+386
+00:26:04,330 --> 00:26:08,350
+بإذن الله تعالى في part اتنين ويعطيكوا العافية
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/T3cTeEw_ujw.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/T3cTeEw_ujw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..be50bdb651355571cc64a193d8ba4e1cb0cb47a9
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/T3cTeEw_ujw.srt
@@ -0,0 +1,1751 @@
+1
+00:00:00,910 --> 00:00:04,790
+صلاة والسلام على أشرف الأنبياء والمرسلين، سأتحدث في
+
+2
+00:00:04,790 --> 00:00:08,690
+هذا الفيديو عن الـ Cardiac Rehabilitation، الـ PART
+
+3
+00:00:08,690 --> 00:00:13,730
+الأول. قمت بتجزئة المحاضرة إلى قسمين: part 1 و part 2.
+
+4
+00:00:13,730 --> 00:00:18,830
+بإذن الله، سأتحدث في هذا الـ part عن شو يعني كلمة الـ
+
+5
+00:00:18,830 --> 00:00:23,010
+rehabilitation، عن شو يعني الـ faces تبع الـ
+
+6
+00:00:23,010 --> 00:00:26,930
+rehabilitation، و الـ program اللي أنا كفيزيو
+
+7
+00:00:26,930 --> 00:00:31,150
+ثيرابي بدي أعطيه لـ cardiac patient. نبدأ على
+
+8
+00:00:31,150 --> 00:00:36,080
+بركة الله. حكيت بدي أتكلم عن الـ definition، الـ
+
+9
+00:00:36,080 --> 00:00:39,220
+objectives، تبع الـ indication و الـ contra
+
+10
+00:00:39,220 --> 00:00:42,420
+indication. الـ rehabilitation team members من هما؟
+
+11
+00:00:42,420 --> 00:00:47,220
+الـ faces of cardiac rehabilitation. شو يعني الـ
+
+12
+00:00:47,220 --> 00:00:49,280
+rehabilitation؟ الـ rehabilitation هي عبارة عن
+
+13
+00:00:49,280 --> 00:00:55,400
+عملية إعادة تأهيل المريض.  أخذت على سبيل المثال، ذبح
+
+14
+00:00:55,400 --> 00:01:00,910
+صدرية، أدت لفقد دوره في البيت، فقط دوره في المجتمع.
+
+15
+00:01:00,910 --> 00:01:05,090
+فبالتالي أنا كفيزيو ثيرابيست، مع الـ rehabilitation
+
+16
+00:01:05,090 --> 00:01:09,850
+team members اللي هم موجودين معايا، هنعمل على
+
+17
+00:01:09,850 --> 00:01:14,970
+إعادته as much as possible. إذن، rehabilitation is a
+
+18
+00:01:14,970 --> 00:01:18,410
+therapeutic process designed to facilitate maximal
+
+19
+00:01:18,410 --> 00:01:23,530
+restoration of function. Each patient must be
+
+20
+00:01:23,530 --> 00:01:27,250
+individually assessed to determine diagnoses,
+
+21
+00:01:27,250 --> 00:01:32,430
+associated disorders, response, and achievable goals.
+
+22
+00:01:32,430 --> 00:01:38,290
+كل مريض هو فريد من نوعه. حتى لو أنا دخلت الـ ICU، وكل
+
+23
+00:01:38,290 --> 00:01:42,310
+هذا موجود، اللي عندي مرضى قلب، لكن كل حالة فريدة من
+
+24
+00:01:42,310 --> 00:01:46,790
+نوعها. ممكن هذا يكون عنده MI with hypertension، لكن
+
+25
+00:01:46,790 --> 00:01:51,630
+الثاني MI with diabetes. تمام. فبالتالي كل حالة هي
+
+26
+00:01:51,630 --> 00:01:57,040
+فريدة من نوعها في التقييم اللي أنا بدي أقيمه. الـ
+
+27
+00:01:57,040 --> 00:02:00,580
+objectives تبعيتي، عندي خمسة objectives لازم أنا
+
+28
+00:02:00,580 --> 00:02:08,180
+أؤكد أو أحطها أمام عينيه: reverse pathophysiologic
+
+29
+00:02:08,180 --> 00:02:13,740
+and psychosocial effects of heart disease. بدي أشوف
+
+30
+00:02:13,740 --> 00:02:18,940
+شو الانتكاسات الباثولوجية أو الـ psychosocial على
+
+31
+00:02:18,940 --> 00:02:24,320
+مريض القلب. limited risk for reinfarction. أنا بحكي
+
+32
+00:02:24,320 --> 00:02:29,240
+reinfarction أو sudden death، يعني recurrent attack،
+
+33
+00:02:29,240 --> 00:02:34,240
+نوبة جديدة متجددة. relief للـ cardiac symptoms.
+
+34
+00:02:34,240 --> 00:02:39,680
+أيضًا، retire أو reverse للـ atherosclerosis by
+
+35
+00:02:39,680 --> 00:02:42,860
+instituting programs for exercise training،
+
+36
+00:02:42,860 --> 00:02:47,840
+education، counseling، and risk factor alterations.
+
+37
+00:02:47,840 --> 00:02:55,160
+بدي أحاول أحفظ أو أستعيد الحالات بالـ training، بالـ
+
+38
+00:02:55,160 --> 00:02:59,460
+education، بالتثقيف الصحي. هل الـ risk factor ده
+
+39
+00:02:59,460 --> 00:03:03,080
+المستمر نفسه، ولا فيه اتغير؟ إجاني كمان risk factor
+
+40
+00:03:03,080 --> 00:03:08,180
+آخر. Regenerated للـ heart disease patients into
+
+41
+00:03:08,180 --> 00:03:10,980
+successful function status in their family and
+
+42
+00:03:10,980 --> 00:03:14,720
+society. الـ family والـ patient هم الـ center تبعنا
+
+43
+00:03:14,720 --> 00:03:17,810
+في عملية الـ rehabilitation. كل الأمور وكل الـ
+
+44
+00:03:17,810 --> 00:03:22,310
+objectives لازم تحوم وتدور حول الـ patient and
+
+45
+00:03:22,310 --> 00:03:30,650
+family. الـ
+
+46
+00:03:30,650 --> 00:03:33,410
+indication. في أي حالات أنا بدي أستخدم الـ
+
+47
+00:03:33,410 --> 00:03:36,550
+rehabilitation program؟ Recent myocardial
+
+48
+00:03:36,550 --> 00:03:40,540
+infarction. تمام. في حالات الـ Recent Myocardial
+
+49
+00:03:40,540 --> 00:03:45,220
+Infarction. في حالات الـ Coronary Bypasses، توقيع
+
+50
+00:03:45,220 --> 00:03:49,780
+للشريان التاجي. الـ Valve Severy، Coronary
+
+51
+00:03:49,780 --> 00:03:54,920
+Angioplasty. Inserting and Inflating in Tiny
+
+52
+00:03:54,920 --> 00:03:59,260
+Balloons. زي ما أنتم شايفين، هذه العملية بيروح عشان
+
+53
+00:03:59,260 --> 00:04:04,700
+بيوسع اللي هو الضيق اللي صار هنا في الشريان. في بلون
+
+54
+00:04:04,700 --> 00:04:10,520
+صغير، وبتم وضعه زي شفاط العصير تقريبا، هو كتير رقيق
+
+55
+00:04:10,520 --> 00:04:15,940
+عشان يعمل توسعة لمرور الـ blood. cardiac
+
+56
+00:04:15,940 --> 00:04:19,400
+transplantation. بستخدم الـ rehabilitation program
+
+57
+00:04:19,400 --> 00:04:23,320
+هذا في حالات الـ cardiac transplantation. في حالات
+
+58
+00:04:23,320 --> 00:04:26,760
+الـ angina. في حالات الـ compensated cardio heart
+
+59
+00:04:26,760 --> 00:04:32,010
+failure، اللي هو فشل عضلة القلب. الـ exercise، هذا الـ
+
+60
+00:04:32,010 --> 00:04:36,750
+prescriptions depends on result exercise testing،
+
+61
+00:04:36,750 --> 00:04:40,050
+which often include cardiopulmonary exercise
+
+62
+00:04:40,050 --> 00:04:43,490
+testing. في عندي exercise testing، هناخدها في
+
+63
+00:04:43,490 --> 00:04:47,990
+بارت اتنين. هذا الـ exercise مخصص لحالات الـ cardiac
+
+64
+00:04:47,990 --> 00:04:53,780
+disease، اللي هو بقيس مدى تحمل المريض لهذا التمرين.
+
+65
+00:04:53,780 --> 00:04:57,180
+الآن، زي ما أنتم شايفين في هذه الصورة، الـ
+
+66
+00:04:57,180 --> 00:05:00,480
+Physiotherapist عيونه على الـ Monitoring، اللي هي
+
+67
+00:05:00,480 --> 00:05:04,750
+الشاشة اللي براقب فيها heart rate، وبراقب فيها الـ
+
+68
+00:05:04,750 --> 00:05:08,210
+respiratory rate، وبراقب فيها كل الـ vital signs. أنا
+
+69
+00:05:08,210 --> 00:05:11,230
+هنا بتكلم على مريض قلب، ما بتكلم على أي مريض عادي.
+
+70
+00:05:11,230 --> 00:05:15,530
+مريض قلب، لازم أنا أكون with good supervision، لازم
+
+71
+00:05:15,530 --> 00:05:18,930
+أكون مراقبة بشكل جيد، على أساس إنه هي مثل إمكانية، أو
+
+72
+00:05:18,930 --> 00:05:22,230
+موت. أفرض لسمح الله، حصل attack، أفرض صار فيه
+
+73
+00:05:22,230 --> 00:05:25,510
+مشكلة، فلازم الـ physiotherapist، و أي team members
+
+74
+00:05:25,510 --> 00:05:31,860
+موجود معاه، لازم يكون مراقب له بشكل دقيق جدا. مين
+
+75
+00:05:31,860 --> 00:05:35,360
+أنا مش ممكن أعمل اللي هو rehabilitation program؟
+
+76
+00:05:35,360 --> 00:05:39,420
+Severe residual angina. Uncompensated heart failure.
+
+77
+00:05:39,420 --> 00:05:44,780
+تمام. Uncontrolled Arrhythmia. Severe ischemia. Left
+
+78
+00:05:44,780 --> 00:05:48,140
+ventricular dysfunction. أو الـ arrhythmia during
+
+79
+00:05:48,140 --> 00:05:52,580
+exercise testing. صار عدم انتظام لضغط القلب. هنا أنا
+
+80
+00:05:52,580 --> 00:05:56,260
+ممنوع أشتغل معاهم نهائي. هذه الناس. Poor control
+
+81
+00:05:56,260 --> 00:06:01,010
+hypertension. الحالات اللي هي في عندها صعوبة في
+
+82
+00:06:01,010 --> 00:06:05,570
+التحكم في اللي هو ضغط الدم. مرة بنلاقيه عالي جدا، و
+
+83
+00:06:05,570 --> 00:06:08,710
+بعدين بينخفض، وبعدين بيرجع بيعلى. هنا ممنوع أنا
+
+84
+00:06:08,710 --> 00:06:11,650
+أشتغل معاهم. بتاعة الـ hypertensive أو
+
+85
+00:06:11,650 --> 00:06:14,710
+الـ hypotensive. للـ systolic blood pressure. عارفين
+
+86
+00:06:14,710 --> 00:06:17,670
+في إشي هنا systolic، وفي إشي هنا diastolic. الآن
+
+87
+00:06:17,670 --> 00:06:20,890
+الناس اللي صار عندهم hypertensive أو hypotensive
+
+88
+00:06:20,890 --> 00:06:24,670
+كمان ممنوع أشتغل عندهم. الـ unstable، الـ medically
+
+89
+00:06:24,670 --> 00:06:26,990
+unstable. في حالات الـ medically unstable، زي
+
+90
+00:06:26,990 --> 00:06:30,910
+الحالات اللي هي الـ diabetes. على سبيل المثال، صار
+
+91
+00:06:30,910 --> 00:06:34,350
+لو إيجي عنده كومة سكر زي ما بنحكيها إحنا بالـ
+
+92
+00:06:34,350 --> 00:06:37,750
+common. أو إنه مثلا على سبيل المثال، صار في عندنا
+
+93
+00:06:37,750 --> 00:06:41,250
+ارتفاع مفاجئ في السكر. هنا كمان نفس الشيء، ممنوع أنا
+
+94
+00:06:41,250 --> 00:06:47,120
+أشتغل معها، لأنه لازم أحافظ على الحالة العامة للمريض،
+
+95
+00:06:47,120 --> 00:06:50,320
+الوضع الصحي، تكون stable، عشان أنا ما أقدرش أشتغل معاه
+
+96
+00:06:50,320 --> 00:06:54,540
+في الـ physiotherapy program. تبعي، يكون هو في حالة
+
+97
+00:06:54,540 --> 00:06:58,340
+stable. هي الـ contra indication. الـ rehabilitation
+
+98
+00:06:58,340 --> 00:07:02,700
+team members هم مين؟ أول إشي أخدت اللي هو عنصر الـ
+
+99
+00:07:02,700 --> 00:07:06,040
+patient and his family. الـ patient و الـ family مهم
+
+100
+00:07:06,040 --> 00:07:10,060
+جدا، إنه أنا أحطهم بالـ center. ليش؟ عشان أنا الـ
+
+101
+00:07:10,060 --> 00:07:13,460
+patient و الـ family تبعته، must never be overlooked as
+
+102
+00:07:13,460 --> 00:07:17,280
+a member of the prescribing team. prescribing teams. لازم
+
+103
+00:07:17,280 --> 00:07:21,720
+أنا أحطهم، وما أجهل دور العائلة تماما. لازم أحطها في
+
+104
+00:07:21,720 --> 00:07:25,860
+المنتصف. الـ «home program» هو العائلة اللي هتقوم
+
+105
+00:07:25,860 --> 00:07:29,220
+فيه. أنا ما بحكيش موجود مع المريض بعد ما يطلع من الـ
+
+106
+00:07:29,220 --> 00:07:32,080
+«inpatient». «The patient and his family must be
+
+107
+00:07:32,080 --> 00:07:35,300
+made aware of the program in which he is about to enter
+
+108
+00:07:35,300 --> 00:07:38,400
+with its implications.» أيضا، في عملية التنفيذ، لازم يكون
+
+109
+00:07:38,400 --> 00:07:41,680
+موجود معايا حدا من الـ «family members»، اللي أنا
+
+110
+00:07:41,680 --> 00:07:45,740
+بين قوسين بسميهم الـ «caregivers»، أو مقدمي الرعاية.
+
+111
+00:07:46,020 --> 00:07:48,920
+They must be oriented to the available types of
+
+112
+00:07:48,920 --> 00:07:51,660
+mechanical aids and their individual advantages and
+
+113
+00:07:51,660 --> 00:07:55,240
+disadvantages related to the patient’s personal and work
+
+114
+00:07:55,240 --> 00:07:58,860
+needs. لازم أنا أكون عارفة إيش الـ exercise، أو إيش
+
+115
+00:07:58,860 --> 00:08:00,880
+الـ machine اللي أنا على سبيل المثال بدي أشتغل
+
+116
+00:08:00,880 --> 00:08:04,420
+عليها، شو الـ advantage، شو الـ disadvantage. يعني أكون
+
+117
+00:08:04,420 --> 00:08:08,720
+عاملة إجابة لكل سؤال محتمل، إنه أنا أنقله من أهل الـ
+
+118
+00:08:08,720 --> 00:08:12,500
+patient. على سبيل المثال، لو أنا بدي أشغله، أو أنا
+
+119
+00:08:12,500 --> 00:08:15,560
+بدي أدربه على الـ treadmill، بدي أحكيله إن أنتَ تمشي بسرعة كذا، ما تعمل كذا، لأن هذا وضعك بيعمل مخاطر هيك
+
+120
+00:08:15,560 --> 00:08:20,140
+و بيعمل مخاطر، و بكون أفضل لو كان بسرعة كذا. إذا حتى
+
+121
+00:08:20,140 --> 00:08:24,900
+في التنفيذ، في عملية تنفيذ الـ exercise، بيكون
+
+122
+00:08:24,900 --> 00:08:29,480
+للعائلة دور، وبتكون موجودة معايا في الـ center. الـ
+
+123
+00:08:29,480 --> 00:08:34,240
+physicians، الطبيب، هو الـ Guides تبع كل العملية
+
+124
+00:08:39,690 --> 00:08:44,550
+التأهيلية، بناءً على التحويلة تبع الدكتور القلب.
+
+125
+00:08:34,240 --> 00:08:39,690
+التأهيلية، بناءً على التحويلة تبع دكتور القلب. 
+أنا بشتغل، ما فيش تحويلة، ممنوع تشتغل. إذا، الـ physician
+
+126
+00:08:44,550 --> 00:08:49,490
+هو الـ leader and coordinator للـ team. He attends
+
+127
+00:08:49,490 --> 00:08:54,230
+to all medical aspects of individual cases. هو الـ
+
+128
+00:08:54,230 --> 00:08:58,830
+leader. والله عندك تحويلة، اتفضل تعال فوت على قسم
+
+129
+00:08:58,830 --> 00:09:03,280
+الـ physiotherapy. ما عندكش؟ أنا آسفة، بس ما بشتغل معاك. لو
+
+130
+00:09:03,280 --> 00:09:07,800
+صار في مسار للـ patient، هادي مسئولية الدكتور اللي هو
+
+131
+00:09:07,800 --> 00:09:11,220
+بتابع معاه. The physician referring the patient should
+
+132
+00:09:11,220 --> 00:09:14,120
+be state diagnosis. الـ Present Condition of Patient،
+
+133
+00:09:14,120 --> 00:09:18,370
+Limitations، أو الـ Precautions to Be Observed،
+
+134
+00:09:18,370 --> 00:09:21,990
+Prognosis، و الـ Result كمان To Be Achieved، and
+
+135
+00:09:21,990 --> 00:09:25,130
+Frequency، و Length of Treatment. لازم هي تكون
+
+136
+00:09:25,130 --> 00:09:28,870
+مكتوبة في الخطة، بوجود اللي هو الدكتور، اللي هو دكتور
+
+137
+00:09:28,870 --> 00:09:34,070
+القلب. لإنه عارف، على سبيل المثال، عضلة القلب بتشتغل
+
+138
+00:09:34,070 --> 00:09:37,690
+اليوم 30%، ما بدها long exercise، ما بدها strong
+
+139
+00:09:37,690 --> 00:09:42,750
+intensity للـ exercise. على سبيل المثال، فبالتالي
+
+140
+00:09:42,750 --> 00:09:46,560
+الدكتور هو اللي موجود، هو اللي هيحدد معايا إيش أنا
+
+141
+00:09:46,560 --> 00:09:50,100
+ممكن أعمله. الـ OT و الـ PT in the treatment of
+
+142
+00:09:50,100 --> 00:09:55,480
+physical disabilities. The physical therapy has
+
+143
+00:09:55,480 --> 00:09:58,200
+similar ultimate goals, namely to contribute to the
+
+144
+00:09:58,200 --> 00:10:02,460
+restoration of physical function للـ patient as much
+
+145
+00:10:02,460 --> 00:10:06,400
+as possible. أنا بحكي إنه أنا أعيد المريض تبعي
+
+146
+00:10:06,400 --> 00:10:10,000
+لوضعه اللي كان عليه في السابق، قبل عملية الانجينة.
+
+147
+00:10:10,000 --> 00:10:13,780
+تمام؟ As much as possible. إحنا بنحكي، Psychologists،
+
+148
+00:10:17,520 --> 00:10:21,560
+و Psychiatrists. مهم كتير عندنا الدعم النفسي، خصوصا
+
+149
+00:10:17,520 --> 00:10:21,560
+و Psychiatrists. مهم كثير عندنا الدعم النفسي، خصوصًا
+
+150
+00:10:21,560 --> 00:10:26,160
+إنّه مريض اتعرض لمشكلة، اتعرض لذبح قلبية، أو ذبح
+
+151
+00:10:26,160 --> 00:10:29,920
+صدرية، بين قوسين، إن هو هيدخل في حالة من الاكتئاب،
+
+152
+00:10:29,920 --> 00:10:33,660
+حالة من عدم الاستقرار النفسي، لأن حياته مهددة
+
+153
+00:10:33,660 --> 00:10:37,410
+بالخطر. To provide information concerning the
+
+154
+00:10:37,410 --> 00:10:40,650
+patient’s mental ability. الـ emotional adjustment،
+
+155
+00:10:40,650 --> 00:10:43,930
+أيضًا الـ interested and vocational outputs، الـ
+
+156
+00:10:43,930 --> 00:10:47,990
+mental abilities. كل هذه الأمور، وإن هو هل هيرجع
+
+157
+00:10:47,990 --> 00:10:52,290
+لوظيفته، ولا مش هيرجع؟ كيف هيكون دوره في البيت؟ هل
+
+158
+00:10:52,290 --> 00:10:56,730
+هو كان مثلاً قبل كده أب، هل هو هيرجع مع أسرته ولا لأ؟ هذه الأمور بتأثر في نفسية مريض
+
+159
+00:10:56,730 --> 00:11:00,310
+القلب. أيضًا، في عندنا الـ social service. هم كمان
+
+160
+00:11:00,310 --> 00:11:04,370
+مكملين اللي هم الـ rehabilitation members. الـ social
+
+161
+00:11:04,370 --> 00:11:07,850
+service، اللي هو الـ social worker. الـ social worker
+
+162
+00:11:07,850 --> 00:11:11,210
+أيضًا بيساعد الـ patient و الـ family على إنهم
+
+163
+00:11:11,210 --> 00:11:14,750
+يتجاوزوا هذه المرحلة الأليمة من حياتهم. ممكن بإيجاد
+
+164
+00:11:14,750 --> 00:11:18,390
+حلول لوظيفة أخرى، أو وظيفة مناسبة حسب الـ
+
+165
+00:11:18,390 --> 00:11:23,350
+disabilities اللي صارت عند المريض. الـ nurse طبعًا
+
+166
+00:11:23,350 --> 00:11:26,790
+هو العمود الفقري تبعنا، واللي بيكون متابع المريض
+
+167
+00:11:26,790 --> 00:11:30,130
+في كل أموره الطبية. أيضًا، الـ nutritionist، اللي هو
+
+168
+00:11:30,130 --> 00:11:34,890
+أخصائي التغذية. إنه لازم يكون تواصلُه مع مرضى، أو
+
+169
+00:11:34,890 --> 00:11:40,190
+مريض القلب، بشكل مباشر. ليه؟ لإنه هيتابع معاهم هذا
+
+170
+00:11:40,190 --> 00:11:45,670
+الطعام، high cholesterol، هذا الطعام لأ، كويس. فده كلّه
+
+171
+00:11:45,670 --> 00:11:49,860
+high lipid. الأمور هذه مهمة جدا في مرض القلب، لإنه
+
+172
+00:11:49,860 --> 00:11:53,560
+لو لسمح الله زاد عندي أي إشي مش مفيد لجسم الإنسان،
+
+173
+00:11:53,560 --> 00:11:58,660
+أو إنه مثلاً على سبيل المثال قام بأكل لحم أحمر
+
+174
+00:11:58,660 --> 00:12:02,000
+غنية بالدهون. فبالتالي هنا عملت له ارتفاع في نسبة
+
+175
+00:12:02,000 --> 00:12:06,080
+الكوليسترول في الدم. هذا هيزيد من risk factor، إنّه
+
+176
+00:12:06,080 --> 00:12:09,570
+ممكن يصير في عندي thrombus، وممكن يصير في عندي
+
+177
+00:12:09,570 --> 00:12:12,590
+مشاكل أخرى. إذا، أخصائي التغذية مهم جدا يكون دوره
+
+178
+00:12:12,590 --> 00:12:17,810
+
+223
+00:15:01,100 --> 00:15:04,800
+المريض الـ natural سواء طبيعة الـ angina اللي صارت
+
+224
+00:15:04,800 --> 00:15:09,040
+في أحياناً لأن اللي هو الـ thrombus أو الـ خثرة الدموية
+
+225
+00:15:09,040 --> 00:15:13,140
+اللي عمل الإنسداد للشريان التاجي بتكون بسيطة ممكن
+
+226
+00:15:13,140 --> 00:15:19,150
+تروح مع اللي هو الأدوية المميعة للدم لكن في
+
+227
+00:15:19,150 --> 00:15:22,670
+خثرة بتكون كبيرة يجب أن يكون هناك تدخل جراحي
+
+228
+00:15:22,670 --> 00:15:25,410
+إذا الـ natural of disease أو الـ natural of
+
+229
+00:15:25,410 --> 00:15:30,470
+problems الـ severity of illness كام هي حدتها؟ هل
+
+230
+00:15:30,470 --> 00:15:34,330
+أجى الـ attack مباشرة؟ هل إنه أجى تدريجي
+
+231
+00:15:34,330 --> 00:15:39,090
+gradually؟ كيف وضعها؟ هل هي severe ولا mild ولا
+
+232
+00:15:39,090 --> 00:15:42,890
+moderate ولا simple؟ شو وضعها؟ وشو حدتها؟ الـ
+
+233
+00:15:42,890 --> 00:15:46,110
+complications إيش المضاعفات اللي صارت معي على
+
+234
+00:15:46,110 --> 00:15:49,070
+سبيل المثال صار في عندي مشكلة بالبصر، مشكلة في
+
+235
+00:15:49,070 --> 00:15:52,550
+السمع، مشكلة في الحركة، إذا إيش صار في عندي
+
+236
+00:15:52,550 --> 00:15:56,250
+complications؟ أيضاً بتعتمد اللي هو الـ progression
+
+237
+00:15:56,250 --> 00:16:00,090
+تبعه أو التحسن بيعتمد على الـ rate of recovery كم هي
+
+238
+00:16:00,090 --> 00:16:04,070
+معدل الشفاء أو كيف ممكن هل هو بيتجاوب معي بسرعة و
+
+239
+00:16:04,070 --> 00:16:10,930
+بيصير كويس ولا لسه متأخر و في وضع اللي هو وضع مش
+
+240
+00:16:10,930 --> 00:16:14,770
+مظبوط و لسه بيعاني هذا الشيء اللي هو أو الأربعة
+
+241
+00:16:14,770 --> 00:16:18,210
+factors هدولة هم اللي بيحددوا الـ progression اللي
+
+242
+00:16:18,210 --> 00:16:22,320
+أنا حكيت عليه الـ Phase الأولاني حكينا لسيداتنا احنا
+
+243
+00:16:22,320 --> 00:16:26,060
+هنا في الـ inpatient hospital زي ما أنتم شايفين و
+
+244
+00:16:26,060 --> 00:16:29,500
+معها الـ physiotherapist اللي هي عاملة لها support
+
+245
+00:16:29,500 --> 00:16:33,860
+في حالة الـ acute هذه المرحلة تستمر من 7 إلى 14
+
+246
+00:16:33,860 --> 00:16:37,840
+يوماً في الـ duration تبعتها و بتكون في الـ inpatient
+
+247
+00:16:37,840 --> 00:16:42,880
+hospital هلأ شو أهدافي أنا كـ physiotherapist؟ to
+
+248
+00:16:42,880 --> 00:16:46,780
+initiate early physical therapy activities اللي
+
+249
+00:16:46,780 --> 00:16:50,240
+هي return للـ activity of daily living decrease
+
+250
+00:16:50,240 --> 00:16:54,180
+للـ anxiety and depression أيضاً بتـ remind للـ effect
+
+251
+00:16:54,180 --> 00:16:58,340
+of medication prevent effect للي بيرجع بدرست إنه
+
+252
+00:16:58,340 --> 00:17:02,980
+أنا ما أخليها مع الأسيريو يصير في عندي مشاكل لـ
+
+253
+00:17:02,980 --> 00:17:06,060
+circulation على سبيل المثال زي الـ DVT زي أي
+
+254
+00:17:06,060 --> 00:17:10,300
+مشاكل أخرى الـ PEDISOR مثلاً كل المشاكل الناتجة أو
+
+255
+00:17:10,300 --> 00:17:16,840
+الحاصلة نتيجة اللي هو الـ PEDISOR الهدف الثاني to
+
+256
+00:17:16,840 --> 00:17:20,480
+initiate للـ patient and family education لأن أنا
+
+257
+00:17:20,480 --> 00:17:24,540
+حكيت الـ family members مهم جداً أنه أنا أحط معهم
+
+258
+00:17:24,540 --> 00:17:27,780
+الخطة ويكونوا موجودين معي وقت الـ implementations
+
+259
+00:17:27,780 --> 00:17:30,820
+اللي هو وقت التنفيذ to outline the course of
+
+260
+00:17:30,820 --> 00:17:34,480
+cardiac rehabilitation قضية مضيفة للـ risk factor في
+
+261
+00:17:34,480 --> 00:17:39,290
+الـ atherosclerosis خلال الريسيس الأولاني الـ rate of
+
+262
+00:17:39,290 --> 00:17:42,050
+progression of people who have myocardial
+
+263
+00:17:42,050 --> 00:17:46,910
+infarction is slightly slower than for those who
+
+264
+00:17:46,910 --> 00:17:52,330
+have coronary artery processography الناس اللي هي
+
+265
+00:17:52,330 --> 00:17:58,980
+عندها MI بتتحسن بشكل أبطأ من الناس اللي هي عملت
+
+266
+00:17:58,980 --> 00:18:03,740
+عملية ترقيع لشريان التاجي ليه؟ هذا الشيء أخذناه من
+
+267
+00:18:03,740 --> 00:18:08,780
+دراسات متعددة ناتج ليش؟ لأنه المريض الـ MI هي عبارة
+
+268
+00:18:08,780 --> 00:18:13,320
+عن احتشاء عضلة القلب فبالتالي هنا بتفقد جزء أو
+
+269
+00:18:13,320 --> 00:18:18,060
+بتفقد اللي هو الوظيفة تبع الـ heart بيبطل الـ heart
+
+270
+00:18:18,060 --> 00:18:23,040
+يعمل pumping بشكل جيد فبالتالي الـ recovery تبع هذا
+
+271
+00:18:23,040 --> 00:18:26,540
+المريض بيكون أقل من الـ recovery لـ coronary
+
+272
+00:18:26,540 --> 00:18:30,300
+artery bypass graft الـ mobilization of surgical
+
+273
+00:18:30,300 --> 00:18:34,160
+patients usually starts early and intensity and
+
+274
+00:18:34,160 --> 00:18:37,360
+duration of ambulation are more accelerated كمان
+
+275
+00:18:37,360 --> 00:18:40,500
+الـ mobilization اللي هي عملية الحركة في حالات
+
+276
+00:18:40,500 --> 00:18:45,800
+الجراحة بالأغلب بتبلش في اللي هو intensity خفيفة
+
+277
+00:18:45,800 --> 00:18:50,400
+وبعدين احنا تدريجياً بنزيدها الأول في عندي الجدول
+
+278
+00:18:50,400 --> 00:18:54,040
+هذا اللي هو عبارة عن الـ inpatient hospitals أو
+
+279
+00:18:54,040 --> 00:18:56,480
+الـ inpatient rehabilitation hospitals في سبعة
+
+280
+00:18:56,480 --> 00:18:59,600
+steps لـ myocardial infarction هذا الـ table هو
+
+281
+00:18:59,600 --> 00:19:03,800
+عبارة عن الـ table  الـ step الأول بدي أعمل
+
+282
+00:19:03,800 --> 00:19:07,480
+active and passive exercise في داخل السرير أو في
+
+283
+00:19:07,480 --> 00:19:10,180
+اليوم الأول خليني أشتغل داخل السرير احنا ممكن
+
+284
+00:19:10,180 --> 00:19:14,460
+نشتغل معه إذا هو medically stable وأرجع وأؤكد إذا
+
+285
+00:19:14,460 --> 00:19:17,800
+مريضى medically stable أنا بدخل بشتغل معه بناءً
+
+286
+00:19:17,800 --> 00:19:21,160
+على الـ referral paper من الدكتور تبعه to teach
+
+287
+00:19:21,160 --> 00:19:24,540
+للمريض plantar flexion اللي هي بين قصين
+
+288
+00:19:24,540 --> 00:19:28,380
+بُسميها الـ pumping exercise active range of motion
+
+289
+00:19:28,380 --> 00:19:32,580
+exercise لكل الـ extremities سواء كانت upper and
+
+290
+00:19:32,580 --> 00:19:36,000
+lower limb sitting on the side of bed أو اللي هو
+
+291
+00:19:36,000 --> 00:19:39,460
+sitting at edge of bed كويس أنا أبدأ أجلس المريض
+
+292
+00:19:39,460 --> 00:19:43,310
+على حافة السرير warm-up exercise أيضاً الـ
+
+293
+00:19:43,310 --> 00:19:47,450
+stretching and glutes exercise اللي هو التمرين
+
+294
+00:19:47,450 --> 00:19:51,990
+الرياضي حوالي أنه يمشي خمسين قدماً يعني ما يقارب
+
+295
+00:19:51,990 --> 00:19:57,230
+خمسة عشر متراً هدفي اللي هو الـ step الثالثة تمام؟
+
+296
+00:19:57,230 --> 00:20:00,270
+احنا لسه ما زلنا في الـ inpatient و هايلة حالات الـ
+
+297
+00:20:00,270 --> 00:20:03,270
+myocardial infraction شو يعني التمرين الرياضي؟
+
+298
+00:20:03,270 --> 00:20:05,910
+التمرين الرياضي هنا هي عبارة عن الـ anaerobic
+
+299
+00:20:05,910 --> 00:20:09,890
+exercise تمام؟ اللي هي  هوائية usually without
+
+300
+00:20:09,890 --> 00:20:13,010
+weights and help to increase your strength and
+
+301
+00:20:13,010 --> 00:20:16,570
+flexibility بزيد القوة والـ flexibility أيضاً
+
+302
+00:20:16,570 --> 00:20:18,910
+تمارين رياضية هنا هي عبارة عن الـ isotonic
+
+303
+00:20:18,910 --> 00:20:22,350
+exercise يعني ممكن يكون عن طريق اللي هو الـ push
+
+304
+00:20:22,350 --> 00:20:27,010
+ups والـ sit ups والـ squatting واللي هي الـ lunges
+
+305
+00:20:27,010 --> 00:20:30,920
+طبعاً كل هذه الأمور بتعمل اللي هي strengthening
+
+306
+00:20:30,920 --> 00:20:34,720
+exercise by resistance force إنه أنا بعمل push-up
+
+307
+00:20:34,720 --> 00:20:38,680
+بيدي على الحائط على سبيل المثال فبالتالي بحصل على
+
+308
+00:20:38,680 --> 00:20:44,920
+اللي هو الـ strengthening exercise الـ step الرابعة بدي
+
+309
+00:20:44,920 --> 00:20:48,420
+أعمل range of motion exercise وبدي أزيد المسافة
+
+310
+00:20:48,420 --> 00:20:52,620
+اللي أنا بدي أمشي فيها لـ 75 قدماً يعني ما يقارب 22
+
+311
+00:20:52,620 --> 00:20:57,860
+متراً بلشتها بـ 15 وبعدين ذهبت هنا لـ 22 and back
+
+312
+00:20:57,860 --> 00:21:00,920
+to average to face اللي هو basis range of motion
+
+313
+00:21:00,920 --> 00:21:05,580
+الخطوة الخامسة and lesson 6 practice walking a few
+
+314
+00:21:05,580 --> 00:21:13,040
+stairs steps walking 300 feet اللي هو 90 متراً تمام
+
+315
+00:21:13,880 --> 00:21:18,480
+أيضاً بينكمل كل اللي هو الـ activities بالإضافة للـ
+
+316
+00:21:18,480 --> 00:21:23,540
+walking down flight step return by elevators أرجع بي
+
+317
+00:21:23,540 --> 00:21:28,140
+اللي هو المصعد ولكن امشي 500 قدم يعني ما يقارب
+
+318
+00:21:28,140 --> 00:21:34,260
+150 متراً الـ step السابعة continue للـ above
+
+319
+00:21:34,260 --> 00:21:37,580
+activities بدي أبلش من 1 لـ 6 بالإضافة لإنه أنا بدي
+
+320
+00:21:37,580 --> 00:21:42,970
+أزيد الـ walk up والـ light steps لأكثر من 500 اللي
+
+321
+00:21:42,970 --> 00:21:47,490
+هو قدم هذا الـ table هو table أربعة خاص باللي هو
+
+322
+00:21:47,490 --> 00:21:51,230
+rehabilitation programs لـ myocardial infarction
+
+323
+00:21:51,230 --> 00:21:55,670
+اللي أنا بنقل أعمل إيقاف لهذا البرنامج في حالة
+
+324
+00:21:55,670 --> 00:21:59,930
+الإرهاق في حالة الـ failure of monitoring equipment
+
+325
+00:21:59,930 --> 00:22:03,920
+في حالة الـ light headedness الـ confusion أو الـ
+
+326
+00:22:03,920 --> 00:22:06,740
+cyanosis لو أنا حسيت أن المريض التابع لي دخل في
+
+327
+00:22:06,740 --> 00:22:09,940
+تعب اللي هو difficulty to breathing على طول
+
+328
+00:22:09,940 --> 00:22:14,720
+بعمل stopping لـ exercise إذا حس أنه تعب على طول
+
+329
+00:22:14,720 --> 00:22:19,100
+بعمل stopping لـ angina ولـ exercise  ألم
+
+330
+00:22:19,100 --> 00:22:22,480
+angina جديدة على طول خلال أداء التمرين بعمل
+
+331
+00:22:22,480 --> 00:22:26,790
+stopping الـ ST طبعاً هي عبارة عن اللي هو هذا الشكل
+
+332
+00:22:26,790 --> 00:22:30,290
+اللي موجود عندنا اللي هو عبارة عن الرسمة في الـ ECG
+
+333
+00:22:30,290 --> 00:22:34,150
+displacement أيضاً horizontal or down sloping للي
+
+334
+00:22:34,150 --> 00:22:38,550
+هو الـ risk ventricular tachycardia ممكن يصير في
+
+335
+00:22:38,550 --> 00:22:42,110
+عندنا تاكيكارديا increasing في الـ heart rate طبعاً
+
+336
+00:22:42,110 --> 00:22:47,390
+زيادة في معدل ضربات القلب هذه ست حالة أنا بعمل
+
+337
+00:22:47,390 --> 00:22:51,770
+stopping لـ الـ exercise program طبعاً هنا بدي يورينا
+
+338
+00:22:51,770 --> 00:22:55,590
+إن anterior و lateral في حالات اللي هي الـ
+
+339
+00:22:55,590 --> 00:23:00,570
+ventricular واللي هو الـ tachycardia اللي صارت على
+
+340
+00:23:00,570 --> 00:23:04,850
+طول أنا بعمل اللي هو stopping أيضاً في عندي تكملة
+
+341
+00:23:04,850 --> 00:23:07,970
+لباقي الـ exercise أو باقي اللي هو الـ stopping of
+
+342
+00:23:07,970 --> 00:23:11,810
+exercise تبع الـ exercise induced left bundle
+
+343
+00:23:11,810 --> 00:23:16,440
+branch blocks إنه هذا الـ exercise بدي أزيد طبعاً
+
+344
+00:23:16,440 --> 00:23:21,740
+من الـ block اللي صارت في الـ left bundle branches
+
+345
+00:23:21,740 --> 00:23:25,400
+زي ما أنتم شايفينها هنا طبعاً في عندي right وفي
+
+346
+00:23:25,400 --> 00:23:29,780
+عندي left الـ atrioventricular blocks second and third AV
+
+347
+00:23:29,780 --> 00:23:34,880
+اللي هو atrioventricular block الـ exercise اللي صار
+
+348
+00:23:34,880 --> 00:23:38,660
+فيه إنه الـ hypotension less than twenty
+
+349
+00:23:38,660 --> 00:23:42,080
+millimeters a drop in systolic blood pressure
+
+350
+00:23:42,080 --> 00:23:45,960
+during exercise hypotension أنا بحكي يعني أقل من
+
+351
+00:23:45,960 --> 00:23:49,510
+الطبيعي excessive blood pressure rises إذا كان الـ
+
+352
+00:23:49,510 --> 00:23:52,570
+systolic blood pressure 220 معناته هو هنا high،
+
+353
+00:23:52,570 --> 00:23:56,630
+عالي جداً، فبالتالي، والـ diastolic 110، معناه
+
+354
+00:23:56,630 --> 00:24:00,330
+الكلام هذا hypertensive patient inappropriate
+
+355
+00:24:00,330 --> 00:24:04,310
+bradycardia المريض اللي صار عنده bradycardia،
+
+356
+00:24:04,310 --> 00:24:08,090
+drop في الـ heart rate greater than 10 during
+
+357
+00:24:08,090 --> 00:24:14,130
+exercise هنا أنا طبعاً لازم أبعد أو أسحب أي
+
+358
+00:24:14,130 --> 00:24:18,450
+exercise أنا كنت راح أشتغله مع مريض، اللي هو القلب
+
+359
+00:24:19,210 --> 00:24:22,970
+لأن هذا كله أنا كنت بحكي عنه في phase 1 phase 2
+
+360
+00:24:22,970 --> 00:24:27,050
+اللي هو الـ term of phase 2 that the part of
+
+361
+00:24:27,050 --> 00:24:29,470
+cardiac rehabilitation program conducted in
+
+362
+00:24:29,470 --> 00:24:33,690
+outpatient إذا في phase 2 هشتغل مع الـ outpatient
+
+363
+00:24:33,690 --> 00:24:36,930
+أما في phase 1 كنت شغالة على inpatient المريض ما
+
+364
+00:24:36,930 --> 00:24:41,330
+زال عندي داخل الـ department تبعي في المستشفى it's
+
+365
+00:24:41,330 --> 00:24:45,030
+early to convalescent phase من 8 إلى 12 أسبوعاً
+
+366
+00:24:45,030 --> 00:24:49,510
+تقريباً ما بعد اللي هي صارت الحادثة ثمانية عشر
+
+367
+00:24:49,510 --> 00:24:52,810
+أسبوعاً الثامن لا الأسبوع الأسبوع الثامن نحكي للأسبوع
+
+368
+00:24:52,810 --> 00:24:55,350
+الثاني عشر الـ duration during this phase الـ
+
+369
+00:24:55,350 --> 00:24:58,090
+myocardial and postoperative healing is taking
+
+370
+00:24:58,090 --> 00:25:01,870
+place تمام في اللي هو من ستة لثمانية أسابيع في الـ
+
+371
+00:25:01,870 --> 00:25:04,970
+myocardial scar formation has taken place and the
+
+372
+00:25:04,970 --> 00:25:09,750
+sternum is healed following surgery إذا أنا بحكي
+
+373
+00:25:09,750 --> 00:25:12,990
+على حالة اللي هي الـ open heart surgery أنا عملت
+
+374
+00:25:12,990 --> 00:25:17,760
+cutting  معناته الكلام أنا بدي أستنى من 6 لـ 8
+
+375
+00:25:17,760 --> 00:25:21,380
+أسابيع عشان أعمل اللي هو يصير في عندي الـ good
+
+376
+00:25:21,380 --> 00:25:25,140
+healing للـ surgery بعدين أدخل في اللي هو الـ
+
+377
+00:25:25,140 --> 00:25:28,620
+rehabilitation team الـ goals تبعتي في هذا الـ team
+
+378
+00:25:28,620 --> 00:25:32,140
+increasing الـ exercise capacity أنا هنا بدي أزيد
+
+379
+00:25:32,140 --> 00:25:35,480
+الـ endurance لأن المريض التابع لي صار خلاص يعني مش
+
+380
+00:25:35,480 --> 00:25:39,460
+جديد stable هو و medically تمام تمام فبالتالي بدي
+
+381
+00:25:39,460 --> 00:25:42,300
+أزيد الـ endurance to educate للـ patient and the proper
+
+382
+00:25:42,300 --> 00:25:45,100
+technique of exercise بدي أعلّمه التكنيك  اللي زيد
+
+383
+00:25:45,100 --> 00:25:48,300
+للـ exercise اللي أنا هزيدها to work with patient and
+
+384
+00:25:48,300 --> 00:25:52,880
+family برضه حكينا الـ family هنا هي عبارة عن شيء
+
+385
+00:25:52,880 --> 00:25:56,430
+مهم جداً أساسي لنا to prepare الـ patient to return to
+
+386
+00:25:56,430 --> 00:26:00,450
+work إذا كان والله هو مدرس جامعي بده يرجع على
+
+387
+00:26:00,450 --> 00:26:03,770
+وظيفته هل بيناسبه أو لا هذا بيحكي عليه
+
+388
+00:26:03,770 --> 00:26:08,010
+الأخصائي المهني to enhance the psychological status
+
+389
+00:26:08,010 --> 00:26:12,710
+بعزز اللي هي الحالة النفسية to provide the patient with
+
+390
+00:26:12,710 --> 00:26:17,030
+guidelines in long term exercise كمان أنا
+
+391
+00:26:17,030 --> 00:26:20,800
+بعزز اللي هو أنك قادر على أنك تقدّم هذا الـ
+
+392
+00:26:20,800 --> 00:26:25,560
+exercise ما بخليه دائماً أنه fair ومش حابب يعمل
+
+393
+00:26:25,560 --> 00:26:29,440
+exercise لإنه ممكن تجيئه angina  لأ إذا موضوع stable
+
+394
+00:26:29,440 --> 00:26:35,460
+و تمام  أتفضل أنا بعزز هذه الفكرة معه الـ training
+
+395
+00:26:35,460 --> 00:26:39,840
+program فيه عندنا الـ conditioning exercise زي الـ
+
+396
+00:26:39,840 --> 00:26:43,990
+rhythmic aerobic exercise الـ walking jogging
+
+397
+00:26:43,990 --> 00:26:48,430
+swimming and running  السباحة هذه الأمور كلها
+
+398
+00:26:48,430 --> 00:26:51,350
+بعتبرها conditioning exercise في عندنا lower
+
+399
+00:26:51,350 --> 00:26:55,190
+extremity أو lower extremity aerobic exercise زي
+
+400
+00:26:55,190 --> 00:26:58,530
+اللي هو الـ treadmill زي ما حكينا والـ bicycle
+
+401
+00:26:58,530 --> 00:27:02,370
+ergometers زي ما أنتم شايفينهم هنا عاملين لهم
+
+402
+00:27:02,370 --> 00:27:06,450
+group therapy في اللي هو الـ department أو الـ
+
+403
+00:27:06,450 --> 00:27:09,790
+physiotherapy department أيضاً الـ
+
+445
+00:29:56,110 --> 00:30:00,430
+شهور لسنة بيظلوا متواصلين معانا by telephone على
+
+446
+00:30:00,430 --> 00:30:05,170
+سبيل المثال، بما إنه في ظل COVID-19 أو على سبيل
+
+447
+00:30:05,170 --> 00:30:09,410
+المثال، ممكن يكون عنده فيزيو ثيرابي في البيت ويتبع
+
+448
+00:30:09,410 --> 00:30:13,970
+معه الـ goals تبعتنا في هذا الـ exercise أو في هذا
+
+449
+00:30:13,970 --> 00:30:17,630
+الـ phase، improve الـ exercise fitness، أنا بدي أُعلي
+
+450
+00:30:17,630 --> 00:30:20,770
+الـ exercise intensity، improve my cardio، aerobic
+
+451
+00:30:20,770 --> 00:30:24,470
+capacity، improve my cardio oxygen supply، and
+
+452
+00:30:24,470 --> 00:30:28,690
+psychological orientations، كل هذه الأمور مهمة جداً
+
+453
+00:30:28,690 --> 00:30:32,270
+أن أحافظ عليها لأن أنا شغالة في الـ outpatient يعني
+
+454
+00:30:32,270 --> 00:30:37,090
+في الـ phase الآخر، تابع الأربعة suggestions اللي
+
+455
+00:30:37,090 --> 00:30:40,170
+أنا كنت حكيت عليها قبلها، suggestions for exercise
+
+456
+00:30:40,170 --> 00:30:43,750
+at home، أيضاً بالإضافة له في عن الـ walking daily،
+
+457
+00:30:43,750 --> 00:30:48,910
+sleep من 6 إلى 8 ساعات، مهم جداً، wait at least one hour
+
+458
+00:30:48,910 --> 00:30:52,150
+after meal before exercising، مش يأكل الوجبة من هنا
+
+459
+00:30:52,150 --> 00:30:55,310
+ويروح يعمل الـ exercise من هنا، لأ avoid الـ
+
+460
+00:30:55,310 --> 00:30:58,550
+extremity weather in winter، طبعاً الـ exercise
+
+461
+00:30:58,550 --> 00:31:02,940
+during warmer part of day، and summer، exercise long
+
+462
+00:31:02,940 --> 00:31:07,080
+and evening، اللي هو ما أخلي، يعني كل الهدف من هذه
+
+463
+00:31:07,080 --> 00:31:09,740
+الفترة أنه أنا ما أزيد درجة حرارة الجسم بالـ
+
+464
+00:31:09,740 --> 00:31:12,960
+exercise، إذا كان الجو حار، أبدأ أشتغل معاه في عصر
+
+465
+00:31:12,960 --> 00:31:16,940
+الظهر، لازم يكون الوضع مناسب حتى ما يصير فعلاً
+
+466
+00:31:16,940 --> 00:31:21,110
+increasing الـ fever، avoid vigorous arm and shoulder
+
+467
+00:31:21,110 --> 00:31:25,370
+activities، مش إنه خلاص احنا خلصنا و عدينا و روحنا
+
+468
+00:31:25,370 --> 00:31:28,070
+على البيت وصار في أنا out patient الـ program، إنه
+
+469
+00:31:28,070 --> 00:31:31,850
+أبلش معاه exercise قوية، لأ، هذه بدي أُمنعها خصوصاً
+
+470
+00:31:31,850 --> 00:31:35,350
+إذا كان عندي الـ activity هذه بتعملي مشاكل زي أن هو
+
+471
+00:31:35,350 --> 00:31:39,030
+المريض ممكن يدوخ منها، زي إنه ممكن تجي نوازيه الأمور
+
+472
+00:31:39,030 --> 00:31:42,290
+زيها، لازم أنا أخدها في عين الاعتبار، الـ arm
+
+473
+00:31:42,290 --> 00:31:45,930
+activities require more energy than leg
+
+474
+00:31:45,930 --> 00:31:52,790
+activities، طبعاً أكيد أي شيء في الـ arms طبعاً بيكون
+
+475
+00:31:52,790 --> 00:31:58,270
+أكثر اللي هو شغل وأكثر مجهود، suggest use الـ
+
+476
+00:31:58,270 --> 00:32:03,190
+exercise at home، avoid lifting heavy weight، ممنوع
+
+477
+00:32:03,190 --> 00:32:08,010
+يشيل أيضاً اللي هو الأحمال الثقيلة، avoid situations
+
+478
+00:32:08,010 --> 00:32:12,070
+اللي هي الـ people who make you anxious or angry،
+
+479
+00:32:12,070 --> 00:32:16,530
+ممنوع يعصب، ممنوع يزعل، ممنوع يتخانق مع حدا ويجي
+
+480
+00:32:16,530 --> 00:32:20,540
+يعمل exercise، لأ هو بيكون لو عنده ضغط عالِ، ضغطه، If
+
+481
+00:32:20,540 --> 00:32:23,540
+you have chest pain, dizziness, excess of fatigue,
+
+482
+00:32:23,720 --> 00:32:26,540
+unusual vibrations, and shortness of breath type
+
+483
+00:32:26,540 --> 00:32:33,060
+فوراً يوقف الـ exercise، أي مشاكل واجهته كفيزيو
+
+484
+00:32:33,060 --> 00:32:36,580
+ثيرابيست أو واجهتك أنت كمريض، على طول احنا بنوصيه
+
+485
+00:32:36,580 --> 00:32:39,720
+أنه يعمل stopping الـ exercise and take a rest and
+
+486
+00:32:39,720 --> 00:32:43,680
+then call his doctor، لازم يعمل اللي هو مكالمة
+
+487
+00:32:43,680 --> 00:32:47,040
+للدكتور، أيضاً الـ medication مهم جداً أنه ياخذها
+
+488
+00:32:47,040 --> 00:32:52,830
+بمواعيدها، الوقت يكون دقيقاً، «لا تتمرّن إذا كانت لديك
+
+489
+00:32:52,830 --> 00:32:56,950
+أعراض عضوية»، في حالة الـ acute ما بشتغل لأنه ممكن
+
+490
+00:32:56,950 --> 00:33:02,690
+أعمل على تعظيم المشكلة، تابع الخمسة «ما هي الـ
+
+491
+00:33:02,690 --> 00:33:06,310
+contraindications للدخول في برنامج patient and
+
+492
+00:33:06,310 --> 00:33:10,410
+outpatient exercise»، ما أشتغل مع الناس اللي هم
+
+493
+00:33:10,410 --> 00:33:14,150
+unstable angina، ممنوع أشتغل إذا كان الـ resting
+
+494
+00:33:14,150 --> 00:33:20,450
+الـ systolic blood pressure اللي هو 200 فأعلى،
+
+495
+00:33:20,450 --> 00:33:26,790
+تمام؟ وأداة لك أعلى من 100، الـ orthostatic blood
+
+496
+00:33:26,790 --> 00:33:30,730
+pressure drop، إذا كان high potential لـ moderate
+
+497
+00:33:30,730 --> 00:33:35,610
+and severe aortic stenosis، سداد في الشريان التاجي،
+
+498
+00:33:35,610 --> 00:33:39,050
+الـ acute systemic illness or fever، الناس اللي
+
+499
+00:33:39,050 --> 00:33:41,610
+عندها influence، على سبيل المثال with cardio
+
+500
+00:33:41,610 --> 00:33:45,770
+disease، كمان ما بشتغل لأن هذا بيزيد لي من الـ fever،
+
+501
+00:33:45,770 --> 00:33:49,090
+الـ uncontrolled arterial and ventricle
+
+502
+00:33:49,090 --> 00:33:53,530
+dysarrhythmia، طبعاً الحالات اللي بتكون موجودة في
+
+503
+00:33:53,530 --> 00:33:57,670
+اللي عندها عدم انتظام في ضربات القلب هي كمان ما
+
+504
+00:33:57,670 --> 00:34:02,250
+أشتغل معها، أيضاً ما أشتغلش مع الـ uncontrolled sense
+
+505
+00:34:02,250 --> 00:34:06,670
+of tachycardia، increasing في الـ blood، الـ heart
+
+506
+00:34:06,670 --> 00:34:10,910
+rate، الـ uncontrolled congestive heart failure، CHF،
+
+507
+00:34:10,910 --> 00:34:17,270
+اللي هو فشل في عضلة القلب، الـ three degree AV
+
+508
+00:34:17,270 --> 00:34:20,910
+heart blocks، تمام، three degree، هاي الـ second
+
+509
+00:34:20,910 --> 00:34:24,610
+degree، هاي الـ third، يعني شوفوا كيف بين كل waves و
+
+510
+00:34:24,610 --> 00:34:30,350
+الأخرى، كم هي المسافة، الـ recent embolism، بخاف لأنه
+
+511
+00:34:30,350 --> 00:34:33,730
+ممكن تنتقل من مكان إلى مكان، thromb of the bites،
+
+512
+00:34:33,730 --> 00:34:38,790
+كمان بخاف منها، الـ Resting للـ ST Displacement، هنا
+
+513
+00:34:38,790 --> 00:34:42,350
+زيادة في الـ displacement تبع الـ ST، الـ
+
+514
+00:34:42,350 --> 00:34:48,210
+uncontrolled diabetes، الـ arthritic problem، الـ
+
+515
+00:34:48,210 --> 00:34:52,210
+Bravets Exercise، كمان هاي الناس ممنوعة أنا أشتغل
+
+516
+00:34:52,210 --> 00:34:58,830
+معها، يعني Contra-Indication 15 items أو 15 نقطة أو
+
+517
+00:34:58,830 --> 00:35:04,170
+15
+
+518
+00:35:04,170 --> 00:35:09,490
+عنصر، ممنوعة أنا أشتغل معاهم في اللي هو الـ phase،
+
+519
+00:35:09,490 --> 00:35:12,470
+الـ Exercise في الـ third phase اللي موجود عندنا
+
+520
+00:35:12,470 --> 00:35:17,360
+للـ cardiac rehabilitation patient، يعطيكم ألف عافية،
+
+521
+00:35:17,360 --> 00:35:20,980
+وبهيك بكون أنا خلصت الـ part الأول، ألقاكم بإذن الله
+
+522
+00:35:20,980 --> 00:35:26,080
+في part الثاني بإذن الله، والسلام عليكم ورحمة الله
+
+523
+00:35:26,080 --> 00:35:26,760
+وبركاته
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/T3cTeEw_ujw_postprocess.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/T3cTeEw_ujw_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..a2361a1cc4789281ea7fc88429916995645af0eb
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/T3cTeEw_ujw_postprocess.srt
@@ -0,0 +1,2092 @@
+1
+00:00:00,910 --> 00:00:04,790
+صلاة والسلام على أشرف الأنبياء والمرسلين سأتحدث في
+
+2
+00:00:04,790 --> 00:00:08,690
+هذا الفيديو عن الـ Cardiac Rehabilitation الـ PART
+
+3
+00:00:08,690 --> 00:00:13,730
+الأول قمت بتجزئة المحاضرةالى قسمين part 1 و part 2
+
+4
+00:00:13,730 --> 00:00:18,830
+بإذن الله سأتحدث في هذا ال part عن شو يعني كلمة ال
+
+5
+00:00:18,830 --> 00:00:23,010
+rehabilitation عن شو يعني ال faces تبع ال
+
+6
+00:00:23,010 --> 00:00:26,930
+rehabilitation و ال program اللى انا ازأ فيزيو
+
+7
+00:00:26,930 --> 00:00:31,150
+ثيرابي بدي اعطيه ل ال cardiac patient نبدأ على
+
+8
+00:00:31,150 --> 00:00:36,080
+بركة اللهحكيت بدي أتكلم عن الـ definition الـ
+
+9
+00:00:36,080 --> 00:00:39,220
+objectives تبعتي ال indication و ال contra
+
+10
+00:00:39,220 --> 00:00:42,420
+indication ال rehabilitation team members من هما
+
+11
+00:00:42,420 --> 00:00:47,220
+ال faces of cardiac rehabilitation شو يعني ال
+
+12
+00:00:47,220 --> 00:00:49,280
+rehabilitation؟ ال rehabilitation هي عبارة عن
+
+13
+00:00:49,280 --> 00:00:55,400
+عملية إعادة تأهيل المريض إجته على سبيل المثال ذبح
+
+14
+00:00:55,400 --> 00:01:00,910
+صدريةأدت لفقط دوره في البيت فقط دوره في المجتمع
+
+15
+00:01:00,910 --> 00:01:05,090
+فبالتالي أنا كفيزيو ثيرابيست مع ال rehabilitation
+
+16
+00:01:05,090 --> 00:01:09,850
+team members اللي هم موجودين معايا هنعمل على
+
+17
+00:01:09,850 --> 00:01:14,970
+إعادته as much as possible إذن rehabilitation is a
+
+18
+00:01:14,970 --> 00:01:18,410
+therapeutic process designed to facilitate maximal
+
+19
+00:01:18,410 --> 00:01:23,530
+restrictions of function each patient must be
+
+20
+00:01:23,530 --> 00:01:27,250
+individually assessedto determine diagnoses
+
+21
+00:01:27,250 --> 00:01:32,430
+associated disorders response and achievable goals
+
+22
+00:01:32,430 --> 00:01:38,290
+كل مريض هو فريد من نوعه حتى لو أنا دخلت ال ICU وكل
+
+23
+00:01:38,290 --> 00:01:42,310
+هذا موجود اللي عندي مرضى قلب لكن كل حالة فريدة من
+
+24
+00:01:42,310 --> 00:01:46,790
+نوعها ممكن هذا يكون عنده MI with hypertension لكن
+
+25
+00:01:46,790 --> 00:01:51,630
+التاني MI with diabetes تمام فبالتالي كل حالة هي
+
+26
+00:01:51,630 --> 00:01:57,040
+فريدة من نوعها في التقييم اللي أنا بدي أقيمهالـ
+
+27
+00:01:57,040 --> 00:02:00,580
+objectives تبعتي عندي خمسة objectives لازم انا
+
+28
+00:02:00,580 --> 00:02:08,180
+اؤكد او احطها امام عينيه reverse pathophysiologic
+
+29
+00:02:08,180 --> 00:02:13,740
+and psychosocial effect لل heart disease بدي اشوف
+
+30
+00:02:13,740 --> 00:02:18,940
+شو الانتكاسات الباتولوجية او ال psychosocial على
+
+31
+00:02:18,940 --> 00:02:24,320
+مريض القلبlimited risk for reinfarction أنا بحكي
+
+32
+00:02:24,320 --> 00:02:29,240
+reinfarction أو صدن death يعني recurrent attack
+
+33
+00:02:29,240 --> 00:02:34,240
+نوبة جديدة متجددة relief للـ cardiac symptoms
+
+34
+00:02:34,240 --> 00:02:39,680
+أيضًا retired أو reverse للـ atherosclerosis by
+
+35
+00:02:39,680 --> 00:02:42,860
+instituting program for exercise training
+
+36
+00:02:42,860 --> 00:02:47,840
+education counseling and risk factor alterations
+
+37
+00:02:47,840 --> 00:02:55,160
+بدي أحاولأحفظ أو أستعيد الحالات بالـ training بالـ
+
+38
+00:02:55,160 --> 00:02:59,460
+education بالتفقيف الصحي هل الـ risk factor ده
+
+39
+00:02:59,460 --> 00:03:03,080
+المستمر نفسه ولا فيه اتغير إجاني كمان risk factor
+
+40
+00:03:03,080 --> 00:03:08,180
+آخر Regenerated للheart disease patients into
+
+41
+00:03:08,180 --> 00:03:10,980
+successful function status in their family and
+
+42
+00:03:10,980 --> 00:03:14,720
+society الـ family والpatient هم الـ center تبعنا
+
+43
+00:03:14,720 --> 00:03:17,810
+في عملية الـ rehabilitationكل الأمور وكل ال
+
+44
+00:03:17,810 --> 00:03:22,310
+objectives لازم تحوم وتدور حول ال patient and
+
+45
+00:03:22,310 --> 00:03:30,650
+family ال
+
+46
+00:03:30,650 --> 00:03:33,410
+indication في أي حالات انا بدي استخدم ال
+
+47
+00:03:33,410 --> 00:03:36,550
+rehabilitation program recent myocardial
+
+48
+00:03:36,550 --> 00:03:40,540
+infarction تمامفي حالات الـ Recent Myocardial
+
+49
+00:03:40,540 --> 00:03:45,220
+Infarction في حالات الـ Coronary Bypasses توقيع
+
+50
+00:03:45,220 --> 00:03:49,780
+للشريان التاجي الـ Valve Severy Coronary
+
+51
+00:03:49,780 --> 00:03:54,920
+Angioplasty Inserting and Inflating in Tiny
+
+52
+00:03:54,920 --> 00:03:59,260
+Balloons زي ما انتوا شايفين هذه العملية بيروح عشان
+
+53
+00:03:59,260 --> 00:04:04,700
+بيوسع اللي هو الضيق اللي صار هنا في الشريانفي بلون
+
+54
+00:04:04,700 --> 00:04:10,520
+صغير وبتم وضعه زى شفاط العصير تقريبا هو كتير رقيق
+
+55
+00:04:10,520 --> 00:04:15,940
+علشان يعمل توسعة لمرور ال blood cardiac
+
+56
+00:04:15,940 --> 00:04:19,400
+transplantation بستخدم ال rehabilitation program
+
+57
+00:04:19,400 --> 00:04:23,320
+هذا في حالات ال cardiac transplantation في حالات
+
+58
+00:04:23,320 --> 00:04:26,760
+ال angina في حالات ال compensated cardio heart
+
+59
+00:04:26,760 --> 00:04:32,010
+failure اللى هو فشل عضلة القلبالـ exercise هذا الـ
+
+60
+00:04:32,010 --> 00:04:36,750
+prescriptions depends on result exercise testing
+
+61
+00:04:36,750 --> 00:04:40,050
+which often include cardiopulmonary exercise
+
+62
+00:04:40,050 --> 00:04:43,490
+testing في عندي exercise testing عنده هناخده في
+
+63
+00:04:43,490 --> 00:04:47,990
+بارة اتنين هذا ال exercise مخصص لحالات ال cardiac
+
+64
+00:04:47,990 --> 00:04:53,780
+diseaseاللي هو بقيس مدى تحمل المريض لهذا التمرين
+
+65
+00:04:53,780 --> 00:04:57,180
+الآن زي ما انتوا شايفين في هذه الصورة الـ
+
+66
+00:04:57,180 --> 00:05:00,480
+Physiotherapist عيونه على الـ Monitoring اللي هي
+
+67
+00:05:00,480 --> 00:05:04,750
+الشاشة اللي براقب فيها heart rateوبراقب فيها ال
+
+68
+00:05:04,750 --> 00:05:08,210
+respiratory rate وبراقب فيها كل ال vital signs أنا
+
+69
+00:05:08,210 --> 00:05:11,230
+هنا بتكلم على مريض قلب، مابتكلم على أي مريض عادي
+
+70
+00:05:11,230 --> 00:05:15,530
+مريض قلب لازم انا أكون with good supervision لازم
+
+71
+00:05:15,530 --> 00:05:18,930
+أكون مراقبه بشكل جيد على أساس إنه هي مثل إتحاء أو
+
+72
+00:05:18,930 --> 00:05:22,230
+موت افرض لسمح الله إيش هت attack، افرض صار فيه
+
+73
+00:05:22,230 --> 00:05:25,510
+مشكلة فلازم ال physiotherapist و أي team members
+
+74
+00:05:25,510 --> 00:05:31,860
+موجود معاه لازم يكون مراقب له بشكل دقيق جدالمين
+
+75
+00:05:31,860 --> 00:05:35,360
+أنا مش ممكن أعمل اللي هو rehabilitation program؟
+
+76
+00:05:35,360 --> 00:05:39,420
+Severe residual angina Uncompensated heart failure
+
+77
+00:05:39,420 --> 00:05:44,780
+تمام Uncontrolled Arthmia Severe ischemia Left
+
+78
+00:05:44,780 --> 00:05:48,140
+ventricular dysfunction أو الأرثميا during
+
+79
+00:05:48,140 --> 00:05:52,580
+exercise testing صار عدم انتظام لضغط القلب هنا أنا
+
+80
+00:05:52,580 --> 00:05:56,260
+ممنوع أشتغل معاهم نهائي هذه الناس Poor control
+
+81
+00:05:56,260 --> 00:06:01,010
+hypertensionالحالات اللي هي في عندها صعوبة في
+
+82
+00:06:01,010 --> 00:06:05,570
+التحكم في اللي هو ضغط الدم مرة بنلاقيه عالي جدا و
+
+83
+00:06:05,570 --> 00:06:08,710
+بعدين بينخفض و بعدين بيرجع بيعلى هنا ممنوع أنا
+
+84
+00:06:08,710 --> 00:06:11,650
+أشتغل معاهم بتاعة الـhypertensive أو
+
+85
+00:06:11,650 --> 00:06:14,710
+الـhypotensive للـ systolic blood pressure عارفي
+
+86
+00:06:14,710 --> 00:06:17,670
+في إشي هنا systolic و في إشي هنا diastolic الآن
+
+87
+00:06:17,670 --> 00:06:20,890
+الناس اللي صار عندهم hypertensive أو hypotensive
+
+88
+00:06:20,890 --> 00:06:24,670
+كمان ممنوع أشتغل عندهمالـ unstable الـ medically
+
+89
+00:06:24,670 --> 00:06:26,990
+unstable في حالات الـ medically unstable زي
+
+90
+00:06:26,990 --> 00:06:30,910
+الحالات اللي هي الـ diabetes على سبيل المثال صار
+
+91
+00:06:30,910 --> 00:06:34,350
+لو إيجي عنده كومة سكر زي ما بنحكيها إحنا بالـ
+
+92
+00:06:34,350 --> 00:06:37,750
+common أو إنه مثلا على سبيل المثال صار في عندنا
+
+93
+00:06:37,750 --> 00:06:41,250
+ارتفاع مفالق في السكر هنا كمان نفسي ممنوع أنا
+
+94
+00:06:41,250 --> 00:06:47,120
+أشتغل معها لأنه لازم أحافظ على الحالةالعامة للمريض
+
+95
+00:06:47,120 --> 00:06:50,320
+التابعة الصحية تكون stable عشان أنا ماقش أشغل معاه
+
+96
+00:06:50,320 --> 00:06:54,540
+في ال physiology program تبعي يكون هو في حالة
+
+97
+00:06:54,540 --> 00:06:58,340
+stableهي الـ contra indication ال rehabilitation
+
+98
+00:06:58,340 --> 00:07:02,700
+team members هم مين؟ أول إشي أخدت اللي هو عنصر ال
+
+99
+00:07:02,700 --> 00:07:06,040
+patient and his family ال patient و ال family مهم
+
+100
+00:07:06,040 --> 00:07:10,060
+جدا إنه أنا أحطهم بال center ليش؟ عشان أنا ال
+
+101
+00:07:10,060 --> 00:07:13,460
+patient و ال family تبعته must never overlooked as
+
+102
+00:07:13,460 --> 00:07:17,280
+a member of prescribing team prescribing teamsلازم
+
+103
+00:07:17,280 --> 00:07:21,720
+أنا أحطهم وما أجهل دور العائلة تماما لازم أحطها في
+
+104
+00:07:21,720 --> 00:07:25,860
+المنتصف ال «home program» هو العائلة اللي هتقوم
+
+105
+00:07:25,860 --> 00:07:29,220
+فيه أنا ماحكن موجود مع المريض بعد ما يطلع من ال
+
+106
+00:07:29,220 --> 00:07:32,080
+«inpatient» «The patient and his family must be
+
+107
+00:07:32,080 --> 00:07:35,300
+made aware of a program in which is about to enter
+
+108
+00:07:35,300 --> 00:07:38,400
+with implications» أيضا في عملية التنفيذ لازم يكون
+
+109
+00:07:38,400 --> 00:07:41,680
+موجود معايا حدا من ال «family members» اللي أنا
+
+110
+00:07:41,680 --> 00:07:45,740
+بين قوسين بسميهم ال «caregivers» أو مقدمي الرعاية
+
+111
+00:07:46,020 --> 00:07:48,920
+They must be oriented available types of
+
+112
+00:07:48,920 --> 00:07:51,660
+mechanical aids and individual advantages and
+
+113
+00:07:51,660 --> 00:07:55,240
+disadvantages related patients personal and work
+
+114
+00:07:55,240 --> 00:07:58,860
+needs لازم انا اكون عارفة ايش ال exercise او ايش
+
+115
+00:07:58,860 --> 00:08:00,880
+ال machine اللي انا على سبيل المثال بدي اشتغل
+
+116
+00:08:00,880 --> 00:08:04,420
+عليها شو ال advantage شو ال disadvantage يعني اكون
+
+117
+00:08:04,420 --> 00:08:08,720
+عاملة اجابة لكل سؤال محتمل انه انا انسقلهمن أهل ال
+
+118
+00:08:08,720 --> 00:08:12,500
+patient على سبيل المثال لو أنا بدي أشغله او انا
+
+119
+00:08:12,500 --> 00:08:15,560
+بدي أدربه على ال treadmill بدي أحكيله ان انت مزدس
+
+120
+00:08:15,560 --> 00:08:20,140
+سرعة كذا ما تعمل كذا لأن هذا وضعك بيعمل مخاطر هيك
+
+121
+00:08:20,140 --> 00:08:24,900
+و بيعمل مخاطر و بكون أفضل لو كان بسرعة كذا اذا حتى
+
+122
+00:08:24,900 --> 00:08:29,480
+في التنفيذ في عملية تنفيذ ال exercise بيكون
+
+123
+00:08:29,480 --> 00:08:34,240
+للعائلة دور و بتكون موجودة معايا في ال center ال
+
+124
+00:08:34,240 --> 00:08:39,690
+physicians الطبيبهو الـ Guides تبعت كل العملية
+
+125
+00:08:39,690 --> 00:08:44,550
+التأهيلية بناءً على التحويلة تبعت الدكتور القلب
+
+126
+00:08:44,550 --> 00:08:49,490
+أنا بشتغل، مافيش تحويلة، ممنوع تشتغل، إذا الفيزيشن
+
+127
+00:08:49,490 --> 00:08:54,230
+هو الـ leader and coordinator لل team، he attends
+
+128
+00:08:54,230 --> 00:08:58,830
+to all medical aspects of individual cases، هو ال
+
+129
+00:08:58,830 --> 00:09:03,280
+leaderوالله عندك تحويلة اتفضل تعال فوت على قسم
+
+130
+00:09:03,280 --> 00:09:07,800
+الفيزياثرابي ماعندك لأ أنا أسفة بس مابشتغل معاك لو
+
+131
+00:09:07,800 --> 00:09:11,220
+صار مسار لل patient هادي مسئولية الدكتور اللي هو
+
+132
+00:09:11,220 --> 00:09:14,120
+بتابع معاه the physician referring patient should
+
+133
+00:09:14,120 --> 00:09:18,370
+be state diagnosisالـ Present Condition of Patient
+
+134
+00:09:18,370 --> 00:09:21,990
+Limitation أو الـ Percussions to Be Observed
+
+135
+00:09:21,990 --> 00:09:25,130
+Prognosis والـ Result كمان To Be Achieved and
+
+136
+00:09:25,130 --> 00:09:28,870
+Frequency و Length of Treatment لازم هي تكون
+
+137
+00:09:28,870 --> 00:09:34,070
+محتوطة الخطة بوجود اللي هو الدكتور اللي هو دكتور
+
+138
+00:09:34,070 --> 00:09:37,690
+القلب لإنه عارف على سبيل المثال عضلة القلب بتشتغل
+
+139
+00:09:37,690 --> 00:09:42,750
+اليوم 30% ما بدها long exercise ما بدها strong
+
+140
+00:09:42,750 --> 00:09:46,560
+intensity للexercise على سبيل المثالفبالتالي
+
+141
+00:09:46,560 --> 00:09:50,100
+الدكتور هو اللي موجود هو اللي هيحدد معايا إيش أنا
+
+142
+00:09:50,100 --> 00:09:55,480
+ممكن أعمل الـ OT و الـ PT in the treatment of
+
+143
+00:09:55,480 --> 00:09:58,200
+physical disabilities the physical therapy have
+
+144
+00:09:58,200 --> 00:10:02,460
+similar ultimate goal namely to contribute the
+
+145
+00:10:02,460 --> 00:10:06,400
+restoration of physical function للpatient as much
+
+146
+00:10:06,400 --> 00:10:10,000
+as possible أنا بحكي إنه أنا أعيد المريض تبعي
+
+147
+00:10:10,000 --> 00:10:13,780
+لوضعه اللي كان عليه في السابق قبل عملية الانجينة
+
+148
+00:10:13,780 --> 00:10:17,520
+تمام؟As much as possible احنا بنحكيه Psychologists
+
+149
+00:10:17,520 --> 00:10:21,560
+و Psychiatrists مهم كتير عندنا الدعم النفسي خصوصا
+
+150
+00:10:21,560 --> 00:10:26,160
+انه مريض اتعرض لمشكلة اتعرض لذبح قلبية او ذبح
+
+151
+00:10:26,160 --> 00:10:29,920
+صدرية بين قوسين ان هو هيدخل في حالة من الاكتئاب
+
+152
+00:10:29,920 --> 00:10:33,660
+حالة في عدم الاستقرار النفسي لان حياته مهددة
+
+153
+00:10:33,660 --> 00:10:37,410
+بالخطرto provide information concerning the
+
+154
+00:10:37,410 --> 00:10:40,650
+patient's mental ability الـ emotional adjustment
+
+155
+00:10:40,650 --> 00:10:43,930
+أيضًا الـ interested and vocational outputs الـ
+
+156
+00:10:43,930 --> 00:10:47,990
+mental abilities كل هذه الأمور وإن هو هل هيرجع
+
+157
+00:10:47,990 --> 00:10:52,290
+لوظيفته و لا مش هيرجع كيف هيكون دوره في البيت هل
+
+158
+00:10:52,290 --> 00:10:56,730
+هو كان مثلًا قبل أطفال هل هو هيرجع معيد لهذه
+
+159
+00:10:56,730 --> 00:11:00,310
+الأسرة و لا لأ هذه الأمور بتأثر في نفسية مريض
+
+160
+00:11:00,310 --> 00:11:04,370
+القلبأيضًا في عنا ال social service هم ما زلنا
+
+161
+00:11:04,370 --> 00:11:07,850
+مكملين اللي هم ال rehabilitation members ال social
+
+162
+00:11:07,850 --> 00:11:11,210
+service اللي هو ال social worker ال social worker
+
+163
+00:11:11,210 --> 00:11:14,750
+أيضًا بيساعد ال patient و ال family على إنهم
+
+164
+00:11:14,750 --> 00:11:18,390
+يتجاوزوا هذه المرحلة الأليمة من حياتهم ممكن بإيجاد
+
+165
+00:11:18,390 --> 00:11:23,350
+حلول لوظيفة أخرى أو وظيفة مناسبة حسب ال
+
+166
+00:11:23,350 --> 00:11:26,790
+disabilities اللي صارت عند المريض ال nurse طبعًا
+
+167
+00:11:26,790 --> 00:11:30,130
+هو العمود الفقري تبعنا و اللي بيكون متابع المريض
+
+168
+00:11:30,130 --> 00:11:34,890
+في كل أموره الطبيةأيضا ال nutritious اللي هو
+
+169
+00:11:34,890 --> 00:11:40,190
+العالم التغذية أنه لازم يكون تواصله مع مرضى أو
+
+170
+00:11:40,190 --> 00:11:45,670
+مريض القلب بشكل مباشر ليه؟ لأنه هيتابع معاهم هذا
+
+171
+00:11:45,670 --> 00:11:49,860
+الطعام high cholesterol هذا الطعام لأ كويسفده كلقه
+
+172
+00:11:49,860 --> 00:11:53,560
+high lipid الأمور هذه مهمة جدا في مرض القلب لأنه
+
+173
+00:11:53,560 --> 00:11:58,660
+لو لصمح الله زاد عندي أي إشي مش مفيد لجسم الإنسان
+
+174
+00:11:58,660 --> 00:12:02,000
+أو أنه مثلا على سبيل المثال قام بأكل لحم حمراء
+
+175
+00:12:02,000 --> 00:12:06,080
+غنية بالدهون فبالتالي هنا عملتله ارتفاع في نسبة
+
+176
+00:12:06,080 --> 00:12:09,570
+الكوليسترول في الدم هذا هيزيد من risk factorإنه
+
+177
+00:12:09,570 --> 00:12:12,590
+ممكن يصير في عندي thrombus وممكن يصير في عندي
+
+178
+00:12:12,590 --> 00:12:17,810
+مشاكل أخرى إذا الأخصائي التغذية مهم جدا يكون دوره
+
+179
+00:12:17,810 --> 00:12:21,390
+في مرضى القلب في ال rehabilitation members لمرضى
+
+180
+00:12:21,390 --> 00:12:25,380
+القلبVocational Counseling اللي هو المرشد تبع
+
+181
+00:12:25,380 --> 00:12:29,020
+الوظيفة أو المرشد ال vocational اللي هو تدريبي أو
+
+182
+00:12:29,020 --> 00:12:32,080
+المهني ال program frequently begins in hospitals
+
+183
+00:12:32,080 --> 00:12:35,680
+seating constitute outpatient bases after the
+
+184
+00:12:35,680 --> 00:12:39,160
+patient is discharged تمام؟ لأن هو بدى يعرف حاله
+
+185
+00:12:39,160 --> 00:12:43,320
+وين هل هو بدى بيبقى في وظيفته؟ هو موظف وزارة على
+
+186
+00:12:43,320 --> 00:12:46,960
+سبيل المثال؟ كان قاعد على مكتب؟فبالتالي هل هو
+
+187
+00:12:46,960 --> 00:12:51,540
+هيكمل ولا هيشوف وظيفة تانية تناسب الإعاقة اللي
+
+188
+00:12:51,540 --> 00:12:56,080
+استحبته بعد الـ Angina هذا الاشي بياخد اللي هو
+
+189
+00:12:56,080 --> 00:13:00,300
+بيكون في فترة من 6 ل 12 شهر لما بعد حدوث ال attack
+
+190
+00:13:00,300 --> 00:13:03,920
+الآن بدي أتحدث عن ال faces ل ال cardiac
+
+191
+00:13:03,920 --> 00:13:07,660
+rehabilitation عندي تلاتة facesالـ cardiac
+
+192
+00:13:07,660 --> 00:13:10,420
+rehabilitation includes three phases الفيس
+
+193
+00:13:10,420 --> 00:13:14,040
+الأولاني أو first phase اللي هو initiated while
+
+194
+00:13:14,040 --> 00:13:17,720
+patient is still in the hospital من لحظة وقوع ال
+
+195
+00:13:17,720 --> 00:13:22,180
+attack سواء كانت اللي هي ال myocardial infarction
+
+196
+00:13:22,180 --> 00:13:26,180
+أو ال atherosclerosis أو أي شيء من لحظة وقوعها
+
+197
+00:13:26,180 --> 00:13:29,680
+للحظة ال patient ما بقى في ال hospital في ال
+
+198
+00:13:29,680 --> 00:13:33,340
+inpatient departmentأما الـ phase التانية أو
+
+199
+00:13:33,340 --> 00:13:35,840
+second phase that is supervised ambulatory
+
+200
+00:13:35,840 --> 00:13:40,120
+outpatient program spanning تاخد المرحلة من تلت
+
+201
+00:13:40,120 --> 00:13:44,160
+لست شهور هي المرحلة التانية هنا فيها ال exercise
+
+202
+00:13:44,160 --> 00:13:46,760
+وفيها ال ambulatory وفيها ال ambulation وفيها كل
+
+203
+00:13:46,760 --> 00:13:50,600
+الأمور هي ال phase التالتة أو third phase اللي هي
+
+204
+00:13:50,600 --> 00:13:53,940
+a lifetime maintenance phase in which physical
+
+205
+00:13:53,940 --> 00:13:56,080
+fitness as well as additional risk factors
+
+206
+00:13:56,080 --> 00:14:01,110
+reduction are emphasizedالـ «I'll face» اللي هي
+
+207
+00:14:01,110 --> 00:14:04,790
+النهائية اللي بتستمر مع مرضي القلب على المدى
+
+208
+00:14:04,790 --> 00:14:08,210
+البعيد على مدى حياته إنه أنا بدأ أشتغل معاه بحيث
+
+209
+00:14:08,210 --> 00:14:12,510
+إنه يكون physically good يكون في عندي أيضًا إن ال
+
+210
+00:14:12,510 --> 00:14:17,970
+risk factor كمان reduced إنه قلت ما صار زي زمان إن
+
+211
+00:14:17,970 --> 00:14:21,810
+هو كان heavy smoker وكان هدى من ال risk factor
+
+212
+00:14:21,810 --> 00:14:24,790
+عشان يعملي ال «I'm I» فبالتالي أنا إذا خففتها
+
+213
+00:14:24,790 --> 00:14:28,740
+معناة الحكي إنه أنا قللت من ال risk factorشو ال
+
+214
+00:14:28,740 --> 00:14:31,620
+basic program اللي انا هشتغل عليه؟ traditionally
+
+215
+00:14:31,620 --> 00:14:34,160
+cardiac rehabilitation is divided into three
+
+216
+00:14:34,160 --> 00:14:37,580
+phases في عند ال essential medically ال
+
+217
+00:14:37,580 --> 00:14:41,420
+educational and exercise component beginning to
+
+218
+00:14:41,420 --> 00:14:44,480
+apply during each phase each patent progression
+
+219
+00:14:44,480 --> 00:14:49,080
+according to الآن مش كل المرضى اللي موجودين في ال
+
+220
+00:14:49,080 --> 00:14:53,300
+ICU تبع القلب على سبيل المثال أو في قسمجراحة القلب
+
+221
+00:14:53,300 --> 00:14:58,160
+كلهم لهم نفس الدرجة في ال recovery أو عملية ال
+
+222
+00:14:58,160 --> 00:15:01,100
+recovery process هذا بيتمد على إيش؟ على طبيعة
+
+223
+00:15:01,100 --> 00:15:04,800
+المريض ال natural سواء طبيعة ال angina اللي صارت
+
+224
+00:15:04,800 --> 00:15:09,040
+في أحيانا لأن اللي هو ال thombus أو الخسر الدموية
+
+225
+00:15:09,040 --> 00:15:13,140
+اللي عمل الإنسداد للشريان التاجي بتكون بسيطة ممكن
+
+226
+00:15:13,140 --> 00:15:19,150
+تروح مع اللي هو الالأدوية الممية على الدم لكن في
+
+227
+00:15:19,150 --> 00:15:22,670
+ثرومبس بتكون كبيرة يجب أن يكون هناك فيه تدخل جراحي
+
+228
+00:15:22,670 --> 00:15:25,410
+إذا ال natural of disease أو ال natural of
+
+229
+00:15:25,410 --> 00:15:30,470
+problems ال severity of illness كام هي حدتها؟ هل
+
+230
+00:15:30,470 --> 00:15:34,330
+إجته ال attack مباشرة؟ هل إنه إجته تدريجي
+
+231
+00:15:34,330 --> 00:15:39,090
+gradually؟ كيف وضعها؟ هل هي severe ولا mild ولا
+
+232
+00:15:39,090 --> 00:15:42,890
+moderate ولا simple؟ شو وضعها؟ وشو حدتها؟الـ
+
+233
+00:15:42,890 --> 00:15:46,110
+Complication إيش المضاعفات اللي قعدتني إياها على
+
+234
+00:15:46,110 --> 00:15:49,070
+سبيل المثال صار في عندي مشكلة بالبصر، مشكلة في
+
+235
+00:15:49,070 --> 00:15:52,550
+السمع، مشكلة في الحركة، إذا إيش صار في عندي
+
+236
+00:15:52,550 --> 00:15:56,250
+Complication؟أيضا بتعتمد اللي هو ال progression
+
+237
+00:15:56,250 --> 00:16:00,090
+تبعي أو التحسن بيعتمد على rate of recovery كم هي
+
+238
+00:16:00,090 --> 00:16:04,070
+معدل الشفاء أو كيف ممكن هل هو بتجاوب معايا بسرعة و
+
+239
+00:16:04,070 --> 00:16:10,930
+بيصير كويس ولا لسه مغيب و في وضع اللي هو وضع مش
+
+240
+00:16:10,930 --> 00:16:14,770
+مظبوط و لسه بيعاني هذا الاشي اللي هو أو الأربعة
+
+241
+00:16:14,770 --> 00:16:18,210
+factors هدولة هم اللي بيحددوني ال progression اللي
+
+242
+00:16:18,210 --> 00:16:22,320
+أنا حكيت عليهالـ Phase الأولاني حكينا لستاتنا احنا
+
+243
+00:16:22,320 --> 00:16:26,060
+هنا في الـ Inpatient Hospital زي ما انتوا شايفين و
+
+244
+00:16:26,060 --> 00:16:29,500
+معاها الـ Physiotherapist اللي هي عاملالها support
+
+245
+00:16:29,500 --> 00:16:33,860
+في حالة الـ acute هذه المرحلات تستمر من 7 إلى 14
+
+246
+00:16:33,860 --> 00:16:37,840
+يوم في ال duration تبعتها و بتكون في ال Inpatient
+
+247
+00:16:37,840 --> 00:16:42,880
+Hospital هلأ شو أهدافي انا ك Physiotherapist؟to
+
+248
+00:16:42,880 --> 00:16:46,780
+initiated early physical therapy activities اللي
+
+249
+00:16:46,780 --> 00:16:50,240
+هي return للactivity daily living decrease
+
+250
+00:16:50,240 --> 00:16:54,180
+للanxiety and depression ايضا بت remind لل effect
+
+251
+00:16:54,180 --> 00:16:58,340
+of medication prevent effect للي بيرنجت بدرست انه
+
+252
+00:16:58,340 --> 00:17:02,980
+انا ما اخلي ناية مع الاسريرو يصير في عندي مشاكل لـ
+
+253
+00:17:02,980 --> 00:17:06,060
+circulation على تابعي المثال زي الـ DVT زي أي
+
+254
+00:17:06,060 --> 00:17:10,300
+مشاكل أخرى الـ PEDSOR مثلا كل المشاكل الناتجة أو
+
+255
+00:17:10,300 --> 00:17:16,840
+الحاصلة نتيجة اللي هو الـ PEDSORالهدف التاني to
+
+256
+00:17:16,840 --> 00:17:20,480
+initiated لل patient and family education لأن أنا
+
+257
+00:17:20,480 --> 00:17:24,540
+حكيت ال family members مهم جدا أنه أنا أحط معاهم
+
+258
+00:17:24,540 --> 00:17:27,780
+الخطة ويكونوا موجودين معايا وقت ال implementations
+
+259
+00:17:27,780 --> 00:17:30,820
+اللي هو وقت التنفيذ أ outline the course of
+
+260
+00:17:30,820 --> 00:17:34,480
+cardiac rehabilitation قضة مضيفة لل risk factor في
+
+261
+00:17:34,480 --> 00:17:39,290
+الatherosclerosisخلال الريسيس الأولاني الـ rate of
+
+262
+00:17:39,290 --> 00:17:42,050
+progression of people who have myocardial
+
+263
+00:17:42,050 --> 00:17:46,910
+infarction is slightly slower than for those who
+
+264
+00:17:46,910 --> 00:17:52,330
+have coronary artery processography الناس اللي هي
+
+265
+00:17:52,330 --> 00:17:58,980
+عندها MIبتتحسن بشكل أبطأ من الناس اللي هي عملت
+
+266
+00:17:58,980 --> 00:18:03,740
+عملية ترقيع لشريان التاجي ليه؟ هذا الأشي أخدناه من
+
+267
+00:18:03,740 --> 00:18:08,780
+دراسات متعددة ناتج ليش؟ لأنه الميء الـMI هي عبارة
+
+268
+00:18:08,780 --> 00:18:13,320
+عن احتشاق عضلة القلبفبالتالي هنا بتفقد جزء أو
+
+269
+00:18:13,320 --> 00:18:18,060
+بتفقد اللي هو الوظيفة تبع ال heart بيبطل ال heart
+
+270
+00:18:18,060 --> 00:18:23,040
+يعمل pumping بشكل جيد فبالتالي ال recovery تبع هذا
+
+271
+00:18:23,040 --> 00:18:26,540
+ال patient بيكون أقل من ال recovery ل ال coronary
+
+272
+00:18:26,540 --> 00:18:30,300
+artery bypass graftالـ Mobilization of surgical
+
+273
+00:18:30,300 --> 00:18:34,160
+patients usually start early and intensity and
+
+274
+00:18:34,160 --> 00:18:37,360
+duration of ambulation are more accelerated كمان
+
+275
+00:18:37,360 --> 00:18:40,500
+الـ Mobilization اللي هي عملية الحركة في حالات
+
+276
+00:18:40,500 --> 00:18:45,800
+الجراحة بالأغلب بتبلش في اللي هو intensity خفيفة
+
+277
+00:18:45,800 --> 00:18:50,400
+وبعدين احنا تدريجيا بنزيدهاالأول في عندي الجدول
+
+278
+00:18:50,400 --> 00:18:54,040
+هذا اللي هو عبارة عن الـ Inpatient Hospitals أو
+
+279
+00:18:54,040 --> 00:18:56,480
+الـ Inpatient Rehabilitation Hospitals في سبعة
+
+280
+00:18:56,480 --> 00:18:59,600
+steps لـ Myocardial Infarction هذا الـ table هو
+
+281
+00:18:59,600 --> 00:19:03,800
+عبارة عن الـ table أربعة ال step الأولة بدي أعمل
+
+282
+00:19:03,800 --> 00:19:07,480
+active and passive exercise في داخل السترير أو في
+
+283
+00:19:07,480 --> 00:19:10,180
+اليوم الأول خليني أشتغل داخل السترير احنا ممكن
+
+284
+00:19:10,180 --> 00:19:14,460
+نشتغل معاه إذا هو medically stableوبرجع و بأكد إذا
+
+285
+00:19:14,460 --> 00:19:17,800
+مريضي medically stable أنا بفوت بشتغل معاه بناءً
+
+286
+00:19:17,800 --> 00:19:21,160
+على الـ referral paper من الدكتور تبعه teach
+
+287
+00:19:21,160 --> 00:19:24,540
+للpatient and plantar deflection اللي هي بين قصين
+
+288
+00:19:24,540 --> 00:19:28,380
+بسميها الـbumping exercise active range of motion
+
+289
+00:19:28,380 --> 00:19:32,580
+exercise لكل ال extremity سواء كانت upper and
+
+290
+00:19:32,580 --> 00:19:36,000
+lower limb sitting on the side of bed أو اللي هو
+
+291
+00:19:36,000 --> 00:19:39,460
+sitting at edge of bed كويس أنا أبدأ أجلس المريض
+
+292
+00:19:39,460 --> 00:19:43,310
+على حافة السرير warm-up exerciseأيضًا الـ
+
+293
+00:19:43,310 --> 00:19:47,450
+Stretching and Glutes Exercise اللي هو التمرين
+
+294
+00:19:47,450 --> 00:19:51,990
+الرياضي حوالي أنه يمشي خمسين قدم يعني ما يقارب
+
+295
+00:19:51,990 --> 00:19:57,230
+خمستاشر متر هدفي اللي هو ال step التالتة تمام؟
+
+296
+00:19:57,230 --> 00:20:00,270
+احنا لسه ما زلنا في ال impatient و هايلة حالات ال
+
+297
+00:20:00,270 --> 00:20:03,270
+myocardial infraction شو يعني التمرين الرياضي؟
+
+298
+00:20:03,270 --> 00:20:05,910
+التمرين الرياضي هنا هي عبارة عن الـ anaerobic
+
+299
+00:20:05,910 --> 00:20:09,890
+exercise تمام؟ اللي هي هوائيةusually without
+
+300
+00:20:09,890 --> 00:20:13,010
+weights and help to increase your strength and
+
+301
+00:20:13,010 --> 00:20:16,570
+flexibility بزيد القوة و ال flexibility ايضا
+
+302
+00:20:16,570 --> 00:20:18,910
+تمارين الرياضية هنا هي عبارة عن ال isotonic
+
+303
+00:20:18,910 --> 00:20:22,350
+exercise يعني ممكن يكون عن طريق اللي هو ال push
+
+304
+00:20:22,350 --> 00:20:27,010
+ups و ال sit ups و ال squatting و اللي هي ال lungs
+
+305
+00:20:27,010 --> 00:20:30,920
+طبعاكل هذه الأمور بتعمل اللي هي strengthening
+
+306
+00:20:30,920 --> 00:20:34,720
+exercise by resistance force إنه أنا بعمل push-up
+
+307
+00:20:34,720 --> 00:20:38,680
+بإيدي على الحرف على سبيل المثال فبالتالي بحصل على
+
+308
+00:20:38,680 --> 00:20:44,920
+اللي هو ال strengthening exercise step الرابعةبدى
+
+309
+00:20:44,920 --> 00:20:48,420
+اعمل range of motion exercise وبدى ازيد المسافة
+
+310
+00:20:48,420 --> 00:20:52,620
+اللى انا بدى امشي فيها لـ 75 قدم يعني ما يقارب 22
+
+311
+00:20:52,620 --> 00:20:57,860
+متر بلشتها بـ 15 و بعدين ذهبت هنا لـ 22 and back
+
+312
+00:20:57,860 --> 00:21:00,920
+average to face اللى هو basis range of motion
+
+313
+00:21:00,920 --> 00:21:05,580
+الخطوة الخامسة and lesson 6 practice walking a few
+
+314
+00:21:05,580 --> 00:21:13,040
+stairs steps walking 300 feet اللى هو 90 متر تمام
+
+315
+00:21:13,880 --> 00:21:18,480
+أيضا بينكمل كل اللي هو ال activities بالإضافة لل
+
+316
+00:21:18,480 --> 00:21:23,540
+walking down flight step return by elevators ارجعي
+
+317
+00:21:23,540 --> 00:21:28,140
+بي اللي هو المصعد ولكن امشي 500 قدم يعني ما يقارب
+
+318
+00:21:28,140 --> 00:21:34,260
+150 متر ال step السابع continue لل above
+
+319
+00:21:34,260 --> 00:21:37,580
+activities بدي أبلش من 1 ل 6 بالإضافة لإنه أنا بدي
+
+320
+00:21:37,580 --> 00:21:42,970
+أزيد ال walk up و ال light steps لأكتر من 500اللي
+
+321
+00:21:42,970 --> 00:21:47,490
+هو قدم هذا ال table هو table أربعة خاص باللي هو
+
+322
+00:21:47,490 --> 00:21:51,230
+rehabilitation programs لال myocardial infarction
+
+323
+00:21:51,230 --> 00:21:55,670
+اللي أنا نقلت أعمل إيقاف لهذا ال program في حالة
+
+324
+00:21:55,670 --> 00:21:59,930
+الفتيج في حالة ال failure of monitoring equipment
+
+325
+00:21:59,930 --> 00:22:03,920
+في حالة ال light hiddenالـ confusion أو الـ
+
+326
+00:22:03,920 --> 00:22:06,740
+cyanosis لو أنا حسيت أن المريض التابعي دخل في
+
+327
+00:22:06,740 --> 00:22:09,940
+تسيبنيا اللي هو difficulty to breathing على طول
+
+328
+00:22:09,940 --> 00:22:14,720
+بعمل stopping لـexercise إذا حس أنه نازية على طول
+
+329
+00:22:14,720 --> 00:22:19,100
+بعمل stopping honest لـangina و لـexercise أتار
+
+330
+00:22:19,100 --> 00:22:22,480
+angina جديدة على طول خلال أداء التمرين بعمل
+
+331
+00:22:22,480 --> 00:22:26,790
+stoppingالـ ST طبعا هي عبارة عن اللي هو هذا الشكل
+
+332
+00:22:26,790 --> 00:22:30,290
+اللي موجود عندنا اللي هو عبارة عن الرسمة في ال ECG
+
+333
+00:22:30,290 --> 00:22:34,150
+displacement ايضا horizontal or down sloping للي
+
+334
+00:22:34,150 --> 00:22:38,550
+هو ال risk ventricular tachycardia ممكن يصير في
+
+335
+00:22:38,550 --> 00:22:42,110
+عنا تاكيكارديا increasing في ال heart rate طبعا
+
+336
+00:22:42,110 --> 00:22:47,390
+زيادة في معدل ضربات القلب هاي ست حالة انا بعمل
+
+337
+00:22:47,390 --> 00:22:51,770
+stopping ل ال exercise programطبعا هنا بدى يورينا
+
+338
+00:22:51,770 --> 00:22:55,590
+ان anterior و lateral في حالات اللى هى ال
+
+339
+00:22:55,590 --> 00:23:00,570
+ventricular و اللى هو ال tachycardia اللى صارت على
+
+340
+00:23:00,570 --> 00:23:04,850
+طول انا بعمل اللى هو stopping ايضا فى عندي تكملة
+
+341
+00:23:04,850 --> 00:23:07,970
+لباقي ال exercise او باقي اللى هو ال stopping of
+
+342
+00:23:07,970 --> 00:23:11,810
+exercise تبع ال exercise induced left bandell
+
+343
+00:23:11,810 --> 00:23:16,440
+branch blocksإن هو هذا ال exercise بدي ازيد طبعا
+
+344
+00:23:16,440 --> 00:23:21,740
+من ال block اللي صارت في ال left band ال branches
+
+345
+00:23:21,740 --> 00:23:25,400
+زي ما انتوا شايفينها هنا طبعا في عندي right و في
+
+346
+00:23:25,400 --> 00:23:29,780
+عندي leftالـ Honest اللي هو second and third AV
+
+347
+00:23:29,780 --> 00:23:34,880
+اللي هو a triumventrical block الاكسرسيز اللي صار
+
+348
+00:23:34,880 --> 00:23:38,660
+فيه انه الـ Hypotension less than twenty
+
+349
+00:23:38,660 --> 00:23:42,080
+millimeters أبقى drop in systolic blood pressure
+
+350
+00:23:42,080 --> 00:23:45,960
+during exercise Hypotension أنا بحكي يعني أقل من
+
+351
+00:23:45,960 --> 00:23:49,510
+الطبيعي excessive blood pressure risesإذا كان الـ
+
+352
+00:23:49,510 --> 00:23:52,570
+systolic blood pressure 220 معناته هو هنا high،
+
+353
+00:23:52,570 --> 00:23:56,630
+عالي جدا، فبالتالي، و الـ diastolic 110، معناه
+
+354
+00:23:56,630 --> 00:24:00,330
+الكلام هذا hypertensive patient inapropriating
+
+355
+00:24:00,330 --> 00:24:04,310
+bradycardia ال patient اللي صار عنده bradycardia،
+
+356
+00:24:04,310 --> 00:24:08,090
+drop في ال heart rate greater than 10 during
+
+357
+00:24:08,090 --> 00:24:14,130
+exercise هنا أنا طبعا لازم أبعد أو أسحب أي
+
+358
+00:24:14,130 --> 00:24:18,450
+exercise أنا كنت راح أشتغله مع مريض، اللي هو القلب
+
+359
+00:24:19,210 --> 00:24:22,970
+لأن هذا كله أنا كنت بحكي عنه في phase 1 phase 2
+
+360
+00:24:22,970 --> 00:24:27,050
+اللي هو ال term of phase 2 that the part of
+
+361
+00:24:27,050 --> 00:24:29,470
+cardiac rehabilitation program conduct in
+
+362
+00:24:29,470 --> 00:24:33,690
+outpatient إذا في phase 2 هشتغل مع ال outpatient
+
+363
+00:24:33,690 --> 00:24:36,930
+أما في phase 1 كنت شغالة على inpatient المريض ما
+
+364
+00:24:36,930 --> 00:24:41,330
+زال عندي داخل ال department تبعي في المستشفى it's
+
+365
+00:24:41,330 --> 00:24:45,030
+early to convalescent phase من 8 إلى 12 أسبوع
+
+366
+00:24:45,030 --> 00:24:49,510
+تقريبا ما بعد اللي هي صارت الحادثةثمانة اتناشر
+
+367
+00:24:49,510 --> 00:24:52,810
+اسبوع التامن لا الاسبوع اسبوع التامن نحكي للاسبوع
+
+368
+00:24:52,810 --> 00:24:55,350
+الاتناشر ال duration during this phase ال
+
+369
+00:24:55,350 --> 00:24:58,090
+myocardial and postoperative healing is taking
+
+370
+00:24:58,090 --> 00:25:01,870
+place تمام في اللي هو من ست ل تمان أسابيع في ال
+
+371
+00:25:01,870 --> 00:25:04,970
+myocardial scar formation has taken place and the
+
+372
+00:25:04,970 --> 00:25:09,750
+sternum is healed following surgery إذا أنا بحكي
+
+373
+00:25:09,750 --> 00:25:12,990
+على حالة اللي هي ال open heart surgery أنا عملت
+
+374
+00:25:12,990 --> 00:25:17,760
+cutting أومعناة الكلام أنا بدي أستنى من 6 ل 8
+
+375
+00:25:17,760 --> 00:25:21,380
+أسابيع انه عشان أعمل اللي هو يصير في عندى ال good
+
+376
+00:25:21,380 --> 00:25:25,140
+healing ل ال surgery بعدين أفوت في اللي هو ال
+
+377
+00:25:25,140 --> 00:25:28,620
+rehabilitation team ال goals تبعتي في هذا ال team
+
+378
+00:25:28,620 --> 00:25:32,140
+increasing ال exercise capacity أنا هنا بدي أزيد
+
+379
+00:25:32,140 --> 00:25:35,480
+ال endurance لإن المريض التبعى صار خلاص يعني مش
+
+380
+00:25:35,480 --> 00:25:39,460
+جديد stable هو و medically تمام تمام فبالتالي بدي
+
+381
+00:25:39,460 --> 00:25:42,300
+أزيد ال enduranceeducated للpatient and the proper
+
+382
+00:25:42,300 --> 00:25:45,100
+technique of exercise بدي أعلمه التكنيك اللي زيد
+
+383
+00:25:45,100 --> 00:25:48,300
+لل exercise اللي أنا هزيدها work with patient and
+
+384
+00:25:48,300 --> 00:25:52,880
+family برضه حكينا ال family هنا هي عبارة عن إشي
+
+385
+00:25:52,880 --> 00:25:56,430
+ورنصر هام أساسي لناPrepare الpatient to return
+
+386
+00:25:56,430 --> 00:26:00,450
+work إذا كان والله هو مدرس جامعي بده يرجع على
+
+387
+00:26:00,450 --> 00:26:03,770
+وظيفته هل بيناسبه أو بيناسبوش هذا بيحكي عليه
+
+388
+00:26:03,770 --> 00:26:08,010
+الأخصائي المهني Enhance the psychological status
+
+389
+00:26:08,010 --> 00:26:12,710
+بعزز اللي هي الحالة النفسية to provide the patient
+
+390
+00:26:12,710 --> 00:26:17,030
+with guidelines in long term exercise كمان أنا
+
+391
+00:26:17,030 --> 00:26:20,800
+بعززاللي هو ان انت قادر على انك تقدي هذا ال
+
+392
+00:26:20,800 --> 00:26:25,560
+exercise ما بخليه دائما ان هو fair ومش حابب يعمل
+
+393
+00:26:25,560 --> 00:26:29,440
+exercise لإنه ممكن تجيه angina لأ إذا موضوع stable
+
+394
+00:26:29,440 --> 00:26:35,460
+و تمام اتفضل انا بعزز هاي الفكرة معاه ال training
+
+395
+00:26:35,460 --> 00:26:39,840
+program فيه عندنا ال conditioning exercise زي ال
+
+396
+00:26:39,840 --> 00:26:43,990
+rhythmic aerobic exercise ال walkingjogging
+
+397
+00:26:43,990 --> 00:26:48,430
+swimming and running التشديف هذه الأمور كلها
+
+398
+00:26:48,430 --> 00:26:51,350
+بعتبرها conditioning exercise في عندنا lower
+
+399
+00:26:51,350 --> 00:26:55,190
+exercise أو lower extremity aerobic exercise زي
+
+400
+00:26:55,190 --> 00:26:58,530
+اللي هو ال treadmill زي ما حكينا و ال bicycle
+
+401
+00:26:58,530 --> 00:27:02,370
+ergometers زي ما انتوا شايفينهم هنا عامل اليهم
+
+402
+00:27:02,370 --> 00:27:06,450
+group therapy في اللي هو ال department أو ال
+
+403
+00:27:06,450 --> 00:27:09,790
+physiotherapy departmentأيضًا الـ Upper Extremity
+
+404
+00:27:09,790 --> 00:27:12,950
+with Ergometers أو Arm Ergometers and Drawing
+
+405
+00:27:12,950 --> 00:27:17,030
+Machines اللي هو زي ما أنتوا شايفينها هنا شغالة
+
+406
+00:27:17,030 --> 00:27:21,130
+الـ Upper Extremity This type of equipment improve
+
+407
+00:27:21,130 --> 00:27:25,250
+both endurance and physical work capacity مهم جدًا
+
+408
+00:27:25,250 --> 00:27:27,350
+أنه أنا أزيد ال endurance لأنه أنا في phase 2
+
+409
+00:27:27,350 --> 00:27:31,870
+شغالة للبست my card للinfarction by bus اللي هو by
+
+410
+00:27:31,870 --> 00:27:38,520
+bus patient during phase 2الان التمارين الرياضية
+
+411
+00:27:38,520 --> 00:27:41,580
+اللى انا بدي اقديها بعد ما عملت ال conditioning
+
+412
+00:27:41,580 --> 00:27:44,940
+exercise فى عندى اللى هي ال eclipses exercise
+
+413
+00:27:44,940 --> 00:27:48,740
+active free exercise لل upper extremities and
+
+414
+00:27:48,740 --> 00:27:51,840
+lower limbs and trunk لاحظوا كمان هنا الصلاة
+
+415
+00:27:51,840 --> 00:27:55,620
+الرياضية مليانة فهو group therapy كامل على الأغلب
+
+416
+00:27:55,620 --> 00:28:00,940
+كلهميعني درلي و كلهم مسنين هنا برضه في عندي فى هذه
+
+417
+00:28:00,940 --> 00:28:04,300
+الصورة اللى هو فى ال treadmill كيف أنه انا ممكن
+
+418
+00:28:04,300 --> 00:28:10,500
+اخليها تبدأ تزاود السرعة تبعتها بناء على phase 2
+
+419
+00:28:10,500 --> 00:28:14,980
+specific monitoring and phase لازم انا هنا اكون
+
+420
+00:28:14,980 --> 00:28:19,240
+مراقبة ال vital signs خليني احكى heart rate blood
+
+421
+00:28:19,240 --> 00:28:23,280
+pressure ال ECG ال heart sound و ال signs and
+
+422
+00:28:23,280 --> 00:28:28,460
+symptoms كل هذه الأمور مهم جداأنا أتابعها وأكون مع
+
+423
+00:28:28,460 --> 00:28:33,400
+المريض دقيقة بدقيقة return to work after phase 2
+
+424
+00:28:33,400 --> 00:28:37,040
+والآن خلصنا احنا من تأهيل المريض في phase 2 بدي
+
+425
+00:28:37,040 --> 00:28:41,200
+ارجع على وظيفته من 75 ل 80% من ال rehabilitated
+
+426
+00:28:41,200 --> 00:28:45,690
+patient will return to work withineight to ten
+
+427
+00:28:45,690 --> 00:28:49,730
+weeks after my cardiac infarction يعني عشر أسابيع
+
+428
+00:28:49,730 --> 00:28:54,210
+تقريبا خلينا نحكي من شهرين لتلت شهور وأنا برجعه
+
+429
+00:28:54,210 --> 00:28:58,660
+لوضعه في اللي هو الدوام تبعهThey found the cardiac
+
+430
+00:28:58,660 --> 00:29:01,280
+rehabilitation patient returned to work average
+
+431
+00:29:01,280 --> 00:29:05,280
+almost 40 days sooner than non-rehabilitated
+
+432
+00:29:05,280 --> 00:29:09,520
+patients لجينا إن هو ال patient اللي هم ال average
+
+433
+00:29:09,520 --> 00:29:13,640
+معدلهم اللي رجعوا لعملهم حوالي أبعد 40 يوم من
+
+434
+00:29:13,640 --> 00:29:19,000
+السنة than اللي هم ما حصلوا rehabilitation patient
+
+435
+00:29:20,200 --> 00:29:23,420
+الفاس الأخير وهو الفاس اللي out patient وال
+
+436
+00:29:23,420 --> 00:29:26,760
+patient خلاص هيكون فيه في ال home program اللي هو
+
+437
+00:29:26,760 --> 00:29:30,160
+الفاس التالت خلال هذا الفاس التالت during phase
+
+438
+00:29:30,160 --> 00:29:33,460
+three ال patient do their exercise independently
+
+439
+00:29:33,460 --> 00:29:38,190
+خلاص أنا وصلت معاه ما بعد التلت شهورThe role of
+
+440
+00:29:38,190 --> 00:29:40,750
+physical therapist is guidance هنا ال role of
+
+441
+00:29:40,750 --> 00:29:44,850
+physiotherapist دوره كعلاج طبيعي فقط اللي هو مرشد
+
+442
+00:29:44,850 --> 00:29:48,530
+أو معلم and follow up لل patient to ask to keep
+
+443
+00:29:48,530 --> 00:29:51,830
+contact with rehabilitation teamThe duration of
+
+444
+00:29:51,830 --> 00:29:56,110
+phase 3 ranged from six months to one year من ست
+
+445
+00:29:56,110 --> 00:30:00,430
+شهور لسنة بيظلوا متواصل معانا by telephone على
+
+446
+00:30:00,430 --> 00:30:05,170
+سبيل المثالبما إنه في ضل COVID-19 أو على سبيل
+
+447
+00:30:05,170 --> 00:30:09,410
+المثال ممكن يكون عنده فيزيو ترابي في البيت ويتبع
+
+448
+00:30:09,410 --> 00:30:13,970
+معاه ال goals تبعتنا في هذا ال exercise أو في هذا
+
+449
+00:30:13,970 --> 00:30:17,630
+ال phase improve ال exercise fitness أنا بدي أعلي
+
+450
+00:30:17,630 --> 00:30:20,770
+ال exercise intensityimprove my cardio aerobic
+
+451
+00:30:20,770 --> 00:30:24,470
+capacity improve my cardio oxygen supply and
+
+452
+00:30:24,470 --> 00:30:28,690
+psychological orientations كل هذه الأمور مهمة جدا
+
+453
+00:30:28,690 --> 00:30:32,270
+ان احافظ عليها لأن انا شغالة في ال outpatient يعني
+
+454
+00:30:32,270 --> 00:30:37,090
+في ال phase الأخر تابع الأربعة suggestions اللي
+
+455
+00:30:37,090 --> 00:30:40,170
+انا كنت حكيت عليه قبلها suggestions for exercise
+
+456
+00:30:40,170 --> 00:30:43,750
+at home ايضا بالاضافة له في عن ال walking daily
+
+457
+00:30:43,750 --> 00:30:48,910
+sleep من 6 ل 8 ساعات مهم جداwait at least one hour
+
+458
+00:30:48,910 --> 00:30:52,150
+after meal before exercising مش يأكل الوجبة من هنا
+
+459
+00:30:52,150 --> 00:30:55,310
+و يروح يعمل ال exercise من هنا لأ avoid ال
+
+460
+00:30:55,310 --> 00:30:58,550
+extremity weather in winter طبعا ال exercise
+
+461
+00:30:58,550 --> 00:31:02,940
+during warmer partof day and summer exercise long
+
+462
+00:31:02,940 --> 00:31:07,080
+and evening اللي هو ما أخلي يعني كل الهدف من هذه
+
+463
+00:31:07,080 --> 00:31:09,740
+الفترة أنه أنا ما أزيد درجة حرارة الجسم بال
+
+464
+00:31:09,740 --> 00:31:12,960
+exercise إذا كان الجو شوب أبدأ أشتغل معاه في عصر
+
+465
+00:31:12,960 --> 00:31:16,940
+الظهر لأ لازم يكون الوضع مناسب حتى ما يصير فعلا
+
+466
+00:31:16,940 --> 00:31:21,110
+increasing ال feveravoid vigorous arm and shoulder
+
+467
+00:31:21,110 --> 00:31:25,370
+activities مش انه خلاص احنا خلصنا و عدينا و روحنا
+
+468
+00:31:25,370 --> 00:31:28,070
+ع البيت و صار في انا out patient ال program انه
+
+469
+00:31:28,070 --> 00:31:31,850
+ابلش معاه exercise قوية لأ هذه بدي امنحها خصوصا
+
+470
+00:31:31,850 --> 00:31:35,350
+اذا كان عندي ال activity هذه بتعملي مشاكل زي ان هو
+
+471
+00:31:35,350 --> 00:31:39,030
+المرض ممكن يدوخ منها زي انه ممكن تجي نوازيه الأمور
+
+472
+00:31:39,030 --> 00:31:42,290
+زيها لازم انا اخدها في عين الاعتبار ال arm
+
+473
+00:31:42,290 --> 00:31:45,930
+activities required more energy than leg
+
+474
+00:31:45,930 --> 00:31:52,790
+activities طبعا اكيدأي إشي في ال arms طبعا بيكون
+
+475
+00:31:52,790 --> 00:31:58,270
+أكتر اللي هو شغل و أكتر مجهود suggest use ال
+
+476
+00:31:58,270 --> 00:32:03,190
+exercise at home avoid lifting heavy weight ممنوع
+
+477
+00:32:03,190 --> 00:32:08,010
+يشيل أيضا اللي هو الأحمل السقيلة avoid situation
+
+478
+00:32:08,010 --> 00:32:12,070
+اللي هي ال people who make you anoxious or angry
+
+479
+00:32:12,070 --> 00:32:16,530
+ممنوع يعصب ممنوع يزعل ممنوع يتخانق مع حدا و يجي
+
+480
+00:32:16,530 --> 00:32:20,540
+يعمل exercise لأ هو هيكون لو عنده ضغط حيال ضغطهIf
+
+481
+00:32:20,540 --> 00:32:23,540
+you have chest pain, dizziness, excess of fatigue,
+
+482
+00:32:23,720 --> 00:32:26,540
+unusual vibrations, and shortness of breath type
+
+483
+00:32:26,540 --> 00:32:33,060
+فورا تبلى ال exercise اي مشاكل واجهته كفيزيو
+
+484
+00:32:33,060 --> 00:32:36,580
+ثيرابيس او واجهتك انت كمريض على طول احنا بنوصيه
+
+485
+00:32:36,580 --> 00:32:39,720
+انه يعمل stopping ال exercise and take a rest and
+
+486
+00:32:39,720 --> 00:32:43,680
+then call his doctor لازم يعمل اللي هو مكالمة
+
+487
+00:32:43,680 --> 00:32:47,040
+للدكتور ايضا ال medication مهم جدا انه ياخدوا
+
+488
+00:32:47,040 --> 00:32:52,830
+بمواعيدهالوقت يكون دقيقًا «لا تتجارب إذا كانت لديك
+
+489
+00:32:52,830 --> 00:32:56,950
+أشعار عضوية» في حالة الـ acute ما بشتغل لإنه ممكن
+
+490
+00:32:56,950 --> 00:33:02,690
+أعمل على تعظيم المشكلة تابع الخمسة «ما هي الـ
+
+491
+00:33:02,690 --> 00:33:06,310
+contraindications للدخول بين program patient and
+
+492
+00:33:06,310 --> 00:33:10,410
+outpatient exercise» ما أشتغل مع الناس اللي هم
+
+493
+00:33:10,410 --> 00:33:14,150
+unstable angina ممنوع أشتغل إذا كان الـ resting
+
+494
+00:33:14,150 --> 00:33:20,450
+للسيستوليكي blood pressure اللي هو 200فما أعلى،
+
+495
+00:33:20,450 --> 00:33:26,790
+تمام؟ و أداسة لك أعلى من 100 الـ orthostatic blood
+
+496
+00:33:26,790 --> 00:33:30,730
+pressure drop إذا كان high potential لـ moderate
+
+497
+00:33:30,730 --> 00:33:35,610
+and severe aortic stenosis سداد في الشريان التاجي
+
+498
+00:33:35,610 --> 00:33:39,050
+الـ acute systemic illness or fever الناس اللي
+
+499
+00:33:39,050 --> 00:33:41,610
+عندها influence على سبيل المثال with cardio
+
+500
+00:33:41,610 --> 00:33:45,770
+diseaseكمان مابشتغل لأن هذا بيزيد لي من ال fever
+
+501
+00:33:45,770 --> 00:33:49,090
+ال uncontrolled arterial and ventricle
+
+502
+00:33:49,090 --> 00:33:53,530
+dysarrhythmia طبعا الحالات اللي بتكون موجودة في
+
+503
+00:33:53,530 --> 00:33:57,670
+اللي عندها علم انتظام في ضغاط القلب هي كمان ما
+
+504
+00:33:57,670 --> 00:34:02,250
+أشتغل معها أيضا ماأشتغلش مع ال uncontrolled sense
+
+505
+00:34:02,250 --> 00:34:06,670
+of tachycardia increasing في ال bloodالـ heart
+
+506
+00:34:06,670 --> 00:34:10,910
+rate الـ uncontrolled congestive heart failure CHF
+
+507
+00:34:10,910 --> 00:34:17,270
+اللي هو فشل في عضلة القلب الـ three degree AV
+
+508
+00:34:17,270 --> 00:34:20,910
+heart blocks تمام three degree هاي ال second
+
+509
+00:34:20,910 --> 00:34:24,610
+degree هاي ال third يعني شوفوا كيف بين كل waves و
+
+510
+00:34:24,610 --> 00:34:30,350
+الأخرى كام هي المسافة ال recent embolism بخاف لإنه
+
+511
+00:34:30,350 --> 00:34:33,730
+ممكن تنتقل من مكان إلى مكان thromb of the bites
+
+512
+00:34:33,730 --> 00:34:38,790
+كمان بخاف منهاالـ Resting للـ ST Displacement هنا
+
+513
+00:34:38,790 --> 00:34:42,350
+زيادة في الـ displacement تبع الـ ST ال
+
+514
+00:34:42,350 --> 00:34:48,210
+uncontrolled diabetes الarthritic problemالـ
+
+515
+00:34:48,210 --> 00:34:52,210
+Bravets Exercise كمان هاي الناس ممنوعة أنا أشتغل
+
+516
+00:34:52,210 --> 00:34:58,830
+معاها يعني Contra-Indication 15 items أو 15 حلق أو
+
+517
+00:34:58,830 --> 00:35:04,170
+15
+
+518
+00:35:04,170 --> 00:35:09,490
+عنصر ممنوعة أنا أشتغل معاهم في اللي هو الحلق،
+
+519
+00:35:09,490 --> 00:35:12,470
+الـExercise في الـthird phase اللي موجود عندنا
+
+520
+00:35:12,470 --> 00:35:17,360
+للـcardiac rehabilitation patientيعطيكوا ألف عافية
+
+521
+00:35:17,360 --> 00:35:20,980
+وبهك بكون أنا خلصت ال part الأول ألقاكم بإذن الله
+
+522
+00:35:20,980 --> 00:35:26,080
+في part اتنين بإذن الله والسلام عليكم ورحمة الله
+
+523
+00:35:26,080 --> 00:35:26,760
+وبركاته
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/T3cTeEw_ujw_raw.json b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/T3cTeEw_ujw_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..747747679ba440f985efaf3bf6fa0ff4cf689894
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/T3cTeEw_ujw_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 1111, "start": 0.91, "end": 11.11, "text": "صلاة والسلام على أشرف الأنبياء والمرسلين سأتحدث في هذا الفيديو عن الـ Cardiac Rehabilitation الـ PART الأول قمت بتجزئة المحاضرة", "tokens": [9381, 15040, 3660, 16070, 3794, 37440, 15844, 5551, 8592, 28480, 16247, 1863, 21292, 16606, 16070, 29973, 3794, 1211, 9957, 8608, 10721, 2655, 24401, 12984, 8978, 23758, 27188, 1829, 16254, 2407, 18871, 2423, 39184, 11877, 13921, 1300, 71, 5177, 4614, 2423, 39184, 430, 15118, 16247, 12610, 12174, 2304, 2655, 39894, 7435, 11622, 19986, 3660, 9673, 5016, 46958, 25720], "avg_logprob": -0.19369611400982428, "compression_ratio": 1.3043478260869565, "no_speech_prob": 1.1682510375976562e-05, "words": [{"start": 0.91, "end": 1.29, "word": "صلاة", "probability": 0.6208902994791666}, {"start": 1.29, "end": 1.71, "word": " والسلام", "probability": 0.8767903645833334}, {"start": 1.71, "end": 1.93, "word": " على", "probability": 0.392333984375}, {"start": 1.93, "end": 2.29, "word": " أشرف", "probability": 0.9845377604166666}, {"start": 2.29, "end": 2.75, "word": " الأنبياء", "probability": 0.8660888671875}, {"start": 2.75, "end": 3.47, "word": " والمرسلين", "probability": 0.9494140625}, {"start": 3.47, "end": 4.67, "word": " سأتحدث", "probability": 0.92578125}, {"start": 4.67, "end": 4.79, "word": " في", "probability": 0.9814453125}, {"start": 4.79, "end": 5.01, "word": " هذا", "probability": 0.94921875}, {"start": 5.01, "end": 5.61, "word": " الفيديو", "probability": 0.905517578125}, {"start": 5.61, "end": 5.97, "word": " عن", "probability": 0.984375}, {"start": 5.97, "end": 6.45, "word": " الـ", "probability": 0.625}, {"start": 6.45, "end": 6.87, "word": " Cardiac", "probability": 0.649658203125}, {"start": 6.87, "end": 7.73, "word": " Rehabilitation", "probability": 0.9244384765625}, {"start": 7.73, "end": 8.51, "word": " الـ", "probability": 0.61669921875}, {"start": 8.51, "end": 8.69, "word": " PART", "probability": 0.6632080078125}, {"start": 8.69, "end": 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"end": 1273.04, "text": "بدى اعمل range of motion exercise وبدى ازيد المسافة اللى انا بدى امشي فيها لـ 75 قدم يعني ما يقارب 22 متر بلشتها بـ 15 و بعدين ذهبت هنا لـ 22 and back average to face اللى هو basis range of motion الخطوة الخامسة and lesson 6 practice walking a few stairs steps walking 300 feet اللى هو 90 متر تمام", "tokens": [44510, 7578, 1975, 25957, 1211, 3613, 295, 5394, 5380, 4032, 44510, 7578, 1975, 11622, 25708, 9673, 3794, 31845, 3660, 13672, 7578, 1975, 8315, 47525, 7578, 1975, 2304, 8592, 1829, 8978, 11296, 5296, 39184, 9562, 12174, 40448, 37495, 22653, 19446, 7251, 4587, 9640, 3555, 5853, 44650, 2288, 4724, 1211, 8592, 2655, 11296, 4724, 39184, 2119, 4032, 39182, 9957, 29910, 3224, 3555, 2655, 34105, 5296, 39184, 5853, 293, 646, 4274, 281, 1851, 13672, 7578, 31439, 5143, 3613, 295, 5394, 33962, 9566, 2407, 3660, 33962, 10943, 3794, 3660, 293, 6898, 1386, 3124, 4494, 257, 1326, 13471, 4439, 4494, 6641, 3521, 13672, 7578, 31439, 4289, 44650, 2288, 46811, 10943], 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2094.79, "word": "-Indication", "probability": 0.5819498697916666}, {"start": 2094.79, "end": 2095.39, "word": " 15", "probability": 0.41455078125}, {"start": 2095.39, "end": 2096.71, "word": " items", "probability": 0.73486328125}, {"start": 2096.71, "end": 2096.93, "word": " أو", "probability": 0.9765625}, {"start": 2096.93, "end": 2097.47, "word": " 15", "probability": 0.9716796875}, {"start": 2097.47, "end": 2098.11, "word": " حلق", "probability": 0.7737630208333334}, {"start": 2098.11, "end": 2098.83, "word": " أو", "probability": 0.90380859375}, {"start": 2098.83, "end": 2104.17, "word": " 15", "probability": 0.60986328125}, {"start": 2104.17, "end": 2105.63, "word": " عنصر", "probability": 0.9703776041666666}, {"start": 2105.63, "end": 2106.01, "word": " ممنوعة", "probability": 0.8646240234375}, {"start": 2106.01, "end": 2106.15, "word": " أنا", "probability": 0.822265625}, {"start": 2106.15, "end": 2106.53, "word": " أشتغل", "probability": 0.99111328125}, {"start": 2106.53, "end": 2107.11, "word": " معاهم", "probability": 0.99462890625}, {"start": 2107.11, "end": 2107.53, "word": " في", "probability": 0.91552734375}, {"start": 2107.53, "end": 2107.79, "word": " اللي", "probability": 0.95166015625}, {"start": 2107.79, "end": 2108.15, "word": " هو", "probability": 0.98046875}, {"start": 2108.15, "end": 2109.49, "word": " الحلق،", "probability": 0.765380859375}, {"start": 2109.49, "end": 2110.21, "word": " الـExercise", "probability": 0.85673828125}, {"start": 2110.21, "end": 2110.43, "word": " في", "probability": 0.79443359375}, {"start": 2110.43, "end": 2110.91, "word": " الـthird", "probability": 0.7062174479166666}, {"start": 2110.91, "end": 2111.43, "word": " phase", "probability": 0.9326171875}, {"start": 2111.43, "end": 2111.95, "word": " اللي", "probability": 0.958984375}, {"start": 2111.95, "end": 2112.25, "word": " موجود", "probability": 0.9729817708333334}, {"start": 2112.25, "end": 2112.47, "word": " عندنا", "probability": 0.9013671875}, {"start": 2112.47, "end": 2113.15, "word": " للـcardiac", "probability": 0.7432861328125}, {"start": 2113.15, "end": 2113.53, "word": " rehabilitation", "probability": 0.7666015625}, {"start": 2113.53, "end": 2115.17, "word": " patient", "probability": 0.7939453125}], "temperature": 1.0}, {"id": 93, "seek": 212676, "start": 2116.02, "end": 2126.76, "text": "يعطيكوا ألف عافية وبهك بكون أنا خلصت ال part الأول ألقاكم بإذن الله في part اتنين بإذن الله والسلام عليكم ورحمة الله وبركاته", "tokens": [40228, 9566, 1829, 4117, 14407, 5551, 46538, 6225, 31845, 10632, 46599, 3224, 4117, 4724, 30544, 41850, 16490, 1211, 9381, 2655, 2423, 644, 16247, 12610, 5551, 1211, 4587, 995, 24793, 4724, 28814, 8848, 1863, 21984, 8978, 644, 1975, 2655, 1863, 9957, 4724, 28814, 8848, 1863, 21984, 16070, 3794, 37440, 25894, 24793, 4032, 2288, 35571, 3660, 21984, 4032, 26890, 4117, 9307, 3224], "avg_logprob": -0.14267418716774613, "compression_ratio": 1.5797101449275361, "no_speech_prob": 1.7285346984863281e-06, "words": [{"start": 2116.02, "end": 2116.6, "word": "يعطيكوا", "probability": 0.74169921875}, {"start": 2116.6, "end": 2116.82, "word": " ألف", "probability": 0.799072265625}, {"start": 2116.82, "end": 2117.36, "word": " عافية", "probability": 0.9689127604166666}, {"start": 2117.36, "end": 2117.86, "word": " وبهك", "probability": 0.5863444010416666}, {"start": 2117.86, "end": 2118.2, "word": " بكون", "probability": 0.760009765625}, {"start": 2118.2, "end": 2118.42, "word": " أنا", "probability": 0.73095703125}, {"start": 2118.42, "end": 2118.92, "word": " خلصت", "probability": 0.98583984375}, {"start": 2118.92, "end": 2118.98, "word": " ال", "probability": 0.91943359375}, {"start": 2118.98, "end": 2119.18, "word": " part", "probability": 0.8916015625}, {"start": 2119.18, "end": 2119.7, "word": " الأول", "probability": 0.907958984375}, {"start": 2119.7, "end": 2120.4, "word": " ألقاكم", "probability": 0.88662109375}, {"start": 2120.4, "end": 2120.74, "word": " بإذن", "probability": 0.9580078125}, {"start": 2120.74, "end": 2120.98, "word": " الله", "probability": 0.9501953125}, {"start": 2120.98, "end": 2121.6, "word": " في", "probability": 0.65380859375}, {"start": 2121.6, "end": 2122.04, "word": " part", "probability": 0.96044921875}, {"start": 2122.04, "end": 2122.62, "word": " اتنين", "probability": 0.8494873046875}, {"start": 2122.62, "end": 2123.46, "word": " بإذن", "probability": 0.9696044921875}, {"start": 2123.46, "end": 2124.46, "word": " الله", "probability": 0.95703125}, {"start": 2124.46, "end": 2125.14, "word": " والسلام", "probability": 0.8850911458333334}, {"start": 2125.14, "end": 2125.54, "word": " عليكم", "probability": 0.96533203125}, {"start": 2125.54, "end": 2125.94, "word": " ورحمة", "probability": 0.97802734375}, {"start": 2125.94, "end": 2126.08, "word": " الله", "probability": 0.96875}, {"start": 2126.08, "end": 2126.76, "word": " وبركاته", "probability": 0.98837890625}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 2184.1850625, "duration_after_vad": 2096.0393749999926}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/T3cTeEw_ujw_raw.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/T3cTeEw_ujw_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..a2361a1cc4789281ea7fc88429916995645af0eb
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/T3cTeEw_ujw_raw.srt
@@ -0,0 +1,2092 @@
+1
+00:00:00,910 --> 00:00:04,790
+صلاة والسلام على أشرف الأنبياء والمرسلين سأتحدث في
+
+2
+00:00:04,790 --> 00:00:08,690
+هذا الفيديو عن الـ Cardiac Rehabilitation الـ PART
+
+3
+00:00:08,690 --> 00:00:13,730
+الأول قمت بتجزئة المحاضرةالى قسمين part 1 و part 2
+
+4
+00:00:13,730 --> 00:00:18,830
+بإذن الله سأتحدث في هذا ال part عن شو يعني كلمة ال
+
+5
+00:00:18,830 --> 00:00:23,010
+rehabilitation عن شو يعني ال faces تبع ال
+
+6
+00:00:23,010 --> 00:00:26,930
+rehabilitation و ال program اللى انا ازأ فيزيو
+
+7
+00:00:26,930 --> 00:00:31,150
+ثيرابي بدي اعطيه ل ال cardiac patient نبدأ على
+
+8
+00:00:31,150 --> 00:00:36,080
+بركة اللهحكيت بدي أتكلم عن الـ definition الـ
+
+9
+00:00:36,080 --> 00:00:39,220
+objectives تبعتي ال indication و ال contra
+
+10
+00:00:39,220 --> 00:00:42,420
+indication ال rehabilitation team members من هما
+
+11
+00:00:42,420 --> 00:00:47,220
+ال faces of cardiac rehabilitation شو يعني ال
+
+12
+00:00:47,220 --> 00:00:49,280
+rehabilitation؟ ال rehabilitation هي عبارة عن
+
+13
+00:00:49,280 --> 00:00:55,400
+عملية إعادة تأهيل المريض إجته على سبيل المثال ذبح
+
+14
+00:00:55,400 --> 00:01:00,910
+صدريةأدت لفقط دوره في البيت فقط دوره في المجتمع
+
+15
+00:01:00,910 --> 00:01:05,090
+فبالتالي أنا كفيزيو ثيرابيست مع ال rehabilitation
+
+16
+00:01:05,090 --> 00:01:09,850
+team members اللي هم موجودين معايا هنعمل على
+
+17
+00:01:09,850 --> 00:01:14,970
+إعادته as much as possible إذن rehabilitation is a
+
+18
+00:01:14,970 --> 00:01:18,410
+therapeutic process designed to facilitate maximal
+
+19
+00:01:18,410 --> 00:01:23,530
+restrictions of function each patient must be
+
+20
+00:01:23,530 --> 00:01:27,250
+individually assessedto determine diagnoses
+
+21
+00:01:27,250 --> 00:01:32,430
+associated disorders response and achievable goals
+
+22
+00:01:32,430 --> 00:01:38,290
+كل مريض هو فريد من نوعه حتى لو أنا دخلت ال ICU وكل
+
+23
+00:01:38,290 --> 00:01:42,310
+هذا موجود اللي عندي مرضى قلب لكن كل حالة فريدة من
+
+24
+00:01:42,310 --> 00:01:46,790
+نوعها ممكن هذا يكون عنده MI with hypertension لكن
+
+25
+00:01:46,790 --> 00:01:51,630
+التاني MI with diabetes تمام فبالتالي كل حالة هي
+
+26
+00:01:51,630 --> 00:01:57,040
+فريدة من نوعها في التقييم اللي أنا بدي أقيمهالـ
+
+27
+00:01:57,040 --> 00:02:00,580
+objectives تبعتي عندي خمسة objectives لازم انا
+
+28
+00:02:00,580 --> 00:02:08,180
+اؤكد او احطها امام عينيه reverse pathophysiologic
+
+29
+00:02:08,180 --> 00:02:13,740
+and psychosocial effect لل heart disease بدي اشوف
+
+30
+00:02:13,740 --> 00:02:18,940
+شو الانتكاسات الباتولوجية او ال psychosocial على
+
+31
+00:02:18,940 --> 00:02:24,320
+مريض القلبlimited risk for reinfarction أنا بحكي
+
+32
+00:02:24,320 --> 00:02:29,240
+reinfarction أو صدن death يعني recurrent attack
+
+33
+00:02:29,240 --> 00:02:34,240
+نوبة جديدة متجددة relief للـ cardiac symptoms
+
+34
+00:02:34,240 --> 00:02:39,680
+أيضًا retired أو reverse للـ atherosclerosis by
+
+35
+00:02:39,680 --> 00:02:42,860
+instituting program for exercise training
+
+36
+00:02:42,860 --> 00:02:47,840
+education counseling and risk factor alterations
+
+37
+00:02:47,840 --> 00:02:55,160
+بدي أحاولأحفظ أو أستعيد الحالات بالـ training بالـ
+
+38
+00:02:55,160 --> 00:02:59,460
+education بالتفقيف الصحي هل الـ risk factor ده
+
+39
+00:02:59,460 --> 00:03:03,080
+المستمر نفسه ولا فيه اتغير إجاني كمان risk factor
+
+40
+00:03:03,080 --> 00:03:08,180
+آخر Regenerated للheart disease patients into
+
+41
+00:03:08,180 --> 00:03:10,980
+successful function status in their family and
+
+42
+00:03:10,980 --> 00:03:14,720
+society الـ family والpatient هم الـ center تبعنا
+
+43
+00:03:14,720 --> 00:03:17,810
+في عملية الـ rehabilitationكل الأمور وكل ال
+
+44
+00:03:17,810 --> 00:03:22,310
+objectives لازم تحوم وتدور حول ال patient and
+
+45
+00:03:22,310 --> 00:03:30,650
+family ال
+
+46
+00:03:30,650 --> 00:03:33,410
+indication في أي حالات انا بدي استخدم ال
+
+47
+00:03:33,410 --> 00:03:36,550
+rehabilitation program recent myocardial
+
+48
+00:03:36,550 --> 00:03:40,540
+infarction تمامفي حالات الـ Recent Myocardial
+
+49
+00:03:40,540 --> 00:03:45,220
+Infarction في حالات الـ Coronary Bypasses توقيع
+
+50
+00:03:45,220 --> 00:03:49,780
+للشريان التاجي الـ Valve Severy Coronary
+
+51
+00:03:49,780 --> 00:03:54,920
+Angioplasty Inserting and Inflating in Tiny
+
+52
+00:03:54,920 --> 00:03:59,260
+Balloons زي ما انتوا شايفين هذه العملية بيروح عشان
+
+53
+00:03:59,260 --> 00:04:04,700
+بيوسع اللي هو الضيق اللي صار هنا في الشريانفي بلون
+
+54
+00:04:04,700 --> 00:04:10,520
+صغير وبتم وضعه زى شفاط العصير تقريبا هو كتير رقيق
+
+55
+00:04:10,520 --> 00:04:15,940
+علشان يعمل توسعة لمرور ال blood cardiac
+
+56
+00:04:15,940 --> 00:04:19,400
+transplantation بستخدم ال rehabilitation program
+
+57
+00:04:19,400 --> 00:04:23,320
+هذا في حالات ال cardiac transplantation في حالات
+
+58
+00:04:23,320 --> 00:04:26,760
+ال angina في حالات ال compensated cardio heart
+
+59
+00:04:26,760 --> 00:04:32,010
+failure اللى هو فشل عضلة القلبالـ exercise هذا الـ
+
+60
+00:04:32,010 --> 00:04:36,750
+prescriptions depends on result exercise testing
+
+61
+00:04:36,750 --> 00:04:40,050
+which often include cardiopulmonary exercise
+
+62
+00:04:40,050 --> 00:04:43,490
+testing في عندي exercise testing عنده هناخده في
+
+63
+00:04:43,490 --> 00:04:47,990
+بارة اتنين هذا ال exercise مخصص لحالات ال cardiac
+
+64
+00:04:47,990 --> 00:04:53,780
+diseaseاللي هو بقيس مدى تحمل المريض لهذا التمرين
+
+65
+00:04:53,780 --> 00:04:57,180
+الآن زي ما انتوا شايفين في هذه الصورة الـ
+
+66
+00:04:57,180 --> 00:05:00,480
+Physiotherapist عيونه على الـ Monitoring اللي هي
+
+67
+00:05:00,480 --> 00:05:04,750
+الشاشة اللي براقب فيها heart rateوبراقب فيها ال
+
+68
+00:05:04,750 --> 00:05:08,210
+respiratory rate وبراقب فيها كل ال vital signs أنا
+
+69
+00:05:08,210 --> 00:05:11,230
+هنا بتكلم على مريض قلب، مابتكلم على أي مريض عادي
+
+70
+00:05:11,230 --> 00:05:15,530
+مريض قلب لازم انا أكون with good supervision لازم
+
+71
+00:05:15,530 --> 00:05:18,930
+أكون مراقبه بشكل جيد على أساس إنه هي مثل إتحاء أو
+
+72
+00:05:18,930 --> 00:05:22,230
+موت افرض لسمح الله إيش هت attack، افرض صار فيه
+
+73
+00:05:22,230 --> 00:05:25,510
+مشكلة فلازم ال physiotherapist و أي team members
+
+74
+00:05:25,510 --> 00:05:31,860
+موجود معاه لازم يكون مراقب له بشكل دقيق جدالمين
+
+75
+00:05:31,860 --> 00:05:35,360
+أنا مش ممكن أعمل اللي هو rehabilitation program؟
+
+76
+00:05:35,360 --> 00:05:39,420
+Severe residual angina Uncompensated heart failure
+
+77
+00:05:39,420 --> 00:05:44,780
+تمام Uncontrolled Arthmia Severe ischemia Left
+
+78
+00:05:44,780 --> 00:05:48,140
+ventricular dysfunction أو الأرثميا during
+
+79
+00:05:48,140 --> 00:05:52,580
+exercise testing صار عدم انتظام لضغط القلب هنا أنا
+
+80
+00:05:52,580 --> 00:05:56,260
+ممنوع أشتغل معاهم نهائي هذه الناس Poor control
+
+81
+00:05:56,260 --> 00:06:01,010
+hypertensionالحالات اللي هي في عندها صعوبة في
+
+82
+00:06:01,010 --> 00:06:05,570
+التحكم في اللي هو ضغط الدم مرة بنلاقيه عالي جدا و
+
+83
+00:06:05,570 --> 00:06:08,710
+بعدين بينخفض و بعدين بيرجع بيعلى هنا ممنوع أنا
+
+84
+00:06:08,710 --> 00:06:11,650
+أشتغل معاهم بتاعة الـhypertensive أو
+
+85
+00:06:11,650 --> 00:06:14,710
+الـhypotensive للـ systolic blood pressure عارفي
+
+86
+00:06:14,710 --> 00:06:17,670
+في إشي هنا systolic و في إشي هنا diastolic الآن
+
+87
+00:06:17,670 --> 00:06:20,890
+الناس اللي صار عندهم hypertensive أو hypotensive
+
+88
+00:06:20,890 --> 00:06:24,670
+كمان ممنوع أشتغل عندهمالـ unstable الـ medically
+
+89
+00:06:24,670 --> 00:06:26,990
+unstable في حالات الـ medically unstable زي
+
+90
+00:06:26,990 --> 00:06:30,910
+الحالات اللي هي الـ diabetes على سبيل المثال صار
+
+91
+00:06:30,910 --> 00:06:34,350
+لو إيجي عنده كومة سكر زي ما بنحكيها إحنا بالـ
+
+92
+00:06:34,350 --> 00:06:37,750
+common أو إنه مثلا على سبيل المثال صار في عندنا
+
+93
+00:06:37,750 --> 00:06:41,250
+ارتفاع مفالق في السكر هنا كمان نفسي ممنوع أنا
+
+94
+00:06:41,250 --> 00:06:47,120
+أشتغل معها لأنه لازم أحافظ على الحالةالعامة للمريض
+
+95
+00:06:47,120 --> 00:06:50,320
+التابعة الصحية تكون stable عشان أنا ماقش أشغل معاه
+
+96
+00:06:50,320 --> 00:06:54,540
+في ال physiology program تبعي يكون هو في حالة
+
+97
+00:06:54,540 --> 00:06:58,340
+stableهي الـ contra indication ال rehabilitation
+
+98
+00:06:58,340 --> 00:07:02,700
+team members هم مين؟ أول إشي أخدت اللي هو عنصر ال
+
+99
+00:07:02,700 --> 00:07:06,040
+patient and his family ال patient و ال family مهم
+
+100
+00:07:06,040 --> 00:07:10,060
+جدا إنه أنا أحطهم بال center ليش؟ عشان أنا ال
+
+101
+00:07:10,060 --> 00:07:13,460
+patient و ال family تبعته must never overlooked as
+
+102
+00:07:13,460 --> 00:07:17,280
+a member of prescribing team prescribing teamsلازم
+
+103
+00:07:17,280 --> 00:07:21,720
+أنا أحطهم وما أجهل دور العائلة تماما لازم أحطها في
+
+104
+00:07:21,720 --> 00:07:25,860
+المنتصف ال «home program» هو العائلة اللي هتقوم
+
+105
+00:07:25,860 --> 00:07:29,220
+فيه أنا ماحكن موجود مع المريض بعد ما يطلع من ال
+
+106
+00:07:29,220 --> 00:07:32,080
+«inpatient» «The patient and his family must be
+
+107
+00:07:32,080 --> 00:07:35,300
+made aware of a program in which is about to enter
+
+108
+00:07:35,300 --> 00:07:38,400
+with implications» أيضا في عملية التنفيذ لازم يكون
+
+109
+00:07:38,400 --> 00:07:41,680
+موجود معايا حدا من ال «family members» اللي أنا
+
+110
+00:07:41,680 --> 00:07:45,740
+بين قوسين بسميهم ال «caregivers» أو مقدمي الرعاية
+
+111
+00:07:46,020 --> 00:07:48,920
+They must be oriented available types of
+
+112
+00:07:48,920 --> 00:07:51,660
+mechanical aids and individual advantages and
+
+113
+00:07:51,660 --> 00:07:55,240
+disadvantages related patients personal and work
+
+114
+00:07:55,240 --> 00:07:58,860
+needs لازم انا اكون عارفة ايش ال exercise او ايش
+
+115
+00:07:58,860 --> 00:08:00,880
+ال machine اللي انا على سبيل المثال بدي اشتغل
+
+116
+00:08:00,880 --> 00:08:04,420
+عليها شو ال advantage شو ال disadvantage يعني اكون
+
+117
+00:08:04,420 --> 00:08:08,720
+عاملة اجابة لكل سؤال محتمل انه انا انسقلهمن أهل ال
+
+118
+00:08:08,720 --> 00:08:12,500
+patient على سبيل المثال لو أنا بدي أشغله او انا
+
+119
+00:08:12,500 --> 00:08:15,560
+بدي أدربه على ال treadmill بدي أحكيله ان انت مزدس
+
+120
+00:08:15,560 --> 00:08:20,140
+سرعة كذا ما تعمل كذا لأن هذا وضعك بيعمل مخاطر هيك
+
+121
+00:08:20,140 --> 00:08:24,900
+و بيعمل مخاطر و بكون أفضل لو كان بسرعة كذا اذا حتى
+
+122
+00:08:24,900 --> 00:08:29,480
+في التنفيذ في عملية تنفيذ ال exercise بيكون
+
+123
+00:08:29,480 --> 00:08:34,240
+للعائلة دور و بتكون موجودة معايا في ال center ال
+
+124
+00:08:34,240 --> 00:08:39,690
+physicians الطبيبهو الـ Guides تبعت كل العملية
+
+125
+00:08:39,690 --> 00:08:44,550
+التأهيلية بناءً على التحويلة تبعت الدكتور القلب
+
+126
+00:08:44,550 --> 00:08:49,490
+أنا بشتغل، مافيش تحويلة، ممنوع تشتغل، إذا الفيزيشن
+
+127
+00:08:49,490 --> 00:08:54,230
+هو الـ leader and coordinator لل team، he attends
+
+128
+00:08:54,230 --> 00:08:58,830
+to all medical aspects of individual cases، هو ال
+
+129
+00:08:58,830 --> 00:09:03,280
+leaderوالله عندك تحويلة اتفضل تعال فوت على قسم
+
+130
+00:09:03,280 --> 00:09:07,800
+الفيزياثرابي ماعندك لأ أنا أسفة بس مابشتغل معاك لو
+
+131
+00:09:07,800 --> 00:09:11,220
+صار مسار لل patient هادي مسئولية الدكتور اللي هو
+
+132
+00:09:11,220 --> 00:09:14,120
+بتابع معاه the physician referring patient should
+
+133
+00:09:14,120 --> 00:09:18,370
+be state diagnosisالـ Present Condition of Patient
+
+134
+00:09:18,370 --> 00:09:21,990
+Limitation أو الـ Percussions to Be Observed
+
+135
+00:09:21,990 --> 00:09:25,130
+Prognosis والـ Result كمان To Be Achieved and
+
+136
+00:09:25,130 --> 00:09:28,870
+Frequency و Length of Treatment لازم هي تكون
+
+137
+00:09:28,870 --> 00:09:34,070
+محتوطة الخطة بوجود اللي هو الدكتور اللي هو دكتور
+
+138
+00:09:34,070 --> 00:09:37,690
+القلب لإنه عارف على سبيل المثال عضلة القلب بتشتغل
+
+139
+00:09:37,690 --> 00:09:42,750
+اليوم 30% ما بدها long exercise ما بدها strong
+
+140
+00:09:42,750 --> 00:09:46,560
+intensity للexercise على سبيل المثالفبالتالي
+
+141
+00:09:46,560 --> 00:09:50,100
+الدكتور هو اللي موجود هو اللي هيحدد معايا إيش أنا
+
+142
+00:09:50,100 --> 00:09:55,480
+ممكن أعمل الـ OT و الـ PT in the treatment of
+
+143
+00:09:55,480 --> 00:09:58,200
+physical disabilities the physical therapy have
+
+144
+00:09:58,200 --> 00:10:02,460
+similar ultimate goal namely to contribute the
+
+145
+00:10:02,460 --> 00:10:06,400
+restoration of physical function للpatient as much
+
+146
+00:10:06,400 --> 00:10:10,000
+as possible أنا بحكي إنه أنا أعيد المريض تبعي
+
+147
+00:10:10,000 --> 00:10:13,780
+لوضعه اللي كان عليه في السابق قبل عملية الانجينة
+
+148
+00:10:13,780 --> 00:10:17,520
+تمام؟As much as possible احنا بنحكيه Psychologists
+
+149
+00:10:17,520 --> 00:10:21,560
+و Psychiatrists مهم كتير عندنا الدعم النفسي خصوصا
+
+150
+00:10:21,560 --> 00:10:26,160
+انه مريض اتعرض لمشكلة اتعرض لذبح قلبية او ذبح
+
+151
+00:10:26,160 --> 00:10:29,920
+صدرية بين قوسين ان هو هيدخل في حالة من الاكتئاب
+
+152
+00:10:29,920 --> 00:10:33,660
+حالة في عدم الاستقرار النفسي لان حياته مهددة
+
+153
+00:10:33,660 --> 00:10:37,410
+بالخطرto provide information concerning the
+
+154
+00:10:37,410 --> 00:10:40,650
+patient's mental ability الـ emotional adjustment
+
+155
+00:10:40,650 --> 00:10:43,930
+أيضًا الـ interested and vocational outputs الـ
+
+156
+00:10:43,930 --> 00:10:47,990
+mental abilities كل هذه الأمور وإن هو هل هيرجع
+
+157
+00:10:47,990 --> 00:10:52,290
+لوظيفته و لا مش هيرجع كيف هيكون دوره في البيت هل
+
+158
+00:10:52,290 --> 00:10:56,730
+هو كان مثلًا قبل أطفال هل هو هيرجع معيد لهذه
+
+159
+00:10:56,730 --> 00:11:00,310
+الأسرة و لا لأ هذه الأمور بتأثر في نفسية مريض
+
+160
+00:11:00,310 --> 00:11:04,370
+القلبأيضًا في عنا ال social service هم ما زلنا
+
+161
+00:11:04,370 --> 00:11:07,850
+مكملين اللي هم ال rehabilitation members ال social
+
+162
+00:11:07,850 --> 00:11:11,210
+service اللي هو ال social worker ال social worker
+
+163
+00:11:11,210 --> 00:11:14,750
+أيضًا بيساعد ال patient و ال family على إنهم
+
+164
+00:11:14,750 --> 00:11:18,390
+يتجاوزوا هذه المرحلة الأليمة من حياتهم ممكن بإيجاد
+
+165
+00:11:18,390 --> 00:11:23,350
+حلول لوظيفة أخرى أو وظيفة مناسبة حسب ال
+
+166
+00:11:23,350 --> 00:11:26,790
+disabilities اللي صارت عند المريض ال nurse طبعًا
+
+167
+00:11:26,790 --> 00:11:30,130
+هو العمود الفقري تبعنا و اللي بيكون متابع المريض
+
+168
+00:11:30,130 --> 00:11:34,890
+في كل أموره الطبيةأيضا ال nutritious اللي هو
+
+169
+00:11:34,890 --> 00:11:40,190
+العالم التغذية أنه لازم يكون تواصله مع مرضى أو
+
+170
+00:11:40,190 --> 00:11:45,670
+مريض القلب بشكل مباشر ليه؟ لأنه هيتابع معاهم هذا
+
+171
+00:11:45,670 --> 00:11:49,860
+الطعام high cholesterol هذا الطعام لأ كويسفده كلقه
+
+172
+00:11:49,860 --> 00:11:53,560
+high lipid الأمور هذه مهمة جدا في مرض القلب لأنه
+
+173
+00:11:53,560 --> 00:11:58,660
+لو لصمح الله زاد عندي أي إشي مش مفيد لجسم الإنسان
+
+174
+00:11:58,660 --> 00:12:02,000
+أو أنه مثلا على سبيل المثال قام بأكل لحم حمراء
+
+175
+00:12:02,000 --> 00:12:06,080
+غنية بالدهون فبالتالي هنا عملتله ارتفاع في نسبة
+
+176
+00:12:06,080 --> 00:12:09,570
+الكوليسترول في الدم هذا هيزيد من risk factorإنه
+
+177
+00:12:09,570 --> 00:12:12,590
+ممكن يصير في عندي thrombus وممكن يصير في عندي
+
+178
+00:12:12,590 --> 00:12:17,810
+مشاكل أخرى إذا الأخصائي التغذية مهم جدا يكون دوره
+
+179
+00:12:17,810 --> 00:12:21,390
+في مرضى القلب في ال rehabilitation members لمرضى
+
+180
+00:12:21,390 --> 00:12:25,380
+القلبVocational Counseling اللي هو المرشد تبع
+
+181
+00:12:25,380 --> 00:12:29,020
+الوظيفة أو المرشد ال vocational اللي هو تدريبي أو
+
+182
+00:12:29,020 --> 00:12:32,080
+المهني ال program frequently begins in hospitals
+
+183
+00:12:32,080 --> 00:12:35,680
+seating constitute outpatient bases after the
+
+184
+00:12:35,680 --> 00:12:39,160
+patient is discharged تمام؟ لأن هو بدى يعرف حاله
+
+185
+00:12:39,160 --> 00:12:43,320
+وين هل هو بدى بيبقى في وظيفته؟ هو موظف وزارة على
+
+186
+00:12:43,320 --> 00:12:46,960
+سبيل المثال؟ كان قاعد على مكتب؟فبالتالي هل هو
+
+187
+00:12:46,960 --> 00:12:51,540
+هيكمل ولا هيشوف وظيفة تانية تناسب الإعاقة اللي
+
+188
+00:12:51,540 --> 00:12:56,080
+استحبته بعد الـ Angina هذا الاشي بياخد اللي هو
+
+189
+00:12:56,080 --> 00:13:00,300
+بيكون في فترة من 6 ل 12 شهر لما بعد حدوث ال attack
+
+190
+00:13:00,300 --> 00:13:03,920
+الآن بدي أتحدث عن ال faces ل ال cardiac
+
+191
+00:13:03,920 --> 00:13:07,660
+rehabilitation عندي تلاتة facesالـ cardiac
+
+192
+00:13:07,660 --> 00:13:10,420
+rehabilitation includes three phases الفيس
+
+193
+00:13:10,420 --> 00:13:14,040
+الأولاني أو first phase اللي هو initiated while
+
+194
+00:13:14,040 --> 00:13:17,720
+patient is still in the hospital من لحظة وقوع ال
+
+195
+00:13:17,720 --> 00:13:22,180
+attack سواء كانت اللي هي ال myocardial infarction
+
+196
+00:13:22,180 --> 00:13:26,180
+أو ال atherosclerosis أو أي شيء من لحظة وقوعها
+
+197
+00:13:26,180 --> 00:13:29,680
+للحظة ال patient ما بقى في ال hospital في ال
+
+198
+00:13:29,680 --> 00:13:33,340
+inpatient departmentأما الـ phase التانية أو
+
+199
+00:13:33,340 --> 00:13:35,840
+second phase that is supervised ambulatory
+
+200
+00:13:35,840 --> 00:13:40,120
+outpatient program spanning تاخد المرحلة من تلت
+
+201
+00:13:40,120 --> 00:13:44,160
+لست شهور هي المرحلة التانية هنا فيها ال exercise
+
+202
+00:13:44,160 --> 00:13:46,760
+وفيها ال ambulatory وفيها ال ambulation وفيها كل
+
+203
+00:13:46,760 --> 00:13:50,600
+الأمور هي ال phase التالتة أو third phase اللي هي
+
+204
+00:13:50,600 --> 00:13:53,940
+a lifetime maintenance phase in which physical
+
+205
+00:13:53,940 --> 00:13:56,080
+fitness as well as additional risk factors
+
+206
+00:13:56,080 --> 00:14:01,110
+reduction are emphasizedالـ «I'll face» اللي هي
+
+207
+00:14:01,110 --> 00:14:04,790
+النهائية اللي بتستمر مع مرضي القلب على المدى
+
+208
+00:14:04,790 --> 00:14:08,210
+البعيد على مدى حياته إنه أنا بدأ أشتغل معاه بحيث
+
+209
+00:14:08,210 --> 00:14:12,510
+إنه يكون physically good يكون في عندي أيضًا إن ال
+
+210
+00:14:12,510 --> 00:14:17,970
+risk factor كمان reduced إنه قلت ما صار زي زمان إن
+
+211
+00:14:17,970 --> 00:14:21,810
+هو كان heavy smoker وكان هدى من ال risk factor
+
+212
+00:14:21,810 --> 00:14:24,790
+عشان يعملي ال «I'm I» فبالتالي أنا إذا خففتها
+
+213
+00:14:24,790 --> 00:14:28,740
+معناة الحكي إنه أنا قللت من ال risk factorشو ال
+
+214
+00:14:28,740 --> 00:14:31,620
+basic program اللي انا هشتغل عليه؟ traditionally
+
+215
+00:14:31,620 --> 00:14:34,160
+cardiac rehabilitation is divided into three
+
+216
+00:14:34,160 --> 00:14:37,580
+phases في عند ال essential medically ال
+
+217
+00:14:37,580 --> 00:14:41,420
+educational and exercise component beginning to
+
+218
+00:14:41,420 --> 00:14:44,480
+apply during each phase each patent progression
+
+219
+00:14:44,480 --> 00:14:49,080
+according to الآن مش كل المرضى اللي موجودين في ال
+
+220
+00:14:49,080 --> 00:14:53,300
+ICU تبع القلب على سبيل المثال أو في قسمجراحة القلب
+
+221
+00:14:53,300 --> 00:14:58,160
+كلهم لهم نفس الدرجة في ال recovery أو عملية ال
+
+222
+00:14:58,160 --> 00:15:01,100
+recovery process هذا بيتمد على إيش؟ على طبيعة
+
+223
+00:15:01,100 --> 00:15:04,800
+المريض ال natural سواء طبيعة ال angina اللي صارت
+
+224
+00:15:04,800 --> 00:15:09,040
+في أحيانا لأن اللي هو ال thombus أو الخسر الدموية
+
+225
+00:15:09,040 --> 00:15:13,140
+اللي عمل الإنسداد للشريان التاجي بتكون بسيطة ممكن
+
+226
+00:15:13,140 --> 00:15:19,150
+تروح مع اللي هو الالأدوية الممية على الدم لكن في
+
+227
+00:15:19,150 --> 00:15:22,670
+ثرومبس بتكون كبيرة يجب أن يكون هناك فيه تدخل جراحي
+
+228
+00:15:22,670 --> 00:15:25,410
+إذا ال natural of disease أو ال natural of
+
+229
+00:15:25,410 --> 00:15:30,470
+problems ال severity of illness كام هي حدتها؟ هل
+
+230
+00:15:30,470 --> 00:15:34,330
+إجته ال attack مباشرة؟ هل إنه إجته تدريجي
+
+231
+00:15:34,330 --> 00:15:39,090
+gradually؟ كيف وضعها؟ هل هي severe ولا mild ولا
+
+232
+00:15:39,090 --> 00:15:42,890
+moderate ولا simple؟ شو وضعها؟ وشو حدتها؟الـ
+
+233
+00:15:42,890 --> 00:15:46,110
+Complication إيش المضاعفات اللي قعدتني إياها على
+
+234
+00:15:46,110 --> 00:15:49,070
+سبيل المثال صار في عندي مشكلة بالبصر، مشكلة في
+
+235
+00:15:49,070 --> 00:15:52,550
+السمع، مشكلة في الحركة، إذا إيش صار في عندي
+
+236
+00:15:52,550 --> 00:15:56,250
+Complication؟أيضا بتعتمد اللي هو ال progression
+
+237
+00:15:56,250 --> 00:16:00,090
+تبعي أو التحسن بيعتمد على rate of recovery كم هي
+
+238
+00:16:00,090 --> 00:16:04,070
+معدل الشفاء أو كيف ممكن هل هو بتجاوب معايا بسرعة و
+
+239
+00:16:04,070 --> 00:16:10,930
+بيصير كويس ولا لسه مغيب و في وضع اللي هو وضع مش
+
+240
+00:16:10,930 --> 00:16:14,770
+مظبوط و لسه بيعاني هذا الاشي اللي هو أو الأربعة
+
+241
+00:16:14,770 --> 00:16:18,210
+factors هدولة هم اللي بيحددوني ال progression اللي
+
+242
+00:16:18,210 --> 00:16:22,320
+أنا حكيت عليهالـ Phase الأولاني حكينا لستاتنا احنا
+
+243
+00:16:22,320 --> 00:16:26,060
+هنا في الـ Inpatient Hospital زي ما انتوا شايفين و
+
+244
+00:16:26,060 --> 00:16:29,500
+معاها الـ Physiotherapist اللي هي عاملالها support
+
+245
+00:16:29,500 --> 00:16:33,860
+في حالة الـ acute هذه المرحلات تستمر من 7 إلى 14
+
+246
+00:16:33,860 --> 00:16:37,840
+يوم في ال duration تبعتها و بتكون في ال Inpatient
+
+247
+00:16:37,840 --> 00:16:42,880
+Hospital هلأ شو أهدافي انا ك Physiotherapist؟to
+
+248
+00:16:42,880 --> 00:16:46,780
+initiated early physical therapy activities اللي
+
+249
+00:16:46,780 --> 00:16:50,240
+هي return للactivity daily living decrease
+
+250
+00:16:50,240 --> 00:16:54,180
+للanxiety and depression ايضا بت remind لل effect
+
+251
+00:16:54,180 --> 00:16:58,340
+of medication prevent effect للي بيرنجت بدرست انه
+
+252
+00:16:58,340 --> 00:17:02,980
+انا ما اخلي ناية مع الاسريرو يصير في عندي مشاكل لـ
+
+253
+00:17:02,980 --> 00:17:06,060
+circulation على تابعي المثال زي الـ DVT زي أي
+
+254
+00:17:06,060 --> 00:17:10,300
+مشاكل أخرى الـ PEDSOR مثلا كل المشاكل الناتجة أو
+
+255
+00:17:10,300 --> 00:17:16,840
+الحاصلة نتيجة اللي هو الـ PEDSORالهدف التاني to
+
+256
+00:17:16,840 --> 00:17:20,480
+initiated لل patient and family education لأن أنا
+
+257
+00:17:20,480 --> 00:17:24,540
+حكيت ال family members مهم جدا أنه أنا أحط معاهم
+
+258
+00:17:24,540 --> 00:17:27,780
+الخطة ويكونوا موجودين معايا وقت ال implementations
+
+259
+00:17:27,780 --> 00:17:30,820
+اللي هو وقت التنفيذ أ outline the course of
+
+260
+00:17:30,820 --> 00:17:34,480
+cardiac rehabilitation قضة مضيفة لل risk factor في
+
+261
+00:17:34,480 --> 00:17:39,290
+الatherosclerosisخلال الريسيس الأولاني الـ rate of
+
+262
+00:17:39,290 --> 00:17:42,050
+progression of people who have myocardial
+
+263
+00:17:42,050 --> 00:17:46,910
+infarction is slightly slower than for those who
+
+264
+00:17:46,910 --> 00:17:52,330
+have coronary artery processography الناس اللي هي
+
+265
+00:17:52,330 --> 00:17:58,980
+عندها MIبتتحسن بشكل أبطأ من الناس اللي هي عملت
+
+266
+00:17:58,980 --> 00:18:03,740
+عملية ترقيع لشريان التاجي ليه؟ هذا الأشي أخدناه من
+
+267
+00:18:03,740 --> 00:18:08,780
+دراسات متعددة ناتج ليش؟ لأنه الميء الـMI هي عبارة
+
+268
+00:18:08,780 --> 00:18:13,320
+عن احتشاق عضلة القلبفبالتالي هنا بتفقد جزء أو
+
+269
+00:18:13,320 --> 00:18:18,060
+بتفقد اللي هو الوظيفة تبع ال heart بيبطل ال heart
+
+270
+00:18:18,060 --> 00:18:23,040
+يعمل pumping بشكل جيد فبالتالي ال recovery تبع هذا
+
+271
+00:18:23,040 --> 00:18:26,540
+ال patient بيكون أقل من ال recovery ل ال coronary
+
+272
+00:18:26,540 --> 00:18:30,300
+artery bypass graftالـ Mobilization of surgical
+
+273
+00:18:30,300 --> 00:18:34,160
+patients usually start early and intensity and
+
+274
+00:18:34,160 --> 00:18:37,360
+duration of ambulation are more accelerated كمان
+
+275
+00:18:37,360 --> 00:18:40,500
+الـ Mobilization اللي هي عملية الحركة في حالات
+
+276
+00:18:40,500 --> 00:18:45,800
+الجراحة بالأغلب بتبلش في اللي هو intensity خفيفة
+
+277
+00:18:45,800 --> 00:18:50,400
+وبعدين احنا تدريجيا بنزيدهاالأول في عندي الجدول
+
+278
+00:18:50,400 --> 00:18:54,040
+هذا اللي هو عبارة عن الـ Inpatient Hospitals أو
+
+279
+00:18:54,040 --> 00:18:56,480
+الـ Inpatient Rehabilitation Hospitals في سبعة
+
+280
+00:18:56,480 --> 00:18:59,600
+steps لـ Myocardial Infarction هذا الـ table هو
+
+281
+00:18:59,600 --> 00:19:03,800
+عبارة عن الـ table أربعة ال step الأولة بدي أعمل
+
+282
+00:19:03,800 --> 00:19:07,480
+active and passive exercise في داخل السترير أو في
+
+283
+00:19:07,480 --> 00:19:10,180
+اليوم الأول خليني أشتغل داخل السترير احنا ممكن
+
+284
+00:19:10,180 --> 00:19:14,460
+نشتغل معاه إذا هو medically stableوبرجع و بأكد إذا
+
+285
+00:19:14,460 --> 00:19:17,800
+مريضي medically stable أنا بفوت بشتغل معاه بناءً
+
+286
+00:19:17,800 --> 00:19:21,160
+على الـ referral paper من الدكتور تبعه teach
+
+287
+00:19:21,160 --> 00:19:24,540
+للpatient and plantar deflection اللي هي بين قصين
+
+288
+00:19:24,540 --> 00:19:28,380
+بسميها الـbumping exercise active range of motion
+
+289
+00:19:28,380 --> 00:19:32,580
+exercise لكل ال extremity سواء كانت upper and
+
+290
+00:19:32,580 --> 00:19:36,000
+lower limb sitting on the side of bed أو اللي هو
+
+291
+00:19:36,000 --> 00:19:39,460
+sitting at edge of bed كويس أنا أبدأ أجلس المريض
+
+292
+00:19:39,460 --> 00:19:43,310
+على حافة السرير warm-up exerciseأيضًا الـ
+
+293
+00:19:43,310 --> 00:19:47,450
+Stretching and Glutes Exercise اللي هو التمرين
+
+294
+00:19:47,450 --> 00:19:51,990
+الرياضي حوالي أنه يمشي خمسين قدم يعني ما يقارب
+
+295
+00:19:51,990 --> 00:19:57,230
+خمستاشر متر هدفي اللي هو ال step التالتة تمام؟
+
+296
+00:19:57,230 --> 00:20:00,270
+احنا لسه ما زلنا في ال impatient و هايلة حالات ال
+
+297
+00:20:00,270 --> 00:20:03,270
+myocardial infraction شو يعني التمرين الرياضي؟
+
+298
+00:20:03,270 --> 00:20:05,910
+التمرين الرياضي هنا هي عبارة عن الـ anaerobic
+
+299
+00:20:05,910 --> 00:20:09,890
+exercise تمام؟ اللي هي هوائيةusually without
+
+300
+00:20:09,890 --> 00:20:13,010
+weights and help to increase your strength and
+
+301
+00:20:13,010 --> 00:20:16,570
+flexibility بزيد القوة و ال flexibility ايضا
+
+302
+00:20:16,570 --> 00:20:18,910
+تمارين الرياضية هنا هي عبارة عن ال isotonic
+
+303
+00:20:18,910 --> 00:20:22,350
+exercise يعني ممكن يكون عن طريق اللي هو ال push
+
+304
+00:20:22,350 --> 00:20:27,010
+ups و ال sit ups و ال squatting و اللي هي ال lungs
+
+305
+00:20:27,010 --> 00:20:30,920
+طبعاكل هذه الأمور بتعمل اللي هي strengthening
+
+306
+00:20:30,920 --> 00:20:34,720
+exercise by resistance force إنه أنا بعمل push-up
+
+307
+00:20:34,720 --> 00:20:38,680
+بإيدي على الحرف على سبيل المثال فبالتالي بحصل على
+
+308
+00:20:38,680 --> 00:20:44,920
+اللي هو ال strengthening exercise step الرابعةبدى
+
+309
+00:20:44,920 --> 00:20:48,420
+اعمل range of motion exercise وبدى ازيد المسافة
+
+310
+00:20:48,420 --> 00:20:52,620
+اللى انا بدى امشي فيها لـ 75 قدم يعني ما يقارب 22
+
+311
+00:20:52,620 --> 00:20:57,860
+متر بلشتها بـ 15 و بعدين ذهبت هنا لـ 22 and back
+
+312
+00:20:57,860 --> 00:21:00,920
+average to face اللى هو basis range of motion
+
+313
+00:21:00,920 --> 00:21:05,580
+الخطوة الخامسة and lesson 6 practice walking a few
+
+314
+00:21:05,580 --> 00:21:13,040
+stairs steps walking 300 feet اللى هو 90 متر تمام
+
+315
+00:21:13,880 --> 00:21:18,480
+أيضا بينكمل كل اللي هو ال activities بالإضافة لل
+
+316
+00:21:18,480 --> 00:21:23,540
+walking down flight step return by elevators ارجعي
+
+317
+00:21:23,540 --> 00:21:28,140
+بي اللي هو المصعد ولكن امشي 500 قدم يعني ما يقارب
+
+318
+00:21:28,140 --> 00:21:34,260
+150 متر ال step السابع continue لل above
+
+319
+00:21:34,260 --> 00:21:37,580
+activities بدي أبلش من 1 ل 6 بالإضافة لإنه أنا بدي
+
+320
+00:21:37,580 --> 00:21:42,970
+أزيد ال walk up و ال light steps لأكتر من 500اللي
+
+321
+00:21:42,970 --> 00:21:47,490
+هو قدم هذا ال table هو table أربعة خاص باللي هو
+
+322
+00:21:47,490 --> 00:21:51,230
+rehabilitation programs لال myocardial infarction
+
+323
+00:21:51,230 --> 00:21:55,670
+اللي أنا نقلت أعمل إيقاف لهذا ال program في حالة
+
+324
+00:21:55,670 --> 00:21:59,930
+الفتيج في حالة ال failure of monitoring equipment
+
+325
+00:21:59,930 --> 00:22:03,920
+في حالة ال light hiddenالـ confusion أو الـ
+
+326
+00:22:03,920 --> 00:22:06,740
+cyanosis لو أنا حسيت أن المريض التابعي دخل في
+
+327
+00:22:06,740 --> 00:22:09,940
+تسيبنيا اللي هو difficulty to breathing على طول
+
+328
+00:22:09,940 --> 00:22:14,720
+بعمل stopping لـexercise إذا حس أنه نازية على طول
+
+329
+00:22:14,720 --> 00:22:19,100
+بعمل stopping honest لـangina و لـexercise أتار
+
+330
+00:22:19,100 --> 00:22:22,480
+angina جديدة على طول خلال أداء التمرين بعمل
+
+331
+00:22:22,480 --> 00:22:26,790
+stoppingالـ ST طبعا هي عبارة عن اللي هو هذا الشكل
+
+332
+00:22:26,790 --> 00:22:30,290
+اللي موجود عندنا اللي هو عبارة عن الرسمة في ال ECG
+
+333
+00:22:30,290 --> 00:22:34,150
+displacement ايضا horizontal or down sloping للي
+
+334
+00:22:34,150 --> 00:22:38,550
+هو ال risk ventricular tachycardia ممكن يصير في
+
+335
+00:22:38,550 --> 00:22:42,110
+عنا تاكيكارديا increasing في ال heart rate طبعا
+
+336
+00:22:42,110 --> 00:22:47,390
+زيادة في معدل ضربات القلب هاي ست حالة انا بعمل
+
+337
+00:22:47,390 --> 00:22:51,770
+stopping ل ال exercise programطبعا هنا بدى يورينا
+
+338
+00:22:51,770 --> 00:22:55,590
+ان anterior و lateral في حالات اللى هى ال
+
+339
+00:22:55,590 --> 00:23:00,570
+ventricular و اللى هو ال tachycardia اللى صارت على
+
+340
+00:23:00,570 --> 00:23:04,850
+طول انا بعمل اللى هو stopping ايضا فى عندي تكملة
+
+341
+00:23:04,850 --> 00:23:07,970
+لباقي ال exercise او باقي اللى هو ال stopping of
+
+342
+00:23:07,970 --> 00:23:11,810
+exercise تبع ال exercise induced left bandell
+
+343
+00:23:11,810 --> 00:23:16,440
+branch blocksإن هو هذا ال exercise بدي ازيد طبعا
+
+344
+00:23:16,440 --> 00:23:21,740
+من ال block اللي صارت في ال left band ال branches
+
+345
+00:23:21,740 --> 00:23:25,400
+زي ما انتوا شايفينها هنا طبعا في عندي right و في
+
+346
+00:23:25,400 --> 00:23:29,780
+عندي leftالـ Honest اللي هو second and third AV
+
+347
+00:23:29,780 --> 00:23:34,880
+اللي هو a triumventrical block الاكسرسيز اللي صار
+
+348
+00:23:34,880 --> 00:23:38,660
+فيه انه الـ Hypotension less than twenty
+
+349
+00:23:38,660 --> 00:23:42,080
+millimeters أبقى drop in systolic blood pressure
+
+350
+00:23:42,080 --> 00:23:45,960
+during exercise Hypotension أنا بحكي يعني أقل من
+
+351
+00:23:45,960 --> 00:23:49,510
+الطبيعي excessive blood pressure risesإذا كان الـ
+
+352
+00:23:49,510 --> 00:23:52,570
+systolic blood pressure 220 معناته هو هنا high،
+
+353
+00:23:52,570 --> 00:23:56,630
+عالي جدا، فبالتالي، و الـ diastolic 110، معناه
+
+354
+00:23:56,630 --> 00:24:00,330
+الكلام هذا hypertensive patient inapropriating
+
+355
+00:24:00,330 --> 00:24:04,310
+bradycardia ال patient اللي صار عنده bradycardia،
+
+356
+00:24:04,310 --> 00:24:08,090
+drop في ال heart rate greater than 10 during
+
+357
+00:24:08,090 --> 00:24:14,130
+exercise هنا أنا طبعا لازم أبعد أو أسحب أي
+
+358
+00:24:14,130 --> 00:24:18,450
+exercise أنا كنت راح أشتغله مع مريض، اللي هو القلب
+
+359
+00:24:19,210 --> 00:24:22,970
+لأن هذا كله أنا كنت بحكي عنه في phase 1 phase 2
+
+360
+00:24:22,970 --> 00:24:27,050
+اللي هو ال term of phase 2 that the part of
+
+361
+00:24:27,050 --> 00:24:29,470
+cardiac rehabilitation program conduct in
+
+362
+00:24:29,470 --> 00:24:33,690
+outpatient إذا في phase 2 هشتغل مع ال outpatient
+
+363
+00:24:33,690 --> 00:24:36,930
+أما في phase 1 كنت شغالة على inpatient المريض ما
+
+364
+00:24:36,930 --> 00:24:41,330
+زال عندي داخل ال department تبعي في المستشفى it's
+
+365
+00:24:41,330 --> 00:24:45,030
+early to convalescent phase من 8 إلى 12 أسبوع
+
+366
+00:24:45,030 --> 00:24:49,510
+تقريبا ما بعد اللي هي صارت الحادثةثمانة اتناشر
+
+367
+00:24:49,510 --> 00:24:52,810
+اسبوع التامن لا الاسبوع اسبوع التامن نحكي للاسبوع
+
+368
+00:24:52,810 --> 00:24:55,350
+الاتناشر ال duration during this phase ال
+
+369
+00:24:55,350 --> 00:24:58,090
+myocardial and postoperative healing is taking
+
+370
+00:24:58,090 --> 00:25:01,870
+place تمام في اللي هو من ست ل تمان أسابيع في ال
+
+371
+00:25:01,870 --> 00:25:04,970
+myocardial scar formation has taken place and the
+
+372
+00:25:04,970 --> 00:25:09,750
+sternum is healed following surgery إذا أنا بحكي
+
+373
+00:25:09,750 --> 00:25:12,990
+على حالة اللي هي ال open heart surgery أنا عملت
+
+374
+00:25:12,990 --> 00:25:17,760
+cutting أومعناة الكلام أنا بدي أستنى من 6 ل 8
+
+375
+00:25:17,760 --> 00:25:21,380
+أسابيع انه عشان أعمل اللي هو يصير في عندى ال good
+
+376
+00:25:21,380 --> 00:25:25,140
+healing ل ال surgery بعدين أفوت في اللي هو ال
+
+377
+00:25:25,140 --> 00:25:28,620
+rehabilitation team ال goals تبعتي في هذا ال team
+
+378
+00:25:28,620 --> 00:25:32,140
+increasing ال exercise capacity أنا هنا بدي أزيد
+
+379
+00:25:32,140 --> 00:25:35,480
+ال endurance لإن المريض التبعى صار خلاص يعني مش
+
+380
+00:25:35,480 --> 00:25:39,460
+جديد stable هو و medically تمام تمام فبالتالي بدي
+
+381
+00:25:39,460 --> 00:25:42,300
+أزيد ال enduranceeducated للpatient and the proper
+
+382
+00:25:42,300 --> 00:25:45,100
+technique of exercise بدي أعلمه التكنيك اللي زيد
+
+383
+00:25:45,100 --> 00:25:48,300
+لل exercise اللي أنا هزيدها work with patient and
+
+384
+00:25:48,300 --> 00:25:52,880
+family برضه حكينا ال family هنا هي عبارة عن إشي
+
+385
+00:25:52,880 --> 00:25:56,430
+ورنصر هام أساسي لناPrepare الpatient to return
+
+386
+00:25:56,430 --> 00:26:00,450
+work إذا كان والله هو مدرس جامعي بده يرجع على
+
+387
+00:26:00,450 --> 00:26:03,770
+وظيفته هل بيناسبه أو بيناسبوش هذا بيحكي عليه
+
+388
+00:26:03,770 --> 00:26:08,010
+الأخصائي المهني Enhance the psychological status
+
+389
+00:26:08,010 --> 00:26:12,710
+بعزز اللي هي الحالة النفسية to provide the patient
+
+390
+00:26:12,710 --> 00:26:17,030
+with guidelines in long term exercise كمان أنا
+
+391
+00:26:17,030 --> 00:26:20,800
+بعززاللي هو ان انت قادر على انك تقدي هذا ال
+
+392
+00:26:20,800 --> 00:26:25,560
+exercise ما بخليه دائما ان هو fair ومش حابب يعمل
+
+393
+00:26:25,560 --> 00:26:29,440
+exercise لإنه ممكن تجيه angina لأ إذا موضوع stable
+
+394
+00:26:29,440 --> 00:26:35,460
+و تمام اتفضل انا بعزز هاي الفكرة معاه ال training
+
+395
+00:26:35,460 --> 00:26:39,840
+program فيه عندنا ال conditioning exercise زي ال
+
+396
+00:26:39,840 --> 00:26:43,990
+rhythmic aerobic exercise ال walkingjogging
+
+397
+00:26:43,990 --> 00:26:48,430
+swimming and running التشديف هذه الأمور كلها
+
+398
+00:26:48,430 --> 00:26:51,350
+بعتبرها conditioning exercise في عندنا lower
+
+399
+00:26:51,350 --> 00:26:55,190
+exercise أو lower extremity aerobic exercise زي
+
+400
+00:26:55,190 --> 00:26:58,530
+اللي هو ال treadmill زي ما حكينا و ال bicycle
+
+401
+00:26:58,530 --> 00:27:02,370
+ergometers زي ما انتوا شايفينهم هنا عامل اليهم
+
+402
+00:27:02,370 --> 00:27:06,450
+group therapy في اللي هو ال department أو ال
+
+403
+00:27:06,450 --> 00:27:09,790
+physiotherapy departmentأيضًا الـ Upper Extremity
+
+404
+00:27:09,790 --> 00:27:12,950
+with Ergometers أو Arm Ergometers and Drawing
+
+405
+00:27:12,950 --> 00:27:17,030
+Machines اللي هو زي ما أنتوا شايفينها هنا شغالة
+
+406
+00:27:17,030 --> 00:27:21,130
+الـ Upper Extremity This type of equipment improve
+
+407
+00:27:21,130 --> 00:27:25,250
+both endurance and physical work capacity مهم جدًا
+
+408
+00:27:25,250 --> 00:27:27,350
+أنه أنا أزيد ال endurance لأنه أنا في phase 2
+
+409
+00:27:27,350 --> 00:27:31,870
+شغالة للبست my card للinfarction by bus اللي هو by
+
+410
+00:27:31,870 --> 00:27:38,520
+bus patient during phase 2الان التمارين الرياضية
+
+411
+00:27:38,520 --> 00:27:41,580
+اللى انا بدي اقديها بعد ما عملت ال conditioning
+
+412
+00:27:41,580 --> 00:27:44,940
+exercise فى عندى اللى هي ال eclipses exercise
+
+413
+00:27:44,940 --> 00:27:48,740
+active free exercise لل upper extremities and
+
+414
+00:27:48,740 --> 00:27:51,840
+lower limbs and trunk لاحظوا كمان هنا الصلاة
+
+415
+00:27:51,840 --> 00:27:55,620
+الرياضية مليانة فهو group therapy كامل على الأغلب
+
+416
+00:27:55,620 --> 00:28:00,940
+كلهميعني درلي و كلهم مسنين هنا برضه في عندي فى هذه
+
+417
+00:28:00,940 --> 00:28:04,300
+الصورة اللى هو فى ال treadmill كيف أنه انا ممكن
+
+418
+00:28:04,300 --> 00:28:10,500
+اخليها تبدأ تزاود السرعة تبعتها بناء على phase 2
+
+419
+00:28:10,500 --> 00:28:14,980
+specific monitoring and phase لازم انا هنا اكون
+
+420
+00:28:14,980 --> 00:28:19,240
+مراقبة ال vital signs خليني احكى heart rate blood
+
+421
+00:28:19,240 --> 00:28:23,280
+pressure ال ECG ال heart sound و ال signs and
+
+422
+00:28:23,280 --> 00:28:28,460
+symptoms كل هذه الأمور مهم جداأنا أتابعها وأكون مع
+
+423
+00:28:28,460 --> 00:28:33,400
+المريض دقيقة بدقيقة return to work after phase 2
+
+424
+00:28:33,400 --> 00:28:37,040
+والآن خلصنا احنا من تأهيل المريض في phase 2 بدي
+
+425
+00:28:37,040 --> 00:28:41,200
+ارجع على وظيفته من 75 ل 80% من ال rehabilitated
+
+426
+00:28:41,200 --> 00:28:45,690
+patient will return to work withineight to ten
+
+427
+00:28:45,690 --> 00:28:49,730
+weeks after my cardiac infarction يعني عشر أسابيع
+
+428
+00:28:49,730 --> 00:28:54,210
+تقريبا خلينا نحكي من شهرين لتلت شهور وأنا برجعه
+
+429
+00:28:54,210 --> 00:28:58,660
+لوضعه في اللي هو الدوام تبعهThey found the cardiac
+
+430
+00:28:58,660 --> 00:29:01,280
+rehabilitation patient returned to work average
+
+431
+00:29:01,280 --> 00:29:05,280
+almost 40 days sooner than non-rehabilitated
+
+432
+00:29:05,280 --> 00:29:09,520
+patients لجينا إن هو ال patient اللي هم ال average
+
+433
+00:29:09,520 --> 00:29:13,640
+معدلهم اللي رجعوا لعملهم حوالي أبعد 40 يوم من
+
+434
+00:29:13,640 --> 00:29:19,000
+السنة than اللي هم ما حصلوا rehabilitation patient
+
+435
+00:29:20,200 --> 00:29:23,420
+الفاس الأخير وهو الفاس اللي out patient وال
+
+436
+00:29:23,420 --> 00:29:26,760
+patient خلاص هيكون فيه في ال home program اللي هو
+
+437
+00:29:26,760 --> 00:29:30,160
+الفاس التالت خلال هذا الفاس التالت during phase
+
+438
+00:29:30,160 --> 00:29:33,460
+three ال patient do their exercise independently
+
+439
+00:29:33,460 --> 00:29:38,190
+خلاص أنا وصلت معاه ما بعد التلت شهورThe role of
+
+440
+00:29:38,190 --> 00:29:40,750
+physical therapist is guidance هنا ال role of
+
+441
+00:29:40,750 --> 00:29:44,850
+physiotherapist دوره كعلاج طبيعي فقط اللي هو مرشد
+
+442
+00:29:44,850 --> 00:29:48,530
+أو معلم and follow up لل patient to ask to keep
+
+443
+00:29:48,530 --> 00:29:51,830
+contact with rehabilitation teamThe duration of
+
+444
+00:29:51,830 --> 00:29:56,110
+phase 3 ranged from six months to one year من ست
+
+445
+00:29:56,110 --> 00:30:00,430
+شهور لسنة بيظلوا متواصل معانا by telephone على
+
+446
+00:30:00,430 --> 00:30:05,170
+سبيل المثالبما إنه في ضل COVID-19 أو على سبيل
+
+447
+00:30:05,170 --> 00:30:09,410
+المثال ممكن يكون عنده فيزيو ترابي في البيت ويتبع
+
+448
+00:30:09,410 --> 00:30:13,970
+معاه ال goals تبعتنا في هذا ال exercise أو في هذا
+
+449
+00:30:13,970 --> 00:30:17,630
+ال phase improve ال exercise fitness أنا بدي أعلي
+
+450
+00:30:17,630 --> 00:30:20,770
+ال exercise intensityimprove my cardio aerobic
+
+451
+00:30:20,770 --> 00:30:24,470
+capacity improve my cardio oxygen supply and
+
+452
+00:30:24,470 --> 00:30:28,690
+psychological orientations كل هذه الأمور مهمة جدا
+
+453
+00:30:28,690 --> 00:30:32,270
+ان احافظ عليها لأن انا شغالة في ال outpatient يعني
+
+454
+00:30:32,270 --> 00:30:37,090
+في ال phase الأخر تابع الأربعة suggestions اللي
+
+455
+00:30:37,090 --> 00:30:40,170
+انا كنت حكيت عليه قبلها suggestions for exercise
+
+456
+00:30:40,170 --> 00:30:43,750
+at home ايضا بالاضافة له في عن ال walking daily
+
+457
+00:30:43,750 --> 00:30:48,910
+sleep من 6 ل 8 ساعات مهم جداwait at least one hour
+
+458
+00:30:48,910 --> 00:30:52,150
+after meal before exercising مش يأكل الوجبة من هنا
+
+459
+00:30:52,150 --> 00:30:55,310
+و يروح يعمل ال exercise من هنا لأ avoid ال
+
+460
+00:30:55,310 --> 00:30:58,550
+extremity weather in winter طبعا ال exercise
+
+461
+00:30:58,550 --> 00:31:02,940
+during warmer partof day and summer exercise long
+
+462
+00:31:02,940 --> 00:31:07,080
+and evening اللي هو ما أخلي يعني كل الهدف من هذه
+
+463
+00:31:07,080 --> 00:31:09,740
+الفترة أنه أنا ما أزيد درجة حرارة الجسم بال
+
+464
+00:31:09,740 --> 00:31:12,960
+exercise إذا كان الجو شوب أبدأ أشتغل معاه في عصر
+
+465
+00:31:12,960 --> 00:31:16,940
+الظهر لأ لازم يكون الوضع مناسب حتى ما يصير فعلا
+
+466
+00:31:16,940 --> 00:31:21,110
+increasing ال feveravoid vigorous arm and shoulder
+
+467
+00:31:21,110 --> 00:31:25,370
+activities مش انه خلاص احنا خلصنا و عدينا و روحنا
+
+468
+00:31:25,370 --> 00:31:28,070
+ع البيت و صار في انا out patient ال program انه
+
+469
+00:31:28,070 --> 00:31:31,850
+ابلش معاه exercise قوية لأ هذه بدي امنحها خصوصا
+
+470
+00:31:31,850 --> 00:31:35,350
+اذا كان عندي ال activity هذه بتعملي مشاكل زي ان هو
+
+471
+00:31:35,350 --> 00:31:39,030
+المرض ممكن يدوخ منها زي انه ممكن تجي نوازيه الأمور
+
+472
+00:31:39,030 --> 00:31:42,290
+زيها لازم انا اخدها في عين الاعتبار ال arm
+
+473
+00:31:42,290 --> 00:31:45,930
+activities required more energy than leg
+
+474
+00:31:45,930 --> 00:31:52,790
+activities طبعا اكيدأي إشي في ال arms طبعا بيكون
+
+475
+00:31:52,790 --> 00:31:58,270
+أكتر اللي هو شغل و أكتر مجهود suggest use ال
+
+476
+00:31:58,270 --> 00:32:03,190
+exercise at home avoid lifting heavy weight ممنوع
+
+477
+00:32:03,190 --> 00:32:08,010
+يشيل أيضا اللي هو الأحمل السقيلة avoid situation
+
+478
+00:32:08,010 --> 00:32:12,070
+اللي هي ال people who make you anoxious or angry
+
+479
+00:32:12,070 --> 00:32:16,530
+ممنوع يعصب ممنوع يزعل ممنوع يتخانق مع حدا و يجي
+
+480
+00:32:16,530 --> 00:32:20,540
+يعمل exercise لأ هو هيكون لو عنده ضغط حيال ضغطهIf
+
+481
+00:32:20,540 --> 00:32:23,540
+you have chest pain, dizziness, excess of fatigue,
+
+482
+00:32:23,720 --> 00:32:26,540
+unusual vibrations, and shortness of breath type
+
+483
+00:32:26,540 --> 00:32:33,060
+فورا تبلى ال exercise اي مشاكل واجهته كفيزيو
+
+484
+00:32:33,060 --> 00:32:36,580
+ثيرابيس او واجهتك انت كمريض على طول احنا بنوصيه
+
+485
+00:32:36,580 --> 00:32:39,720
+انه يعمل stopping ال exercise and take a rest and
+
+486
+00:32:39,720 --> 00:32:43,680
+then call his doctor لازم يعمل اللي هو مكالمة
+
+487
+00:32:43,680 --> 00:32:47,040
+للدكتور ايضا ال medication مهم جدا انه ياخدوا
+
+488
+00:32:47,040 --> 00:32:52,830
+بمواعيدهالوقت يكون دقيقًا «لا تتجارب إذا كانت لديك
+
+489
+00:32:52,830 --> 00:32:56,950
+أشعار عضوية» في حالة الـ acute ما بشتغل لإنه ممكن
+
+490
+00:32:56,950 --> 00:33:02,690
+أعمل على تعظيم المشكلة تابع الخمسة «ما هي الـ
+
+491
+00:33:02,690 --> 00:33:06,310
+contraindications للدخول بين program patient and
+
+492
+00:33:06,310 --> 00:33:10,410
+outpatient exercise» ما أشتغل مع الناس اللي هم
+
+493
+00:33:10,410 --> 00:33:14,150
+unstable angina ممنوع أشتغل إذا كان الـ resting
+
+494
+00:33:14,150 --> 00:33:20,450
+للسيستوليكي blood pressure اللي هو 200فما أعلى،
+
+495
+00:33:20,450 --> 00:33:26,790
+تمام؟ و أداسة لك أعلى من 100 الـ orthostatic blood
+
+496
+00:33:26,790 --> 00:33:30,730
+pressure drop إذا كان high potential لـ moderate
+
+497
+00:33:30,730 --> 00:33:35,610
+and severe aortic stenosis سداد في الشريان التاجي
+
+498
+00:33:35,610 --> 00:33:39,050
+الـ acute systemic illness or fever الناس اللي
+
+499
+00:33:39,050 --> 00:33:41,610
+عندها influence على سبيل المثال with cardio
+
+500
+00:33:41,610 --> 00:33:45,770
+diseaseكمان مابشتغل لأن هذا بيزيد لي من ال fever
+
+501
+00:33:45,770 --> 00:33:49,090
+ال uncontrolled arterial and ventricle
+
+502
+00:33:49,090 --> 00:33:53,530
+dysarrhythmia طبعا الحالات اللي بتكون موجودة في
+
+503
+00:33:53,530 --> 00:33:57,670
+اللي عندها علم انتظام في ضغاط القلب هي كمان ما
+
+504
+00:33:57,670 --> 00:34:02,250
+أشتغل معها أيضا ماأشتغلش مع ال uncontrolled sense
+
+505
+00:34:02,250 --> 00:34:06,670
+of tachycardia increasing في ال bloodالـ heart
+
+506
+00:34:06,670 --> 00:34:10,910
+rate الـ uncontrolled congestive heart failure CHF
+
+507
+00:34:10,910 --> 00:34:17,270
+اللي هو فشل في عضلة القلب الـ three degree AV
+
+508
+00:34:17,270 --> 00:34:20,910
+heart blocks تمام three degree هاي ال second
+
+509
+00:34:20,910 --> 00:34:24,610
+degree هاي ال third يعني شوفوا كيف بين كل waves و
+
+510
+00:34:24,610 --> 00:34:30,350
+الأخرى كام هي المسافة ال recent embolism بخاف لإنه
+
+511
+00:34:30,350 --> 00:34:33,730
+ممكن تنتقل من مكان إلى مكان thromb of the bites
+
+512
+00:34:33,730 --> 00:34:38,790
+كمان بخاف منهاالـ Resting للـ ST Displacement هنا
+
+513
+00:34:38,790 --> 00:34:42,350
+زيادة في الـ displacement تبع الـ ST ال
+
+514
+00:34:42,350 --> 00:34:48,210
+uncontrolled diabetes الarthritic problemالـ
+
+515
+00:34:48,210 --> 00:34:52,210
+Bravets Exercise كمان هاي الناس ممنوعة أنا أشتغل
+
+516
+00:34:52,210 --> 00:34:58,830
+معاها يعني Contra-Indication 15 items أو 15 حلق أو
+
+517
+00:34:58,830 --> 00:35:04,170
+15
+
+518
+00:35:04,170 --> 00:35:09,490
+عنصر ممنوعة أنا أشتغل معاهم في اللي هو الحلق،
+
+519
+00:35:09,490 --> 00:35:12,470
+الـExercise في الـthird phase اللي موجود عندنا
+
+520
+00:35:12,470 --> 00:35:17,360
+للـcardiac rehabilitation patientيعطيكوا ألف عافية
+
+521
+00:35:17,360 --> 00:35:20,980
+وبهك بكون أنا خلصت ال part الأول ألقاكم بإذن الله
+
+522
+00:35:20,980 --> 00:35:26,080
+في part اتنين بإذن الله والسلام عليكم ورحمة الله
+
+523
+00:35:26,080 --> 00:35:26,760
+وبركاته
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/TRy9edu8e-w.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/TRy9edu8e-w.srt
new file mode 100644
index 0000000000000000000000000000000000000000..7ad3eb4bd0fe5f757463dd57e6a481f271851674
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/TRy9edu8e-w.srt
@@ -0,0 +1,1367 @@
+1
+00:00:01,100 --> 00:00:05,060
+اللهم صل وسلم على محمد وعلى آله وصحبه أجمعين
+
+2
+00:00:05,060 --> 00:00:10,280
+السلام عليكم ورحمة الله وبركاته، سأبدأ اليوم إن شاء
+
+3
+00:00:10,280 --> 00:00:14,680
+الله في chapter دور العلاج الطبيعي في حالات ال
+
+4
+00:00:14,680 --> 00:00:18,360
+cardiothoracic surgery كنا أخذنا في المحاضرة
+
+5
+00:00:18,360 --> 00:00:24,880
+السابقة عن الأسباب، الآن سأتحدث عن موضوع ال
+
+6
+00:00:24,880 --> 00:00:28,180
+physiotherapy أو دور الـ physiotherapy في حالات
+
+7
+00:00:28,180 --> 00:00:33,390
+الـ cardiothoracic surgery بإذن الله تعالى، سيكون
+
+8
+00:00:33,390 --> 00:00:39,470
+عندنا تسعة عشر slide تقريباً، سأشرح مباشرةً دور الـ
+
+9
+00:00:39,470 --> 00:00:43,250
+of physiotherapy، لن أدخل في الـ anatomy الآن، هذا
+
+10
+00:00:43,250 --> 00:00:48,570
+بالنسبة لأول صورة معكم، ستكون عبارة عن صورة
+
+11
+00:00:48,570 --> 00:00:51,710
+للقلب، طبعاً أنتم أخذتم الـ anatomy  للـ heart و
+
+12
+00:00:51,710 --> 00:00:58,230
+أخذتم كيف الـ circulation و الدورة الدموية الصغرى
+
+13
+00:00:58,230 --> 00:01:01,730
+و الدورة الدموية الكبرى، و كل هذه الأمور في الجزء
+
+14
+00:01:01,730 --> 00:01:05,090
+النظري، دعوني أدخل هنا مباشرةً على دور الـ physiotherapy
+
+15
+00:01:05,090 --> 00:01:14,550
+دور الـ physiotherapy، سأبدأ مباشرةً في دور الـ
+
+16
+00:01:14,550 --> 00:01:19,670
+physiotherapy، سيكون ما قبل العملية و ما بعد العملية، الـ pre-operative و الـ post-operative
+
+17
+00:01:19,670 --> 00:01:22,690
+preoperative، سأتحدث عن الأهداف، سأتحدث عن الـ
+
+18
+00:01:22,690 --> 00:01:26,550
+exercises التي سأقدمها للمريض، تهيئة نفسية المريض
+
+19
+00:01:26,550 --> 00:01:31,990
+لما قبل العملية، تمام؟ الـ post-op، التي هي الـ post
+
+20
+00:01:31,990 --> 00:01:36,370
+-operative، سنعمل الـ exercises مع المريض
+
+21
+00:01:36,370 --> 00:01:41,530
+بعد العملية، لمنع المضاعفات، وللوصول
+
+22
+00:01:41,530 --> 00:01:45,520
+مع المريض إلى مرحلة الاستقلالية، نحن نتحدث
+
+23
+00:01:45,520 --> 00:01:49,380
+عن عملية كبرى، نتحدث عن جراحة القلب، نتحدث عن
+
+24
+00:01:49,380 --> 00:01:52,940
+جراحة قلب مفتوح،  وقد لا تكون جراحة قلب مفتوح
+
+25
+00:01:53,580 --> 00:01:58,360
+في كل الأحوال، أنا أتحدث عن عملية كبيرة، ليست صغيرة، هي
+
+26
+00:01:58,360 --> 00:02:03,400
+ليست عملية كسور، ولا عملية مرارة، أو أي عملية
+
+27
+00:02:03,400 --> 00:02:08,060
+باطنية، لا، هي عملية في القلب، وبالتالي
+
+28
+00:02:08,060 --> 00:02:12,580
+يجب أن أكون حذرة في كل شيء أفعله، دعونا نبدأ
+
+29
+00:02:12,580 --> 00:02:18,580
+أولاً، ما قبل العملية، أهداف العلاج الطبيعي لكل الـ
+
+30
+00:02:18,580 --> 00:02:25,790
+exercises التي أقدمها للمريض، يجب
+
+31
+00:02:25,790 --> 00:02:33,550
+الحفاظ على مستوى التهوية الجيد، الذي هو الـ
+
+32
+00:02:33,550 --> 00:02:37,990
+ventilation الجيد للمريض، الرئتان يجب أن تكونا
+
+33
+00:02:37,990 --> 00:02:42,110
+مملوءتين بالأكسجين، قادرتين على استيعاب أكبر كمية و
+
+34
+00:02:42,110 --> 00:02:48,210
+لتبادل الغازات بداخلهما، لتزويد القلب بالأكسجين
+
+35
+00:02:48,210 --> 00:02:52,850
+لذلك، يجب أن يحافظ المريض دائماً على كمية
+
+36
+00:02:52,850 --> 00:02:56,330
+adequate ventilation للمساعدة في إزالة
+
+37
+00:02:56,330 --> 00:03:00,960
+الـ excessive secretion في الجهاز التنفسي، تمام، الذي هو
+
+38
+00:03:00,960 --> 00:03:07,120
+سأحاول إزالة أي
+
+39
+00:03:07,120 --> 00:03:11,380
+secretion موجود، في الوضعية،
+
+40
+00:03:11,380 --> 00:03:15,280
+تحدثنا عن التصريف الوضعي، أخذنا أيضاً ما يسمى
+
+41
+00:03:15,280 --> 00:03:19,040
+التدليك، و التغيرات في أطراف الأصابع،  هذه الأمور  لتحريك
+
+42
+00:03:19,040 --> 00:03:23,640
+الـ secretions، للمساعدة في تحسين الدورة الدموية في
+
+43
+00:03:23,640 --> 00:03:27,020
+الساقين والصدر، للمساعدة في منع الجلطة أو
+
+44
+00:03:27,020 --> 00:03:31,340
+الجلطات الوريدية العميقة، أنا هنا أريد منع الـ DVT
+
+45
+00:03:31,340 --> 00:03:35,900
+عن طريق تمارين الضغط أو حركات الكاحل
+
+46
+00:03:35,900 --> 00:03:41,980
+رقم 4 و 8،  أيضاً من أجل حركة الكتفين و
+
+47
+00:03:41,980 --> 00:03:45,140
+حزام الكتف والعمود الفقري، أريد الحفاظ عليها لأنها
+
+48
+00:03:45,140 --> 00:03:47,740
+المنطقة التي أجريت فيها الجراحة، منطقة الـ
+
+49
+00:03:47,740 --> 00:03:50,520
+الصدر، لذلك أريد الحفاظ على الحركة
+
+50
+00:03:50,520 --> 00:03:53,380
+للمريض في الكتف وحزام الكتف،
+
+51
+00:03:53,380 --> 00:03:57,640
+تمام؟ أنا لا أريد أي مشاكل، أي تشوهات
+
+52
+00:03:57,640 --> 00:04:02,520
+تحدث في هذا المكان،  على سبيل المثال، شيء طبيعي
+
+53
+00:04:02,520 --> 00:04:06,500
+جميعنا نعود إلى وضع حرف الـ C،  الوضع الجنيني
+
+54
+00:04:06,500 --> 00:04:10,300
+الذي كنا فيه، هنا نلاحظ أن المريض يميل إلى الأمام
+
+55
+00:04:10,300 --> 00:04:16,020
+بسبب الانحناء، لماذا؟ لأن العملية مؤلمة
+
+56
+00:04:16,020 --> 00:04:20,100
+فنحن،  حتى لو كان لديك شخص ما، أو أي شخص لديه
+
+57
+00:04:20,100 --> 00:04:24,120
+مغص، يضع يده على بطنه وينحني للأمام، هذا
+
+58
+00:04:24,120 --> 00:04:28,100
+شيء طبيعي، تمام؟ فما بالكم بعملية جراحة القلب مثل
+
+59
+00:04:28,100 --> 00:04:34,120
+هذه،  والتي تحتوي على ثلاثين أو أربعين غرزة، وأمور كبيرة
+
+60
+00:04:34,120 --> 00:04:40,700
+مثل هذه، سيحدث هذا،  لأنه سيتخذ هذه الوضعية، التي هي
+
+61
+00:04:40,700 --> 00:04:48,070
+ستعمل على حدوث تشوهات مثل الـ K-forces، لمنع حدوث تشوهات
+
+62
+00:04:48,070 --> 00:04:51,730
+وضعية، هذا ما كنت أتحدث عنه، أنني أريد منع
+
+63
+00:04:51,730 --> 00:04:56,330
+أي قوى، أي تشوهات تحدث في العمود الفقري، لا نريد
+
+64
+00:04:56,330 --> 00:05:00,810
+أي شيء يحدث بعد ذلك، كان المرضى يفعلون ذلك كعملية
+
+65
+00:05:00,810 --> 00:05:05,730
+تعويضية، لماذا؟ لأني لا أريد أن يزداد الوضع سوءاً، وبعد
+
+66
+00:05:05,730 --> 00:05:10,930
+ذلك تصبح المشكلة دائمة، لا، كانت في البداية
+
+67
+00:05:10,930 --> 00:05:15,750
+عادةً، أنه كان يشعر بألم في صدره، فكان يميل إلى الأمام
+
+68
+00:05:15,750 --> 00:05:19,890
+بعد فترة، أصبحت هذه عادة دائمة، وهذا ما يعمل على
+
+69
+00:05:19,890 --> 00:05:25,320
+حدوث تشوه وضعي مثل الـ K-forces، لاستعادة
+
+70
+00:05:25,320 --> 00:05:30,900
+تحمل التمارين، لأجعله قادراً على أداء
+
+71
+00:05:30,900 --> 00:05:34,260
+التمارين،  زيادة تحمله، إذا أردت
+
+72
+00:05:34,260 --> 00:05:38,320
+زيادة التمارين من خمس إلى عشر مرات،  بعد فترة، أو بعد
+
+73
+00:05:38,320 --> 00:05:41,320
+يومين أو ثلاثة، أزيدها مثلاً إلى خمس عشرة مرة من التمارين
+
+74
+00:05:41,320 --> 00:05:45,140
+يعني، أبدأ مثلاً بثني المرفق، أول مرة خمس
+
+75
+00:05:45,140 --> 00:05:49,120
+مرات، هيا لنفعلها معاً، خمس مرات يا سيدتي، بعد يومين لا
+
+76
+00:05:49,120 --> 00:05:53,010
+الخمس مرات تتطور، أريد زيادة التحمل، الذي هو
+
+77
+00:05:53,010 --> 00:05:55,710
+عدد التمارين،  المريض يتحمل أن أزيد معه
+
+78
+00:05:55,710 --> 00:06:00,190
+التمارين، هنا لدينا ستة أهداف لـ
+
+79
+00:06:00,190 --> 00:06:03,550
+برامج العلاج الطبيعي في حالات القلب، أو في قسم
+
+80
+00:06:03,550 --> 00:06:08,510
+القلب داخل المستشفى، دعوني أرى
+
+81
+00:06:08,510 --> 00:06:12,810
+التدريب قبل العملية، لدينا قبل العملية
+
+82
+00:06:12,810 --> 00:06:17,760
+ستة أهداف أساسية، أولاً، شرح كل شيء للمريض
+
+83
+00:06:17,760 --> 00:06:21,780
+شرح من قبل
+
+84
+00:06:21,780 --> 00:06:25,000
+أخصائي العلاج الطبيعي، من أجل كسب ثقة المريض
+
+85
+00:06:25,000 --> 00:06:28,660
+وتعاونه، إذا جلست مع
+
+86
+00:06:28,660 --> 00:06:33,060
+المريض، وأنتم وصلتم إلى المستوى الرابع، هذا الشيء
+
+87
+00:06:33,060 --> 00:06:38,280
+يجعل ثقة المريض بكم ممتازة جداً، أنني شرحت لكِ
+
+88
+00:06:38,280 --> 00:06:42,480
+ما سيحدث معكِ يا سيدتي، واحد، اثنان، ثلاثة، سنقوم بعملية قلب
+
+89
+00:06:42,480 --> 00:06:48,820
+مفتوح،  زراعة صمام، أي عملية، طبعاً
+
+90
+00:06:48,820 --> 00:06:51,760
+كوننا قرأنا الملف الطبي كاملاً
+
+91
+00:06:51,760 --> 00:06:55,780
+ونعرف ما سنفعله، أو نعرف مع من سنعمل
+
+92
+00:06:55,780 --> 00:06:59,600
+لذلك، إذا حدثت ثقة بين أخصائي العلاج الطبيعي و
+
+93
+00:06:59,600 --> 00:07:02,640
+المريض، هذا يعني زيادة التعاون
+
+94
+00:07:02,640 --> 00:07:06,800
+يصبح يحب الجلسة بالفعل، هذا ما لاحظته
+
+95
+00:07:06,800 --> 00:07:10,640
+أيام العمل،  حتى مع الأطفال
+
+96
+00:07:10,640 --> 00:07:15,760
+نفس الشيء، إذا الطفل حصل على، أو كسب ثقتك،
+
+97
+00:07:15,760 --> 00:07:20,340
+هذا يعني أنه سيحب الجلسة، سيحب المجيء إليك، ليس
+
+98
+00:07:20,340 --> 00:07:24,460
+الطفل الذي قد لا تتواصل معه، أو لا تستطيع
+
+99
+00:07:24,460 --> 00:07:28,160
+كسب ثقته، هذا لكم، ومفتاحكم، كيف تريدون
+
+100
+00:07:28,160 --> 00:07:31,540
+التعامل مع الناس، مهارات التواصل
+
+101
+00:07:31,540 --> 00:07:35,960
+مهمة جداً في التعامل مع أي مريض، هذا أول
+
+102
+00:07:35,960 --> 00:07:40,160
+هدف، شرح للمريض
+
+103
+00:07:40,160 --> 00:07:43,360
+لتوضيح أهمية الحفاظ على تهوية
+
+104
+00:07:43,360 --> 00:07:47,360
+الرئتين عن طريق تمارين التنفس، أنا
+
+105
+00:07:47,360 --> 00:07:52,520
+أريد الحفاظ على التهوية بكميات كافية عن طريق
+
+106
+00:07:52,520 --> 00:07:56,620
+تمارين التنفس، وإزالة الإفرازات
+
+107
+00:07:56,620 --> 00:08:00,760
+الحفاظ عليها بتمرين التنفس، وإن شاء الله
+
+108
+00:08:00,760 --> 00:08:04,860
+ستأخذونها في المعمل أيضاً، إزالة أي
+
+109
+00:08:04,860 --> 00:08:09,680
+إفرازات تعيق حركتها، لذلك أريد الحفاظ على
+
+110
+00:08:09,680 --> 00:08:12,960
+التهوية كاملةً،  الريئة قادرة على عمل
+
+111
+00:08:12,960 --> 00:08:18,920
+شرحها في الشهيق والزفير، تمام؟
+
+112
+00:08:18,920 --> 00:08:22,000
+يجب التأكد من أن تمارين التنفس
+
+113
+00:08:22,000 --> 00:08:26,230
+هذه، أريد التأكد من أن المريض قادر
+
+114
+00:08:26,230 --> 00:08:32,370
+على عمل التمارين، السعال، ومحاولة
+
+115
+00:08:32,370 --> 0:08:36,190
+المشي بشكل طبيعي، خاصة في اليوم الأول،  إذا كان
+
+116
+00:08:36,190 --> 00:08:40,110
+قادراً،  إذا كان مستقراً طبياً،  دائماً أضع هذا أمام
+
+117
+00:08:40,110 --> 00:08:44,030
+عيني، إذا كان المريض مستقراً طبياً، أنا
+
+118
+00:08:44,030 --> 00:08:49,870
+في أمان، في وضع جيد،  إذا لم يكن
+
+119
+00:08:49,870 --> 00:08:54,950
+مستقراً طبياً، لا أقوم بذلك،  لكن إذا
+
+120
+00:08:54,950 --> 00:08:59,350
+شعرت بأنه واعٍ،  أن كل الأمور لديه
+
+121
+00:08:59,350 --> 00:09:03,290
+تمام، تهويته جيدة، التنفس طبيعي،
+
+122
+00:09:03,290 --> 00:09:06,590
+لا توجد مشكلة، أبدأ مع الجلسة، وسنأخذ هدف ما بعد
+
+123
+00:09:06,590 --> 00:09:10,930
+العمليه إن شاء الله في المحاضرات القادمة، إذا
+
+124
+00:09:10,930 --> 00:09:15,230
+أريد التأكد من أن تمارين التنفس
+
+125
+00:09:15,230 --> 00:09:19,310
+والزفير القصير، والسعال، وكل هذه الأمور تمام
+
+126
+00:09:19,310 --> 00:09:23,210
+تمام،  وأنني قادرة على تقديم الجلسة للمريض دون
+
+127
+00:09:23,210 --> 00:09:28,180
+أي ضرر،  دون أن أؤذيه، سواء كان هناك أنبوب
+
+128
+00:09:28,180 --> 00:09:34,300
+يخرج من الرئة، أو أنبوب التنبيب، الذي هو
+
+129
+00:09:34,300 --> 00:09:37,040
+الأنبوب الموجود في القصبة الهوائية،  أريد الحفاظ عليه دون
+
+130
+00:09:37,040 --> 00:09:41,300
+أن أؤذيه بأي شيء في التمرين الذي أريد أن أسير فيه وأعمل
+
+131
+00:09:41,300 --> 00:09:47,720
+عليه، الهدف الثاني هو إزالة الإفرازات، اليوم
+
+132
+00:09:47,720 --> 00:09:52,260
+لدينا وظيفة الرئتين،  التي تعمل أثناء
+
+133
+00:09:52,260 --> 00:09:56,420
+الشهيق والزفير، يحدث تبادل الغازات،
+
+134
+00:09:56,420 --> 00:10:00,340
+إذا وجدت إفرازات، وهذا الـ
+
+135
+00:10:00,340 --> 00:10:03,020
+secretion  على فكرة هو نعمة من الله سبحانه وتعالى،
+
+136
+00:10:03,020 --> 00:10:08,400
+لماذا؟ لأنه يلتصق به أي ميكروب، أي مسبب مرض، أي
+
+137
+00:10:08,400 --> 00:10:11,800
+شيء يدخل إلى داخل الرئتين يلتصق في هذه الـ
+
+138
+00:10:11,800 --> 00:10:17,260
+الحالة، الصحيح هو إخراجه للخارج، لأنه قد
+
+139
+00:10:17,260 --> 00:10:22,040
+بما أننا في جائحة كورونا، و كوفيد-19، ماذا يحدث؟ هذا الـ
+
+140
+00:10:22,040 --> 00:10:25,600
+الفيروس يدخل إلى الرئتين، ويسبب
+
+141
+00:10:25,600 --> 00:10:29,560
+انهيار،  أي أن الرئتين تنقبضان، وبالتالي لا يحدث
+
+142
+00:10:29,560 --> 00:10:32,600
+تهوية جيدة،  لذلك الحالات الحرجة
+
+143
+00:10:32,600 --> 00:10:36,500
+والحالات الصعبة تموت بسرعة،
+
+144
+00:10:36,500 --> 00:10:39,800
+لماذا؟ لأنه لا توجد تهوية جيدة،
+
+145
+00:10:39,800 --> 00:10:42,760
+معظم المرضى الذين يخضعون لجراحة القلب
+
+146
+00:10:42,760 --> 00:10:46,380
+لا يعانون من إفرازات برونشية زائدة
+
+147
+00:10:46,380 --> 00:10:50,140
+تمام؟  معظم هؤلاء المرضى في
+
+148
+00:10:50,140 --> 00:10:53,280
+جراحة القلب لا يعانون من إفرازات برونشية زائدة
+
+149
+00:10:53,280 --> 00:10:57,620
+لكن، يوجد بعض المرضى
+
+150
+00:10:57,620 --> 00:11:02,460
+الذين يعانون من مرض صمام القلب الشديد، الأشخاص
+
+151
+00:11:02,460 --> 00:11:06,560
+الذين يعانون من مشكلة في الصمام
+
+152
+00:11:06,560 --> 00:11:09,840
+المترالي، أو ارتفاع ضغط الدم الرئوي طويل الأمد
+
+153
+00:11:09,840 --> 00:11:13,700
+الذي قد يكون قد طور مرض الانسداد الرئوي المزمن المصاحب
+
+154
+00:11:13,700 --> 00:11:16,940
+الذي أسميه
+
+155
+00:11:16,940 --> 00:11:20,640
+COPD،  أي مرض الانسداد الرئوي المزمن
+
+156
+00:11:20,640 --> 00:11:25,380
+والمساعدة في إزالة الإفرازات مطلوبة،
+
+157
+00:11:25,380 --> 00:11:29,540
+يجب أن أقوم بإزالة الإفرازات، سواء
+
+158
+00:11:29,540 --> 00:11:33,080
+كان ذلك آلياً أو يدوياً، يدوياً بالسعال
+
+159
+00:11:33,080 --> 00:11:36,960
+والزفير القصير، والتدليك، والتمارين، أما
+
+160
+00:11:36,960 --> 00:11:39,320
+آلياً، لدينا أجهزة، سنراها إن شاء الله في
+
+161
+00:11:39,320 --> 00:11:42,780
+قسم الصدر، أو في محاضرات الصدر، كيف يمكنني
+
+162
+00:11:42,780 --> 00:11:46,760
+إجراء الشفط وإزالة هذه الإفرازات، في المرحلة المبكرة
+
+163
+00:11:46,760 --> 00:11:49,380
+من أمراض القلب،  يقاوم المريض السعال الجاف
+
+164
+00:11:49,380 --> 00:11:53,000
+في بداية المراحل،
+
+165
+00:11:53,000 --> 00:11:55,860
+وخاصة بعد التخدير،  وهذه الأمور
+
+166
+00:11:55,860 --> 00:12:01,060
+يكون السعال جافاً،  لا يوجد بلغم، وفعلاً،  يقلقني
+
+167
+00:12:01,060 --> 00:12:04,640
+أنني لا أراه مع المرضى،  أشعر بالأسف على
+
+168
+00:12:04,640 --> 00:12:09,920
+المريض، سيخرج روحه، جراحة القلب
+
+169
+00:12:09,920 --> 00:12:13,020
+وليس السعال الجاف، لا يستطيع إخراج
+
+170
+00:12:13,020 --> 00:12:17,800
+شيء، أو البلغم المتوقع، طبعاً نحن
+
+171
+00:12:17,800 --> 00:12:21,280
+نقصد ما يسمى بالمقشع، أو البلغم، هذا الذي
+
+172
+00:12:21,280 --> 00:12:25,860
+لا يستطيع المريض إخراجه، هذه ليست مشكلة يمكن
+
+173
+00:12:25,860 --> 00:12:28,620
+التعامل معها بالعلاج الطبيعي، هنا يمكنني
+
+174
+00:12:28,620 --> 00:12:33,980
+التعامل معها عن طريق،  نلجأ إلى مقدمي الرعاية
+
+175
+00:12:33,980 --> 00:12:37,960
+الموجودين معه، أو العائلة،  إذا سمح الطبيب،  طبعاً بعد
+
+176
+00:12:37,960 --> 00:12:41,500
+إذن الطبيب،  يعتمد ذلك على الشراب
+
+177
+00:12:41,500 --> 00:12:46,640
+والطعام،  نقدم له مشروبات دافئة،  للبدء
+
+178
+00:12:46,640 --> 00:12:50,820
+في الجسم،  وإراحة المكان،  وتلطيفه أيضاً،  الت
+
+223
+00:15:57,970 --> 00:16:02,000
+All patients have simple exercise and
+
+224
+00:16:02,000 --> 00:16:04,640
+knee flexion and extension in order to assist
+
+225
+00:16:04,640 --> 00:16:08,940
+circulation حتى أنا أساعد الـcirculation وأمنع أي
+
+226
+00:16:08,940 --> 00:16:15,060
+DVT لأنه بتعرف بعد operative أو بعد العملية، بدي
+
+227
+00:16:15,060 --> 00:16:18,280
+يصير في عندي اللي هو blood coagulation، فبالتالي
+
+228
+00:16:18,280 --> 00:16:22,800
+بدخل أنا في الـthrombosis، بعمل اللي هو DVT وهذه
+
+229
+00:16:22,800 --> 00:16:26,380
+Contraindication أن يصير المريض عنده DVT. الـ
+
+230
+00:16:26,380 --> 00:16:30,800
+Postural shoulder girdle and arm movement مهم جدا
+
+231
+00:16:30,800 --> 00:16:34,380
+زي ما حكينا، أنا بدي أعمل prevent لأي deformity
+
+232
+00:16:34,380 --> 00:16:38,300
+this patient having a median sternotomy، بالذات الـ
+
+233
+00:16:38,300 --> 00:16:42,570
+patient اللي عمل cutting في الـ sternum، يعني عضمة
+
+234
+00:16:42,570 --> 00:16:47,010
+وصار فيها cutting. هذا الشيء مش سهل جدا، مش سهل خالص
+
+235
+00:16:47,010 --> 00:16:50,290
+لأن patient تبعي هيدخل فيه مضاعفات، فأنا لازم
+
+236
+00:16:50,290 --> 00:16:55,610
+أخليه في وضعية يكون فيها صحيح، مش عامل اللي هو
+
+237
+00:16:55,610 --> 00:16:59,490
+contractures أو kyphosis على سبيل المثال، after
+
+238
+00:16:59,490 --> 00:17:03,250
+surgery. But the shoulder girdle may become stiff and
+
+239
+00:17:03,250 --> 00:17:06,250
+maybe patients, and many patients tend to adapt
+
+240
+00:17:06,250 --> 00:17:09,730
+slightly with a kyphotic posture. هو بالأول بتكون بس
+
+241
+00:17:09,730 --> 00:17:13,670
+إنه مجرد إن هو شيء compensatory، كشيء يعني تعويضي
+
+242
+00:17:13,670 --> 00:17:17,230
+إن هو بده يعوضها للحركة هذه، عشان تمنع الألم
+
+243
+00:17:17,230 --> 00:17:21,410
+فبعد شوية بتصير شيء دائم، permanent shoulders
+
+244
+00:17:21,410 --> 00:17:26,730
+shrinking. تمام، إنه يهز كتفه هو أفضل exercise، يعني
+
+245
+00:17:26,730 --> 00:17:28,230
+يعمل upward
+
+246
+00:17:31,350 --> 00:17:35,710
+and downward retraction. هنشوفها كمان في الصور في الـ
+
+247
+00:17:35,710 --> 00:17:39,010
+exercise. هذا بالنسبة لحالة open heart surgery.
+
+248
+00:17:39,010 --> 00:17:42,390
+شايفين الشيء ممكن، هاي الـ sternum اللي أنتو شايفين
+
+249
+00:17:42,390 --> 00:17:46,350
+فيه يصير فيها cutting و remove كامل، فبالتالي العملية
+
+250
+00:17:46,350 --> 00:17:49,970
+it's difficult، مش سهلة. هاي الـ shoulder
+
+251
+00:17:49,970 --> 00:17:57,210
+stretch اللي هو upward and downward retraction، هذا
+
+252
+00:17:57,210 --> 00:18:00,910
+اللي هو عبارة عن الـ exercise اللي أنا بشتغله معاه
+
+253
+00:18:00,910 --> 00:18:04,770
+حتى أحافظ على range of motion لـ shoulder و
+
+254
+00:18:04,770 --> 00:18:09,790
+shoulder girdle. الآن خلصناه من الـ exercise اللي
+
+255
+00:18:09,790 --> 00:18:12,850
+هي preoperative، أجل الـ exercise الـ
+
+256
+00:18:12,850 --> 00:18:17,570
+preoperative، if the patient is not on a ventilator، إذا كان
+
+257
+00:18:17,570 --> 00:18:20,410
+هو مش على ventilator، هنا بحكي على mechanical
+
+258
+00:18:20,410 --> 00:18:24,330
+ventilator، إذا كان medically stable، ببلش معاه
+
+259
+00:18:24,330 --> 00:18:27,900
+breathing exercise من أول يوم، تمام؟ شو يعني أنا
+
+260
+00:18:27,900 --> 00:18:30,960
+بحكي medical statement؟ يعني هو conscious؟ يعني
+
+261
+00:18:30,960 --> 00:18:36,980
+ما في أي علامة بتأثر أو بتوحيلي أن هذا المريض في
+
+262
+00:18:36,980 --> 00:18:43,560
+خطر، يعني التنفس طبيعي، الـ heart rate طبيعي، كل شيء
+
+263
+00:18:43,560 --> 00:18:47,080
+حواليه طبيعي، هو واعي لإيش أنا بحكي أو إيش الـ
+
+264
+00:18:47,080 --> 00:18:50,460
+exercise اللي أنا بعمله، فبالتالي هنا ممكن أبلش
+
+265
+00:18:50,460 --> 00:18:53,740
+معاه breathing exercise، لكن لو كان في عندي أي
+
+266
+00:18:53,740 --> 00:18:57,580
+مشكلة، سواء إنه على mechanical ventilation أو سواء
+
+267
+00:18:57,580 --> 00:18:59,940
+الـ vision تبعه لسه في كومة أو لسه
+
+268
+00:19:02,620 --> 00:19:07,120
+ممنوع أشتغل معاه. after breathing exercise، بحاول
+
+269
+00:19:07,120 --> 00:19:11,200
+أعلمه اللي هو كان أخذه الـ exercise قبل الـ huffing
+
+270
+00:19:11,200 --> 00:19:15,980
+و الـ coughing should be made، تمام؟ إذا بعد اللي هو
+
+271
+00:19:15,980 --> 00:19:18,580
+الـ breathing exercise، في عندي huffing and coughing
+
+272
+00:19:18,580 --> 00:19:22,800
+في أول يوم، هنا ما بحسمهم نوع نوع في الـ exercise، لأ
+
+273
+00:19:22,800 --> 00:19:26,340
+بحسمهم حسب الأيام. أول يوم، the physiotherapy will
+
+274
+00:19:26,340 --> 00:19:29,460
+probably be necessary four times during the day، أربع
+
+275
+00:19:29,460 --> 00:19:33,300
+مرات يمر عليه الـ physiotherapy، تمام؟ مهم جدا The
+
+276
+00:19:33,300 --> 00:19:36,280
+length، لأن أنا بدي أمنع أي secretion، ما بدي أي شيء
+
+277
+00:19:36,280 --> 00:19:39,220
+يصير فرقتين. The length of a treatment should be
+
+278
+00:19:39,220 --> 00:19:42,040
+modified according to the patient's condition and
+
+279
+00:19:42,040 --> 00:19:46,040
+should not cause fatigue. مهم جدا الشيء هذا، إنه أنا
+
+280
+00:19:46,040 --> 00:19:51,150
+ما هدفي أعطي والله أنا اليوم عملت 16 جلسة لـ 4
+
+281
+00:19:51,150 --> 00:19:57,190
+مرضى، لأ. بدي أشوف الـ result تبعته، أشوف هل إن الـ
+
+282
+00:19:57,190 --> 00:20:00,030
+exercise اللي أنت عملته كان بنتيجة ولا مش نتيجة؟
+
+283
+00:20:00,030 --> 00:20:03,010
+هل الـ exercise اللي أنت عملته أدى لـ fatigue في
+
+284
+00:20:03,010 --> 00:20:07,070
+المريض ولا لأ؟ إن الشيء مش بالعدد، الشيء لازم أنا
+
+285
+00:20:07,070 --> 00:20:11,830
+أعرف الجودة تبعته عشان أكون في الصواب. breathing
+
+286
+00:20:11,830 --> 00:20:16,040
+exercise. طبعا إذا كان الشخص لا يبدأ في الهواء
+
+287
+00:20:16,040 --> 00:20:18,460
+الاصطناعي، أو بسميها mechanical ventilation، الهواء
+
+288
+00:20:18,460 --> 00:20:21,740
+الاصطناعي يجب أن يتم إزالته، تمام؟
+
+289
+00:20:23,330 --> 00:20:27,430
+بدي أعمل الـ exercise، بس إيش يكون المريض تبعي
+
+290
+00:20:27,430 --> 00:20:30,910
+أمكنها.  This, having been ventilated, should also
+
+291
+00:20:30,910 --> 00:20:34,490
+start breathing exercise.  If the endotracheal tubes
+
+292
+00:20:34,490 --> 00:20:37,790
+have been removed. يعني لو كان في عندي endotracheal
+
+293
+00:20:37,790 --> 00:20:42,030
+tubes، اللي هي في الـ endo، داخلية في الـ trachea، في
+
+294
+00:20:42,030 --> 00:20:45,720
+أنابيب داخلية. إذا أزيلت هالانابيب، أنا بشتغل، لكن لو
+
+295
+00:20:45,720 --> 00:20:49,440
+كانت موجودة، لأ ما بشتغل، لأنه ممكن تهدد حياة المريض.
+
+296
+00:20:49,440 --> 00:20:52,480
+The patient should be sitting up in bed with
+
+297
+00:20:52,480 --> 00:20:55,320
+his back supported by pillows so that the
+
+298
+00:20:55,320 --> 00:20:58,220
+rhythmic and chest movement are not inhibited.
+
+299
+00:20:58,220 --> 00:21:01,400
+تمام. الـ patient في وضع الـ long sitting position أو
+
+300
+00:21:01,400 --> 00:21:07,070
+الـ sitting نفسه، Okay، أو اللي هو sitting up، إنه جالس
+
+301
+00:21:07,070 --> 00:21:12,510
+و ظهره من وراء مسنود، سواء بالbed أو سواء بالـ pillows
+
+302
+00:21:12,510 --> 00:21:16,910
+اللي موجودة، وبخليه يشتغل الـ exercise. الـ exercise
+
+303
+00:21:16,910 --> 00:21:20,990
+should include diaphragmatic breathing, unilateral
+
+304
+00:21:20,990 --> 00:21:25,530
+lower thoracic expansion. يعني رح اشتغل على الـ two types of
+
+305
+00:21:25,530 --> 00:21:28,050
+breathing exercise، في عندي diaphragmatic و في
+
+306
+00:21:28,050 --> 00:21:31,150
+عندي الـ unilateral lower thoracic expansion في
+
+307
+00:21:31,150 --> 00:21:35,680
+الـ both sides، اللي هو الـ right و الـ left. If pain
+
+308
+00:21:35,680 --> 00:21:39,100
+is severely limiting the respiratory excursions,
+
+309
+00:21:39,220 --> 00:21:42,320
+the physiotherapist should treat the patient after
+
+310
+00:21:42,320 --> 00:21:48,330
+analgesics are administered. إذا كان الألم واضح
+
+311
+00:21:48,330 --> 00:21:52,790
+جدا، نتيجة أو بتحد من الـ respiration، أو اللي هي
+
+312
+00:21:52,790 --> 00:21:55,170
+respiratory excursions، اللي هو إفرازات
+
+313
+00:21:55,170 --> 00:21:59,510
+الـ secretion اللي موجودة، على طول، بقى أعطيه أي مسكن
+
+314
+00:21:59,510 --> 00:22:04,250
+أو أي مهدئ، على أساس أبلش أشتغل معاه من أول وجديد.
+
+315
+00:22:04,250 --> 00:22:09,250
+The patient should be reminded. المريض لازم
+
+316
+00:22:09,250 --> 00:22:12,030
+أنا أبقى ذاكره في الـ practice briefing. Exercise at
+
+317
+00:22:12,030 --> 00:22:17,160
+least every hour. على الأقل كل ساعة. Why؟ لسه weak
+
+318
+00:22:17,160 --> 00:22:21,500
+بينما هو لسه مش قادر معايا، إذا مش بس الـ exercise
+
+319
+00:22:21,500 --> 00:22:25,000
+يعمله مقتصر، فلأ كل ساعة لازم يعمل breathing
+
+320
+00:22:25,000 --> 00:22:28,140
+exercise. إحنا يا جماعة بنحكي على التنفس، بنحكي على
+
+321
+00:22:28,140 --> 00:22:32,520
+حياة مريض، فبالتالي هنا مهم جدا نسبة الـ oxygen اللي
+
+322
+00:22:32,520 --> 00:22:36,380
+موجودة. معظم مرضى COVID-19 ليه بيصيروا أو ليه
+
+323
+00:22:36,380 --> 00:22:39,560
+بيتوفوا؟ لأنه بيكون في عندنا الـ oxygen saturation
+
+324
+00:22:39,560 --> 00:22:43,860
+أو مستوى تشبع الأكسجين في الدم بيكون منخفض جدا. ليه؟
+
+325
+00:22:43,860 --> 00:22:49,820
+لعدم good ventilation، أو لعدم اللي هو الـ lung
+
+326
+00:22:49,820 --> 00:22:54,060
+functioning is not good، ما بتكون منيحة، الـ lung في
+
+327
+00:22:54,060 --> 00:22:59,570
+شغلها، تمام؟ الـ huffing and coughing. Effectiveness
+
+328
+00:22:59,570 --> 00:23:03,010
+of huffing and coughing is suitably operative. طبعا
+
+329
+00:23:03,010 --> 00:23:05,790
+مصدر بي encourage with the chest firmly supported.
+
+330
+00:23:05,790 --> 00:23:10,110
+نفس الحكي. و الـ foot and leg exercise، نفس الكلام،
+
+331
+00:23:10,110 --> 00:23:14,610
+اللي هو الـ  pumping exercise، هنا من خمسة لعشر مرات
+
+332
+00:23:14,610 --> 00:23:20,150
+كل ساعة، هذا بيعتمد على الـ tolerance تبع الـ patient،
+
+333
+00:23:20,150 --> 00:23:25,670
+الـ endurance، كم هو قادر يتحمل من اللي هو عمل الـ
+
+334
+00:23:25,670 --> 00:23:29,080
+exercises. Shoulder movement with lateral
+
+335
+00:23:29,080 --> 00:23:33,540
+thoracotectomy. طبعا thoracotectomy اللي هو it's
+
+336
+00:23:33,540 --> 00:23:36,740
+important to start arm movements: flexion, abduction,
+
+337
+00:23:36,740 --> 00:23:40,580
+extension. كل هذه الـ exercises مهمة جدا في أول يوم
+
+338
+00:23:40,580 --> 00:23:44,960
+من الـ exercise. With median sternotomy، طبعا الـ
+
+339
+00:23:44,960 --> 00:23:48,460
+cutting الـ sternotomy. This need not be started until
+
+340
+00:23:48,460 --> 00:23:52,740
+the second day. هذا مش من أول يوم أنا بشتغله، لأ، ثاني
+
+341
+00:23:52,740 --> 00:23:58,390
+يوم. لأن المسألة هنا بتكون مش سهلة. Third day
+
+342
+00:23:58,390 --> 00:24:02,900
+onwards, the patient will start، اللي هو "Sitting out
+
+343
+00:24:02,900 --> 00:24:06,720
+of bed 24 hours after surgery according to his
+
+344
+00:24:06,720 --> 00:24:09,880
+progress and the surgeon's instructions." ما بعملش أي
+
+345
+00:24:09,880 --> 00:24:14,400
+program إلا بناءً على توصية الطبيب، تمام؟ إذا
+
+346
+00:24:14,400 --> 00:24:19,600
+الطبيب سمح إنه أنا أجلس على حافة السرير، فبمشي في
+
+347
+00:24:19,600 --> 00:24:23,280
+هذه التوصية. لكن الطبيب حكى أن "Patient X is
+
+348
+00:24:23,280 --> 00:24:26,800
+unstable." خلاص، "unstable" معناته الكلام أنه
+
+349
+00:24:26,800 --> 00:24:30,410
+"contraindicated to movement." الـ walking around
+
+350
+00:24:30,410 --> 00:24:35,110
+and getting out of bed as soon as the second to third post
+
+351
+00:24:35,110 --> 00:24:41,290
+operative day. طبعا بمشي حوالين السرير شوية في ثاني
+
+352
+00:24:41,290 --> 00:24:43,510
+و ثالث يوم. The treatment should include
+
+353
+00:24:43,510 --> 00:24:46,450
+breathing exercises, huffing and coughing if
+
+354
+00:24:46,450 --> 00:24:50,190
+secretions are present، اللي هي بتكون موجودة في الـ
+
+355
+00:24:50,190 --> 00:24:55,330
+lungs.  The foot and leg exercises. الـ arm و الـ shoulder مهم
+
+356
+00:24:55,330 --> 00:25:00,260
+جدا. Postural correction زي ما حكينا عنها. الـ
+
+357
+00:25:00,260 --> 00:25:04,740
+walking upstairs، إنه يطلع درج وينزل درج في اليوم
+
+358
+00:25:04,740 --> 00:25:07,780
+السادس للعملية، مش من ثاني يوم، لأ، صارنا في اليوم
+
+359
+00:25:07,780 --> 00:25:10,720
+السادس. This will depend on the instructions of the
+
+360
+00:25:10,720 --> 00:25:14,960
+individual surgeon. طبعا بيعتمد على الجراح اللي
+
+361
+00:25:14,960 --> 00:25:18,510
+عمل العملية. After cardiac surgery, most patients
+
+362
+00:25:18,510 --> 00:25:22,750
+find climbing stairs, tears, muscle aches، اللي هو بأقل
+
+363
+00:25:22,750 --> 00:25:26,770
+جهد than preoperative. Treatment must be modified
+
+364
+00:25:26,770 --> 00:25:31,860
+if any complications arise. إذن الـ exercise
+
+365
+00:25:31,860 --> 00:25:36,160
+رح يكون توزيعه على الأيام، خصوصا الـ post-op، objective حكي
+
+366
+00:25:36,160 --> 00:25:39,100
+إن أنا عندي عامل مهم، إذا كان الـ patient stable
+
+367
+00:25:39,100 --> 00:25:43,440
+بمشي في الـ exercise، إذا الـ patient مش stable، بوقف
+
+368
+00:25:43,440 --> 00:25:48,560
+الـ programme، اللي هي أو بوقف برنامج العلاج الطبيعي، الآن
+
+369
+00:25:48,560 --> 00:25:53,750
+خلاص، الـ patient بده يتخرج، بدي أكتب له اللي هو
+
+370
+00:25:53,750 --> 00:25:57,430
+home program قبل الخروج. الـ thoracic expansion مهم
+
+371
+00:25:57,430 --> 00:26:02,450
+جدا، shoulder mobility، الـ postural، كل هذا الشيء مهم
+
+372
+00:26:02,450 --> 00:26:06,010
+جدا، لازم أقيمه، عشان أنا في تقدير الخروج، بأبعث له
+
+373
+00:26:06,010 --> 00:26:08,970
+يعني، the patient should be increasing his exercise
+
+374
+00:26:08,970 --> 00:26:13,730
+tolerance. لازم الـ patient يكون قادر على إنه يعمل
+
+375
+00:26:13,730 --> 00:26:17,510
+الـ exercise كذا مرة لكذا وقت. The patient should be
+
+376
+00:26:17,510 --> 00:26:20,850
+continuing breathing exercises for about three weeks
+
+377
+00:26:20,850 --> 00:26:24,660
+following the operation. طبعا لبعد ثلاثة أسابيع، على الرغم
+
+378
+00:26:24,660 --> 00:26:28,800
+من إنه discharge after، اللي هو ممكن يصير اللي هو
+
+379
+00:26:28,800 --> 00:26:32,680
+الخروج من عشرة لـ أربعة عشر يوم، يعني بعد أسبوعين هو
+
+380
+00:26:32,680 --> 00:26:36,140
+هيكون في الـ inpatient، موجود داخلي في المستشفى،
+
+381
+00:26:36,140 --> 00:26:41,140
+لكن أنا لازم أعلمه الـ home program لما بعد ذلك، إذا
+
+382
+00:26:41,140 --> 00:26:47,160
+كان فيه خروج، discharge. وبهيك بيكون أنا خلصت هذه
+
+383
+00:26:47,160 --> 00:26:50,000
+المحاضرة، اللي هي role of physiotherapy in
+
+384
+00:26:50,000 --> 00:26:54,900
+cardiothoracic surgery. حوالي تقريبا chapter 4.
+
+385
+00:26:54,900 --> 00:27:00,140
+أعتقد، وألقاكم بإذن الله في الـ chapter القادم، على
+
+386
+00:27:00,140 --> 00:27:00,780
+بركة الله.
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/TRy9edu8e-w_postprocess.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/TRy9edu8e-w_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..f12a0fc33120e675046ad85b621b3285cf1b267a
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/TRy9edu8e-w_postprocess.srt
@@ -0,0 +1,1544 @@
+1
+00:00:01,100 --> 00:00:05,060
+اللهم الصلي وسلم على محمد وعلى قلبي وصحبه أشمال
+
+2
+00:00:05,060 --> 00:00:10,280
+السلام عليكم ورحمة الله وبركاته هبدأ اليوم ان شاء
+
+3
+00:00:10,280 --> 00:00:14,680
+الله في chapter دور العلاج الطبيعي في حالات ال
+
+4
+00:00:14,680 --> 00:00:18,360
+cardio thoracic surgery كنا أخدنا في المحاضرة
+
+5
+00:00:18,360 --> 00:00:24,880
+السابقة عن الأسباب الآن هحكي على اللي هو موضوع ال
+
+6
+00:00:24,880 --> 00:00:28,180
+physiotherapy أو ال role ال physiotherapy في حالات
+
+7
+00:00:28,180 --> 00:00:33,390
+ال cardio thoracic surgeryبإذن الله تعالى هيكون
+
+8
+00:00:33,390 --> 00:00:39,470
+عندنا تسعتاشر slide تقريباهشرح مباشرة على ال role
+
+9
+00:00:39,470 --> 00:00:43,250
+of physiotherapy مارح أدخل في ال anatomy الأن هذا
+
+10
+00:00:43,250 --> 00:00:48,570
+بالنسبة أول صورة معاكم هيكون اللي هو عبارة عن صورة
+
+11
+00:00:48,570 --> 00:00:51,710
+القلب طبعا انتوا أخدتوا ال anatomy تبع ال heart و
+
+12
+00:00:51,710 --> 00:00:58,230
+أخدتوا كيف ال circulation و الدورة الدموية الصغيرة
+
+13
+00:00:58,230 --> 00:01:01,730
+و الدورة الدموية الكبرى و كل هذه الأمور في الجزء
+
+14
+00:01:01,730 --> 00:01:05,090
+النظري خليني أدخل هنا مباشرة على ال physiotherapy
+
+15
+00:01:05,090 --> 00:01:14,550
+role طبعا هبدأ فيمباشرة الفيزيotherapy
+
+16
+00:01:14,550 --> 00:01:19,670
+role هيكون pre-operative و post-operativeالـ
+
+17
+00:01:19,670 --> 00:01:22,690
+Preoperative هحكي على الـ aims هحكي على ال
+
+18
+00:01:22,690 --> 00:01:26,550
+exercise اللي هعطيها للمريض ههيئ نفسيه المريض
+
+19
+00:01:26,550 --> 00:01:31,990
+لمقبل العملية تمام؟ ال post-op اللي هي ال post
+
+20
+00:01:31,990 --> 00:01:36,370
+-operative هنعملها اللي هو ال exercise مع المريض
+
+21
+00:01:36,370 --> 00:01:41,530
+لما بعد العملية حتى أمنع ال complication حتى أوصل
+
+22
+00:01:41,530 --> 00:01:45,520
+مع المريض لمرحلة ال independence levelأحنا بنحكي
+
+23
+00:01:45,520 --> 00:01:49,380
+على عملية كبرى بنحكي على heart surgery بنحكي على
+
+24
+00:01:49,380 --> 00:01:52,940
+ممكن يكون open heart وممكن يكون لأ مش open heart
+
+25
+00:01:53,580 --> 00:01:58,360
+بكل الأحوال أنا بتكلم عن عملية كبيرة مش صغيرة هي
+
+26
+00:01:58,360 --> 00:02:03,400
+مش عملية كسور ولا عبارة عن عملية مرارة أو أي عملية
+
+27
+00:02:03,400 --> 00:02:08,060
+في الباطنة لأ هي عبارة عن عملية في الهاتف فبالتالي
+
+28
+00:02:08,060 --> 00:02:12,580
+لازم أكون أنا حاذرة في كل إشي بشتغل خلّيني نبدأ
+
+29
+00:02:12,580 --> 00:02:18,580
+أولا ل pre-operator لأني physiotherapy aims لكل ال
+
+30
+00:02:18,580 --> 00:02:25,790
+exercise اللي أنا بعطيهملأ مريض القلب لازم
+
+31
+00:02:25,790 --> 00:02:33,550
+احافظ على مستوى اوالتهوية الجيدة في اللي هي ال
+
+32
+00:02:33,550 --> 00:02:37,990
+ventilation الجيد للمريض يعني ال lung لازم تكون
+
+33
+00:02:37,990 --> 00:02:42,110
+عندى مليئة بالأكسجين قادرة على استيعاب أكبر كمية و
+
+34
+00:02:42,110 --> 00:02:48,210
+تتبادل الغازات داخلها لتورد للقلب اللي هو الأكسجين
+
+35
+00:02:48,210 --> 00:02:52,850
+فبالتالي لازم يكون المريض دائما محافظ على كمية ال
+
+36
+00:02:52,850 --> 00:02:56,330
+adequate ventilation to assist with removal of
+
+37
+00:02:56,330 --> 00:03:00,960
+excessive secretion in the airwaysتمام اللي هو
+
+38
+00:03:00,960 --> 00:03:07,120
+بيكون طبعا انه انا بحاول اعمل على ازالة اي
+
+39
+00:03:07,120 --> 00:03:11,380
+secretion موجود فيه اللي هو في ال positioning
+
+40
+00:03:11,380 --> 00:03:15,280
+حكينا ال postural drainage اخدنا كمان اللي هو
+
+41
+00:03:15,280 --> 00:03:19,040
+المساج ال clubbing الأمور اللي زيها يكونها ت move
+
+42
+00:03:19,040 --> 00:03:23,640
+ل ال secretion I learn to assist circulation in
+
+43
+00:03:23,640 --> 00:03:27,020
+legs and thora بي help to prevent bust or
+
+44
+00:03:27,020 --> 00:03:31,340
+pallative venous thrombosisانا هنا بدي امنع ال DVT
+
+45
+00:03:31,340 --> 00:03:35,900
+عن طريق ال pumping exercise او ال ankle movement
+
+46
+00:03:35,900 --> 00:03:41,980
+exerciseرقم 4 و 8 تان لـ mobility of shoulders and
+
+47
+00:03:41,980 --> 00:03:45,140
+shoulder girdle and spine بدي أحافظ لأنه هي
+
+48
+00:03:45,140 --> 00:03:47,740
+المنطقة اللي عملت فيها ال surgery منطقة ال
+
+49
+00:03:47,740 --> 00:03:50,520
+thoracic فبالتالي أنا بدي أحافظ على ال mobility
+
+50
+00:03:50,520 --> 00:03:53,380
+تبعي المريض تبعي في ال shoulder و ال shoulder
+
+51
+00:03:53,380 --> 00:03:57,640
+girdle تمام؟ أنا مارديش أي مشاكل أي deformity
+
+52
+00:03:57,640 --> 00:04:02,520
+تتصير في هاي المكان يعني على سبيل المثال إشي طبيعي
+
+53
+00:04:02,520 --> 00:04:06,500
+كلنا بنرجع لوضع ال C shape اللي هو الوضع الجنيني
+
+54
+00:04:06,500 --> 00:04:10,300
+اللي احنا كنا فيههنا بناجى المريض بدى ينحني للأمام
+
+55
+00:04:10,300 --> 00:04:16,020
+بوضع الكيفوس ليه؟ لأنه بتكون painful عملية مؤلمة
+
+56
+00:04:16,020 --> 00:04:20,100
+فاحنا أي واحد حتى لو انت عندك شخص او اي شخص عنده
+
+57
+00:04:20,100 --> 00:04:24,120
+مغص على طول بحط ايده على بطنه وبنتني لقدام هذا
+
+58
+00:04:24,120 --> 00:04:28,100
+الاشي طبيعى تمام فمبالكوا بعملية heart surgery زى
+
+59
+00:04:28,100 --> 00:04:34,120
+هذه وفيهاتقريباً تلاتين أو اربعين غرزة وامور كبيرة
+
+60
+00:04:34,120 --> 00:04:40,700
+زي هذه هو هيفنين لإنه يوضع في هذه الوضعية اللي هي
+
+61
+00:04:40,700 --> 00:04:48,070
+هتعمل deformity زي الـ K-forcesto prevent postural
+
+62
+00:04:48,070 --> 00:04:51,730
+defest هذا اللي انا كنت احكي عنه انه انا بدي امنع
+
+63
+00:04:51,730 --> 00:04:56,330
+اي key forces اي deformity تصير في ال spine مابدنا
+
+64
+00:04:56,330 --> 00:05:00,810
+اي اشي يصير بعد هيك هو كان المرضى بيعمله كعملية
+
+65
+00:05:00,810 --> 00:05:05,730
+تعوضية ليش انه انا مابديش اتوجه اكتر و اكتر وبعد
+
+66
+00:05:05,730 --> 00:05:10,930
+هيك بتصير المشكلةدائمة و قائمة لأ هي كانت في الأول
+
+67
+00:05:10,930 --> 00:05:15,750
+عادة ان هو كان يتوجع من ألم في صدره كان يميل لقدام
+
+68
+00:05:15,750 --> 00:05:19,890
+بعد شوية صارت عادة دائمة هذا بيعمللي اللي هو
+
+69
+00:05:19,890 --> 00:05:25,320
+postural deformity زي ال K-forcesto restore
+
+70
+00:05:25,320 --> 00:05:30,900
+exercise tolerance حتى أخليه إنه قادر على إنه يعمل
+
+71
+00:05:30,900 --> 00:05:34,260
+ال exercise tolerance أزيده يعني إن إذا بدي أنا
+
+72
+00:05:34,260 --> 00:05:38,320
+يزيد ال exercise من خمس لعشر مرات يبعد شوية أو بعد
+
+73
+00:05:38,320 --> 00:05:41,320
+يومين تلاتة يزيده مثلا لخمستاشر مرة في ال exercise
+
+74
+00:05:41,320 --> 00:05:45,140
+يعني أعمل elbow flexion أول مرة ببدأها معاها خمس
+
+75
+00:05:45,140 --> 00:05:49,120
+مرات يلا نعمل مع بعض خمس مرات يا حجة بعد يومين لأ
+
+76
+00:05:49,120 --> 00:05:53,010
+الخمس مرات هي بتتطور بدي أزيد ال toleranceاللي هو
+
+77
+00:05:53,010 --> 00:05:55,710
+الـ number of exercises جدّي المريض بيتحمل أنه أنا
+
+78
+00:05:55,710 --> 00:06:00,190
+أزيد معاه ال exercise هي عندى هنا ست أهداف ل ال
+
+79
+00:06:00,190 --> 00:06:03,550
+physiology programs في حالات ال cardiac أو في قسم
+
+80
+00:06:03,550 --> 00:06:08,510
+ال cardiac اللى موجود في داخل المستشفى خلّينى أشوف
+
+81
+00:06:08,510 --> 00:06:12,810
+ال preoperative training هي عندى لما قبل العملية
+
+82
+00:06:12,810 --> 00:06:17,760
+ست أهداف أساسيةأول إشي explanation to the patient
+
+83
+00:06:17,760 --> 00:06:21,780
+إنه أنا أوضح كل إشي للمريض explanation by
+
+84
+00:06:21,780 --> 00:06:25,000
+physiotherapist in order to gain the patient
+
+85
+00:06:25,000 --> 00:06:28,660
+confidence and cooperation إذا أنا أخدت و أقعدت مع
+
+86
+00:06:28,660 --> 00:06:33,060
+المريض و طبعا أنت اليوم وصلت مستوى رابع هذا الإشي
+
+87
+00:06:33,060 --> 00:06:38,280
+بيخلي ثقة المريض فيك ممتازة جدا إنه أنا شرحت لك
+
+88
+00:06:38,280 --> 00:06:42,480
+هيصير معاك يا حجة واحد اتنين تلاتة هنعمل عملية قلب
+
+89
+00:06:42,480 --> 00:06:48,820
+مفتوح هيصير فيهزراعة صمام هيصير في أي process طبعا
+
+90
+00:06:48,820 --> 00:06:51,760
+كون احنا قرائين اللي هو ال medical file كامل
+
+91
+00:06:51,760 --> 00:06:55,780
+وعارفين ايش بدنا نعمل او عارفين مع مين احنا بدنا
+
+92
+00:06:55,780 --> 00:06:59,600
+نشتغل فبالتالي اذا صار في ثقة بين ال physicalist و
+
+93
+00:06:59,600 --> 00:07:02,640
+ال patient تبعه معناته ده بيزيد ال cooperation
+
+94
+00:07:02,640 --> 00:07:06,800
+بيصير هو يحب الجلسة فعلا انا هذا الاشي كنت الاحظه
+
+95
+00:07:06,800 --> 00:07:10,640
+في ايام اللي هو الشغل الاتنينيكي حتى الأطفال كمان
+
+96
+00:07:10,640 --> 00:07:15,760
+نفس الكلامإذا الطفل أخد أو كسب .. أنت كسبت ثقته،
+
+97
+00:07:15,760 --> 00:07:20,340
+معناة الكلام إن هو هيحب الجلسة، هيحب ييجي عليك، مش
+
+98
+00:07:20,340 --> 00:07:24,460
+الطفل اللي ممكن أنت تتـ network فيه أو أن أنت ما
+
+99
+00:07:24,460 --> 00:07:28,160
+تعطي ثقتك، هذا لكم و لمفتاحكم إن أنتوا كيف بدكم
+
+100
+00:07:28,160 --> 00:07:31,540
+تتعاملوا مع الناس بال skills communication skills
+
+101
+00:07:31,540 --> 00:07:35,960
+طبعا مهمة جدا في التعامل مع أي patient، هذا أول
+
+102
+00:07:35,960 --> 00:07:40,160
+هدفتاني إشي في الـ Explanation للـ patient to
+
+103
+00:07:40,160 --> 00:07:43,360
+impair importance of maintaining educated
+
+104
+00:07:43,360 --> 00:07:47,360
+ventilation للـ lungs by breathing exercise أنا
+
+105
+00:07:47,360 --> 00:07:52,520
+بدي أحافظ على مجال التهوية بكميات وثيرة عن طريق ال
+
+106
+00:07:52,520 --> 00:07:56,620
+breathing exercise and clearance من ال secretion
+
+107
+00:07:56,620 --> 00:08:00,760
+أحافظ عليه بتمرين التنفس وإن شاء الله رب العالمين
+
+108
+00:08:00,760 --> 00:08:04,860
+هتاخدوها في المعملأيضا خلو الريقتين من أي
+
+109
+00:08:04,860 --> 00:08:09,680
+secretion يعيق حركتهم فبالتالي أنا بدي أحافظ على
+
+110
+00:08:09,680 --> 00:08:12,960
+ال ventilation كاملة الريقة تقدر تعمل ال
+
+111
+00:08:12,960 --> 00:08:18,920
+explanation تبعها في ال inhale و ال exhale تمام؟
+
+112
+00:08:18,920 --> 00:08:22,000
+reinsurance should be given that breathing
+
+113
+00:08:22,000 --> 00:08:26,230
+exercise ها thing بدي أتأكدإنه ال patient يقدر
+
+114
+00:08:26,230 --> 00:08:32,370
+يعمل exercise، يعمل coughing، و يحاول
+
+115
+00:08:32,370 --> 00:08:36,190
+أن يمشي حول السليم، بالذات أول يوم هذا، إذا كان
+
+116
+00:08:36,190 --> 00:08:40,110
+قادر، إذا هو medically stable دائما أنا بحط يفتق
+
+117
+00:08:40,110 --> 00:08:44,030
+أمام عيني، if the patient is medically stable، I
+
+118
+00:08:44,030 --> 00:08:49,870
+am in safe side، أنا بوضع السليم، إذا هو ما كان
+
+119
+00:08:49,870 --> 00:08:54,950
+medically stable،ما بمسكه Contra-indicated لكن إذا
+
+120
+00:08:54,950 --> 00:08:59,350
+أنا حسيت إن هو واعي، حسيت إن هو كل الأمور عنده
+
+121
+00:08:59,350 --> 00:09:03,290
+تمام، ال ventilation عنده تمام، التنفس طبيعي،
+
+122
+00:09:03,290 --> 00:09:06,590
+مافيش أي مشكلة، ببدأ مع ال session وحناخده هدف ال
+
+123
+00:09:06,590 --> 00:09:10,930
+post-operative إن شاء الله في ال styles القادمةأذا
+
+124
+00:09:10,930 --> 00:09:15,230
+أنا بدى أتأكد أن ال breathing اللى هو ال exercise
+
+125
+00:09:15,230 --> 00:09:19,310
+و ال huffing و ال coughing و كل هذه الأمور تمام
+
+126
+00:09:19,310 --> 00:09:23,210
+تمام و أنه أنا قادرة أعطي الجلسة للمريض without
+
+127
+00:09:23,210 --> 00:09:28,180
+any harm من غير أن أنا أؤذيهسواء كان في تيوب طالع
+
+128
+00:09:28,180 --> 00:09:34,300
+من الرئة أو في تيوب اللي هو تبع ال van هذا اللي هو
+
+129
+00:09:34,300 --> 00:09:37,040
+في ال canyon المحطوط بدي أحافظ عليه من غير ما
+
+130
+00:09:37,040 --> 00:09:41,300
+أؤذيه بأي إشي في التمرين اللي أنا بدي أمشي و أشتغل
+
+131
+00:09:41,300 --> 00:09:47,720
+عليهاالهدف التاني تبعنا remove للsecretions اليوم
+
+132
+00:09:47,720 --> 00:09:52,260
+عندنا اللى هو وظيفة ال lungs انه تعمل في أثناء ال
+
+133
+00:09:52,260 --> 00:09:56,420
+inhale و ال exhale بيصير فيه gas exchange تبادل
+
+134
+00:09:56,420 --> 00:10:00,340
+الغذاء إذا أنا موجود فيه عندي secretion وهذا ال
+
+135
+00:10:00,340 --> 00:10:03,020
+secretion على فكرة هو نعمة من الله سبحانه وتعالى
+
+136
+00:10:03,020 --> 00:10:08,400
+ليه؟ لإنه تلتصق فيه أي microorganismأي pathogen أي
+
+137
+00:10:08,400 --> 00:10:11,800
+إشي دخل إلى داخل الريعتين بيلقصق في هذا ال
+
+138
+00:10:11,800 --> 00:10:17,260
+situation فالصح أنه أنا أطلع لبرا لأنه ممكن يعني
+
+139
+00:10:17,260 --> 00:10:22,040
+بما أننا في جائحة كورونا و COVID-19 هذه شو اللي
+
+140
+00:10:22,040 --> 00:10:25,600
+بيصير أن هذا ال virus بيدخل لريعتين و بيعمل فيهم
+
+141
+00:10:25,600 --> 00:10:29,560
+collapse يعني بتنقبض الريعتين فبالتالي ما بيصير في
+
+142
+00:10:29,560 --> 00:10:32,600
+educated ventilationعشان كده الحالات الـ critical
+
+143
+00:10:32,600 --> 00:10:36,500
+و الحالات الصعبة بتلاقيها will die بتموت على طول
+
+144
+00:10:36,500 --> 00:10:39,800
+ليه؟ لإن مافي عندنا educate ventilation the
+
+145
+00:10:39,800 --> 00:10:42,760
+majority of patients about undergo cardiac surgery
+
+146
+00:10:42,760 --> 00:10:46,380
+do not have excessive bronchial or bronchial
+
+147
+00:10:46,380 --> 00:10:50,140
+secretion تمام؟ الأغلبى من هدول المرضى في ال
+
+148
+00:10:50,140 --> 00:10:53,280
+cardiac surgery في عندهم do not have excessive
+
+149
+00:10:53,280 --> 00:10:57,620
+bronchial secretion لكن there are however some
+
+150
+00:10:57,620 --> 00:11:02,460
+patientswith severe metral valve disease الناس
+
+151
+00:11:02,460 --> 00:11:06,560
+اللي عندها أو المرضى اللي عندها مشكلة في الصمام
+
+152
+00:11:06,560 --> 00:11:09,840
+المترالي أو الـ long-standing pulmonary
+
+153
+00:11:09,840 --> 00:11:13,700
+hypertension that may have developed associated
+
+154
+00:11:13,700 --> 00:11:16,940
+chronic obstructive lung disease اللي أنا بسميها
+
+155
+00:11:16,940 --> 00:11:20,640
+COPD تمام؟ اللي هو chronic obstructive lung
+
+156
+00:11:20,640 --> 00:11:25,380
+diseaseand assisting with removal secretion is
+
+157
+00:11:25,380 --> 00:11:29,540
+required لازم انا اعمل على ازالة ال secretion سواء
+
+158
+00:11:29,540 --> 00:11:33,080
+كان mechanically او manually manually بال coughing
+
+159
+00:11:33,080 --> 00:11:36,960
+و ال huffing و المساج و ال exercise تمام اما
+
+160
+00:11:36,960 --> 00:11:39,320
+mechanically في عندنا آلات هنشوفها ان شاء الله في
+
+161
+00:11:39,320 --> 00:11:42,780
+قسم الصدرية او في محاضرات الصدرية ان كيف انا بقدر
+
+162
+00:11:42,780 --> 00:11:46,760
+اعمل suction و اشيل هذا ال secretionفي الـ Early
+
+163
+00:11:46,760 --> 00:11:49,380
+stage الـ cardiac disease ال patient have
+
+164
+00:11:49,380 --> 00:11:53,000
+resistance dry coughing لسه في بداية المراحل و
+
+165
+00:11:53,000 --> 00:11:55,860
+خصوصا بعد التخطير و ال binge و الأمور اللي زي هذه
+
+166
+00:11:55,860 --> 00:12:01,060
+بتكون الكحة ناشرة لسه مافي بلغة و فعلا هي بنفل
+
+167
+00:12:01,060 --> 00:12:04,640
+يعني أنا ماكنت أشوفها مع المرضى يعني بتحسي حرام ال
+
+168
+00:12:04,640 --> 00:12:09,920
+patient هتطلع روحه النوة اللي هو ال heart surgery
+
+169
+00:12:09,920 --> 00:12:13,020
+و لا ال coughing اللي هي ناشرة مش عارف يطلع فيها
+
+170
+00:12:13,020 --> 00:12:17,800
+إشيأو الـ Expected Fertile Wiltsiputam طبعا احنا
+
+171
+00:12:17,800 --> 00:12:21,280
+قصده باللي هو المقشع أو اللي هو السبيوتم هذا اللي
+
+172
+00:12:21,280 --> 00:12:25,860
+مش جادر المريض يطلعه This is not a problem that
+
+173
+00:12:25,860 --> 00:12:28,620
+can be dealt with physiotherapy هنا انا ممكن
+
+174
+00:12:28,620 --> 00:12:33,980
+اتعامل معاها اللي هو عن طريق طبعابنوصل caregiver
+
+175
+00:12:33,980 --> 00:12:37,960
+اللي موجودين معاه أو الأهل أنه لو سمحوله طبعا بعد
+
+176
+00:12:37,960 --> 00:12:41,500
+ما يسمحله الطبيب بيأخذ اللي هو بالاعتماد على الشرب
+
+177
+00:12:41,500 --> 00:12:46,640
+و الأكل نعطيه سواقل دافية عشان تبدأ يعني تشتغل
+
+178
+00:12:46,640 --> 00:12:50,820
+داخل الجسم و تلطب المكان و تلطفه كمان لو تبخيرة
+
+179
+00:12:50,820 --> 00:12:55,120
+صغيرة من ال bronchodilators بتفيدني في هذه الحالة
+
+180
+00:12:55,470 --> 00:12:58,370
+الان ال breathing exercise شو يعني breathing
+
+181
+00:12:58,370 --> 00:13:01,150
+exercise؟ في عندنا diaphragmatic breathing في
+
+182
+00:13:01,150 --> 00:13:04,390
+عندنا ال unilateral لل lower thoracic expansion
+
+183
+00:13:04,390 --> 00:13:07,370
+diaphragm muscles هي ال main muscles في ال
+
+184
+00:13:07,370 --> 00:13:11,570
+respiratory system عضلة أساسية بيغذيها الفرن كنيل
+
+185
+00:13:11,890 --> 00:13:17,250
+هذه العضنة عادة تعمل عدلة إدافرة حوالي 70% من
+
+186
+00:13:17,250 --> 00:13:21,330
+التنفس اللي إحنا بنتنفس و بتشتغل عضلات إدافرة لكن
+
+187
+00:13:21,330 --> 00:13:25,890
+عدلة إدافرة عادة تعمل عدلة 13% للـ action of
+
+188
+00:13:25,890 --> 00:13:29,050
+breathing the first day في الـ postoperative لكن
+
+189
+00:13:29,050 --> 00:13:31,830
+أيام اللي هم اللي بيكون عندي مريض ال cardio
+
+190
+00:13:31,830 --> 00:13:36,650
+surgery تشتغل فقط 30% يعني أقل من النص، وهذا
+
+191
+00:13:36,650 --> 00:13:39,390
+بيعمللي مشكلة لأنها ال mainly muscle في
+
+192
+00:13:39,390 --> 00:13:42,940
+الrespirationفبالتالي أنا هنا لازم أحافظ عليها الـ
+
+193
+00:13:42,940 --> 00:13:46,280
+diaphragm improving للventilation and lower loops
+
+194
+00:13:46,280 --> 00:13:48,760
+which is the site of communication of secretion
+
+195
+00:13:48,760 --> 00:13:53,360
+okay إنه أنا بدي أحافظ عليها تكون strong على قدر
+
+196
+00:13:53,360 --> 00:13:57,400
+الاستطاع حتى تعمل remove لل secretion الـ
+
+197
+00:13:57,400 --> 00:14:02,100
+unilateral lower thoracic expansion unilateral
+
+198
+00:14:02,100 --> 00:14:06,820
+lower costal breathing لأضلع اللي هي السفلة في ال
+
+199
+00:14:06,820 --> 00:14:09,460
+breathing exercise improve ventilation
+
+200
+00:14:15,250 --> 00:14:19,470
+الجزئية السفلاء اللي موجودة بدي أشتغل فيها على
+
+201
+00:14:19,470 --> 00:14:23,330
+أساس إنه أنا المريض يكمل باقي ال ventilation في
+
+202
+00:14:23,330 --> 00:14:27,590
+الـ Unilateral Thoracic Expansion هيكون الاشي واضح
+
+203
+00:14:27,590 --> 00:14:32,710
+و أفضل في المعمل مع اللي هو الأخصائيين اللي
+
+204
+00:14:32,710 --> 00:14:38,390
+موجودين معاكمالـ goals الرابع ال effectiveness لل
+
+205
+00:14:38,390 --> 00:14:41,930
+huffing and cuffing طبعا انا لازم اكون عرفت شو
+
+206
+00:14:41,930 --> 00:14:46,470
+يعني huffing وشو يعني cuffing تمام الفرق ما بينهم
+
+207
+00:14:46,470 --> 00:14:50,310
+مهم جدا و هاخده الفيزيوثera بي show the patient
+
+208
+00:14:50,310 --> 00:14:53,970
+اللي هو should show the patient لأن انا لازم اعلم
+
+209
+00:14:53,970 --> 00:14:58,040
+ال patient كيف يعمل huffing كيف يعمل cuffingهذا
+
+210
+00:14:58,040 --> 00:15:05,580
+مهم جداً و support لمنطقة الجراحة زي اللي هو لما
+
+211
+00:15:05,580 --> 00:15:09,380
+انا بدي اجي على سبيل المثال والده قيصري معناة
+
+212
+00:15:09,380 --> 00:15:12,820
+الكلام انه انا لازم احط pillow حتى ايش اعمل
+
+213
+00:15:12,820 --> 00:15:16,920
+support لاللي هو ال surgery site لموقع اللي هي
+
+214
+00:15:16,920 --> 00:15:21,480
+العمليةنفس الكلام هنتعامل فيه هنا هدعمه اللي هو
+
+215
+00:15:21,480 --> 00:15:25,300
+بال chest support سواء أنا بإيده و هو نفسه إذا هو
+
+216
+00:15:25,300 --> 00:15:28,800
+مش قادر يعملها أنا بإيدي أو بإيد أي حد من اللي
+
+217
+00:15:28,800 --> 00:15:33,380
+موجودين أو إنه أنا أعطيه pillow الخد صغيرة يحطها
+
+218
+00:15:33,380 --> 00:15:38,920
+عشان الدعم الجرح و ما أفتحه من أول و جديد إذا she
+
+219
+00:15:38,920 --> 00:15:43,460
+will support the chest of her incision and how he
+
+220
+00:15:43,460 --> 00:15:48,730
+can supportit himself كيف ممكن هو يدعم نفسه بنفسه
+
+221
+00:15:48,730 --> 00:15:53,730
+ال goals الخامس أو ال exercise الخامس foot and leg
+
+222
+00:15:53,730 --> 00:15:57,970
+exercise ال bombing exercise مهم جدا to prevent
+
+223
+00:15:57,970 --> 00:16:02,000
+PVTAll patients have thought simple exercise and
+
+224
+00:16:02,000 --> 00:16:04,640
+knee flexion extension in order to assist
+
+225
+00:16:04,640 --> 00:16:08,940
+circulation حتى أنا أساعد الcirculation أمنع أي
+
+226
+00:16:08,940 --> 00:16:15,060
+DVT لأنه بتعرفه after operative أو بعد العملية بدي
+
+227
+00:16:15,060 --> 00:16:18,280
+يصير في عندي اللي هو blood coagulation فبالتالي
+
+228
+00:16:18,280 --> 00:16:22,800
+هدخل أنا في الthrombosis هعمل اللي هو DVT وهذه
+
+229
+00:16:22,800 --> 00:16:26,380
+Contra indication أن يصير المريض تبعيا عنده DVTالـ
+
+230
+00:16:26,380 --> 00:16:30,800
+Postural shoulder girdle and arm movement مهم جدا
+
+231
+00:16:30,800 --> 00:16:34,380
+زى ما حكينا أنا بدى أعمل prevent لأى deformity
+
+232
+00:16:34,380 --> 00:16:38,300
+this patient having median sternotomy بالذات ال
+
+233
+00:16:38,300 --> 00:16:42,570
+patient اللى عمل cutting فى الـ sternumيعني عضمة
+
+234
+00:16:42,570 --> 00:16:47,010
+وصار فيها cutting هذا الأشي مش سهل جدا مش سهل خالص
+
+235
+00:16:47,010 --> 00:16:50,290
+لإن ال patient تبعي هيدخل فيه مضاعفات فأنا لازم
+
+236
+00:16:50,290 --> 00:16:55,610
+أجلس فيه وضعية يكون فيها صحيح مش عامل اللي هو
+
+237
+00:16:55,610 --> 00:16:59,490
+contractures أو kyphosis على سبيل المثال after
+
+238
+00:16:59,490 --> 00:17:03,250
+surgery but shoulder girdle may become stiffand
+
+239
+00:17:03,250 --> 00:17:06,250
+maybe patients and many patients tend to adapt
+
+240
+00:17:06,250 --> 00:17:09,730
+slightly with kyphotic posture هو بالأول بتكون بس
+
+241
+00:17:09,730 --> 00:17:13,670
+إنه مجرد إن هو إشي compensatory كإشي يعني تعويضي
+
+242
+00:17:13,670 --> 00:17:17,230
+إن هو بده يعوضها للحركة هذه إنه عشان تمنع القلم
+
+243
+00:17:17,230 --> 00:17:21,410
+فبعد شوية بتصير إشي دائم permanent shoulders
+
+244
+00:17:21,410 --> 00:17:26,730
+shrinking تمام إنه يهز كتابة هو أفضل exercise يعني
+
+245
+00:17:26,730 --> 00:17:28,230
+يعمل upward
+
+246
+00:17:31,350 --> 00:17:35,710
+Downward Retraction هنشوفها كمان في الصور في ال
+
+247
+00:17:35,710 --> 00:17:39,010
+exercise هذا بالنسبة لحالة open heart surgery
+
+248
+00:17:39,010 --> 00:17:42,390
+شايفين الاشي ممكن هاي ال sternum اللي انتوا شايفين
+
+249
+00:17:42,390 --> 00:17:46,350
+هيصير فيها cutting و remove كامل فبالتالي الحين
+
+250
+00:17:46,350 --> 00:17:49,970
+العملية it's difficult مش سهلة هاي ال shoulder
+
+251
+00:17:49,970 --> 00:17:57,210
+stretch اللي هو upward downward Retraction هذا
+
+252
+00:17:57,210 --> 00:18:00,910
+اللي هو عبارة عن ال exerciseاللي أنا بشتغله معاه
+
+253
+00:18:00,910 --> 00:18:04,770
+حتى أحافظ على range of motion لـ shoulder و
+
+254
+00:18:04,770 --> 00:18:09,790
+shoulder girdage الآن خلصناه من ال exercise اللي
+
+255
+00:18:09,790 --> 00:18:12,850
+هي preoperative أجل ال exercise ال boss
+
+256
+00:18:12,850 --> 00:18:17,570
+preoperative if patient is not ventilator إذا كان
+
+257
+00:18:17,570 --> 00:18:20,410
+هو مش على ventilator هنا بحكي على mechanical
+
+258
+00:18:20,410 --> 00:18:24,330
+ventilator إذا كان medically stable هبلش معاه
+
+259
+00:18:24,330 --> 00:18:27,900
+breathing exercise من أول يومتمام؟ شو يعني أنا
+
+260
+00:18:27,900 --> 00:18:30,960
+بحكي medical statement؟ يعني هو conscious؟يعني
+
+261
+00:18:30,960 --> 00:18:36,980
+مافي أي علامة بتأثر أو بتوحيلي أن هذا المريض في
+
+262
+00:18:36,980 --> 00:18:43,560
+خطر يعني التنفس طبيعي ال heart rate طبيعي كل إش
+
+263
+00:18:43,560 --> 00:18:47,080
+حواليه طبيعي هو واعي لإيش أنا بحكي أو إيش ال
+
+264
+00:18:47,080 --> 00:18:50,460
+exercise اللي أنا بعمله فبالتالي هنا ممكن أبلش
+
+265
+00:18:50,460 --> 00:18:53,740
+معاه breathing exercise لكن لو كان في عندي أي
+
+266
+00:18:53,740 --> 00:18:57,580
+مشكلة سواء إنه على mechanical ventilation أو سواء
+
+267
+00:18:57,580 --> 00:18:59,940
+ال vision تبعي لسه في كومة أو لسه
+
+268
+00:19:02,620 --> 00:19:07,120
+ممنوع اشتغل معاه after breathing exercise بحاول
+
+269
+00:19:07,120 --> 00:19:11,200
+اعلمه اللي هو كان أخدهم ال exercise قبل ال hoofing
+
+270
+00:19:11,200 --> 00:19:15,980
+و ال cuffing should be made تمام؟ اذا بعد اللي هو
+
+271
+00:19:15,980 --> 00:19:18,580
+ال breathing exercise في عندي hoofing and cuffing
+
+272
+00:19:18,580 --> 00:19:22,800
+في أول يوم هنا ماحجسمهم نوع نوع في ال exercise لأ
+
+273
+00:19:22,800 --> 00:19:26,340
+حجسمهم حسب الأيام أول يومالفيزيotherapy will
+
+274
+00:19:26,340 --> 00:19:29,460
+probably necessary four times during the day أربع
+
+275
+00:19:29,460 --> 00:19:33,300
+مرات يمر عليه الفيزيotherapy تمام؟ مهم جدا The
+
+276
+00:19:33,300 --> 00:19:36,280
+length لأن أنا بدي أمنع أي secretion مابدي أي إشي
+
+277
+00:19:36,280 --> 00:19:39,220
+يصير فرقتين The length of a treatment should be
+
+278
+00:19:39,220 --> 00:19:42,040
+modified according to the patient condition and
+
+279
+00:19:42,040 --> 00:19:46,040
+should not cause fatigue مهم جدا الإشي هذا إنه أنا
+
+280
+00:19:46,040 --> 00:19:51,150
+مابس هدفي اعطي والله انا اليوم عملت 16 جلسة ل 4
+
+281
+00:19:51,150 --> 00:19:57,190
+مرضى لأ واريني اشوف ال result تبعتك اشوف هل انه ال
+
+282
+00:19:57,190 --> 00:20:00,030
+exercise اللي انت عملته كان بنتيجة ولا مش نتيجة؟
+
+283
+00:20:00,030 --> 00:20:03,010
+هل ال exercise اللي انت عملته قد ل fatigue في
+
+284
+00:20:03,010 --> 00:20:07,070
+المريض ولا لأ؟ انه الاشي مش بالعدل، الاشي لازم انا
+
+285
+00:20:07,070 --> 00:20:11,830
+اعرف الجودة تبعته عشان اكون في الصليب breathing
+
+286
+00:20:11,830 --> 00:20:16,040
+exerciseطبعاً إذا كان الشخص لا يبدأ في الهواء
+
+287
+00:20:16,040 --> 00:20:18,460
+الاصطناعي أو بسميها mechanical ventilating الهواء
+
+288
+00:20:18,460 --> 00:20:21,740
+الاصطناعي يجب أن يتم تحميله تمام؟
+
+289
+00:20:23,330 --> 00:20:27,430
+بدي أعمل الـ exercise بس إيش يكون المريض تبعي
+
+290
+00:20:27,430 --> 00:20:30,910
+امكملها this have been ventilated should also
+
+291
+00:20:30,910 --> 00:20:34,490
+start breathing exercise في الـ endotracheal tubes
+
+292
+00:20:34,490 --> 00:20:37,790
+have been removed يعني لو كان في عندي endotracheal
+
+293
+00:20:37,790 --> 00:20:42,030
+tubes اللي هي في الـ endo داخلي في الأتراكيا في
+
+294
+00:20:42,030 --> 00:20:45,720
+أنابيب داخليةإذا انشأت هالاناريب أنا بشتغل لكن لو
+
+295
+00:20:45,720 --> 00:20:49,440
+كانت موجودة لأ مابشتغل لانه ممكن تهدد حياة المرض
+
+296
+00:20:49,440 --> 00:20:52,480
+ال patient should be sitting up at the bed with
+
+297
+00:20:52,480 --> 00:20:55,320
+hull back supported by pillows so that the
+
+298
+00:20:55,320 --> 00:20:58,220
+rheumatic and chest movement are not inhibited
+
+299
+00:20:58,220 --> 00:21:01,400
+تمام ال patient في وضع ال long sitting position أو
+
+300
+00:21:01,400 --> 00:21:07,070
+ال sitting نفسهOkay او اللي هو setting up انه جالس
+
+301
+00:21:07,070 --> 00:21:12,510
+و الدهر من ورا مسنود سواء بالبد او سواء بالبلو
+
+302
+00:21:12,510 --> 00:21:16,910
+اللي موجودة و بخلي يشتغل ال exercise ال exercise
+
+303
+00:21:16,910 --> 00:21:20,990
+should include diaphragmatic breathing unilateral
+
+304
+00:21:20,990 --> 00:21:25,530
+لل thoracic expansion يعني هشتغل ع ال two types of
+
+305
+00:21:25,530 --> 00:21:28,050
+breathing exercise في عند ال diaphragmatic و في
+
+306
+00:21:28,050 --> 00:21:31,150
+عند ال unilateral لل lower thoracic expansion في
+
+307
+00:21:31,150 --> 00:21:35,680
+ال both sidesاللي هو الـ Right و الـ Left If pain
+
+308
+00:21:35,680 --> 00:21:39,100
+is severely limiting the respiratory excursions,
+
+309
+00:21:39,220 --> 00:21:42,320
+the physiotherapist should treat patient after
+
+310
+00:21:42,320 --> 00:21:48,330
+analgesics and administrate itإذا كان الألم واضح
+
+311
+00:21:48,330 --> 00:21:52,790
+جدا نتيجة أو بتحد من الـ Respiration أو اللي هي
+
+312
+00:21:52,790 --> 00:21:55,170
+Respiration Exclusions اللي هو إفرازات
+
+313
+00:21:55,170 --> 00:21:59,510
+الـsecretion اللي موجودة على طول بقى أعطيه أي مسكن
+
+314
+00:21:59,510 --> 00:22:04,250
+أو أي مهدق على أساس أبلش أشتغل معاه من أول و جديد
+
+315
+00:22:04,250 --> 00:22:09,250
+ال patient should be remained reminded المريض لازم
+
+316
+00:22:09,250 --> 00:22:12,030
+أنا أبقى ذاكره في ال practice briefing exercise at
+
+317
+00:22:12,030 --> 00:22:17,160
+least every hour على الأقل كل ساعةwhy لسه weak
+
+318
+00:22:17,160 --> 00:22:21,500
+بينما هو لسه مش قادر معايا إذا مش بس ال exercise
+
+319
+00:22:21,500 --> 00:22:25,000
+يعمله مقتلجل فلأ كل ساعة لازم يعمل breathing
+
+320
+00:22:25,000 --> 00:22:28,140
+exercise إحنا يا جماعة بنحكي على التنفس بنحكي على
+
+321
+00:22:28,140 --> 00:22:32,520
+حياة مريض فبالتالي هنا مهم جدا نسبة ال oxygen اللي
+
+322
+00:22:32,520 --> 00:22:36,380
+موجودةمعظم مرضى COVID-19 ليه بيصيروا أو ليه
+
+323
+00:22:36,380 --> 00:22:39,560
+بيتوفوا لإنه بيكون في عندنا ال oxygen saturation
+
+324
+00:22:39,560 --> 00:22:43,860
+أو مادة تشبع الأكسجين في الدم بيكون منخفض جدا ليه؟
+
+325
+00:22:43,860 --> 00:22:49,820
+لعدم ال good ventilating أو لعدم اللي هو ال lung
+
+326
+00:22:49,820 --> 00:22:54,060
+working is not good ما بتكون منيحة ال lung في
+
+327
+00:22:54,060 --> 00:22:59,570
+شغلها تمام؟ ال huffing and coughingEffectiveness
+
+328
+00:22:59,570 --> 00:23:03,010
+للـ Huffing and Cuffing is suitably operative طبعا
+
+329
+00:23:03,010 --> 00:23:05,790
+مصدر بي encourage with the chest firmly support
+
+330
+00:23:05,790 --> 00:23:10,110
+نفس الحكي و ال foot and leg exercise نفس الكلام
+
+331
+00:23:10,110 --> 00:23:14,610
+اللي هو ال bombing exercise هنا من خمسة لعشر مرات
+
+332
+00:23:14,610 --> 00:23:20,150
+كل ساعة هذا بعتمد على ال tolerance تبع ال patient
+
+333
+00:23:20,150 --> 00:23:25,670
+ال endurance كام هو جادر يتحمل من اللي هو عمل ال
+
+334
+00:23:25,670 --> 00:23:29,080
+exerciseshoulder movement with lateral
+
+335
+00:23:29,080 --> 00:23:33,540
+thoracotectomy طبعا thoracotectomy اللي هو it's
+
+336
+00:23:33,540 --> 00:23:36,740
+important to start arm movement friction abduction
+
+337
+00:23:36,740 --> 00:23:40,580
+extension كل هذه ال exercise مهمة جدا في أول يوم
+
+338
+00:23:40,580 --> 00:23:44,960
+من ال exercise with medium فلستيرنوتمي طبعا ال
+
+339
+00:23:44,960 --> 00:23:48,460
+cutting فلستيرنا this need not started until
+
+340
+00:23:48,460 --> 00:23:52,740
+second day هذا مش من أول يوم أنا بشتغله لأ تاني
+
+341
+00:23:52,740 --> 00:23:58,390
+يوم لأن المسألة هنا بتكون مشقليلة third day
+
+342
+00:23:58,390 --> 00:24:02,900
+onwards ال patient will startاللي هو «Sitting out
+
+343
+00:24:02,900 --> 00:24:06,720
+of bed 24 hours after surgery according to his
+
+344
+00:24:06,720 --> 00:24:09,880
+progress and surgeon's instructions» بعملش أي
+
+345
+00:24:09,880 --> 00:24:14,400
+program إلا بناءً على توصية الطبيب تمام؟ إذا
+
+346
+00:24:14,400 --> 00:24:19,600
+الطبيب سمح أنه أنا أجلس على حافة للصرير فبمشي في
+
+347
+00:24:19,600 --> 00:24:23,280
+هذه التوصية لكن الطبيب حكى أن «Patient X is
+
+348
+00:24:23,280 --> 00:24:26,800
+unstable» خلاص «unstable» معناته الكلام أنه
+
+349
+00:24:26,800 --> 00:24:30,410
+«contraindicated to movement»الـ Walking around
+
+350
+00:24:30,410 --> 00:24:35,110
+and word of bed as soon as second to third past
+
+351
+00:24:35,110 --> 00:24:41,290
+operative day طبعا بمشي حوالين السرير شوية فى تانى
+
+352
+00:24:41,290 --> 00:24:43,510
+و تالت يوم ال treatment should be include
+
+353
+00:24:43,510 --> 00:24:46,450
+breathing exercise, huffing and coughing if
+
+354
+00:24:46,450 --> 00:24:50,190
+secretion للي present اللى هى بتكون موجودة فى ال
+
+355
+00:24:50,190 --> 00:24:55,330
+lung ال foot and leg exercise الارم و الشدر مهم
+
+356
+00:24:55,330 --> 00:25:00,260
+جدا postural correction زى ما حكينا عنهاالـ
+
+357
+00:25:00,260 --> 00:25:04,740
+Walking Upstairs إنه يطلع درج وينزل درج في اليوم
+
+358
+00:25:04,740 --> 00:25:07,780
+السادس للعملية، مش من تاني يوم، لأ صارنا في اليوم
+
+359
+00:25:07,780 --> 00:25:10,720
+السادس، this will depends on the instruction of
+
+360
+00:25:10,720 --> 00:25:14,960
+individual surgeon، طبعا بيعتمد على الجراح اللي
+
+361
+00:25:14,960 --> 00:25:18,510
+أدى العمليةAfter cardiac surgery, most patients
+
+362
+00:25:18,510 --> 00:25:22,750
+find clumping, tears, muscle aches اللي هو بأقل
+
+363
+00:25:22,750 --> 00:25:26,770
+جهود than preoperative Treatment must be modified
+
+364
+00:25:26,770 --> 00:25:31,860
+if any complications صارت معناإذن ال exercise
+
+365
+00:25:31,860 --> 00:25:36,160
+هيبقى عملها بالأيام خصوصا ال boss ده objective حكي
+
+366
+00:25:36,160 --> 00:25:39,100
+إن أنا عندي عامل مهم إذا كان ال patient stable
+
+367
+00:25:39,100 --> 00:25:43,440
+بمشي في ال exercise إذا ال patient مش stable بوقف
+
+368
+00:25:43,440 --> 00:25:48,560
+العملية اللي هي أو بوقف برنامج العلاج الطبيعي الآن
+
+369
+00:25:48,560 --> 00:25:53,750
+خلاص ال patient بده يتخرجبدي أكتب له اللي هو
+
+370
+00:25:53,750 --> 00:25:57,430
+surgeon خروجي قبل الخروج ال thoracic expansion مهم
+
+371
+00:25:57,430 --> 00:26:02,450
+جدا shoulder mobility ال postural كل هذا الاشي مهم
+
+372
+00:26:02,450 --> 00:26:06,010
+جدا لازم أقيمه عشان أنا في تقدير الخروج أبعتله
+
+373
+00:26:06,010 --> 00:26:08,970
+يعني ال patient should be increasing his exercise
+
+374
+00:26:08,970 --> 00:26:13,730
+tolerance لازم ال patient يكون قادر على أنه يعمل
+
+375
+00:26:13,730 --> 00:26:17,510
+ال exercise كذا مرة لكذا وقت ال patient should be
+
+376
+00:26:17,510 --> 00:26:20,850
+continue breathing exercise for about three weeks
+
+377
+00:26:20,850 --> 00:26:24,660
+following operationطبعا لبعد تلتة سابيع على الرغم
+
+378
+00:26:24,660 --> 00:26:28,800
+من انه discharge after اللي هو ممكن يصير اللي هو
+
+379
+00:26:28,800 --> 00:26:32,680
+الخروج من عشرة لاربعتاشر يوم يعني بعد اسبوعين هو
+
+380
+00:26:32,680 --> 00:26:36,140
+هيكون في ال impatient موجود داخلي انه في المستشفى
+
+381
+00:26:36,140 --> 00:26:41,140
+لكن انا لازم اعلمه ال home program لما بعد ذلك اذا
+
+382
+00:26:41,140 --> 00:26:47,160
+كان فيه خروج dischargeوبهيك بيكون أنا خلصت هذه
+
+383
+00:26:47,160 --> 00:26:50,000
+المحاضرة اللي هي role of physiotherapy in
+
+384
+00:26:50,000 --> 00:26:54,900
+cardiothoracic surgery حوالي تقريبا chapter 4
+
+385
+00:26:54,900 --> 00:27:00,140
+أعتقد وألقاكم بإذن الله في ال chapter القادم على
+
+386
+00:27:00,140 --> 00:27:00,780
+بركة الله
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/TRy9edu8e-w_raw.json b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/TRy9edu8e-w_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..1e930761189984564170d10e87f2975374ccf082
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/TRy9edu8e-w_raw.json
@@ -0,0 +1 @@
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hypertension that may have developed associated chronic obstructive lung disease اللي أنا بسميها COPD تمام؟ اللي هو chronic obstructive lung disease", "tokens": [11820, 8922, 1131, 2155, 15294, 4752, 2423, 8315, 3794, 13672, 1829, 43242, 11296, 34051, 9673, 43042, 7578, 13672, 1829, 43242, 11296, 37893, 28820, 3660, 8978, 31767, 2304, 10943, 9673, 2655, 2288, 6027, 1829, 34051, 2423, 39184, 938, 12, 8618, 8331, 46386, 46172, 300, 815, 362, 4743, 6615, 14493, 9579, 21673, 16730, 4752, 13672, 1829, 41850, 4724, 38251, 1829, 11296, 383, 12059, 35, 46811, 10943, 22807, 13672, 1829, 31439, 14493, 9579, 21673, 16730, 4752], "avg_logprob": -0.17440877995780996, "compression_ratio": 1.5822222222222222, "no_speech_prob": 1.1920928955078125e-07, "words": [{"start": 658.58, "end": 659.06, "word": "with", "probability": 0.1552734375}, {"start": 659.06, "end": 659.92, "word": " severe", "probability": 0.83642578125}, {"start": 659.92, "end": 660.4, "word": " metral", "probability": 0.591796875}, 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هو بالاعتماد على الشرب و الأكل نعطيه سواقل دافية عشان تبدأ يعني تشتغل داخل الجسم و تلطب المكان و تلطفه كمان لو تبخيرة صغيرة من ال bronchodilators بتفيدني في هذه الحالة", "tokens": [3555, 1863, 2407, 36520, 1127, 7834, 331, 13672, 1829, 3714, 29245, 23328, 9957, 20449, 40294, 34051, 16247, 3224, 1211, 14739, 3224, 45164, 8608, 2304, 5016, 12610, 3224, 23032, 3555, 3615, 995, 39182, 19446, 7251, 38251, 5016, 43761, 41950, 21292, 3555, 4724, 1829, 10721, 9778, 8848, 13672, 1829, 31439, 20666, 995, 34268, 15042, 3215, 15844, 25124, 25513, 4032, 16247, 28820, 8717, 3615, 9566, 1829, 3224, 8608, 14407, 4587, 1211, 11778, 31845, 10632, 6225, 8592, 7649, 6055, 44510, 10721, 37495, 22653, 6055, 8592, 2655, 17082, 1211, 11778, 47283, 1211, 25724, 38251, 4032, 6055, 1211, 9566, 3555, 9673, 41361, 4032, 6055, 1211, 9566, 5172, 3224, 9122, 2304, 7649, 45164, 6055, 3555, 9778, 48923, 20328, 17082, 48923, 9154, 2423, 16586, 29914, 388, 3391, 39894, 5172, 25708, 22653, 8978, 29538, 21542, 6027, 3660], 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shoulder girdle and arm movement مهم جدا زى ما حكينا أنا بدى أعمل prevent لأى deformity this patient having median sternotomy بالذات ال patient اللى عمل cutting فى الـ sternum", "tokens": [6027, 39184, 10223, 1807, 7948, 48219, 306, 293, 3726, 3963, 3714, 16095, 10874, 28259, 30767, 7578, 19446, 11331, 4117, 1829, 8315, 41850, 47525, 7578, 5551, 25957, 1211, 4871, 5296, 10721, 7578, 36094, 507, 341, 4537, 1419, 26779, 38312, 310, 8488, 20666, 8848, 9307, 2423, 4537, 13672, 7578, 6225, 42213, 6492, 6156, 7578, 2423, 39184, 38312, 449], "avg_logprob": -0.35142543023092704, "compression_ratio": 1.335195530726257, "no_speech_prob": 0.0, "words": [{"start": 986.16, "end": 986.38, "word": "الـ", "probability": 0.63134765625}, {"start": 986.38, "end": 986.76, "word": " Postural", "probability": 0.6812744140625}, {"start": 986.76, "end": 988.32, "word": " shoulder", "probability": 0.4423828125}, {"start": 988.32, "end": 988.8, "word": " girdle", "probability": 0.923095703125}, {"start": 988.8, 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"probability": 0.80810546875}, {"start": 1000.14, "end": 1000.38, "word": " فى", "probability": 0.772705078125}, {"start": 1000.38, "end": 1000.54, "word": " الـ", "probability": 0.50439453125}, {"start": 1000.54, "end": 1001.04, "word": " sternum", "probability": 0.679931640625}], "temperature": 1.0}, {"id": 46, "seek": 102243, "start": 1001.29, "end": 1022.43, "text": "يعني عضمة وصار فيها cutting هذا الأشي مش سهل جدا مش سهل خالص لإن ال patient تبعي هيدخل فيه مضاعفات فأنا لازم أجلس فيه وضعية يكون فيها صحيح مش عامل اللي هو contractures أو kyphosis على سبيل المثال after surgery but shoulder girdle may become stiff", "tokens": [40228, 22653, 6225, 11242, 46007, 4032, 9381, 9640, 8978, 11296, 6492, 23758, 16247, 8592, 1829, 37893, 8608, 3224, 1211, 10874, 28259, 37893, 8608, 3224, 1211, 16490, 6027, 9381, 5296, 28814, 1863, 2423, 4537, 6055, 3555, 3615, 1829, 39896, 3215, 9778, 1211, 8978, 3224, 3714, 11242, 45761, 5172, 9307, 6156, 10721, 8315, 5296, 31377, 2304, 5551, 7435, 1211, 3794, 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1021.13, "word": " girdle", "probability": 0.856201171875}, {"start": 1021.13, "end": 1021.37, "word": " may", "probability": 0.7724609375}, {"start": 1021.37, "end": 1021.83, "word": " become", "probability": 0.724609375}, {"start": 1021.83, "end": 1022.43, "word": " stiff", "probability": 0.80322265625}], "temperature": 1.0}, {"id": 47, "seek": 104823, "start": 1022.81, "end": 1048.23, "text": "and maybe patients and many patients tend to adapt slightly with kyphotic posture هو بالأول بتكون بس إنه مجرد إن هو إشي compensatory كإشي يعني تعويضي إن هو بده يعوضها للحركة هذه إنه عشان تمنع القلم فبعد شوية بتصير إشي دائم permanent shoulders shrinking تمام إنه يهز كتابة هو أفضل exercise يعني يعمل upward", "tokens": [474, 1310, 4209, 293, 867, 4209, 3928, 281, 6231, 4748, 365, 28740, 950, 9411, 18502, 31439, 20666, 10721, 12610, 39894, 30544, 4724, 3794, 36145, 3224, 3714, 7435, 2288, 3215, 36145, 31439, 11933, 8592, 1829, 11598, 4745, 9122, 28814, 8592, 1829, 37495, 22653, 37279, 45865, 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"start": 1605.2, "end": 1620.78, "text": "وبهيك بيكون أنا خلصت هذه المحاضرة اللي هي role of physiotherapy in cardiothoracic surgery حوالي تقريبا chapter 4 أعتقد وألقاكم بإذن الله في ال chapter القادم على بركة الله", "tokens": [37746, 3224, 1829, 4117, 4724, 1829, 30544, 41850, 16490, 1211, 9381, 2655, 29538, 9673, 5016, 46958, 25720, 13672, 1829, 39896, 3090, 295, 21265, 23208, 294, 37051, 900, 284, 326, 299, 7930, 11331, 2407, 6027, 1829, 6055, 4587, 16572, 3555, 995, 7187, 1017, 5551, 34268, 28543, 4032, 10721, 1211, 4587, 995, 24793, 4724, 28814, 8848, 1863, 21984, 8978, 2423, 7187, 25062, 18513, 2304, 15844, 4724, 31747, 3660, 21984], "avg_logprob": -0.139820770086611, "compression_ratio": 1.3670212765957446, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 1605.2, "end": 1605.8, "word": "وبهيك", "probability": 0.841552734375}, {"start": 1605.8, "end": 1606.12, "word": " بيكون", "probability": 0.84716796875}, {"start": 1606.12, "end": 1606.32, "word": " أنا", 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diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/TRy9edu8e-w_raw.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/TRy9edu8e-w_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..f12a0fc33120e675046ad85b621b3285cf1b267a
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/TRy9edu8e-w_raw.srt
@@ -0,0 +1,1544 @@
+1
+00:00:01,100 --> 00:00:05,060
+اللهم الصلي وسلم على محمد وعلى قلبي وصحبه أشمال
+
+2
+00:00:05,060 --> 00:00:10,280
+السلام عليكم ورحمة الله وبركاته هبدأ اليوم ان شاء
+
+3
+00:00:10,280 --> 00:00:14,680
+الله في chapter دور العلاج الطبيعي في حالات ال
+
+4
+00:00:14,680 --> 00:00:18,360
+cardio thoracic surgery كنا أخدنا في المحاضرة
+
+5
+00:00:18,360 --> 00:00:24,880
+السابقة عن الأسباب الآن هحكي على اللي هو موضوع ال
+
+6
+00:00:24,880 --> 00:00:28,180
+physiotherapy أو ال role ال physiotherapy في حالات
+
+7
+00:00:28,180 --> 00:00:33,390
+ال cardio thoracic surgeryبإذن الله تعالى هيكون
+
+8
+00:00:33,390 --> 00:00:39,470
+عندنا تسعتاشر slide تقريباهشرح مباشرة على ال role
+
+9
+00:00:39,470 --> 00:00:43,250
+of physiotherapy مارح أدخل في ال anatomy الأن هذا
+
+10
+00:00:43,250 --> 00:00:48,570
+بالنسبة أول صورة معاكم هيكون اللي هو عبارة عن صورة
+
+11
+00:00:48,570 --> 00:00:51,710
+القلب طبعا انتوا أخدتوا ال anatomy تبع ال heart و
+
+12
+00:00:51,710 --> 00:00:58,230
+أخدتوا كيف ال circulation و الدورة الدموية الصغيرة
+
+13
+00:00:58,230 --> 00:01:01,730
+و الدورة الدموية الكبرى و كل هذه الأمور في الجزء
+
+14
+00:01:01,730 --> 00:01:05,090
+النظري خليني أدخل هنا مباشرة على ال physiotherapy
+
+15
+00:01:05,090 --> 00:01:14,550
+role طبعا هبدأ فيمباشرة الفيزيotherapy
+
+16
+00:01:14,550 --> 00:01:19,670
+role هيكون pre-operative و post-operativeالـ
+
+17
+00:01:19,670 --> 00:01:22,690
+Preoperative هحكي على الـ aims هحكي على ال
+
+18
+00:01:22,690 --> 00:01:26,550
+exercise اللي هعطيها للمريض ههيئ نفسيه المريض
+
+19
+00:01:26,550 --> 00:01:31,990
+لمقبل العملية تمام؟ ال post-op اللي هي ال post
+
+20
+00:01:31,990 --> 00:01:36,370
+-operative هنعملها اللي هو ال exercise مع المريض
+
+21
+00:01:36,370 --> 00:01:41,530
+لما بعد العملية حتى أمنع ال complication حتى أوصل
+
+22
+00:01:41,530 --> 00:01:45,520
+مع المريض لمرحلة ال independence levelأحنا بنحكي
+
+23
+00:01:45,520 --> 00:01:49,380
+على عملية كبرى بنحكي على heart surgery بنحكي على
+
+24
+00:01:49,380 --> 00:01:52,940
+ممكن يكون open heart وممكن يكون لأ مش open heart
+
+25
+00:01:53,580 --> 00:01:58,360
+بكل الأحوال أنا بتكلم عن عملية كبيرة مش صغيرة هي
+
+26
+00:01:58,360 --> 00:02:03,400
+مش عملية كسور ولا عبارة عن عملية مرارة أو أي عملية
+
+27
+00:02:03,400 --> 00:02:08,060
+في الباطنة لأ هي عبارة عن عملية في الهاتف فبالتالي
+
+28
+00:02:08,060 --> 00:02:12,580
+لازم أكون أنا حاذرة في كل إشي بشتغل خلّيني نبدأ
+
+29
+00:02:12,580 --> 00:02:18,580
+أولا ل pre-operator لأني physiotherapy aims لكل ال
+
+30
+00:02:18,580 --> 00:02:25,790
+exercise اللي أنا بعطيهملأ مريض القلب لازم
+
+31
+00:02:25,790 --> 00:02:33,550
+احافظ على مستوى اوالتهوية الجيدة في اللي هي ال
+
+32
+00:02:33,550 --> 00:02:37,990
+ventilation الجيد للمريض يعني ال lung لازم تكون
+
+33
+00:02:37,990 --> 00:02:42,110
+عندى مليئة بالأكسجين قادرة على استيعاب أكبر كمية و
+
+34
+00:02:42,110 --> 00:02:48,210
+تتبادل الغازات داخلها لتورد للقلب اللي هو الأكسجين
+
+35
+00:02:48,210 --> 00:02:52,850
+فبالتالي لازم يكون المريض دائما محافظ على كمية ال
+
+36
+00:02:52,850 --> 00:02:56,330
+adequate ventilation to assist with removal of
+
+37
+00:02:56,330 --> 00:03:00,960
+excessive secretion in the airwaysتمام اللي هو
+
+38
+00:03:00,960 --> 00:03:07,120
+بيكون طبعا انه انا بحاول اعمل على ازالة اي
+
+39
+00:03:07,120 --> 00:03:11,380
+secretion موجود فيه اللي هو في ال positioning
+
+40
+00:03:11,380 --> 00:03:15,280
+حكينا ال postural drainage اخدنا كمان اللي هو
+
+41
+00:03:15,280 --> 00:03:19,040
+المساج ال clubbing الأمور اللي زيها يكونها ت move
+
+42
+00:03:19,040 --> 00:03:23,640
+ل ال secretion I learn to assist circulation in
+
+43
+00:03:23,640 --> 00:03:27,020
+legs and thora بي help to prevent bust or
+
+44
+00:03:27,020 --> 00:03:31,340
+pallative venous thrombosisانا هنا بدي امنع ال DVT
+
+45
+00:03:31,340 --> 00:03:35,900
+عن طريق ال pumping exercise او ال ankle movement
+
+46
+00:03:35,900 --> 00:03:41,980
+exerciseرقم 4 و 8 تان لـ mobility of shoulders and
+
+47
+00:03:41,980 --> 00:03:45,140
+shoulder girdle and spine بدي أحافظ لأنه هي
+
+48
+00:03:45,140 --> 00:03:47,740
+المنطقة اللي عملت فيها ال surgery منطقة ال
+
+49
+00:03:47,740 --> 00:03:50,520
+thoracic فبالتالي أنا بدي أحافظ على ال mobility
+
+50
+00:03:50,520 --> 00:03:53,380
+تبعي المريض تبعي في ال shoulder و ال shoulder
+
+51
+00:03:53,380 --> 00:03:57,640
+girdle تمام؟ أنا مارديش أي مشاكل أي deformity
+
+52
+00:03:57,640 --> 00:04:02,520
+تتصير في هاي المكان يعني على سبيل المثال إشي طبيعي
+
+53
+00:04:02,520 --> 00:04:06,500
+كلنا بنرجع لوضع ال C shape اللي هو الوضع الجنيني
+
+54
+00:04:06,500 --> 00:04:10,300
+اللي احنا كنا فيههنا بناجى المريض بدى ينحني للأمام
+
+55
+00:04:10,300 --> 00:04:16,020
+بوضع الكيفوس ليه؟ لأنه بتكون painful عملية مؤلمة
+
+56
+00:04:16,020 --> 00:04:20,100
+فاحنا أي واحد حتى لو انت عندك شخص او اي شخص عنده
+
+57
+00:04:20,100 --> 00:04:24,120
+مغص على طول بحط ايده على بطنه وبنتني لقدام هذا
+
+58
+00:04:24,120 --> 00:04:28,100
+الاشي طبيعى تمام فمبالكوا بعملية heart surgery زى
+
+59
+00:04:28,100 --> 00:04:34,120
+هذه وفيهاتقريباً تلاتين أو اربعين غرزة وامور كبيرة
+
+60
+00:04:34,120 --> 00:04:40,700
+زي هذه هو هيفنين لإنه يوضع في هذه الوضعية اللي هي
+
+61
+00:04:40,700 --> 00:04:48,070
+هتعمل deformity زي الـ K-forcesto prevent postural
+
+62
+00:04:48,070 --> 00:04:51,730
+defest هذا اللي انا كنت احكي عنه انه انا بدي امنع
+
+63
+00:04:51,730 --> 00:04:56,330
+اي key forces اي deformity تصير في ال spine مابدنا
+
+64
+00:04:56,330 --> 00:05:00,810
+اي اشي يصير بعد هيك هو كان المرضى بيعمله كعملية
+
+65
+00:05:00,810 --> 00:05:05,730
+تعوضية ليش انه انا مابديش اتوجه اكتر و اكتر وبعد
+
+66
+00:05:05,730 --> 00:05:10,930
+هيك بتصير المشكلةدائمة و قائمة لأ هي كانت في الأول
+
+67
+00:05:10,930 --> 00:05:15,750
+عادة ان هو كان يتوجع من ألم في صدره كان يميل لقدام
+
+68
+00:05:15,750 --> 00:05:19,890
+بعد شوية صارت عادة دائمة هذا بيعمللي اللي هو
+
+69
+00:05:19,890 --> 00:05:25,320
+postural deformity زي ال K-forcesto restore
+
+70
+00:05:25,320 --> 00:05:30,900
+exercise tolerance حتى أخليه إنه قادر على إنه يعمل
+
+71
+00:05:30,900 --> 00:05:34,260
+ال exercise tolerance أزيده يعني إن إذا بدي أنا
+
+72
+00:05:34,260 --> 00:05:38,320
+يزيد ال exercise من خمس لعشر مرات يبعد شوية أو بعد
+
+73
+00:05:38,320 --> 00:05:41,320
+يومين تلاتة يزيده مثلا لخمستاشر مرة في ال exercise
+
+74
+00:05:41,320 --> 00:05:45,140
+يعني أعمل elbow flexion أول مرة ببدأها معاها خمس
+
+75
+00:05:45,140 --> 00:05:49,120
+مرات يلا نعمل مع بعض خمس مرات يا حجة بعد يومين لأ
+
+76
+00:05:49,120 --> 00:05:53,010
+الخمس مرات هي بتتطور بدي أزيد ال toleranceاللي هو
+
+77
+00:05:53,010 --> 00:05:55,710
+الـ number of exercises جدّي المريض بيتحمل أنه أنا
+
+78
+00:05:55,710 --> 00:06:00,190
+أزيد معاه ال exercise هي عندى هنا ست أهداف ل ال
+
+79
+00:06:00,190 --> 00:06:03,550
+physiology programs في حالات ال cardiac أو في قسم
+
+80
+00:06:03,550 --> 00:06:08,510
+ال cardiac اللى موجود في داخل المستشفى خلّينى أشوف
+
+81
+00:06:08,510 --> 00:06:12,810
+ال preoperative training هي عندى لما قبل العملية
+
+82
+00:06:12,810 --> 00:06:17,760
+ست أهداف أساسيةأول إشي explanation to the patient
+
+83
+00:06:17,760 --> 00:06:21,780
+إنه أنا أوضح كل إشي للمريض explanation by
+
+84
+00:06:21,780 --> 00:06:25,000
+physiotherapist in order to gain the patient
+
+85
+00:06:25,000 --> 00:06:28,660
+confidence and cooperation إذا أنا أخدت و أقعدت مع
+
+86
+00:06:28,660 --> 00:06:33,060
+المريض و طبعا أنت اليوم وصلت مستوى رابع هذا الإشي
+
+87
+00:06:33,060 --> 00:06:38,280
+بيخلي ثقة المريض فيك ممتازة جدا إنه أنا شرحت لك
+
+88
+00:06:38,280 --> 00:06:42,480
+هيصير معاك يا حجة واحد اتنين تلاتة هنعمل عملية قلب
+
+89
+00:06:42,480 --> 00:06:48,820
+مفتوح هيصير فيهزراعة صمام هيصير في أي process طبعا
+
+90
+00:06:48,820 --> 00:06:51,760
+كون احنا قرائين اللي هو ال medical file كامل
+
+91
+00:06:51,760 --> 00:06:55,780
+وعارفين ايش بدنا نعمل او عارفين مع مين احنا بدنا
+
+92
+00:06:55,780 --> 00:06:59,600
+نشتغل فبالتالي اذا صار في ثقة بين ال physicalist و
+
+93
+00:06:59,600 --> 00:07:02,640
+ال patient تبعه معناته ده بيزيد ال cooperation
+
+94
+00:07:02,640 --> 00:07:06,800
+بيصير هو يحب الجلسة فعلا انا هذا الاشي كنت الاحظه
+
+95
+00:07:06,800 --> 00:07:10,640
+في ايام اللي هو الشغل الاتنينيكي حتى الأطفال كمان
+
+96
+00:07:10,640 --> 00:07:15,760
+نفس الكلامإذا الطفل أخد أو كسب .. أنت كسبت ثقته،
+
+97
+00:07:15,760 --> 00:07:20,340
+معناة الكلام إن هو هيحب الجلسة، هيحب ييجي عليك، مش
+
+98
+00:07:20,340 --> 00:07:24,460
+الطفل اللي ممكن أنت تتـ network فيه أو أن أنت ما
+
+99
+00:07:24,460 --> 00:07:28,160
+تعطي ثقتك، هذا لكم و لمفتاحكم إن أنتوا كيف بدكم
+
+100
+00:07:28,160 --> 00:07:31,540
+تتعاملوا مع الناس بال skills communication skills
+
+101
+00:07:31,540 --> 00:07:35,960
+طبعا مهمة جدا في التعامل مع أي patient، هذا أول
+
+102
+00:07:35,960 --> 00:07:40,160
+هدفتاني إشي في الـ Explanation للـ patient to
+
+103
+00:07:40,160 --> 00:07:43,360
+impair importance of maintaining educated
+
+104
+00:07:43,360 --> 00:07:47,360
+ventilation للـ lungs by breathing exercise أنا
+
+105
+00:07:47,360 --> 00:07:52,520
+بدي أحافظ على مجال التهوية بكميات وثيرة عن طريق ال
+
+106
+00:07:52,520 --> 00:07:56,620
+breathing exercise and clearance من ال secretion
+
+107
+00:07:56,620 --> 00:08:00,760
+أحافظ عليه بتمرين التنفس وإن شاء الله رب العالمين
+
+108
+00:08:00,760 --> 00:08:04,860
+هتاخدوها في المعملأيضا خلو الريقتين من أي
+
+109
+00:08:04,860 --> 00:08:09,680
+secretion يعيق حركتهم فبالتالي أنا بدي أحافظ على
+
+110
+00:08:09,680 --> 00:08:12,960
+ال ventilation كاملة الريقة تقدر تعمل ال
+
+111
+00:08:12,960 --> 00:08:18,920
+explanation تبعها في ال inhale و ال exhale تمام؟
+
+112
+00:08:18,920 --> 00:08:22,000
+reinsurance should be given that breathing
+
+113
+00:08:22,000 --> 00:08:26,230
+exercise ها thing بدي أتأكدإنه ال patient يقدر
+
+114
+00:08:26,230 --> 00:08:32,370
+يعمل exercise، يعمل coughing، و يحاول
+
+115
+00:08:32,370 --> 00:08:36,190
+أن يمشي حول السليم، بالذات أول يوم هذا، إذا كان
+
+116
+00:08:36,190 --> 00:08:40,110
+قادر، إذا هو medically stable دائما أنا بحط يفتق
+
+117
+00:08:40,110 --> 00:08:44,030
+أمام عيني، if the patient is medically stable، I
+
+118
+00:08:44,030 --> 00:08:49,870
+am in safe side، أنا بوضع السليم، إذا هو ما كان
+
+119
+00:08:49,870 --> 00:08:54,950
+medically stable،ما بمسكه Contra-indicated لكن إذا
+
+120
+00:08:54,950 --> 00:08:59,350
+أنا حسيت إن هو واعي، حسيت إن هو كل الأمور عنده
+
+121
+00:08:59,350 --> 00:09:03,290
+تمام، ال ventilation عنده تمام، التنفس طبيعي،
+
+122
+00:09:03,290 --> 00:09:06,590
+مافيش أي مشكلة، ببدأ مع ال session وحناخده هدف ال
+
+123
+00:09:06,590 --> 00:09:10,930
+post-operative إن شاء الله في ال styles القادمةأذا
+
+124
+00:09:10,930 --> 00:09:15,230
+أنا بدى أتأكد أن ال breathing اللى هو ال exercise
+
+125
+00:09:15,230 --> 00:09:19,310
+و ال huffing و ال coughing و كل هذه الأمور تمام
+
+126
+00:09:19,310 --> 00:09:23,210
+تمام و أنه أنا قادرة أعطي الجلسة للمريض without
+
+127
+00:09:23,210 --> 00:09:28,180
+any harm من غير أن أنا أؤذيهسواء كان في تيوب طالع
+
+128
+00:09:28,180 --> 00:09:34,300
+من الرئة أو في تيوب اللي هو تبع ال van هذا اللي هو
+
+129
+00:09:34,300 --> 00:09:37,040
+في ال canyon المحطوط بدي أحافظ عليه من غير ما
+
+130
+00:09:37,040 --> 00:09:41,300
+أؤذيه بأي إشي في التمرين اللي أنا بدي أمشي و أشتغل
+
+131
+00:09:41,300 --> 00:09:47,720
+عليهاالهدف التاني تبعنا remove للsecretions اليوم
+
+132
+00:09:47,720 --> 00:09:52,260
+عندنا اللى هو وظيفة ال lungs انه تعمل في أثناء ال
+
+133
+00:09:52,260 --> 00:09:56,420
+inhale و ال exhale بيصير فيه gas exchange تبادل
+
+134
+00:09:56,420 --> 00:10:00,340
+الغذاء إذا أنا موجود فيه عندي secretion وهذا ال
+
+135
+00:10:00,340 --> 00:10:03,020
+secretion على فكرة هو نعمة من الله سبحانه وتعالى
+
+136
+00:10:03,020 --> 00:10:08,400
+ليه؟ لإنه تلتصق فيه أي microorganismأي pathogen أي
+
+137
+00:10:08,400 --> 00:10:11,800
+إشي دخل إلى داخل الريعتين بيلقصق في هذا ال
+
+138
+00:10:11,800 --> 00:10:17,260
+situation فالصح أنه أنا أطلع لبرا لأنه ممكن يعني
+
+139
+00:10:17,260 --> 00:10:22,040
+بما أننا في جائحة كورونا و COVID-19 هذه شو اللي
+
+140
+00:10:22,040 --> 00:10:25,600
+بيصير أن هذا ال virus بيدخل لريعتين و بيعمل فيهم
+
+141
+00:10:25,600 --> 00:10:29,560
+collapse يعني بتنقبض الريعتين فبالتالي ما بيصير في
+
+142
+00:10:29,560 --> 00:10:32,600
+educated ventilationعشان كده الحالات الـ critical
+
+143
+00:10:32,600 --> 00:10:36,500
+و الحالات الصعبة بتلاقيها will die بتموت على طول
+
+144
+00:10:36,500 --> 00:10:39,800
+ليه؟ لإن مافي عندنا educate ventilation the
+
+145
+00:10:39,800 --> 00:10:42,760
+majority of patients about undergo cardiac surgery
+
+146
+00:10:42,760 --> 00:10:46,380
+do not have excessive bronchial or bronchial
+
+147
+00:10:46,380 --> 00:10:50,140
+secretion تمام؟ الأغلبى من هدول المرضى في ال
+
+148
+00:10:50,140 --> 00:10:53,280
+cardiac surgery في عندهم do not have excessive
+
+149
+00:10:53,280 --> 00:10:57,620
+bronchial secretion لكن there are however some
+
+150
+00:10:57,620 --> 00:11:02,460
+patientswith severe metral valve disease الناس
+
+151
+00:11:02,460 --> 00:11:06,560
+اللي عندها أو المرضى اللي عندها مشكلة في الصمام
+
+152
+00:11:06,560 --> 00:11:09,840
+المترالي أو الـ long-standing pulmonary
+
+153
+00:11:09,840 --> 00:11:13,700
+hypertension that may have developed associated
+
+154
+00:11:13,700 --> 00:11:16,940
+chronic obstructive lung disease اللي أنا بسميها
+
+155
+00:11:16,940 --> 00:11:20,640
+COPD تمام؟ اللي هو chronic obstructive lung
+
+156
+00:11:20,640 --> 00:11:25,380
+diseaseand assisting with removal secretion is
+
+157
+00:11:25,380 --> 00:11:29,540
+required لازم انا اعمل على ازالة ال secretion سواء
+
+158
+00:11:29,540 --> 00:11:33,080
+كان mechanically او manually manually بال coughing
+
+159
+00:11:33,080 --> 00:11:36,960
+و ال huffing و المساج و ال exercise تمام اما
+
+160
+00:11:36,960 --> 00:11:39,320
+mechanically في عندنا آلات هنشوفها ان شاء الله في
+
+161
+00:11:39,320 --> 00:11:42,780
+قسم الصدرية او في محاضرات الصدرية ان كيف انا بقدر
+
+162
+00:11:42,780 --> 00:11:46,760
+اعمل suction و اشيل هذا ال secretionفي الـ Early
+
+163
+00:11:46,760 --> 00:11:49,380
+stage الـ cardiac disease ال patient have
+
+164
+00:11:49,380 --> 00:11:53,000
+resistance dry coughing لسه في بداية المراحل و
+
+165
+00:11:53,000 --> 00:11:55,860
+خصوصا بعد التخطير و ال binge و الأمور اللي زي هذه
+
+166
+00:11:55,860 --> 00:12:01,060
+بتكون الكحة ناشرة لسه مافي بلغة و فعلا هي بنفل
+
+167
+00:12:01,060 --> 00:12:04,640
+يعني أنا ماكنت أشوفها مع المرضى يعني بتحسي حرام ال
+
+168
+00:12:04,640 --> 00:12:09,920
+patient هتطلع روحه النوة اللي هو ال heart surgery
+
+169
+00:12:09,920 --> 00:12:13,020
+و لا ال coughing اللي هي ناشرة مش عارف يطلع فيها
+
+170
+00:12:13,020 --> 00:12:17,800
+إشيأو الـ Expected Fertile Wiltsiputam طبعا احنا
+
+171
+00:12:17,800 --> 00:12:21,280
+قصده باللي هو المقشع أو اللي هو السبيوتم هذا اللي
+
+172
+00:12:21,280 --> 00:12:25,860
+مش جادر المريض يطلعه This is not a problem that
+
+173
+00:12:25,860 --> 00:12:28,620
+can be dealt with physiotherapy هنا انا ممكن
+
+174
+00:12:28,620 --> 00:12:33,980
+اتعامل معاها اللي هو عن طريق طبعابنوصل caregiver
+
+175
+00:12:33,980 --> 00:12:37,960
+اللي موجودين معاه أو الأهل أنه لو سمحوله طبعا بعد
+
+176
+00:12:37,960 --> 00:12:41,500
+ما يسمحله الطبيب بيأخذ اللي هو بالاعتماد على الشرب
+
+177
+00:12:41,500 --> 00:12:46,640
+و الأكل نعطيه سواقل دافية عشان تبدأ يعني تشتغل
+
+178
+00:12:46,640 --> 00:12:50,820
+داخل الجسم و تلطب المكان و تلطفه كمان لو تبخيرة
+
+179
+00:12:50,820 --> 00:12:55,120
+صغيرة من ال bronchodilators بتفيدني في هذه الحالة
+
+180
+00:12:55,470 --> 00:12:58,370
+الان ال breathing exercise شو يعني breathing
+
+181
+00:12:58,370 --> 00:13:01,150
+exercise؟ في عندنا diaphragmatic breathing في
+
+182
+00:13:01,150 --> 00:13:04,390
+عندنا ال unilateral لل lower thoracic expansion
+
+183
+00:13:04,390 --> 00:13:07,370
+diaphragm muscles هي ال main muscles في ال
+
+184
+00:13:07,370 --> 00:13:11,570
+respiratory system عضلة أساسية بيغذيها الفرن كنيل
+
+185
+00:13:11,890 --> 00:13:17,250
+هذه العضنة عادة تعمل عدلة إدافرة حوالي 70% من
+
+186
+00:13:17,250 --> 00:13:21,330
+التنفس اللي إحنا بنتنفس و بتشتغل عضلات إدافرة لكن
+
+187
+00:13:21,330 --> 00:13:25,890
+عدلة إدافرة عادة تعمل عدلة 13% للـ action of
+
+188
+00:13:25,890 --> 00:13:29,050
+breathing the first day في الـ postoperative لكن
+
+189
+00:13:29,050 --> 00:13:31,830
+أيام اللي هم اللي بيكون عندي مريض ال cardio
+
+190
+00:13:31,830 --> 00:13:36,650
+surgery تشتغل فقط 30% يعني أقل من النص، وهذا
+
+191
+00:13:36,650 --> 00:13:39,390
+بيعمللي مشكلة لأنها ال mainly muscle في
+
+192
+00:13:39,390 --> 00:13:42,940
+الrespirationفبالتالي أنا هنا لازم أحافظ عليها الـ
+
+193
+00:13:42,940 --> 00:13:46,280
+diaphragm improving للventilation and lower loops
+
+194
+00:13:46,280 --> 00:13:48,760
+which is the site of communication of secretion
+
+195
+00:13:48,760 --> 00:13:53,360
+okay إنه أنا بدي أحافظ عليها تكون strong على قدر
+
+196
+00:13:53,360 --> 00:13:57,400
+الاستطاع حتى تعمل remove لل secretion الـ
+
+197
+00:13:57,400 --> 00:14:02,100
+unilateral lower thoracic expansion unilateral
+
+198
+00:14:02,100 --> 00:14:06,820
+lower costal breathing لأضلع اللي هي السفلة في ال
+
+199
+00:14:06,820 --> 00:14:09,460
+breathing exercise improve ventilation
+
+200
+00:14:15,250 --> 00:14:19,470
+الجزئية السفلاء اللي موجودة بدي أشتغل فيها على
+
+201
+00:14:19,470 --> 00:14:23,330
+أساس إنه أنا المريض يكمل باقي ال ventilation في
+
+202
+00:14:23,330 --> 00:14:27,590
+الـ Unilateral Thoracic Expansion هيكون الاشي واضح
+
+203
+00:14:27,590 --> 00:14:32,710
+و أفضل في المعمل مع اللي هو الأخصائيين اللي
+
+204
+00:14:32,710 --> 00:14:38,390
+موجودين معاكمالـ goals الرابع ال effectiveness لل
+
+205
+00:14:38,390 --> 00:14:41,930
+huffing and cuffing طبعا انا لازم اكون عرفت شو
+
+206
+00:14:41,930 --> 00:14:46,470
+يعني huffing وشو يعني cuffing تمام الفرق ما بينهم
+
+207
+00:14:46,470 --> 00:14:50,310
+مهم جدا و هاخده الفيزيوثera بي show the patient
+
+208
+00:14:50,310 --> 00:14:53,970
+اللي هو should show the patient لأن انا لازم اعلم
+
+209
+00:14:53,970 --> 00:14:58,040
+ال patient كيف يعمل huffing كيف يعمل cuffingهذا
+
+210
+00:14:58,040 --> 00:15:05,580
+مهم جداً و support لمنطقة الجراحة زي اللي هو لما
+
+211
+00:15:05,580 --> 00:15:09,380
+انا بدي اجي على سبيل المثال والده قيصري معناة
+
+212
+00:15:09,380 --> 00:15:12,820
+الكلام انه انا لازم احط pillow حتى ايش اعمل
+
+213
+00:15:12,820 --> 00:15:16,920
+support لاللي هو ال surgery site لموقع اللي هي
+
+214
+00:15:16,920 --> 00:15:21,480
+العمليةنفس الكلام هنتعامل فيه هنا هدعمه اللي هو
+
+215
+00:15:21,480 --> 00:15:25,300
+بال chest support سواء أنا بإيده و هو نفسه إذا هو
+
+216
+00:15:25,300 --> 00:15:28,800
+مش قادر يعملها أنا بإيدي أو بإيد أي حد من اللي
+
+217
+00:15:28,800 --> 00:15:33,380
+موجودين أو إنه أنا أعطيه pillow الخد صغيرة يحطها
+
+218
+00:15:33,380 --> 00:15:38,920
+عشان الدعم الجرح و ما أفتحه من أول و جديد إذا she
+
+219
+00:15:38,920 --> 00:15:43,460
+will support the chest of her incision and how he
+
+220
+00:15:43,460 --> 00:15:48,730
+can supportit himself كيف ممكن هو يدعم نفسه بنفسه
+
+221
+00:15:48,730 --> 00:15:53,730
+ال goals الخامس أو ال exercise الخامس foot and leg
+
+222
+00:15:53,730 --> 00:15:57,970
+exercise ال bombing exercise مهم جدا to prevent
+
+223
+00:15:57,970 --> 00:16:02,000
+PVTAll patients have thought simple exercise and
+
+224
+00:16:02,000 --> 00:16:04,640
+knee flexion extension in order to assist
+
+225
+00:16:04,640 --> 00:16:08,940
+circulation حتى أنا أساعد الcirculation أمنع أي
+
+226
+00:16:08,940 --> 00:16:15,060
+DVT لأنه بتعرفه after operative أو بعد العملية بدي
+
+227
+00:16:15,060 --> 00:16:18,280
+يصير في عندي اللي هو blood coagulation فبالتالي
+
+228
+00:16:18,280 --> 00:16:22,800
+هدخل أنا في الthrombosis هعمل اللي هو DVT وهذه
+
+229
+00:16:22,800 --> 00:16:26,380
+Contra indication أن يصير المريض تبعيا عنده DVTالـ
+
+230
+00:16:26,380 --> 00:16:30,800
+Postural shoulder girdle and arm movement مهم جدا
+
+231
+00:16:30,800 --> 00:16:34,380
+زى ما حكينا أنا بدى أعمل prevent لأى deformity
+
+232
+00:16:34,380 --> 00:16:38,300
+this patient having median sternotomy بالذات ال
+
+233
+00:16:38,300 --> 00:16:42,570
+patient اللى عمل cutting فى الـ sternumيعني عضمة
+
+234
+00:16:42,570 --> 00:16:47,010
+وصار فيها cutting هذا الأشي مش سهل جدا مش سهل خالص
+
+235
+00:16:47,010 --> 00:16:50,290
+لإن ال patient تبعي هيدخل فيه مضاعفات فأنا لازم
+
+236
+00:16:50,290 --> 00:16:55,610
+أجلس فيه وضعية يكون فيها صحيح مش عامل اللي هو
+
+237
+00:16:55,610 --> 00:16:59,490
+contractures أو kyphosis على سبيل المثال after
+
+238
+00:16:59,490 --> 00:17:03,250
+surgery but shoulder girdle may become stiffand
+
+239
+00:17:03,250 --> 00:17:06,250
+maybe patients and many patients tend to adapt
+
+240
+00:17:06,250 --> 00:17:09,730
+slightly with kyphotic posture هو بالأول بتكون بس
+
+241
+00:17:09,730 --> 00:17:13,670
+إنه مجرد إن هو إشي compensatory كإشي يعني تعويضي
+
+242
+00:17:13,670 --> 00:17:17,230
+إن هو بده يعوضها للحركة هذه إنه عشان تمنع القلم
+
+243
+00:17:17,230 --> 00:17:21,410
+فبعد شوية بتصير إشي دائم permanent shoulders
+
+244
+00:17:21,410 --> 00:17:26,730
+shrinking تمام إنه يهز كتابة هو أفضل exercise يعني
+
+245
+00:17:26,730 --> 00:17:28,230
+يعمل upward
+
+246
+00:17:31,350 --> 00:17:35,710
+Downward Retraction هنشوفها كمان في الصور في ال
+
+247
+00:17:35,710 --> 00:17:39,010
+exercise هذا بالنسبة لحالة open heart surgery
+
+248
+00:17:39,010 --> 00:17:42,390
+شايفين الاشي ممكن هاي ال sternum اللي انتوا شايفين
+
+249
+00:17:42,390 --> 00:17:46,350
+هيصير فيها cutting و remove كامل فبالتالي الحين
+
+250
+00:17:46,350 --> 00:17:49,970
+العملية it's difficult مش سهلة هاي ال shoulder
+
+251
+00:17:49,970 --> 00:17:57,210
+stretch اللي هو upward downward Retraction هذا
+
+252
+00:17:57,210 --> 00:18:00,910
+اللي هو عبارة عن ال exerciseاللي أنا بشتغله معاه
+
+253
+00:18:00,910 --> 00:18:04,770
+حتى أحافظ على range of motion لـ shoulder و
+
+254
+00:18:04,770 --> 00:18:09,790
+shoulder girdage الآن خلصناه من ال exercise اللي
+
+255
+00:18:09,790 --> 00:18:12,850
+هي preoperative أجل ال exercise ال boss
+
+256
+00:18:12,850 --> 00:18:17,570
+preoperative if patient is not ventilator إذا كان
+
+257
+00:18:17,570 --> 00:18:20,410
+هو مش على ventilator هنا بحكي على mechanical
+
+258
+00:18:20,410 --> 00:18:24,330
+ventilator إذا كان medically stable هبلش معاه
+
+259
+00:18:24,330 --> 00:18:27,900
+breathing exercise من أول يومتمام؟ شو يعني أنا
+
+260
+00:18:27,900 --> 00:18:30,960
+بحكي medical statement؟ يعني هو conscious؟يعني
+
+261
+00:18:30,960 --> 00:18:36,980
+مافي أي علامة بتأثر أو بتوحيلي أن هذا المريض في
+
+262
+00:18:36,980 --> 00:18:43,560
+خطر يعني التنفس طبيعي ال heart rate طبيعي كل إش
+
+263
+00:18:43,560 --> 00:18:47,080
+حواليه طبيعي هو واعي لإيش أنا بحكي أو إيش ال
+
+264
+00:18:47,080 --> 00:18:50,460
+exercise اللي أنا بعمله فبالتالي هنا ممكن أبلش
+
+265
+00:18:50,460 --> 00:18:53,740
+معاه breathing exercise لكن لو كان في عندي أي
+
+266
+00:18:53,740 --> 00:18:57,580
+مشكلة سواء إنه على mechanical ventilation أو سواء
+
+267
+00:18:57,580 --> 00:18:59,940
+ال vision تبعي لسه في كومة أو لسه
+
+268
+00:19:02,620 --> 00:19:07,120
+ممنوع اشتغل معاه after breathing exercise بحاول
+
+269
+00:19:07,120 --> 00:19:11,200
+اعلمه اللي هو كان أخدهم ال exercise قبل ال hoofing
+
+270
+00:19:11,200 --> 00:19:15,980
+و ال cuffing should be made تمام؟ اذا بعد اللي هو
+
+271
+00:19:15,980 --> 00:19:18,580
+ال breathing exercise في عندي hoofing and cuffing
+
+272
+00:19:18,580 --> 00:19:22,800
+في أول يوم هنا ماحجسمهم نوع نوع في ال exercise لأ
+
+273
+00:19:22,800 --> 00:19:26,340
+حجسمهم حسب الأيام أول يومالفيزيotherapy will
+
+274
+00:19:26,340 --> 00:19:29,460
+probably necessary four times during the day أربع
+
+275
+00:19:29,460 --> 00:19:33,300
+مرات يمر عليه الفيزيotherapy تمام؟ مهم جدا The
+
+276
+00:19:33,300 --> 00:19:36,280
+length لأن أنا بدي أمنع أي secretion مابدي أي إشي
+
+277
+00:19:36,280 --> 00:19:39,220
+يصير فرقتين The length of a treatment should be
+
+278
+00:19:39,220 --> 00:19:42,040
+modified according to the patient condition and
+
+279
+00:19:42,040 --> 00:19:46,040
+should not cause fatigue مهم جدا الإشي هذا إنه أنا
+
+280
+00:19:46,040 --> 00:19:51,150
+مابس هدفي اعطي والله انا اليوم عملت 16 جلسة ل 4
+
+281
+00:19:51,150 --> 00:19:57,190
+مرضى لأ واريني اشوف ال result تبعتك اشوف هل انه ال
+
+282
+00:19:57,190 --> 00:20:00,030
+exercise اللي انت عملته كان بنتيجة ولا مش نتيجة؟
+
+283
+00:20:00,030 --> 00:20:03,010
+هل ال exercise اللي انت عملته قد ل fatigue في
+
+284
+00:20:03,010 --> 00:20:07,070
+المريض ولا لأ؟ انه الاشي مش بالعدل، الاشي لازم انا
+
+285
+00:20:07,070 --> 00:20:11,830
+اعرف الجودة تبعته عشان اكون في الصليب breathing
+
+286
+00:20:11,830 --> 00:20:16,040
+exerciseطبعاً إذا كان الشخص لا يبدأ في الهواء
+
+287
+00:20:16,040 --> 00:20:18,460
+الاصطناعي أو بسميها mechanical ventilating الهواء
+
+288
+00:20:18,460 --> 00:20:21,740
+الاصطناعي يجب أن يتم تحميله تمام؟
+
+289
+00:20:23,330 --> 00:20:27,430
+بدي أعمل الـ exercise بس إيش يكون المريض تبعي
+
+290
+00:20:27,430 --> 00:20:30,910
+امكملها this have been ventilated should also
+
+291
+00:20:30,910 --> 00:20:34,490
+start breathing exercise في الـ endotracheal tubes
+
+292
+00:20:34,490 --> 00:20:37,790
+have been removed يعني لو كان في عندي endotracheal
+
+293
+00:20:37,790 --> 00:20:42,030
+tubes اللي هي في الـ endo داخلي في الأتراكيا في
+
+294
+00:20:42,030 --> 00:20:45,720
+أنابيب داخليةإذا انشأت هالاناريب أنا بشتغل لكن لو
+
+295
+00:20:45,720 --> 00:20:49,440
+كانت موجودة لأ مابشتغل لانه ممكن تهدد حياة المرض
+
+296
+00:20:49,440 --> 00:20:52,480
+ال patient should be sitting up at the bed with
+
+297
+00:20:52,480 --> 00:20:55,320
+hull back supported by pillows so that the
+
+298
+00:20:55,320 --> 00:20:58,220
+rheumatic and chest movement are not inhibited
+
+299
+00:20:58,220 --> 00:21:01,400
+تمام ال patient في وضع ال long sitting position أو
+
+300
+00:21:01,400 --> 00:21:07,070
+ال sitting نفسهOkay او اللي هو setting up انه جالس
+
+301
+00:21:07,070 --> 00:21:12,510
+و الدهر من ورا مسنود سواء بالبد او سواء بالبلو
+
+302
+00:21:12,510 --> 00:21:16,910
+اللي موجودة و بخلي يشتغل ال exercise ال exercise
+
+303
+00:21:16,910 --> 00:21:20,990
+should include diaphragmatic breathing unilateral
+
+304
+00:21:20,990 --> 00:21:25,530
+لل thoracic expansion يعني هشتغل ع ال two types of
+
+305
+00:21:25,530 --> 00:21:28,050
+breathing exercise في عند ال diaphragmatic و في
+
+306
+00:21:28,050 --> 00:21:31,150
+عند ال unilateral لل lower thoracic expansion في
+
+307
+00:21:31,150 --> 00:21:35,680
+ال both sidesاللي هو الـ Right و الـ Left If pain
+
+308
+00:21:35,680 --> 00:21:39,100
+is severely limiting the respiratory excursions,
+
+309
+00:21:39,220 --> 00:21:42,320
+the physiotherapist should treat patient after
+
+310
+00:21:42,320 --> 00:21:48,330
+analgesics and administrate itإذا كان الألم واضح
+
+311
+00:21:48,330 --> 00:21:52,790
+جدا نتيجة أو بتحد من الـ Respiration أو اللي هي
+
+312
+00:21:52,790 --> 00:21:55,170
+Respiration Exclusions اللي هو إفرازات
+
+313
+00:21:55,170 --> 00:21:59,510
+الـsecretion اللي موجودة على طول بقى أعطيه أي مسكن
+
+314
+00:21:59,510 --> 00:22:04,250
+أو أي مهدق على أساس أبلش أشتغل معاه من أول و جديد
+
+315
+00:22:04,250 --> 00:22:09,250
+ال patient should be remained reminded المريض لازم
+
+316
+00:22:09,250 --> 00:22:12,030
+أنا أبقى ذاكره في ال practice briefing exercise at
+
+317
+00:22:12,030 --> 00:22:17,160
+least every hour على الأقل كل ساعةwhy لسه weak
+
+318
+00:22:17,160 --> 00:22:21,500
+بينما هو لسه مش قادر معايا إذا مش بس ال exercise
+
+319
+00:22:21,500 --> 00:22:25,000
+يعمله مقتلجل فلأ كل ساعة لازم يعمل breathing
+
+320
+00:22:25,000 --> 00:22:28,140
+exercise إحنا يا جماعة بنحكي على التنفس بنحكي على
+
+321
+00:22:28,140 --> 00:22:32,520
+حياة مريض فبالتالي هنا مهم جدا نسبة ال oxygen اللي
+
+322
+00:22:32,520 --> 00:22:36,380
+موجودةمعظم مرضى COVID-19 ليه بيصيروا أو ليه
+
+323
+00:22:36,380 --> 00:22:39,560
+بيتوفوا لإنه بيكون في عندنا ال oxygen saturation
+
+324
+00:22:39,560 --> 00:22:43,860
+أو مادة تشبع الأكسجين في الدم بيكون منخفض جدا ليه؟
+
+325
+00:22:43,860 --> 00:22:49,820
+لعدم ال good ventilating أو لعدم اللي هو ال lung
+
+326
+00:22:49,820 --> 00:22:54,060
+working is not good ما بتكون منيحة ال lung في
+
+327
+00:22:54,060 --> 00:22:59,570
+شغلها تمام؟ ال huffing and coughingEffectiveness
+
+328
+00:22:59,570 --> 00:23:03,010
+للـ Huffing and Cuffing is suitably operative طبعا
+
+329
+00:23:03,010 --> 00:23:05,790
+مصدر بي encourage with the chest firmly support
+
+330
+00:23:05,790 --> 00:23:10,110
+نفس الحكي و ال foot and leg exercise نفس الكلام
+
+331
+00:23:10,110 --> 00:23:14,610
+اللي هو ال bombing exercise هنا من خمسة لعشر مرات
+
+332
+00:23:14,610 --> 00:23:20,150
+كل ساعة هذا بعتمد على ال tolerance تبع ال patient
+
+333
+00:23:20,150 --> 00:23:25,670
+ال endurance كام هو جادر يتحمل من اللي هو عمل ال
+
+334
+00:23:25,670 --> 00:23:29,080
+exerciseshoulder movement with lateral
+
+335
+00:23:29,080 --> 00:23:33,540
+thoracotectomy طبعا thoracotectomy اللي هو it's
+
+336
+00:23:33,540 --> 00:23:36,740
+important to start arm movement friction abduction
+
+337
+00:23:36,740 --> 00:23:40,580
+extension كل هذه ال exercise مهمة جدا في أول يوم
+
+338
+00:23:40,580 --> 00:23:44,960
+من ال exercise with medium فلستيرنوتمي طبعا ال
+
+339
+00:23:44,960 --> 00:23:48,460
+cutting فلستيرنا this need not started until
+
+340
+00:23:48,460 --> 00:23:52,740
+second day هذا مش من أول يوم أنا بشتغله لأ تاني
+
+341
+00:23:52,740 --> 00:23:58,390
+يوم لأن المسألة هنا بتكون مشقليلة third day
+
+342
+00:23:58,390 --> 00:24:02,900
+onwards ال patient will startاللي هو «Sitting out
+
+343
+00:24:02,900 --> 00:24:06,720
+of bed 24 hours after surgery according to his
+
+344
+00:24:06,720 --> 00:24:09,880
+progress and surgeon's instructions» بعملش أي
+
+345
+00:24:09,880 --> 00:24:14,400
+program إلا بناءً على توصية الطبيب تمام؟ إذا
+
+346
+00:24:14,400 --> 00:24:19,600
+الطبيب سمح أنه أنا أجلس على حافة للصرير فبمشي في
+
+347
+00:24:19,600 --> 00:24:23,280
+هذه التوصية لكن الطبيب حكى أن «Patient X is
+
+348
+00:24:23,280 --> 00:24:26,800
+unstable» خلاص «unstable» معناته الكلام أنه
+
+349
+00:24:26,800 --> 00:24:30,410
+«contraindicated to movement»الـ Walking around
+
+350
+00:24:30,410 --> 00:24:35,110
+and word of bed as soon as second to third past
+
+351
+00:24:35,110 --> 00:24:41,290
+operative day طبعا بمشي حوالين السرير شوية فى تانى
+
+352
+00:24:41,290 --> 00:24:43,510
+و تالت يوم ال treatment should be include
+
+353
+00:24:43,510 --> 00:24:46,450
+breathing exercise, huffing and coughing if
+
+354
+00:24:46,450 --> 00:24:50,190
+secretion للي present اللى هى بتكون موجودة فى ال
+
+355
+00:24:50,190 --> 00:24:55,330
+lung ال foot and leg exercise الارم و الشدر مهم
+
+356
+00:24:55,330 --> 00:25:00,260
+جدا postural correction زى ما حكينا عنهاالـ
+
+357
+00:25:00,260 --> 00:25:04,740
+Walking Upstairs إنه يطلع درج وينزل درج في اليوم
+
+358
+00:25:04,740 --> 00:25:07,780
+السادس للعملية، مش من تاني يوم، لأ صارنا في اليوم
+
+359
+00:25:07,780 --> 00:25:10,720
+السادس، this will depends on the instruction of
+
+360
+00:25:10,720 --> 00:25:14,960
+individual surgeon، طبعا بيعتمد على الجراح اللي
+
+361
+00:25:14,960 --> 00:25:18,510
+أدى العمليةAfter cardiac surgery, most patients
+
+362
+00:25:18,510 --> 00:25:22,750
+find clumping, tears, muscle aches اللي هو بأقل
+
+363
+00:25:22,750 --> 00:25:26,770
+جهود than preoperative Treatment must be modified
+
+364
+00:25:26,770 --> 00:25:31,860
+if any complications صارت معناإذن ال exercise
+
+365
+00:25:31,860 --> 00:25:36,160
+هيبقى عملها بالأيام خصوصا ال boss ده objective حكي
+
+366
+00:25:36,160 --> 00:25:39,100
+إن أنا عندي عامل مهم إذا كان ال patient stable
+
+367
+00:25:39,100 --> 00:25:43,440
+بمشي في ال exercise إذا ال patient مش stable بوقف
+
+368
+00:25:43,440 --> 00:25:48,560
+العملية اللي هي أو بوقف برنامج العلاج الطبيعي الآن
+
+369
+00:25:48,560 --> 00:25:53,750
+خلاص ال patient بده يتخرجبدي أكتب له اللي هو
+
+370
+00:25:53,750 --> 00:25:57,430
+surgeon خروجي قبل الخروج ال thoracic expansion مهم
+
+371
+00:25:57,430 --> 00:26:02,450
+جدا shoulder mobility ال postural كل هذا الاشي مهم
+
+372
+00:26:02,450 --> 00:26:06,010
+جدا لازم أقيمه عشان أنا في تقدير الخروج أبعتله
+
+373
+00:26:06,010 --> 00:26:08,970
+يعني ال patient should be increasing his exercise
+
+374
+00:26:08,970 --> 00:26:13,730
+tolerance لازم ال patient يكون قادر على أنه يعمل
+
+375
+00:26:13,730 --> 00:26:17,510
+ال exercise كذا مرة لكذا وقت ال patient should be
+
+376
+00:26:17,510 --> 00:26:20,850
+continue breathing exercise for about three weeks
+
+377
+00:26:20,850 --> 00:26:24,660
+following operationطبعا لبعد تلتة سابيع على الرغم
+
+378
+00:26:24,660 --> 00:26:28,800
+من انه discharge after اللي هو ممكن يصير اللي هو
+
+379
+00:26:28,800 --> 00:26:32,680
+الخروج من عشرة لاربعتاشر يوم يعني بعد اسبوعين هو
+
+380
+00:26:32,680 --> 00:26:36,140
+هيكون في ال impatient موجود داخلي انه في المستشفى
+
+381
+00:26:36,140 --> 00:26:41,140
+لكن انا لازم اعلمه ال home program لما بعد ذلك اذا
+
+382
+00:26:41,140 --> 00:26:47,160
+كان فيه خروج dischargeوبهيك بيكون أنا خلصت هذه
+
+383
+00:26:47,160 --> 00:26:50,000
+المحاضرة اللي هي role of physiotherapy in
+
+384
+00:26:50,000 --> 00:26:54,900
+cardiothoracic surgery حوالي تقريبا chapter 4
+
+385
+00:26:54,900 --> 00:27:00,140
+أعتقد وألقاكم بإذن الله في ال chapter القادم على
+
+386
+00:27:00,140 --> 00:27:00,780
+بركة الله
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/Y6k4syDoc6c.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/Y6k4syDoc6c.srt
new file mode 100644
index 0000000000000000000000000000000000000000..f60e30a8cdfad18bd51f891aa1a21fddb58f150c
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/Y6k4syDoc6c.srt
@@ -0,0 +1,2002 @@
+1
+00:00:01,010 --> 00:00:06,010
+السلام علي أشرف الأنبياء و المرسلين محمد، عليه أبطل
+
+2
+00:00:06,010 --> 00:00:09,950
+الصلاة و أتم التسليم، إن شاء الله رب العالمين، اليوم
+
+3
+00:00:09,950 --> 00:00:14,470
+هنشرح المحاضرة رقم 2 في مساق علاج طبيعي لأمراض
+
+4
+00:00:14,470 --> 00:00:20,020
+القلب و الصدر و الباطنة. المحاضرة هنتحدث عن الـ
+
+5
+00:00:20,020 --> 00:00:24,180
+Diabetes، هو عبارة عن مرض العصر، زي ما بنعرف، هنحكي
+
+6
+00:00:24,180 --> 00:00:27,660
+عنه. أول شيء في هذه الجزئية، أنا قسمت المحاضرة إلى
+
+7
+00:00:27,660 --> 00:00:31,620
+جزئين، الجزء الأول هذا اللي اليوم، أو هذه المحاضرة
+
+8
+00:00:31,620 --> 00:00:36,180
+هتكلم عنه في هذا الفيديو، عبارة عن introduction عن
+
+9
+00:00:36,180 --> 00:00:41,100
+شو هو الـ Diabetes من وجهة نظر الفيزيوثيرابي. هنعرف
+
+10
+00:00:41,100 --> 00:00:44,900
+أنواعه، هنعرف كيف التعامل معه، شو الـ
+
+11
+00:00:44,900 --> 00:00:48,960
+guidelines، أو شو الـ advice اللي أنا ممكن أعطيها
+
+12
+00:00:48,960 --> 00:00:53,600
+للمريض تبعي أثناء جلسة الـ Physiotherapy. كل هذا
+
+13
+00:00:53,600 --> 00:00:56,800
+الشيء، إن شاء الله رب العالمين، راح أشرحه في هذه
+
+14
+00:00:56,800 --> 00:00:59,260
+المحاضرة، نبدأ على بركة الله.
+
+15
+00:01:03,140 --> 00:01:06,280
+طبعاً الـ diabetes والـ exercise اللي أنا بدي
+
+16
+00:01:06,280 --> 00:01:10,820
+أعطيهم للمريض تبعي، هيكون المريض مشخص وجاهز، ويجيني
+
+17
+00:01:10,820 --> 00:01:15,540
+أنا عشان أعمل جلسة علاج طبيعي، نظراً لإن في عنده
+
+18
+00:01:15,540 --> 00:01:18,700
+osteoarthritis مثلاً، عنده مشاكل مثلاً في الـ
+
+19
+00:01:18,700 --> 00:01:23,260
+muscles، عنده أي مشاكل أخرى، سواء كانت على صعيد
+
+20
+00:01:23,260 --> 00:01:28,180
+systemic أو على صعيد الأطراف. خليني أشوف شو يعني
+
+21
+00:01:28,180 --> 00:01:31,840
+ذيابيتس. عشان أنا أعرف شو يعني كلمة ذيابيتس، لازم
+
+22
+00:01:31,840 --> 00:01:35,340
+أعرف إن أنا لازم يكون في عندي مشكلة، أو خلل شوية بس
+
+23
+00:01:35,340 --> 00:01:39,400
+نرجع للـ Anatomy قليلاً. الـ Endocrine System هو
+
+24
+00:01:39,400 --> 00:01:45,040
+عبارة عن System مهم جداً، بيمشي مباشر مع الـ Nervous
+
+25
+00:01:45,040 --> 00:01:49,440
+System. يعني الـ Endocrine مسؤول عن اللي هو الغدد
+
+26
+00:01:49,440 --> 00:01:52,940
+اللي موجودة عندنا في الجسم، بيمشي parallel أو with
+
+27
+00:01:52,940 --> 00:01:57,440
+together مع اللي هو الـ Nervous System. تمام؟ هنا أنا
+
+28
+00:01:57,440 --> 00:02:03,700
+القصة إنه أنا بدي أعرف إنه أنا إذا الانسولين، أو
+
+29
+00:02:03,700 --> 00:02:08,000
+مشكلة الديابيتس اللي هي في ارتفاع نسبة السكر في
+
+30
+00:02:08,000 --> 00:02:13,420
+الدم، هيحلها مشكلة معينة، أو هيحلها شيء، إنه أنا
+
+31
+00:02:13,420 --> 00:02:17,780
+الغدة التي تفرز هرمون الانسولين، بتكون لحظتها غير
+
+32
+00:02:17,780 --> 00:02:22,340
+قادرة على إفراز ما يكفي للجسم. معنى الكلام أنه فيه
+
+33
+00:02:22,340 --> 00:02:26,140
+لازم يكون سيالة عصبية رايحة على الـ brain، وسيالة
+
+34
+00:02:26,140 --> 00:02:28,740
+عصبية راجعة من الـ brain. إذا نرتبط الـ
+
+35
+00:02:28,740 --> 00:02:33,020
+endocrine system مع الـ nervous system بشكل مباشر.
+
+36
+00:02:33,020 --> 00:02:36,520
+The effect on most every cell, organs, and functional
+
+37
+00:02:36,520 --> 00:02:39,830
+of the body. بتأثر الـ Endocrine System على كل
+
+38
+00:02:39,830 --> 00:02:43,610
+الجسم، وعلى كل الوظائف اللي موجودة. The endocrine
+
+39
+00:02:43,610 --> 00:02:47,550
+system is closely linked with the nervous system. حكينا
+
+40
+00:02:47,550 --> 00:02:52,250
+عليه هذا الموضوع، إن هم بيكونوا مرتبطين بشكل مباشر
+
+41
+00:02:52,250 --> 00:02:55,390
+مع الـ nervous system، أيضاً مع الـ immunity system،
+
+42
+00:02:55,390 --> 00:02:59,930
+جهاز المناعة. اللي إحنا في ظل هاي الجائحة COVID-19،
+
+43
+00:02:59,930 --> 00:03:03,850
+لازم أنه معزز، ونقوي اللي هو الـ immunity system.
+
+44
+00:03:03,850 --> 00:03:08,860
+Negative feedback mechanism. بيصير في عندنا مشكلة، و
+
+45
+00:03:08,860 --> 00:03:12,340
+لخبطة بالهرمون اللي هي بتتضمن إفرازها عن طريق الـ
+
+46
+00:03:12,340 --> 00:03:15,460
+endocrine system. طبعاً الـ chemical messenger اللي
+
+47
+00:03:15,460 --> 00:03:18,480
+جاي من الـ body، و ما يلقى specific target
+
+48
+00:03:18,480 --> 00:03:21,040
+cells. في عندنا alpha cells، وفي عندنا beta cells،
+
+49
+00:03:21,040 --> 00:03:24,340
+هاي كلها موجودة في البنكرياس، وإحنا كلنا بنعرف إن
+
+50
+00:03:24,340 --> 00:03:28,880
+البنكرياس هي الغدة المسؤولة عن إنتاج و إفراز
+
+51
+00:03:28,880 --> 00:03:32,900
+الهرمون. هلأ الـ glands اللي أنا بدي أحكي عليها،
+
+52
+00:03:32,900 --> 00:03:38,860
+البنكرياس، تقع خلف المعدة، أيضاً، back of abdomen، ورا
+
+53
+00:03:38,860 --> 00:03:43,380
+اللي هي البطن. الهرمون اللي بتفرزه، بيساعد في عملية
+
+54
+00:03:43,380 --> 00:03:48,040
+الـ Digestive. في Exocrine وفي Endocrine. Exo معناته
+
+55
+00:03:48,040 --> 00:03:53,320
+لبره، outside. أما Endo لجوه، معناته inside. الـ
+
+56
+00:03:53,320 --> 00:03:57,140
+Exocrine pancreatic Secretion of Digestive Enzymes،
+
+57
+00:03:57,140 --> 00:04:01,860
+بيفرز الإنزيمات اللي مسؤولة عن عملية الهضم. لكن الـ
+
+58
+00:04:01,860 --> 00:04:05,640
+Endocrine، تعمل على إفراز الأنسولين والجلوكاجون، which
+
+59
+00:04:05,640 --> 00:04:10,920
+is regulated للجليكوجين، واللي هو مسؤول عن تنظيم
+
+60
+00:04:10,920 --> 00:04:16,060
+الجلوكوز داخل الدم. إذا two parts أو جزئين أساسيين
+
+61
+00:04:16,060 --> 00:04:19,630
+بيشتغل فيهم البنكرياس، يا إما Exocrine، يا إما
+
+62
+00:04:19,630 --> 00:04:23,850
+Endocrine. إذا حكينا Exocrine، معنى الكلام إنه هو
+
+63
+00:04:23,850 --> 00:04:26,330
+بدّه يشتغل على الإنزيمات اللي الها علاقة بالـ
+
+64
+00:04:26,330 --> 00:04:29,850
+digestive system، زي الببسين، زي أي شيء يحتاج، أما الـ
+
+65
+00:04:29,850 --> 00:04:34,150
+Endocrine، فهي مسؤولة عن إفراز الأنسولين اللي هو
+
+66
+00:04:34,150 --> 00:04:38,770
+أو الجلوكاجون اللي مسؤول عن إفراز الجلوكوز، أو تنظيم
+
+67
+00:04:38,770 --> 00:04:43,650
+الـ glucose level في الدم. طبعاً لحد
+
+68
+00:04:43,650 --> 00:04:46,390
+الآن الأمور ماشية معانا، إحنا لسة بنمشي
+
+69
+00:04:46,390 --> 00:04:51,970
+introduction بسيطة عن شو هو مرض السكري، diabetes.
+
+70
+00:04:51,970 --> 00:04:55,070
+هو عبارة عن مجموعة من الـ metabolic diseases، يعني
+
+71
+00:04:55,070 --> 00:05:00,350
+مجموعة من الأمراض التي تعني أو تخص اللي هي عمليات
+
+72
+00:05:00,350 --> 00:05:06,940
+الأيض، ويتصف بـ hyperglycemia، طبعاً، يا ربيعة، ما
+
+73
+00:05:06,940 --> 00:05:11,300
+حكيت hypo، ما حكيت hyper، الجلايسيميا، اللي ناتجة
+
+74
+00:05:11,300 --> 00:05:14,520
+عن الـ defect of insulin secretion، ناتجة عن الـ
+
+75
+00:05:14,520 --> 00:05:18,240
+deficiency في إفراز الأنسولين اللي بتتم من الـ
+
+76
+00:05:18,240 --> 00:05:22,400
+بنكرياس، اللي أيضاً بيكون في عنده deficiency أو
+
+77
+00:05:22,400 --> 00:05:26,730
+problems in insulin action. فيه منه نوعين، النوع الأول
+
+78
+00:05:26,730 --> 00:05:30,950
+اللي هو بسميه الـ absolute deficiency in insulin
+
+79
+00:05:30,950 --> 00:05:35,130
+secretion، اللي هو auto-immune disease. تمام؟ إنه
+
+80
+00:05:35,130 --> 00:05:39,070
+جهاز المناعة، أو الخلايا المناعية اللي موجودة
+
+81
+00:05:39,070 --> 00:05:43,570
+عندي في الجسم، بتهاجم الخلايا اللي هي مسؤولة في
+
+82
+00:05:43,570 --> 00:05:47,590
+البنكرياس عن إنتاج الأنسولين. ولحد الآن، العلماء
+
+83
+00:05:47,590 --> 00:05:51,890
+ما عرفوا السبب. أما type 2، اللي هو بيكون a
+
+84
+00:05:51,890 --> 00:05:56,770
+combination لمقاومة، إنه بيصير في عندي عملية مقاومة
+
+85
+00:05:56,770 --> 00:06:00,410
+لعمل الأنسولين. هنا بيصير في عندي inadequate
+
+86
+00:06:00,410 --> 00:06:03,430
+compensatory insulin secretion. فبالتالي بيفرز
+
+87
+00:06:03,430 --> 00:06:07,730
+الأنسولين، ولكن لا تكفي حاجة الجسم. الأنسولين هو
+
+88
+00:06:07,730 --> 00:06:12,770
+عبارة عن الهرمون اللي بيحول السكر أو الجلوكوز إلى
+
+89
+00:06:12,770 --> 00:06:16,230
+glucose، extra into energy needed for daily life.
+
+90
+00:06:16,230 --> 00:06:20,170
+بيحوله لإشي من إشي ضار لإشي مفيد، أنا أستفيد
+
+91
+00:06:20,170 --> 00:06:23,970
+منه في الجسم. خليني أعمل سمراية لموضوع اللي هو
+
+92
+00:06:23,970 --> 00:06:28,480
+نوعين الداء السكري، النوعين: type 1 و type 2. type
+
+93
+00:06:28,480 --> 00:06:33,720
+1، حكينا absolute deficiency، فقدان أو فقر أو قلة أو
+
+94
+00:06:33,720 --> 00:06:37,440
+نقص في إفراز الأنسولين. تمام؟ حكينا autoimmune
+
+95
+00:06:37,440 --> 00:06:41,040
+disease. أما type 2 فهو عبارة عن combination للـ
+
+96
+00:06:41,040 --> 00:06:44,180
+resistance to insulin action and inadequate
+
+97
+00:06:44,180 --> 00:06:50,450
+compensatory نقص في اللي هو إفراز الأنسولين، وأيضاً
+
+98
+00:06:50,450 --> 00:06:55,710
+عملية معاكسة، أو عملية مقاومة لعمل الأنسولين. طبعاً
+
+99
+00:06:55,710 --> 00:06:59,750
+هذا الشيء بيكون ذاتي داخل الجسم، ناتج عن أسباب كثيرة،
+
+100
+00:06:59,750 --> 00:07:06,790
+هنعرفها الآن. في ناس pre-diabetic، تمام؟ اللي هم
+
+101
+00:07:06,790 --> 00:07:11,560
+الناس هاي اللي لسة ما صاروا ديابيتس، ولكن كل
+
+102
+00:07:11,560 --> 00:07:17,980
+المؤشرات بتعطي إنذار أحمر، إن أنت انتبه please. الـ
+
+103
+00:07:17,980 --> 00:07:23,600
+obesity، الـ high level sugar في الأكل، الـ stress، الـ
+
+104
+00:07:23,600 --> 00:07:27,500
+stationary daily life، كل هذه الأمور بتكون مؤشر
+
+105
+00:07:27,500 --> 00:07:32,240
+وإنذار أحمر، لأن هذا الشخص يقع عندنا في فئة اللي هم
+
+106
+00:07:32,240 --> 00:07:36,070
+مرضى السكري. Their blood glucose levels are higher than
+
+107
+00:07:36,070 --> 00:07:38,930
+normal but not high enough to diagnose a
+
+108
+00:07:38,930 --> 00:07:42,650
+diabetes. تمام؟ okay، السكري عندك، وهعرف القيمة الآن
+
+109
+00:07:42,650 --> 00:07:48,950
+كم هي عالية، ولكن ما بيعطيني مؤشر كطبيب، إني أنا
+
+110
+00:07:48,950 --> 00:07:52,830
+أشخصه في خلال، أو من خلال الـ medical file، إنه أنت
+
+111
+00:07:52,830 --> 00:07:57,130
+diabetes، diabetes patient. لأ، هيت ما بيكون إن هذا
+
+112
+00:07:57,130 --> 00:08:00,310
+المريض تبعي إنه اتشخص على إنه مريض سكري. no
+
+113
+00:08:00,310 --> 00:08:03,940
+symptoms، ما عنده أي أعراض. the treatment هنا سهلة جداً،
+
+114
+00:08:03,940 --> 00:08:07,900
+بأجي أنا لهذه الـ patient اللي إجتنى، عمرها أقل من
+
+115
+00:08:07,900 --> 00:08:12,820
+الأربعين، بتشكي من سمنة، بتاكل حلو كثير، الـ life
+
+116
+00:08:12,820 --> 00:08:18,580
+style تبعها إن هي قاعدة، ما في أي activities، ما في أي
+
+117
+00:08:18,580 --> 00:08:22,320
+sports، ما في شيء. معنى الكلام، إني أنا بدي أشتغل على
+
+118
+00:08:22,320 --> 00:08:27,360
+ثلاثة عوامل أساسية. أول شيء، الأكل الصحي. ثاني شيء، الـ
+
+119
+00:08:27,360 --> 00:08:32,000
+weight، من 5 لـ 10% من وزنها، والـ exercise اللي هو
+
+120
+00:08:32,000 --> 00:08:36,860
+عن طريق الرياضة، إنه أنا، لأن لسة هي جاية إنها تحمي
+
+121
+00:08:36,860 --> 00:08:40,540
+نفسها. هذا الناس اللي pre-diabetic. لو أنا عرفتهم،
+
+122
+00:08:40,540 --> 00:08:45,240
+هم الناس اللي لسة ما وصلوا لحد معين من الـ glucose
+
+123
+00:08:45,240 --> 00:08:50,360
+level، إنه يخليني أشخصهم إنهم ديابيتس. تمام؟ الـ
+
+124
+00:08:50,360 --> 00:08:55,580
+growing problems. حوالي المشكلة طبعاً بتتطور. 7% من الـ
+
+125
+00:08:55,580 --> 00:09:00,120
+population تبع الـ US يابا، و twice that many have
+
+126
+00:09:00,120 --> 00:09:04,420
+pre-diabetic. وحوالي 2% عندنا الناس hybrid
+
+127
+00:09:04,420 --> 00:09:10,000
+pre-diabetic. 21% فوق 60%، وهذا شيء له علاقة بالـ aging.
+
+128
+00:09:10,000 --> 00:09:14,110
+طبعاً، هنعرف من إنه نوع منهم. الـ 45% من الـ new
+
+129
+00:09:14,110 --> 00:09:17,130
+diagnoses are being made in children and
+
+130
+00:09:17,130 --> 00:09:20,830
+adolescents. طبعاً، وشيء خطير جداً، لأن type 1 إله
+
+131
+00:09:20,830 --> 00:09:25,290
+علاقة بالـ pediatrics والـ adolescents. أما type 2،
+
+132
+00:09:25,290 --> 00:09:30,830
+إله علاقة بالناس اللي هم اللي فوق سن الأربعين. risk
+
+133
+00:09:30,830 --> 00:09:34,450
+factors تبعتها، family history، والله الأب والأم،
+
+134
+00:09:34,450 --> 00:09:39,450
+والجد والجدة عندهم DM، اللي هو اختصار للسكري،
+
+135
+00:09:39,450 --> 00:09:43,110
+diabetes، احتمال كبير يكون عند الأبناء. الـ
+
+136
+00:09:43,110 --> 00:09:47,070
+cardiovascular diseases، أمراض القلب، حدث ولا حرج. الـ
+
+137
+00:09:47,070 --> 00:09:51,650
+obesity، السمنة، extraordinary lifestyle، الحياة
+
+138
+00:09:51,650 --> 00:09:58,710
+الرفاهية. الست قاعدة في البيت، مرفهة، ما في أي نشاط
+
+139
+00:09:58,710 --> 00:10:02,870
+بتقوم به، أو ما بتقوم فيه، فبالتالي بتلاقي إنه هي
+
+140
+00:10:02,870 --> 00:10:06,790
+كل ما لها، ما شاء الله عليها، overweight، وبيصير
+
+141
+00:10:06,790 --> 00:10:09,670
+زيادة في الأنسولين، بيصير في زيادة في الـ glucose
+
+142
+00:10:09,670 --> 00:10:12,810
+level في الدم. الـ history of impaired fasting
+
+143
+00:10:12,810 --> 00:10:17,870
+glucose، أو impaired glucose tolerance. طبعاً، إذا كان
+
+144
+00:10:17,870 --> 00:10:21,470
+في عندها في تاريخها، إنه لو حللت سكري وهي
+
+145
+00:10:21,470 --> 00:10:25,310
+صائمة، عندها أعلى من الـ normal line اللي أنا هحكي
+
+146
+00:10:25,310 --> 00:10:30,610
+عليه. هيكون الـ Hypertension مباشرة في الملف الطبي،
+
+147
+00:10:30,610 --> 00:10:34,330
+وزي ما شوفته في التدريبات العملية، إنه بتلاقوا إنه
+
+148
+00:10:34,330 --> 00:10:38,270
+إذا كان هذا المريض ضغط، معناته هو بيكون مصاحب للسكري، و
+
+149
+00:10:38,270 --> 00:10:44,210
+هي ليست قاعدة أساسية، لأ، بنحكي ممكن، وفي احتمالية، يعني
+
+150
+00:10:44,210 --> 00:10:48,390
+ممكن الناس تكون هي مريضة ضغط، ولكن لا يوجد لديها
+
+151
+00:10:48,390 --> 00:10:52,950
+diabetes. gestational diabetes، اللي هو سكري الحمل.
+
+152
+00:10:52,950 --> 00:10:58,350
+اليوم أنا حامل في اللي هو الأشهر الأولى، بلاقي إنه
+
+153
+00:10:58,350 --> 00:11:02,490
+بعد اللي هو فحص السكري للحامل، إنه أنت يا ست، عندك
+
+154
+00:11:02,490 --> 00:11:06,990
+السكري مرتفع، ولكن بعد الولادة مباشرة بيروح هذا
+
+155
+00:11:06,990 --> 00:11:12,820
+السكري، فهو عرضي، ليس مستمر، لكن أنا بكون حاطة اللي هو
+
+156
+00:11:12,820 --> 00:11:18,820
+red marks، إنه ديري بالك، إنه أنت pre-diabetic، إنه
+
+157
+00:11:18,820 --> 00:11:23,120
+أنت في مؤشر، أو أنت في الـ risk area، إنه أنت ديري
+
+158
+00:11:23,120 --> 00:11:27,060
+بالك... ديري بالك، إنه ممكن لو تكرر الشيء، أو ممكن
+
+159
+00:11:27,060 --> 00:11:30,740
+لو ما اتبعت نظام معين، إنه تصيري أنت diabetic
+
+160
+00:11:30,740 --> 00:11:36,880
+patient. high risk factors تبع الـ DM. الـ diagnostic في
+
+161
+00:11:36,880 --> 00:11:40,340
+الآن عندي، عشان أنا أشخص إنه أنت مريض سكري أو لأ،
+
+162
+00:11:40,340 --> 00:11:45,020
+بتعمل الـ fasting plasma glucose، مش لازم يكون أعلى
+
+163
+00:11:45,020 --> 00:11:51,680
+من 125. هذا الـ line تبعه. إذا أنا عملت التحليل
+
+164
+00:11:51,680 --> 00:11:58,060
+عشوائي، مش لازم يكون أعلى من 200. أكثر من 200 معناته
+
+165
+00:11:58,060 --> 00:12:03,740
+أنت مريض سكري. في عندنا الـ OGTT اللي هو الـ oral
+
+166
+00:12:03,740 --> 00:12:08,000
+glucose tolerance test. هو أبرع من test. بتم أخذ
+
+167
+00:12:08,000 --> 00:12:12,860
+جلوكوز فيه orally، تمام؟ إذا الـ diagnostic طبعاً،
+
+168
+00:12:12,860 --> 00:12:16,060
+إحنا هيك دخلنا على التحليل، بدي أعرف فيه ثلاثة
+
+169
+00:12:16,060 --> 00:12:20,500
+تحاليل أساسية. الـ FBG هذا بيكون موجود عندكم في رقم
+
+170
+00:12:20,500 --> 00:12:24,800
+التحليل، مش لازم يكون أعلى من 125، وإلا بأعتبره دايابيتك.
+
+171
+00:12:24,800 --> 00:12:30,270
+بالنسبة للـ random، تحليل عشوائي، إذا كان أعلى من
+
+172
+00:12:30,270 --> 00:12:33,730
+200، معناته أنا بخاف من هذه الإشكالية، إيه المشكلة،
+
+173
+00:12:33,730 --> 00:12:38,870
+
+223
+00:16:26,630 --> 00:16:30,870
+بحكيلها معلش هي بتكون لسه مش دارية عن حالها أنه لو
+
+224
+00:16:30,870 --> 00:16:35,890
+سمحت بس اعمليلي تحليل كذا أو سويلي تحليل كذا أنه
+
+225
+00:16:35,890 --> 00:16:39,890
+أنا مش مخولة أنه أنا أحكي أنه خلينا نحلل ولكن
+
+226
+00:16:39,890 --> 00:16:44,340
+كنصيحة أنا ممكن أعطيها إياها ففعلا بتلاقي اللي هو
+
+227
+00:16:44,340 --> 00:16:49,340
+high blood glucose level في التحليل العلاج تبعه
+
+228
+00:16:49,340 --> 00:16:53,100
+بيكون الـ oral medication، بيستخدم اللي هو oral
+
+229
+00:16:53,100 --> 00:16:59,600
+medication لتنظيم عملية اللي هي الـ الـ الـ الهضم،
+
+230
+00:16:59,600 --> 00:17:04,060
+تنظيم عملية اللي هو زي الـ Gelofax أو الأدوية اللي
+
+231
+00:17:04,060 --> 00:17:07,620
+بتكون موجودة مع مرضى السكري،  insulin shots may
+
+232
+00:17:07,620 --> 00:17:11,410
+have to be prescribed. exercise كمان الـ exercise
+
+233
+00:17:11,410 --> 00:17:17,350
+مهمة لمريض السكري من النوع الثاني type two و الـ
+
+234
+00:17:17,350 --> 00:17:22,510
+weight loss كمان أو فقدان الوزن كمان شيء مهم جدا
+
+235
+00:17:22,510 --> 00:17:28,070
+الآن، الست الحامل اللي حكينا عليها قبل شوية، هاي بدها
+
+236
+00:17:28,070 --> 00:17:32,650
+يصير في عندها سكري الحمل،  الـ placenta هنا قادرة على
+
+237
+00:17:32,650 --> 00:17:38,090
+أنها تغير أو أن هي تنتج الـ hormones اللي بتعيق
+
+238
+00:17:38,500 --> 00:17:42,920
+الأنسولين، okay. when the placenta produced hormones
+
+239
+00:17:42,920 --> 00:17:47,220
+which impair action of الأنسولين in tissue when
+
+240
+00:17:47,220 --> 00:17:51,280
+blood sugar level rise too high، it can affect the
+
+241
+00:17:51,280 --> 00:17:54,520
+growth and development للـ baby، عشان هيك بتلاقي أن
+
+242
+00:17:54,520 --> 00:17:59,560
+هو الطفل الصغير لما انولد كان 6 كيلو، آه والله، أمه
+
+243
+00:17:59,560 --> 00:18:02,980
+ما شاء الله عليها مهتمة فيه، كانت بتتغذى وهي حامل
+
+244
+00:18:02,980 --> 00:18:09,620
+هي بتكون سكري أصلا، فبالتالي أثرت على الـ growth و
+
+245
+00:18:09,620 --> 00:18:13,840
+الـ weight تبع الـ baby. no noticeable signs or
+
+246
+00:18:13,840 --> 00:18:17,240
+symptoms but may cause increased stress and
+
+247
+00:18:17,240 --> 00:18:21,060
+urination. بتلاقي حالها ما في أي symptoms ظاهرة زي
+
+248
+00:18:21,060 --> 00:18:26,530
+ما شفنا فيه D1 و D2، ولكن على الأغلب هي بتكون دائما
+
+249
+00:18:26,530 --> 00:18:31,330
+تشعر بالعطش الشديد، بالـ urination، والدكتور will
+
+250
+00:18:31,330 --> 00:18:34,590
+address it، لأنه لازم تظل متابعة مع الدكتور تبعها
+
+251
+00:18:34,590 --> 00:18:39,310
+أيضا بعد الولادة، تمام، كل شيء بيصير و بيرجع لـ
+
+252
+00:18:39,310 --> 00:18:43,490
+glucose level، أو بيرجع مستوى السكري لوضعه الطبيعي
+
+253
+00:18:43,490 --> 00:18:49,390
+ولكن احنا بنحكي لها أنك لازم تظلي متابعة ومستمرة مع
+
+254
+00:18:49,390 --> 00:18:54,510
+الدكتور، لأنه في مجال أن ترجع لها، أن هي المشكلة من
+
+255
+00:18:54,510 --> 00:19:01,550
+الأول و جديد.  أيضا الـ treatment، حكينا بالـ exercise و
+
+256
+00:19:01,550 --> 00:19:05,490
+الـ diet و الـ medication، بعض الأحيان بنضطر، أو
+
+257
+00:19:05,490 --> 00:19:09,190
+بتضطر الدكتور أن يعطيها الـ insulin injection و الـ
+
+258
+00:19:09,190 --> 00:19:12,370
+oral، الـ blood glucose أو الـ blood sugar monitoring
+
+259
+00:19:12,370 --> 00:19:17,230
+4 إلى 5 times daily، لأنه مهم جدا زي ما أنا بخاف من
+
+260
+00:19:17,230 --> 00:19:21,290
+الـ hyperglycemia، كمان بخاف من الـ hypoglycemia
+
+261
+00:19:21,290 --> 00:19:28,310
+تمام؟ draw blood from tip of fingers، هذا اللي هو
+
+262
+00:19:28,310 --> 00:19:32,790
+الـ blood sugar monitoring، و place on test strap
+
+263
+00:19:32,790 --> 00:19:37,350
+put under glucose. مثلا هنا بدنا نحكي على الـ drawel
+
+264
+00:19:37,350 --> 00:19:42,650
+تبع الـ blood، بدي يكون من طرف الإصبع، و place on test
+
+265
+00:19:42,650 --> 00:19:46,890
+طبعا بتحطيه على strip، وعلى شريط يعني اللي هنا
+
+266
+00:19:46,890 --> 00:19:52,170
+العملية هي خاصة بالتحاليل، احنا بس نتعلمها لإنه بعض
+
+267
+00:19:52,170 --> 00:19:57,570
+الأهالي أو بعض أمهاتكم عندهم الأجهزة اللي هي خاصة
+
+268
+00:19:57,570 --> 00:20:00,470
+فيهم، موجودة في البيت، تسحب أنتِ العينة من طرف
+
+269
+00:20:00,470 --> 00:20:04,330
+الإصبع و بتحطيها على شريط اللاصق، وبعدين بتعملي ..
+
+270
+00:20:04,330 --> 00:20:09,790
+بتحطيها على الجهاز. geriatric considerations
+
+271
+00:20:10,530 --> 00:20:14,250
+اللي هو علم الشيخوخة. elevated of blood glucose
+
+272
+00:20:14,250 --> 00:20:18,710
+level are also age related، لها علاقة بالعمر، الـ
+
+273
+00:20:18,710 --> 00:20:22,410
+increasing with advancing age، شيء طبيعي، اليوم
+
+274
+00:20:22,410 --> 00:20:25,430
+الأنسولين، أسفل البنكرياس، لما بدو يشتغل في عمر
+
+275
+00:20:25,430 --> 00:20:29,150
+العشرين سنة مش نفسه لما بيشتغل في عمر الثمانين، لأ، الـ
+
+276
+00:20:29,150 --> 00:20:32,650
+capacity تبعته أو القدرة تبعته ما بتعطي نفس
+
+277
+00:20:32,650 --> 00:20:36,270
+الإنتاج اللي كان، فبالتالي أنه بيسبب لي increase لـ
+
+278
+00:20:36,270 --> 00:20:39,380
+الـ fatty shock، decrease للإنسولين production، الـ
+
+279
+00:20:39,380 --> 00:20:42,860
+physical inactivity كمان مهم جدا، احنا بمجرد نصير
+
+280
+00:20:42,860 --> 00:20:47,200
+بالستين، خلاص على الله السلام، decrease للـ lean of
+
+281
+00:20:47,200 --> 00:20:50,920
+body mass، كمان اللي هو الكتلة العضلية تبعنا، و
+
+282
+00:20:50,920 --> 00:20:54,820
+بتصير الست، ما شاء الله عليها، overweight، فبالتالي هذا
+
+283
+00:20:54,820 --> 00:21:03,180
+بيؤدي إلى وجود السكري عند المسنين. كيف بدي أعمل فحص
+
+284
+00:21:03,180 --> 00:21:07,260
+أو كيف بدي أراقب الـ glucose level؟  the patient on
+
+285
+00:21:07,260 --> 00:21:11,420
+insulin should check sugar two or five times per
+
+286
+00:21:11,420 --> 00:21:15,400
+day. لازم تشيك على حالها هاي الست من مرتين لأربع مرات
+
+287
+00:21:15,400 --> 00:21:19,340
+في اليوم. not on insulin two or three times، بيختلف
+
+288
+00:21:19,340 --> 00:21:23,120
+according to text. الناس اللي هي مش معتمدة على
+
+289
+00:21:23,120 --> 00:21:25,920
+الأنسولين، أما الناس اللي معتمدة على الأنسولين لازم
+
+290
+00:21:25,920 --> 00:21:30,020
+يكون مرتين لثلاث خلال اليوم، ولكن خلال الأسبوع
+
+291
+00:21:30,020 --> 00:21:33,100
+للناس اللي مش معتمدة على أنسولين، should check
+
+292
+00:21:33,100 --> 00:21:37,160
+before meals and two hours after meals، شيء بده
+
+293
+00:21:37,160 --> 00:21:41,400
+يكون قبل الوجبات طبعا، لإن الـ fasting بده يكون، وشيء
+
+294
+00:21:41,400 --> 00:21:44,720
+بعد الوجبة ساعتين، عشان أنا آخذ الـ parameter الصحيح
+
+295
+00:21:44,720 --> 00:21:48,100
+الـ parameter from physician is very important، إن
+
+296
+00:21:48,100 --> 00:21:52,020
+هو أنا آخذ القياسات الصحيحة، عشان كمان الدكتور يتبع
+
+297
+00:21:52,020 --> 00:21:58,190
+معايا في الموضوع.  ماهي الـ complications اللي ممكن تصير
+
+298
+00:21:58,190 --> 00:22:01,470
+عندك؟ في عندي acute complications و في عندي chronic
+
+299
+00:22:01,470 --> 00:22:05,710
+complications. hypoglycemia اللي هو انخفاض مستوى
+
+300
+00:22:05,710 --> 00:22:14,370
+السكر عن 70، عن 70 milligram لكل dcl، طبعا يعني إذا
+
+301
+00:22:14,370 --> 00:22:18,850
+عالي 125، هذا بعتبره hyperglycemia، ولكن أنا اللي
+
+302
+00:22:18,850 --> 00:22:24,410
+بدي أحكي hypoglycemia، بدي أقل عن 70، ممكن يصير عندي
+
+303
+00:22:24,410 --> 00:22:30,860
+من الـ complications، ketoacidosis، بختصرها بالـ DKA، هو
+
+304
+00:22:30,860 --> 00:22:35,020
+عبارة عن الحمض الكيتوني السكري، إنه بيتم التشخيص
+
+305
+00:22:35,020 --> 00:22:39,120
+للإصابة بمرض السكري من النوع الأول، ومعالجته، وممكن
+
+306
+00:22:39,120 --> 00:22:42,860
+المريض في هذه اللحظة يقع في غيبوبة، قد يموت
+
+307
+00:22:42,860 --> 00:22:47,630
+إذا ما تم معالجته. الـ non-ketotic اللي هو أو hyper
+
+308
+00:22:47,630 --> 00:22:52,410
+osmolar diabetic coma، أنه طبعا ممكن يكون اللي هو
+
+309
+00:22:52,410 --> 00:22:56,850
+محتاج علاج، وبعد الكوما ممكن يدخل في حالة وفاة أو
+
+310
+00:22:56,850 --> 00:23:00,890
+موت سريري. الـ chronic complications، على المدى البعيد،
+
+311
+00:23:00,890 --> 00:23:05,090
+يا إما بدها تكون على صعيد الـ micro أو الـ macro
+
+312
+00:23:05,090 --> 00:23:09,430
+طالما حكيت أنا micro، معناته أن الـ issue صغير
+
+313
+00:23:09,430 --> 00:23:15,310
+neuropathy، retinopathy، and nephropathy.النيروباتي
+
+314
+00:23:15,310 --> 00:23:20,190
+أنا كنت ذكرتها سابقا، هي عبارة عن التهاب أو خلل
+
+315
+00:23:20,190 --> 00:23:25,450
+وعلة في الأطراف، اللي ناتجة عن مرض السكري. من الرتنة
+
+316
+00:23:25,450 --> 00:23:29,830
+أو الشبكية، بيصير في عندنا مشكلة في الإبصار و
+
+317
+00:23:29,830 --> 00:23:33,870
+الرؤية. nephropathy لها علاقة بالـ kidney، معناته الكلام في
+
+318
+00:23:33,870 --> 00:23:38,030
+عندنا مشاكل في وظائف الكلى. أنا هنا بحكي على صعيد
+
+319
+00:23:38,030 --> 00:23:42,850
+الـ micro، أما إذا حكينا على صعيد الـ macro، فهي بتبدأ
+
+320
+00:23:42,850 --> 00:23:48,430
+تكون على شكل CVA، على شكل macro، إذا هي large
+
+321
+00:23:48,430 --> 00:23:53,490
+معناته الكلام أنه رح نحكي على stroke. فإذا لاحظنا أو
+
+322
+00:23:53,490 --> 00:23:57,590
+إذا دخلنا قسم الباطنية أثناء التدريب العملي، فلان ملفه
+
+323
+00:23:57,590 --> 00:24:02,070
+بيحكي أنه مريض أو stroke patient، high blood
+
+324
+00:24:02,070 --> 00:24:06,950
+glucose level أو diabetes أو hypertension، معناته هو
+
+325
+00:24:06,950 --> 00:24:14,490
+شيء أساسي موجود عنده، اللي هو مرض أو دخول في جلطة
+
+326
+00:24:14,490 --> 00:24:18,650
+دماغية، تمام؟ إذا الـ complications، في عندنا acute، في
+
+327
+00:24:18,650 --> 00:24:24,870
+عندنا chronic، أيضا من المشاكل وهي شائعة جدا، الـ
+
+328
+00:24:24,870 --> 00:24:29,870
+foot and leg problems. حدث ولا حرج، مني قلقانة بهذا
+
+329
+00:24:29,870 --> 00:24:34,020
+الكلام. sensory losses. pseudomotor neuropathy lead
+
+330
+00:24:34,020 --> 00:24:38,140
+to dry and cracking feet. pseudomotor neuropathy
+
+331
+00:24:38,140 --> 00:24:40,720
+رجعنا لكلمة neuropathy اللي لها علاقة
+
+332
+00:24:40,720 --> 00:24:46,120
+بالنيورولوجيا، أيضا المريض نفسه بيكون في عنده مشكلة
+
+333
+00:24:46,120 --> 00:24:49,740
+بالـ skin، الناتج عن الـ high blood glucose level
+
+334
+00:24:49,740 --> 00:24:54,500
+وحكينا، أو أن أنا سابقا كنت أحكيها، ممكن تنحرق رجل
+
+335
+00:24:54,500 --> 00:24:59,000
+المريض وهو مش حاسس فيها، ليه؟ لأن عدم الإحساس، loss
+
+336
+00:24:59,000 --> 00:25:05,970
+of sensory، تمام؟ أيضا اللي هي الـ PAD، اللي هي slow
+
+337
+00:25:05,970 --> 00:25:10,510
+wound healing، poor wound healing، ليه؟ لإن ما في
+
+338
+00:25:10,510 --> 00:25:15,090
+عندي good circulation، إنها تعمل الـ wound healing
+
+339
+00:25:15,090 --> 00:25:20,010
+بتوصل لمرحلة الغرغرينا، معناته الكلام أنا في قسم
+
+340
+00:25:20,010 --> 00:25:23,670
+الباطنية، رح يصير في عندي amputation، الـ amputation
+
+341
+00:25:23,670 --> 00:25:27,950
+معناته cutting للرجل، إذا هذا من الـ complications
+
+342
+00:25:27,950 --> 00:25:32,070
+اللي صارت نتيجة اللي هي diabetes. lowered
+
+343
+00:25:32,070 --> 00:25:37,690
+resistance to infection. ضعف المقاومة لأي التهاب
+
+344
+00:25:37,690 --> 00:25:43,950
+عندهم. على سبيل المثال، في عندها عدوى جلدية لهذه
+
+345
+00:25:43,950 --> 00:25:48,710
+الست، صعب أن يحصل في مقاومة أو اللي هي تشتغل الـ
+
+346
+00:25:48,710 --> 00:25:52,110
+white blood cells، ليه؟ لأن الـ circulation ضعيفة
+
+347
+00:25:52,110 --> 00:25:55,110
+بتكون، فبالتالي الـ white blood cells ما بتوصل
+
+348
+00:25:55,110 --> 00:26:02,110
+للمكان بشكل مباشر وسريع، في تأخير، في بطء في عملية
+
+349
+00:26:02,110 --> 00:26:07,730
+الـ wound healing. الآن، الـ management للـ foot and leg
+
+350
+00:26:07,730 --> 00:26:12,530
+problems، كثير حكينا، الموضوع شائك ومهم جدا بالنسبة
+
+351
+00:26:12,530 --> 00:26:16,110
+لنا كـ physiotherapist، teaching للـ patient، كيف أنا
+
+352
+00:26:16,110 --> 00:26:20,970
+ممكن أحل المشكلة، أن أعلمه كيف يرتدي الحذاء، دائما
+
+353
+00:26:20,970 --> 00:26:26,750
+يكون معه مرآة لفحص اللي هي الـ foot من تحت، أنّه
+
+354
+00:26:26,750 --> 00:26:31,770
+يشوف الأطراف، أو الـ tools اللي موجودة فيها. wound or
+
+355
+00:26:31,770 --> 00:26:36,160
+not. examine للـ feet every time he goes to the
+
+356
+00:26:36,160 --> 00:26:40,360
+doctor، دائما يعمل examination وفحص لقدميه.
+
+357
+00:26:40,360 --> 00:26:44,000
+للـ podiatrist، أو الـ podiatrist اللي هو طبيب الأقدام
+
+358
+00:26:44,000 --> 00:26:48,220
+أو الأرجل، على الأقل annually. بده يكون close للـ two
+
+359
+00:26:48,220 --> 00:26:54,600
+shoes، إنّه بده يكون في عنده .. دائما يكون يلبس
+
+360
+00:26:54,600 --> 00:26:59,250
+الأحذية المغلقة من الأمام، مش صح تكون الأحذية مفتوحة
+
+361
+00:26:59,250 --> 00:27:05,010
+والـ trauma ممكن توصل لأي رجل. trimming toenails، قص
+
+362
+00:27:05,010 --> 00:27:09,010
+الأظافر مهم جدا، ليه؟ لأنه ممكن لو لا سمح الله
+
+363
+00:27:09,010 --> 00:27:13,010
+الأظافر لو ما انقصت بشكل جيد، أنه يتسبب في infection
+
+364
+00:27:13,010 --> 00:27:17,970
+وبعدين من جروح صغير، أدخل أنا في عملية amputation
+
+365
+00:27:17,970 --> 00:27:23,010
+good foot hygiene، النظافة مهمة جدا، وخصوصا بين
+
+366
+00:27:23,010 --> 00:27:27,310
+الأصابع في القدم اللي موجودة. الـ glycemic control
+
+367
+00:27:27,310 --> 00:27:31,110
+is the key to preventing complications. أحافظ على
+
+368
+00:27:31,110 --> 00:27:35,790
+مستوى السكري في الدم، هو أهم موضوع في كل المشكلة
+
+369
+00:27:35,790 --> 00:27:38,990
+جدا، ش أنا محافظة على السكري تبعي، ش أنا في الـ
+
+370
+00:27:38,990 --> 00:27:42,490
+safe side. شو الـ recommended في الـ clinic؟ الـ
+
+371
+00:27:42,490 --> 00:27:47,630
+fasting glucose level. فحص السكر، الـ oral
+
+372
+00:27:47,630 --> 00:27:52,650
+glucose tolerance testing using اللي هو 75 جرام للـ
+
+373
+00:27:52,650 --> 00:27:55,290
+glucose
+
+374
+00:27:56,070 --> 00:28:03,310
+fasting glucose، في المية 125 زي ما حكينا، بأعتبره
+
+375
+00:28:03,310 --> 00:28:10,170
+pre-diabetes. الـ fasting level أقل أو أكبر من 126
+
+376
+00:28:10,170 --> 00:28:14,830
+is diagnostic. إذا كان على سبيل المثال، حللت وأنا
+
+377
+00:28:14,830 --> 00:28:19,690
+صائمة اليوم الصبح، وطلع عندي 140، على طول بيتم تشخيص
+
+378
+00:28:19,690 --> 00:28:25,970
+diabetes. الـ oral glucose tolerance test 200،
+
+379
+00:28:25,970 --> 00:28:30,750
+الـ diagnostic معناته أكبر من 200، معناته اللي هو
+
+380
+00:28:30,750 --> 00:28:35,810
+بتتشخص على أنك مصابة بـ diabetes، تمام؟ هاي مهمة جدا لـ slide
+
+381
+00:28:35,810 --> 00:28:42,090
+لكم في المساء، ومهمة أيضا في حياتكم العملية. show
+
+382
+00:28:42,090 --> 00:28:47,130
+reducing risk، weight reduction، خفف وزنك، الـ exercise
+
+383
+00:28:47,130 --> 00:28:50,930
+على الأقل بدي 150 دقيقة خلال الأسبوع، الـ
+
+384
+00:28:50,930 --> 00:28:55,530
+comprehensive، أو اللي هو أنّه أعمل diet مناسب، و
+
+385
+00:28:55,530 --> 00:29:00,450
+اللي هو حمية غذائية جيدة. الـ education، تعلم كيف
+
+386
+00:29:00,450 --> 00:29:04,190
+أنا أحافظ على أطرافي، تعلم كيف أحافظ على أنّه
+
+387
+00:29:04,190 --> 00:29:08,910
+ما يصير في عندي أي wound، أي trauma للجسم تبعي
+
+388
+00:29:10,210 --> 00:29:13,390
+controlling للـ body أو للـ blood sugar، الـ
+
+389
+00:29:13,390 --> 00:29:17,970
+hemoglobin A1c، اللي هو بده يكون less than or equal
+
+390
+00:29:17,970 --> 00:29:28,670
+من 6.5%. الـ fasting، طبعا أقل من 110، فحص السكر
+
+391
+00:29:28,670 --> 00:29:34,250
+صائم. two hour، post prandial sugar، 140. comprehensive
+
+392
+00:29:34,250 --> 00:29:38,670
+education، لازم يكون في عنده معلومات ويكون في عنده
+
+393
+00:29:38,670 --> 00:29:43,530
+إرشادات وتعليمات قادر هو يستخدمهم أو قادر يتبعهم
+
+394
+00:29:43,530 --> 00:29:48,470
+الـ management لمريض السكري. nutrition، exercise،
+
+395
+00:29:48,470 --> 00:29:53,670
+monitoring، pharmacology، and education، خمسة محاور
+
+396
+00:29:53
+
+445
+00:33:34,390 --> 00:33:39,210
+من أنه لا سمح الله بعد هذا الالتهاب يصير في عندنا
+
+446
+00:33:39,210 --> 00:33:43,350
+مشكلة وdebridment و amputation حسب المنطقة اللي
+
+447
+00:33:43,350 --> 00:33:48,650
+صار فيها الالتهاب كمان لازم أعالج اللي هو الـ
+
+448
+00:33:48,650 --> 00:33:54,250
+factors إذا كانت obesity إذا كان الشيء مثلاً له
+
+449
+00:33:54,250 --> 00:33:57,450
+علاقة بنوع الحياة اللي أنا عايشاها إذا له علاقة
+
+450
+00:33:57,450 --> 00:34:03,910
+بأي شيء في اللي هو الـ risk factor الآن كيف بدي أعلم
+
+451
+00:34:03,910 --> 00:34:08,770
+المريض تبعي كيف إنه ياخد الأنسولين تبعه Stronger.
+
+452
+00:34:08,770 --> 00:34:13,070
+Insulin may not be refrigerated or used within one
+
+453
+00:34:13,070 --> 00:34:18,050
+month. طبعاً الأنسولين مش لازم يتثلج، بنحط عادي في
+
+454
+00:34:18,050 --> 00:34:22,050
+باب الثلاجة إذا فتحت أنا الأمبول أو فتحت العبوة
+
+455
+00:34:22,050 --> 00:34:26,290
+لمدة شهر فقط. أكثر من هيك على طول أنا بتخلص منها.
+
+456
+00:34:26,290 --> 00:34:30,350
+Detailed instructions should be followed regarding storage.
+
+457
+00:34:30,660 --> 00:34:34,480
+بنعبّي السرنجة حسب ما الدكتور حكالنا: ثلاثة ملي،
+
+458
+00:34:34,480 --> 00:34:38,460
+ثلاثة سنتي، اثنين، واحد، صباحاً، وثلاثة مثلاً على
+
+459
+00:34:38,460 --> 00:34:43,300
+سبيل المثال، والسرنجة طبعاً الـ concentration of
+
+460
+00:34:43,300 --> 00:34:45,800
+أنسولين فيها على الأنسولين الصافي وفيه الأنسولين
+
+461
+00:34:45,800 --> 00:34:49,080
+العادي. أكيد طبعاً الدكتور محمد ما قصر في هذا الموضوع
+
+462
+00:34:49,080 --> 00:34:53,200
+الـ mixing الأنسولين اللي هو طبعاً اللي حكينا عليه فيه
+
+463
+00:34:53,200 --> 00:34:55,480
+على نوعين من الأنسولين اللي هو الأنسولين الصافي
+
+464
+00:34:55,480 --> 00:35:00,140
+والأنسولين العادي. Don't rotate injection sites. طبعاً
+
+465
+00:35:00,140 --> 00:35:06,360
+بكون ماخدة اللي هي الأماكن وين أنا بتم اللي هي حقن
+
+466
+00:35:06,360 --> 00:35:11,520
+جرعة الأنسولين، على سبيل المثال تحت اللي هو الجزء
+
+467
+00:35:11,520 --> 00:35:13,920
+الـ lower limb أو في الـ upper limb أحياناً في منطقة
+
+468
+00:35:13,920 --> 00:35:18,940
+الـ abdomen. No need to aspirate. تمام أنه احنا ليس
+
+469
+00:35:18,940 --> 00:35:22,520
+بحاجة نعمل aspiration من الجسم لأنّه احنا بنعطى
+
+470
+00:35:22,520 --> 00:35:27,700
+هذا الأنسولين. Exercise is the best insulin sister on the
+
+471
+00:35:28,260 --> 00:35:31,340
+market, better than any medication we currently
+
+472
+00:35:31,340 --> 00:35:35,900
+have available. اختصرها بورتال هنا عندنا بورتال فيه
+
+473
+00:35:35,900 --> 00:35:40,300
+اللي هو المشكلة كلها أنه أنا ما قلتش بتابع الـ
+
+474
+00:35:40,300 --> 00:35:43,660
+exercise. معناه الكلام أنا حَلّيت مشكلتي بإيدي،
+
+475
+00:35:43,660 --> 00:35:48,600
+ما استنيت لحد ما يصل الأمر فيا لعواقب وخيمة. الـ
+
+476
+00:35:48,600 --> 00:35:52,160
+physiology خلال اللي هو الـ first few minutes من الـ
+
+477
+00:35:52,160 --> 00:35:55,420
+exercise. حكينا في مساق اللي هو الـ exercise في
+
+478
+00:35:55,420 --> 00:35:59,220
+الفيسيولوجيا كنت بتاخده عن الـ calories و كيف الـ
+
+479
+00:35:59,220 --> 00:36:02,600
+exercise وكم من الـ calories أنا ممكن أحرق في هذا
+
+480
+00:36:02,600 --> 00:36:07,600
+الـ exercise في بداية أول دقائق الـ exercise، الـ
+
+481
+00:36:07,600 --> 00:36:14,800
+glycogen في الـ muscles is broken down and aerobic
+
+482
+00:36:14,800 --> 00:36:24,350
+له، وأني إذا بيصير تكسير للـGlycogen مباشرة في
+
+483
+00:36:24,350 --> 00:36:29,430
+الـexercise اللي هو بعد 5 to 10 minutes، الـ
+
+484
+00:36:29,430 --> 00:36:33,370
+muscle glycogen break down decreases. بيقل تكسير
+
+485
+00:36:33,370 --> 00:36:37,670
+الجليكوجين اللي موجود في الـ muscle. الجلوكوز broken
+
+486
+00:36:37,670 --> 00:36:43,440
+down in the liver. بيبلش الجلوكوز يتكسر في الكبد، is
+
+487
+00:36:43,440 --> 00:36:47,780
+released to blood، وبتّم إطلاقه في مجرى الدم، and
+
+488
+00:36:47,780 --> 00:36:53,040
+taken up by muscles as a fuel. بتاخده العضلات كوقود
+
+489
+00:36:53,040 --> 00:36:58,820
+لها. This glucose becomes a major source. بيكون مصدر
+
+490
+00:36:58,820 --> 00:37:03,840
+أساسي للعضلات من الوقود. معناته هنا صار في عندي
+
+491
+00:37:03,840 --> 00:37:09,320
+hepatic glycogenolysis. إذا العملية سهلة جداً. بداية
+
+492
+00:37:09,320 --> 00:37:13,170
+بتّم تكسير الجليكوجين اللي موجود في العضلات. أول
+
+493
+00:37:13,170 --> 00:37:18,250
+دقيقتين، بعد خمس لعشر دقائق بيصير الـ muscles
+
+494
+00:37:18,250 --> 00:37:23,050
+glycogen يتوقف، الجليكوجين الموجود أو الجلوكوز الموجود
+
+495
+00:37:23,050 --> 00:37:27,750
+داخل الـ liver، داخل الكبد بيفرز الجلوكوز، فبالتالي
+
+496
+00:37:27,750 --> 00:37:32,310
+بتعتمد العضلات عليه كوقود مباشر. بهيك بيكون
+
+497
+00:37:32,310 --> 00:37:37,230
+أنا قلّلت من كمية الجلوكوز الموجودة في الدم. Role of
+
+498
+00:37:37,230 --> 00:37:40,610
+physical activity to improve blood glucose
+
+499
+00:37:40,610 --> 00:37:47,500
+control and HbA1c level in type 2 diabetes. Improves
+
+500
+00:37:47,500 --> 00:37:52,700
+insulin sensitivity. بيحسن مدى حساسية أو مدى
+
+501
+00:37:52,700 --> 00:37:57,380
+استجابة الأنسولين، and lowers insulin requirement،
+
+502
+00:37:57,380 --> 00:38:00,840
+often leading to reduced dose of insulin. فبالتالي
+
+503
+00:38:00,840 --> 00:38:04,660
+بيقلل من الـ dose لهذا الأنسولين. الـ oral
+
+504
+00:38:04,660 --> 00:38:08,000
+hypoglycemic agent، especially in people with type
+
+505
+00:38:08,000 --> 00:38:13,250
+2. طبعاً بوصل لـ Maintenance of Ideal Body Weight.
+
+506
+00:38:13,250 --> 00:38:17,190
+نتيجة اللي هو الـ Physical Activities. Reduction
+
+507
+00:38:17,190 --> 00:38:22,330
+للـ Coronary Risk Factors. بيقلل المشاكل اللي هي الـ
+
+508
+00:38:22,330 --> 00:38:26,750
+Cardiovascular Disease. أيضاً بيكون بيغيّر الجسم
+
+509
+00:38:26,750 --> 00:38:35,190
+لوضعيات مناسبة جداً. By
+
+510
+00:38:35,190 --> 00:38:38,550
+body composition: Decrease in body fat and weight، و
+
+511
+00:38:38,550 --> 00:38:42,510
+Increase in muscle mass. Lowers the cardiovascular and
+
+512
+00:38:42,510 --> 00:38:48,850
+overall mortality. بيقلل من احتمالية الوفيات لأمراض
+
+513
+00:38:48,850 --> 00:38:54,730
+اللي هم مرضى القلب اللي موجودين. شو تأثير الـ
+
+514
+00:38:54,730 --> 00:38:59,030
+exercise؟ في الـ acute phase، الـ exercise results in
+
+515
+00:38:59,030 --> 00:39:03,750
+translocation للجلوكوز زي ما حكينا عليها المعلومة
+
+516
+00:39:03,750 --> 00:39:07,010
+هذه سابقاً، و transported to the plasma membrane، and
+
+517
+00:39:07,010 --> 00:39:09,670
+increases glucose uptake. With prolonged
+
+518
+00:39:09,670 --> 00:39:14,170
+exercise، this upregulation مع الـexercise الطويل
+
+519
+00:39:14,170 --> 00:39:17,550
+الأمد، الجلوكوز transporters، the numbers of
+
+520
+00:39:17,550 --> 00:39:21,910
+change capillary density which overall causes an
+
+521
+00:39:21,910 --> 00:39:25,230
+improvement في insulin sensitivity. بيحسن من سرعة
+
+522
+00:39:25,230 --> 00:39:30,870
+استجابة الأنسولين داخل الجسم.  Clinical
+
+523
+00:39:30,870 --> 00:39:35,690
+implications: Even short-term (two weeks) regular
+
+524
+00:39:35,690 --> 00:39:40,370
+aerobic exercise. الـ exercise اللي هي بتكون aerobic
+
+525
+00:39:40,370 --> 00:39:44,830
+exercise لـ type 2 patients بتساعد في اللي هي both
+
+526
+00:39:44,830 --> 00:39:47,050
+aerobic capacity and whole body insulin
+
+527
+00:39:47,050 --> 00:39:50,870
+sensitivity. حسّنت من وضع اللي هو الـ weight تبع
+
+528
+00:39:50,870 --> 00:39:55,070
+الجسم، وأيضاً من الـ insulin sensitivity. وهذا المطلوب
+
+529
+00:39:55,070 --> 00:39:58,610
+على الـ long term. Endurance training and diet of
+
+530
+00:39:58,610 --> 00:40:03,140
+patients. Or Markley improved the whole-body insulin
+
+531
+00:40:03,140 --> 00:40:07,220
+sensitivity and excretion of K-muscle enzymes
+
+532
+00:40:07,220 --> 00:40:11,140
+regulated by insulin. However، maintenance of
+
+533
+00:40:11,140 --> 00:40:15,140
+effects seemed to require dedication and regular
+
+534
+00:40:15,140 --> 00:40:22,300
+uninterrupted exercise. عدم اللي
+
+535
+00:40:22,300 --> 00:40:22,700
+هو
+
+536
+00:40:25,920 --> 00:40:29,500
+التزام هذا الشخص بالـ exercise أو برنامج الـ
+
+537
+00:40:29,500 --> 00:40:34,170
+exercise اللي احنا حطيناه. طبعاً من الـ clinical
+
+538
+00:40:34,170 --> 00:40:37,450
+implications أيضاً اللي هو الـ intramyocellular
+
+539
+00:40:37,450 --> 00:40:43,170
+lipid accumulation. وجود أو اللي هو تخزين الدهون أو
+
+540
+00:40:43,170 --> 00:40:47,350
+الدهون في داخل أو ما بين العضلات، which is associated
+
+541
+00:40:47,350 --> 00:40:50,330
+with insulin resistance in the muscles، can be
+
+542
+00:40:50,330 --> 00:40:53,650
+acutely decreased by even a single bout of
+
+543
+00:40:53,650 --> 00:40:57,170
+sustained endurance exercise. الـ exercise is
+
+544
+00:40:57,170 --> 00:41:00,750
+beneficial for both glucose uptake mechanisms and
+
+545
+00:41:00,750 --> 00:41:05,290
+antilipolytic effects. مهم جداً الـ exercise على صعيدين
+
+546
+00:41:05,290 --> 00:41:09,890
+على أنه أنا بدي آخذ الجلوكوز أو ميكانيكية الجلوكوز
+
+547
+00:41:09,890 --> 00:41:14,570
+and its antilipolytic effect on insulin، اللي هو
+
+548
+00:41:14,570 --> 00:41:20,550
+تحليل الـ lipids اللي هي الدهون، تمام؟
+
+549
+00:41:20,550 --> 00:41:23,890
+الـ exercise precautions and diabetes. شو الـ
+
+550
+00:41:23,890 --> 00:41:27,950
+precautions تبعّتي؟ تحذيرات. أهم شيء في مرض السكري
+
+551
+00:41:27,950 --> 00:41:33,910
+أنه أنا أمنع أي إصابة للقدم. بدي أعمل رياضة، جَرْي،
+
+552
+00:41:33,910 --> 00:41:38,190
+please، الحذاء مناسب، please ما يصير فيه أي trauma
+
+553
+00:41:38,190 --> 00:41:42,570
+وأنت بتجري، تمام؟ Avoid bouncing activities that
+
+554
+00:41:42,570 --> 00:41:46,370
+cause vitreous hemorrhage، أي نشاط بيعمل
+
+555
+00:41:46,370 --> 00:41:52,530
+bleeding أو نزيف، please أوقف عنده. بأخذ بالي من
+
+556
+00:41:52,530 --> 00:41:57,270
+مرضى اللي هم الـ coronary heart disease، تمام؟ اللي
+
+557
+00:41:57,270 --> 00:42:00,730
+هم الـ cardiovascular disease أو أمراض القلب.
+
+558
+00:42:01,220 --> 00:42:04,480
+Baseline stress test. الـ Baseline stress test هذا
+
+559
+00:42:04,480 --> 00:42:08,100
+كمان مهم جداً. Indicated especially for patients older than
+
+560
+00:42:08,100 --> 00:42:11,400
+60 and with two or more risk factors. من
+
+561
+00:42:11,400 --> 00:42:13,460
+الـcardiopulmonary disease أو الـ coronary artery
+
+562
+00:42:13,460 --> 00:42:17,440
+disease. لازم أكون أنا ماخذة في بالي للناس اللي هم
+
+563
+00:42:17,440 --> 00:42:23,120
+عمرهم فوق 60 سنة. من الـ Baseline stress test. شو الـ
+
+564
+00:42:23,120 --> 00:42:26,820
+potential adverse effects of exercise؟ الآثار
+
+565
+00:42:26,820 --> 00:42:31,980
+السلبية اللي ممكن تصير عندي لا سمح الله مع ممارسة
+
+566
+00:42:31,980 --> 00:42:35,400
+الرياضة. في حالات الـ cardiovascular disease و الـ
+
+567
+00:42:35,400 --> 00:42:37,840
+microvascular و الـ metabolic و على الصعيد الـ
+
+568
+00:42:37,840 --> 00:42:40,820
+musculoskeletal. خليني أشوف في البداية الـ
+
+569
+00:42:40,820 --> 00:42:43,960
+cardiovascular. الـ cardiac ممكن يكون في مشكلة و
+
+570
+00:42:43,960 --> 00:42:48,360
+dysfunction and asthma due to ischemia، اللي هي
+
+571
+00:42:48,360 --> 00:42:53,860
+heart disease. ما أعطى اللي هي عضلة القلب كمية الدم
+
+572
+00:42:53,860 --> 00:42:57,670
+المناسبة للـ circulation. Excessive increment in blood
+
+573
+00:42:57,670 --> 00:43:02,490
+pressure. زيادة في اللي هو الضغط تبع المريض. Basic
+
+574
+00:43:02,490 --> 00:43:06,750
+exercise-induced orthostatic hypotension. الـ hypotension
+
+575
+00:43:06,750 --> 00:43:10,390
+أو الـ orthostatic hypotension اللي هو مشكلة عامة
+
+576
+00:43:10,390 --> 00:43:15,350
+عند الناس هاي اللي بيبقى تكون نتيجة لوجود مشكلة في
+
+577
+00:43:15,350 --> 00:43:20,060
+اللي هي الـ circulation بشكل عام. على صعيد الـ
+
+578
+00:43:20,060 --> 00:43:23,660
+microvascular، اللي هي الـ Retinal hemorrhages أو
+
+579
+00:43:23,660 --> 00:43:27,180
+الانفصال الشبكية أو نزيف الشبكية زي ما أنتم
+
+580
+00:43:27,180 --> 00:43:30,320
+شايفين عندنا هنا، تمام؟ هذه اللي هي كرة العين.
+
+581
+00:43:30,320 --> 00:43:34,780
+Acceleration of other microvascular lesions. بيصير
+
+582
+00:43:34,780 --> 00:43:38,620
+في عندنا طبعاً انفصال الشبكية نتيجة للنزيف اللي صار
+
+583
+00:43:38,620 --> 00:43:43,540
+عندها. على صعيد الـ metabolic، بيصير في عندنا أو عمليات
+
+584
+00:43:43,540 --> 00:43:46,960
+الـ worsening للـ hyperglycemia and ketosis.
+
+585
+00:43:47,470 --> 00:43:52,170
+وبعدين ممكن يصير في عندي hypoglycemia. أعلى من 125،
+
+586
+00:43:52,170 --> 00:43:59,470
+أقل من 70 بيصير في عندي hypoglycemia. على صعيد الـ
+
+587
+00:43:59,470 --> 00:44:04,170
+musculoskeletal and traumatic foot ulcer. طبعاً
+
+588
+00:44:04,170 --> 00:44:07,610
+هذه اللي هي البقعة العميقة بسميها، أو البقعة اللي
+
+589
+00:44:07,610 --> 00:44:11,990
+هي السوداء. بتكون مجرد حاجة بسيطة جداً في إصبع المريض
+
+590
+00:44:11,990 --> 00:44:18,350
+السكري. ولكن بعد ذلك نكتشف أن ما تحتها dead tissue أو
+
+591
+00:44:18,350 --> 00:44:23,550
+dead tissue، طبعاً نتيجة له اللي هو الـ infection
+
+592
+00:44:23,550 --> 00:44:28,120
+اللي صارت، وهو المريض السكري مش حاسس فيها. بتصير
+
+593
+00:44:28,120 --> 00:44:30,540
+عملية الـ debridement، بتصير عملية الـ amputation
+
+594
+00:44:30,540 --> 00:44:33,880
+لإصبع أول، بعدين لـ metatarsal bone، بعدين للقدم
+
+595
+00:44:33,880 --> 00:44:41,480
+كلها، وقد ندخل في عمليات أخرى مساعدة، تمام؟ هذا على
+
+596
+00:44:41,480 --> 00:44:45,060
+صعيد الـ musculoskeletal trauma. Thank you for your
+
+597
+00:44:45,060 --> 00:44:49,880
+attention. وألقاكم بإذن الله تعالى في فيديو آخر
+
+598
+00:44:49,880 --> 00:44:57,280
+تكملة للسكري، طبعاً اللي هو part 2، في رعاية الله.
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/Y6k4syDoc6c_postprocess.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/Y6k4syDoc6c_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..1f3374980c7e568a170fa3fac684643607d5c3ee
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/Y6k4syDoc6c_postprocess.srt
@@ -0,0 +1,2392 @@
+1
+00:00:01,010 --> 00:00:06,010
+السلام علي أشرف الأنبياء و المرسلين محمد علي أبطل
+
+2
+00:00:06,010 --> 00:00:09,950
+الصلاة و أتم التسليم ان شاء الله رب العالمين اليوم
+
+3
+00:00:09,950 --> 00:00:14,470
+هنشرح المحاضرة رقم 2 في مساق علاج طبيعي لأمرض
+
+4
+00:00:14,470 --> 00:00:20,020
+القلب و الصدر و الباطنةالمحاضرة هنتحدث عن الـ
+
+5
+00:00:20,020 --> 00:00:24,180
+Diabetes هو عبارة عن مرض العصر زي ما بنعرف هنحكي
+
+6
+00:00:24,180 --> 00:00:27,660
+عنه أول إشي في هذه الجزئية أنا قسمت المحاضرة إلى
+
+7
+00:00:27,660 --> 00:00:31,620
+جزئين الجزء الأول هذا اللي اليوم أو هذه المحاضرة
+
+8
+00:00:31,620 --> 00:00:36,180
+هتكلم عنه في هذا الفيديو عبارة عن introduction عن
+
+9
+00:00:36,180 --> 00:00:41,100
+شو هو الـ Diabetes من وجهة نظر الفيزيوثيرابيةهنعرف
+
+10
+00:00:41,100 --> 00:00:44,900
+أنواعه، هنعرف كيف من التعامل معاه، شو ال
+
+11
+00:00:44,900 --> 00:00:48,960
+guidelines أو شو ال advice اللي أنا ممكن أعطيها
+
+12
+00:00:48,960 --> 00:00:53,600
+للمريض تبعي أثناء جلسة الـ Physotherapy كل هذا
+
+13
+00:00:53,600 --> 00:00:56,800
+الاشي ان شاء الله رب العالمين راح أشرحه في هذه
+
+14
+00:00:56,800 --> 00:00:59,260
+المحاضرة، نبدأ على بركة الله
+
+15
+00:01:03,140 --> 00:01:06,280
+طبعا الـ diabetes والـ exercise اللي أنا بدي
+
+16
+00:01:06,280 --> 00:01:10,820
+أعطيهم للمريض تبعي هيكون المريض مشخص وجاهز ويجاني
+
+17
+00:01:10,820 --> 00:01:15,540
+أنا عشان أعمل جلسة علاج طبيعي نظرا لإن في عنده
+
+18
+00:01:15,540 --> 00:01:18,700
+osteoarthritis منيه، عنده مشاكل مثلا في ال
+
+19
+00:01:18,700 --> 00:01:23,260
+muscles، عنده أي مشاكل أخرى، سواء كانت على صعيد
+
+20
+00:01:23,260 --> 00:01:28,180
+systemic أو على صعيد الأطرافخلّيني أشوف شو يعني
+
+21
+00:01:28,180 --> 00:01:31,840
+ذيابيتس عشان أنا أعرف شو يعني كلمة ذيابيتس لازم
+
+22
+00:01:31,840 --> 00:01:35,340
+أعرف إن أنا لازم يكون في عندي مشكلة أو خلق شوية بس
+
+23
+00:01:35,340 --> 00:01:39,400
+نرجع للـAnatomy قليلاً الـEndocrine System هو
+
+24
+00:01:39,400 --> 00:01:45,040
+عبارة عن System مهم جدا بيمشي مباشر مع الـNervous
+
+25
+00:01:45,040 --> 00:01:49,440
+System يعني الـEndocrine مسؤول عن اللي هو الغدد
+
+26
+00:01:49,440 --> 00:01:52,940
+اللي موجود عندنا في الجسم بيمشي بررل أو with
+
+27
+00:01:52,940 --> 00:01:57,440
+together مع اللي هو الـNervous Systemتمام؟ هنا أنا
+
+28
+00:01:57,440 --> 00:02:03,700
+القصة إنه أنا بدي أعرف إنه أنا إذا الانسولين أو
+
+29
+00:02:03,700 --> 00:02:08,000
+مشكلة الديابيتات اللي هي في ارتباط نسبة السكر في
+
+30
+00:02:08,000 --> 00:02:13,420
+الدم هيحلها مشكلة معينة أو هيحلها إشي إنه أنا
+
+31
+00:02:13,420 --> 00:02:17,780
+الغدة التي تفرض hormone الانسولين بتكون لحظتها غير
+
+32
+00:02:17,780 --> 00:02:22,340
+قادرة على إفراز ما يكفي للجسممعناة الكلام أنه فيه
+
+33
+00:02:22,340 --> 00:02:26,140
+لازم يكون سيالة عصبية رايحة على ال brain وسيالة
+
+34
+00:02:26,140 --> 00:02:28,740
+عصبية راجعة عالية من ال brain إذا نرتبط ال
+
+35
+00:02:28,740 --> 00:02:33,020
+endocrine system مع ال nervous system بشكل مباشر
+
+36
+00:02:33,020 --> 00:02:36,520
+ال effect on most every cell organs and functional
+
+37
+00:02:36,520 --> 00:02:39,830
+of the bodyباتأثر للـ Endocrine System على كل
+
+38
+00:02:39,830 --> 00:02:43,610
+الجسم وعلى كل الوظائف اللي موجودة The endocrine
+
+39
+00:02:43,610 --> 00:02:47,550
+system is closely linked with nervous system حكينا
+
+40
+00:02:47,550 --> 00:02:52,250
+عليه هذا الموضوع إن هم بيكونوا مرتبطين بشكل مباشر
+
+41
+00:02:52,250 --> 00:02:55,390
+مع ال nervous system أيضًا مع ال immunity system
+
+42
+00:02:55,390 --> 00:02:59,930
+جهاز المنع اللي إحنا في ضل هاي الجائحة COVID-19
+
+43
+00:02:59,930 --> 00:03:03,850
+لازم أنه معزز ونقوي اللي هو ال immunity system
+
+44
+00:03:03,850 --> 00:03:08,860
+Negative feedback mechanismبيصير في عندنا مشكلة و
+
+45
+00:03:08,860 --> 00:03:12,340
+لخبطة بالهرمون اللي هي بتبني إفرازها عن طريق الـ
+
+46
+00:03:12,340 --> 00:03:15,460
+endocrine system طبعا ال chemical messenger اللي
+
+47
+00:03:15,460 --> 00:03:18,480
+جايالي من ال body و لقاش اننا specific target
+
+48
+00:03:18,480 --> 00:03:21,040
+cells في عندنا alpha cells و في عندنا beta cells
+
+49
+00:03:21,040 --> 00:03:24,340
+هاي كلها موجودة في البنكرياس و احنا كلنا بنعرف ان
+
+50
+00:03:24,340 --> 00:03:28,880
+البنكرياس هي الغضب المسئولة عن إنتاج و إفراز
+
+51
+00:03:28,880 --> 00:03:32,900
+الهرمون هلأ ال glands اللي انا بدى أحكي عليها
+
+52
+00:03:32,900 --> 00:03:38,860
+البنكرياس تقع خلف المعدةأيضًا، back of abdomen ورا
+
+53
+00:03:38,860 --> 00:03:43,380
+اللي هي البطن الهرمون اللي بتفرضه بيساعد في عملية
+
+54
+00:03:43,380 --> 00:03:48,040
+الـ Digestive في Exocrine وفي Endocrine Exo معناته
+
+55
+00:03:48,040 --> 00:03:53,320
+لبره، outside أما Endo لجوه معناته inside ال
+
+56
+00:03:53,320 --> 00:03:57,140
+Exocrine بينكريها Secretion of Digestive Enzyme
+
+57
+00:03:57,140 --> 00:04:01,860
+بيفرض الإنذيمات اللي مسؤولة عن عملية الهضبولكن الـ
+
+58
+00:04:01,860 --> 00:04:05,640
+Endocrine تعمل على إفراز الأنسلين والجليكوز which
+
+59
+00:04:05,640 --> 00:04:10,920
+is regulated للجليكوجين واللي هو مسؤول عن تنظيم
+
+60
+00:04:10,920 --> 00:04:16,060
+الجليكوز داخل الدم، إذا two parts أو جزئين أساسيا
+
+61
+00:04:16,060 --> 00:04:19,630
+بيشتغل فيهم البنكرياز، يا إن اكسوكرينيا إما
+
+62
+00:04:19,630 --> 00:04:23,850
+Endocrine إذا حكينا Exocrine معناة الكلام إن هو
+
+63
+00:04:23,850 --> 00:04:26,330
+بدي يشتغل على الإنزيمات اللي إلها علاقة بال
+
+64
+00:04:26,330 --> 00:04:29,850
+digestive system زي الببسين زي أي إشي بحاجة أما ال
+
+65
+00:04:29,850 --> 00:04:34,150
+Endocrine فهكية مسؤولة عن إفراز الأنسلين اللي هو
+
+66
+00:04:34,150 --> 00:04:38,770
+أو glycogen اللي مسؤول عن إفراز الجلوكوز أو تنظيم
+
+67
+00:04:38,770 --> 00:04:43,650
+S تنظيم اللي هو الجلوكوز levelفى الدب طبعا لحد
+
+68
+00:04:43,650 --> 00:04:46,390
+الآن الأمور ماشية معانا احنا لسه بنمشي
+
+69
+00:04:46,390 --> 00:04:51,970
+introduction بسيطة عن شو هو مرض السكرين الديابيتاس
+
+70
+00:04:51,970 --> 00:04:55,070
+هو عبارة عن مجموعة من ال metabolic diseases يعني
+
+71
+00:04:55,070 --> 00:05:00,350
+مجموعة من الأمراض التي تعني أو تخص اللى هى عمليات
+
+72
+00:05:00,350 --> 00:05:06,940
+ال ice يتصف بمادة hyperglycemia طبعا يا رابعة؟ما
+
+73
+00:05:06,940 --> 00:05:11,300
+حكيت hypo، ما حكيت hyper، الجليسيميا، اللي ناتجة
+
+74
+00:05:11,300 --> 00:05:14,520
+عن ال defect of insulin secretion، ناتجة عن ال
+
+75
+00:05:14,520 --> 00:05:18,240
+deficiency في إثراز الإنسولين اللي بتتم من ال
+
+76
+00:05:18,240 --> 00:05:22,400
+بنكريات، اللي أيضا بيكون في عامة deficiency أو
+
+77
+00:05:22,400 --> 00:05:26,730
+problems in insulin actionفي منه نوعين النوع الأول
+
+78
+00:05:26,730 --> 00:05:30,950
+اللي هو بسميه الـabsolutely deficiency insulin
+
+79
+00:05:30,950 --> 00:05:35,130
+secretion اللي هو auto-immuno disease تمام إنه
+
+80
+00:05:35,130 --> 00:05:39,070
+جهاز المناعة أو الخلايا المناعية اللي أنا موجودة
+
+81
+00:05:39,070 --> 00:05:43,570
+عندي في الجسم بتهاجم الخلايا اللي هي مسئولة في
+
+82
+00:05:43,570 --> 00:05:47,590
+البنكرياز عن إنتاج الإنسونات ولحد الآن العلماء
+
+83
+00:05:47,590 --> 00:05:51,890
+ماعرفوا شو السببأما type 2 اللي هو بيكون a
+
+84
+00:05:51,890 --> 00:05:56,770
+combination لمقاومة إنه بيصير في عندي عملية مقاومة
+
+85
+00:05:56,770 --> 00:06:00,410
+لعرل الأنسلينهنا بيصير في عندي in educate
+
+86
+00:06:00,410 --> 00:06:03,430
+compensatory insulin secretion فبالتالي بيفرز
+
+87
+00:06:03,430 --> 00:06:07,730
+الانسولين ولكن لا تكفي حاجة الجسم الانسولين هو
+
+88
+00:06:07,730 --> 00:06:12,770
+عبارة عن الهرمون اللي بيحول السكر او الشجر إلى
+
+89
+00:06:12,770 --> 00:06:16,230
+stretches extra into energy needed for daily life
+
+90
+00:06:16,230 --> 00:06:20,170
+بيحوله لإيشي من إيشي ضال إلى إيشي مفيد أنا أستفيد
+
+91
+00:06:20,170 --> 00:06:23,970
+منه في الجسم خليني أعمل سمراية لموضوع اللي هو
+
+92
+00:06:23,970 --> 00:06:28,480
+نوعين الانسول النوعين الديابيداtype 1 وtype 2 type
+
+93
+00:06:28,480 --> 00:06:33,720
+1 حكينا absolute deficiency فقدال أو فقر أو قلة أو
+
+94
+00:06:33,720 --> 00:06:37,440
+نقص في إفراز الأنسونين تمام حكينا autoimmune
+
+95
+00:06:37,440 --> 00:06:41,040
+disease أما type 2 فهو عبارة عن combination لل
+
+96
+00:06:41,040 --> 00:06:44,180
+resistance to insulin action and ineducate
+
+97
+00:06:44,180 --> 00:06:50,450
+compensatory نقصفي اللي هو إثران الانسولين و أيضا
+
+98
+00:06:50,450 --> 00:06:55,710
+عملية معاكسة أو عملية مقاومة لعمل الانسولين طبعا
+
+99
+00:06:55,710 --> 00:06:59,750
+هذا الاشي يكون ذاتي داخل الجسم ناتج عن أسباب كتيرة
+
+100
+00:06:59,750 --> 00:07:06,790
+هنعرفها الآن في ناس pre-diabetic تمام اللي هم
+
+101
+00:07:06,790 --> 00:07:11,560
+الناس هاي اللي لسهما صاروا بيابيتس ولكن كل
+
+102
+00:07:11,560 --> 00:07:17,980
+المؤشرات بتعطي دوق أحمر ان انت انتبه please ال
+
+103
+00:07:17,980 --> 00:07:23,600
+obesity ال high level sugar في الأكل ال stress ال
+
+104
+00:07:23,600 --> 00:07:27,500
+stationary daily life كل هذه الأمور بتكون مؤشر
+
+105
+00:07:27,500 --> 00:07:32,240
+ودوق أحمر لإن هذا الشخص يقع عندنا في حفرات اللي هم
+
+106
+00:07:32,240 --> 00:07:36,070
+مرضى السكر ل blood glucose levelare higher than
+
+107
+00:07:36,070 --> 00:07:38,930
+normal about not high enough to diagnose a
+
+108
+00:07:38,930 --> 00:07:42,650
+diabetes تمام okay السكري عندك و هعرف القيمة الآن
+
+109
+00:07:42,650 --> 00:07:48,950
+كام هو عالي ولكن مابيعطيني مؤشر كطبيب انه انا
+
+110
+00:07:48,950 --> 00:07:52,830
+اشخصه في خلال او من خلال ال medical file انه انت
+
+111
+00:07:52,830 --> 00:07:57,130
+diabetes diabetes patient لأ هيت مابيكون ان هذا
+
+112
+00:07:57,130 --> 00:08:00,310
+المريض تبعي انه اتشخص على انه مريض سكري no
+
+113
+00:08:00,310 --> 00:08:03,940
+symptoms ماعنده اي اعراضب treatment هنا سهلة جدا
+
+114
+00:08:03,940 --> 00:08:07,900
+باجي انا لهذه ال fit اللي إيجتني عمرها أقل من
+
+115
+00:08:07,900 --> 00:08:12,820
+الأربعين بتشكي من سمنة بتاكل حلو كتير ال life
+
+116
+00:08:12,820 --> 00:08:18,580
+تبعتها لإنهارها جاعدة مافي اي activities مافي اي
+
+117
+00:08:18,580 --> 00:08:22,320
+sports مافي اشي معناة الكلام ان انا بدي أشتغل على
+
+118
+00:08:22,320 --> 00:08:27,360
+ثلاث عوامل أساسية أول اشيالأكل الصحي تاني إشي ال
+
+119
+00:08:27,360 --> 00:08:32,000
+weight من 5 ل 10% من وزنها و ال exercise اللي هو
+
+120
+00:08:32,000 --> 00:08:36,860
+عن طريق الرياضة أنه أنا لأنه لسه هي جادة أنها تحمي
+
+121
+00:08:36,860 --> 00:08:40,540
+نفسها هذا الناس اللي بريه تيابة تسكت لو أنا عرفتهم
+
+122
+00:08:40,540 --> 00:08:45,240
+هم الناس اللي لسه ماوصلوا لحد معين من ال glucose
+
+123
+00:08:45,240 --> 00:08:50,360
+level أنه يخليني أشخصهم أنهم تيابة تسكت تمام؟الـ
+
+124
+00:08:50,360 --> 00:08:55,580
+Growing Problems حوالي المشكلة طبعا تتطور 7% من ال
+
+125
+00:08:55,580 --> 00:09:00,120
+population تبع ال US يابوتك و twice that many have
+
+126
+00:09:00,120 --> 00:09:04,420
+pre-diabetic و 2% حوالي عندنا الناس hybrid
+
+127
+00:09:04,420 --> 00:09:10,000
+-diabetic 21% فوق 60% وهذا إشي له علاقة بال aging
+
+128
+00:09:10,000 --> 00:09:14,110
+طبعا هنعرف من أنه نوع منهمالـ 45% من الـ new
+
+129
+00:09:14,110 --> 00:09:17,130
+diagnoses are behind made in children and
+
+130
+00:09:17,130 --> 00:09:20,830
+adolescents طبعا، وإشي خطير جدا لإن type 1 إلو
+
+131
+00:09:20,830 --> 00:09:25,290
+علاقة بالـ pediatrics والـ adolescents أما type 2
+
+132
+00:09:25,290 --> 00:09:30,830
+إلو علاقة بالناس اللي هم اللي فوق سن الأربعين risk
+
+133
+00:09:30,830 --> 00:09:34,450
+factor تبعتناه family history والله الأب والأم
+
+134
+00:09:34,450 --> 00:09:39,450
+والجد والجدة عندهمDM اللي هو اختصار للديابتس
+
+135
+00:09:39,450 --> 00:09:43,110
+مالديتس احتمال كبير يكون عند الأبناء ال
+
+136
+00:09:43,110 --> 00:09:47,070
+cardiovascular disease أمراض القلب حدث ولا حرج ال
+
+137
+00:09:47,070 --> 00:09:51,650
+obesity السمنة extraordinary lifestyle الحياة
+
+138
+00:09:51,650 --> 00:09:58,710
+الرفاهيةالست عايشة في البيت مرفوها، مافي أي نشاط
+
+139
+00:09:58,710 --> 00:10:02,870
+بتقوم عنه أو ما بتقوم فيه فبالتالي بتلاقي أنه هي
+
+140
+00:10:02,870 --> 00:10:06,790
+كل مالها، ما شاء الله عليها overweight وبيصير
+
+141
+00:10:06,790 --> 00:10:09,670
+زيادة في الانسليكي، بيصير في زيادة في الـglucose
+
+142
+00:10:09,670 --> 00:10:12,810
+level في الدم الـhistory of impaired fasting
+
+143
+00:10:12,810 --> 00:10:17,870
+glucose أو impaired glucose toleranceطبعا إذا كان
+
+144
+00:10:17,870 --> 00:10:21,470
+في عندهم في تاريخها العالى إنه لو حللت سكري و هي
+
+145
+00:10:21,470 --> 00:10:25,310
+صايم عندها أعلى من الـ Normal line اللي أنا هحكي
+
+146
+00:10:25,310 --> 00:10:30,610
+عليه هيكون الـ Hypertension مباشرة في الملف الطبي
+
+147
+00:10:30,610 --> 00:10:34,330
+و زي ما شوفته في التدريبات العملية إنه بتلاقوا إنه
+
+148
+00:10:34,330 --> 00:10:38,270
+إذا كان هذا مريض ضغط معناته هو بيكون مصاحب للسكر و
+
+149
+00:10:38,270 --> 00:10:44,210
+هي ليس قاعدةأساسية لأ بنحكي ممكن وفي احتمالية يعني
+
+150
+00:10:44,210 --> 00:10:48,390
+ممكن الناس تكون هي مريضة ضغط ولكن لا يوجد لديها
+
+151
+00:10:48,390 --> 00:10:52,950
+diabetes gestational diabetes اللي هو سكري الحامل
+
+152
+00:10:52,950 --> 00:10:58,350
+اليوم أنا حامل في اللي هو الأشهر الأولى بلاجئ انه
+
+153
+00:10:58,350 --> 00:11:02,490
+بعد اللي هو فحص السكري للحامل انه انت يا ست عندك
+
+154
+00:11:02,490 --> 00:11:06,990
+السكري مرتفع ولكن بعد الولادة مباشرة بيروح هذا
+
+155
+00:11:06,990 --> 00:11:12,820
+السكري فهو عرضيليس مستمر لكن انا بكون حاطة اللي هو
+
+156
+00:11:12,820 --> 00:11:18,820
+read marks انه ديري بالك انه انت pre-diabetic انه
+
+157
+00:11:18,820 --> 00:11:23,120
+انت في مؤشر او انت في ال risk area انه انت ديري
+
+158
+00:11:23,120 --> 00:11:27,060
+بالك .. ديري بالك انه ممكن لو اتكرر الاشي أو ممكن
+
+159
+00:11:27,060 --> 00:11:30,740
+لو ما اتبعت رزة معينة انه تصير انت diabetic
+
+160
+00:11:30,740 --> 00:11:36,880
+patient high risk factor تبع ال DM ال diagnosticفي
+
+161
+00:11:36,880 --> 00:11:40,340
+الآن عندي عشان انا اشخص انه انت مريض سكري او لا
+
+162
+00:11:40,340 --> 00:11:45,020
+بتعمل ال fasting plasma glucose مش لازم يكون اعلى
+
+163
+00:11:45,020 --> 00:11:51,680
+من 125 هذا ال line تبعناه اذا انا عملت التحليل
+
+164
+00:11:51,680 --> 00:11:58,060
+عشوائي مش لازم يكون اعلى من 200 اكتر من 200 معناته
+
+165
+00:11:58,060 --> 00:12:03,740
+انت مريض سكريفي عندنا ال OGTT اللي هو ال oral
+
+166
+00:12:03,740 --> 00:12:08,000
+glucose tolerance test هو ابرع عن test بتم اخرج
+
+167
+00:12:08,000 --> 00:12:12,860
+جلوكوز فيه orally تمام؟ اذا ال diagnostic طبعا
+
+168
+00:12:12,860 --> 00:12:16,060
+احنا كده دخلنا على التحليل بدي اعرف فيه تلاتة
+
+169
+00:12:16,060 --> 00:12:20,500
+تحليل أساسية ال FBG هذا بيكون موجود عندكم في رقم
+
+170
+00:12:20,500 --> 00:12:24,800
+التحليل مش لازم يكون أعلى من 125 وإلا هعده دايق
+
+171
+00:12:24,800 --> 00:12:30,270
+بالتكلفة ال randomتحليل عشوائي، إذا كان أعلى من
+
+172
+00:12:30,270 --> 00:12:33,730
+200، معناته أنا بخاف من هذه الإشكال، إيه المشكلة،
+
+173
+00:12:33,730 --> 00:12:38,870
+تمام؟ و الـ Oral بتاعك، خليني أبدأ في أنواع اللي
+
+174
+00:12:38,870 --> 00:12:42,170
+هو الـ Diameters، في عندي type 1 و في عندي type 2
+
+175
+00:12:42,580 --> 00:12:46,840
+type 1 اللي هو ال beta cell بيصير فيه destroyed by
+
+176
+00:12:46,840 --> 00:12:51,080
+autoimmune process زي ما حكينا في البداية انه
+
+177
+00:12:51,080 --> 00:12:55,360
+autoimmune disease الجسم بيهاجم نفسه بنفسه صار في
+
+178
+00:12:55,360 --> 00:12:59,240
+عندي مهاجمة لخلايا beta cell اللي هي مسئولة عن
+
+179
+00:12:59,240 --> 00:13:04,400
+إفراز الأنسلين في البنكنياز معناة الكلام انه ما
+
+180
+00:13:04,400 --> 00:13:08,760
+بيصير في عندي استجابة أو إنتاج للأنسلين بيصيب
+
+181
+00:13:08,760 --> 00:13:13,770
+للأطفال وال young adultالناس اللي عندها استعداد
+
+182
+00:13:13,770 --> 00:13:19,690
+ويراثي لإن أبوه إيجاز سكري على عمر 14 سنة احتمالية
+
+183
+00:13:19,690 --> 00:13:24,010
+إنه يجي الإبن كذلك احتمالية عالية جدا وزي ما حكينا
+
+184
+00:13:24,010 --> 00:13:26,990
+من ال characteristics تبعته إنه autoimmune disease
+
+185
+00:13:26,990 --> 00:13:33,170
+مرض مناعي و الخلايا أو الجسم بيهاجم نفسه بنفسه
+
+186
+00:13:33,170 --> 00:13:38,810
+وحكينا لحد الآن مش معروف السبب type 1 diabetes
+
+187
+00:13:38,810 --> 00:13:43,470
+كانتالـ Symptoms اللي هي continue الـ Symptoms
+
+188
+00:13:43,470 --> 00:13:47,890
+سبعته Increased blood pressure عطش Frequent
+
+189
+00:13:47,890 --> 00:13:53,230
+urination ال weight تبعه losses دائما جائع سرعان
+
+190
+00:13:53,230 --> 00:13:58,950
+ما بيتعب الزغللة تشويش بالرؤية كل هذه الأمور بيكون
+
+191
+00:13:58,950 --> 00:14:03,150
+على سبيل المثال عند طفل مثلا على سبيل المثال عنده
+
+192
+00:14:03,150 --> 00:14:07,750
+عشر سنواتهنا أنا لازم في العلاج أو دكتور الباطنة
+
+193
+00:14:07,750 --> 00:14:11,350
+اللي موجود عندنا هيوصف له insulin injection لأن هو
+
+194
+00:14:11,350 --> 00:14:14,370
+من النوع الأول ال insulin injection يعني اللي هي
+
+195
+00:14:14,370 --> 00:14:17,550
+إيبر الأنسولين اللي أنا بشوفها مع المرضى تبعي
+
+196
+00:14:17,550 --> 00:14:21,730
+عندنا no oral medication هنا مافي عندى اللي هي
+
+197
+00:14:21,730 --> 00:14:27,490
+أدوية تتاخد orally تمام؟ هذا بالنسبة ل type 1 type
+
+198
+00:14:27,490 --> 00:14:32,350
+2 هو اللي هو على الأقل 90% من العالم عندهم ديابتة
+
+199
+00:14:32,350 --> 00:14:38,510
+سمنةبيصير في قلة في إنتاج الانسولين اللي موجود and
+
+200
+00:14:38,510 --> 00:14:43,570
+decrease the sensitivity to insulin وقلة في مدى
+
+201
+00:14:43,570 --> 00:14:50,810
+الاستجابة لحساسية الانسولين على الأغلب هو وراثي ال
+
+202
+00:14:50,810 --> 00:14:55,290
+obesity و ال overweight major factors و ال most
+
+203
+00:14:55,290 --> 00:14:59,530
+common أنه شائع و على الأغلب بيجي للأشخاص البالغين
+
+204
+00:14:59,530 --> 00:15:06,370
+هذا النوع التانيالنوع التاني شو أعراضه وشو العلاج
+
+205
+00:15:06,370 --> 00:15:11,030
+تبعه نفس أعراض النوع الأولمع ده انه فيه headache
+
+206
+00:15:11,030 --> 00:15:15,530
+slow healing لـ cuts or sores لو على سبيل المثال
+
+207
+00:15:15,530 --> 00:15:19,850
+هيستدت و هي بالمطبخ ان جرحت إيدها جرح صغير بيطول
+
+208
+00:15:19,850 --> 00:15:23,790
+لما يلتقم ليه؟ لإن ال white blood cells اللي
+
+209
+00:15:23,790 --> 00:15:28,270
+موجودة عندها ما هي جادة تعملي healing لمكان الجروح
+
+210
+00:15:28,270 --> 00:15:31,890
+ال frequent yeast infection بيكونوا هدول الناس
+
+211
+00:15:31,890 --> 00:15:37,260
+أكتر عرضة لالاتهابات الفطرية و الخمائرأيضا بيصير
+
+212
+00:15:37,260 --> 00:15:42,320
+في عندهم حكة بنلاقي هاي الناس على سبيل المثال في
+
+213
+00:15:42,320 --> 00:15:47,340
+bleeding لبعض الأطراف نتيجة اللي هو الحكة، أيضا في
+
+214
+00:15:47,340 --> 00:15:51,890
+عندهم non-bansاللي هو خذلان و تنميل للإيدين
+
+215
+00:15:51,890 --> 00:15:55,610
+والإجرين أحيانا ممكن أنا بين قصين أربطه على المدى
+
+216
+00:15:55,610 --> 00:15:58,630
+اللي بعيد إنه يصير في عندي حاجة اسمها bullying
+
+217
+00:15:58,630 --> 00:16:02,890
+neuropathy إنه أنا دخلت في الأعصاب وصار في عندي
+
+218
+00:16:02,890 --> 00:16:06,590
+مشكلة في الأعصاب بنلاقي فيه صار عندهم darkens اللي
+
+219
+00:16:06,590 --> 00:16:13,110
+هو اغمقاق أو تعتيم للجلد اللي موجود في الرقبة في
+
+220
+00:16:13,110 --> 00:16:18,570
+الإبقفي اللي هو منطقة الـ Grind طبعاً هذا مؤشر
+
+221
+00:16:18,570 --> 00:16:23,030
+يعني تقريبا بعض المرضى كنت أشوفهم من الرقبة تبع
+
+222
+00:16:23,030 --> 00:16:26,630
+الست اللي نلاقي أنه هي بتكون dark فبالتالي أنا هنا
+
+223
+00:16:26,630 --> 00:16:30,870
+بحكيلها معلش هي بتكون لسه مش دارية عن حالها أنه لو
+
+224
+00:16:30,870 --> 00:16:35,890
+سمحت بس اعمليلي تحليل كذا أو سويلي تحليل كذا أنه
+
+225
+00:16:35,890 --> 00:16:39,890
+أنا مش مخولة أنه انا أحكي أنه خلينا نحلل ولكن
+
+226
+00:16:39,890 --> 00:16:44,340
+كنصيحة أنا ممكن أعطيها إياها ففعلا بتلاقياللي هو
+
+227
+00:16:44,340 --> 00:16:49,340
+high blood glucose level في التحليل العلاج تبعه
+
+228
+00:16:49,340 --> 00:16:53,100
+بيكون الـ oral medication بيستخد اللي هو oral
+
+229
+00:16:53,100 --> 00:16:59,600
+medication لتنظيم عملية اللي هي الـ الـ الـ الهضم،
+
+230
+00:16:59,600 --> 00:17:04,060
+تنظيم عملية اللي هو زي الـ Gelofax أو الأدوية اللي
+
+231
+00:17:04,060 --> 00:17:07,620
+بتكون موجودة مع مرضاء سكري الأنسولين shots may
+
+232
+00:17:07,620 --> 00:17:11,410
+have to be prescribedexercise كمان ال exercise
+
+233
+00:17:11,410 --> 00:17:17,350
+مهمة لمريض السكري من ديابتك two type two و ال
+
+234
+00:17:17,350 --> 00:17:22,510
+weight losses كمان او فقدان الوزن كمان اشي مهم جدا
+
+235
+00:17:22,510 --> 00:17:28,070
+الان الست الحامل اللى حكينا عليها قبل شوية هاي بدى
+
+236
+00:17:28,070 --> 00:17:32,650
+يصير في عندها سكري حامل البلسنتا هنا قادرة على
+
+237
+00:17:32,650 --> 00:17:38,090
+انها تغير او ان هي تنتج ال hormones اللى بيعيق
+
+238
+00:17:38,500 --> 00:17:42,920
+الأنسولين okay when البلد سنتا produced hormones
+
+239
+00:17:42,920 --> 00:17:47,220
+which impair action of أنسولين in tissue when
+
+240
+00:17:47,220 --> 00:17:51,280
+blood sugar level rise too high it can affect the
+
+241
+00:17:51,280 --> 00:17:54,520
+growth and development لال baby عشان هيك بتلاقي ان
+
+242
+00:17:54,520 --> 00:17:59,560
+هو الطفل الصغير لما انولد جانى 6 كيلو اه والله امه
+
+243
+00:17:59,560 --> 00:18:02,980
+ما شاء الله عليها مهتمة فيه كانت اتغذى و هي حامل
+
+244
+00:18:02,980 --> 00:18:09,620
+هي بتكون سكري بالاصلفبالتالي أثرت على الـ growth و
+
+245
+00:18:09,620 --> 00:18:13,840
+ال weight تبع ال baby no noticeable signs or
+
+246
+00:18:13,840 --> 00:18:17,240
+symptoms but may cause increased stress and
+
+247
+00:18:17,240 --> 00:18:21,060
+urination بتلاقي حالها مافي اي symptoms ظاهرة زي
+
+248
+00:18:21,060 --> 00:18:26,530
+ما شوفنا فيهD1 وD2 ولكن على الأغلب هي بتكون دائما
+
+249
+00:18:26,530 --> 00:18:31,330
+تشعر بالعطش الشديد بال urination والدكتور will
+
+250
+00:18:31,330 --> 00:18:34,590
+address it لأنه لازم تظل متابعة مع الدكتور تبعها
+
+251
+00:18:34,590 --> 00:18:39,310
+ايضا لبعد الولادة تمام كل شي بيصير و بيرجع لل
+
+252
+00:18:39,310 --> 00:18:43,490
+glucose level او بيرجع لهو السكري لوضعه الطبيعي
+
+253
+00:18:43,490 --> 00:18:49,390
+ولكن احنا بنبحها ان انت لازم تظل متابعة ومستمرة مع
+
+254
+00:18:49,390 --> 00:18:54,510
+الدكتور لانهفي مجال ان انت ترجعلك ان هي المشكلة من
+
+255
+00:18:54,510 --> 00:19:01,550
+اول و جديد ايضا ال treatment حاكينا بال exercise و
+
+256
+00:19:01,550 --> 00:19:05,490
+ال diet و ال medication بعض الأحيان بنضطر لانه او
+
+257
+00:19:05,490 --> 00:19:09,190
+بتضطر الدكتور انه يعطيها ال insulin injection و ال
+
+258
+00:19:09,190 --> 00:19:12,370
+oral ال blood glucose او ال blood sugar monitoring
+
+259
+00:19:12,370 --> 00:19:17,230
+4 على 5 times daily لانه مهم جدا زي ما انا بخاف من
+
+260
+00:19:17,230 --> 00:19:21,290
+ال hyperglycemiaكمان بخاف من الـ hypoglycemia
+
+261
+00:19:21,290 --> 00:19:28,310
+تمام؟ draw blood from tip of fingers هذا اللي هو
+
+262
+00:19:28,310 --> 00:19:32,790
+ال blood sugar monitoring و ال place on test strap
+
+263
+00:19:32,790 --> 00:19:37,350
+put under glucose مثلا هنا بدنا نحكي على ال drawel
+
+264
+00:19:37,350 --> 00:19:42,650
+تبع ال blood بدي يكون من طرف الإصبعو place on test
+
+265
+00:19:42,650 --> 00:19:46,890
+طبعا بتحطيه على استرابة و على شريطة يعني اللي هنا
+
+266
+00:19:46,890 --> 00:19:52,170
+العملية هي خاصة بالتحاليل احنا بس نتعلمها لإنه بعض
+
+267
+00:19:52,170 --> 00:19:57,570
+الأهالي او بعض أمياتكم عندهم الأجهزة اللي هي خاصة
+
+268
+00:19:57,570 --> 00:20:00,470
+فيهم موجودة في البيت تسحب انتي العينة من طرف
+
+269
+00:20:00,470 --> 00:20:04,330
+الإصبع و بتحطيها على شريط اللاصق و بعدين بتعملي ..
+
+270
+00:20:04,330 --> 00:20:09,790
+بتحوتيها على الجهاز ال ungrantologic consideration
+
+271
+00:20:10,530 --> 00:20:14,250
+اللي هو علم الشيخوخة elevated of blood glucose
+
+272
+00:20:14,250 --> 00:20:18,710
+level are also age related لها علاقة بالعمر ال
+
+273
+00:20:18,710 --> 00:20:22,410
+increasing with advancing age اشي طبيعي اليوم
+
+274
+00:20:22,410 --> 00:20:25,430
+الأنسلين أسفل بينكرياس لما بدي يشتغل في عمر
+
+275
+00:20:25,430 --> 00:20:29,150
+العشرين سنة مش نفسه لما هيشتغل في عمر التمانين لأ
+
+276
+00:20:29,150 --> 00:20:32,650
+ال capacity تبعته أو القدرة تبعته ما بتعطي نفس
+
+277
+00:20:32,650 --> 00:20:36,270
+الإنتاج اللي كان فبالتالي انه بيسببلي increase ل
+
+278
+00:20:36,270 --> 00:20:39,380
+ال fatity shockdecrease للإنسلين production ال
+
+279
+00:20:39,380 --> 00:20:42,860
+physical inactivity كمان مهم جدا احنا بمجرد نصير
+
+280
+00:20:42,860 --> 00:20:47,200
+بالستين خلاص على الله السلام decrease لل lean of
+
+281
+00:20:47,200 --> 00:20:50,920
+body mass كمان اللي هو الكتلة العضلية تبعتنا و
+
+282
+00:20:50,920 --> 00:20:54,820
+بتصير الست مشاء الله عليها overweight فبالتالي هذا
+
+283
+00:20:54,820 --> 00:21:03,180
+بيقدر إلى وجول السكري عند المسنين كيف بدي اعمل فحص
+
+284
+00:21:03,180 --> 00:21:07,260
+او كيف بدي اراقب ال gelocose levelال patient on
+
+285
+00:21:07,260 --> 00:21:11,420
+insulin should check sugar two or five times per
+
+286
+00:21:11,420 --> 00:21:15,400
+day لازم تشيك على حالها هاي ست من مرتين لاربع مرات
+
+287
+00:21:15,400 --> 00:21:19,340
+في اليوم not on insulin two or three times بيرويك
+
+288
+00:21:19,340 --> 00:21:23,120
+according to text الناس اللي هي مش معتمدة على
+
+289
+00:21:23,120 --> 00:21:25,920
+الانسولين أما الناس اللي معتمدة على الانسولين لازم
+
+290
+00:21:25,920 --> 00:21:30,020
+يكون مرتين لتلاتةخلال اليوم ولكن خلال الإسبوع
+
+291
+00:21:30,020 --> 00:21:33,100
+للناس اللى مش معتمدة على أنسولين should check
+
+292
+00:21:33,100 --> 00:21:37,160
+before meals and two hours after meals إشي بدى
+
+293
+00:21:37,160 --> 00:21:41,400
+يكون قبل الوجبات طبعا لإن ال fasting بدى يكون وإشي
+
+294
+00:21:41,400 --> 00:21:44,720
+بعد الوجبة ساعتين عشان أنا أخد ال parameter صحيح
+
+295
+00:21:44,720 --> 00:21:48,100
+ال parameter from physician is very important إن
+
+296
+00:21:48,100 --> 00:21:52,020
+هو أنا أخد القياسات الصحيحة عشان كمان الدكتور يتبع
+
+297
+00:21:52,020 --> 00:21:58,190
+معايا في الموضوعماهي ال complicated اللى ممكن تصير
+
+298
+00:21:58,190 --> 00:22:01,470
+عندك؟ في عندي acute complicated و في عندي chronic
+
+299
+00:22:01,470 --> 00:22:05,710
+complicated hypoglycemia اللى هو انخفاض مستوى
+
+300
+00:22:05,710 --> 00:22:14,370
+السكر عن 70% عن 70 milligram لكل DCL طبعا يعني إذا
+
+301
+00:22:14,370 --> 00:22:18,850
+عالى 125 هذا بعتبره hyperglycemia ولكن أنا اللى
+
+302
+00:22:18,850 --> 00:22:24,410
+بدى أحكي hypoglycemia بدي أقل عن 70 ممكن يصير عندي
+
+303
+00:22:24,410 --> 00:22:30,860
+من ال complicatedKetoacidosis بختصرها بالـ DKA هو
+
+304
+00:22:30,860 --> 00:22:35,020
+عبارة عن الحمض الكيتواني السكري إنه بيتم التشخيص
+
+305
+00:22:35,020 --> 00:22:39,120
+للإصابة بمراد السكر من النوع الأول ومعالجته وممكن
+
+306
+00:22:39,120 --> 00:22:42,860
+المريض في هذه اللحظة يفوت لي في غيبوبة قد يوفقته
+
+307
+00:22:42,860 --> 00:22:47,630
+إذا ما تم معالجتهالـ non-keytic اللي هو او hyper
+
+308
+00:22:47,630 --> 00:22:52,410
+-smaller ديابت الكومة انه طبعا ممكن يكون اللي هو
+
+309
+00:22:52,410 --> 00:22:56,850
+مادة علاج وبعد الكومة ممكن يدخل في حالة وفاة او
+
+310
+00:22:56,850 --> 00:23:00,890
+موت سريري ال chronic complication على المدى البعيد
+
+311
+00:23:00,890 --> 00:23:05,090
+يا اما بدها تكون على صعيد ال micro او ال macro
+
+312
+00:23:05,090 --> 00:23:09,430
+طالما حكيت انا micro معناته ان ال issue صغير
+
+313
+00:23:09,430 --> 00:23:15,310
+neuropathy retinopathy and nephropathyالنيروباتي
+
+314
+00:23:15,310 --> 00:23:20,190
+أنا كنت ذكرتها سابقا هي عبارة عن انتهاب أو خلل
+
+315
+00:23:20,190 --> 00:23:25,450
+وعلّة الأطراف اللي ناتجة عن المرض السكري من الرتنة
+
+316
+00:23:25,450 --> 00:23:29,830
+أو الشبكية بيصير في عندنا مشكلة في الإبصار و
+
+317
+00:23:29,830 --> 00:23:33,870
+الرؤية نفرو إلها علاقة بال kidney معناه الكلام في
+
+318
+00:23:33,870 --> 00:23:38,030
+عندنا مشاكل فارث وضائف الكلة أنا هنا بحكي على صعيد
+
+319
+00:23:38,030 --> 00:23:42,850
+ال micro أما إذا حكينا على صعيد ال macroفهي بدأت
+
+320
+00:23:42,850 --> 00:23:48,430
+تكون على CVA على إش عظم macro إذا ان هي large
+
+321
+00:23:48,430 --> 00:23:53,490
+معناة الكلام أنه هحكي على stroke فإذا لاحظنا أو
+
+322
+00:23:53,490 --> 00:23:57,590
+إذا دخلت قسم الباطن أثناء التدريب العملي فلان ملفه
+
+323
+00:23:57,590 --> 00:24:02,070
+بيحكي أنه مريض أو stroke patient الكل high blood
+
+324
+00:24:02,070 --> 00:24:06,950
+glucose level أوDiabetes او hypertension معناته هو
+
+325
+00:24:06,950 --> 00:24:14,490
+اشي اساسي موجود انديلا اللي هو مرض او دخول في جلطة
+
+326
+00:24:14,490 --> 00:24:18,650
+دماغية تمام؟ اذا ال complication في عندنا acute في
+
+327
+00:24:18,650 --> 00:24:24,870
+عندنا chronic ايضا من المشاكل وهي شائعة جدا ال
+
+328
+00:24:24,870 --> 00:24:29,870
+foot and leg problems حدث ولا حرج مانيقا غزة بهذا
+
+329
+00:24:29,870 --> 00:24:34,020
+الكلام sensory lossesPseudomotor neuropathy lead
+
+330
+00:24:34,020 --> 00:24:38,140
+to dry and cracking feet Pseudomotor neuropathy
+
+331
+00:24:38,140 --> 00:24:40,720
+رجعنا لكلمة neuropathy اللي لها علاقة
+
+332
+00:24:40,720 --> 00:24:46,120
+بالنيورولوجيا أيضا المريض نفسه بيكون في عنده مشكلة
+
+333
+00:24:46,120 --> 00:24:49,740
+بال skin الناتج عن ال high blood glucose level
+
+334
+00:24:49,740 --> 00:24:54,500
+وحكينا أو أنه أنا سابقا كنت أحكيها ممكن تنحرق أجر
+
+335
+00:24:54,500 --> 00:24:59,000
+المريض و هو مش حاسس فيها ليه؟ لأن عدم الإحساس loss
+
+336
+00:24:59,000 --> 00:25:05,970
+of sensory تمام؟ايضا اللى هى الـ PAD اللى هى stop
+
+337
+00:25:05,970 --> 00:25:10,510
+war wound healingpoor wound healing ليه؟ لإن مافي
+
+338
+00:25:10,510 --> 00:25:15,090
+عندي good circulation إنها تعمل ال wound healing
+
+339
+00:25:15,090 --> 00:25:20,010
+بتوصل لمرحلة الغرينة معناه الكلام أنا في قسم
+
+340
+00:25:20,010 --> 00:25:23,670
+الباطنة، هيصير في عندي amputation ال amputation
+
+341
+00:25:23,670 --> 00:25:27,950
+معناته cutting لللمس، إذا هذا من ال complicated
+
+342
+00:25:27,950 --> 00:25:32,070
+اللي صارت نتيجة اللي هي diabetes lowered
+
+343
+00:25:32,070 --> 00:25:37,690
+resistance to infectionتعوبة المقاومة لأي التهاب
+
+344
+00:25:37,690 --> 00:25:43,950
+عندهم على سبيل المثال في عندها عدوى إيجدها لهذه
+
+345
+00:25:43,950 --> 00:25:48,710
+الست صعب أن يحصل في مقاومة أو اللي هي تشتغل ال
+
+346
+00:25:48,710 --> 00:25:52,110
+white blood cells ليه؟ لأن ال circulation ضعيفة
+
+347
+00:25:52,110 --> 00:25:55,110
+بتكون فبالتالي ال white blood cells ما بتوصل
+
+348
+00:25:55,110 --> 00:26:02,110
+للمكان بشكل مباشر وسريع في تأخير في بطء في عملية
+
+349
+00:26:02,110 --> 00:26:07,730
+ال wound healingالان ال management لل foot and leg
+
+350
+00:26:07,730 --> 00:26:12,530
+problems كتير حكات الموضوع شائك ومهم جدا بالنسبة
+
+351
+00:26:12,530 --> 00:26:16,110
+لنا ك physiotherapist teaching لل patient كيف انا
+
+352
+00:26:16,110 --> 00:26:20,970
+ممكن احل المشكلة انه اعلمه كيف يرتدي الحذاء دائما
+
+353
+00:26:20,970 --> 00:26:26,750
+يكون معاه مرقا لفحص اللي هي ال foot من تحت انه
+
+354
+00:26:26,750 --> 00:26:31,770
+يشوف الأطراف او ال tools اللي موجودة فيها wound or
+
+355
+00:26:31,770 --> 00:26:36,160
+notExamine للـ feet every time he goes to the
+
+356
+00:26:36,160 --> 00:26:40,360
+doctor دائما يعمل examination وفحص لإجرين C
+
+357
+00:26:40,360 --> 00:26:44,000
+للبيدياترست أو ال podiatrist اللي هو طبيب الأقدام
+
+358
+00:26:44,000 --> 00:26:48,220
+أو الأرجل على الأقل annually بدي يكون Close لل two
+
+359
+00:26:48,220 --> 00:26:54,600
+shoes إن هو بدي يكون في عنده .. دائما يكون يلبس
+
+360
+00:26:54,600 --> 00:26:59,250
+الأحذية المغلقة من الأماممش صح تكون الأحذية مفتوحة
+
+361
+00:26:59,250 --> 00:27:05,010
+و ال trauma ممكن توصل لأي أجر trimig toenails قص
+
+362
+00:27:05,010 --> 00:27:09,010
+الأضافر مهم جدا ليه؟ لأنه ممكن لو لا سمح الله
+
+363
+00:27:09,010 --> 00:27:13,010
+الإدفار لو ما انقص بشكل جيد أنه يتسبب في infection
+
+364
+00:27:13,010 --> 00:27:17,970
+و بعدين من جروح صغير أدخل أنا في عملية amputation
+
+365
+00:27:17,970 --> 00:27:23,010
+good food hygiene الهياجين مهم جدا و خصوصا بين
+
+366
+00:27:23,010 --> 00:27:27,310
+الأصابع في القدم اللي موجودةالـ glycemic control
+
+367
+00:27:27,310 --> 00:27:31,110
+is the key to preventing complications أحافظ على
+
+368
+00:27:31,110 --> 00:27:35,790
+مستوى السكري في الدم هو أهم موضوع في كل المشكلة
+
+369
+00:27:35,790 --> 00:27:38,990
+جداش أنا محافظة على السكري تبعي جداش أنا في ال
+
+370
+00:27:38,990 --> 00:27:42,490
+safe side شو ال recommended في ال clinic؟ ال
+
+371
+00:27:42,490 --> 00:27:47,630
+fasting glucose level فحص السكر صحيح ال oral
+
+372
+00:27:47,630 --> 00:27:52,650
+glucose tolerance testing using اللي هو 75 جرام لل
+
+373
+00:27:52,650 --> 00:27:55,290
+glycogen
+
+374
+00:27:56,070 --> 00:28:03,310
+fasting glucose في المية 125 زي ما حكينا باعتبره
+
+375
+00:28:03,310 --> 00:28:10,170
+pre-diabetes ال fasting level اقل او اكبر من 126
+
+376
+00:28:10,170 --> 00:28:14,830
+is diagnostic اذا كان على سبيل المثال حللت وانا
+
+377
+00:28:14,830 --> 00:28:19,690
+صايمة اليوم الصبح وطلع عندى 140 على طول بتم تشخيص
+
+378
+00:28:19,690 --> 00:28:25,970
+ديابته ال oralاللي هو glucose tolerance test 200
+
+379
+00:28:25,970 --> 00:28:30,750
+ال diagnostic معناته أكبر من 200 معناته اللي هو
+
+380
+00:28:30,750 --> 00:28:35,810
+بتتشخص على أني ضيابيكاس تمام؟ هاي مهمة جدا ل slide
+
+381
+00:28:35,810 --> 00:28:42,090
+لكم في المساء ومهمة أيضا في حياتكم العمليةshow
+
+382
+00:28:42,090 --> 00:28:47,130
+reducing risk ال wet reduction خفف وزن ال exercise
+
+383
+00:28:47,130 --> 00:28:50,930
+على الأقل بدي 150 دقيقة خلال الأسبوع ال
+
+384
+00:28:50,930 --> 00:28:55,530
+comprehensive او اللي هو انه اعمل diet مناسب و
+
+385
+00:28:55,530 --> 00:29:00,450
+اللي هو حمية غذائية جيدة ال education اتعلم كيف
+
+386
+00:29:00,450 --> 00:29:04,190
+انا احافظ على الأطراف اتعلم كيف احافظ على انه
+
+387
+00:29:04,190 --> 00:29:08,910
+مايصير في عندي اي wound اي trauma لل body تبعي
+
+388
+00:29:10,210 --> 00:29:13,390
+controlling لل body أو لل blood sugar ال
+
+389
+00:29:13,390 --> 00:29:17,970
+homoglobin A1 اللى هو بدى يكون less than or equal
+
+390
+00:29:17,970 --> 00:29:28,670
+من 6.5% الفاستنج بلازمة طبعا قل من 110 فحص السكر
+
+391
+00:29:28,670 --> 00:29:34,250
+سايم two hourبص برن دي الشجارز 140 comprehensive
+
+392
+00:29:34,250 --> 00:29:38,670
+education لازم يكون في عنده معلومات ويكون في عنده
+
+393
+00:29:38,670 --> 00:29:43,530
+إرشادات و تعليمات جادر هو يستخدمهم أو جادر يتبعهم
+
+394
+00:29:43,530 --> 00:29:48,470
+ال management لمريض السكري nitrogen exercise
+
+395
+00:29:48,470 --> 00:29:53,670
+monitoring pharmacology and education خمس محاور
+
+396
+00:29:53,670 --> 00:29:57,690
+هتكلمنا فيهم وبإذن الله تعالى هنتكلم كمان مرة في
+
+397
+00:29:57,690 --> 00:30:03,810
+أشياءاخرى تخص مريض السكر زى ما انتوا شايفين ال
+
+398
+00:30:03,810 --> 00:30:07,530
+nutrition ال medication عن طريق ال pharmacology و
+
+399
+00:30:07,530 --> 00:30:16,350
+ال exercise و ال education مهمة جدا تمام الدياتري
+
+400
+00:30:16,350 --> 00:30:23,990
+management ال carbohydrate رز خبز مكارونة كل هذه
+
+401
+00:30:23,990 --> 00:30:31,010
+الأمور أقل منهاالبروتين 15-20% كالوريز أخدت طبعا
+
+402
+00:30:31,010 --> 00:30:35,150
+مادة اللي هي exercise physiology كتير مهم أنه أنا
+
+403
+00:30:35,150 --> 00:30:40,270
+هنا أتبع فيها تعليمات ال fats أقل من 30% من ال
+
+404
+00:30:40,270 --> 00:30:42,270
+calories أو إجمال ال calories اللي أنا في اليوم
+
+405
+00:30:42,270 --> 00:30:46,670
+بتكونها وخصوصا ال saturated ال fibers مهم جدا أن
+
+406
+00:30:46,670 --> 00:30:51,150
+أنا أكل منهاالـ Ligaments اللي هي البقليات القابلة
+
+407
+00:30:51,150 --> 00:30:56,390
+للذوبان والدورة و لل fruits و كل الأمور زي هذه
+
+408
+00:30:56,390 --> 00:31:01,610
+لشعير أفضل من اللي هو الخبز الأصمر و الخبز الأصمر
+
+409
+00:31:01,610 --> 00:31:05,590
+أفضل من الخبز الأبيض و لو أن حديثا أنا قرأت أن
+
+410
+00:31:05,590 --> 00:31:09,770
+كلاهما نفس ال calories ما بين الخبز الأصمر و الخبز
+
+411
+00:31:09,770 --> 00:31:13,680
+الأبيضإلا إنه احنا بعض الأحيان يعني ممكن نكون نضحك
+
+412
+00:31:13,680 --> 00:31:17,400
+على حالنا إنه أنا باكل خبز أسمر عشان أنا سكري، لأ
+
+413
+00:31:17,400 --> 00:31:22,100
+كتير هي بسمعها الكلمة فهي للأمانة أنا حديثا قرأتها
+
+414
+00:31:22,100 --> 00:31:26,780
+إنه هو لا علاقة للون الخبز بال calories إلا اللي
+
+415
+00:31:26,780 --> 00:31:33,830
+هو خبز الشعير الأفضل لمرضاء السكري، تمام؟الـ
+
+416
+00:31:33,830 --> 00:31:36,690
+Consisting will balance small meals several times
+
+417
+00:31:36,690 --> 00:31:41,410
+per day طبعا إشي مهم جدا إنه أنا أوزع الواجبة خلال
+
+418
+00:31:41,410 --> 00:31:46,710
+اليوم مش من الصح إنه أنا أقعد على الواجبة وما أخد
+
+419
+00:31:46,710 --> 00:31:51,310
+بالي إيش أنا أكلت ال exchange system or continuing
+
+420
+00:31:51,310 --> 00:31:55,350
+carbohydrates نغير من وضعنا ومن حياتنا وال system
+
+421
+00:31:55,350 --> 00:31:58,370
+اللي إحنا عايشين فيه وخصوصا الاعتماد بشكل كامل على
+
+422
+00:31:58,370 --> 00:32:02,150
+ال carbohydratesشو ال teaching plan؟ ال education
+
+423
+00:32:02,150 --> 00:32:08,290
+is critical مهم جدا simple pathophysiology مهم جدا
+
+424
+00:32:08,290 --> 00:32:12,190
+ان انا اعرف ال pathophysiology او قليل المرض عشان
+
+425
+00:32:12,190 --> 00:32:16,660
+انا اقدر احط حط لنفسي ال treatment modulatedإيش
+
+426
+00:32:16,660 --> 00:32:20,380
+بدي أخد في العلاج؟ هل أنا اليوم بس هاخد اللي هي ال
+
+427
+00:32:20,380 --> 00:32:23,540
+oral medication و لا بعد شوية هفشل في ال oral
+
+428
+00:32:23,540 --> 00:32:26,860
+medication و يحولني الدكتور ل insulin injection؟
+
+429
+00:32:26,860 --> 00:32:29,220
+لأ لازم أكون عارفة إيش ال modalities اللي أنا
+
+430
+00:32:29,220 --> 00:32:32,620
+رايحة عليها ال recognition and treatment to
+
+431
+00:32:32,620 --> 00:32:35,500
+prevention لل acute complications لازم يكون عندي
+
+432
+00:32:35,500 --> 00:32:39,060
+مدى الإدراك عالي جدا لعملية ال prevention لعملية
+
+433
+00:32:39,060 --> 00:32:43,420
+إنه أنا أوقي نفسي من أي مشكلة ممكن تكون عواقبها
+
+434
+00:32:43,420 --> 00:32:47,560
+وخيمة على سبيل المثال amputationwhen to call the
+
+435
+00:32:47,560 --> 00:32:52,120
+doctor طبعا لما بحتاج الأمر لازم أذهب للدكتور وما
+
+436
+00:32:52,120 --> 00:32:57,140
+أتوانى عن هاي المشكلة ال food care و ال eye care
+
+437
+00:32:57,140 --> 00:33:00,620
+مهم جدا لإن الزغلال بالعينين و التشويش بالرؤية
+
+438
+00:33:00,620 --> 00:33:04,620
+ممكن بعد شوية يأدي لانفصال الشبكية و أنا هاي هون
+
+439
+00:33:04,830 --> 00:33:09,070
+حصلت أمامي و صارت أمامي الـ General يعني إيشي
+
+440
+00:33:09,070 --> 00:33:13,590
+الوضع خطير إنه أنا أظلني مهملة في نفسي لحد ما يصير
+
+441
+00:33:13,590 --> 00:33:20,150
+انفصال تم في اللي هو الشبكية الـ General هيجين
+
+442
+00:33:20,150 --> 00:33:23,870
+طبعا النضافة الشخصية و النضافة العامة لإنه حكيتلكم
+
+443
+00:33:23,870 --> 00:33:29,030
+Diabetes او Diabetic patient من نوع اتنين بيكونوا
+
+444
+00:33:29,030 --> 00:33:34,390
+قابلين لإن يصير في عندهم التهاباتفبالتالي أنا بخاف
+
+445
+00:33:34,390 --> 00:33:39,210
+من أنه لا سمح الله بعد هذا الالتهاب يصير في عندنا
+
+446
+00:33:39,210 --> 00:33:43,350
+مشكلة و debreatment و amputation حسب المنطقة اللي
+
+447
+00:33:43,350 --> 00:33:48,650
+صار فيها الالتهاب كمان لازم أعالج اللي هو ال
+
+448
+00:33:48,650 --> 00:33:54,250
+factors إذا كانت obesity إذا كان الإشي مثلا إله
+
+449
+00:33:54,250 --> 00:33:57,450
+علاقة بنوع الحياة اللي أنا عايشاها إذا إله علاقة
+
+450
+00:33:57,450 --> 00:34:03,910
+بأي إشي في اللي هو ال risk factorالأن كيف بدي أعلم
+
+451
+00:34:03,910 --> 00:34:08,770
+المريض تبعي كيف إنه ياخد الأنسولين تبعته Stronger
+
+452
+00:34:08,770 --> 00:34:13,070
+Insulin may not be refrigerated of use within one
+
+453
+00:34:13,070 --> 00:34:18,050
+month طبعا الأنسولين مش لازم يتتلج، بنحط عادي في
+
+454
+00:34:18,050 --> 00:34:22,050
+باب التلاجة إذا فتحت أنا الأمبيولة أو فتحت العبوة
+
+455
+00:34:22,050 --> 00:34:26,290
+لمدة شهر فقط أكتر من هيك على طول أنا بتخلص منها
+
+456
+00:34:26,290 --> 00:34:30,350
+Detailed listeners should be stored standing up
+
+457
+00:34:30,660 --> 00:34:34,480
+بنعبّي السرنجة حسب ما الدكتور حكالنا تلاتة ملي،
+
+458
+00:34:34,480 --> 00:34:38,460
+تلاتة صانتي، اتنين، واحد، صباحا، و تلاتة مثلا على
+
+459
+00:34:38,460 --> 00:34:43,300
+سبيل المثال والسرنجة طبعا الـ concentration of
+
+460
+00:34:43,300 --> 00:34:45,800
+أنسولين فيه على الأنسولين الصافي وفيه الأنسولين
+
+461
+00:34:45,800 --> 00:34:49,080
+العكل أكيد طبعا الدكتور محمد ما قصر في هذا الموضوع
+
+462
+00:34:49,080 --> 00:34:53,200
+ال mixing أنسولين اللي هو طبعا اللي حكينا عليه فيه
+
+463
+00:34:53,200 --> 00:34:55,480
+على نوعين من الأنسولين اللي هو الأنسولين الصافي
+
+464
+00:34:55,480 --> 00:35:00,140
+والأنسولين العكل don't rotate area to areaطبعا
+
+465
+00:35:00,140 --> 00:35:06,360
+بكون ماخدة اللى هى الأناكن وين أنا بتم اللى هى حقن
+
+466
+00:35:06,360 --> 00:35:11,520
+قبرة الانسولين على سبيل المثال تحت اللى هو الجزء
+
+467
+00:35:11,520 --> 00:35:13,920
+ال lower limb او فى ال upper limb احيانا فى منطقة
+
+468
+00:35:13,920 --> 00:35:18,940
+ال abdomen no need to aspirate تمام انه احنا ليس
+
+469
+00:35:18,940 --> 00:35:22,520
+بحاجة نعمل aspiration من الجسم لأ انه احنا بنعطى
+
+470
+00:35:22,520 --> 00:35:27,700
+هاي الانسولين ال exercise best insulin sisters on
+
+471
+00:35:28,260 --> 00:35:31,340
+the market better than any medication we currently
+
+472
+00:35:31,340 --> 00:35:35,900
+have available اختصرها بورتال هنا عندنا بورتال بيه
+
+473
+00:35:35,900 --> 00:35:40,300
+اللي هو المشكلة كلها انه انا ماقلتش بتابع ال
+
+474
+00:35:40,300 --> 00:35:43,660
+exercise معناة الكلام انا حلت مشكلتي بإيدي
+
+475
+00:35:43,660 --> 00:35:48,600
+مااستنيت لحد ما يصل الأمر فيا لعواقب وخينام ال
+
+476
+00:35:48,600 --> 00:35:52,160
+physiology خلال اللي هو ال first few minutes من ال
+
+477
+00:35:52,160 --> 00:35:55,420
+exerciseحكينا في مساق اللي هو ال exercise في
+
+478
+00:35:55,420 --> 00:35:59,220
+السيولوجيا كنت بتاخده عن ال calories و كيف ال
+
+479
+00:35:59,220 --> 00:36:02,600
+exercise و كام من ال calories أنا ممكن أحرق في هذا
+
+480
+00:36:02,600 --> 00:36:07,600
+ال exercise في بداية أول دقائق ال exercise ال
+
+481
+00:36:07,600 --> 00:36:14,800
+glycogen في ال muscles is broken down and aerobic
+
+482
+00:36:14,800 --> 00:36:24,350
+لها واني اذا بيصيرتكسير للـGlycogen مباشرة في
+
+483
+00:36:24,350 --> 00:36:29,430
+الـexercise اللي هواهي بعد 5 to 10 minutes ال
+
+484
+00:36:29,430 --> 00:36:33,370
+muscle glycogen break down decrease بقل تكسير
+
+485
+00:36:33,370 --> 00:36:37,670
+الجليكوجين اللي موجود في ال muscle الجلوكوز broken
+
+486
+00:36:37,670 --> 00:36:43,440
+down in the liver ببلش الجلوكوز يتكسر في الكبدis
+
+487
+00:36:43,440 --> 00:36:47,780
+released to blood وبتم إطلاقه في مجرة الدم and
+
+488
+00:36:47,780 --> 00:36:53,040
+taken up by muscles as a fuel تاخد العضلات كوقود
+
+489
+00:36:53,040 --> 00:36:58,820
+لإلها this glucose becomes major source بيكون مصدر
+
+490
+00:36:58,820 --> 00:37:03,840
+أساسي للعضلات من الوقود معناته هنا صار في عندي
+
+491
+00:37:03,840 --> 00:37:09,320
+hepatic glycogenolysis إذا العملية سهلة جدا بداية
+
+492
+00:37:09,320 --> 00:37:13,170
+بتم تكسير الجليكوجين اللي موجود في العضلاتأول
+
+493
+00:37:13,170 --> 00:37:18,250
+دقيقتين بعد خمس لعشر دقائق بيصير ال muscles
+
+494
+00:37:18,250 --> 00:37:23,050
+glycogen تقف لجليكوجين الموجود أو الجلوكوز الموجود
+
+495
+00:37:23,050 --> 00:37:27,750
+داخل ال liver داخل الكبد بيفرز الجلوكوز فبالتالي
+
+496
+00:37:27,750 --> 00:37:32,310
+بتعتمد العضلات على ان وقود مباشر فيها بهيك بيكون
+
+497
+00:37:32,310 --> 00:37:37,230
+انا قللت من كمية الجلوكوز الموجودة في الدم role of
+
+498
+00:37:37,230 --> 00:37:40,610
+physical activity improve over blood glucose
+
+499
+00:37:40,610 --> 00:37:47,500
+control andHbA1c level in type 2 diabetes Improve
+
+500
+00:37:47,500 --> 00:37:52,700
+للأنسلين sensitivity بيحسن مدى حساسية أو مدى
+
+501
+00:37:52,700 --> 00:37:57,380
+استجابة الأنسلين and lowers للأنسلين requirement
+
+502
+00:37:57,380 --> 00:38:00,840
+often leading to reduced dose of insulin فبالتالي
+
+503
+00:38:00,840 --> 00:38:04,660
+بيقلل من ال dose لهذا الأنسلين ال oral
+
+504
+00:38:04,660 --> 00:38:08,000
+hypoglycemic agent especially in people with type
+
+505
+00:38:08,000 --> 00:38:13,250
+2طبعا بوصل لـ Maintenance of Ideal Body Weight
+
+506
+00:38:13,250 --> 00:38:17,190
+نتيجة اللي هو الـ Physical Activities Reduction
+
+507
+00:38:17,190 --> 00:38:22,330
+للـ Coronary Risk Factor بقلل المشاكل اللي هي الـ
+
+508
+00:38:22,330 --> 00:38:26,750
+Cardiovascular Disease أيضا بيكون بيغير الجسم
+
+509
+00:38:26,750 --> 00:38:35,190
+لوضعيات مناسبة جدا By
+
+510
+00:38:35,190 --> 00:38:38,550
+Composition Decrease للـ Body Fat and Weight و
+
+511
+00:38:38,550 --> 00:38:42,510
+Increase للمسلماتLowers the cardiovascular and
+
+512
+00:38:42,510 --> 00:38:48,850
+oval-ore mortality بقلل من احتمالية الوفيات لأمراض
+
+513
+00:38:48,850 --> 00:38:54,730
+اللي هم المرضى القلب اللي موجودين شو تأثير ال
+
+514
+00:38:54,730 --> 00:38:59,030
+exercise؟ في ال acute phase ال exercise result in
+
+515
+00:38:59,030 --> 00:39:03,750
+translocation للجلوكوز زي ما حكينا عليها المعلومة
+
+516
+00:39:03,750 --> 00:39:07,010
+هاي سابقا و transported to the plasma membrane and
+
+517
+00:39:07,010 --> 00:39:09,670
+increase the glucose uptakeWith prolonged
+
+518
+00:39:09,670 --> 00:39:14,170
+exercise، this upregulation مع الـExercise الطويل
+
+519
+00:39:14,170 --> 00:39:17,550
+الأماد، الجلوكوزة transporters the numbers of
+
+520
+00:39:17,550 --> 00:39:21,910
+change capillary endicity which overall causes an
+
+521
+00:39:21,910 --> 00:39:25,230
+improvement للأنسونين سبستيفتي بيحسن من سرعة
+
+522
+00:39:25,230 --> 00:39:30,870
+استجابة الأنسونين داخل الجسم لـclinical
+
+523
+00:39:30,870 --> 00:39:35,690
+implications even short term، two weeks regular
+
+524
+00:39:35,690 --> 00:39:40,370
+aerobic exerciseالـ exercise اللي هي بتكون aerobic
+
+525
+00:39:40,370 --> 00:39:44,830
+exercise لـ type 2 patients بتساعد في اللي هي both
+
+526
+00:39:44,830 --> 00:39:47,050
+aerobic capacity and whole body insulin
+
+527
+00:39:47,050 --> 00:39:50,870
+sensitivity حسنتني من وضع اللي هو ال weight تبع
+
+528
+00:39:50,870 --> 00:39:55,070
+الجسم وأيضا من ال insulin sensitivity وهذا المطلوب
+
+529
+00:39:55,070 --> 00:39:58,610
+على ال long term endurance لل training and diet of
+
+530
+00:39:58,610 --> 00:40:03,140
+patientsأو Markley improved the whole-body insulin
+
+531
+00:40:03,140 --> 00:40:07,220
+sensitivity and excretion of K-muscle enzymes
+
+532
+00:40:07,220 --> 00:40:11,140
+regulated by insulin. However, maintenance of
+
+533
+00:40:11,140 --> 00:40:15,140
+effects seemed to require dictation and regular
+
+534
+00:40:15,140 --> 00:40:22,300
+uninterrupted أو uninterrupted للإكسرسيز عدم اللي
+
+535
+00:40:22,300 --> 00:40:22,700
+هو
+
+536
+00:40:25,920 --> 00:40:29,500
+التزام هذا الشخص بالـ exercise أو برنامج الـ
+
+537
+00:40:29,500 --> 00:40:34,170
+exercise اللي احنا حطيناه طبعامن الـ clinical
+
+538
+00:40:34,170 --> 00:40:37,450
+implication أيضًا اللي هو الـ intramyocellular
+
+539
+00:40:37,450 --> 00:40:43,170
+lipid accumulation وجود أو اللي هو تخزين اللبد أو
+
+540
+00:40:43,170 --> 00:40:47,350
+الدهون في داخل أو ما بين العضلات which associated
+
+541
+00:40:47,350 --> 00:40:50,330
+with insulin resistance in the muscles can be
+
+542
+00:40:50,330 --> 00:40:53,650
+acutely decreased بقل by even single about
+
+543
+00:40:53,650 --> 00:40:57,170
+sustained endurance exercise ال exercise is
+
+544
+00:40:57,170 --> 00:41:00,750
+beneficial for both glucose uptaking mechanism and
+
+545
+00:41:00,750 --> 00:41:05,290
+antilipolytic effectمهم جدا ال exercise على صعيدين
+
+546
+00:41:05,290 --> 00:41:09,890
+على انه انا بدي اخد الجلوكوز او ميكانيكية الجلوكوز
+
+547
+00:41:09,890 --> 00:41:14,570
+and its antipolytic effect of insulin اللي هو
+
+548
+00:41:14,570 --> 00:41:20,550
+تحليل ال .. ال .. ال lipids اللي هي الدهون تمام؟
+
+549
+00:41:20,550 --> 00:41:23,890
+ال exercise, percussions and diabetes شو ال
+
+550
+00:41:23,890 --> 00:41:27,950
+percussions تبعتي؟ تحذيرات اهم اشي في مرض السكري
+
+551
+00:41:27,950 --> 00:41:33,910
+انه انا امنع اي اصابة للفوت بدي اعملرياض تلجري،
+
+552
+00:41:33,910 --> 00:41:38,190
+please البسفوت مناسب، please مايصير فيه أي trauma
+
+553
+00:41:38,190 --> 00:41:42,570
+وانت بتجري، تمام؟ avoid bonding activities that is
+
+554
+00:41:42,570 --> 00:41:46,370
+called vitreous hemorrhagic، أي نشاط بيعمل
+
+555
+00:41:46,370 --> 00:41:52,530
+bleeding أو نزيف، please أوجف عنده، باخد بالي من
+
+556
+00:41:52,530 --> 00:41:57,270
+مرضى اللي هم ال coronary heart disease، تمام؟ اللي
+
+557
+00:41:57,270 --> 00:42:00,730
+هم ال cardiovascular disease أو أمراض القلب
+
+558
+00:42:01,220 --> 00:42:04,480
+Baseline stress test الـ Baseline stress test هذا
+
+559
+00:42:04,480 --> 00:42:08,100
+كمان مهم جدا Indicated especially for older than
+
+560
+00:42:08,100 --> 00:42:11,400
+13 and with two or more risk factors من
+
+561
+00:42:11,400 --> 00:42:13,460
+الcardiopulmonary disease أو ال cardio artery
+
+562
+00:42:13,460 --> 00:42:17,440
+disease لازم أكون أنا ماخدة في بالي للناس اللي هم
+
+563
+00:42:17,440 --> 00:42:23,120
+عمرهم فوق 30 سنة من ال Baseline stress test شو ال
+
+564
+00:42:23,120 --> 00:42:26,820
+potential adverse لل effect exercise الأثار
+
+565
+00:42:26,820 --> 00:42:31,980
+السلبية اللي ممكنيتصير عندى لأ سمح الله مع ممارسة
+
+566
+00:42:31,980 --> 00:42:35,400
+الرياضة في حالات ال cardiovascular disease و ال
+
+567
+00:42:35,400 --> 00:42:37,840
+microvascular و ال metabolic و على الصعيد ال
+
+568
+00:42:37,840 --> 00:42:40,820
+musculoskeletal خلينى اشوف في البداية ال
+
+569
+00:42:40,820 --> 00:42:43,960
+cardiovascular ال cardiac ممكن يكون في مشكلة و
+
+570
+00:42:43,960 --> 00:42:48,360
+dysfunction and asthma due to silence اللى هى
+
+571
+00:42:48,360 --> 00:42:53,860
+heart disease ما اعطى اللى هى عضلة القلب كمية الدم
+
+572
+00:42:53,860 --> 00:42:57,670
+المناسب لcirculationExcessive Increment in Blood
+
+573
+00:42:57,670 --> 00:43:02,490
+Pressure زيادة في اللي هو الضغط تبع المريضBasic
+
+574
+00:43:02,490 --> 00:43:06,750
+Exercise Orthostatic Hypotension الـ Hypotension
+
+575
+00:43:06,750 --> 00:43:10,390
+أو الـ Orthostatic Hypotension اللي هو مشكلة عامة
+
+576
+00:43:10,390 --> 00:43:15,350
+عند الناس هاي اللي بيبقى تكون نتيجة لوجود مشكلة في
+
+577
+00:43:15,350 --> 00:43:20,060
+اللي هي ال circulation بشكل عامعلى صعيد الـ
+
+578
+00:43:20,060 --> 00:43:23,660
+Microvascular اللي هي الـ Retina Hemorrhagic أو
+
+579
+00:43:23,660 --> 00:43:27,180
+الانفصال الشبكية أو نزيف الشبكية زي ما انتوا
+
+580
+00:43:27,180 --> 00:43:30,320
+شايفين عنا هنا تمامها دي اللي هي كرة العين
+
+581
+00:43:30,320 --> 00:43:34,780
+Acceleration for other microvascular lesion بيصير
+
+582
+00:43:34,780 --> 00:43:38,620
+في عنا طبعا انفصال الشبكية نتيجة للنزيف اللي صار
+
+583
+00:43:38,620 --> 00:43:43,540
+عندها على صعيد ال Metabolic بيصير في عنا أو عمليات
+
+584
+00:43:43,540 --> 00:43:46,960
+الايد worsening للـ hyperglycemia and ketosis
+
+585
+00:43:47,470 --> 00:43:52,170
+وبعدين ممكن يصير في أنا hypoglycemia أعلى من 125
+
+586
+00:43:52,170 --> 00:43:59,470
+أقل من 70 بيصير في عندي hypoglycemia على صعيد ال
+
+587
+00:43:59,470 --> 00:44:04,170
+muscle skeletal and traumatic ال foot ulcerطبعاً
+
+588
+00:44:04,170 --> 00:44:07,610
+هذه اللي هي البقعة العامية بسميها أو البقعة اللي
+
+589
+00:44:07,610 --> 00:44:11,990
+هي السوداء بتكون مجرد حاجة بسيطة جدا في أجر المريض
+
+590
+00:44:11,990 --> 00:44:18,350
+السكري ولكن بعد ذلك نكتشف أن ما تحتها deadline أو
+
+591
+00:44:18,350 --> 00:44:23,550
+diet chaud طبعاً نتيجة له اللي هو ال infection
+
+592
+00:44:23,550 --> 00:44:28,120
+اللي صارت وهو المريض السكري مش حاسس فيهابتصير
+
+593
+00:44:28,120 --> 00:44:30,540
+عملية الـ Debridement بتصير عملية الـ Imputation
+
+594
+00:44:30,540 --> 00:44:33,880
+لأول إصبع بعدين لـ Metatarsal Bone بعدين للفوت
+
+595
+00:44:33,880 --> 00:44:41,480
+كلها وقب ندخل في عمليات أخرى مساحبة تمام؟ هذا على
+
+596
+00:44:41,480 --> 00:44:45,060
+صعيد الـ Musculoskeletal Trauma thank you for your
+
+597
+00:44:45,060 --> 00:44:49,880
+attentions و ألقاكم بإذن الله تعالى في فيديو آخر
+
+598
+00:44:49,880 --> 00:44:57,280
+تكملة للديابتاس طبعا اللي هو part 2 في رعاية الله
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/Y6k4syDoc6c_raw.json b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/Y6k4syDoc6c_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..60b1c65c03dbd3ac12a84b4af302504085c237c1
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/Y6k4syDoc6c_raw.json
@@ -0,0 +1 @@
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five times per day لازم تشيك على حالها هاي ست من مرتين لاربع مرات في اليوم not on insulin two or three times بيرويك according to text الناس اللي هي مش معتمدة على الانسولين أما الناس اللي معتمدة على الانسولين لازم يكون مرتين لتلاتة", "tokens": [6027, 4537, 322, 21587, 820, 1520, 5076, 732, 420, 1732, 1413, 680, 786, 5296, 31377, 2304, 6055, 8592, 1829, 4117, 15844, 11331, 6027, 11296, 8032, 47302, 8608, 2655, 9154, 3714, 43500, 9957, 5296, 9640, 3555, 3615, 3714, 2288, 9307, 8978, 45595, 20498, 406, 322, 21587, 732, 420, 1045, 1413, 4724, 13546, 45865, 4117, 4650, 281, 2487, 2423, 8315, 3794, 13672, 1829, 39896, 37893, 20449, 39237, 41891, 15844, 2423, 7649, 3794, 12610, 9957, 5551, 15042, 2423, 8315, 3794, 13672, 1829, 20449, 39237, 41891, 15844, 2423, 7649, 3794, 12610, 9957, 5296, 31377, 2304, 7251, 30544, 3714, 43500, 9957, 5296, 2655, 1211, 9307, 3660], "avg_logprob": -0.13365502202627705, "compression_ratio": 1.774891774891775, "no_speech_prob": 0.0, "words": [{"start": 1266.2, 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diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/Y6k4syDoc6c_raw.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/Y6k4syDoc6c_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..1f3374980c7e568a170fa3fac684643607d5c3ee
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/Y6k4syDoc6c_raw.srt
@@ -0,0 +1,2392 @@
+1
+00:00:01,010 --> 00:00:06,010
+السلام علي أشرف الأنبياء و المرسلين محمد علي أبطل
+
+2
+00:00:06,010 --> 00:00:09,950
+الصلاة و أتم التسليم ان شاء الله رب العالمين اليوم
+
+3
+00:00:09,950 --> 00:00:14,470
+هنشرح المحاضرة رقم 2 في مساق علاج طبيعي لأمرض
+
+4
+00:00:14,470 --> 00:00:20,020
+القلب و الصدر و الباطنةالمحاضرة هنتحدث عن الـ
+
+5
+00:00:20,020 --> 00:00:24,180
+Diabetes هو عبارة عن مرض العصر زي ما بنعرف هنحكي
+
+6
+00:00:24,180 --> 00:00:27,660
+عنه أول إشي في هذه الجزئية أنا قسمت المحاضرة إلى
+
+7
+00:00:27,660 --> 00:00:31,620
+جزئين الجزء الأول هذا اللي اليوم أو هذه المحاضرة
+
+8
+00:00:31,620 --> 00:00:36,180
+هتكلم عنه في هذا الفيديو عبارة عن introduction عن
+
+9
+00:00:36,180 --> 00:00:41,100
+شو هو الـ Diabetes من وجهة نظر الفيزيوثيرابيةهنعرف
+
+10
+00:00:41,100 --> 00:00:44,900
+أنواعه، هنعرف كيف من التعامل معاه، شو ال
+
+11
+00:00:44,900 --> 00:00:48,960
+guidelines أو شو ال advice اللي أنا ممكن أعطيها
+
+12
+00:00:48,960 --> 00:00:53,600
+للمريض تبعي أثناء جلسة الـ Physotherapy كل هذا
+
+13
+00:00:53,600 --> 00:00:56,800
+الاشي ان شاء الله رب العالمين راح أشرحه في هذه
+
+14
+00:00:56,800 --> 00:00:59,260
+المحاضرة، نبدأ على بركة الله
+
+15
+00:01:03,140 --> 00:01:06,280
+طبعا الـ diabetes والـ exercise اللي أنا بدي
+
+16
+00:01:06,280 --> 00:01:10,820
+أعطيهم للمريض تبعي هيكون المريض مشخص وجاهز ويجاني
+
+17
+00:01:10,820 --> 00:01:15,540
+أنا عشان أعمل جلسة علاج طبيعي نظرا لإن في عنده
+
+18
+00:01:15,540 --> 00:01:18,700
+osteoarthritis منيه، عنده مشاكل مثلا في ال
+
+19
+00:01:18,700 --> 00:01:23,260
+muscles، عنده أي مشاكل أخرى، سواء كانت على صعيد
+
+20
+00:01:23,260 --> 00:01:28,180
+systemic أو على صعيد الأطرافخلّيني أشوف شو يعني
+
+21
+00:01:28,180 --> 00:01:31,840
+ذيابيتس عشان أنا أعرف شو يعني كلمة ذيابيتس لازم
+
+22
+00:01:31,840 --> 00:01:35,340
+أعرف إن أنا لازم يكون في عندي مشكلة أو خلق شوية بس
+
+23
+00:01:35,340 --> 00:01:39,400
+نرجع للـAnatomy قليلاً الـEndocrine System هو
+
+24
+00:01:39,400 --> 00:01:45,040
+عبارة عن System مهم جدا بيمشي مباشر مع الـNervous
+
+25
+00:01:45,040 --> 00:01:49,440
+System يعني الـEndocrine مسؤول عن اللي هو الغدد
+
+26
+00:01:49,440 --> 00:01:52,940
+اللي موجود عندنا في الجسم بيمشي بررل أو with
+
+27
+00:01:52,940 --> 00:01:57,440
+together مع اللي هو الـNervous Systemتمام؟ هنا أنا
+
+28
+00:01:57,440 --> 00:02:03,700
+القصة إنه أنا بدي أعرف إنه أنا إذا الانسولين أو
+
+29
+00:02:03,700 --> 00:02:08,000
+مشكلة الديابيتات اللي هي في ارتباط نسبة السكر في
+
+30
+00:02:08,000 --> 00:02:13,420
+الدم هيحلها مشكلة معينة أو هيحلها إشي إنه أنا
+
+31
+00:02:13,420 --> 00:02:17,780
+الغدة التي تفرض hormone الانسولين بتكون لحظتها غير
+
+32
+00:02:17,780 --> 00:02:22,340
+قادرة على إفراز ما يكفي للجسممعناة الكلام أنه فيه
+
+33
+00:02:22,340 --> 00:02:26,140
+لازم يكون سيالة عصبية رايحة على ال brain وسيالة
+
+34
+00:02:26,140 --> 00:02:28,740
+عصبية راجعة عالية من ال brain إذا نرتبط ال
+
+35
+00:02:28,740 --> 00:02:33,020
+endocrine system مع ال nervous system بشكل مباشر
+
+36
+00:02:33,020 --> 00:02:36,520
+ال effect on most every cell organs and functional
+
+37
+00:02:36,520 --> 00:02:39,830
+of the bodyباتأثر للـ Endocrine System على كل
+
+38
+00:02:39,830 --> 00:02:43,610
+الجسم وعلى كل الوظائف اللي موجودة The endocrine
+
+39
+00:02:43,610 --> 00:02:47,550
+system is closely linked with nervous system حكينا
+
+40
+00:02:47,550 --> 00:02:52,250
+عليه هذا الموضوع إن هم بيكونوا مرتبطين بشكل مباشر
+
+41
+00:02:52,250 --> 00:02:55,390
+مع ال nervous system أيضًا مع ال immunity system
+
+42
+00:02:55,390 --> 00:02:59,930
+جهاز المنع اللي إحنا في ضل هاي الجائحة COVID-19
+
+43
+00:02:59,930 --> 00:03:03,850
+لازم أنه معزز ونقوي اللي هو ال immunity system
+
+44
+00:03:03,850 --> 00:03:08,860
+Negative feedback mechanismبيصير في عندنا مشكلة و
+
+45
+00:03:08,860 --> 00:03:12,340
+لخبطة بالهرمون اللي هي بتبني إفرازها عن طريق الـ
+
+46
+00:03:12,340 --> 00:03:15,460
+endocrine system طبعا ال chemical messenger اللي
+
+47
+00:03:15,460 --> 00:03:18,480
+جايالي من ال body و لقاش اننا specific target
+
+48
+00:03:18,480 --> 00:03:21,040
+cells في عندنا alpha cells و في عندنا beta cells
+
+49
+00:03:21,040 --> 00:03:24,340
+هاي كلها موجودة في البنكرياس و احنا كلنا بنعرف ان
+
+50
+00:03:24,340 --> 00:03:28,880
+البنكرياس هي الغضب المسئولة عن إنتاج و إفراز
+
+51
+00:03:28,880 --> 00:03:32,900
+الهرمون هلأ ال glands اللي انا بدى أحكي عليها
+
+52
+00:03:32,900 --> 00:03:38,860
+البنكرياس تقع خلف المعدةأيضًا، back of abdomen ورا
+
+53
+00:03:38,860 --> 00:03:43,380
+اللي هي البطن الهرمون اللي بتفرضه بيساعد في عملية
+
+54
+00:03:43,380 --> 00:03:48,040
+الـ Digestive في Exocrine وفي Endocrine Exo معناته
+
+55
+00:03:48,040 --> 00:03:53,320
+لبره، outside أما Endo لجوه معناته inside ال
+
+56
+00:03:53,320 --> 00:03:57,140
+Exocrine بينكريها Secretion of Digestive Enzyme
+
+57
+00:03:57,140 --> 00:04:01,860
+بيفرض الإنذيمات اللي مسؤولة عن عملية الهضبولكن الـ
+
+58
+00:04:01,860 --> 00:04:05,640
+Endocrine تعمل على إفراز الأنسلين والجليكوز which
+
+59
+00:04:05,640 --> 00:04:10,920
+is regulated للجليكوجين واللي هو مسؤول عن تنظيم
+
+60
+00:04:10,920 --> 00:04:16,060
+الجليكوز داخل الدم، إذا two parts أو جزئين أساسيا
+
+61
+00:04:16,060 --> 00:04:19,630
+بيشتغل فيهم البنكرياز، يا إن اكسوكرينيا إما
+
+62
+00:04:19,630 --> 00:04:23,850
+Endocrine إذا حكينا Exocrine معناة الكلام إن هو
+
+63
+00:04:23,850 --> 00:04:26,330
+بدي يشتغل على الإنزيمات اللي إلها علاقة بال
+
+64
+00:04:26,330 --> 00:04:29,850
+digestive system زي الببسين زي أي إشي بحاجة أما ال
+
+65
+00:04:29,850 --> 00:04:34,150
+Endocrine فهكية مسؤولة عن إفراز الأنسلين اللي هو
+
+66
+00:04:34,150 --> 00:04:38,770
+أو glycogen اللي مسؤول عن إفراز الجلوكوز أو تنظيم
+
+67
+00:04:38,770 --> 00:04:43,650
+S تنظيم اللي هو الجلوكوز levelفى الدب طبعا لحد
+
+68
+00:04:43,650 --> 00:04:46,390
+الآن الأمور ماشية معانا احنا لسه بنمشي
+
+69
+00:04:46,390 --> 00:04:51,970
+introduction بسيطة عن شو هو مرض السكرين الديابيتاس
+
+70
+00:04:51,970 --> 00:04:55,070
+هو عبارة عن مجموعة من ال metabolic diseases يعني
+
+71
+00:04:55,070 --> 00:05:00,350
+مجموعة من الأمراض التي تعني أو تخص اللى هى عمليات
+
+72
+00:05:00,350 --> 00:05:06,940
+ال ice يتصف بمادة hyperglycemia طبعا يا رابعة؟ما
+
+73
+00:05:06,940 --> 00:05:11,300
+حكيت hypo، ما حكيت hyper، الجليسيميا، اللي ناتجة
+
+74
+00:05:11,300 --> 00:05:14,520
+عن ال defect of insulin secretion، ناتجة عن ال
+
+75
+00:05:14,520 --> 00:05:18,240
+deficiency في إثراز الإنسولين اللي بتتم من ال
+
+76
+00:05:18,240 --> 00:05:22,400
+بنكريات، اللي أيضا بيكون في عامة deficiency أو
+
+77
+00:05:22,400 --> 00:05:26,730
+problems in insulin actionفي منه نوعين النوع الأول
+
+78
+00:05:26,730 --> 00:05:30,950
+اللي هو بسميه الـabsolutely deficiency insulin
+
+79
+00:05:30,950 --> 00:05:35,130
+secretion اللي هو auto-immuno disease تمام إنه
+
+80
+00:05:35,130 --> 00:05:39,070
+جهاز المناعة أو الخلايا المناعية اللي أنا موجودة
+
+81
+00:05:39,070 --> 00:05:43,570
+عندي في الجسم بتهاجم الخلايا اللي هي مسئولة في
+
+82
+00:05:43,570 --> 00:05:47,590
+البنكرياز عن إنتاج الإنسونات ولحد الآن العلماء
+
+83
+00:05:47,590 --> 00:05:51,890
+ماعرفوا شو السببأما type 2 اللي هو بيكون a
+
+84
+00:05:51,890 --> 00:05:56,770
+combination لمقاومة إنه بيصير في عندي عملية مقاومة
+
+85
+00:05:56,770 --> 00:06:00,410
+لعرل الأنسلينهنا بيصير في عندي in educate
+
+86
+00:06:00,410 --> 00:06:03,430
+compensatory insulin secretion فبالتالي بيفرز
+
+87
+00:06:03,430 --> 00:06:07,730
+الانسولين ولكن لا تكفي حاجة الجسم الانسولين هو
+
+88
+00:06:07,730 --> 00:06:12,770
+عبارة عن الهرمون اللي بيحول السكر او الشجر إلى
+
+89
+00:06:12,770 --> 00:06:16,230
+stretches extra into energy needed for daily life
+
+90
+00:06:16,230 --> 00:06:20,170
+بيحوله لإيشي من إيشي ضال إلى إيشي مفيد أنا أستفيد
+
+91
+00:06:20,170 --> 00:06:23,970
+منه في الجسم خليني أعمل سمراية لموضوع اللي هو
+
+92
+00:06:23,970 --> 00:06:28,480
+نوعين الانسول النوعين الديابيداtype 1 وtype 2 type
+
+93
+00:06:28,480 --> 00:06:33,720
+1 حكينا absolute deficiency فقدال أو فقر أو قلة أو
+
+94
+00:06:33,720 --> 00:06:37,440
+نقص في إفراز الأنسونين تمام حكينا autoimmune
+
+95
+00:06:37,440 --> 00:06:41,040
+disease أما type 2 فهو عبارة عن combination لل
+
+96
+00:06:41,040 --> 00:06:44,180
+resistance to insulin action and ineducate
+
+97
+00:06:44,180 --> 00:06:50,450
+compensatory نقصفي اللي هو إثران الانسولين و أيضا
+
+98
+00:06:50,450 --> 00:06:55,710
+عملية معاكسة أو عملية مقاومة لعمل الانسولين طبعا
+
+99
+00:06:55,710 --> 00:06:59,750
+هذا الاشي يكون ذاتي داخل الجسم ناتج عن أسباب كتيرة
+
+100
+00:06:59,750 --> 00:07:06,790
+هنعرفها الآن في ناس pre-diabetic تمام اللي هم
+
+101
+00:07:06,790 --> 00:07:11,560
+الناس هاي اللي لسهما صاروا بيابيتس ولكن كل
+
+102
+00:07:11,560 --> 00:07:17,980
+المؤشرات بتعطي دوق أحمر ان انت انتبه please ال
+
+103
+00:07:17,980 --> 00:07:23,600
+obesity ال high level sugar في الأكل ال stress ال
+
+104
+00:07:23,600 --> 00:07:27,500
+stationary daily life كل هذه الأمور بتكون مؤشر
+
+105
+00:07:27,500 --> 00:07:32,240
+ودوق أحمر لإن هذا الشخص يقع عندنا في حفرات اللي هم
+
+106
+00:07:32,240 --> 00:07:36,070
+مرضى السكر ل blood glucose levelare higher than
+
+107
+00:07:36,070 --> 00:07:38,930
+normal about not high enough to diagnose a
+
+108
+00:07:38,930 --> 00:07:42,650
+diabetes تمام okay السكري عندك و هعرف القيمة الآن
+
+109
+00:07:42,650 --> 00:07:48,950
+كام هو عالي ولكن مابيعطيني مؤشر كطبيب انه انا
+
+110
+00:07:48,950 --> 00:07:52,830
+اشخصه في خلال او من خلال ال medical file انه انت
+
+111
+00:07:52,830 --> 00:07:57,130
+diabetes diabetes patient لأ هيت مابيكون ان هذا
+
+112
+00:07:57,130 --> 00:08:00,310
+المريض تبعي انه اتشخص على انه مريض سكري no
+
+113
+00:08:00,310 --> 00:08:03,940
+symptoms ماعنده اي اعراضب treatment هنا سهلة جدا
+
+114
+00:08:03,940 --> 00:08:07,900
+باجي انا لهذه ال fit اللي إيجتني عمرها أقل من
+
+115
+00:08:07,900 --> 00:08:12,820
+الأربعين بتشكي من سمنة بتاكل حلو كتير ال life
+
+116
+00:08:12,820 --> 00:08:18,580
+تبعتها لإنهارها جاعدة مافي اي activities مافي اي
+
+117
+00:08:18,580 --> 00:08:22,320
+sports مافي اشي معناة الكلام ان انا بدي أشتغل على
+
+118
+00:08:22,320 --> 00:08:27,360
+ثلاث عوامل أساسية أول اشيالأكل الصحي تاني إشي ال
+
+119
+00:08:27,360 --> 00:08:32,000
+weight من 5 ل 10% من وزنها و ال exercise اللي هو
+
+120
+00:08:32,000 --> 00:08:36,860
+عن طريق الرياضة أنه أنا لأنه لسه هي جادة أنها تحمي
+
+121
+00:08:36,860 --> 00:08:40,540
+نفسها هذا الناس اللي بريه تيابة تسكت لو أنا عرفتهم
+
+122
+00:08:40,540 --> 00:08:45,240
+هم الناس اللي لسه ماوصلوا لحد معين من ال glucose
+
+123
+00:08:45,240 --> 00:08:50,360
+level أنه يخليني أشخصهم أنهم تيابة تسكت تمام؟الـ
+
+124
+00:08:50,360 --> 00:08:55,580
+Growing Problems حوالي المشكلة طبعا تتطور 7% من ال
+
+125
+00:08:55,580 --> 00:09:00,120
+population تبع ال US يابوتك و twice that many have
+
+126
+00:09:00,120 --> 00:09:04,420
+pre-diabetic و 2% حوالي عندنا الناس hybrid
+
+127
+00:09:04,420 --> 00:09:10,000
+-diabetic 21% فوق 60% وهذا إشي له علاقة بال aging
+
+128
+00:09:10,000 --> 00:09:14,110
+طبعا هنعرف من أنه نوع منهمالـ 45% من الـ new
+
+129
+00:09:14,110 --> 00:09:17,130
+diagnoses are behind made in children and
+
+130
+00:09:17,130 --> 00:09:20,830
+adolescents طبعا، وإشي خطير جدا لإن type 1 إلو
+
+131
+00:09:20,830 --> 00:09:25,290
+علاقة بالـ pediatrics والـ adolescents أما type 2
+
+132
+00:09:25,290 --> 00:09:30,830
+إلو علاقة بالناس اللي هم اللي فوق سن الأربعين risk
+
+133
+00:09:30,830 --> 00:09:34,450
+factor تبعتناه family history والله الأب والأم
+
+134
+00:09:34,450 --> 00:09:39,450
+والجد والجدة عندهمDM اللي هو اختصار للديابتس
+
+135
+00:09:39,450 --> 00:09:43,110
+مالديتس احتمال كبير يكون عند الأبناء ال
+
+136
+00:09:43,110 --> 00:09:47,070
+cardiovascular disease أمراض القلب حدث ولا حرج ال
+
+137
+00:09:47,070 --> 00:09:51,650
+obesity السمنة extraordinary lifestyle الحياة
+
+138
+00:09:51,650 --> 00:09:58,710
+الرفاهيةالست عايشة في البيت مرفوها، مافي أي نشاط
+
+139
+00:09:58,710 --> 00:10:02,870
+بتقوم عنه أو ما بتقوم فيه فبالتالي بتلاقي أنه هي
+
+140
+00:10:02,870 --> 00:10:06,790
+كل مالها، ما شاء الله عليها overweight وبيصير
+
+141
+00:10:06,790 --> 00:10:09,670
+زيادة في الانسليكي، بيصير في زيادة في الـglucose
+
+142
+00:10:09,670 --> 00:10:12,810
+level في الدم الـhistory of impaired fasting
+
+143
+00:10:12,810 --> 00:10:17,870
+glucose أو impaired glucose toleranceطبعا إذا كان
+
+144
+00:10:17,870 --> 00:10:21,470
+في عندهم في تاريخها العالى إنه لو حللت سكري و هي
+
+145
+00:10:21,470 --> 00:10:25,310
+صايم عندها أعلى من الـ Normal line اللي أنا هحكي
+
+146
+00:10:25,310 --> 00:10:30,610
+عليه هيكون الـ Hypertension مباشرة في الملف الطبي
+
+147
+00:10:30,610 --> 00:10:34,330
+و زي ما شوفته في التدريبات العملية إنه بتلاقوا إنه
+
+148
+00:10:34,330 --> 00:10:38,270
+إذا كان هذا مريض ضغط معناته هو بيكون مصاحب للسكر و
+
+149
+00:10:38,270 --> 00:10:44,210
+هي ليس قاعدةأساسية لأ بنحكي ممكن وفي احتمالية يعني
+
+150
+00:10:44,210 --> 00:10:48,390
+ممكن الناس تكون هي مريضة ضغط ولكن لا يوجد لديها
+
+151
+00:10:48,390 --> 00:10:52,950
+diabetes gestational diabetes اللي هو سكري الحامل
+
+152
+00:10:52,950 --> 00:10:58,350
+اليوم أنا حامل في اللي هو الأشهر الأولى بلاجئ انه
+
+153
+00:10:58,350 --> 00:11:02,490
+بعد اللي هو فحص السكري للحامل انه انت يا ست عندك
+
+154
+00:11:02,490 --> 00:11:06,990
+السكري مرتفع ولكن بعد الولادة مباشرة بيروح هذا
+
+155
+00:11:06,990 --> 00:11:12,820
+السكري فهو عرضيليس مستمر لكن انا بكون حاطة اللي هو
+
+156
+00:11:12,820 --> 00:11:18,820
+read marks انه ديري بالك انه انت pre-diabetic انه
+
+157
+00:11:18,820 --> 00:11:23,120
+انت في مؤشر او انت في ال risk area انه انت ديري
+
+158
+00:11:23,120 --> 00:11:27,060
+بالك .. ديري بالك انه ممكن لو اتكرر الاشي أو ممكن
+
+159
+00:11:27,060 --> 00:11:30,740
+لو ما اتبعت رزة معينة انه تصير انت diabetic
+
+160
+00:11:30,740 --> 00:11:36,880
+patient high risk factor تبع ال DM ال diagnosticفي
+
+161
+00:11:36,880 --> 00:11:40,340
+الآن عندي عشان انا اشخص انه انت مريض سكري او لا
+
+162
+00:11:40,340 --> 00:11:45,020
+بتعمل ال fasting plasma glucose مش لازم يكون اعلى
+
+163
+00:11:45,020 --> 00:11:51,680
+من 125 هذا ال line تبعناه اذا انا عملت التحليل
+
+164
+00:11:51,680 --> 00:11:58,060
+عشوائي مش لازم يكون اعلى من 200 اكتر من 200 معناته
+
+165
+00:11:58,060 --> 00:12:03,740
+انت مريض سكريفي عندنا ال OGTT اللي هو ال oral
+
+166
+00:12:03,740 --> 00:12:08,000
+glucose tolerance test هو ابرع عن test بتم اخرج
+
+167
+00:12:08,000 --> 00:12:12,860
+جلوكوز فيه orally تمام؟ اذا ال diagnostic طبعا
+
+168
+00:12:12,860 --> 00:12:16,060
+احنا كده دخلنا على التحليل بدي اعرف فيه تلاتة
+
+169
+00:12:16,060 --> 00:12:20,500
+تحليل أساسية ال FBG هذا بيكون موجود عندكم في رقم
+
+170
+00:12:20,500 --> 00:12:24,800
+التحليل مش لازم يكون أعلى من 125 وإلا هعده دايق
+
+171
+00:12:24,800 --> 00:12:30,270
+بالتكلفة ال randomتحليل عشوائي، إذا كان أعلى من
+
+172
+00:12:30,270 --> 00:12:33,730
+200، معناته أنا بخاف من هذه الإشكال، إيه المشكلة،
+
+173
+00:12:33,730 --> 00:12:38,870
+تمام؟ و الـ Oral بتاعك، خليني أبدأ في أنواع اللي
+
+174
+00:12:38,870 --> 00:12:42,170
+هو الـ Diameters، في عندي type 1 و في عندي type 2
+
+175
+00:12:42,580 --> 00:12:46,840
+type 1 اللي هو ال beta cell بيصير فيه destroyed by
+
+176
+00:12:46,840 --> 00:12:51,080
+autoimmune process زي ما حكينا في البداية انه
+
+177
+00:12:51,080 --> 00:12:55,360
+autoimmune disease الجسم بيهاجم نفسه بنفسه صار في
+
+178
+00:12:55,360 --> 00:12:59,240
+عندي مهاجمة لخلايا beta cell اللي هي مسئولة عن
+
+179
+00:12:59,240 --> 00:13:04,400
+إفراز الأنسلين في البنكنياز معناة الكلام انه ما
+
+180
+00:13:04,400 --> 00:13:08,760
+بيصير في عندي استجابة أو إنتاج للأنسلين بيصيب
+
+181
+00:13:08,760 --> 00:13:13,770
+للأطفال وال young adultالناس اللي عندها استعداد
+
+182
+00:13:13,770 --> 00:13:19,690
+ويراثي لإن أبوه إيجاز سكري على عمر 14 سنة احتمالية
+
+183
+00:13:19,690 --> 00:13:24,010
+إنه يجي الإبن كذلك احتمالية عالية جدا وزي ما حكينا
+
+184
+00:13:24,010 --> 00:13:26,990
+من ال characteristics تبعته إنه autoimmune disease
+
+185
+00:13:26,990 --> 00:13:33,170
+مرض مناعي و الخلايا أو الجسم بيهاجم نفسه بنفسه
+
+186
+00:13:33,170 --> 00:13:38,810
+وحكينا لحد الآن مش معروف السبب type 1 diabetes
+
+187
+00:13:38,810 --> 00:13:43,470
+كانتالـ Symptoms اللي هي continue الـ Symptoms
+
+188
+00:13:43,470 --> 00:13:47,890
+سبعته Increased blood pressure عطش Frequent
+
+189
+00:13:47,890 --> 00:13:53,230
+urination ال weight تبعه losses دائما جائع سرعان
+
+190
+00:13:53,230 --> 00:13:58,950
+ما بيتعب الزغللة تشويش بالرؤية كل هذه الأمور بيكون
+
+191
+00:13:58,950 --> 00:14:03,150
+على سبيل المثال عند طفل مثلا على سبيل المثال عنده
+
+192
+00:14:03,150 --> 00:14:07,750
+عشر سنواتهنا أنا لازم في العلاج أو دكتور الباطنة
+
+193
+00:14:07,750 --> 00:14:11,350
+اللي موجود عندنا هيوصف له insulin injection لأن هو
+
+194
+00:14:11,350 --> 00:14:14,370
+من النوع الأول ال insulin injection يعني اللي هي
+
+195
+00:14:14,370 --> 00:14:17,550
+إيبر الأنسولين اللي أنا بشوفها مع المرضى تبعي
+
+196
+00:14:17,550 --> 00:14:21,730
+عندنا no oral medication هنا مافي عندى اللي هي
+
+197
+00:14:21,730 --> 00:14:27,490
+أدوية تتاخد orally تمام؟ هذا بالنسبة ل type 1 type
+
+198
+00:14:27,490 --> 00:14:32,350
+2 هو اللي هو على الأقل 90% من العالم عندهم ديابتة
+
+199
+00:14:32,350 --> 00:14:38,510
+سمنةبيصير في قلة في إنتاج الانسولين اللي موجود and
+
+200
+00:14:38,510 --> 00:14:43,570
+decrease the sensitivity to insulin وقلة في مدى
+
+201
+00:14:43,570 --> 00:14:50,810
+الاستجابة لحساسية الانسولين على الأغلب هو وراثي ال
+
+202
+00:14:50,810 --> 00:14:55,290
+obesity و ال overweight major factors و ال most
+
+203
+00:14:55,290 --> 00:14:59,530
+common أنه شائع و على الأغلب بيجي للأشخاص البالغين
+
+204
+00:14:59,530 --> 00:15:06,370
+هذا النوع التانيالنوع التاني شو أعراضه وشو العلاج
+
+205
+00:15:06,370 --> 00:15:11,030
+تبعه نفس أعراض النوع الأولمع ده انه فيه headache
+
+206
+00:15:11,030 --> 00:15:15,530
+slow healing لـ cuts or sores لو على سبيل المثال
+
+207
+00:15:15,530 --> 00:15:19,850
+هيستدت و هي بالمطبخ ان جرحت إيدها جرح صغير بيطول
+
+208
+00:15:19,850 --> 00:15:23,790
+لما يلتقم ليه؟ لإن ال white blood cells اللي
+
+209
+00:15:23,790 --> 00:15:28,270
+موجودة عندها ما هي جادة تعملي healing لمكان الجروح
+
+210
+00:15:28,270 --> 00:15:31,890
+ال frequent yeast infection بيكونوا هدول الناس
+
+211
+00:15:31,890 --> 00:15:37,260
+أكتر عرضة لالاتهابات الفطرية و الخمائرأيضا بيصير
+
+212
+00:15:37,260 --> 00:15:42,320
+في عندهم حكة بنلاقي هاي الناس على سبيل المثال في
+
+213
+00:15:42,320 --> 00:15:47,340
+bleeding لبعض الأطراف نتيجة اللي هو الحكة، أيضا في
+
+214
+00:15:47,340 --> 00:15:51,890
+عندهم non-bansاللي هو خذلان و تنميل للإيدين
+
+215
+00:15:51,890 --> 00:15:55,610
+والإجرين أحيانا ممكن أنا بين قصين أربطه على المدى
+
+216
+00:15:55,610 --> 00:15:58,630
+اللي بعيد إنه يصير في عندي حاجة اسمها bullying
+
+217
+00:15:58,630 --> 00:16:02,890
+neuropathy إنه أنا دخلت في الأعصاب وصار في عندي
+
+218
+00:16:02,890 --> 00:16:06,590
+مشكلة في الأعصاب بنلاقي فيه صار عندهم darkens اللي
+
+219
+00:16:06,590 --> 00:16:13,110
+هو اغمقاق أو تعتيم للجلد اللي موجود في الرقبة في
+
+220
+00:16:13,110 --> 00:16:18,570
+الإبقفي اللي هو منطقة الـ Grind طبعاً هذا مؤشر
+
+221
+00:16:18,570 --> 00:16:23,030
+يعني تقريبا بعض المرضى كنت أشوفهم من الرقبة تبع
+
+222
+00:16:23,030 --> 00:16:26,630
+الست اللي نلاقي أنه هي بتكون dark فبالتالي أنا هنا
+
+223
+00:16:26,630 --> 00:16:30,870
+بحكيلها معلش هي بتكون لسه مش دارية عن حالها أنه لو
+
+224
+00:16:30,870 --> 00:16:35,890
+سمحت بس اعمليلي تحليل كذا أو سويلي تحليل كذا أنه
+
+225
+00:16:35,890 --> 00:16:39,890
+أنا مش مخولة أنه انا أحكي أنه خلينا نحلل ولكن
+
+226
+00:16:39,890 --> 00:16:44,340
+كنصيحة أنا ممكن أعطيها إياها ففعلا بتلاقياللي هو
+
+227
+00:16:44,340 --> 00:16:49,340
+high blood glucose level في التحليل العلاج تبعه
+
+228
+00:16:49,340 --> 00:16:53,100
+بيكون الـ oral medication بيستخد اللي هو oral
+
+229
+00:16:53,100 --> 00:16:59,600
+medication لتنظيم عملية اللي هي الـ الـ الـ الهضم،
+
+230
+00:16:59,600 --> 00:17:04,060
+تنظيم عملية اللي هو زي الـ Gelofax أو الأدوية اللي
+
+231
+00:17:04,060 --> 00:17:07,620
+بتكون موجودة مع مرضاء سكري الأنسولين shots may
+
+232
+00:17:07,620 --> 00:17:11,410
+have to be prescribedexercise كمان ال exercise
+
+233
+00:17:11,410 --> 00:17:17,350
+مهمة لمريض السكري من ديابتك two type two و ال
+
+234
+00:17:17,350 --> 00:17:22,510
+weight losses كمان او فقدان الوزن كمان اشي مهم جدا
+
+235
+00:17:22,510 --> 00:17:28,070
+الان الست الحامل اللى حكينا عليها قبل شوية هاي بدى
+
+236
+00:17:28,070 --> 00:17:32,650
+يصير في عندها سكري حامل البلسنتا هنا قادرة على
+
+237
+00:17:32,650 --> 00:17:38,090
+انها تغير او ان هي تنتج ال hormones اللى بيعيق
+
+238
+00:17:38,500 --> 00:17:42,920
+الأنسولين okay when البلد سنتا produced hormones
+
+239
+00:17:42,920 --> 00:17:47,220
+which impair action of أنسولين in tissue when
+
+240
+00:17:47,220 --> 00:17:51,280
+blood sugar level rise too high it can affect the
+
+241
+00:17:51,280 --> 00:17:54,520
+growth and development لال baby عشان هيك بتلاقي ان
+
+242
+00:17:54,520 --> 00:17:59,560
+هو الطفل الصغير لما انولد جانى 6 كيلو اه والله امه
+
+243
+00:17:59,560 --> 00:18:02,980
+ما شاء الله عليها مهتمة فيه كانت اتغذى و هي حامل
+
+244
+00:18:02,980 --> 00:18:09,620
+هي بتكون سكري بالاصلفبالتالي أثرت على الـ growth و
+
+245
+00:18:09,620 --> 00:18:13,840
+ال weight تبع ال baby no noticeable signs or
+
+246
+00:18:13,840 --> 00:18:17,240
+symptoms but may cause increased stress and
+
+247
+00:18:17,240 --> 00:18:21,060
+urination بتلاقي حالها مافي اي symptoms ظاهرة زي
+
+248
+00:18:21,060 --> 00:18:26,530
+ما شوفنا فيهD1 وD2 ولكن على الأغلب هي بتكون دائما
+
+249
+00:18:26,530 --> 00:18:31,330
+تشعر بالعطش الشديد بال urination والدكتور will
+
+250
+00:18:31,330 --> 00:18:34,590
+address it لأنه لازم تظل متابعة مع الدكتور تبعها
+
+251
+00:18:34,590 --> 00:18:39,310
+ايضا لبعد الولادة تمام كل شي بيصير و بيرجع لل
+
+252
+00:18:39,310 --> 00:18:43,490
+glucose level او بيرجع لهو السكري لوضعه الطبيعي
+
+253
+00:18:43,490 --> 00:18:49,390
+ولكن احنا بنبحها ان انت لازم تظل متابعة ومستمرة مع
+
+254
+00:18:49,390 --> 00:18:54,510
+الدكتور لانهفي مجال ان انت ترجعلك ان هي المشكلة من
+
+255
+00:18:54,510 --> 00:19:01,550
+اول و جديد ايضا ال treatment حاكينا بال exercise و
+
+256
+00:19:01,550 --> 00:19:05,490
+ال diet و ال medication بعض الأحيان بنضطر لانه او
+
+257
+00:19:05,490 --> 00:19:09,190
+بتضطر الدكتور انه يعطيها ال insulin injection و ال
+
+258
+00:19:09,190 --> 00:19:12,370
+oral ال blood glucose او ال blood sugar monitoring
+
+259
+00:19:12,370 --> 00:19:17,230
+4 على 5 times daily لانه مهم جدا زي ما انا بخاف من
+
+260
+00:19:17,230 --> 00:19:21,290
+ال hyperglycemiaكمان بخاف من الـ hypoglycemia
+
+261
+00:19:21,290 --> 00:19:28,310
+تمام؟ draw blood from tip of fingers هذا اللي هو
+
+262
+00:19:28,310 --> 00:19:32,790
+ال blood sugar monitoring و ال place on test strap
+
+263
+00:19:32,790 --> 00:19:37,350
+put under glucose مثلا هنا بدنا نحكي على ال drawel
+
+264
+00:19:37,350 --> 00:19:42,650
+تبع ال blood بدي يكون من طرف الإصبعو place on test
+
+265
+00:19:42,650 --> 00:19:46,890
+طبعا بتحطيه على استرابة و على شريطة يعني اللي هنا
+
+266
+00:19:46,890 --> 00:19:52,170
+العملية هي خاصة بالتحاليل احنا بس نتعلمها لإنه بعض
+
+267
+00:19:52,170 --> 00:19:57,570
+الأهالي او بعض أمياتكم عندهم الأجهزة اللي هي خاصة
+
+268
+00:19:57,570 --> 00:20:00,470
+فيهم موجودة في البيت تسحب انتي العينة من طرف
+
+269
+00:20:00,470 --> 00:20:04,330
+الإصبع و بتحطيها على شريط اللاصق و بعدين بتعملي ..
+
+270
+00:20:04,330 --> 00:20:09,790
+بتحوتيها على الجهاز ال ungrantologic consideration
+
+271
+00:20:10,530 --> 00:20:14,250
+اللي هو علم الشيخوخة elevated of blood glucose
+
+272
+00:20:14,250 --> 00:20:18,710
+level are also age related لها علاقة بالعمر ال
+
+273
+00:20:18,710 --> 00:20:22,410
+increasing with advancing age اشي طبيعي اليوم
+
+274
+00:20:22,410 --> 00:20:25,430
+الأنسلين أسفل بينكرياس لما بدي يشتغل في عمر
+
+275
+00:20:25,430 --> 00:20:29,150
+العشرين سنة مش نفسه لما هيشتغل في عمر التمانين لأ
+
+276
+00:20:29,150 --> 00:20:32,650
+ال capacity تبعته أو القدرة تبعته ما بتعطي نفس
+
+277
+00:20:32,650 --> 00:20:36,270
+الإنتاج اللي كان فبالتالي انه بيسببلي increase ل
+
+278
+00:20:36,270 --> 00:20:39,380
+ال fatity shockdecrease للإنسلين production ال
+
+279
+00:20:39,380 --> 00:20:42,860
+physical inactivity كمان مهم جدا احنا بمجرد نصير
+
+280
+00:20:42,860 --> 00:20:47,200
+بالستين خلاص على الله السلام decrease لل lean of
+
+281
+00:20:47,200 --> 00:20:50,920
+body mass كمان اللي هو الكتلة العضلية تبعتنا و
+
+282
+00:20:50,920 --> 00:20:54,820
+بتصير الست مشاء الله عليها overweight فبالتالي هذا
+
+283
+00:20:54,820 --> 00:21:03,180
+بيقدر إلى وجول السكري عند المسنين كيف بدي اعمل فحص
+
+284
+00:21:03,180 --> 00:21:07,260
+او كيف بدي اراقب ال gelocose levelال patient on
+
+285
+00:21:07,260 --> 00:21:11,420
+insulin should check sugar two or five times per
+
+286
+00:21:11,420 --> 00:21:15,400
+day لازم تشيك على حالها هاي ست من مرتين لاربع مرات
+
+287
+00:21:15,400 --> 00:21:19,340
+في اليوم not on insulin two or three times بيرويك
+
+288
+00:21:19,340 --> 00:21:23,120
+according to text الناس اللي هي مش معتمدة على
+
+289
+00:21:23,120 --> 00:21:25,920
+الانسولين أما الناس اللي معتمدة على الانسولين لازم
+
+290
+00:21:25,920 --> 00:21:30,020
+يكون مرتين لتلاتةخلال اليوم ولكن خلال الإسبوع
+
+291
+00:21:30,020 --> 00:21:33,100
+للناس اللى مش معتمدة على أنسولين should check
+
+292
+00:21:33,100 --> 00:21:37,160
+before meals and two hours after meals إشي بدى
+
+293
+00:21:37,160 --> 00:21:41,400
+يكون قبل الوجبات طبعا لإن ال fasting بدى يكون وإشي
+
+294
+00:21:41,400 --> 00:21:44,720
+بعد الوجبة ساعتين عشان أنا أخد ال parameter صحيح
+
+295
+00:21:44,720 --> 00:21:48,100
+ال parameter from physician is very important إن
+
+296
+00:21:48,100 --> 00:21:52,020
+هو أنا أخد القياسات الصحيحة عشان كمان الدكتور يتبع
+
+297
+00:21:52,020 --> 00:21:58,190
+معايا في الموضوعماهي ال complicated اللى ممكن تصير
+
+298
+00:21:58,190 --> 00:22:01,470
+عندك؟ في عندي acute complicated و في عندي chronic
+
+299
+00:22:01,470 --> 00:22:05,710
+complicated hypoglycemia اللى هو انخفاض مستوى
+
+300
+00:22:05,710 --> 00:22:14,370
+السكر عن 70% عن 70 milligram لكل DCL طبعا يعني إذا
+
+301
+00:22:14,370 --> 00:22:18,850
+عالى 125 هذا بعتبره hyperglycemia ولكن أنا اللى
+
+302
+00:22:18,850 --> 00:22:24,410
+بدى أحكي hypoglycemia بدي أقل عن 70 ممكن يصير عندي
+
+303
+00:22:24,410 --> 00:22:30,860
+من ال complicatedKetoacidosis بختصرها بالـ DKA هو
+
+304
+00:22:30,860 --> 00:22:35,020
+عبارة عن الحمض الكيتواني السكري إنه بيتم التشخيص
+
+305
+00:22:35,020 --> 00:22:39,120
+للإصابة بمراد السكر من النوع الأول ومعالجته وممكن
+
+306
+00:22:39,120 --> 00:22:42,860
+المريض في هذه اللحظة يفوت لي في غيبوبة قد يوفقته
+
+307
+00:22:42,860 --> 00:22:47,630
+إذا ما تم معالجتهالـ non-keytic اللي هو او hyper
+
+308
+00:22:47,630 --> 00:22:52,410
+-smaller ديابت الكومة انه طبعا ممكن يكون اللي هو
+
+309
+00:22:52,410 --> 00:22:56,850
+مادة علاج وبعد الكومة ممكن يدخل في حالة وفاة او
+
+310
+00:22:56,850 --> 00:23:00,890
+موت سريري ال chronic complication على المدى البعيد
+
+311
+00:23:00,890 --> 00:23:05,090
+يا اما بدها تكون على صعيد ال micro او ال macro
+
+312
+00:23:05,090 --> 00:23:09,430
+طالما حكيت انا micro معناته ان ال issue صغير
+
+313
+00:23:09,430 --> 00:23:15,310
+neuropathy retinopathy and nephropathyالنيروباتي
+
+314
+00:23:15,310 --> 00:23:20,190
+أنا كنت ذكرتها سابقا هي عبارة عن انتهاب أو خلل
+
+315
+00:23:20,190 --> 00:23:25,450
+وعلّة الأطراف اللي ناتجة عن المرض السكري من الرتنة
+
+316
+00:23:25,450 --> 00:23:29,830
+أو الشبكية بيصير في عندنا مشكلة في الإبصار و
+
+317
+00:23:29,830 --> 00:23:33,870
+الرؤية نفرو إلها علاقة بال kidney معناه الكلام في
+
+318
+00:23:33,870 --> 00:23:38,030
+عندنا مشاكل فارث وضائف الكلة أنا هنا بحكي على صعيد
+
+319
+00:23:38,030 --> 00:23:42,850
+ال micro أما إذا حكينا على صعيد ال macroفهي بدأت
+
+320
+00:23:42,850 --> 00:23:48,430
+تكون على CVA على إش عظم macro إذا ان هي large
+
+321
+00:23:48,430 --> 00:23:53,490
+معناة الكلام أنه هحكي على stroke فإذا لاحظنا أو
+
+322
+00:23:53,490 --> 00:23:57,590
+إذا دخلت قسم الباطن أثناء التدريب العملي فلان ملفه
+
+323
+00:23:57,590 --> 00:24:02,070
+بيحكي أنه مريض أو stroke patient الكل high blood
+
+324
+00:24:02,070 --> 00:24:06,950
+glucose level أوDiabetes او hypertension معناته هو
+
+325
+00:24:06,950 --> 00:24:14,490
+اشي اساسي موجود انديلا اللي هو مرض او دخول في جلطة
+
+326
+00:24:14,490 --> 00:24:18,650
+دماغية تمام؟ اذا ال complication في عندنا acute في
+
+327
+00:24:18,650 --> 00:24:24,870
+عندنا chronic ايضا من المشاكل وهي شائعة جدا ال
+
+328
+00:24:24,870 --> 00:24:29,870
+foot and leg problems حدث ولا حرج مانيقا غزة بهذا
+
+329
+00:24:29,870 --> 00:24:34,020
+الكلام sensory lossesPseudomotor neuropathy lead
+
+330
+00:24:34,020 --> 00:24:38,140
+to dry and cracking feet Pseudomotor neuropathy
+
+331
+00:24:38,140 --> 00:24:40,720
+رجعنا لكلمة neuropathy اللي لها علاقة
+
+332
+00:24:40,720 --> 00:24:46,120
+بالنيورولوجيا أيضا المريض نفسه بيكون في عنده مشكلة
+
+333
+00:24:46,120 --> 00:24:49,740
+بال skin الناتج عن ال high blood glucose level
+
+334
+00:24:49,740 --> 00:24:54,500
+وحكينا أو أنه أنا سابقا كنت أحكيها ممكن تنحرق أجر
+
+335
+00:24:54,500 --> 00:24:59,000
+المريض و هو مش حاسس فيها ليه؟ لأن عدم الإحساس loss
+
+336
+00:24:59,000 --> 00:25:05,970
+of sensory تمام؟ايضا اللى هى الـ PAD اللى هى stop
+
+337
+00:25:05,970 --> 00:25:10,510
+war wound healingpoor wound healing ليه؟ لإن مافي
+
+338
+00:25:10,510 --> 00:25:15,090
+عندي good circulation إنها تعمل ال wound healing
+
+339
+00:25:15,090 --> 00:25:20,010
+بتوصل لمرحلة الغرينة معناه الكلام أنا في قسم
+
+340
+00:25:20,010 --> 00:25:23,670
+الباطنة، هيصير في عندي amputation ال amputation
+
+341
+00:25:23,670 --> 00:25:27,950
+معناته cutting لللمس، إذا هذا من ال complicated
+
+342
+00:25:27,950 --> 00:25:32,070
+اللي صارت نتيجة اللي هي diabetes lowered
+
+343
+00:25:32,070 --> 00:25:37,690
+resistance to infectionتعوبة المقاومة لأي التهاب
+
+344
+00:25:37,690 --> 00:25:43,950
+عندهم على سبيل المثال في عندها عدوى إيجدها لهذه
+
+345
+00:25:43,950 --> 00:25:48,710
+الست صعب أن يحصل في مقاومة أو اللي هي تشتغل ال
+
+346
+00:25:48,710 --> 00:25:52,110
+white blood cells ليه؟ لأن ال circulation ضعيفة
+
+347
+00:25:52,110 --> 00:25:55,110
+بتكون فبالتالي ال white blood cells ما بتوصل
+
+348
+00:25:55,110 --> 00:26:02,110
+للمكان بشكل مباشر وسريع في تأخير في بطء في عملية
+
+349
+00:26:02,110 --> 00:26:07,730
+ال wound healingالان ال management لل foot and leg
+
+350
+00:26:07,730 --> 00:26:12,530
+problems كتير حكات الموضوع شائك ومهم جدا بالنسبة
+
+351
+00:26:12,530 --> 00:26:16,110
+لنا ك physiotherapist teaching لل patient كيف انا
+
+352
+00:26:16,110 --> 00:26:20,970
+ممكن احل المشكلة انه اعلمه كيف يرتدي الحذاء دائما
+
+353
+00:26:20,970 --> 00:26:26,750
+يكون معاه مرقا لفحص اللي هي ال foot من تحت انه
+
+354
+00:26:26,750 --> 00:26:31,770
+يشوف الأطراف او ال tools اللي موجودة فيها wound or
+
+355
+00:26:31,770 --> 00:26:36,160
+notExamine للـ feet every time he goes to the
+
+356
+00:26:36,160 --> 00:26:40,360
+doctor دائما يعمل examination وفحص لإجرين C
+
+357
+00:26:40,360 --> 00:26:44,000
+للبيدياترست أو ال podiatrist اللي هو طبيب الأقدام
+
+358
+00:26:44,000 --> 00:26:48,220
+أو الأرجل على الأقل annually بدي يكون Close لل two
+
+359
+00:26:48,220 --> 00:26:54,600
+shoes إن هو بدي يكون في عنده .. دائما يكون يلبس
+
+360
+00:26:54,600 --> 00:26:59,250
+الأحذية المغلقة من الأماممش صح تكون الأحذية مفتوحة
+
+361
+00:26:59,250 --> 00:27:05,010
+و ال trauma ممكن توصل لأي أجر trimig toenails قص
+
+362
+00:27:05,010 --> 00:27:09,010
+الأضافر مهم جدا ليه؟ لأنه ممكن لو لا سمح الله
+
+363
+00:27:09,010 --> 00:27:13,010
+الإدفار لو ما انقص بشكل جيد أنه يتسبب في infection
+
+364
+00:27:13,010 --> 00:27:17,970
+و بعدين من جروح صغير أدخل أنا في عملية amputation
+
+365
+00:27:17,970 --> 00:27:23,010
+good food hygiene الهياجين مهم جدا و خصوصا بين
+
+366
+00:27:23,010 --> 00:27:27,310
+الأصابع في القدم اللي موجودةالـ glycemic control
+
+367
+00:27:27,310 --> 00:27:31,110
+is the key to preventing complications أحافظ على
+
+368
+00:27:31,110 --> 00:27:35,790
+مستوى السكري في الدم هو أهم موضوع في كل المشكلة
+
+369
+00:27:35,790 --> 00:27:38,990
+جداش أنا محافظة على السكري تبعي جداش أنا في ال
+
+370
+00:27:38,990 --> 00:27:42,490
+safe side شو ال recommended في ال clinic؟ ال
+
+371
+00:27:42,490 --> 00:27:47,630
+fasting glucose level فحص السكر صحيح ال oral
+
+372
+00:27:47,630 --> 00:27:52,650
+glucose tolerance testing using اللي هو 75 جرام لل
+
+373
+00:27:52,650 --> 00:27:55,290
+glycogen
+
+374
+00:27:56,070 --> 00:28:03,310
+fasting glucose في المية 125 زي ما حكينا باعتبره
+
+375
+00:28:03,310 --> 00:28:10,170
+pre-diabetes ال fasting level اقل او اكبر من 126
+
+376
+00:28:10,170 --> 00:28:14,830
+is diagnostic اذا كان على سبيل المثال حللت وانا
+
+377
+00:28:14,830 --> 00:28:19,690
+صايمة اليوم الصبح وطلع عندى 140 على طول بتم تشخيص
+
+378
+00:28:19,690 --> 00:28:25,970
+ديابته ال oralاللي هو glucose tolerance test 200
+
+379
+00:28:25,970 --> 00:28:30,750
+ال diagnostic معناته أكبر من 200 معناته اللي هو
+
+380
+00:28:30,750 --> 00:28:35,810
+بتتشخص على أني ضيابيكاس تمام؟ هاي مهمة جدا ل slide
+
+381
+00:28:35,810 --> 00:28:42,090
+لكم في المساء ومهمة أيضا في حياتكم العمليةshow
+
+382
+00:28:42,090 --> 00:28:47,130
+reducing risk ال wet reduction خفف وزن ال exercise
+
+383
+00:28:47,130 --> 00:28:50,930
+على الأقل بدي 150 دقيقة خلال الأسبوع ال
+
+384
+00:28:50,930 --> 00:28:55,530
+comprehensive او اللي هو انه اعمل diet مناسب و
+
+385
+00:28:55,530 --> 00:29:00,450
+اللي هو حمية غذائية جيدة ال education اتعلم كيف
+
+386
+00:29:00,450 --> 00:29:04,190
+انا احافظ على الأطراف اتعلم كيف احافظ على انه
+
+387
+00:29:04,190 --> 00:29:08,910
+مايصير في عندي اي wound اي trauma لل body تبعي
+
+388
+00:29:10,210 --> 00:29:13,390
+controlling لل body أو لل blood sugar ال
+
+389
+00:29:13,390 --> 00:29:17,970
+homoglobin A1 اللى هو بدى يكون less than or equal
+
+390
+00:29:17,970 --> 00:29:28,670
+من 6.5% الفاستنج بلازمة طبعا قل من 110 فحص السكر
+
+391
+00:29:28,670 --> 00:29:34,250
+سايم two hourبص برن دي الشجارز 140 comprehensive
+
+392
+00:29:34,250 --> 00:29:38,670
+education لازم يكون في عنده معلومات ويكون في عنده
+
+393
+00:29:38,670 --> 00:29:43,530
+إرشادات و تعليمات جادر هو يستخدمهم أو جادر يتبعهم
+
+394
+00:29:43,530 --> 00:29:48,470
+ال management لمريض السكري nitrogen exercise
+
+395
+00:29:48,470 --> 00:29:53,670
+monitoring pharmacology and education خمس محاور
+
+396
+00:29:53,670 --> 00:29:57,690
+هتكلمنا فيهم وبإذن الله تعالى هنتكلم كمان مرة في
+
+397
+00:29:57,690 --> 00:30:03,810
+أشياءاخرى تخص مريض السكر زى ما انتوا شايفين ال
+
+398
+00:30:03,810 --> 00:30:07,530
+nutrition ال medication عن طريق ال pharmacology و
+
+399
+00:30:07,530 --> 00:30:16,350
+ال exercise و ال education مهمة جدا تمام الدياتري
+
+400
+00:30:16,350 --> 00:30:23,990
+management ال carbohydrate رز خبز مكارونة كل هذه
+
+401
+00:30:23,990 --> 00:30:31,010
+الأمور أقل منهاالبروتين 15-20% كالوريز أخدت طبعا
+
+402
+00:30:31,010 --> 00:30:35,150
+مادة اللي هي exercise physiology كتير مهم أنه أنا
+
+403
+00:30:35,150 --> 00:30:40,270
+هنا أتبع فيها تعليمات ال fats أقل من 30% من ال
+
+404
+00:30:40,270 --> 00:30:42,270
+calories أو إجمال ال calories اللي أنا في اليوم
+
+405
+00:30:42,270 --> 00:30:46,670
+بتكونها وخصوصا ال saturated ال fibers مهم جدا أن
+
+406
+00:30:46,670 --> 00:30:51,150
+أنا أكل منهاالـ Ligaments اللي هي البقليات القابلة
+
+407
+00:30:51,150 --> 00:30:56,390
+للذوبان والدورة و لل fruits و كل الأمور زي هذه
+
+408
+00:30:56,390 --> 00:31:01,610
+لشعير أفضل من اللي هو الخبز الأصمر و الخبز الأصمر
+
+409
+00:31:01,610 --> 00:31:05,590
+أفضل من الخبز الأبيض و لو أن حديثا أنا قرأت أن
+
+410
+00:31:05,590 --> 00:31:09,770
+كلاهما نفس ال calories ما بين الخبز الأصمر و الخبز
+
+411
+00:31:09,770 --> 00:31:13,680
+الأبيضإلا إنه احنا بعض الأحيان يعني ممكن نكون نضحك
+
+412
+00:31:13,680 --> 00:31:17,400
+على حالنا إنه أنا باكل خبز أسمر عشان أنا سكري، لأ
+
+413
+00:31:17,400 --> 00:31:22,100
+كتير هي بسمعها الكلمة فهي للأمانة أنا حديثا قرأتها
+
+414
+00:31:22,100 --> 00:31:26,780
+إنه هو لا علاقة للون الخبز بال calories إلا اللي
+
+415
+00:31:26,780 --> 00:31:33,830
+هو خبز الشعير الأفضل لمرضاء السكري، تمام؟الـ
+
+416
+00:31:33,830 --> 00:31:36,690
+Consisting will balance small meals several times
+
+417
+00:31:36,690 --> 00:31:41,410
+per day طبعا إشي مهم جدا إنه أنا أوزع الواجبة خلال
+
+418
+00:31:41,410 --> 00:31:46,710
+اليوم مش من الصح إنه أنا أقعد على الواجبة وما أخد
+
+419
+00:31:46,710 --> 00:31:51,310
+بالي إيش أنا أكلت ال exchange system or continuing
+
+420
+00:31:51,310 --> 00:31:55,350
+carbohydrates نغير من وضعنا ومن حياتنا وال system
+
+421
+00:31:55,350 --> 00:31:58,370
+اللي إحنا عايشين فيه وخصوصا الاعتماد بشكل كامل على
+
+422
+00:31:58,370 --> 00:32:02,150
+ال carbohydratesشو ال teaching plan؟ ال education
+
+423
+00:32:02,150 --> 00:32:08,290
+is critical مهم جدا simple pathophysiology مهم جدا
+
+424
+00:32:08,290 --> 00:32:12,190
+ان انا اعرف ال pathophysiology او قليل المرض عشان
+
+425
+00:32:12,190 --> 00:32:16,660
+انا اقدر احط حط لنفسي ال treatment modulatedإيش
+
+426
+00:32:16,660 --> 00:32:20,380
+بدي أخد في العلاج؟ هل أنا اليوم بس هاخد اللي هي ال
+
+427
+00:32:20,380 --> 00:32:23,540
+oral medication و لا بعد شوية هفشل في ال oral
+
+428
+00:32:23,540 --> 00:32:26,860
+medication و يحولني الدكتور ل insulin injection؟
+
+429
+00:32:26,860 --> 00:32:29,220
+لأ لازم أكون عارفة إيش ال modalities اللي أنا
+
+430
+00:32:29,220 --> 00:32:32,620
+رايحة عليها ال recognition and treatment to
+
+431
+00:32:32,620 --> 00:32:35,500
+prevention لل acute complications لازم يكون عندي
+
+432
+00:32:35,500 --> 00:32:39,060
+مدى الإدراك عالي جدا لعملية ال prevention لعملية
+
+433
+00:32:39,060 --> 00:32:43,420
+إنه أنا أوقي نفسي من أي مشكلة ممكن تكون عواقبها
+
+434
+00:32:43,420 --> 00:32:47,560
+وخيمة على سبيل المثال amputationwhen to call the
+
+435
+00:32:47,560 --> 00:32:52,120
+doctor طبعا لما بحتاج الأمر لازم أذهب للدكتور وما
+
+436
+00:32:52,120 --> 00:32:57,140
+أتوانى عن هاي المشكلة ال food care و ال eye care
+
+437
+00:32:57,140 --> 00:33:00,620
+مهم جدا لإن الزغلال بالعينين و التشويش بالرؤية
+
+438
+00:33:00,620 --> 00:33:04,620
+ممكن بعد شوية يأدي لانفصال الشبكية و أنا هاي هون
+
+439
+00:33:04,830 --> 00:33:09,070
+حصلت أمامي و صارت أمامي الـ General يعني إيشي
+
+440
+00:33:09,070 --> 00:33:13,590
+الوضع خطير إنه أنا أظلني مهملة في نفسي لحد ما يصير
+
+441
+00:33:13,590 --> 00:33:20,150
+انفصال تم في اللي هو الشبكية الـ General هيجين
+
+442
+00:33:20,150 --> 00:33:23,870
+طبعا النضافة الشخصية و النضافة العامة لإنه حكيتلكم
+
+443
+00:33:23,870 --> 00:33:29,030
+Diabetes او Diabetic patient من نوع اتنين بيكونوا
+
+444
+00:33:29,030 --> 00:33:34,390
+قابلين لإن يصير في عندهم التهاباتفبالتالي أنا بخاف
+
+445
+00:33:34,390 --> 00:33:39,210
+من أنه لا سمح الله بعد هذا الالتهاب يصير في عندنا
+
+446
+00:33:39,210 --> 00:33:43,350
+مشكلة و debreatment و amputation حسب المنطقة اللي
+
+447
+00:33:43,350 --> 00:33:48,650
+صار فيها الالتهاب كمان لازم أعالج اللي هو ال
+
+448
+00:33:48,650 --> 00:33:54,250
+factors إذا كانت obesity إذا كان الإشي مثلا إله
+
+449
+00:33:54,250 --> 00:33:57,450
+علاقة بنوع الحياة اللي أنا عايشاها إذا إله علاقة
+
+450
+00:33:57,450 --> 00:34:03,910
+بأي إشي في اللي هو ال risk factorالأن كيف بدي أعلم
+
+451
+00:34:03,910 --> 00:34:08,770
+المريض تبعي كيف إنه ياخد الأنسولين تبعته Stronger
+
+452
+00:34:08,770 --> 00:34:13,070
+Insulin may not be refrigerated of use within one
+
+453
+00:34:13,070 --> 00:34:18,050
+month طبعا الأنسولين مش لازم يتتلج، بنحط عادي في
+
+454
+00:34:18,050 --> 00:34:22,050
+باب التلاجة إذا فتحت أنا الأمبيولة أو فتحت العبوة
+
+455
+00:34:22,050 --> 00:34:26,290
+لمدة شهر فقط أكتر من هيك على طول أنا بتخلص منها
+
+456
+00:34:26,290 --> 00:34:30,350
+Detailed listeners should be stored standing up
+
+457
+00:34:30,660 --> 00:34:34,480
+بنعبّي السرنجة حسب ما الدكتور حكالنا تلاتة ملي،
+
+458
+00:34:34,480 --> 00:34:38,460
+تلاتة صانتي، اتنين، واحد، صباحا، و تلاتة مثلا على
+
+459
+00:34:38,460 --> 00:34:43,300
+سبيل المثال والسرنجة طبعا الـ concentration of
+
+460
+00:34:43,300 --> 00:34:45,800
+أنسولين فيه على الأنسولين الصافي وفيه الأنسولين
+
+461
+00:34:45,800 --> 00:34:49,080
+العكل أكيد طبعا الدكتور محمد ما قصر في هذا الموضوع
+
+462
+00:34:49,080 --> 00:34:53,200
+ال mixing أنسولين اللي هو طبعا اللي حكينا عليه فيه
+
+463
+00:34:53,200 --> 00:34:55,480
+على نوعين من الأنسولين اللي هو الأنسولين الصافي
+
+464
+00:34:55,480 --> 00:35:00,140
+والأنسولين العكل don't rotate area to areaطبعا
+
+465
+00:35:00,140 --> 00:35:06,360
+بكون ماخدة اللى هى الأناكن وين أنا بتم اللى هى حقن
+
+466
+00:35:06,360 --> 00:35:11,520
+قبرة الانسولين على سبيل المثال تحت اللى هو الجزء
+
+467
+00:35:11,520 --> 00:35:13,920
+ال lower limb او فى ال upper limb احيانا فى منطقة
+
+468
+00:35:13,920 --> 00:35:18,940
+ال abdomen no need to aspirate تمام انه احنا ليس
+
+469
+00:35:18,940 --> 00:35:22,520
+بحاجة نعمل aspiration من الجسم لأ انه احنا بنعطى
+
+470
+00:35:22,520 --> 00:35:27,700
+هاي الانسولين ال exercise best insulin sisters on
+
+471
+00:35:28,260 --> 00:35:31,340
+the market better than any medication we currently
+
+472
+00:35:31,340 --> 00:35:35,900
+have available اختصرها بورتال هنا عندنا بورتال بيه
+
+473
+00:35:35,900 --> 00:35:40,300
+اللي هو المشكلة كلها انه انا ماقلتش بتابع ال
+
+474
+00:35:40,300 --> 00:35:43,660
+exercise معناة الكلام انا حلت مشكلتي بإيدي
+
+475
+00:35:43,660 --> 00:35:48,600
+مااستنيت لحد ما يصل الأمر فيا لعواقب وخينام ال
+
+476
+00:35:48,600 --> 00:35:52,160
+physiology خلال اللي هو ال first few minutes من ال
+
+477
+00:35:52,160 --> 00:35:55,420
+exerciseحكينا في مساق اللي هو ال exercise في
+
+478
+00:35:55,420 --> 00:35:59,220
+السيولوجيا كنت بتاخده عن ال calories و كيف ال
+
+479
+00:35:59,220 --> 00:36:02,600
+exercise و كام من ال calories أنا ممكن أحرق في هذا
+
+480
+00:36:02,600 --> 00:36:07,600
+ال exercise في بداية أول دقائق ال exercise ال
+
+481
+00:36:07,600 --> 00:36:14,800
+glycogen في ال muscles is broken down and aerobic
+
+482
+00:36:14,800 --> 00:36:24,350
+لها واني اذا بيصيرتكسير للـGlycogen مباشرة في
+
+483
+00:36:24,350 --> 00:36:29,430
+الـexercise اللي هواهي بعد 5 to 10 minutes ال
+
+484
+00:36:29,430 --> 00:36:33,370
+muscle glycogen break down decrease بقل تكسير
+
+485
+00:36:33,370 --> 00:36:37,670
+الجليكوجين اللي موجود في ال muscle الجلوكوز broken
+
+486
+00:36:37,670 --> 00:36:43,440
+down in the liver ببلش الجلوكوز يتكسر في الكبدis
+
+487
+00:36:43,440 --> 00:36:47,780
+released to blood وبتم إطلاقه في مجرة الدم and
+
+488
+00:36:47,780 --> 00:36:53,040
+taken up by muscles as a fuel تاخد العضلات كوقود
+
+489
+00:36:53,040 --> 00:36:58,820
+لإلها this glucose becomes major source بيكون مصدر
+
+490
+00:36:58,820 --> 00:37:03,840
+أساسي للعضلات من الوقود معناته هنا صار في عندي
+
+491
+00:37:03,840 --> 00:37:09,320
+hepatic glycogenolysis إذا العملية سهلة جدا بداية
+
+492
+00:37:09,320 --> 00:37:13,170
+بتم تكسير الجليكوجين اللي موجود في العضلاتأول
+
+493
+00:37:13,170 --> 00:37:18,250
+دقيقتين بعد خمس لعشر دقائق بيصير ال muscles
+
+494
+00:37:18,250 --> 00:37:23,050
+glycogen تقف لجليكوجين الموجود أو الجلوكوز الموجود
+
+495
+00:37:23,050 --> 00:37:27,750
+داخل ال liver داخل الكبد بيفرز الجلوكوز فبالتالي
+
+496
+00:37:27,750 --> 00:37:32,310
+بتعتمد العضلات على ان وقود مباشر فيها بهيك بيكون
+
+497
+00:37:32,310 --> 00:37:37,230
+انا قللت من كمية الجلوكوز الموجودة في الدم role of
+
+498
+00:37:37,230 --> 00:37:40,610
+physical activity improve over blood glucose
+
+499
+00:37:40,610 --> 00:37:47,500
+control andHbA1c level in type 2 diabetes Improve
+
+500
+00:37:47,500 --> 00:37:52,700
+للأنسلين sensitivity بيحسن مدى حساسية أو مدى
+
+501
+00:37:52,700 --> 00:37:57,380
+استجابة الأنسلين and lowers للأنسلين requirement
+
+502
+00:37:57,380 --> 00:38:00,840
+often leading to reduced dose of insulin فبالتالي
+
+503
+00:38:00,840 --> 00:38:04,660
+بيقلل من ال dose لهذا الأنسلين ال oral
+
+504
+00:38:04,660 --> 00:38:08,000
+hypoglycemic agent especially in people with type
+
+505
+00:38:08,000 --> 00:38:13,250
+2طبعا بوصل لـ Maintenance of Ideal Body Weight
+
+506
+00:38:13,250 --> 00:38:17,190
+نتيجة اللي هو الـ Physical Activities Reduction
+
+507
+00:38:17,190 --> 00:38:22,330
+للـ Coronary Risk Factor بقلل المشاكل اللي هي الـ
+
+508
+00:38:22,330 --> 00:38:26,750
+Cardiovascular Disease أيضا بيكون بيغير الجسم
+
+509
+00:38:26,750 --> 00:38:35,190
+لوضعيات مناسبة جدا By
+
+510
+00:38:35,190 --> 00:38:38,550
+Composition Decrease للـ Body Fat and Weight و
+
+511
+00:38:38,550 --> 00:38:42,510
+Increase للمسلماتLowers the cardiovascular and
+
+512
+00:38:42,510 --> 00:38:48,850
+oval-ore mortality بقلل من احتمالية الوفيات لأمراض
+
+513
+00:38:48,850 --> 00:38:54,730
+اللي هم المرضى القلب اللي موجودين شو تأثير ال
+
+514
+00:38:54,730 --> 00:38:59,030
+exercise؟ في ال acute phase ال exercise result in
+
+515
+00:38:59,030 --> 00:39:03,750
+translocation للجلوكوز زي ما حكينا عليها المعلومة
+
+516
+00:39:03,750 --> 00:39:07,010
+هاي سابقا و transported to the plasma membrane and
+
+517
+00:39:07,010 --> 00:39:09,670
+increase the glucose uptakeWith prolonged
+
+518
+00:39:09,670 --> 00:39:14,170
+exercise، this upregulation مع الـExercise الطويل
+
+519
+00:39:14,170 --> 00:39:17,550
+الأماد، الجلوكوزة transporters the numbers of
+
+520
+00:39:17,550 --> 00:39:21,910
+change capillary endicity which overall causes an
+
+521
+00:39:21,910 --> 00:39:25,230
+improvement للأنسونين سبستيفتي بيحسن من سرعة
+
+522
+00:39:25,230 --> 00:39:30,870
+استجابة الأنسونين داخل الجسم لـclinical
+
+523
+00:39:30,870 --> 00:39:35,690
+implications even short term، two weeks regular
+
+524
+00:39:35,690 --> 00:39:40,370
+aerobic exerciseالـ exercise اللي هي بتكون aerobic
+
+525
+00:39:40,370 --> 00:39:44,830
+exercise لـ type 2 patients بتساعد في اللي هي both
+
+526
+00:39:44,830 --> 00:39:47,050
+aerobic capacity and whole body insulin
+
+527
+00:39:47,050 --> 00:39:50,870
+sensitivity حسنتني من وضع اللي هو ال weight تبع
+
+528
+00:39:50,870 --> 00:39:55,070
+الجسم وأيضا من ال insulin sensitivity وهذا المطلوب
+
+529
+00:39:55,070 --> 00:39:58,610
+على ال long term endurance لل training and diet of
+
+530
+00:39:58,610 --> 00:40:03,140
+patientsأو Markley improved the whole-body insulin
+
+531
+00:40:03,140 --> 00:40:07,220
+sensitivity and excretion of K-muscle enzymes
+
+532
+00:40:07,220 --> 00:40:11,140
+regulated by insulin. However, maintenance of
+
+533
+00:40:11,140 --> 00:40:15,140
+effects seemed to require dictation and regular
+
+534
+00:40:15,140 --> 00:40:22,300
+uninterrupted أو uninterrupted للإكسرسيز عدم اللي
+
+535
+00:40:22,300 --> 00:40:22,700
+هو
+
+536
+00:40:25,920 --> 00:40:29,500
+التزام هذا الشخص بالـ exercise أو برنامج الـ
+
+537
+00:40:29,500 --> 00:40:34,170
+exercise اللي احنا حطيناه طبعامن الـ clinical
+
+538
+00:40:34,170 --> 00:40:37,450
+implication أيضًا اللي هو الـ intramyocellular
+
+539
+00:40:37,450 --> 00:40:43,170
+lipid accumulation وجود أو اللي هو تخزين اللبد أو
+
+540
+00:40:43,170 --> 00:40:47,350
+الدهون في داخل أو ما بين العضلات which associated
+
+541
+00:40:47,350 --> 00:40:50,330
+with insulin resistance in the muscles can be
+
+542
+00:40:50,330 --> 00:40:53,650
+acutely decreased بقل by even single about
+
+543
+00:40:53,650 --> 00:40:57,170
+sustained endurance exercise ال exercise is
+
+544
+00:40:57,170 --> 00:41:00,750
+beneficial for both glucose uptaking mechanism and
+
+545
+00:41:00,750 --> 00:41:05,290
+antilipolytic effectمهم جدا ال exercise على صعيدين
+
+546
+00:41:05,290 --> 00:41:09,890
+على انه انا بدي اخد الجلوكوز او ميكانيكية الجلوكوز
+
+547
+00:41:09,890 --> 00:41:14,570
+and its antipolytic effect of insulin اللي هو
+
+548
+00:41:14,570 --> 00:41:20,550
+تحليل ال .. ال .. ال lipids اللي هي الدهون تمام؟
+
+549
+00:41:20,550 --> 00:41:23,890
+ال exercise, percussions and diabetes شو ال
+
+550
+00:41:23,890 --> 00:41:27,950
+percussions تبعتي؟ تحذيرات اهم اشي في مرض السكري
+
+551
+00:41:27,950 --> 00:41:33,910
+انه انا امنع اي اصابة للفوت بدي اعملرياض تلجري،
+
+552
+00:41:33,910 --> 00:41:38,190
+please البسفوت مناسب، please مايصير فيه أي trauma
+
+553
+00:41:38,190 --> 00:41:42,570
+وانت بتجري، تمام؟ avoid bonding activities that is
+
+554
+00:41:42,570 --> 00:41:46,370
+called vitreous hemorrhagic، أي نشاط بيعمل
+
+555
+00:41:46,370 --> 00:41:52,530
+bleeding أو نزيف، please أوجف عنده، باخد بالي من
+
+556
+00:41:52,530 --> 00:41:57,270
+مرضى اللي هم ال coronary heart disease، تمام؟ اللي
+
+557
+00:41:57,270 --> 00:42:00,730
+هم ال cardiovascular disease أو أمراض القلب
+
+558
+00:42:01,220 --> 00:42:04,480
+Baseline stress test الـ Baseline stress test هذا
+
+559
+00:42:04,480 --> 00:42:08,100
+كمان مهم جدا Indicated especially for older than
+
+560
+00:42:08,100 --> 00:42:11,400
+13 and with two or more risk factors من
+
+561
+00:42:11,400 --> 00:42:13,460
+الcardiopulmonary disease أو ال cardio artery
+
+562
+00:42:13,460 --> 00:42:17,440
+disease لازم أكون أنا ماخدة في بالي للناس اللي هم
+
+563
+00:42:17,440 --> 00:42:23,120
+عمرهم فوق 30 سنة من ال Baseline stress test شو ال
+
+564
+00:42:23,120 --> 00:42:26,820
+potential adverse لل effect exercise الأثار
+
+565
+00:42:26,820 --> 00:42:31,980
+السلبية اللي ممكنيتصير عندى لأ سمح الله مع ممارسة
+
+566
+00:42:31,980 --> 00:42:35,400
+الرياضة في حالات ال cardiovascular disease و ال
+
+567
+00:42:35,400 --> 00:42:37,840
+microvascular و ال metabolic و على الصعيد ال
+
+568
+00:42:37,840 --> 00:42:40,820
+musculoskeletal خلينى اشوف في البداية ال
+
+569
+00:42:40,820 --> 00:42:43,960
+cardiovascular ال cardiac ممكن يكون في مشكلة و
+
+570
+00:42:43,960 --> 00:42:48,360
+dysfunction and asthma due to silence اللى هى
+
+571
+00:42:48,360 --> 00:42:53,860
+heart disease ما اعطى اللى هى عضلة القلب كمية الدم
+
+572
+00:42:53,860 --> 00:42:57,670
+المناسب لcirculationExcessive Increment in Blood
+
+573
+00:42:57,670 --> 00:43:02,490
+Pressure زيادة في اللي هو الضغط تبع المريضBasic
+
+574
+00:43:02,490 --> 00:43:06,750
+Exercise Orthostatic Hypotension الـ Hypotension
+
+575
+00:43:06,750 --> 00:43:10,390
+أو الـ Orthostatic Hypotension اللي هو مشكلة عامة
+
+576
+00:43:10,390 --> 00:43:15,350
+عند الناس هاي اللي بيبقى تكون نتيجة لوجود مشكلة في
+
+577
+00:43:15,350 --> 00:43:20,060
+اللي هي ال circulation بشكل عامعلى صعيد الـ
+
+578
+00:43:20,060 --> 00:43:23,660
+Microvascular اللي هي الـ Retina Hemorrhagic أو
+
+579
+00:43:23,660 --> 00:43:27,180
+الانفصال الشبكية أو نزيف الشبكية زي ما انتوا
+
+580
+00:43:27,180 --> 00:43:30,320
+شايفين عنا هنا تمامها دي اللي هي كرة العين
+
+581
+00:43:30,320 --> 00:43:34,780
+Acceleration for other microvascular lesion بيصير
+
+582
+00:43:34,780 --> 00:43:38,620
+في عنا طبعا انفصال الشبكية نتيجة للنزيف اللي صار
+
+583
+00:43:38,620 --> 00:43:43,540
+عندها على صعيد ال Metabolic بيصير في عنا أو عمليات
+
+584
+00:43:43,540 --> 00:43:46,960
+الايد worsening للـ hyperglycemia and ketosis
+
+585
+00:43:47,470 --> 00:43:52,170
+وبعدين ممكن يصير في أنا hypoglycemia أعلى من 125
+
+586
+00:43:52,170 --> 00:43:59,470
+أقل من 70 بيصير في عندي hypoglycemia على صعيد ال
+
+587
+00:43:59,470 --> 00:44:04,170
+muscle skeletal and traumatic ال foot ulcerطبعاً
+
+588
+00:44:04,170 --> 00:44:07,610
+هذه اللي هي البقعة العامية بسميها أو البقعة اللي
+
+589
+00:44:07,610 --> 00:44:11,990
+هي السوداء بتكون مجرد حاجة بسيطة جدا في أجر المريض
+
+590
+00:44:11,990 --> 00:44:18,350
+السكري ولكن بعد ذلك نكتشف أن ما تحتها deadline أو
+
+591
+00:44:18,350 --> 00:44:23,550
+diet chaud طبعاً نتيجة له اللي هو ال infection
+
+592
+00:44:23,550 --> 00:44:28,120
+اللي صارت وهو المريض السكري مش حاسس فيهابتصير
+
+593
+00:44:28,120 --> 00:44:30,540
+عملية الـ Debridement بتصير عملية الـ Imputation
+
+594
+00:44:30,540 --> 00:44:33,880
+لأول إصبع بعدين لـ Metatarsal Bone بعدين للفوت
+
+595
+00:44:33,880 --> 00:44:41,480
+كلها وقب ندخل في عمليات أخرى مساحبة تمام؟ هذا على
+
+596
+00:44:41,480 --> 00:44:45,060
+صعيد الـ Musculoskeletal Trauma thank you for your
+
+597
+00:44:45,060 --> 00:44:49,880
+attentions و ألقاكم بإذن الله تعالى في فيديو آخر
+
+598
+00:44:49,880 --> 00:44:57,280
+تكملة للديابتاس طبعا اللي هو part 2 في رعاية الله
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/YPAqhUQon04.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/YPAqhUQon04.srt
new file mode 100644
index 0000000000000000000000000000000000000000..64d6f6d9694d3cb44359d8b0b5ebd9643c0f77fa
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/YPAqhUQon04.srt
@@ -0,0 +1,2268 @@
+1
+00:00:00,930 --> 00:00:04,590
+الصلاة والسلام على أشرف الأنبياء والمرسلين، بإذن
+
+2
+00:00:04,590 --> 00:00:08,210
+الله تعالى، اليوم سأكمل part two من مرض السكري
+
+3
+00:00:08,210 --> 00:00:12,690
+mellitus، أو اللي هو المرض السكري المزمن اللي احنا
+
+4
+00:00:12,690 --> 00:00:16,730
+حكينا واتكلمنا عليه في الفيديو السابق، لأن بإذن
+
+5
+00:00:16,730 --> 00:00:20,390
+الله تعالى، هبدأ بالـ physiotherapy program والـ
+
+6
+00:00:20,390 --> 00:00:24,370
+role of physiotherapy لمرض السكري، نبدأ بسم الله
+
+7
+00:00:24,370 --> 00:00:26,250
+الرحمن الرحيم، على بركة الله
+
+8
+00:00:29,750 --> 00:00:33,990
+ونأخذ الـ evaluation لـ patients before exercise
+
+9
+00:00:33,990 --> 00:00:38,570
+لأن قبل ما أبدأ أعمل exercise، لازم أنا أعمل تقييم
+
+10
+00:00:38,570 --> 00:00:42,830
+كامل وشامل لهذا المريض، لأنه بدي أعرف إذا كان
+
+11
+00:00:42,830 --> 00:00:46,470
+يعاني من أي مشاكل أخرى، إذا كان في عنده على سبيل
+
+12
+00:00:46,470 --> 00:00:52,190
+المثال wound في رجله، إذا كان في عنده swelling،
+
+13
+00:00:52,190 --> 00:00:55,070
+إذا كان في عنده cellulite، كل هذه الأمور لازم أنا
+
+14
+00:00:55,070 --> 00:01:00,080
+أقيمها قبل ما نبدأ الـ exercise program، أول شيء بدي
+
+15
+00:01:00,080 --> 00:01:04,120
+أعمل عملية التحضير preparing للـ exercise، زي ما
+
+16
+00:01:04,120 --> 00:01:08,220
+بتعرفوا، لازم يكون في عندنا warm up و cooling down
+
+17
+00:01:08,220 --> 00:01:12,580
+الـ warm up بيكون قبل التمرين، ما بصير أنا أبلش مع الـ
+
+18
+00:01:12,580 --> 00:01:16,880
+exercise وبرنامج رياضي كامل قبل ما أبلش معاه في
+
+19
+00:01:16,880 --> 00:01:20,530
+عملية الإحماء، تأخذ عملية الإحماء من خمس إلى عشر
+
+20
+00:01:20,530 --> 00:01:24,750
+دقائق، aerobic activity، الـ activity session حوالي
+
+21
+00:01:24,750 --> 00:01:29,830
+جلسة بتبدأ معايا من 15 إلى 30 دقيقة، تمام، بعد هيك
+
+22
+00:01:29,830 --> 00:01:33,810
+بدي أمشي أنا مع الـ cooling down اللي هو أنا أبرد
+
+23
+00:01:33,810 --> 00:01:37,250
+بعد عملية الإحماء والـ exercise اللي استمرت حوالي
+
+24
+00:01:37,250 --> 00:01:40,470
+نصف ساعة، structurally similar to the warm up and
+
+25
+00:01:40,470 --> 00:01:45,630
+should last about five to ten minutes، نفس الشيء
+
+26
+00:01:45,630 --> 00:01:51,300
+بدأنا الـ warm up session والـ cooling down، بعدين هذا
+
+27
+00:01:51,300 --> 00:01:56,300
+اللي هو بسميه عملية التحضير، لأن الأنواع تبع الـ
+
+28
+00:01:56,300 --> 00:02:01,400
+physical activities تبع اللي هم الـ exercise تبعنا
+
+29
+00:02:01,920 --> 00:02:07,220
+اختصارها، باختصارها بـ .. اللي هو SAFE، خليني
+
+30
+00:02:07,220 --> 00:02:11,320
+أشوف هاي اختصار أو abbreviation، ليش؟ أول شيء الـ S
+
+31
+00:02:11,320 --> 00:02:14,860
+هي عبارة عن strengthening exercise، الـ A هي عبارة
+
+32
+00:02:14,860 --> 00:02:19,140
+عن الـ aerobic exercise، والـ flexibility الـ F، والـ
+
+33
+00:02:19,140 --> 00:02:22,720
+E هي عبارة عن الـ endurance، هنمر عليهم واحدة واحدة
+
+34
+00:02:22,720 --> 00:02:27,660
+بإذن الله تعالى، وأعرف أنه هذا اللي هو ما يحتاجه الـ
+
+35
+00:02:27,660 --> 00:02:30,500
+physical activities، ما يحتاجه المريض، بيحتاج للـ
+
+36
+00:02:30,500 --> 00:02:33,860
+strengthening exercise، بيحتاج لـ aerobic exercise،
+
+37
+00:02:33,860 --> 00:02:38,520
+لـ flexibility and endurance، بيجي نشوف الـ Aerobic
+
+38
+00:02:38,520 --> 00:02:43,620
+exercise اللي هو التنفس طبعًا، الهوايا والـ Oxygen
+
+39
+00:02:43,620 --> 00:02:47,260
+aerobic exercise، ده type of movement لـ large
+
+40
+00:02:47,260 --> 00:02:52,000
+muscle group، طبعًا هو aerobic وبدنا نستخدمه لعضلات
+
+41
+00:02:52,000 --> 00:02:55,640
+كبيرة، cause you to breathe more deeply and your
+
+42
+00:02:55,640 --> 00:03:00,580
+heart to work harder than أكثر، تضخم الـ heart
+
+43
+00:03:00,580 --> 00:03:04,920
+بيشتغل وبيعمل pumping للـ blood، it's also called
+
+44
+00:03:04,920 --> 00:03:09,120
+cardiovascular exercise، الـ aerobic exercise ممكن
+
+45
+00:03:09,120 --> 00:03:13,620
+أنا كمان أسميه cardiovascular exercise، it's
+
+46
+00:03:13,620 --> 00:03:16,660
+improve للـ health for your heart and lungs، حلو
+
+47
+00:03:16,660 --> 00:03:21,500
+كتير، هاي التمرين الـ aerobic exercise في اللي هي الـ
+
+48
+00:03:21,500 --> 00:03:26,200
+exercise الخاصة بـ diabetic patient، تمام، الـ diabetic
+
+49
+00:03:26,200 --> 00:03:30,840
+patient، إذا بسميها أيضًا الـ cardiovascular exercise
+
+50
+00:03:30,840 --> 00:03:34,040
+الـ aerobic resistance exercise، اللي هي الـ
+
+51
+00:03:34,040 --> 00:03:37,380
+anaerobic exercise، uses the large muscles that
+
+52
+00:03:37,380 --> 00:03:42,440
+don't require oxygen، هنا anaerobic غير أو لا هوائي
+
+53
+00:03:42,660 --> 00:03:47,320
+نحن ليس بحاجة إلى الأكسجين، for short period of
+
+54
+00:03:47,320 --> 00:03:51,360
+exercise، it helps build strong muscles and lower
+
+55
+00:03:51,360 --> 00:03:56,480
+blood sugar، وبدنا نخفف أو نخفض مستوى الجلوكوز في
+
+56
+00:03:56,480 --> 00:04:00,320
+الدم، لأن هذا هو هدفنا الأساسي من عمل الـ exercise
+
+57
+00:04:00,320 --> 00:04:03,720
+to make the action of insulin more effective،
+
+58
+00:04:03,720 --> 00:04:07,580
+تمام؟ وأخلي اللي هو شغل الإنسولين يكون أكثر
+
+59
+00:04:07,580 --> 00:04:13,210
+فعالية، بتكسب يعني، الـ F اللي احنا حكينا عليها فيه
+
+60
+00:04:13,210 --> 00:04:16,090
+في الـ stretching exercise، زي ما بتشوفوا هنا في
+
+61
+00:04:16,090 --> 00:04:19,030
+الصور، في عندي stretching exercise للـ upper arm، و
+
+62
+00:04:19,030 --> 00:04:22,390
+stretching للـ lower arm، أيضًا هنا اللي هي في الـ
+
+63
+00:04:22,390 --> 00:04:25,790
+back والـ abdomen، كمان نفس الشيء، في خلال الـ long
+
+64
+00:04:25,790 --> 00:04:30,000
+sitting، للـ upper arm، الـ flexibility exercise aims
+
+65
+00:04:30,000 --> 00:04:33,160
+to increase more or maintaining the range of
+
+66
+00:04:33,160 --> 00:04:36,420
+motion للـ joints، طبعًا also improve الـ tone of
+
+67
+00:04:36,420 --> 00:04:39,000
+muscles، بدي أحافظ على الـ tone of muscles وأبقى
+
+68
+00:04:39,000 --> 00:04:42,400
+ثابت، أخليها ما تزال في اللي هي الـ flexibility
+
+69
+00:04:42,400 --> 00:04:48,430
+تبعها وثابتة قابلة للمرونة، They developed better
+
+70
+00:04:48,430 --> 00:04:52,430
+muscular body control، وهنا احنا كمان بنحافظ أو
+
+71
+00:04:52,430 --> 00:04:57,030
+بنحفظ اللي هو أن نكون عندنا في body control، واللي
+
+72
+00:04:57,030 --> 00:05:01,150
+هو عن طريق الأداء اللي هي الجلسة الرياضية، الـ
+
+73
+00:05:01,150 --> 00:05:05,010
+endurance، كلمة endurance لحالها، بعني فيها اللي هو
+
+74
+00:05:05,010 --> 00:05:10,250
+مدى قابلية المريض لإعادة وتكرار التمرين، جدية هو
+
+75
+00:05:10,250 --> 00:05:16,240
+قادر، قابلية قدرة التمرين للمريض على أداء التمرين، الـ
+
+76
+00:05:16,240 --> 00:05:20,480
+low resistance، لازم تكون طبعًا في مقاومة قليلة، و
+
+77
+00:05:20,480 --> 00:05:23,960
+ضعيفة، وليس مقاومة قوية جدًا، high repetition
+
+78
+00:05:23,960 --> 00:05:28,680
+exercise، وأنه قادر على إعادة التمرين كذا مرة، على
+
+79
+00:05:28,680 --> 00:05:32,300
+سبيل المثال، الـ walking، الـ cycling، الـ swimming،
+
+80
+00:05:32,300 --> 00:05:36,280
+والـ upper extremity، والـ ergometry، وأيضًا بتشمل
+
+81
+00:05:36,280 --> 00:05:40,480
+الـ large muscles of body، تمام؟ إذا قدرة المريضة
+
+82
+00:05:40,480 --> 00:05:44,000
+على إعادة التمرين كذا مرة، ولكن إذا كان في
+
+83
+00:05:44,000 --> 00:05:50,400
+resistance، بعطيه مقاومة أقل، how much exercise؟
+
+84
+00:05:50,400 --> 00:05:54,480
+جدا، أنا بدي من هذا الـ exercise؟ هتتبع قانون F.I.T.
+
+85
+00:05:54,480 --> 00:06:00,190
+F.I.T. بيحكي إيش؟ frequency، intensity، timing، and
+
+86
+00:06:00,190 --> 00:06:05,250
+type، تمام؟ إذا الـ frequency، كام مرة في الأسبوع
+
+87
+00:06:05,250 --> 00:06:09,630
+أنا بدي أعمل هذا التمرين، على سبيل المثال، بنعمل
+
+88
+00:06:09,630 --> 00:06:13,930
+التمرين هذا عشر مرات خلال الأسبوع، الـ intensity
+
+89
+00:06:13,930 --> 00:06:18,650
+جدّي، أنا بدي في كل تمرين من الوقت، ثلاثين لأربعين
+
+90
+00:06:18,650 --> 00:06:22,890
+دقيقة في كل exercise، حوالي اللي هو من الـ target
+
+91
+00:06:22,890 --> 00:06:27,310
+heart rate، group exercise، تمام؟ إذا، كام من الوقت
+
+92
+00:06:27,310 --> 00:06:29,990
+لهذا الـ exercise، على سبيل المثال، بدي أعمل
+
+93
+00:06:29,990 --> 00:06:33,670
+stretching exercise، بدي أستخدم لهم جلسة فيها ثلاثين
+
+94
+00:06:33,670 --> 00:06:38,670
+دقيقة بالـ exercise، حوالي خمسين لستين في اللي هو الـ
+
+95
+00:06:38,670 --> 00:06:42,110
+target heart rate، اللي هم أغلبهم بنشتغل معاهم هناك
+
+96
+00:06:42,110 --> 00:06:45,390
+الـ type، الـ safe exercise اللي احنا حكينا عليهم قبل
+
+97
+00:06:45,390 --> 00:06:50,770
+شوية، تمام؟ اللي أنا لسه مخلصة منهم قبل قليل، الـ
+
+98
+00:06:50,770 --> 00:06:54,270
+time، اللي هو الـ morning، it's ideal exercise، زي ما
+
+99
+00:06:54,270 --> 00:06:57,690
+بنشوف معظم الناس اللي بتصحى بتجرس صباحًا بيكون
+
+100
+00:06:57,690 --> 00:07:02,710
+الوقت مبكر، لأنه بتكون درجة حرارة أقل، الشيء بيكون
+
+101
+00:07:02,710 --> 00:07:08,070
+more relaxed، أكثر، ولسه هو صاحي من النوم، وعنده
+
+102
+00:07:08,070 --> 00:07:12,210
+دافعية، وتحافظ طبعًا لأنه يعمل هذا الـ exercise،
+
+103
+00:07:12,210 --> 00:07:15,630
+لاحظوني هنا في الـ breathing exercise، الـ breathing
+
+104
+00:07:15,630 --> 00:07:19,590
+exercise مهم جدًا، لاحظوا هنا في البداية تم
+
+105
+00:07:19,590 --> 00:07:25,870
+الاستنشاق عن طريق الأنف، الـ nose، تمام؟ وبعدين اللي
+
+106
+00:07:25,870 --> 00:07:31,010
+هو تم إخراجه طبعًا عن طريق اللي هو الـ mouth، بهيك
+
+107
+00:07:31,010 --> 00:07:35,750
+بقول أنا دخلت كمية كبيرة من الـ oxygen داخل
+
+108
+00:07:35,750 --> 00:07:40,910
+الرئتين، وهذا المهم والكُويس، عندي هناخد إن شاء
+
+109
+00:07:40,910 --> 00:07:44,690
+الله رب العالمين تمارين كتيرة خلال اللي هي الـ
+
+110
+00:07:44,690 --> 00:07:48,010
+breathing exercise، في حالات الـ chest، وحالات الـ
+
+111
+00:07:48,010 --> 00:07:52,870
+cardiology، الـ neck exercise، الكثير منا يعاني من
+
+112
+00:07:52,870 --> 00:07:56,830
+مشاكل الـ neck problems، تمام، فما بالكم بمريض سكري
+
+113
+00:07:56,830 --> 00:07:59,650
+طبعًا، وخصوصًا إذا كان من الناس الـ chronic، الناس
+
+114
+00:07:59,650 --> 00:08:03,330
+اللي سّرّهم السكري حوالي عشرين لتلاتين سنة، كم في
+
+115
+00:08:03,330 --> 00:08:06,790
+عندهم بعض المشاكل، الـ stretching exercise مهم جدًا،
+
+116
+00:08:06,790 --> 00:08:12,610
+الـ rotation، up، down، protraction، retraction، كل هذه
+
+117
+00:08:12,610 --> 00:08:15,610
+الأمور مهمة جدًا في الـ neck exercise، to
+
+118
+00:08:15,610 --> 00:08:19,690
+strengthening exercise for the neck، الـ hand
+
+119
+00:08:19,690 --> 00:08:25,000
+exercise، طبعًا للإيدين، لأن في حكينا على موضوع خصوصًا
+
+120
+00:08:25,000 --> 00:08:28,600
+هنا الـ hand grip، في عندنا موضوع اللي هو بيحكي على
+
+121
+00:08:28,600 --> 00:08:32,200
+الـ neuropathy، الـ neuropathy من الحاجات اللي أنا
+
+122
+00:08:32,200 --> 00:08:37,140
+قلت ممكن تأثر على الـ micro اللي هو system، على
+
+123
+00:08:37,140 --> 00:08:42,260
+الأجهزة اللي هي في الـ micro، تمام، فأنا هنا بحاول
+
+124
+00:08:42,260 --> 00:08:46,180
+أنه أنا أحافظ على الـ mobility أو أحافظ على الـ good
+
+125
+00:08:46,180 --> 00:08:50,760
+range of motion لمعصم اليدين والأصابع، اللي هم
+
+126
+00:08:52,120 --> 00:08:55,580
+الأصابع، لأنه عند هذه الحالات ممكن إنه يصير في عندها
+
+127
+00:08:55,580 --> 00:09:01,280
+stiffness نتيجة لـ  useless، في بعض الأحيان أيضًا الـ
+
+128
+00:09:01,280 --> 00:09:06,620
+trunk exercise، ما أهمله، لأنه شيء مهم إنه أنا أحافظ
+
+129
+00:09:06,620 --> 00:09:09,480
+على الـ back muscles والـ abdomen muscles، الـ
+
+130
+00:09:09,480 --> 00:09:12,140
+exercise سواء كان في وضع الـ supine position أو
+
+131
+00:09:12,140 --> 00:09:16,480
+اللي هو crook lying position، بأرْون وبحط مخدة تحت
+
+132
+00:09:16,480 --> 00:09:21,540
+البطن، تمام؟ أيضًا في عندي اللي هو الـ exercise من الـ
+
+133
+00:09:21,540 --> 00:09:25,560
+trunk، في وضع اللي هو الـ side lying position، وأيضًا
+
+134
+00:09:25,560 --> 00:09:29,740
+الوضعية اللي هي الـ bridging، هذه، أو بنسميها اللي هو
+
+135
+00:09:29,740 --> 00:09:34,680
+الجسر أو تمرين الجسر، أيضًا في عندي الـ leg exercise،
+
+136
+00:09:34,680 --> 00:09:39,220
+سواء كانت الـ leg، لاحظوا اللي هي الـ leg اللي تحت
+
+137
+00:09:39,220 --> 00:09:43,400
+عاملة بوضع اللي هو الـ flexion للـ hip، flexion للـ
+
+138
+00:09:43,400 --> 00:09:47,940
+knee، يعني to اللي هو stabilize، وبرفع اللي هي اللي
+
+139
+00:09:47,940 --> 00:09:48,260
+فوق
+
+140
+00:09:51,100 --> 00:09:54,120
+أيضًا في وضع prone، في وضع اللي هو هنا pumping
+
+141
+00:09:54,120 --> 00:09:58,440
+exercise للـ ankle، نفس الشيء، في وضع اللي
+
+142
+00:09:58,440 --> 00:10:02,920
+هو long sitting، كلها هذه الـ exercise مهمة، الـ
+
+143
+00:10:02,920 --> 00:10:05,980
+peripheral and autonomic neuropathy، حكينا احنا على
+
+144
+00:10:05,980 --> 00:10:09,710
+موضوع الـ neuropathy، لأن في مريض neuropathy هو يعتبر
+
+145
+00:10:09,710 --> 00:10:13,370
+مريض neurology، إله علاقة بالأعصاب، المطلوب مني
+
+146
+00:10:13,370 --> 00:10:16,030
+أنه أنا ما أخليه يعمل non-weight bearing
+
+147
+00:10:16,030 --> 00:10:21,030
+activities، المطلوب مني أنه يعمل الـ exercise non-
+
+148
+00:10:21,030 --> 00:10:24,910
+weight bearing، ما يحمل كل الوزن على القدمين مرة
+
+149
+00:10:24,910 --> 00:10:28,550
+واحدة، الـ swimming، الـ bicycling، الـ chair and arm
+
+150
+00:10:28,550 --> 00:10:31,850
+exercise، تمام، إنه هو يحاول إنه يعمل stretching
+
+151
+00:10:31,850 --> 00:10:36,150
+exercise عن طريق الكرسي، Contraindication، ممنوع
+
+152
+00:10:36,150 --> 00:10:40,470
+لمريض من neuropathy إنه يركب أو يجري على الـ
+
+153
+00:10:40,470 --> 00:10:44,590
+treadmill، ممنوع إنه يظل ماشي بيه اللي هو prolonged
+
+154
+00:10:44,590 --> 00:10:48,970
+walking، jogging، ركض، step exercise، هذه الشغلات
+
+155
+00:10:48,970 --> 00:10:53,810
+ممنوعة لمريض من neuropathy، سواء كان peripheral أو
+
+156
+00:10:53,810 --> 00:11:00,240
+autonomic، neuroapthy recommended، إله أيضًا اللي هو
+
+157
+00:11:00,240 --> 00:11:04,820
+low to moderate intensity من الـ exercise، يعني مش
+
+158
+00:11:04,820 --> 00:11:08,780
+intensity عالية جدًا، لأنه ممكن ترهقه، وبالتالي هو
+
+159
+00:11:08,780 --> 00:11:11,940
+أصلًا ممكن يكون عنده مشكلة في الـ grasping أو مشكلة
+
+160
+00:11:11,940 --> 00:11:16,060
+في الـ food sensation، فما يحس معايا، إذا الـ low للـ
+
+161
+00:11:16,060 --> 00:11:20,380
+moderate okay، مسموح، لكن الـ high intensity مش
+
+162
+00:11:20,380 --> 00:11:23,840
+مسموحة، الـ diabetic retinopathy، كلمة diabetic retinopathy
+
+163
+00:11:23,840 --> 00:11:26,660
+حكيت أنا من اللي هي الشبكية، وحكينا، شبكية
+
+164
+00:11:26,660 --> 00:11:30,780
+الاعتلال السكري، هيالها دور كبير لمريضنا، مريضنا
+
+165
+00:11:30,780 --> 00:11:34,460
+لازم يكون low impact في الـ cardiovascular، بسمح له
+
+166
+00:11:34,460 --> 00:11:38,020
+بالتمارين اللي هي بتأثر على الـ cardiovascular
+
+167
+00:11:38,020 --> 00:11:41,180
+conditioning، زي الـ swimming، زي الـ walking، الـ low
+
+168
+00:11:41,180 --> 00:11:44,720
+impact aerobic exercise، الـ stationary cycling and
+
+169
+00:11:44,720 --> 00:11:48,170
+endurance exercise، هذه الأمور مسموحة، إلي أنا لبريد
+
+170
+00:11:48,170 --> 00:11:52,230
+اللي هو السكري اللي عنده مشكلة في retinopathy، أما
+
+171
+00:11:52,230 --> 00:11:55,810
+Contra Indication، إن هي الحركات اللي فيها اهتزاز
+
+172
+00:11:55,810 --> 00:12:01,350
+زي النط والقفز، وهذه الأمور، هل بتؤدي لاختلال في
+
+173
+00:12:01,350 --> 00:12:05,870
+توازنه، فبالتالي ممكن أنا أثر على شبكية العين اللي
+
+174
+00:12:05,870 --> 00:12:11,710
+موجودة عليها، Hypoglycemia، الآن احنا كل كلام، أو لو
+
+175
+00:12:11,710 --> 00:12:15,410
+جيت على أي مريض سكري، بيقول لك أنا بخاف أكثر شيء من
+
+176
+00:12:15,410 --> 00:12:21,420
+اللي هو ارتفاع السكر في الدم، تمام، انخفاض السكر في
+
+177
+00:12:21,420 --> 00:12:25,640
+الدم أيضًا مصيبة، وبعتبره حالة clinical، حالة
+
+178
+00:12:25,640 --> 00:12:29,900
+pathological، حالة سيئة جدًا، يعني لو دخل المريض عندي
+
+179
+00:12:29,900 --> 00:
+
+223
+00:15:38,830 --> 00:15:41,870
+لمريض السكري أهم شيء حكيناه معنا اللي هي البطاقة
+
+224
+00:15:41,870 --> 00:15:46,540
+الطبية، والله هذا فلان، تين ومريض سكري، العناية
+
+225
+00:15:46,540 --> 00:15:50,400
+بالقدمين، قبل ما أبدأ أي exercise لازم أنا أطلع
+
+226
+00:15:50,400 --> 00:15:54,880
+بالمراية على الأصابع، فيهم لا سمح الله جروح، فيهم
+
+227
+00:15:54,880 --> 00:15:58,920
+خدش، فيهم أثر صدمة، لازم آخذ ذالك، الحذاء اللي بدهم
+
+228
+00:15:58,920 --> 00:16:04,010
+يلبسوه لازم يكون مناسب، ومش محكم أو مش ضيق على رجله
+
+229
+00:16:04,010 --> 00:16:07,990
+عشان ما يصير فيه أي مشاكل، عالطول لازم يكون معه
+
+230
+00:16:07,990 --> 00:16:12,190
+اللي هي الماء لأنه ممكن لا سمح الله يصير فيه
+
+231
+00:16:12,190 --> 00:16:16,490
+عنده أي مشاكل، ما أشغله أو ما أجهدّه بـ exercise أو
+
+232
+00:16:16,490 --> 00:16:21,330
+activity طويلة جدا، أيضا اللي هي الحرارة العالية، مش
+
+233
+00:16:21,330 --> 00:16:26,050
+ضروري أن أعمل فيها exercise في الأجواء الحارة، نبدأ
+
+234
+00:16:26,050 --> 00:16:28,450
+بهي اللي هم الـ always carry identification card
+
+235
+00:16:28,450 --> 00:16:32,040
+with you، أيضا check your feet before walking،
+
+236
+00:16:32,660 --> 00:16:36,860
+choose good footwear and light clothes، drink of
+
+237
+00:16:36,860 --> 00:16:41,820
+water، don't exercise during hot seasons and when
+
+238
+00:16:41,820 --> 00:16:46,050
+not feeling well، السكري أن الـ physical activity
+
+239
+00:16:46,050 --> 00:16:49,130
+should be encouraged for all people with diabetes، مهم
+
+240
+00:16:49,130 --> 00:16:53,670
+جدا الرياضة للناس اللي هم موجودين هنا على الكرة
+
+241
+00:16:53,670 --> 00:16:58,070
+الأرضية، وبالذات اللي هم مرضى السكري، الـ people
+
+242
+00:16:58,070 --> 00:17:01,530
+need to be educated about prevention and treatment
+
+243
+00:17:01,530 --> 00:17:07,480
+of hypoglycemia، people should be able to plan  الـ period
+
+244
+00:17:07,480 --> 00:17:11,080
+of، دي هي for period for physical activities، أنه
+
+245
+00:17:11,080 --> 00:17:15,060
+بالنهاية أنا بدي أعمل التمرين، ولكن في عندي قواعد
+
+246
+00:17:15,060 --> 00:17:19,640
+وقوانين لازم أمشي عليها مع هذا المريض، هذا مش مريض
+
+247
+00:17:19,640 --> 00:17:23,200
+عادي، لأن رح أحكي على حالة طبية كنا حكيناه عليها في
+
+248
+00:17:23,200 --> 00:17:26,640
+بداية اللي هو المحاضرة، اللي هي حاجة بنسميها
+
+249
+00:17:26,640 --> 00:17:30,260
+هتشوفوها أو إنكم ممكن شفتوها لناس اللي اتدربت في
+
+250
+00:17:30,260 --> 00:17:34,040
+أقسام الباطنة، حاجة اسمها الـ medical أو diabetic
+
+251
+00:17:34,040 --> 00:17:41,710
+foot، طبعا قدم السكري الشيء شائع جدا، يعني كنت بسمع
+
+252
+00:17:41,710 --> 00:17:46,590
+على مستشفى كامل راح يفتحوها في اللي هو قطاع غزة فقط
+
+253
+00:17:46,590 --> 00:17:50,590
+خاصة بحاجة اسمها diabetic foot، على جد ما هي مليانة
+
+254
+00:17:50,590 --> 00:17:54,250
+وجدا ما إحنا في عندنا حالة amputation، diabetic foot
+
+255
+00:17:54,250 --> 00:17:57,150
+can be defined as a group of syndromes in which
+
+256
+00:17:57,150 --> 00:18:02,220
+neuropathy، ischemic and infection، تمام؟ لاحظوا الـ
+
+257
+00:18:02,220 --> 00:18:05,300
+stages اللي أنا بدي أمشي عليهم هي neuropathy،
+
+258
+00:18:05,300 --> 00:18:09,820
+ischemic and infection lead to tissue breakdown،
+
+259
+00:18:09,820 --> 00:18:14,380
+then ulceration and resulting in morbidity and
+
+260
+00:18:14,380 --> 00:18:19,780
+possibility of amputation، trauma صغيرة صار فيه على
+
+261
+00:18:19,780 --> 00:18:23,340
+سبيل المثال والحجة، بده قص إظافره، صار في عندها
+
+262
+00:18:23,340 --> 00:18:28,500
+جرح صغير على حافة الإصبع، أهملته مرة على مرة وإحنا
+
+263
+00:18:28,500 --> 00:18:31,580
+بنعرف لمرضى السكري في عندهم poor blood circulation،
+
+264
+00:18:31,580 --> 00:18:36,120
+أدى إلى تعفن هذه المنطقة، أدى إلى infection في هذه
+
+265
+00:18:36,120 --> 00:18:39,740
+المنطقة، بعد شوية صار في breakdown للجلد، بعد شوية
+
+266
+00:18:39,740 --> 00:18:45,800
+صارت تدخل الحالة في ازرقاق cyanosis للمنطقة، بعدين
+
+267
+00:18:45,800 --> 00:18:50,640
+بيصير في عندي اللي هي الـ amputation، تمام؟ لأنه
+
+268
+00:18:50,640 --> 00:18:54,220
+خلاص بيكون دخلت في اللي هو poor blood circulation
+
+269
+00:18:54,220 --> 00:18:58,380
+أو poor blood supply لهذه المنطقة، دي بتكون
+
+270
+00:18:58,380 --> 00:19:01,620
+pathology grouped into two broad categories، ممكن
+
+271
+00:19:01,620 --> 00:19:06,000
+أنا أقسمها لحالتين: نيورباتيك ونيورإسكيميك،
+
+272
+00:19:06,000 --> 00:19:16,760
+تمام، أنّه الـ نيورباتيك ونيورإسكيميك،
+
+273
+00:19:16,760 --> 00:19:19,060
+نيرو باتيكو نيرو نيرو نيرو نيرو نيرو نيرو نيرو
+
+274
+00:19:19,060 --> 00:19:19,560
+نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو
+
+275
+00:19:19,560 --> 00:19:21,760
+نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو
+
+276
+00:19:21,760 --> 00:19:21,800
+نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو
+
+277
+00:19:21,800 --> 00:19:31,080
+نيرو نيرو
+
+278
+00:19:31,080 --> 00:19:35,650
+نقص الإحساس في هذه المنطقة may
+
+279
+00:19:35,650 --> 00:19:39,130
+result in subsequent foot deformity causing abnormal
+
+280
+00:19:39,130 --> 00:19:41,650
+biomechanical loading in the feet and then a
+
+281
+00:19:41,650 --> 00:19:46,810
+breakdown of the skin and ulcers، أنه أنا بدي يصير
+
+282
+00:19:46,810 --> 00:19:51,570
+في عندي فقدان بالإحساس في اللي هو القدم، ممكن أكون
+
+283
+00:19:51,570 --> 00:19:57,350
+مشيت بطريقة خاطئة، أدت لعوجاج القدم، فبالتالي بعد
+
+284
+00:19:57,350 --> 00:20:00,450
+فترة من الفترات بدي يصير في عندي تحميل على منطقة
+
+285
+00:20:00,450 --> 00:20:05,090
+معينة من القدم باللي هو الإضافة اللي أنا مشيت
+
+286
+00:20:05,090 --> 00:20:08,750
+المنطقة الثانية اللي هي بالأصل في الـ normal gait
+
+287
+00:20:08,750 --> 00:20:11,670
+اللي أنا ما مشيتش عليها صحيح، بإنها أدت لإن
+
+288
+00:20:11,670 --> 00:20:15,800
+يصير في عندي breakdown للـ skin and ulceration، تمام؟
+
+289
+00:20:15,800 --> 00:20:19,260
+هذا الشيء في الـ Neuropathy، إيش اللي عندنا؟ الـ
+
+290
+00:20:19,260 --> 00:20:26,020
+Neuropathic phase، طبعا هيكون دافئ، warm
+
+291
+00:20:26,020 --> 00:20:30,440
+and nonetheless dry، usually painless and pulse
+
+292
+00:20:30,440 --> 00:20:35,920
+remain palpable، طبعا الإجر ما زالت لسه فيها النبض
+
+293
+00:20:36,180 --> 00:20:40,200
+اللي ممكن يحس بخدر، تنميل، بس جافة، to make no
+
+294
+00:20:40,200 --> 00:20:44,960
+complications،  اللي هي الـ neuropathic joint
+
+295
+00:20:44,960 --> 00:20:48,740
+طبعا نوع من أنواع الـ deformity اللي رح تصير، الـ
+
+296
+00:20:48,740 --> 00:20:52,600
+neuropathic ulcer found mainly on soles and feet،
+
+297
+00:20:52,600 --> 00:20:57,290
+موجود، طبعا في عندنا ulcer اللي هو عبارة عن تقرح في
+
+298
+00:20:57,290 --> 00:21:00,470
+باطن القدم، Minority trauma، على سبيل المثال بسبب
+
+299
+00:21:00,470 --> 00:21:04,450
+ليه المشكلة زي ما حكينا، walking اللي هو barefoot
+
+300
+00:21:04,450 --> 00:21:08,230
+or acute injury، اللي هو طبعا إذا مشى هيه الشخص
+
+301
+00:21:08,230 --> 00:21:12,810
+وهو حافي من غير ما يتخذ إجراءات الوقاية والسلامة
+
+302
+00:21:12,810 --> 00:21:17,630
+وممكن ينأذي بأي إصابة بسيطة، Participated in a
+
+303
+00:21:17,630 --> 00:21:20,930
+chlorine attack؟ أه صح، النوع الثاني من الـ adaptive
+
+304
+00:21:20,930 --> 00:21:25,150
+foot اللي هو neuroischemic foot، الـ نيورإسكيمك من
+
+305
+00:21:25,150 --> 00:21:28,250
+اسمها إسكيمك معناته الـ peripheral artery disease،
+
+306
+00:21:28,250 --> 00:21:32,090
+إيش علاقتها بالـ artery؟ الـ infection often complicated
+
+307
+00:21:32,090 --> 00:21:35,450
+أو often اللي هو neuropathy complicated and
+
+308
+00:21:35,450 --> 00:21:38,550
+ischemic coils considerably damaged، ده بتكون
+
+309
+00:21:38,550 --> 00:21:44,110
+المشكلة هنا، هنا إسكيمك معناته إيش؟ تيجي تحس بِإجر
+
+310
+00:21:44,110 --> 00:21:49,170
+المريضة تبعنا أو المريض، باردة والـ pulse ما في
+
+311
+00:21:49,170 --> 00:21:52,970
+pulse، فبالتالي هنا المشكلة في الـ artery، هنا أنا
+
+312
+00:21:52,970 --> 00:21:55,110
+تشاهد نيرو بس الـ complication intermediate
+
+313
+00:21:55,110 --> 00:21:58,610
+claudication، طبعا بدي يكون في عندي intermediate
+
+314
+00:21:58,610 --> 00:22:02,410
+claudications، اللي هو بشكل متقطع، rest pain and
+
+315
+00:22:02,410 --> 00:22:07,010
+gangrene may occur، ممكن تحدث الغرغرينا كـ نهاية هاي
+
+316
+00:22:07,010 --> 00:22:10,630
+الـ complication، الـ neuroischemic ulcer resulting
+
+317
+00:22:10,630 --> 00:22:15,380
+from localized pressure damage، بيصير فيه ضغط
+
+318
+00:22:15,380 --> 00:22:19,720
+معين على هذه المنطقة، على سبيل المثال، عندي ديابتي
+
+319
+00:22:19,720 --> 00:22:23,060
+و stroke patient، وموجود هو في وضع الـ supine
+
+320
+00:22:23,060 --> 00:22:26,560
+position، وما بيصير فيه له تغيير أو تقليب للفراش،
+
+321
+00:22:26,560 --> 00:22:30,800
+ممكن وضعيته في الـ supine يصير في عندنا
+
+322
+00:22:30,800 --> 00:22:34,170
+ulceration في منطقة الـ calcaneus، يعني الـ calcaneal
+
+323
+00:22:34,170 --> 00:22:37,990
+area، بيصير فيها نتيجة لهذا الـ pressure، بيصير في
+
+324
+00:22:37,990 --> 00:22:41,510
+عنا اللي هو الـ  and found mainly at the edge
+
+325
+00:22:41,510 --> 00:22:45,450
+of foot، اللي هو زي ما حكينا في نهاية أطراف الأصابع،
+
+326
+00:22:45,450 --> 00:22:49,110
+ممكن يصير أيضا ومنطقة الـ calcaneal،
+
+327
+00:22:51,820 --> 00:22:56,920
+هذه بعض الصور للحالات اللي أنا ممكن أشوفها، طبعا
+
+328
+00:22:56,920 --> 00:23:01,620
+لاحظوا كيف الأظافر هنا، ما فيه حناية بالأظافر، في
+
+329
+00:23:01,620 --> 00:23:04,960
+عندنا بعض الـ trauma اللي موجودة، لازم نأخذ بالنا
+
+330
+00:23:04,960 --> 00:23:08,890
+منها، الـ symptoms، loss of protective sensation للـ
+
+331
+00:23:08,890 --> 00:23:11,770
+pain and tingling sensation، الـ sensation طبعا
+
+332
+00:23:11,770 --> 00:23:15,790
+بنلاحظها في هذه الحالات، الـ patient may develop
+
+333
+00:23:15,790 --> 00:23:22,510
+blisters، فقاعات وكأنه الشيء أو كأنه المشكلة بدأت
+
+334
+00:23:22,510 --> 00:23:27,670
+باللي هو زي حروق من الدرجة الثانية، اللي هي الفقاعات
+
+335
+00:23:27,670 --> 00:23:31,350
+اللي بتكون موجودة عندهم،  Ablation and wound may not
+
+336
+00:23:31,350 --> 00:23:35,640
+to feel any pain، بكون انتهى هذا المريض تبعنا باللي
+
+337
+00:23:35,640 --> 00:23:41,660
+هو على سبيل المثال بـ shoes تبعته اللي مش مناسبة،
+
+338
+00:23:41,660 --> 00:23:45,840
+وضل ماشي مشواره وما حس فيها، وأغلب الحالات كانت
+
+339
+00:23:45,840 --> 00:23:48,040
+تجينا مباشرة على المستشفى بهذه الطريقة،
+
+340
+00:23:51,980 --> 00:23:55,540
+أيضا الـ circulation لما يكون فيها مشاكل بتسبب أنه
+
+341
+00:23:55,540 --> 00:23:59,880
+تكسر للجلد، الـ circulation و الـ skin temperature
+
+342
+00:23:59,880 --> 00:24:03,960
+أيضا بتختلف معنا في البداية، يعني بتلاحظ أن المنطقة
+
+343
+00:24:03,960 --> 00:24:07,040
+لا لونها أصفر، يوم أسمر، يوم أحمر، يوم ملونة،
+
+344
+00:24:07,040 --> 00:24:11,840
+فبالتالي هنا المشكلة تبقى مستمرة إلى أن ندخل في
+
+345
+00:24:11,840 --> 00:24:15,490
+اللي هي الـ complication الأخرى، Depending on a
+
+346
+00:24:15,490 --> 00:24:18,510
+specific problem، the developed patient may notice
+
+347
+00:24:18,510 --> 00:24:21,390
+swelling and discoloration، زي ما حكيت أنه أنا
+
+348
+00:24:21,390 --> 00:24:26,750
+بتتطور المشكلة، يوم الإجر أزرق، أحمر، رمادي، أبيض،
+
+349
+00:24:26,750 --> 00:24:30,270
+وبعدين خلاص بندخل في اللي هو غرغرينا، red streak
+
+350
+00:24:30,270 --> 00:24:34,030
+and increasingly warm and coldest، طبعا وما زالت
+
+351
+00:24:34,030 --> 00:24:38,550
+الإجر عندي اللي هو قليلة درجة الحرارة، لأنها باردة
+
+352
+00:24:38,550 --> 00:24:43,110
+جدا، with no or minimal pain، a wound without drainage،
+
+353
+00:24:43,110 --> 00:24:48,670
+ممكن في بعض الأحيان أنه يكون في عندي خراج أو قيح من
+
+354
+00:24:48,670 --> 00:24:52,590
+هذه المنطقة، وبعض الأحيان ما يكون فيه، طبعا نتيجة
+
+355
+00:24:52,590 --> 00:24:55,310
+taking off socks and tingling، بين deformity،
+
+356
+00:24:55,340 --> 00:25:00,720
+الـ patient with infection may have fever، ارتفاع
+
+357
+00:25:00,720 --> 00:25:07,080
+درجة الحرارة، اللي هي الرعشة أو القشعريرة اللي بتصير،
+
+358
+00:25:07,080 --> 00:25:11,580
+checks of redness، احمرار ودرينج طبعا، وفي وجود اللي
+
+359
+00:25:11,580 --> 00:25:17,190
+هو قيح الخراج، Blood sugar control، بيصير فيه عدم
+
+360
+00:25:17,190 --> 00:25:20,890
+تحكم في اللي هو السكري في الدم، المرض ممكن يدخل فيه
+
+361
+00:25:20,890 --> 00:25:25,230
+حالة من اللي هو الـ confused and  coma، الهذيان واللي
+
+362
+00:25:25,230 --> 00:25:28,670
+هو نتيجة ارتفاع الضغط الدم وارتفاع الـ blood
+
+363
+00:25:28,670 --> 00:25:34,750
+sugars، اللي موجود في cost factors، في عندي، بدي
+
+364
+00:25:34,750 --> 00:25:41,190
+أتكلم عوامل داخلية وعوامل خارجية، خليني أشوف من إيش
+
+365
+00:25:41,190 --> 00:25:45,350
+ممكن يصير في الـ extrinsic factor، bad fitting، طبعا
+
+366
+00:25:45,350 --> 00:25:50,110
+للفوت وير، الـ shoes، هذا مش مناسب، لبسته هاي الست
+
+367
+00:25:50,110 --> 00:25:54,270
+وما كان مناسب لها تماما، قد لـ injury، very foot
+
+368
+00:25:54,270 --> 00:26:00,170
+walking، أتمشت مشوارها أو أتمشت في أرجاء منزلها وهي
+
+369
+00:26:00,170 --> 00:26:05,290
+مش لابسة الـ shoes تبعها، falling أو accident، صار
+
+370
+00:26:05,290 --> 00:26:09,650
+في عندها مشكلة accident وصار في عملية crashing،
+
+371
+00:26:09,650 --> 00:26:14,040
+جري أدى إلى الـ infected، لهذا اللون، object
+
+372
+00:26:14,040 --> 00:26:18,300
+inside shoes، ما اهتمت إنها تشوف لما  قد تلمس حذاء
+
+373
+00:26:18,300 --> 00:26:22,040
+تبعها، أنه فيه على سبيل المثال بعض الأحيان ممكن
+
+374
+00:26:22,040 --> 00:26:27,780
+يكون قطعة صغيرة من الـ plastic أو ممكن تكون أي شيء
+
+375
+00:26:27,780 --> 00:26:33,100
+مؤلم أو شيء مؤذي، ننتبه للحاجة إن في الحذاء تبعه
+
+376
+00:26:33,100 --> 00:26:38,020
+مشكلة، Thermal Trauma، بعض الأحيان خصوصا اللي هو
+
+377
+00:26:38,020 --> 00:26:43,520
+أثناء جول البرت، بتلاقي أن السيدة جالسة على الدفاية،
+
+378
+00:26:43,520 --> 00:26:48,400
+ومدّة إجرها طبعا تدفّيهم، وانضغطت حرارة عالية طبعا،
+
+379
+00:26:48,400 --> 00:26:53,040
+صار اللي صار وهي لسة مش حاسة بحالها، Injury by
+
+380
+00:26:53,040 --> 00:26:59,490
+sharp objects، طبعا النتيجة أنه ننتبه لما حكينا،
+
+381
+00:26:59,490 --> 00:27:03,230
+السيدة، أنّه في وجود مسمار على سبيل المثال في داخل
+
+382
+00:27:03,230 --> 00:27:08,010
+الشوز، هاي بالنسبة للعوامل الـ extrinsic، العامل الـ
+
+383
+00:27:08,010 --> 00:27:14,010
+intrinsic، اللي هو limited joint mobility، نفس الـ
+
+384
+00:27:14,010 --> 00:27:16,970
+joint في الـ tarsal bone أو الـ metatarsal bone أو
+
+385
+00:27:16,970 --> 00:27:22,010
+الـ phalanges فيهم مشكلة، هذه الـ deformity نفسها بتعمل
+
+386
+00:27:22,010 --> 00:27:25,030
+compression أو pressure على منطقة معينة، الـ poly
+
+387
+00:27:25,030 --> 00:27:29,430
+prominence، طبعا اللي هي زي ما حكينا بعض اللي هو الـ
+
+388
+00:27:29,430 --> 00:27:32,050
+poly prominence خصوصا بالـ little finger أو الـ
+
+389
+00:27:32,050 --> 00:27:34,750
+fifth finger، بتبرز العظم، foot deformity زي ما
+
+390
+00:27:34,750 --> 00:27:37,970
+حكينا، بعض الأحيان في ناس بتمشي وفي عندها اللي هو
+
+391
+00:27:37,970 --> 00:27:41,630
+الـ hammer toe أو بنسميه الـ big toe، الـ plantar
+
+392
+00:27:41,630 --> 00:27:45,270
+callus، طبعا نتيجة لإن هو في عنده مشكلة في التكثف
+
+393
+00:27:45,270 --> 00:27:49,870
+الزيادة، الـ fissures، صار في عنده fissures،
+
+394
+00:27:49,870 --> 00:27:54,670
+الـ fissures بعض اللي هي الشروخ اللي بتصير، هذه عوامل
+
+395
+00:27:54,670 --> 00:27:58,190
+اللي هي علاقة بداخل القدم نفسها، يعني ما فيش إيش
+
+396
+00:27:58,190 --> 00:28:01,370
+إصابة من برّا، كله من نفس الـ foot تبعنا والـ
+
+397
+00:28:01,370 --> 00:28:05,230
+anatomical و الـ changes اللي بتصير داخل الـ foot،
+
+398
+00:28:05
+
+445
+00:31:08,020 --> 00:31:11,100
+in the bottom of metatarsal head بلشلي من ال
+
+446
+00:31:11,100 --> 00:31:13,620
+bottom of metatarsal heads and then spread rapidly
+
+447
+00:31:13,620 --> 00:31:17,380
+along with tendon wall to ankles امتد من بداية
+
+448
+00:31:17,380 --> 00:31:20,520
+اللي هي ال metatarsal وامتد لعند اللي هي ال tendon
+
+449
+00:31:20,520 --> 00:31:25,710
+تبع ال ankle هاي اللي احنا حكينا عليهم ال top of
+
+450
+00:31:25,710 --> 00:31:29,690
+foot هاي اللي هي ال pony marking أو اللي هو بعض
+
+451
+00:31:29,690 --> 00:31:32,330
+الأحيان ال pony prominence هذه بتبقى واضحة عنا
+
+452
+00:31:32,330 --> 00:31:37,330
+شايفين كيف صارت الأجر للي هو ال shoes اللي مكنش
+
+453
+00:31:37,330 --> 00:31:42,290
+مظبوط أدى للي هي ال deformity هاي ال bottom of
+
+454
+00:31:42,290 --> 00:31:45,930
+foot اللي هو بعض القدم هذا اللي هنا هاي بعتبرها
+
+455
+00:31:45,930 --> 00:31:49,290
+bad وهنا اللي هي منطقة ال calcaneus أو منطقة اللي
+
+456
+00:31:49,290 --> 00:31:53,990
+هي ل ال foot ال classification of ulcer طبعا هذا
+
+457
+00:31:53,990 --> 00:31:57,330
+موضوع ال ulcer موضوع كبير جدا طبعا هو عبارة عن
+
+458
+00:31:57,330 --> 00:32:02,790
+five degrees إن شاء الله رب العالمين هنشرحه و
+
+459
+00:32:02,790 --> 00:32:06,410
+نتكلم عنه في مواضيع تانية هنا بس هي صورة تعبيرية
+
+460
+00:32:06,410 --> 00:32:10,590
+عشان تشوفوا قداش يعني صفر ال grade صفر ولا إشي لكن
+
+461
+00:32:10,590 --> 00:32:13,110
+لاحظوا لما يكون ال grade خمسة لاحظوا لما يكون ال
+
+462
+00:32:13,110 --> 00:32:17,190
+grade أربعة الإشي ممكن يوصل ل ال bone  عفونا الله و
+
+463
+00:32:17,190 --> 00:32:21,550
+إياكم ال problem diagnosis ال nerve function may
+
+464
+00:32:21,550 --> 00:32:25,350
+be abnormal so the patient may not feel pain
+
+465
+00:32:25,350 --> 00:32:30,810
+في عندنا احتراقة الأجر ودخلنا في infection ومع هيك
+
+466
+00:32:30,810 --> 00:32:36,050
+الست مش قادرة تحس أو مش حاسة أن والله في مشكلة
+
+467
+00:32:36,050 --> 00:32:40,830
+بإصبع أجر غير الكبير لو ما إجا عليها حد على سبيل
+
+468
+00:32:40,830 --> 00:32:45,990
+المثال وشاف والله حجة أن الوضع عندك مش مظبوط أو
+
+469
+00:32:45,990 --> 00:32:49,550
+ممكن هي ترتفع درجة حرارتها و تدخل في ال infection
+
+470
+00:32:49,550 --> 00:32:53,780
+science عن symptoms بعدين يعرفوا أنه والله عندها
+
+471
+00:32:53,780 --> 00:32:57,920
+مشكلة نتيجة جروح معين في جرحهم this frequently
+
+472
+00:32:57,920 --> 00:33:01,420
+causes delayed diagnosis وهذا السبب الأساسي اللي هو
+
+473
+00:33:01,420 --> 00:33:06,300
+يؤخر عملية ال LTM بالإضافة لوجود سبب أساسي اللي هو
+
+474
+00:33:06,300 --> 00:33:10,020
+أنه أنا عندي هدول مرضى السكري هم بالأساس ضعيفي
+
+475
+00:33:10,020 --> 00:33:13,060
+المناعة and the patient may be diagnosed late
+
+476
+00:33:13,060 --> 00:33:16,100
+with limb- or life-threatening infection as a result
+
+477
+00:33:16,100 --> 00:33:20,080
+بعد ما يكون دخلنا في مشاكل عميقة حددت حياته حتى
+
+478
+00:33:20,080 --> 00:33:23,280
+حددت حياته هذه ال infection ال diagnosis is based
+
+479
+00:33:23,280 --> 00:33:26,120
+on the symptoms, unsigned not before, and the
+
+480
+00:33:26,120 --> 00:33:28,940
+absence of protective sensation may confirm هذا
+
+481
+00:33:28,940 --> 00:33:33,320
+بيأكد لي أن ال radiographs may show gas in soft
+
+482
+00:33:33,320 --> 00:33:36,860
+tissue طبعا بياخدوها للمرضى و بيعملوها x-ray
+
+483
+00:33:36,860 --> 00:33:40,580
+بيلاحظوا وجود ال gas اللي هو في قاعة بابلز صغيرة
+
+484
+00:33:40,580 --> 00:33:44,220
+في ال soft tissue طبعا و ال soft tissue بتبقى
+
+485
+00:33:44,220 --> 00:33:48,260
+الريحة تبعتها سيئة جدا، أيضا ال swelling، defect،
+
+486
+00:33:48,260 --> 00:33:51,140
+ال changes ال consensus ل infection، ممكن أحيانا
+
+487
+00:33:51,140 --> 00:33:55,740
+تسبب لي fractures و اللي هو dislocations للمفصل
+
+488
+00:33:55,740 --> 00:34:01,470
+نفسه، كل هذا بيصير مع الإهمال لمريض السكري ال
+
+489
+00:34:01,470 --> 00:34:05,850
+ulcers are graded by size إن أنا بقيمه حسب ال
+
+490
+00:34:05,850 --> 00:34:09,950
+size تبعه و الحجم تبعه طبعا و الدبث أهم إيش الدبث
+
+491
+00:34:09,950 --> 00:34:13,450
+لأنو إذا بتذكروا في ال slide السابقة حكيت أنو أنا
+
+492
+00:34:13,450 --> 00:34:16,510
+ممكن ال ulcer يوصل لل bone معناة الكلام أنا
+
+493
+00:34:16,510 --> 00:34:19,250
+اخترقت ال skin و ال muscles و ال fascia و كل
+
+494
+00:34:19,250 --> 00:34:23,270
+الأمور هاي و دخلت على اللي هو ال bone additional
+
+495
+00:34:23,270 --> 00:34:27,270
+imaging studies may be helpful including لل bone طبعا
+
+496
+00:34:27,270 --> 00:34:30,450
+ال MRI و ال CT ممكن يبين لي لوين أنا عندي ال
+
+497
+00:34:30,450 --> 00:34:33,490
+infection لأنو لازم يتدخل معي بهذه الحالة اللي
+
+498
+00:34:33,490 --> 00:34:36,890
+هو الدكتور الأوعية الدموية حتى يحدد لوين الغيرين على
+
+499
+00:34:36,890 --> 00:34:39,990
+سبيل المثال و أيضا ال culture of the wound base
+
+500
+00:34:39,990 --> 00:34:43,810
+in ulcer may be more reliable than swab cultures
+
+501
+00:34:43,810 --> 00:34:47,130
+from ulcer هنا ليش أنا بدي ال cultures؟ ليش بدي
+
+502
+00:34:47,130 --> 00:34:50,630
+المزرعة من هذه المنطقة اللي infected؟ عشان أعرف
+
+503
+00:34:50,630 --> 00:34:54,850
+مدى حساسية هذا الشخص لل antibiotics اللي يعطيها
+
+504
+00:34:54,850 --> 00:34:58,630
+دكتور الباطنة يعني على سبيل المثال بيجيب معه ال
+
+505
+00:34:58,630 --> 00:35:04,390
+antibiotic كذا ال body بتاعي ما بيجيبش فبالتالي أنا
+
+506
+00:35:04,390 --> 00:35:08,770
+بعمل اللي هي مزرعة في هذه المنطقة بعينة صغيرة
+
+507
+00:35:08,770 --> 00:35:12,670
+vascular studies may help determine how well blood
+
+508
+00:35:12,670 --> 00:35:16,600
+is circulating which is important for wound healing
+
+509
+00:35:16,600 --> 00:35:18,700
+أنا بتهمني ال circulation و ال vascular
+
+510
+00:35:18,700 --> 00:35:23,240
+circulation حتى أحسن من ال healing لأن المنطقة
+
+511
+00:35:23,240 --> 00:35:27,460
+بيكون فيها التهاب قام الدكتور و عمل debridement  كشط و
+
+512
+00:35:27,460 --> 00:35:33,360
+إزالة لبعض اللي هي الأنسجة في المنطقة المصابة على سبيل
+
+513
+00:35:33,360 --> 00:35:36,760
+المثال و انشل منها حاجة كتيرة فبالتالي أنا بدي
+
+514
+00:35:36,760 --> 00:35:41,520
+مناعة عالية عشان يصير في عندنا wound healing و ما
+
+515
+00:35:41,520 --> 00:35:46,380
+أدخل في later complications ل treatment طبعا يا
+
+516
+00:35:46,380 --> 00:35:50,220
+إما لل non-surgical أو surgical لل non-surgical
+
+517
+00:35:50,220 --> 00:35:53,700
+by drugs إذا كان الأمر بسيط و خفيف، لكن إذا كان
+
+518
+00:35:53,700 --> 00:35:57,680
+بحاجة ل surgical، زي ما اتكلمت عنه سابقا، بتتم عن
+
+519
+00:35:57,680 --> 00:36:02,280
+طريق اللي هو استئصال كل المشاكل و الأنسجة و اللي هو
+
+520
+00:36:02,280 --> 00:36:08,520
+بعد هيك بحسن المناعة، physical therapy أيضا
+
+521
+00:36:08,520 --> 00:36:11,600
+فيزيكال ثيرابي  ده dead pig foot clinical to control
+
+522
+00:36:11,600 --> 00:36:14,640
+شو أهدافنا؟ أن أنا أعمل control and maintenance لل
+
+523
+00:36:14,640 --> 00:36:19,260
+blood glucose level أحافظ على ال blood glucose
+
+524
+00:36:19,260 --> 00:36:24,700
+level أهم خطوة عندي لمرضى السكري to teach لل
+
+525
+00:36:24,700 --> 00:36:29,640
+area at risk of foot ulcer أن أنا دائما أي منطقة
+
+526
+00:36:29,640 --> 00:36:36,010
+فيها مشكلة أعمل عليها مراقبة و ملاحظة  close care
+
+527
+00:36:36,010 --> 00:36:38,850
+of that risky area to educate لل foot care and
+
+528
+00:36:38,850 --> 00:36:42,170
+prevention methods دائما أعطي نصائح، دائما أعطي
+
+529
+00:36:42,170 --> 00:36:46,010
+تعليمات to advise proper footwear، لبس حذاء
+
+530
+00:36:46,010 --> 00:36:51,710
+مناسب، الضيق سيبك منه، الحذاء اللي مفتوح من الأمام
+
+531
+00:36:51,710 --> 00:36:55,250
+كمان سيبك منه، كل الأمور هذه أنا بعطيها advice لل
+
+532
+00:36:55,250 --> 00:37:01,540
+patient تبعي to educate do's and don'ts أعمل قائمة ب
+
+533
+00:37:01,540 --> 00:37:05,260
+أعمل هذه الأشياء و قائمة ما تعمل هذه الأشياء خصوصا
+
+534
+00:37:05,260 --> 00:37:08,740
+إذا كان ما عندها الحالة caregiver أو مقدم رعاية
+
+535
+00:37:08,740 --> 00:37:13,160
+during daily activities properly أيضا to advise
+
+536
+00:37:13,160 --> 00:37:16,680
+proper foot support  بعض الأحيان هدول الناس بحاجة
+
+537
+00:37:16,680 --> 00:37:19,600
+لسupport to correct deformity to minimize
+
+538
+00:37:19,600 --> 00:37:23,100
+neuropathic pain أقلل ال neuropathic pain to
+
+539
+00:37:23,100 --> 00:37:27,320
+prevent deformity أمنع أي ألم to improve muscle
+
+540
+00:37:27,320 --> 00:37:31,670
+power and prevent muscle wasting الشيء طبيعي بال
+
+541
+00:37:31,670 --> 00:37:34,570
+exercise لازم to increase the range of motion
+
+542
+00:37:34,570 --> 00:37:37,290
+strength and endurance to prevent limited
+
+543
+00:37:37,290 --> 00:37:42,110
+joint mobility ال objectives تبعتنا للي هو
+
+544
+00:37:42,110 --> 00:37:45,850
+proper footwear أول إشي لازم أعمل relieve ل ال
+
+545
+00:37:45,850 --> 00:37:49,050
+excessive plantar pressure أي plantar pressure أنا
+
+546
+00:37:49,050 --> 00:37:52,990
+أمنعها لأنه ما بديش أعمل pressure على منطقة معينة و
+
+547
+00:37:52,990 --> 00:37:58,020
+بعد كده أدخل في  shock absorption لل shock أقل من
+
+548
+00:37:58,020 --> 00:38:01,420
+كمية الصدمات الموجودة reduction لل shear friction
+
+549
+00:38:01,420 --> 00:38:05,960
+forces إن أنا ما أعملش اللي هو قوة مشاركة تزيد من
+
+550
+00:38:05,960 --> 00:38:09,020
+الوزن على سبيل المثال و الضغط على هذه المنطقة
+
+551
+00:38:09,020 --> 00:38:13,080
+accommodations for minimal deformity تمام
+
+552
+00:38:13,080 --> 00:38:16,140
+stabilization لل deformity و preventing
+
+553
+00:38:16,140 --> 00:38:21,880
+ل recurrence of ulcer أمنع أي recurrence of ulcer advice
+
+554
+00:38:21,880 --> 00:38:25,660
+about shoes and socks  اللي هي بعض النصائح
+
+555
+00:38:25,660 --> 00:38:31,060
+للي هو مريضنا السكري في لبس الحذاء و الجوارب
+
+556
+00:38:31,060 --> 00:38:35,780
+choose and wear your shoes carefully بهدوء بنلبس
+
+557
+00:38:35,780 --> 00:38:39,500
+اللي هو حذائنا اللي عندنا buy new shoes later in
+
+558
+00:38:39,500 --> 00:38:42,880
+the day when your feet are swollen later in the day when
+
+559
+00:38:42,880 --> 00:38:45,400
+your feet are larger buy shoes that are
+
+560
+00:38:45,400 --> 00:38:48,730
+comfortable without breaking them in بعض الأحيان
+
+561
+00:38:48,730 --> 00:38:52,990
+احنا بحاجة لإنه احنا نشتري الحذاء في آخر النهار،
+
+562
+00:38:52,990 --> 00:38:56,230
+ليش؟ لأنه في آخر النهار بتبقى الأجر أكبر حجما،
+
+563
+00:38:56,230 --> 00:39:04,170
+فاحنا بحاجة إلى .. بحاجة لحذاء أوسع أو أكبر
+
+564
+00:39:04,170 --> 00:39:09,510
+نمرة، تمام؟ check how your shoe fits in width and
+
+565
+00:39:09,510 --> 00:39:13,430
+length، check the back and the
+
+566
+00:39:13,430 --> 00:39:17,550
+bottoms of heel and sole لازم أنا أشيك على ال
+
+567
+00:39:17,550 --> 00:39:21,430
+shoes في كل الأماكن بعض الأحيان ممكن يكون في دبوس
+
+568
+00:39:21,430 --> 00:39:25,630
+ممكن يكون في حاجة مقلمة  لهذا المرض Avoid pointed
+
+569
+00:39:25,630 --> 00:39:29,790
+toes اللي هي avoid pointing toe styles and high
+
+570
+00:39:29,790 --> 00:39:33,890
+heels ممنوع تلبس اللي هو ال high heels اللي هو ال shoes
+
+571
+00:39:33,890 --> 00:39:38,990
+العالية بلاش يختي تطولي لك شوية و بعد هيك ندخل في
+
+572
+00:39:38,990 --> 00:39:43,530
+ulcer و amputation Try to get shoes made with
+
+573
+00:39:43,530 --> 00:39:47,650
+leather upper material and deep toe boxes حاول
+
+574
+00:39:47,650 --> 00:39:51,530
+أن هو يستخدم اللي هو leather الجلد الطبيعي طبعا
+
+575
+00:39:51,530 --> 00:39:55,410
+اللي هي المادة الخام مهمة جدا في صناعة ال shoes
+
+576
+00:39:55,410 --> 00:40:00,150
+عشان أنا ما أدخلش في ألصار و مشاكل don't wear the
+
+577
+00:40:00,150 --> 00:40:04,930
+same pair everyday ما تظلك كل يوم لابس نفس اللي هو
+
+578
+00:40:04,930 --> 00:40:09,190
+shoes لأنه طبعا لازم تتهوا و أنا أبدلها ب shoes
+
+579
+00:40:09,190 --> 00:40:13,550
+تانية حتى إنها تتهوا و تتعقم inspect the inside of
+
+580
+00:40:13,550 --> 00:40:17,140
+each shoe before putting it on feel inside with
+
+581
+00:40:17,140 --> 00:40:21,560
+your hand طبعا شاك على اللي هو ال inside  بإيدك و تأكد من سلامته و خلوه من أي foreign body
+
+582
+00:40:21,560 --> 00:40:26,600
+don't lace your shoes too tightly or loosely دائما
+
+583
+00:40:26,600 --> 00:40:31,200
+شيك على أن الموضوع ما يكون اللي هو ال shoes  tight
+
+584
+00:40:31,200 --> 00:40:35,460
+أو اللي هو ضيق
+
+585
+00:40:35,460 --> 00:40:39,800
+أو واسع أنه يسقط من رجلك لأنه هذا الناس طبعا بتكون
+
+586
+00:40:39,800 --> 00:40:43,680
+النتيجة لنيوروباتي ما في عندها تحكم أو إحساس أنه ال
+
+587
+00:40:43,680 --> 00:40:48,180
+shoes وجعت رجليها و هي ماشية و هي مش دارية عن
+
+588
+00:40:48,180 --> 00:40:51,000
+حالتها لأنه ما في عندها إحساس ب
+
+589
+00:40:51,000 --> 00:40:55,180
+اللي هو القدمين choose your socks and stockings carefully طبعا
+
+590
+00:40:55,180 --> 00:40:58,760
+اختيار اللي هو أو اختيار الجوارب مهم جدا أنه يكون
+
+591
+00:40:58,760 --> 00:41:07,180
+مناسب wear clean الجوارب طبعا wear
+
+592
+00:41:07,180 --> 00:41:12,240
+clean and dry socks every day مش ضروري أنه كل أسبوع
+
+593
+00:41:12,240 --> 00:41:15,440
+مرة أنا ألبس الجوارب هي هي لأ لازم كل يوم يكون
+
+594
+00:41:15,440 --> 00:41:21,240
+في عندنا نظافة تمام؟ و نلبس أشياء نظيفة avoid socks
+
+595
+00:41:21,240 --> 00:41:26,470
+with holes or wrinkles ممنوع ألبس الشرابات
+
+596
+00:41:26,470 --> 00:41:31,290
+اللي فيهم فتحات أو اللي فيهم تجاعيد لأن هذا ممكن
+
+597
+00:41:31,290 --> 00:41:35,110
+يؤدي إلى مشاكل choose cotton طبعا نوع الجوارب لازم
+
+598
+00:41:35,110 --> 00:41:38,630
+يكون قطن  وفي جوارب خاصة بمرضى السكري
+
+599
+00:41:38,630 --> 00:41:41,830
+موجودة في السوق and absorbent ones for summer wear بعض
+
+600
+00:41:41,830 --> 00:41:45,390
+الأحيان اللي هي جوارب الصيف مهمة جدا secure the
+
+601
+00:41:45,390 --> 00:41:49,750
+socks so they will not squeeze your toes avoid socks with
+
+602
+00:41:49,750 --> 00:41:54,100
+elastic tops seamless stockings are available for
+
+603
+00:41:54,100 --> 00:41:57,080
+those with neuropathy consider using compression
+
+604
+00:41:57,080 --> 00:42:00,740
+stockings if your feet tend to swell دائما نأخذ
+
+605
+00:42:00,740 --> 00:42:05,260
+ببالنا من أي شيء بيكون ضغط خصوصا اللي هو المطاط
+
+606
+00:42:05,260 --> 00:42:10,120
+اللي بيكون في نهاية الجوارب الجوارب بيؤدي لضغط
+
+607
+00:42:10,120 --> 00:42:14,720
+على ال circulation do's and don'ts for diabetic foot
+
+608
+00:42:14,720 --> 00:42:19,480
+افعل و لا تفعل في اللي هو مرض السكري inspect your
+
+609
+00:42:19,480 --> 00:42:22,240
+feet daily هذه بعض النصائح اللي أنت بدك تقدمها
+
+610
+00:42:22,240 --> 00:42:27,240
+أو تقدمها لمرضى السكري دائما افحص اللي هو القدمين
+
+611
+00:42:28,350 --> 00:42:32,630
+بالكامل في المراية especially at the high pressure areas
+
+612
+00:42:32,630 --> 00:42:36,210
+بمراه صغيرة شوف في عندنا على سبيل
+
+613
+00:42:36,210 --> 00:42:40,830
+المثال فطريات بين الأصابع في عندنا جروح في عندنا شيء
+
+614
+00:42:40,830 --> 00:42:44,870
+wash your feet daily with water apply lotions and oil
+
+615
+00:42:44,870 --> 00:42:48,970
+to your feet after drying حتى الإجرين مش لازم يضلوا جافة
+
+616
+00:42:48,970 --> 00:42:54,690
+لازم أنا أرطبها بأي لوشن avoid extreme temperatures
+
+617
+00:42:54,690 --> 00:42:58,630
+أو تعريضها لدرجة حرارة عالية have your feet checked
+
+618
+00:42:58,630 --> 00:43:01,790
+at each clinic visit inspect your shoes daily and
+
+619
+00:43:01,790 --> 00:43:05,630
+remove any foreign body change your shoes often regular
+
+620
+00:43:05,630 --> 00:43:10,190
+skin and nail care تمام؟ كل هذه الأمور لازم أنا آخذ
+
+621
+00:43:10,190 --> 00:43:15,570
+ببالي منها don't walk barefoot مش لازم تمشي حافية
+
+622
+00:43:15,570 --> 00:43:19,030
+القدم  avoid smoking هذا له مشاكله لأنه أيضا بيؤخر عملية
+
+623
+00:43:19,030 --> 00:43:22,850
+الالتئام test the water before stepping into the bath
+
+624
+00:43:22,850 --> 00:43:26,910
+checking the water temperature لازم خلال اللي هو
+
+625
+00:43:26,910 --> 00:43:31,030
+الاستحمام أنا أعمل اللي هو فحص للماء إذا كان ساخن
+
+626
+00:43:31,030 --> 0
+
+667
+00:46:23,070 --> 00:46:28,870
+تمام، do this exercise until you pick up all twenty
+
+668
+00:46:28,870 --> 00:46:33,810
+marbles اللي هي الكريات الصغيرة أو الكرة الصغيرة
+
+669
+00:46:33,810 --> 00:46:35,710
+اللي بتكون زي الـ marble recommended for people with
+
+670
+00:46:35,710 --> 00:46:39,170
+pen or ball and foot, the hammer toe and cramps كمان
+
+671
+00:46:39,170 --> 00:46:43,030
+كويسة اللي هي هاي اللعبة Sand Walking أنه يمشي
+
+672
+00:46:43,030 --> 00:46:47,810
+على شاطئ البحر كتير بنسمع من أمهاتنا وإجدادنا طبعا
+
+673
+00:46:47,810 --> 00:46:52,110
+أنه خليه يمشي حافي على شاطئ البحر. Any chance you
+
+674
+00:46:52,110 --> 00:46:55,330
+get to kick off your shoes and walk with the sand at the
+
+675
+00:46:55,330 --> 00:46:59,530
+beach? طبعا الـ exercise massage your feet. In the heat of this
+
+676
+00:46:59,530 --> 00:47:02,590
+heat, it is melting your toes and provides good general foot
+
+677
+00:47:02,590 --> 00:47:06,890
+condition. الـ watch طبعا لازم اكون هنا انا حريصة
+
+678
+00:47:06,890 --> 00:47:11,530
+لأنه أنا شلّت المريض أو خلعت المريض الـ food تبعته
+
+679
+00:47:11,530 --> 00:47:17,190
+فأنا لازم أكون حريصة أو أكون مهتمة جداً لموضوع أنه
+
+680
+00:47:17,190 --> 00:47:19,370
+فيه جَذْر أو لأ
+
+681
+00:47:23,030 --> 00:47:25,230
+السبلنتينج لإيش؟ أنا بدي أستخدم السبلنتينج؟ بدي
+
+682
+00:47:25,230 --> 00:47:29,370
+أستخدمه لإيه؟ هو correct deformity. بدي أستخدمه لأنه
+
+683
+00:47:29,370 --> 00:47:33,230
+أنا أحافظ على الـ food في وضع الـ anatomical
+
+684
+00:47:33,230 --> 00:47:36,830
+position الصحيحة. Total contact cast is the
+
+685
+00:47:36,830 --> 00:47:40,530
+appropriate way of supporting the foot with a
+
+686
+00:47:40,530 --> 00:47:44,910
+diameter plater. It is the distribution of the weight
+
+687
+00:47:44,910 --> 00:47:48,210
+long in the center of the plantar aspects of the foot. It
+
+688
+00:47:48,210 --> 00:47:51,990
+reduces pressure. طبعا بيقلل الـ share تبع الـ force
+
+689
+00:47:51,990 --> 00:47:56,010
+normally present between the foot and shoes. It produces
+
+690
+00:47:56,010 --> 00:47:58,950
+shortening and straight length, and decreases
+
+691
+00:47:58,950 --> 00:48:02,670
+walking velocity. لازم انا طبعا لما أنتو شايفين
+
+692
+00:48:02,670 --> 00:48:05,730
+اللي هو بعض الـ splints أو بعض الـ prosthesis
+
+693
+00:48:05,730 --> 00:48:09,530
+اللي موجودة، الـ orthosis اللي موجودة هنا مهم جداً
+
+694
+00:48:09,530 --> 00:48:14,190
+أنا أستخدمها مع هدول الناس حتى أعمل correct لـ الـ
+
+695
+00:48:14,190 --> 00:48:18,220
+deformity. Thank you for your attention. وألقاكم بإذن
+
+696
+00:48:18,220 --> 00:48:22,840
+الله تعالى في فيديو آخر بإذن الله تعالى. يعطيكم
+
+697
+00:48:22,840 --> 00:48:23,420
+الفافية
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/YPAqhUQon04_postprocess.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/YPAqhUQon04_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..6143d3278ac33ad8712b90c6dca02f13448023e1
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/YPAqhUQon04_postprocess.srt
@@ -0,0 +1,2788 @@
+1
+00:00:00,930 --> 00:00:04,590
+الصلاة والسلام على أشرف الأنبياء والمرسلين بإذن
+
+2
+00:00:04,590 --> 00:00:08,210
+الله اتعالى اليوم سأكمل part two من ال diabetes
+
+3
+00:00:08,210 --> 00:00:12,690
+mellitus او اللي هو المرض السكري المذمن اللي احنا
+
+4
+00:00:12,690 --> 00:00:16,730
+حكينا واتكلمنا عليه في الفيديو السابق لأن بإذن
+
+5
+00:00:16,730 --> 00:00:20,390
+الله اتعالى هبدأ بال physiotherapy program و ال
+
+6
+00:00:20,390 --> 00:00:24,370
+role of physiotherapy لالdiabetes نبدأ بسم الله
+
+7
+00:00:24,370 --> 00:00:26,250
+الرحمن الرحيم على بركة الله
+
+8
+00:00:29,750 --> 00:00:33,990
+وناخد ال evaluation لل patients before exercise
+
+9
+00:00:33,990 --> 00:00:38,570
+لأن قبل ما أبدأ أعمل exercise لازم أنا أعمل تقييم
+
+10
+00:00:38,570 --> 00:00:42,830
+شامل وكامل لهذا المريض لإنه بدي أعرف إذا كان
+
+11
+00:00:42,830 --> 00:00:46,470
+بيعاني من أي مشاكل أخرى، إذا كان في عنده على سبيل
+
+12
+00:00:46,470 --> 00:00:52,190
+المثال wound في رجله، إذا كان في عنده swelling،
+
+13
+00:00:52,190 --> 00:00:55,070
+إذا كان في عنده cellulite كل هذه الأمور لازم أنا
+
+14
+00:00:55,070 --> 00:01:00,080
+أقيمها قبل ما نبدأ ال exercise programأول اشي بدي
+
+15
+00:01:00,080 --> 00:01:04,120
+اعمل عملية التحضير preparing ل ال exercise زى ما
+
+16
+00:01:04,120 --> 00:01:08,220
+بتعرفوا لازم يكون في عندنا warm up و cooling down
+
+17
+00:01:08,220 --> 00:01:12,580
+ال warm up بيكون قبل التمرين مابصير انا ابلش معاه
+
+18
+00:01:12,580 --> 00:01:16,880
+exercise وبرنامج رياضي كامل قبل ماابلش معاه في
+
+19
+00:01:16,880 --> 00:01:20,530
+عملية الإحماءتاخد عملية الإحماء من خمس إلى عشر
+
+20
+00:01:20,530 --> 00:01:24,750
+دقائق aerobic activity ال activity session حوالي
+
+21
+00:01:24,750 --> 00:01:29,830
+جلسة بتبتد معايا من 15 إلى 30 دقيقة تمام بعد هيك
+
+22
+00:01:29,830 --> 00:01:33,810
+بدي أمشي أنا مع ال cooling down اللي هو أنا أدرد
+
+23
+00:01:33,810 --> 00:01:37,250
+بعد عملية الإحماء وال exercise اللي استمرت حوالي
+
+24
+00:01:37,250 --> 00:01:40,470
+نصف ساعة structurally similar to the warm up and
+
+25
+00:01:40,470 --> 00:01:45,630
+should last about five to ten minutes نفس الشيء
+
+26
+00:01:45,630 --> 00:01:51,300
+بدأنا warm upالـ session و calling down بعدين هذا
+
+27
+00:01:51,300 --> 00:01:56,300
+اللي هو بسميها عملية التحضير لأن الأنواع تبعت ال
+
+28
+00:01:56,300 --> 00:02:01,400
+physical activities تبعت اللي هم ال exercise تبعنا
+
+29
+00:02:01,920 --> 00:02:07,220
+اختصارها باختصارها ب .. اللي هو safe S-A-F-E خليني
+
+30
+00:02:07,220 --> 00:02:11,320
+اشوف هاي اختصار او abbreviation ليش اول اشي ال S
+
+31
+00:02:11,320 --> 00:02:14,860
+هي عبارة عن strengthening exercise ال A هي عبارة
+
+32
+00:02:14,860 --> 00:02:19,140
+عن ال aerobic exercise و ال flexibility ال F و ال
+
+33
+00:02:19,140 --> 00:02:22,720
+E هي عبارة عن ال endurance هنمر عليهم واحدة واحدة
+
+34
+00:02:22,720 --> 00:02:27,660
+بإذن الله تعالى و اعرف انه هذااللي هو ما يحتاجه ال
+
+35
+00:02:27,660 --> 00:02:30,500
+physical activities، ما يحتاجه المريض، بيحتاج لل
+
+36
+00:02:30,500 --> 00:02:33,860
+strengthening exercise، بيحتاج ل aerobic exercise،
+
+37
+00:02:33,860 --> 00:02:38,520
+ل flexibility and endurance، بيجي نشوفالـ Aerobic
+
+38
+00:02:38,520 --> 00:02:43,620
+exercise اللى هو التنفس طبعا الهوايا و ال Oxygen
+
+39
+00:02:43,620 --> 00:02:47,260
+aerobic exercise ده type of movement ل large
+
+40
+00:02:47,260 --> 00:02:52,000
+muscle group طبعا هو aerobic و بدنا نستخدمه لعضلات
+
+41
+00:02:52,000 --> 00:02:55,640
+كبيرة cause you to breathe more deeply and your
+
+42
+00:02:55,640 --> 00:03:00,580
+heart to work harder than أكتر تضخم ال heart
+
+43
+00:03:00,580 --> 00:03:04,920
+بيشتغل و بيعمل pumping ل bloodit's also called
+
+44
+00:03:04,920 --> 00:03:09,120
+cardiovascular exercise ال aerobic exercise ممكن
+
+45
+00:03:09,120 --> 00:03:13,620
+أنا كمان أسميها cardiovascular exercise it's
+
+46
+00:03:13,620 --> 00:03:16,660
+improve لل health for your heart and lungs حلو
+
+47
+00:03:16,660 --> 00:03:21,500
+كتير هاي التمرين ال aerobic exercise في اللي هي ال
+
+48
+00:03:21,500 --> 00:03:26,200
+exercise الخاصة بالديابت patient تمام ال diabetic
+
+49
+00:03:26,200 --> 00:03:30,840
+patientإذا بسميها أيضا ال cardiovascular exercise
+
+50
+00:03:30,840 --> 00:03:34,040
+ال aerobic resistance exercise اللي هي ال
+
+51
+00:03:34,040 --> 00:03:37,380
+anaerobic exercise uses the large muscles that
+
+52
+00:03:37,380 --> 00:03:42,440
+don't require exogen هنا anaerobic غير أو لا هواي
+
+53
+00:03:42,660 --> 00:03:47,320
+نحن ليس بحاجة إلى الأكسجين for short period of
+
+54
+00:03:47,320 --> 00:03:51,360
+exercise it helps build strong muscles and lower
+
+55
+00:03:51,360 --> 00:03:56,480
+blood sugar و بدنا نخفف أو نخفض مستوى الجلوكوز في
+
+56
+00:03:56,480 --> 00:04:00,320
+الدم لأن هذا هو هدفنا الأساسي من عمل ال exercise
+
+57
+00:04:00,320 --> 00:04:03,720
+to make the action of insulin more effectiveness
+
+58
+00:04:03,720 --> 00:04:07,580
+تمام؟ و أخلي اللي هو شغل الانسولين يكون أكثر
+
+59
+00:04:07,580 --> 00:04:13,210
+فعالية لبتكسب يعنيال F اللى احنا حكينا عليها فيه
+
+60
+00:04:13,210 --> 00:04:16,090
+فى ال stretching exercise زى ما بتشوفوا هنا فى
+
+61
+00:04:16,090 --> 00:04:19,030
+الصور فى عندي stretching exercise لل upper arm و
+
+62
+00:04:19,030 --> 00:04:22,390
+stretching لل lower arm ايضا هنا اللى هى فى ال
+
+63
+00:04:22,390 --> 00:04:25,790
+back و ال abdomen كمان نفس الاشي فى خلال ال long
+
+64
+00:04:25,790 --> 00:04:30,000
+sitting لل upper armالـ flexibility exercise aims
+
+65
+00:04:30,000 --> 00:04:33,160
+to increase more or maintaining the range of
+
+66
+00:04:33,160 --> 00:04:36,420
+motion للـ join طبعا also improve ال tool of
+
+67
+00:04:36,420 --> 00:04:39,000
+muscles، بدي أحافظ على ال tool of muscles و أبقى
+
+68
+00:04:39,000 --> 00:04:42,400
+ثابت، أخليها ما زالت في اللي هي ال flexibility
+
+69
+00:04:42,400 --> 00:04:48,430
+تبعتها و ثابت قابلة للمرونةThey developed better
+
+70
+00:04:48,430 --> 00:04:52,430
+muscular of body control وهنا احنا كمان بنحافظ او
+
+71
+00:04:52,430 --> 00:04:57,030
+بنحفظ اللي هو ان نكون عندنا في body control و اللي
+
+72
+00:04:57,030 --> 00:05:01,150
+هو عن طريق الأداء اللي هي الجلسة الرياضية ال
+
+73
+00:05:01,150 --> 00:05:05,010
+endurance كلمة endurance لحالها بعني فيها اللي هو
+
+74
+00:05:05,010 --> 00:05:10,250
+مدى قابلية المريض لإعادة و تكرار التمرين جديه هو
+
+75
+00:05:10,250 --> 00:05:16,240
+قادر قابلة كدر التمرين للمريض على أداء التمرينالـ
+
+76
+00:05:16,240 --> 00:05:20,480
+low resistance لازم تكون طبعا في مقاومة قليلة و
+
+77
+00:05:20,480 --> 00:05:23,960
+ضعيفة و ليس مقاومة قوية جدا high repetition
+
+78
+00:05:23,960 --> 00:05:28,680
+exercise و انه جادر على إعادة التمرين كذا مرة على
+
+79
+00:05:28,680 --> 00:05:32,300
+سبيل المثالالـ walking، الـ cycling، الـ swimming
+
+80
+00:05:32,300 --> 00:05:36,280
+و الـ upper extremity و الـ ergometry و أيضا بتشمل
+
+81
+00:05:36,280 --> 00:05:40,480
+ال large muscles of body تمام؟ إذا قدرة المريضة
+
+82
+00:05:40,480 --> 00:05:44,000
+على إعادة التمرين كذا مرة ولكن إذا كان في
+
+83
+00:05:44,000 --> 00:05:50,400
+resistance بعطيله مقاومة أقل how much exercise؟
+
+84
+00:05:50,400 --> 00:05:54,480
+جداش أنا بدي من هذا ال exercise؟ هتتبع قانون FET
+
+85
+00:05:54,480 --> 00:06:00,190
+FET بيحكي إيش؟frequency intensity timing and
+
+86
+00:06:00,190 --> 00:06:05,250
+typing تمام؟ إذا ال frequency كام مرة في الإسبوع
+
+87
+00:06:05,250 --> 00:06:09,630
+أنا بدي أعمل هذا التمرين على سبيل المثال بنعمل
+
+88
+00:06:09,630 --> 00:06:13,930
+التمرين هذا عشر مرات خلال الإسبوع ال intensity
+
+89
+00:06:13,930 --> 00:06:18,650
+جدّي أنا بدي في كل تمرين من الوقت تلاتين لاربعين
+
+90
+00:06:18,650 --> 00:06:22,890
+دقيقة في كل exercise حوالي اللي هو من ال target
+
+91
+00:06:22,890 --> 00:06:27,310
+heart rate group exerciseتمام؟ إذا كام من الوقت
+
+92
+00:06:27,310 --> 00:06:29,990
+لهذا ال exercise على سبيل المثال بدي أعمل
+
+93
+00:06:29,990 --> 00:06:33,670
+stretching exercise بدي أستخدملهم جلسة فيها تلاتين
+
+94
+00:06:33,670 --> 00:06:38,670
+دقيقة بال exercise حوالي خمسين لستين في اللي هو ال
+
+95
+00:06:38,670 --> 00:06:42,110
+target heart rate اللي هم أغلبهم بنشتغل معاهم هناك
+
+96
+00:06:42,110 --> 00:06:45,390
+ال type ال safe exercise اللي أحنا حكينا عليهم قبل
+
+97
+00:06:45,390 --> 00:06:50,770
+شوية تمام؟ اللي أنا لسه مخلصة منهم قبل قليل ال
+
+98
+00:06:50,770 --> 00:06:54,270
+time اللي هو ال morning it's idealExercise زى ما
+
+99
+00:06:54,270 --> 00:06:57,690
+بنشوف معظم الناس اللى بتصحى بتجرس صباحا بيكون
+
+100
+00:06:57,690 --> 00:07:02,710
+الوقت مبكر لإنه بتكون درجة حرارة أقل الاشي بيكون
+
+101
+00:07:02,710 --> 00:07:08,070
+more relaxed أكتر و لسه هو صاحي من النوم و عنده
+
+102
+00:07:08,070 --> 00:07:12,210
+دافعية و تحافظ طبعا لإنه يعمل هذا ال exercise
+
+103
+00:07:12,210 --> 00:07:15,630
+لاحظونى هنا فى ال breathing exercise ال breathing
+
+104
+00:07:15,630 --> 00:07:19,590
+exercise مهم جدا لاحظوا هنا فى البداية تم
+
+105
+00:07:19,590 --> 00:07:25,870
+الاستنشاق عن طريق الأنف ال noseتمام؟ و بعدين اللي
+
+106
+00:07:25,870 --> 00:07:31,010
+هو تم إخراجه طبعا عن طريق اللي هو ال mouse بهيك
+
+107
+00:07:31,010 --> 00:07:35,750
+بقول أنا أدخلت كمية كبيرة من ال oxygen داخل
+
+108
+00:07:35,750 --> 00:07:40,910
+الرئتين و هذا المهم و الكويس عندى هناخد ان شاء
+
+109
+00:07:40,910 --> 00:07:44,690
+الله رب العالمين تمارين كتيرة خلال اللي هي ال
+
+110
+00:07:44,690 --> 00:07:48,010
+breathing exercise في حالات ال chest و حالات ال
+
+111
+00:07:48,010 --> 00:07:52,870
+cardiology ال neck exerciseالكثير مننا يعانى من
+
+112
+00:07:52,870 --> 00:07:56,830
+مشاكل ال neck problems تمام فما بالكم في مريض سكري
+
+113
+00:07:56,830 --> 00:07:59,650
+طبعا و خصوصا إذا كان من الناس ال chronic الناس
+
+114
+00:07:59,650 --> 00:08:03,330
+اللي سررها السكري حوالي عشرين لتلاتين سنة كم في
+
+115
+00:08:03,330 --> 00:08:06,790
+عندهم بعض المشاكل ال stretching exercise مهم جدا
+
+116
+00:08:06,790 --> 00:08:12,610
+ال rotation up down protraction retraction كل هذه
+
+117
+00:08:12,610 --> 00:08:15,610
+الأمور مهمة جدا في ال neck exercise to
+
+118
+00:08:15,610 --> 00:08:19,690
+strengthening exercise for the neck ال hand
+
+119
+00:08:19,690 --> 00:08:25,000
+exerciseطبعا للإيدانلأن في حكينا على موضوع خصوصا
+
+120
+00:08:25,000 --> 00:08:28,600
+هنا ال hand grip في عندنا موضوع اللي هو بيحكي على
+
+121
+00:08:28,600 --> 00:08:32,200
+ال neuropathy ال neuropathy من الحاجات اللي انا
+
+122
+00:08:32,200 --> 00:08:37,140
+قلت ممكن تأثر على ال micro اللي هو systemet على
+
+123
+00:08:37,140 --> 00:08:42,260
+الأجهزة اللي هي في ال micro تمام فانا هنا بحاول
+
+124
+00:08:42,260 --> 00:08:46,180
+انه انا احافظ على ال mobility او احافظ على ال good
+
+125
+00:08:46,180 --> 00:08:50,760
+range of motion لكربلبون و متكربلبون و اللي هم
+
+126
+00:08:52,120 --> 00:08:55,580
+الأصابع لإنه عند هذه الستات ممكن إنه يصير في عندها
+
+127
+00:08:55,580 --> 00:09:01,280
+stiffness نتيجة لـuseless في بعض الأحيان أيضا ال
+
+128
+00:09:01,280 --> 00:09:06,620
+trunk exercise لأ أهمله لإنه إشي مهم إنه أنا أحافظ
+
+129
+00:09:06,620 --> 00:09:09,480
+على ال back muscles و ال abdomen muscles ال
+
+130
+00:09:09,480 --> 00:09:12,140
+exercise سواء كان في وضع ال supine position أو
+
+131
+00:09:12,140 --> 00:09:16,480
+اللي هو crook line position لبرون و بحط نخدة تحت
+
+132
+00:09:16,480 --> 00:09:21,540
+البطن تمام؟ أيضا في عندي اللي هو ال exerciseمن ال
+
+133
+00:09:21,540 --> 00:09:25,560
+trunk في وضع اللي هو ال side lying position و ايضا
+
+134
+00:09:25,560 --> 00:09:29,740
+الوضعية اللي هي ال bridging هذه او بنسميها اللي هو
+
+135
+00:09:29,740 --> 00:09:34,680
+الجسر او تمرين الجسر ايضا في عندى ال leg exercise
+
+136
+00:09:34,680 --> 00:09:39,220
+سواء كانت ال leg لاحظوا اللي هي ال leg اللي تحت
+
+137
+00:09:39,220 --> 00:09:43,400
+عاملة بوضع اللي هو ال flexion لل hip flexion لل
+
+138
+00:09:43,400 --> 00:09:47,940
+knee يعني to اللي هو stabilize وبرفع اللي هي اللي
+
+139
+00:09:47,940 --> 00:09:48,260
+فوق
+
+140
+00:09:51,100 --> 00:09:54,120
+أيضا في وضع لبران في وضع اللي هو هنا pumping
+
+141
+00:09:54,120 --> 00:09:58,440
+exercise ل اللي هو ال ankle نفس الأشي في وضع اللي
+
+142
+00:09:58,440 --> 00:10:02,920
+هو long sitting كلها هاد ال exercise مهمة ال
+
+143
+00:10:02,920 --> 00:10:05,980
+peripheral and autonomic neuropathy حكينا احنا على
+
+144
+00:10:05,980 --> 00:10:09,710
+موضوع ال neuropathyلأن في مريض Neuropathy هو يعتبر
+
+145
+00:10:09,710 --> 00:10:13,370
+مريض Neurology، إله علاقة بالأعصاب، المطلوب مني
+
+146
+00:10:13,370 --> 00:10:16,030
+أنه أنا ما أخليه يعمل non-weight bearing
+
+147
+00:10:16,030 --> 00:10:21,030
+activities، المطلوب مني أنه يعمل ال exercise non
+
+148
+00:10:21,030 --> 00:10:24,910
+-weight bearing، ما يحمل كل الوزن على القدمين مرة
+
+149
+00:10:24,910 --> 00:10:28,550
+واحدة، ال swimming، ال bicyclingالـ chair and arm
+
+150
+00:10:28,550 --> 00:10:31,850
+exercise تمام إن هو يحاول إنه يعمل stretching
+
+151
+00:10:31,850 --> 00:10:36,150
+exercise عن طريق الكرسي Contraindication ممنوع
+
+152
+00:10:36,150 --> 00:10:40,470
+لمريض من neuropathy إنه يركب أو يجري على ال
+
+153
+00:10:40,470 --> 00:10:44,590
+treadmill ممنوع إنه يظل ماشي بيه اللي هو prolonged
+
+154
+00:10:44,590 --> 00:10:48,970
+walking، jogging، ركض، step exercise هذه الشغلات
+
+155
+00:10:48,970 --> 00:10:53,810
+ممنوعة لمريض من neuropathy سواء كان peripheral أو
+
+156
+00:10:53,810 --> 00:11:00,240
+autonomicلنيرو بثي recommended إله أيضا اللي هو
+
+157
+00:11:00,240 --> 00:11:04,820
+low to moderate intensity من ال exercise يعني مش
+
+158
+00:11:04,820 --> 00:11:08,780
+intensity عالية جدا لإنه ممكن ترهقه وبالتالي هو
+
+159
+00:11:08,780 --> 00:11:11,940
+أصلا ممكن يكون عنده مشكلة في ال grasping أو مشكلة
+
+160
+00:11:11,940 --> 00:11:16,060
+في ال food sensation فما هيحس معايا إذا ال low ل
+
+161
+00:11:16,060 --> 00:11:20,380
+ال moderate okay مسموحي لكن ال high intensity مش
+
+162
+00:11:20,380 --> 00:11:23,840
+مسموحةالدايمة الـ Cretinopathy كلمة Cretinopathy
+
+163
+00:11:23,840 --> 00:11:26,660
+حكيت أنا من اللي هي الشبكية وحاكيناها شبكية
+
+164
+00:11:26,660 --> 00:11:30,780
+الاقتلال السكري هيالها دور كبير لمريضنا مريضنا
+
+165
+00:11:30,780 --> 00:11:34,460
+لازم يكون low impact في ال cardiovascular بسمحله
+
+166
+00:11:34,460 --> 00:11:38,020
+بالتمارين اللي هي بتأثر على ال cardiovascular
+
+167
+00:11:38,020 --> 00:11:41,180
+conditioning زي ال swimming زي ال walking ال low
+
+168
+00:11:41,180 --> 00:11:44,720
+impact aerobic exercise ال stationary cycling and
+
+169
+00:11:44,720 --> 00:11:48,170
+endurance exerciseهذه الأمور مسموحة إلي أنا لبريد
+
+170
+00:11:48,170 --> 00:11:52,230
+اللي هو السكري اللي عنده مشكلة في Erythropia أما
+
+171
+00:11:52,230 --> 00:11:55,810
+Contra Indication إن هي الحركات اللي فيها اهتزاز
+
+172
+00:11:55,810 --> 00:12:01,350
+زي النط والقفز وهذه الأمور هل بتأدي لأختلال في
+
+173
+00:12:01,350 --> 00:12:05,870
+توازنه فبالتالي ممكن أنا أثر على شبكية العين اللي
+
+174
+00:12:05,870 --> 00:12:11,710
+موجودة عليها Hypoglycemiaالان احنا كل كلام او لو
+
+175
+00:12:11,710 --> 00:12:15,410
+جيت على اي مريض سكري بيقولك انا بخاف اكتر اشي من
+
+176
+00:12:15,410 --> 00:12:21,420
+اللي هو ارتفاع السكر في الدم تمامانخفاض السكر في
+
+177
+00:12:21,420 --> 00:12:25,640
+الدم ايضا مصيبة و بعتبره حالة clinical حالة
+
+178
+00:12:25,640 --> 00:12:29,900
+pathological حالة سيئة جدا يعني لو دخل المرض عندى
+
+179
+00:12:29,900 --> 00:12:36,320
+في حالة غيبوبة في السكري حالة بعتبرها emergency و
+
+180
+00:12:36,320 --> 00:12:39,680
+على طول ممكن انا ادخل فيه لأنه لا سماح الله ممكن
+
+181
+00:12:39,680 --> 00:12:45,000
+يدخلي بعد هيك في مشاكل عديدة جدا ال person should
+
+182
+00:12:45,000 --> 00:12:48,630
+be instructed to stop exercisingعلى طول و أنا بعمل
+
+183
+00:12:48,630 --> 00:12:51,590
+exercise إجتوا hypoglycemia على طول بوقف ال
+
+184
+00:12:51,590 --> 00:12:54,950
+exercise لأن ال exercise أصلا بحاجة لجولوكوز و
+
+185
+00:12:54,950 --> 00:12:59,290
+glycogen و كل الأمور هذه فمبالكم أنه أظلني مستمرة
+
+186
+00:12:59,290 --> 00:13:02,270
+فيه في ال exerciseال people at risk الناس اللي
+
+187
+00:13:02,270 --> 00:13:06,630
+عندها يعني المخاطر أو الناس اللي تقع في دائرة
+
+188
+00:13:06,630 --> 00:13:10,050
+الخطر في الhypoglycemia لازم على الأقل يبقى شايل
+
+189
+00:13:10,050 --> 00:13:15,030
+فيه اللي هو في محفظته في جيبته يكون معاه drops
+
+190
+00:13:15,030 --> 00:13:18,930
+يكون معاه حبة شوكلت أو أي إشي من الجلوكوز خلال
+
+191
+00:13:18,930 --> 00:13:22,050
+دقائق يكون فاتحينله إياها وعلى طول ماتينه إياها
+
+192
+00:13:22,050 --> 00:13:25,530
+أهم إشي كمان هذا المريض لازم يكون معاه اللي هو
+
+193
+00:13:25,530 --> 00:13:31,330
+الهوية تبعته أو كرتإن البطاقة الطبية المعرفة إن
+
+194
+00:13:31,330 --> 00:13:35,110
+هذا مريض سكري حتى لو اللي سمح الله صار فيه عنده أي
+
+195
+00:13:35,110 --> 00:13:38,510
+hypoglycemia و هو في الشارع إن الناس تعرف كيف
+
+196
+00:13:38,510 --> 00:13:42,810
+تعمله ال first aid على طول مباشرة تمام؟ ممكن يكون
+
+197
+00:13:42,810 --> 00:13:46,230
+معاه قزازة عصير أو اللي هو بعض ال drops زي ما
+
+198
+00:13:46,230 --> 00:13:49,930
+حاكينا in order to treat hypoglycemia remember
+
+199
+00:13:49,930 --> 00:13:54,900
+it's a medical emergencyطبعا هي حالة طبية وخطيرة
+
+200
+00:13:54,900 --> 00:13:58,480
+جدا زى ما حكى هنا ليس السكري بالارتفاع ايضا
+
+201
+00:13:58,480 --> 00:14:02,640
+بالانخفاض اللى احنا بنحكى بعض ال snacks اللى ممكن
+
+202
+00:14:02,640 --> 00:14:07,580
+تمنعلى اللى هو ال hypoglycemia ممكن مريض ياخد بعض
+
+203
+00:14:07,580 --> 00:14:11,480
+ال snacks أي بعض البسكوتات البسيطة لحتى يمنع اللى
+
+204
+00:14:11,480 --> 00:14:17,470
+هو الالـ basic rules أو القواعد الأساسية لـ snacks
+
+205
+00:14:17,470 --> 00:14:22,170
+قبل ما تتاخد اللي هي لازم تكون قلائمة ومناسبة
+
+206
+00:14:22,170 --> 00:14:28,010
+لمرضى، مش صحيح أنه انا اعطي snacks و بس، لأ ال
+
+207
+00:14:28,010 --> 00:14:31,330
+snacks superior before activities or to activities
+
+208
+00:14:31,330 --> 00:14:34,470
+to prevent hypoglycemia are just a quantity based
+
+209
+00:14:34,470 --> 00:14:37,990
+in pre-activity blood glucose direction of blood
+
+210
+00:14:37,990 --> 00:14:42,270
+glucoseانه انا لازم اعرف هل هو جديش كان عنده
+
+211
+00:14:42,270 --> 00:14:46,390
+glucose جامن ال exercise و بعد الجلسة camp اللي هو
+
+212
+00:14:46,390 --> 00:14:51,730
+ال exercise ال blood glucose له or dropping على
+
+213
+00:14:51,730 --> 00:14:55,370
+طول انا بزيد اللي هو ال crabs او بزيد اللي هي ال
+
+214
+00:14:55,370 --> 00:15:00,380
+snacks اذا كان stableOkay بستخدم اشي عادي ومافيش
+
+215
+00:15:00,380 --> 00:15:03,500
+فيه اي نوع من الشوكولات او السكريات اما اذا كان
+
+216
+00:15:03,500 --> 00:15:08,560
+high بخفض كمية ال crabs اللي موجودة عندي ال snacks
+
+217
+00:15:08,560 --> 00:15:13,000
+at least once per hour during prolonged activities
+
+218
+00:15:13,000 --> 00:15:19,360
+للنشاط او ال exercise التويل سنة واحدة تكفي خلال
+
+219
+00:15:19,360 --> 00:15:24,430
+الساعةChoose a high glycemic form of carbohydrates
+
+220
+00:15:24,430 --> 00:15:29,370
+بستخدمله اللي هي بسعرات عالية جدا هنا useful tip
+
+221
+00:15:29,370 --> 00:15:32,630
+of exercise بعض ال exercise اللي انا بدي استخدمها
+
+222
+00:15:32,630 --> 00:15:38,830
+اهم اشي اللي في عندي نقاط مهمة انا لازم اعدي عليها
+
+223
+00:15:38,830 --> 00:15:41,870
+لمريض السكري اهم اشي حاكيناه معانا اللي هي البطاقة
+
+224
+00:15:41,870 --> 00:15:46,540
+الطبية والله هذا فلان تين و مريض سكريالعناية
+
+225
+00:15:46,540 --> 00:15:50,400
+بالقدمين، جابل ما أبدأ أي exercise لازم أنا أطلع
+
+226
+00:15:50,400 --> 00:15:54,880
+بالامراية عن الأصابع، فيهم لا سمح الله جروح، فيهم
+
+227
+00:15:54,880 --> 00:15:58,920
+خدش، فيهم اترومة، لازم أاخد ذالي، الحذاء اللي بدوا
+
+228
+00:15:58,920 --> 00:16:04,010
+يلبسوا لازم يكون مناسب ومشمحكم او مش ضيق على رجله
+
+229
+00:16:04,010 --> 00:16:07,990
+عشان مايصير فيه اي مشاكل عالطول لازم يكون معاه
+
+230
+00:16:07,990 --> 00:16:12,190
+اللي هي الماء لإنه ممكن اللي سمح الله يصير فيه
+
+231
+00:16:12,190 --> 00:16:16,490
+عنده اي مشاكل ماأشغلوش او ماجهدوش ب exercise او
+
+232
+00:16:16,490 --> 00:16:21,330
+activity طويلة جدا ايضا اللي هي الحرارة العالية مش
+
+233
+00:16:21,330 --> 00:16:26,050
+ضروري ان اعمل فيها exercise في الأجواء الحارة نبدأ
+
+234
+00:16:26,050 --> 00:16:28,450
+هم اللي هم ال always carry identification card
+
+235
+00:16:28,450 --> 00:16:32,040
+with youأيضا check your feet before walking,
+
+236
+00:16:32,660 --> 00:16:36,860
+choose good footwear and light clothes, drink of
+
+237
+00:16:36,860 --> 00:16:41,820
+water, don't exercise during hot seasons and when
+
+238
+00:16:41,820 --> 00:16:46,050
+not feeling wellالسماري ان ال physical activity
+
+239
+00:16:46,050 --> 00:16:49,130
+should be encourage all people with diabetes مهم
+
+240
+00:16:49,130 --> 00:16:53,670
+جدا الرياضة للناس اللي هم موجودين هنا على الكورة
+
+241
+00:16:53,670 --> 00:16:58,070
+الأرضية و بالذات اللي هم المرضى السكري ال people
+
+242
+00:16:58,070 --> 00:17:01,530
+need be educated about prevention and treatment
+
+243
+00:17:01,530 --> 00:17:07,480
+hypoglycemia people should be to planاو ال period
+
+244
+00:17:07,480 --> 00:17:11,080
+of دي هي for period for physical activities انه
+
+245
+00:17:11,080 --> 00:17:15,060
+بالنهاية انا بدي اعمل التمرين ولكن في عندى قواعد
+
+246
+00:17:15,060 --> 00:17:19,640
+وقانونين لازم امشي عليها مع هذا المريض هذا مش مريض
+
+247
+00:17:19,640 --> 00:17:23,200
+عادي لان هحكي على حالة طبية كنا حكينا عليها في
+
+248
+00:17:23,200 --> 00:17:26,640
+بداية اللي هو المحاضرة اللي هي حاجة بنسميها
+
+249
+00:17:26,640 --> 00:17:30,260
+هشوفوها او انه ممكن شوفتوها لناس اللي اتدربت في
+
+250
+00:17:30,260 --> 00:17:34,040
+أقصام الباطنة حاجة اسمها ال medical او diabetic
+
+251
+00:17:34,040 --> 00:17:41,710
+foodطبعا قدم السكري الاشي شائع جدا يعني كنت بسمع
+
+252
+00:17:41,710 --> 00:17:46,590
+على مستشفى كامل هيفتتحوها في اللي هو قطاع غزة فقط
+
+253
+00:17:46,590 --> 00:17:50,590
+خاصة بحاجة اسمها diabetic food على جد ما هي مليانة
+
+254
+00:17:50,590 --> 00:17:54,250
+و جد ما احنا في عندنا حالة amputation ديابتك food
+
+255
+00:17:54,250 --> 00:17:57,150
+can be defined as a group of syndrome in which
+
+256
+00:17:57,150 --> 00:18:02,220
+neuropathy, ischemic and infectionتمام؟ لاحظوا ال
+
+257
+00:18:02,220 --> 00:18:05,300
+stages اللى أنا بدى أمشي عليهم هي neuropathy
+
+258
+00:18:05,300 --> 00:18:09,820
+ischemic and infection lead to tissue breakdown
+
+259
+00:18:09,820 --> 00:18:14,380
+then ulceration and resulting to morbidity and
+
+260
+00:18:14,380 --> 00:18:19,780
+possible of amputation trauma صغيرةصار فيه على
+
+261
+00:18:19,780 --> 00:18:23,340
+سبيل المثال و الحجة بده قص إدفارها صار في عندها
+
+262
+00:18:23,340 --> 00:18:28,500
+جلح صغير على حافة الإصبع أهملته مرة على مرة و احنا
+
+263
+00:18:28,500 --> 00:18:31,580
+بنعرف لمرضى السكري في عندهم poor blood circulation
+
+264
+00:18:31,580 --> 00:18:36,120
+أدى إلى تعفن هذه المنطقة أدى إلى infection في هذه
+
+265
+00:18:36,120 --> 00:18:39,740
+المنطقة بعد شوية صار في breakdown لغشه بعد شوية
+
+266
+00:18:39,740 --> 00:18:45,800
+صارت تدخل الحالة في إذرقاق cyanosisللمنطقة بعدين
+
+267
+00:18:45,800 --> 00:18:50,640
+بيصير في عندي اللي هي ال amputation تمام؟ لإنه
+
+268
+00:18:50,640 --> 00:18:54,220
+خلاص بيكون دخلت في اللي هو poor blood circulation
+
+269
+00:18:54,220 --> 00:18:58,380
+أو poor blood supply لهذه المنطقة دي بتكفوت
+
+270
+00:18:58,380 --> 00:19:01,620
+pathology grouped into two broad categories ممكن
+
+271
+00:19:01,620 --> 00:19:06,000
+أنا أقسمها لحالتين تنتينالنيروباتيكو نيرو اسكيميك
+
+272
+00:19:06,000 --> 00:19:16,760
+تمام انه ال نيرو باتيكو نيرو اسكيميك
+
+273
+00:19:16,760 --> 00:19:19,060
+نيرو باتيكو نيرو نيرو نيرو نيرو نيرو نيرو نيرو
+
+274
+00:19:19,060 --> 00:19:19,560
+نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو
+
+275
+00:19:19,560 --> 00:19:21,760
+نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو
+
+276
+00:19:21,760 --> 00:19:21,800
+نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو
+
+277
+00:19:21,800 --> 00:19:31,080
+نيرو نيرو
+
+278
+00:19:31,080 --> 00:19:35,650
+نRoot sensation فقدان الإحساس في هذه الأجر may
+
+279
+00:19:35,650 --> 00:19:39,130
+result subsequent foot deformity causing abnormal
+
+280
+00:19:39,130 --> 00:19:41,650
+biomechanical loading in the feet and then a
+
+281
+00:19:41,650 --> 00:19:46,810
+breakdown of the skin and ulcersإنه أنا بدي أصير
+
+282
+00:19:46,810 --> 00:19:51,570
+في عندي فقدان بالإحساس في اللي هو القدم ممكن أكون
+
+283
+00:19:51,570 --> 00:19:57,350
+ماشيت و بطريقة خاطئة أدت لعوجاج القدم فبالتالي بعد
+
+284
+00:19:57,350 --> 00:20:00,450
+فترة من الفترات بدي أصير في عندي تحميل على منطقة
+
+285
+00:20:00,450 --> 00:20:05,090
+معينة من الفوت باللي هو الإضافة اللي أنا فوتت
+
+286
+00:20:05,090 --> 00:20:08,750
+المنطقة التانية اللي هي بالأصل في ال normal gate
+
+287
+00:20:08,750 --> 00:20:11,670
+اللي أنا مابماشيتش عليها صحيح بإن انتوا أدت لإن
+
+288
+00:20:11,670 --> 00:20:15,800
+يصير في عندي breakdown لل skin and ulcerationتمام؟
+
+289
+00:20:15,800 --> 00:20:19,260
+هذا الأشي في الـ Neuropathy .. إيه اللي عندنا؟ الـ
+
+290
+00:20:19,260 --> 00:20:26,020
+Neuropathic phase طبعا هيكون warm .. warm
+
+291
+00:20:26,020 --> 00:20:30,440
+and nonetheless dry usually painless and pulse
+
+292
+00:20:30,440 --> 00:20:35,920
+remain balanced طبعا الإجر ما زالت لسه فيها النبض
+
+293
+00:20:36,180 --> 00:20:40,200
+اللي ممكن يحس بخدلان تنميل بس جافة to make no
+
+294
+00:20:40,200 --> 00:20:44,960
+complication Quart اللي هي الـ neuropathic joint
+
+295
+00:20:44,960 --> 00:20:48,740
+طبعا نوع من أنواع الـ deformity اللي هتصير الـ
+
+296
+00:20:48,740 --> 00:20:52,600
+neuropathic ulcer found mainly on soles and feet
+
+297
+00:20:52,600 --> 00:20:57,290
+موجود طبعا في عندنا ulcer اللي هوعبارة عن تقرح في
+
+298
+00:20:57,290 --> 00:21:00,470
+باطن القدم Minority trauma على سبيل المثال بسبب
+
+299
+00:21:00,470 --> 00:21:04,450
+ليه المشكلة زي ما حكينا Walking اللي هو bar foot
+
+300
+00:21:04,450 --> 00:21:08,230
+or acute injury اللي هو طبعا إذا مشى ليه هذا الشخص
+
+301
+00:21:08,230 --> 00:21:12,810
+و هو حافي من غير ما يتخذ إجراءات الوقاية والسلامة
+
+302
+00:21:12,810 --> 00:21:17,630
+وممكن ينأذي بأي إصابة بسيطة Participated in a
+
+303
+00:21:17,630 --> 00:21:20,930
+chlorine attack؟ أه صح النوع التاني من adaptive
+
+304
+00:21:20,930 --> 00:21:25,150
+food اللي هو neuro ischemic fitالنيرو اسكيماك من
+
+305
+00:21:25,150 --> 00:21:28,250
+اسمها اسكيماك معناته ال preferal لل artery disease
+
+306
+00:21:28,250 --> 00:21:32,090
+إيه علاقة بالارتري؟ ال infection often complicated
+
+307
+00:21:32,090 --> 00:21:35,450
+أو often اللي هو neuropathy complicated and
+
+308
+00:21:35,450 --> 00:21:38,550
+ischemic coils considerably damaged ده بتكفور
+
+309
+00:21:38,550 --> 00:21:44,110
+المشكلة هنا هنا اسكيماكة معناه الكلاب تيجي تحس أجر
+
+310
+00:21:44,110 --> 00:21:49,170
+المريضة تبعتنا او المريض كال باردة و ال pulse مافي
+
+311
+00:21:49,170 --> 00:21:52,970
+pulseفبالتالي هنا المشكلة في الـ artery هنا أنا
+
+312
+00:21:52,970 --> 00:21:55,110
+تشهد نيرو بس ال complication intermediate
+
+313
+00:21:55,110 --> 00:21:58,610
+cloudation طبعا بدي يكون في عندي intermediate
+
+314
+00:21:58,610 --> 00:22:02,410
+cloudations اللي هو بشكل متقطع rest لل بين and
+
+315
+00:22:02,410 --> 00:22:07,010
+ganglia may occur ممكن تحدث الغلغانين كنهاية هاي
+
+316
+00:22:07,010 --> 00:22:10,630
+ال complication الـ neuro ischemic ulcer resulting
+
+317
+00:22:10,630 --> 00:22:15,380
+fromالـ Localized Pressure Damage بيصير فيه ضغط
+
+318
+00:22:15,380 --> 00:22:19,720
+معين على هذه المنطقة على سبيل المثال، عندي ديابتك
+
+319
+00:22:19,720 --> 00:22:23,060
+و stroke patient وموجود هو في وضع الـ Sublime
+
+320
+00:22:23,060 --> 00:22:26,560
+Position وما بيصيرش فيه له تغيير أو تقليب للفراش
+
+321
+00:22:26,560 --> 00:22:30,800
+ممكن وضعيته في الـ Sublime يصير في عندنا
+
+322
+00:22:30,800 --> 00:22:34,170
+Ulceration في منطقة الـ Calcaneusيعني ال calcane
+
+323
+00:22:34,170 --> 00:22:37,990
+area بيصير فيها نتيجة لهذا ال pressure بيصير في
+
+324
+00:22:37,990 --> 00:22:41,510
+عنا اللي هو ال alpha and found mainly at the edge
+
+325
+00:22:41,510 --> 00:22:45,450
+of foot اللي هو زي ما حكينا في هاية أطراف الأصابع
+
+326
+00:22:45,450 --> 00:22:49,110
+ممكن يصير أيضا ومنطقة ال calcane
+
+327
+00:22:51,820 --> 00:22:56,920
+هذه بعض الصور للحالات اللى انا ممكن اشوفها طبعا
+
+328
+00:22:56,920 --> 00:23:01,620
+لاحظوا كيف اللى أضافر هنا مافيه حناية بالأضافر فى
+
+329
+00:23:01,620 --> 00:23:04,960
+عندنا بعض ال trauma اللى موجودة لازم ناخد بالنا
+
+330
+00:23:04,960 --> 00:23:08,890
+منها ال symptomsLosses of predictive sensation للـ
+
+331
+00:23:08,890 --> 00:23:11,770
+pain and tingling sensation الـ sensation طبعا
+
+332
+00:23:11,770 --> 00:23:15,790
+بنقله في هذه الحالات ال patient may develop the
+
+333
+00:23:15,790 --> 00:23:22,510
+blister فقاعات و كأنه الاشي أو كأنه المشكلة بدأت
+
+334
+00:23:22,510 --> 00:23:27,670
+بالي هو زي حروق من الدرجة التانية اللي هي الفقاعات
+
+335
+00:23:27,670 --> 00:23:31,350
+اللي بتكون موجودة عندهم Ablation and wound may not
+
+336
+00:23:31,350 --> 00:23:35,640
+to feel any painبكون انتهت هذا المريض تبعنا باللي
+
+337
+00:23:35,640 --> 00:23:41,660
+هو على سبيل المثال ب shoes تبعته اللي مش مناسبة
+
+338
+00:23:41,660 --> 00:23:45,840
+وضلوا ماشي مشواره وماحس فيها و أغلب الحالات كانت
+
+339
+00:23:45,840 --> 00:23:48,040
+تجينا سراحة على المستشفى بهذه الطريقة
+
+340
+00:23:51,980 --> 00:23:55,540
+أيضا ال circulation لما يكون فيها مشاكل بتسبب انه
+
+341
+00:23:55,540 --> 00:23:59,880
+تكسير للجلد ال circulation و ال skin temperatures
+
+342
+00:23:59,880 --> 00:24:03,960
+ايضا بتختلف معانا في البناء يعني بتلاحظ ان المنطقة
+
+343
+00:24:03,960 --> 00:24:07,040
+لا لون الهارو يوم أسمر يوم أحمر يوم متلونة
+
+344
+00:24:07,040 --> 00:24:11,840
+فبالتالي هنا المشكلة تبقى مستمرة إلى أن ندخل في
+
+345
+00:24:11,840 --> 00:24:15,490
+اللي هي ال complication الأخرىDepending on a
+
+346
+00:24:15,490 --> 00:24:18,510
+specific problem, the developed patient may notice
+
+347
+00:24:18,510 --> 00:24:21,390
+swelling and discoloration.زي ما حكيت أنه أنا
+
+348
+00:24:21,390 --> 00:24:26,750
+بتتطور المشكلة يوم الأجر أزرق، أحمر، grey، white،
+
+349
+00:24:26,750 --> 00:24:30,270
+و بعدين خلاص بندخل في اللي غير غرينا، red streak
+
+350
+00:24:30,270 --> 00:24:34,030
+and increasingly warm and coldestطبعا ومازالة
+
+351
+00:24:34,030 --> 00:24:38,550
+الإجر عندي اللى هو قليلة درجة الحرارة لإنه باردة
+
+352
+00:24:38,550 --> 00:24:43,110
+جدا with no or minimal pain a wound without drage
+
+353
+00:24:43,110 --> 00:24:48,670
+ممكن البعض الأحيان أنه يكون في عندي خراج أو قيح من
+
+354
+00:24:48,670 --> 00:24:52,590
+هذه المنطقة وبعض الأحيان مايكون فيه طبعا نتيجة
+
+355
+00:24:52,590 --> 00:24:55,310
+taking on socks and tingling بين deformity
+
+356
+00:24:55,340 --> 00:25:00,720
+الpatient with infection may have fever ارتفاع
+
+357
+00:25:00,720 --> 00:25:07,080
+درجة الحرارة اللي هي الرعشة او القشعيرة اللي بتفير
+
+358
+00:25:07,080 --> 00:25:11,580
+checks of redness احمرار ودرناج طبعا وفي وجود اللي
+
+359
+00:25:11,580 --> 00:25:17,190
+هو قيحة الخراجBlood sugar control بيصير فيه عدم
+
+360
+00:25:17,190 --> 00:25:20,890
+تحكم في اللي هو السكري في الدم المرض ممكن يدخل فيه
+
+361
+00:25:20,890 --> 00:25:25,230
+حالة من اللي هو ال confused أندلبام الهديان و اللي
+
+362
+00:25:25,230 --> 00:25:28,670
+هو نتيجة ارتفاع الضغط الدم و ارتفاع ال blood
+
+363
+00:25:28,670 --> 00:25:34,750
+sugars اللي موجود في cost factors في عندي لدى بدي
+
+364
+00:25:34,750 --> 00:25:41,190
+اكفاتعوامل داخلية وعوامل خارجية خليني أشوف من إيش
+
+365
+00:25:41,190 --> 00:25:45,350
+ممكن يصير في ال extrinsic factor bad fitting طبعا
+
+366
+00:25:45,350 --> 00:25:50,110
+ل الفوت وير ال shoes هذا مش مناسب لبسته هاي الست
+
+367
+00:25:50,110 --> 00:25:54,270
+وماكنش مناسب إلها تماما قد ل injury very foot
+
+368
+00:25:54,270 --> 00:26:00,170
+walkingأتمشت مشورها أو اتمشت في أرجع منزلها و هي
+
+369
+00:26:00,170 --> 00:26:05,290
+مش لابسة في ال shoes تبعها falling أو accident صار
+
+370
+00:26:05,290 --> 00:26:09,650
+في عندها مشكلة accident و صار في عملية crashing
+
+371
+00:26:09,650 --> 00:26:14,040
+جري فادت إلى ال infected لهذا اللونال object
+
+372
+00:26:14,040 --> 00:26:18,300
+inside shows ما اهتمت انها تشوف لما قد تلمس حذاء
+
+373
+00:26:18,300 --> 00:26:22,040
+تبعها انه فيه على سبيل المثال بعض الأحيان ممكن
+
+374
+00:26:22,040 --> 00:26:27,780
+يكون قطعة صغيرة من ال plastic او ممكن تكون اي اشي
+
+375
+00:26:27,780 --> 00:26:33,100
+مؤلم او اشي مؤذىبننتبه الحاج انه في الحذاء تبعه
+
+376
+00:26:33,100 --> 00:26:38,020
+مشكلة Thermal Trauma بعض الأحيان خصوصا اللي هو
+
+377
+00:26:38,020 --> 00:26:43,520
+أثناء جول البرت بتلاقي أن السيدت جاعدة على الدفاية
+
+378
+00:26:43,520 --> 00:26:48,400
+و مدى إجريها طبعا تدفيهم و انشن حرجاته و شاقة طبعا
+
+379
+00:26:48,400 --> 00:26:53,040
+صار اللي صار و هي لسه مش حاسة بحالها Injury by
+
+380
+00:26:53,040 --> 00:26:59,490
+sharp objectsطبعا النتيجة انه المنتبه لما حكينا
+
+381
+00:26:59,490 --> 00:27:03,230
+السيد انه في وجود مصمار على سبيل المثال في داخل
+
+382
+00:27:03,230 --> 00:27:08,010
+الشوز هاي بالنسبة للعوامل ال eccentric العامل ال
+
+383
+00:27:08,010 --> 00:27:14,010
+intrinsic اللي هو limited لل joint mobility نفس ال
+
+384
+00:27:14,010 --> 00:27:16,970
+joint في الtarsal bone او الmetatarsal bone او
+
+385
+00:27:16,970 --> 00:27:22,010
+الفلانجيز فيهم مشكلةهذه ال deformity نفسها بتعمل
+
+386
+00:27:22,010 --> 00:27:25,030
+compression او pressure على منطقة معينة ال poly
+
+387
+00:27:25,030 --> 00:27:29,430
+prominence طبعا اللي هي زي ما حكينا بعض اللي هو ال
+
+388
+00:27:29,430 --> 00:27:32,050
+poly prominence خصوصا بال little finger او ال
+
+389
+00:27:32,050 --> 00:27:34,750
+fifth finger بترسها البون food deformity زي ما
+
+390
+00:27:34,750 --> 00:27:37,970
+حكينا بعض الأحيان في ناس بتمشي و في عندها اللي هو
+
+391
+00:27:37,970 --> 00:27:41,630
+ال hammer foot او بنسميه ال big toeالـ plantar
+
+392
+00:27:41,630 --> 00:27:45,270
+callus طبعا نتيجة لإن هو في عنده مشكلة في التكلث
+
+393
+00:27:45,270 --> 00:27:49,870
+الزيادة، ال skirtishه، صار في عنده skirtishه،
+
+394
+00:27:49,870 --> 00:27:54,670
+الفيشارز بعض، اللي هي الشروخ اللي بتصير، هذه عوامل
+
+395
+00:27:54,670 --> 00:27:58,190
+اللي هي علاقة بداخل القدم نفسها، يعني مافي إيش
+
+396
+00:27:58,190 --> 00:28:01,370
+إيجانة من برا، كله من نفس ال food تبعتنا و ال
+
+397
+00:28:01,370 --> 00:28:05,230
+anatomical و ال changes اللي بتصير داخل ال food،
+
+398
+00:28:05,230 --> 00:28:08,360
+شو ال complication؟النيرو باتي هي مرتبط بـ
+
+399
+00:28:08,360 --> 00:28:12,340
+metabolic abnormalities للديابتس، طبعا إشي أساسي،
+
+400
+00:28:12,340 --> 00:28:16,500
+الديابتس مع هذا الحاج إله حوالي 15 أو 20 سنة، إشي
+
+401
+00:28:16,500 --> 00:28:20,890
+طبيعي أن يجيله نيرو باتي، vascular diseaseطبعا is
+
+402
+00:28:20,890 --> 00:28:23,790
+a present mainly patient with time to diagnosis of
+
+403
+00:28:23,790 --> 00:28:26,330
+the disease وكمان بعد 21 سنة ممكن يجيله of
+
+404
+00:28:26,330 --> 00:28:29,170
+vascular disease ال ulcer may cause by external
+
+405
+00:28:29,170 --> 00:28:33,550
+pressure or rebound كمان بعد هيك عن طريق أي
+
+406
+00:28:33,550 --> 00:28:37,510
+pressure زي ما حكينا أن هو لبس الفوت وكان ضيق على
+
+407
+00:28:37,510 --> 00:28:43,260
+أصابع إجراءأدت له مشاكل بعد مشوار طويل مشى طبعا
+
+408
+00:28:43,260 --> 00:28:47,460
+إنه يمشي حافي اللي هي barefoot and find object in
+
+409
+00:28:47,460 --> 00:28:51,520
+the shoes, ruff and seams, stones or tail بعض
+
+410
+00:28:51,520 --> 00:28:55,540
+الأحيان ممكن يكون عنده فيه مشاكل كبيرة ناتجة عن
+
+411
+00:28:55,540 --> 00:29:00,190
+اللي هو عدم ارتداء وارتداء بشكلطيب، هاي كلها من ال
+
+412
+00:29:00,190 --> 00:29:02,930
+complicated أيضا ال infection usually لإن زي ما
+
+413
+00:29:02,930 --> 00:29:05,490
+حكينا هدول الناس على طول بيصير في عندهم ال wound
+
+414
+00:29:05,490 --> 00:29:09,450
+كنا حاكينا في بداية اللي هو ال chapter إن هذا
+
+415
+00:29:09,450 --> 00:29:12,550
+المرض السكري بتكون عنده ال immunity system ضعيفة
+
+416
+00:29:12,550 --> 00:29:15,750
+جدا، أيضا ال wound بياخد فترة طويلة لما يصير فيه
+
+417
+00:29:15,750 --> 00:29:18,090
+هناالشيء اللى بتقلل ال infection usually are
+
+418
+00:29:18,090 --> 00:29:21,770
+caused by entry of bacteria, direct throat wound
+
+419
+00:29:21,770 --> 00:29:25,570
+اللى هي break in the skin such as ulcer area and
+
+420
+00:29:25,570 --> 00:29:29,950
+toenail pressure اللى هو ingrowing للتونيل بعض
+
+421
+00:29:29,950 --> 00:29:36,070
+الأحيانالنمو غير طبيعي لهو الإدفار أدى لإن يكون
+
+422
+00:29:36,070 --> 00:29:39,850
+فيه infection تالي بيوصل لمرحلة الجانجلينة أو اللي
+
+423
+00:29:39,850 --> 00:29:44,350
+هي بعدها بتتم عملية ال amputation لهذا المريض
+
+424
+00:29:44,350 --> 00:29:47,290
+بنتجة losses of blood supply أو losses of
+
+425
+00:29:47,290 --> 00:29:48,090
+circulation
+
+426
+00:29:50,300 --> 00:29:55,320
+هحكي على شوية anatomy اللى اللى هي ال bottom of
+
+427
+00:29:55,320 --> 00:30:00,300
+fruit عشان أعرف من وين أنا بدي أشتغل مع هذه الحالة
+
+428
+00:30:00,300 --> 00:30:04,860
+typical places that answer come from include بديوا
+
+429
+00:30:04,860 --> 00:30:08,620
+يكونوا ال answer تبعنا أو التقرح along the bottom
+
+430
+00:30:08,620 --> 00:30:12,830
+of fruitعلى ما تاكلها ده هتتوضح بصورة القادمة بإذن
+
+431
+00:30:12,830 --> 00:30:16,590
+الله تعالى a long bottom of fruit at the base of
+
+432
+00:30:16,590 --> 00:30:21,730
+two في اللي هو القاعدة تبعت الأصابع in the mild
+
+433
+00:30:21,730 --> 00:30:25,490
+fruit in the mid in the mid fruit or in the heel
+
+434
+00:30:25,490 --> 00:30:29,210
+طبعا ال side is a long bottom وفي عندنا على ال
+
+435
+00:30:29,210 --> 00:30:33,630
+side كل هذا الاشي بحكي أنا من اللي هي السول من تحت
+
+436
+00:30:33,630 --> 00:30:36,910
+a long to little foot from rubbing in shoes back
+
+437
+00:30:36,910 --> 00:30:42,300
+side of heel fromlying in the bed و ال uncle bones
+
+438
+00:30:42,300 --> 00:30:46,320
+اللى هى ال rubbing تبعنا اللى هى in a boat lying
+
+439
+00:30:46,320 --> 00:30:49,640
+in the bed top foot لاحظوا أخدنا على ال long
+
+440
+00:30:49,640 --> 00:30:53,760
+bottom و ال side و ال medial و ال top foot اللى هى
+
+441
+00:30:53,760 --> 00:30:58,060
+ال toes rubbing and shoes تمامالinfection may
+
+442
+00:30:58,060 --> 00:31:01,920
+start in one location and then spread طبعا بيبدأ
+
+443
+00:31:01,920 --> 00:31:04,740
+في منطقة أو نقطة معينة وبعدين بيبلش بالانتشار
+
+444
+00:31:04,740 --> 00:31:08,020
+along tendon sheets such as infections that start
+
+445
+00:31:08,020 --> 00:31:11,100
+in the bottom of metatarsal head بلشلي من ال
+
+446
+00:31:11,100 --> 00:31:13,620
+bottom of metatarsal heads and then spread rapidly
+
+447
+00:31:13,620 --> 00:31:17,380
+along with tendon wall to ankles امتد من بداية
+
+448
+00:31:17,380 --> 00:31:20,520
+اللي هي ال metatarsal وامتد لعند اللي هي ال tendon
+
+449
+00:31:20,520 --> 00:31:25,710
+تبع ال ankle هاي اللي احنا حكينا عليهمال top of
+
+450
+00:31:25,710 --> 00:31:29,690
+foot هاي اللي هي ال pony marking أو اللي هو بعض
+
+451
+00:31:29,690 --> 00:31:32,330
+الأحيان ال pony prominance هذه بتبقى واضحة عنا
+
+452
+00:31:32,330 --> 00:31:37,330
+شايفين كيف صارت الأجر لاللي هو ال shoes اللي مكونش
+
+453
+00:31:37,330 --> 00:31:42,290
+مظبوط أدى لاللي هي ال deformity هاي ال bottom of
+
+454
+00:31:42,290 --> 00:31:45,930
+foot اللي هو بعض القدم هاد اللي هنا هاي بعتبرها
+
+455
+00:31:45,930 --> 00:31:49,290
+bad وهنا اللي هي منطقة ال calcaneus أو منطقة اللي
+
+456
+00:31:49,290 --> 00:31:53,990
+هي ل ال footال classification of ulcer طبعا هذا
+
+457
+00:31:53,990 --> 00:31:57,330
+موضوع ال ulcer موضوع كبير جدا طبعا هو عبارة عن
+
+458
+00:31:57,330 --> 00:32:02,790
+five degrees ان شاء الله رب العالمين هنشرحه و
+
+459
+00:32:02,790 --> 00:32:06,410
+نتكلم عنه في مواضيع تانية هنا بس هي صورة تعبيرية
+
+460
+00:32:06,410 --> 00:32:10,590
+عشان تشوفوا قداش يعني صفر ال grade صفر ولا إشي لكن
+
+461
+00:32:10,590 --> 00:32:13,110
+لاحظوا لما يكون ال grade خمسة لاحظوا لما يكون ال
+
+462
+00:32:13,110 --> 00:32:17,190
+grade أربعة الإشي ممكن يوصل ل ال bone عفنا الله و
+
+463
+00:32:17,190 --> 00:32:21,550
+إياكم ال problem diagnosisالـ nerve function may
+
+464
+00:32:21,550 --> 00:32:25,350
+abnormal so the patient may feel not feel of pain
+
+465
+00:32:25,350 --> 00:32:30,810
+في عندنا احتراقة الأجر ودخلنا في infection ومع هيك
+
+466
+00:32:30,810 --> 00:32:36,050
+الست مش قادرة تحس أو مش حاسة ان والله في مشكلة
+
+467
+00:32:36,050 --> 00:32:40,830
+بإصبع أجر غير الكبير لو ما إجا عليها حد على سبيل
+
+468
+00:32:40,830 --> 00:32:45,990
+المثال وشاف والله حجة انت الوضع عندك مش مظبوط أو
+
+469
+00:32:45,990 --> 00:32:49,550
+ممكن هي ترتفع درجة حرارتها و تدخل في ال infection
+
+470
+00:32:49,550 --> 00:32:53,780
+scienceعن symptoms بعدين يعرفوا أنه والله عندها
+
+471
+00:32:53,780 --> 00:32:57,920
+مشكلة نتيجة جروح معين في جرحهم this frequently
+
+472
+00:32:57,920 --> 00:33:01,420
+caused daily diagnosis وهذا السبب الأساسي اللي هو
+
+473
+00:33:01,420 --> 00:33:06,300
+يؤخر عملية ال LTM بالإضافة لووجود سببأساسي اللي هو
+
+474
+00:33:06,300 --> 00:33:10,020
+أنه أنا عندي هدول مرضى السكري هم بالأساس ضعيفي
+
+475
+00:33:10,020 --> 00:33:13,060
+المناعة and the patient made diagnosis at late
+
+476
+00:33:13,060 --> 00:33:16,100
+with limb or life treating infection as a result
+
+477
+00:33:16,100 --> 00:33:20,080
+بعد ما يكون دخلنا في مشاكل عميقة حددت حياته حتى
+
+478
+00:33:20,080 --> 00:33:23,280
+حددت حياته هذه ال infectionالـ diagnosis is based
+
+479
+00:33:23,280 --> 00:33:26,120
+in the symptoms unsigned not before and the
+
+480
+00:33:26,120 --> 00:33:28,940
+absence of protective sensation may confirm هدا
+
+481
+00:33:28,940 --> 00:33:33,320
+بيأكدلي أنه ال radiographs may show gas in soft
+
+482
+00:33:33,320 --> 00:33:36,860
+tissue طبعا بياخدوها للمرضى و بيعملوها x-ray
+
+483
+00:33:36,860 --> 00:33:40,580
+بيلاحظوا وجود ال gas اللي هو في قاعة بابلسن صغيرة
+
+484
+00:33:40,580 --> 00:33:44,220
+في ال soft tissueطبعا و ال soft tissue بتبقى
+
+485
+00:33:44,220 --> 00:33:48,260
+الريحة تبعتها سيئة جدا، ايضا ال swelling، defect،
+
+486
+00:33:48,260 --> 00:33:51,140
+ال changes ال consensus ل infection، ممكن أحيانا
+
+487
+00:33:51,140 --> 00:33:55,740
+تسببلي fractures and اللي هو dislocations للمفصل
+
+488
+00:33:55,740 --> 00:34:01,470
+نفسه، كل هذا بيصير مع الإهمان لمريض السكريالـ
+
+489
+00:34:01,470 --> 00:34:05,850
+ulcers are graded for sizes إن أنا بقيمه حسب ال
+
+490
+00:34:05,850 --> 00:34:09,950
+size تبعه و الحجم تبعه طبعا و الدبث أهم إيش الدبث
+
+491
+00:34:09,950 --> 00:34:13,450
+لأنه إذا بتذكروا في ال slide السابقة حكيت إنه أنا
+
+492
+00:34:13,450 --> 00:34:16,510
+ممكن ال ulcer أوصل فيه لل bone معناة الكلام أنا
+
+493
+00:34:16,510 --> 00:34:19,250
+اخترقت ال skin و ال muscles و ال facial و كل
+
+494
+00:34:19,250 --> 00:34:23,270
+الأمور هاي و دخلت على اللي هو ال bone additional
+
+495
+00:34:23,270 --> 00:34:27,270
+imaging study may helpful including لل boneطبعا
+
+496
+00:34:27,270 --> 00:34:30,450
+الأمر I و ال CT ممكن يبينولي لوين أنا عندي ال
+
+497
+00:34:30,450 --> 00:34:33,490
+infection لأنه لازم يتدخل معايا بهذه الحالة اللي
+
+498
+00:34:33,490 --> 00:34:36,890
+هو الدكتور الأوائد دموية حتى يحدد لوين الغيرين على
+
+499
+00:34:36,890 --> 00:34:39,990
+سبيل المثال واصلا ال culture of the chauvron base
+
+500
+00:34:39,990 --> 00:34:43,810
+in ulcer may or more reliable than sweep cultures
+
+501
+00:34:43,810 --> 00:34:47,130
+from ulcer هنا ليش أنا بدي ال cultures؟ ليش بدي
+
+502
+00:34:47,130 --> 00:34:50,630
+المزرعة من هذه المنطقة اللي infected؟ عشان أعرف
+
+503
+00:34:50,630 --> 00:34:54,850
+مدى حساسية هذا الشخص لل antibiotics اللي يعطيها
+
+504
+00:34:54,850 --> 00:34:58,630
+دكتور الباطنةيعني على سبيل المثال بيجيب معاه ال
+
+505
+00:34:58,630 --> 00:35:04,390
+antibiotic كذا ال body بتاعي مابجيبش فبالتالي أنا
+
+506
+00:35:04,390 --> 00:35:08,770
+بعمل اللي هي مزرعة في هذه المنطقة باختعينة صغيرة
+
+507
+00:35:08,770 --> 00:35:12,670
+vascular studies may help determine how will blood
+
+508
+00:35:12,670 --> 00:35:16,600
+circulatingطبعا which is improving للwand healing
+
+509
+00:35:16,600 --> 00:35:18,700
+أنا بتهمني ال circulation و ال vascular
+
+510
+00:35:18,700 --> 00:35:23,240
+circulation حتى أحسن من ال healing لإن المنطقة
+
+511
+00:35:23,240 --> 00:35:27,460
+بيأكملها ملتهبة قام الدكتور و عمل depredment كشت و
+
+512
+00:35:27,460 --> 00:35:33,360
+إزالة لبعض اللي هي الأنسجة فالمنطقة جوفت على سبيل
+
+513
+00:35:33,360 --> 00:35:36,760
+المثال و انشل منها حاجة كتيرة فبالتالي أنا بدي
+
+514
+00:35:36,760 --> 00:35:41,520
+مناعة عالية عشان يصير في عندنا wand healingوما
+
+515
+00:35:41,520 --> 00:35:46,380
+أدخل بـ later complications لـ treatment طبعا، يا
+
+516
+00:35:46,380 --> 00:35:50,220
+إما للـ non-surgical أو surgical للـ non-surgical
+
+517
+00:35:50,220 --> 00:35:53,700
+by drugs إذا كان الأمر بسيط وخفيف، لكن إذا كان
+
+518
+00:35:53,700 --> 00:35:57,680
+بحاجة لـ surgical، زي ما اتكلمت عنه سابقا، بتتم عن
+
+519
+00:35:57,680 --> 00:36:02,280
+طريق اللي هو استئصال كل المشاكل و الدتشة و اللي هو
+
+520
+00:36:02,280 --> 00:36:08,520
+بعد هيك بحسن المناعة، physical therapyالايمو
+
+521
+00:36:08,520 --> 00:36:11,600
+فيزيكال ثرابي ده dead pig foot clinical to control
+
+522
+00:36:11,600 --> 00:36:14,640
+شو احدافنا ان انا اعمل control and maintenance لل
+
+523
+00:36:14,640 --> 00:36:19,260
+blood glucose level احافظ على ال blood glucose
+
+524
+00:36:19,260 --> 00:36:24,700
+level high اهم خطوة عندي لمرضى السكري to teach لل
+
+525
+00:36:24,700 --> 00:36:29,640
+area at risk of food ulcer ان انا دائما اي منطقة
+
+526
+00:36:29,640 --> 00:36:36,010
+فيها مشكلة اعمل عليها مراقبة و ملاحظةalmost care
+
+527
+00:36:36,010 --> 00:36:38,850
+that risky area to educate لل food care and
+
+528
+00:36:38,850 --> 00:36:42,170
+prevention methods دائما أعطي نصائح، دائما أعطي
+
+529
+00:36:42,170 --> 00:36:46,010
+تعليمات to advise brother footwear، لبس حذاء
+
+530
+00:36:46,010 --> 00:36:51,710
+مناسب، مضيق سيبك منه، الحذاء اللي مفتوح من الأمام
+
+531
+00:36:51,710 --> 00:36:55,250
+كمان سيبك منه، كل الأمور هذه أنا بعطيها advice لل
+
+532
+00:36:55,250 --> 00:37:01,540
+patient تبعي to educate do and don'tاعمل قائمة بيه
+
+533
+00:37:01,540 --> 00:37:05,260
+اعمل هذه الأشياء وقائمة ما تعمل هذه الأشياء خصوصا
+
+534
+00:37:05,260 --> 00:37:08,740
+إذا كان ما عندها الحالة caregiver أو مقدم رعاية
+
+535
+00:37:08,740 --> 00:37:13,160
+during daily activities probably ايضا to advise
+
+536
+00:37:13,160 --> 00:37:16,680
+proper food supplant بعض الأحيان هدول الناس بحاجة
+
+537
+00:37:16,680 --> 00:37:19,600
+لsupplant to correct deformity to minimize
+
+538
+00:37:19,600 --> 00:37:23,100
+neuropathic pain أقلل ال neuropathic pain to
+
+539
+00:37:23,100 --> 00:37:27,320
+prevent deformity أمنع أي ألم to improve muscle
+
+540
+00:37:27,320 --> 00:37:31,670
+power and prevent muscle worseningالشي طبيعي بال
+
+541
+00:37:31,670 --> 00:37:34,570
+exercise لازم to increase the range of motion
+
+542
+00:37:34,570 --> 00:37:37,290
+strengthening and endurance to prevent limited
+
+543
+00:37:37,290 --> 00:37:42,110
+joint mobility ال objectives تبعتنا لاللي هو
+
+544
+00:37:42,110 --> 00:37:45,850
+derdic footwear أول إشي لازم أعمل relieve ل ال
+
+545
+00:37:45,850 --> 00:37:49,050
+excessive plantar pressure أي plantar pressure أنا
+
+546
+00:37:49,050 --> 00:37:52,990
+أمنعها لإنه مابديش أعمل pressure على منطقة معينة و
+
+547
+00:37:52,990 --> 00:37:58,020
+بعد كده أدخل في الأنصار reduction لل shockأقل من
+
+548
+00:37:58,020 --> 00:38:01,420
+كمية الصدمات الموجودة reduction لل share friction
+
+549
+00:38:01,420 --> 00:38:05,960
+forces إن أنا ما أعملش اللي هو قوة مشاركة تزيد من
+
+550
+00:38:05,960 --> 00:38:09,020
+الوزن على سبيل المثال والضغط على هذه المنطقة
+
+551
+00:38:09,020 --> 00:38:13,080
+accommodations of minimal deformity تمام
+
+552
+00:38:13,080 --> 00:38:16,140
+stabilization للـ deformity و preventing
+
+553
+00:38:16,140 --> 00:38:21,880
+لrecurrence ulcer أمنع أي recurrence ulceradvice
+
+554
+00:38:21,880 --> 00:38:25,660
+about shoes and socks shoes اللي هي بعض النصائح
+
+555
+00:38:25,660 --> 00:38:31,060
+لاللي هو مرضنا سكري في لبس الحذاء و الإجرابات
+
+556
+00:38:31,060 --> 00:38:35,780
+choose and wear your shoes carefully بهدوء بنلبس
+
+557
+00:38:35,780 --> 00:38:39,500
+اللي هو حذائنا اللي عندنا pay new shoes at late in
+
+558
+00:38:39,500 --> 00:38:42,880
+the day when your foot at late in the day when
+
+559
+00:38:42,880 --> 00:38:45,400
+your foot are larger buy shoes that are
+
+560
+00:38:45,400 --> 00:38:48,730
+comfortable without breaking the periodبعض الأحيان
+
+561
+00:38:48,730 --> 00:38:52,990
+احنا بحاجة لإنه احنا نشتري الحذاء في أخر النهار،
+
+562
+00:38:52,990 --> 00:38:56,230
+ليش؟ لإنه في أخر النهار بتبقى الأجر أكبر حجما،
+
+563
+00:38:56,230 --> 00:39:04,170
+فاحنا بحاجة إلى .. بحاجة إلى حذاء أوسع أو أكبر
+
+564
+00:39:04,170 --> 00:39:09,510
+نمرة، تمام؟ check how your shoe fits in width and
+
+565
+00:39:09,510 --> 00:39:13,430
+length، black للبطونطبعا اللي هو ال back و ال
+
+566
+00:39:13,430 --> 00:39:17,550
+bottoms of heel and sole لازم أنا أشارك على ال
+
+567
+00:39:17,550 --> 00:39:21,430
+shoes في كل الأماكن بعض الأحيان ممكن يكون في دبوس
+
+568
+00:39:21,430 --> 00:39:25,630
+ممكن يكون في حاجة مقلمة لهذا المرض Avoid pointed
+
+569
+00:39:25,630 --> 00:39:29,790
+toes اللي هي avoid لل pointing toe style and high
+
+570
+00:39:29,790 --> 00:39:33,890
+heels ممنوع تلبس اللي هو ال set اللي هو ال shoes
+
+571
+00:39:33,890 --> 00:39:38,990
+العالية بلاش يختي تطولي لك شوية و بعد هيك ندخل في
+
+572
+00:39:38,990 --> 00:39:43,530
+ulcer و amputationTry to get shoes made with
+
+573
+00:39:43,530 --> 00:39:47,650
+leather and upper material and deep toe boxes حاول
+
+574
+00:39:47,650 --> 00:39:51,530
+إن هو تستخدم اللي هو leather الجلد المطبخ طبعا
+
+575
+00:39:51,530 --> 00:39:55,410
+اللي هي المادة الخام مهمة جدا في صناعة ال shoes
+
+576
+00:39:55,410 --> 00:40:00,150
+عشان أنا ماأدخلش في ألصار و مشاكل don't wearthe
+
+577
+00:40:00,150 --> 00:40:04,930
+same pair everyday ما تظلك كل يوم لابس نفس اللي هو
+
+578
+00:40:04,930 --> 00:40:09,190
+shoes لإنه طبعا لازم تتهوأ و أنا أبدلها ب shoes
+
+579
+00:40:09,190 --> 00:40:13,550
+تانية حتى إنه تتشمس و تتعقم inspect the inside of
+
+580
+00:40:13,550 --> 00:40:17,140
+each shoes before putting in thefeel inside with
+
+581
+00:40:17,140 --> 00:40:21,560
+your hand طبعا شاك على اللي هو ال inside of what
+
+582
+00:40:21,560 --> 00:40:26,600
+بإيدك و تأكد من سلامته و خلوه من أي foreign body
+
+583
+00:40:26,600 --> 00:40:31,200
+don't lace your shoes too tightly or loosely دائما
+
+584
+00:40:31,200 --> 00:40:35,460
+شاك على أن الموضوع مايكون اللي هو ال shoesTights
+
+585
+00:40:35,460 --> 00:40:39,800
+أو اللي هو ضيق
+
+586
+00:40:39,800 --> 00:40:43,680
+أو واسع أنه يسقط من إجرك لإنه هاد الناس طبعا بتكون
+
+587
+00:40:43,680 --> 00:40:48,180
+النتيجة لنيروباطي مافي عندها تحكم أو إحساس بإنه ال
+
+588
+00:40:48,180 --> 00:40:51,000
+shoes وجعت من إجرها و هي ماشية و هو مش داري عن
+
+589
+00:40:51,000 --> 00:40:55,180
+حاله لإنه مافي عندهاحساس بيه اللي هو القدمين
+
+590
+00:40:55,180 --> 00:40:58,760
+choose little socks and stocking carefully طبعا
+
+591
+00:40:58,760 --> 00:41:02,240
+اختار اللي هو او اختيار الإجرابات مهم جدا انه يكون
+
+592
+00:41:02,240 --> 00:41:07,180
+مناسب wear .. wear .. wear clean طبعا اللي هو wear
+
+593
+00:41:07,180 --> 00:41:12,240
+clean and dry socks everyday مش ضروري انه كل أسبوع
+
+594
+00:41:12,240 --> 00:41:15,440
+مرة انا ألبس الإجرابات هما هما لأ لازم كل يوم يكون
+
+595
+00:41:15,440 --> 00:41:21,240
+في عنا أنظف تمام؟ و نلبس الأشيء لليل avoid less
+
+596
+00:41:21,240 --> 00:41:26,470
+sockswith holes or wrinkles ممنوع ألبس الشرابات
+
+597
+00:41:26,470 --> 00:41:31,290
+اللي فيهم فتحات أو اللي فيهم تجاعيد لأن هذا ممكن
+
+598
+00:41:31,290 --> 00:41:35,110
+يؤدي إلى مشاكل think cotton طبعا نوع الشرابات لازم
+
+599
+00:41:35,110 --> 00:41:38,630
+يكونوا cotton وفيها نجرابات خاصة بمرضى السكري
+
+600
+00:41:38,630 --> 00:41:41,830
+موجودين في السوق and absorb into summer wear بعض
+
+601
+00:41:41,830 --> 00:41:45,390
+الأحيان اللي هي نجرابات الصيف مهمة جدا secure للتو
+
+602
+00:41:45,390 --> 00:41:49,750
+socks will not squeeze your toes avoid للسكين with
+
+603
+00:41:49,750 --> 00:41:54,100
+elastic stopsseamless stockings are available for
+
+604
+00:41:54,100 --> 00:41:57,080
+this neuropathy consider using compression
+
+605
+00:41:57,080 --> 00:42:00,740
+stockings if your feet tend as well دايما ناخد
+
+606
+00:42:00,740 --> 00:42:05,260
+بالنا من أي إشي بيكون ضغط خصوصا اللي هو المطاط
+
+607
+00:42:05,260 --> 00:42:10,120
+اللي بيكون في نهاية ال socks الإجرابات بيقدّي لضغط
+
+608
+00:42:10,120 --> 00:42:14,720
+على ال circulationdo and don't for diabetic food
+
+609
+00:42:14,720 --> 00:42:19,480
+افعل ولا تفعل في اللي هو مرض السكري inspect your
+
+610
+00:42:19,480 --> 00:42:22,240
+feed daily هاي بعض النصائح اللي انت بديك تقدميها
+
+611
+00:42:22,240 --> 00:42:27,240
+او تقدمها لمرض السكري دائما افحص اللي هو القدمين
+
+612
+00:42:28,350 --> 00:42:32,630
+بالطبع الـ mirror especially at اللي هو بلو طول ال
+
+613
+00:42:32,630 --> 00:42:36,210
+pressure area بمراية صغيرة شوف في عنا على سبيل
+
+614
+00:42:36,210 --> 00:42:40,830
+المثال فطريات بين الأصابع في عنا جروح في عنا إشي
+
+615
+00:42:40,830 --> 00:42:44,870
+washing للفيت daily water apply lotions and oil
+
+616
+00:42:44,870 --> 00:42:48,970
+للفيت after drying حتى الإجرين مش لازم نظل خجافة
+
+617
+00:42:48,970 --> 00:42:54,690
+لازم أناأرطبها بأي لوشن avoid extreme temperatures
+
+618
+00:42:54,690 --> 00:42:58,630
+مقعرضها لدرجة حرارة عالية have your feet checked
+
+619
+00:42:58,630 --> 00:43:01,790
+with each clinic visit انسبكت للشوز daily and
+
+620
+00:43:01,790 --> 00:43:05,630
+affect foreign body change للشوز often regular of
+
+621
+00:43:05,630 --> 00:43:10,190
+skin and nail care تمام؟كل هذه الأمور لازم انا اخد
+
+622
+00:43:10,190 --> 00:43:15,570
+بالي منها don't walk barefoot مش لازم تمشي حافة ال
+
+623
+00:43:15,570 --> 00:43:19,030
+smoking هذا له مشاكله لانه ايضا بيأخر عملية
+
+624
+00:43:19,030 --> 00:43:22,850
+الالتئام في ال one step into ال bath before
+
+625
+00:43:22,850 --> 00:43:26,910
+checking ال water temperatures لازم خلال اللي هو
+
+626
+00:43:26,910 --> 00:43:31,030
+الشوار انا اعمل اللي هو فحص للماء اذا كان ساخن
+
+627
+00:43:31,030 --> 00:43:34,990
+كتير او مش قادر اتحمله ممكن يأدي لحروق و هو مش
+
+628
+00:43:34,990 --> 00:43:39,880
+ذاري عن حاله use heating padsاستخدم اللى هو بعض ال
+
+629
+00:43:39,880 --> 00:43:44,780
+beds اللى هي السخنة ولكن تكون ادافع مش سخنة خالص
+
+630
+00:43:44,780 --> 00:43:49,720
+perform اللى هو ال perform bathroom surgery we use
+
+631
+00:43:49,720 --> 00:43:54,260
+chemical agent to treat corns and callous wear new
+
+632
+00:43:54,260 --> 00:43:58,160
+shoes for more than an hour at a time طبعا اللى هو
+
+633
+00:43:58,160 --> 00:44:02,900
+بعض النظائح هذه ما لازم نعملها how to keep your
+
+634
+00:44:02,900 --> 00:44:07,760
+feet flexible بعض التمرين هنا اللى هعملهاأو هعلمها
+
+635
+00:44:07,760 --> 00:44:11,820
+للمريض التبعى، هيمشي على أطراف أصابعه ال two point
+
+636
+00:44:11,820 --> 00:44:16,820
+أو two كورال، hold each position for five seconds،
+
+637
+00:44:16,820 --> 00:44:20,600
+على الأقل خمس ثوانى، and repeat it ten minutes،
+
+638
+00:44:20,600 --> 00:44:24,700
+وعيده عشر مرات، recommended for people with hammer
+
+639
+00:44:24,700 --> 00:44:29,460
+toe اللى هى أصابع المطرقة بنسميهاR2 Crams هذا
+
+640
+00:44:29,460 --> 00:44:33,260
+مطلوب أو منصوح فيه للناس اللي عندها الhammer 2 هنا
+
+641
+00:44:33,260 --> 00:44:37,420
+واجف على أطراف أصابع و هي بوضع ال extension هنا
+
+642
+00:44:37,420 --> 00:44:41,620
+واجف على أطراف الأصابع و اللي هو الوضع plantar
+
+643
+00:44:41,620 --> 00:44:48,860
+plantar reflection هنا اللي هو عمل على كرل اللي هو
+
+644
+00:44:48,860 --> 00:44:55,040
+لتو انه اتناهم او خلاهم بوضع التعريج golf ballroll
+
+645
+00:44:55,040 --> 00:44:58,340
+أنه أجيب ال golf ball roll و أحطها تحت اللي هو ال
+
+646
+00:44:58,340 --> 00:45:03,280
+plantar area و أخلي دهرج فيها على أساس أعمل اللي
+
+647
+00:45:03,280 --> 00:45:06,020
+هي ال exercise هذا التمرين كتير كمان حلو سواء
+
+648
+00:45:06,020 --> 00:45:10,620
+لمرضى سكري أو لغيرهم لمرضى سكري أو غيرهم roll of
+
+649
+00:45:10,620 --> 00:45:15,310
+golfball under the ball of food for two minutes
+
+650
+00:45:15,310 --> 00:45:19,750
+this is a great message for bottom of food and is
+
+651
+00:45:19,750 --> 00:45:22,830
+recommended لل people with plantar fasciitis طبعا
+
+652
+00:45:22,830 --> 00:45:25,470
+الناس اللي عندها التهاب في الأخماصية اللي هي
+
+653
+00:45:25,470 --> 00:45:29,050
+بنسميها أو ال heel pain arc strain and foot cramps
+
+654
+00:45:29,050 --> 00:45:35,950
+تمام ال tool ال towel crawls اللي هو أنه بلف
+
+655
+00:45:35,950 --> 00:45:40,140
+البشكير و بحاول ياخده بأطراف أصابعهplace a small
+
+656
+00:45:40,140 --> 00:45:43,560
+towel in the floor and correlate و حاول اللي هو
+
+657
+00:45:43,560 --> 00:45:48,020
+انه ياخدو يجعدو towards using with your only foot
+
+658
+00:45:48,020 --> 00:45:50,920
+you can increase and resistance by putting weight
+
+659
+00:45:50,920 --> 00:45:55,040
+on the end of towel relax to repeat this exercise
+
+660
+00:45:55,040 --> 00:45:58,300
+five times يريح و بعدين يرجع يعمل التمرين
+
+661
+00:45:58,300 --> 00:46:01,700
+recommended for people with hammer toe, two cramps
+
+662
+00:46:01,700 --> 00:46:05,740
+and pain of ball اللي هي ال foot نفسها يعني ممكن
+
+663
+00:46:05,740 --> 00:46:11,290
+أستخدم ولا كذا حالة موجودة عنديالـ marble أو اللي
+
+664
+00:46:11,290 --> 00:46:14,690
+هو بنسميه marble pick-up أو لعب الباليه طبعا اللي
+
+665
+00:46:14,690 --> 00:46:19,390
+بلاقي still marble in the floor بعدين pick-up one
+
+666
+00:46:19,390 --> 00:46:23,070
+marble at a time you twist in with small bowl
+
+667
+00:46:23,070 --> 00:46:28,870
+تمام، do this exercise until هفبكد up all twenty
+
+668
+00:46:28,870 --> 00:46:33,810
+marbles اللي هي الكوريات الصغيرة أو الكورة الصغيرة
+
+669
+00:46:33,810 --> 00:46:35,710
+اللي بتكون زي ال marble recommended لل people with
+
+670
+00:46:35,710 --> 00:46:39,170
+pen of ball and footالـ Hammer To and Crams كمان
+
+671
+00:46:39,170 --> 00:46:43,030
+كويسة اللي هم هاي اللعبة Sand of Walking أنه يمشي
+
+672
+00:46:43,030 --> 00:46:47,810
+على شاطئ البحر كتير بنسمع من أمهاتنا وإجدادنا طبعا
+
+673
+00:46:47,810 --> 00:46:52,110
+أنه خليه يمشي حافي على شاطئ البحر any chance you
+
+674
+00:46:52,110 --> 00:46:55,330
+get to cuff your shoes and walking with sand at
+
+675
+00:46:55,330 --> 00:46:59,530
+beach طبعا ال exercise massage youفى heat of this
+
+676
+00:46:59,530 --> 00:47:02,590
+is melting your toes and provide good general food
+
+677
+00:47:02,590 --> 00:47:06,890
+condition ال watch طبعا لازم اكون هنا انا حريصة
+
+678
+00:47:06,890 --> 00:47:11,530
+لإنه انا شلحت المريض او خلّع المريض ال food تبعته
+
+679
+00:47:11,530 --> 00:47:17,190
+فانا لازم اكون حريصة او اكون مهتمة جدا لموضوع انه
+
+680
+00:47:17,190 --> 00:47:19,370
+فيه جذاز او لأ
+
+681
+00:47:23,030 --> 00:47:25,230
+السبلنتينج لإيش أنا بدي أستخدم السبلنتينج؟ بدي
+
+682
+00:47:25,230 --> 00:47:29,370
+أستخدمه لإيه هو correct deformity بدي أستخدمه لإنه
+
+683
+00:47:29,370 --> 00:47:33,230
+أنا أحافظ على ال food في وضع ال anatomical
+
+684
+00:47:33,230 --> 00:47:36,830
+position الصحيحة Total contact cost is the
+
+685
+00:47:36,830 --> 00:47:40,530
+appropriate way of resulting the food with
+
+686
+00:47:40,530 --> 00:47:44,910
+diameter بلنتر ألصق it is distribution لل weight
+
+687
+00:47:44,910 --> 00:47:48,210
+long in the inter of plantar aspects للfood it
+
+688
+00:47:48,210 --> 00:47:51,990
+reduce shareطبعا بيقلل ال share تبع ال force
+
+689
+00:47:51,990 --> 00:47:56,010
+normally present between foot and shoes it produce
+
+690
+00:47:56,010 --> 00:47:58,950
+shortening and straight length and decrease
+
+691
+00:47:58,950 --> 00:48:02,670
+walking velocity لازم انا طبعا لما انتوا شايفين
+
+692
+00:48:02,670 --> 00:48:05,730
+اللي هو بعض ال splendidات او بعض ال prosthesis
+
+693
+00:48:05,730 --> 00:48:09,530
+اللي موجودة ال orthosis اللي موجودة هنا مهم جدا
+
+694
+00:48:09,530 --> 00:48:14,190
+انا استخدمها مع هدول الناس حتى اعمل correct ل ال
+
+695
+00:48:14,190 --> 00:48:18,220
+deformity thank you for your attentionوألقاكم بإذن
+
+696
+00:48:18,220 --> 00:48:22,840
+الله تعالى في فيديو آخر بإذن الله تعالى يعطيكوا
+
+697
+00:48:22,840 --> 00:48:23,420
+الفافية
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/YPAqhUQon04_raw.json b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/YPAqhUQon04_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..a3bf2f438eda085eae298eff9a936797fa20a849
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/YPAqhUQon04_raw.json
@@ -0,0 +1 @@
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"word": " لأختلال", "probability": 0.755859375}, {"start": 721.21, "end": 721.35, "word": " في", "probability": 0.931640625}, {"start": 721.35, "end": 722.01, "word": " توازنه", "probability": 0.9715576171875}, {"start": 722.01, "end": 722.67, "word": " فبالتالي", "probability": 0.9401041666666666}, {"start": 722.67, "end": 722.93, "word": " ممكن", "probability": 0.95556640625}, {"start": 722.93, "end": 723.13, "word": " أنا", "probability": 0.5244140625}, {"start": 723.13, "end": 723.51, "word": " أثر", "probability": 0.87255859375}, {"start": 723.51, "end": 723.77, "word": " على", "probability": 0.94287109375}, {"start": 723.77, "end": 724.43, "word": " شبكية", "probability": 0.966796875}, {"start": 724.43, "end": 725.39, "word": " العين", "probability": 0.985107421875}, {"start": 725.39, "end": 725.87, "word": " اللي", "probability": 0.967529296875}, {"start": 725.87, "end": 726.51, "word": " موجودة", "probability": 0.98291015625}, {"start": 726.51, "end": 727.89, "word": " عليها", 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"probability": 0.979248046875}, {"start": 734.31, "end": 735.01, "word": " اشي", "probability": 0.8889973958333334}, {"start": 735.01, "end": 735.41, "word": " من", "probability": 0.98681640625}, {"start": 735.41, "end": 735.95, "word": " اللي", "probability": 0.823974609375}, {"start": 735.95, "end": 736.19, "word": " هو", "probability": 0.9736328125}, {"start": 736.19, "end": 736.97, "word": " ارتفاع", "probability": 0.988037109375}, {"start": 736.97, "end": 737.49, "word": " السكر", "probability": 0.8583984375}, {"start": 737.49, "end": 737.71, "word": " في", "probability": 0.89990234375}, {"start": 737.71, "end": 737.97, "word": " الدم", "probability": 0.976318359375}, {"start": 737.97, "end": 738.99, "word": " تمام", "probability": 0.857666015625}], "temperature": 1.0}, {"id": 33, "seek": 76720, "start": 740.14, "end": 767.2, "text": "انخفاض السكر في الدم ايضا مصيبة و بعتبره حالة clinical حالة pathological حالة سيئة جدا يعني لو دخل المرض عندى في حالة غيبوبة في السكري حالة بعتبرها emergency و على طول ممكن انا ادخل فيه لأنه لا سماح الله ممكن يدخلي بعد هيك في مشاكل عديدة جدا ال person should be instructed to stop exercising", "tokens": [7649, 9778, 5172, 46958, 21136, 37983, 8978, 32748, 2304, 1975, 1829, 11242, 995, 3714, 9381, 1829, 49401, 4032, 4724, 34268, 26890, 3224, 11331, 6027, 3660, 9115, 11331, 6027, 3660, 3100, 4383, 11331, 6027, 3660, 8608, 1829, 19986, 3660, 10874, 28259, 37495, 22653, 45164, 11778, 9778, 1211, 9673, 43042, 43242, 7578, 8978, 11331, 6027, 3660, 32771, 1829, 3555, 37746, 3660, 8978, 21136, 4117, 16572, 11331, 6027, 3660, 4724, 34268, 26890, 11296, 7473, 4032, 15844, 23032, 12610, 3714, 43020, 1975, 8315, 1975, 3215, 9778, 1211, 8978, 3224, 5296, 33456, 3224, 20193, 8608, 15042, 5016, 21984, 3714, 43020, 7251, 3215, 9778, 20292, 39182, 39896, 4117, 8978, 37893, 995, 28820, 6225, 16254, 41891, 10874, 28259, 2423, 954, 820, 312, 36384, 281, 1590, 27272], "avg_logprob": -0.1390624954054753, "compression_ratio": 1.7, "no_speech_prob": 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"probability": 0.91064453125}, {"start": 848.14, "end": 848.4, "word": " أي", "probability": 0.252685546875}, {"start": 848.4, "end": 848.66, "word": " بعض", "probability": 0.969482421875}, {"start": 848.66, "end": 849.26, "word": " البسكوتات", "probability": 0.94482421875}, {"start": 849.26, "end": 850.18, "word": " البسيطة", "probability": 0.97880859375}, {"start": 850.18, "end": 850.7, "word": " لحتى", "probability": 0.9666341145833334}, {"start": 850.7, "end": 851.2, "word": " يمنع", "probability": 0.9939778645833334}, {"start": 851.2, "end": 851.48, "word": " اللى", "probability": 0.968994140625}, {"start": 851.48, "end": 851.86, "word": " هو", "probability": 0.9697265625}, {"start": 851.86, "end": 852.66, "word": " ال", "probability": 0.94482421875}], "temperature": 1.0}, {"id": 38, "seek": 87887, "start": 854.29, "end": 878.87, "text": "الـ basic rules أو القواعد الأساسية لـ snacks قبل ما تتاخد اللي هي لازم تكون قلائمة ومناسبة لمرضى، مش صحيح أنه انا اعطي snacks و بس، لأ ال snacks superior before activities or to activities to prevent hypoglycemia are just a quantity based in pre-activity blood glucose direction of blood glucose", "tokens": [6027, 39184, 3875, 4474, 34051, 25062, 14407, 22488, 16247, 3794, 32277, 10632, 5296, 39184, 16160, 12174, 36150, 19446, 6055, 2655, 47283, 3215, 13672, 1829, 39896, 5296, 31377, 2304, 6055, 30544, 12174, 1211, 16373, 46007, 4032, 2304, 8315, 35457, 3660, 5296, 29973, 11242, 7578, 12399, 37893, 20328, 5016, 1829, 5016, 14739, 3224, 1975, 8315, 1975, 3615, 9566, 1829, 16160, 4032, 4724, 3794, 12399, 5296, 10721, 2423, 16160, 13028, 949, 5354, 420, 281, 5354, 281, 4871, 7420, 38353, 26422, 654, 366, 445, 257, 11275, 2361, 294, 659, 12, 578, 4253, 3390, 23997, 3513, 295, 3390, 23997], "avg_logprob": -0.3157894655277855, "compression_ratio": 1.4922480620155039, "no_speech_prob": 0.0, "words": [{"start": 854.29, "end": 855.11, "word": "الـ", "probability": 0.43463134765625}, {"start": 855.11, "end": 855.27, "word": " 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{"id": 110, "seek": 248164, "start": 2452.76, "end": 2481.64, "text": "احساس بيه اللي هو القدمين choose little socks and stocking carefully طبعا اختار اللي هو او اختيار الإجرابات مهم جدا انه يكون مناسب wear .. wear .. wear clean طبعا اللي هو wear clean and dry socks everyday مش ضروري انه كل أسبوع مرة انا ألبس الإجرابات هما هما لأ لازم كل يوم يكون في عنا أنظف تمام؟ و نلبس الأشيء لليل avoid less socks", "tokens": [39319, 3794, 32277, 4724, 1829, 3224, 13672, 1829, 31439, 25062, 40448, 9957, 2826, 707, 17564, 293, 4127, 278, 7500, 23032, 3555, 3615, 995, 1975, 46456, 9640, 13672, 1829, 31439, 1975, 2407, 1975, 9778, 31371, 9640, 33688, 7435, 2288, 16758, 9307, 3714, 16095, 10874, 28259, 16472, 3224, 7251, 30544, 3714, 8315, 35457, 3728, 4386, 3728, 4386, 3728, 2541, 23032, 3555, 3615, 995, 13672, 1829, 31439, 3728, 2541, 293, 4016, 17564, 7429, 37893, 48812, 2288, 13063, 1829, 16472, 3224, 28242, 5551, 35457, 45367, 3714, 25720, 1975, 8315, 5551, 46152, 3794, 33688, 7435, 2288, 16758, 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الشرابات لازم يكونوا cotton وفيها نجرابات خاصة بمرضى السكري موجودين في السوق and absorb into summer wear بعض الأحيان اللي هي نجرابات الصيف مهمة جدا secure للتو socks will not squeeze your toes avoid للسكين with elastic stops", "tokens": [11820, 8118, 420, 34822, 3714, 27842, 45367, 5551, 46152, 3794, 25124, 2288, 16758, 9307, 13672, 1829, 8978, 16095, 6156, 2655, 5016, 9307, 34051, 13672, 1829, 8978, 16095, 6055, 7435, 45761, 25708, 5296, 33456, 23758, 3714, 43020, 7251, 33604, 16254, 30731, 37893, 995, 28820, 519, 13764, 23032, 3555, 3615, 995, 8717, 45367, 25124, 2288, 16758, 9307, 5296, 31377, 2304, 7251, 30544, 14407, 13764, 4032, 41185, 11296, 8717, 7435, 2288, 16758, 9307, 16490, 33546, 3660, 4724, 29973, 11242, 7578, 21136, 4117, 16572, 3714, 29245, 23328, 9957, 8978, 21136, 30543, 293, 15631, 666, 4266, 3728, 45030, 11242, 16247, 5016, 1829, 7649, 13672, 1829, 39896, 8717, 7435, 2288, 16758, 9307, 31767, 33911, 3714, 16095, 3660, 10874, 28259, 7144, 24976, 2655, 2407, 17564, 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toes", "probability": 0.96240234375}, {"start": 2507.95, "end": 2508.83, "word": " avoid", "probability": 0.87548828125}, {"start": 2508.83, "end": 2509.49, "word": " للسكين", "probability": 0.4342041015625}, {"start": 2509.49, "end": 2509.75, "word": " with", "probability": 0.44140625}, {"start": 2509.75, "end": 2510.23, "word": " elastic", "probability": 0.96240234375}, {"start": 2510.23, "end": 2510.71, "word": " stops", "probability": 0.53125}], "temperature": 1.0}, {"id": 112, "seek": 253098, "start": 2510.88, "end": 2530.98, "text": "seamless stockings are available for this neuropathy consider using compression stockings if your feet tend as well دايما ناخد بالنا من أي إشي بيكون ضغط خصوصا اللي هو المطاط اللي بيكون في نهاية ال socks الإجرابات بيقدّي لضغط على ال circulation", "tokens": [405, 335, 1832, 4127, 1109, 366, 2435, 337, 341, 22510, 1513, 9527, 1949, 1228, 19355, 4127, 1109, 498, 428, 3521, 3928, 382, 731, 11778, 47302, 15042, 8717, 47283, 3215, 20666, 8315, 9154, 36632, 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fasciitis طبعا الناس اللي عندها التهاب في الأخماصية اللي هي بنسميها أو ال heel pain arc strain and foot cramps تمام ال tool ال towel crawls اللي هو أنه بلف البشكير و بحاول ياخده بأطراف أصابعه", "tokens": [3129, 833, 264, 2594, 295, 1755, 337, 732, 2077, 341, 307, 257, 869, 3636, 337, 2767, 295, 1755, 293, 307, 9628, 24976, 561, 365, 3709, 289, 30632, 537, 16074, 23032, 3555, 3615, 995, 2423, 8315, 3794, 13672, 1829, 43242, 11296, 16712, 11296, 3555, 8978, 16247, 9778, 2304, 33546, 10632, 13672, 1829, 39896, 44945, 38251, 1829, 11296, 34051, 2423, 9430, 1822, 10346, 14249, 293, 2671, 941, 23150, 46811, 10943, 2423, 2290, 2423, 15755, 13999, 11784, 13672, 1829, 31439, 14739, 3224, 4724, 46538, 29739, 8592, 4117, 13546, 4032, 4724, 5016, 995, 12610, 7251, 47283, 3215, 3224, 4724, 10721, 9566, 23557, 5172, 5551, 9381, 16758, 3615, 3224], "avg_logprob": -0.24315475963410876, "compression_ratio": 1.5645756457564575, "no_speech_prob": 1.2516975402832031e-06, "words": [{"start": 2711.35, 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index 0000000000000000000000000000000000000000..8885f70a67d30106e2d3121fbda99453613e7248
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@@ -0,0 +1,2796 @@
+1
+00:00:00,930 --> 00:00:04,590
+الصلاة والسلام على أشرف الأنبياء والمرسلين بإذن
+
+2
+00:00:04,590 --> 00:00:08,210
+الله اتعالى اليوم سأكمل part two من ال diabetes
+
+3
+00:00:08,210 --> 00:00:12,690
+mellitus او اللي هو المرض السكري المذمن اللي احنا
+
+4
+00:00:12,690 --> 00:00:16,730
+حكينا واتكلمنا عليه في الفيديو السابق لأن بإذن
+
+5
+00:00:16,730 --> 00:00:20,390
+الله اتعالى هبدأ بال physiotherapy program و ال
+
+6
+00:00:20,390 --> 00:00:24,370
+role of physiotherapy لالdiabetes نبدأ بسم الله
+
+7
+00:00:24,370 --> 00:00:26,250
+الرحمن الرحيم على بركة الله
+
+8
+00:00:29,750 --> 00:00:33,990
+وناخد ال evaluation لل patients before exercise
+
+9
+00:00:33,990 --> 00:00:38,570
+لأن قبل ما أبدأ أعمل exercise لازم أنا أعمل تقييم
+
+10
+00:00:38,570 --> 00:00:42,830
+شامل وكامل لهذا المريض لإنه بدي أعرف إذا كان
+
+11
+00:00:42,830 --> 00:00:46,470
+بيعاني من أي مشاكل أخرى، إذا كان في عنده على سبيل
+
+12
+00:00:46,470 --> 00:00:52,190
+المثال wound في رجله، إذا كان في عنده swelling،
+
+13
+00:00:52,190 --> 00:00:55,070
+إذا كان في عنده cellulite كل هذه الأمور لازم أنا
+
+14
+00:00:55,070 --> 00:01:00,080
+أقيمها قبل ما نبدأ ال exercise programأول اشي بدي
+
+15
+00:01:00,080 --> 00:01:04,120
+اعمل عملية التحضير preparing ل ال exercise زى ما
+
+16
+00:01:04,120 --> 00:01:08,220
+بتعرفوا لازم يكون في عندنا warm up و cooling down
+
+17
+00:01:08,220 --> 00:01:12,580
+ال warm up بيكون قبل التمرين مابصير انا ابلش معاه
+
+18
+00:01:12,580 --> 00:01:16,880
+exercise وبرنامج رياضي كامل قبل ماابلش معاه في
+
+19
+00:01:16,880 --> 00:01:20,530
+عملية الإحماءتاخد عملية الإحماء من خمس إلى عشر
+
+20
+00:01:20,530 --> 00:01:24,750
+دقائق aerobic activity ال activity session حوالي
+
+21
+00:01:24,750 --> 00:01:29,830
+جلسة بتبتد معايا من 15 إلى 30 دقيقة تمام بعد هيك
+
+22
+00:01:29,830 --> 00:01:33,810
+بدي أمشي أنا مع ال cooling down اللي هو أنا أدرد
+
+23
+00:01:33,810 --> 00:01:37,250
+بعد عملية الإحماء وال exercise اللي استمرت حوالي
+
+24
+00:01:37,250 --> 00:01:40,470
+نصف ساعة structurally similar to the warm up and
+
+25
+00:01:40,470 --> 00:01:45,630
+should last about five to ten minutes نفس الشيء
+
+26
+00:01:45,630 --> 00:01:51,300
+بدأنا warm upالـ session و calling down بعدين هذا
+
+27
+00:01:51,300 --> 00:01:56,300
+اللي هو بسميها عملية التحضير لأن الأنواع تبعت ال
+
+28
+00:01:56,300 --> 00:02:01,400
+physical activities تبعت اللي هم ال exercise تبعنا
+
+29
+00:02:01,920 --> 00:02:07,220
+اختصارها باختصارها ب .. اللي هو safe S-A-F-E خليني
+
+30
+00:02:07,220 --> 00:02:11,320
+اشوف هاي اختصار او abbreviation ليش اول اشي ال S
+
+31
+00:02:11,320 --> 00:02:14,860
+هي عبارة عن strengthening exercise ال A هي عبارة
+
+32
+00:02:14,860 --> 00:02:19,140
+عن ال aerobic exercise و ال flexibility ال F و ال
+
+33
+00:02:19,140 --> 00:02:22,720
+E هي عبارة عن ال endurance هنمر عليهم واحدة واحدة
+
+34
+00:02:22,720 --> 00:02:27,660
+بإذن الله تعالى و اعرف انه هذااللي هو ما يحتاجه ال
+
+35
+00:02:27,660 --> 00:02:30,500
+physical activities، ما يحتاجه المريض، بيحتاج لل
+
+36
+00:02:30,500 --> 00:02:33,860
+strengthening exercise، بيحتاج ل aerobic exercise،
+
+37
+00:02:33,860 --> 00:02:38,520
+ل flexibility and endurance، بيجي نشوفالـ Aerobic
+
+38
+00:02:38,520 --> 00:02:43,620
+exercise اللى هو التنفس طبعا الهوايا و ال Oxygen
+
+39
+00:02:43,620 --> 00:02:47,260
+aerobic exercise ده type of movement ل large
+
+40
+00:02:47,260 --> 00:02:52,000
+muscle group طبعا هو aerobic و بدنا نستخدمه لعضلات
+
+41
+00:02:52,000 --> 00:02:55,640
+كبيرة cause you to breathe more deeply and your
+
+42
+00:02:55,640 --> 00:03:00,580
+heart to work harder than أكتر تضخم ال heart
+
+43
+00:03:00,580 --> 00:03:04,920
+بيشتغل و بيعمل pumping ل bloodit's also called
+
+44
+00:03:04,920 --> 00:03:09,120
+cardiovascular exercise ال aerobic exercise ممكن
+
+45
+00:03:09,120 --> 00:03:13,620
+أنا كمان أسميها cardiovascular exercise it's
+
+46
+00:03:13,620 --> 00:03:16,660
+improve لل health for your heart and lungs حلو
+
+47
+00:03:16,660 --> 00:03:21,500
+كتير هاي التمرين ال aerobic exercise في اللي هي ال
+
+48
+00:03:21,500 --> 00:03:26,200
+exercise الخاصة بالديابت patient تمام ال diabetic
+
+49
+00:03:26,200 --> 00:03:30,840
+patientإذا بسميها أيضا ال cardiovascular exercise
+
+50
+00:03:30,840 --> 00:03:34,040
+ال aerobic resistance exercise اللي هي ال
+
+51
+00:03:34,040 --> 00:03:37,380
+anaerobic exercise uses the large muscles that
+
+52
+00:03:37,380 --> 00:03:42,440
+don't require exogen هنا anaerobic غير أو لا هواي
+
+53
+00:03:42,660 --> 00:03:47,320
+نحن ليس بحاجة إلى الأكسجين for short period of
+
+54
+00:03:47,320 --> 00:03:51,360
+exercise it helps build strong muscles and lower
+
+55
+00:03:51,360 --> 00:03:56,480
+blood sugar و بدنا نخفف أو نخفض مستوى الجلوكوز في
+
+56
+00:03:56,480 --> 00:04:00,320
+الدم لأن هذا هو هدفنا الأساسي من عمل ال exercise
+
+57
+00:04:00,320 --> 00:04:03,720
+to make the action of insulin more effectiveness
+
+58
+00:04:03,720 --> 00:04:07,580
+تمام؟ و أخلي اللي هو شغل الانسولين يكون أكثر
+
+59
+00:04:07,580 --> 00:04:13,210
+فعالية لبتكسب يعنيال F اللى احنا حكينا عليها فيه
+
+60
+00:04:13,210 --> 00:04:16,090
+فى ال stretching exercise زى ما بتشوفوا هنا فى
+
+61
+00:04:16,090 --> 00:04:19,030
+الصور فى عندي stretching exercise لل upper arm و
+
+62
+00:04:19,030 --> 00:04:22,390
+stretching لل lower arm ايضا هنا اللى هى فى ال
+
+63
+00:04:22,390 --> 00:04:25,790
+back و ال abdomen كمان نفس الاشي فى خلال ال long
+
+64
+00:04:25,790 --> 00:04:30,000
+sitting لل upper armالـ flexibility exercise aims
+
+65
+00:04:30,000 --> 00:04:33,160
+to increase more or maintaining the range of
+
+66
+00:04:33,160 --> 00:04:36,420
+motion للـ join طبعا also improve ال tool of
+
+67
+00:04:36,420 --> 00:04:39,000
+muscles، بدي أحافظ على ال tool of muscles و أبقى
+
+68
+00:04:39,000 --> 00:04:42,400
+ثابت، أخليها ما زالت في اللي هي ال flexibility
+
+69
+00:04:42,400 --> 00:04:48,430
+تبعتها و ثابت قابلة للمرونةThey developed better
+
+70
+00:04:48,430 --> 00:04:52,430
+muscular of body control وهنا احنا كمان بنحافظ او
+
+71
+00:04:52,430 --> 00:04:57,030
+بنحفظ اللي هو ان نكون عندنا في body control و اللي
+
+72
+00:04:57,030 --> 00:05:01,150
+هو عن طريق الأداء اللي هي الجلسة الرياضية ال
+
+73
+00:05:01,150 --> 00:05:05,010
+endurance كلمة endurance لحالها بعني فيها اللي هو
+
+74
+00:05:05,010 --> 00:05:10,250
+مدى قابلية المريض لإعادة و تكرار التمرين جديه هو
+
+75
+00:05:10,250 --> 00:05:16,240
+قادر قابلة كدر التمرين للمريض على أداء التمرينالـ
+
+76
+00:05:16,240 --> 00:05:20,480
+low resistance لازم تكون طبعا في مقاومة قليلة و
+
+77
+00:05:20,480 --> 00:05:23,960
+ضعيفة و ليس مقاومة قوية جدا high repetition
+
+78
+00:05:23,960 --> 00:05:28,680
+exercise و انه جادر على إعادة التمرين كذا مرة على
+
+79
+00:05:28,680 --> 00:05:32,300
+سبيل المثالالـ walking، الـ cycling، الـ swimming
+
+80
+00:05:32,300 --> 00:05:36,280
+و الـ upper extremity و الـ ergometry و أيضا بتشمل
+
+81
+00:05:36,280 --> 00:05:40,480
+ال large muscles of body تمام؟ إذا قدرة المريضة
+
+82
+00:05:40,480 --> 00:05:44,000
+على إعادة التمرين كذا مرة ولكن إذا كان في
+
+83
+00:05:44,000 --> 00:05:50,400
+resistance بعطيله مقاومة أقل how much exercise؟
+
+84
+00:05:50,400 --> 00:05:54,480
+جداش أنا بدي من هذا ال exercise؟ هتتبع قانون FET
+
+85
+00:05:54,480 --> 00:06:00,190
+FET بيحكي إيش؟frequency intensity timing and
+
+86
+00:06:00,190 --> 00:06:05,250
+typing تمام؟ إذا ال frequency كام مرة في الإسبوع
+
+87
+00:06:05,250 --> 00:06:09,630
+أنا بدي أعمل هذا التمرين على سبيل المثال بنعمل
+
+88
+00:06:09,630 --> 00:06:13,930
+التمرين هذا عشر مرات خلال الإسبوع ال intensity
+
+89
+00:06:13,930 --> 00:06:18,650
+جدّي أنا بدي في كل تمرين من الوقت تلاتين لاربعين
+
+90
+00:06:18,650 --> 00:06:22,890
+دقيقة في كل exercise حوالي اللي هو من ال target
+
+91
+00:06:22,890 --> 00:06:27,310
+heart rate group exerciseتمام؟ إذا كام من الوقت
+
+92
+00:06:27,310 --> 00:06:29,990
+لهذا ال exercise على سبيل المثال بدي أعمل
+
+93
+00:06:29,990 --> 00:06:33,670
+stretching exercise بدي أستخدملهم جلسة فيها تلاتين
+
+94
+00:06:33,670 --> 00:06:38,670
+دقيقة بال exercise حوالي خمسين لستين في اللي هو ال
+
+95
+00:06:38,670 --> 00:06:42,110
+target heart rate اللي هم أغلبهم بنشتغل معاهم هناك
+
+96
+00:06:42,110 --> 00:06:45,390
+ال type ال safe exercise اللي أحنا حكينا عليهم قبل
+
+97
+00:06:45,390 --> 00:06:50,770
+شوية تمام؟ اللي أنا لسه مخلصة منهم قبل قليل ال
+
+98
+00:06:50,770 --> 00:06:54,270
+time اللي هو ال morning it's idealExercise زى ما
+
+99
+00:06:54,270 --> 00:06:57,690
+بنشوف معظم الناس اللى بتصحى بتجرس صباحا بيكون
+
+100
+00:06:57,690 --> 00:07:02,710
+الوقت مبكر لإنه بتكون درجة حرارة أقل الاشي بيكون
+
+101
+00:07:02,710 --> 00:07:08,070
+more relaxed أكتر و لسه هو صاحي من النوم و عنده
+
+102
+00:07:08,070 --> 00:07:12,210
+دافعية و تحافظ طبعا لإنه يعمل هذا ال exercise
+
+103
+00:07:12,210 --> 00:07:15,630
+لاحظونى هنا فى ال breathing exercise ال breathing
+
+104
+00:07:15,630 --> 00:07:19,590
+exercise مهم جدا لاحظوا هنا فى البداية تم
+
+105
+00:07:19,590 --> 00:07:25,870
+الاستنشاق عن طريق الأنف ال noseتمام؟ و بعدين اللي
+
+106
+00:07:25,870 --> 00:07:31,010
+هو تم إخراجه طبعا عن طريق اللي هو ال mouse بهيك
+
+107
+00:07:31,010 --> 00:07:35,750
+بقول أنا أدخلت كمية كبيرة من ال oxygen داخل
+
+108
+00:07:35,750 --> 00:07:40,910
+الرئتين و هذا المهم و الكويس عندى هناخد ان شاء
+
+109
+00:07:40,910 --> 00:07:44,690
+الله رب العالمين تمارين كتيرة خلال اللي هي ال
+
+110
+00:07:44,690 --> 00:07:48,010
+breathing exercise في حالات ال chest و حالات ال
+
+111
+00:07:48,010 --> 00:07:52,870
+cardiology ال neck exerciseالكثير مننا يعانى من
+
+112
+00:07:52,870 --> 00:07:56,830
+مشاكل ال neck problems تمام فما بالكم في مريض سكري
+
+113
+00:07:56,830 --> 00:07:59,650
+طبعا و خصوصا إذا كان من الناس ال chronic الناس
+
+114
+00:07:59,650 --> 00:08:03,330
+اللي سررها السكري حوالي عشرين لتلاتين سنة كم في
+
+115
+00:08:03,330 --> 00:08:06,790
+عندهم بعض المشاكل ال stretching exercise مهم جدا
+
+116
+00:08:06,790 --> 00:08:12,610
+ال rotation up down protraction retraction كل هذه
+
+117
+00:08:12,610 --> 00:08:15,610
+الأمور مهمة جدا في ال neck exercise to
+
+118
+00:08:15,610 --> 00:08:19,690
+strengthening exercise for the neck ال hand
+
+119
+00:08:19,690 --> 00:08:25,000
+exerciseطبعا للإيدانلأن في حكينا على موضوع خصوصا
+
+120
+00:08:25,000 --> 00:08:28,600
+هنا ال hand grip في عندنا موضوع اللي هو بيحكي على
+
+121
+00:08:28,600 --> 00:08:32,200
+ال neuropathy ال neuropathy من الحاجات اللي انا
+
+122
+00:08:32,200 --> 00:08:37,140
+قلت ممكن تأثر على ال micro اللي هو systemet على
+
+123
+00:08:37,140 --> 00:08:42,260
+الأجهزة اللي هي في ال micro تمام فانا هنا بحاول
+
+124
+00:08:42,260 --> 00:08:46,180
+انه انا احافظ على ال mobility او احافظ على ال good
+
+125
+00:08:46,180 --> 00:08:50,760
+range of motion لكربلبون و متكربلبون و اللي هم
+
+126
+00:08:52,120 --> 00:08:55,580
+الأصابع لإنه عند هذه الستات ممكن إنه يصير في عندها
+
+127
+00:08:55,580 --> 00:09:01,280
+stiffness نتيجة لـuseless في بعض الأحيان أيضا ال
+
+128
+00:09:01,280 --> 00:09:06,620
+trunk exercise لأ أهمله لإنه إشي مهم إنه أنا أحافظ
+
+129
+00:09:06,620 --> 00:09:09,480
+على ال back muscles و ال abdomen muscles ال
+
+130
+00:09:09,480 --> 00:09:12,140
+exercise سواء كان في وضع ال supine position أو
+
+131
+00:09:12,140 --> 00:09:16,480
+اللي هو crook line position لبرون و بحط نخدة تحت
+
+132
+00:09:16,480 --> 00:09:21,540
+البطن تمام؟ أيضا في عندي اللي هو ال exerciseمن ال
+
+133
+00:09:21,540 --> 00:09:25,560
+trunk في وضع اللي هو ال side lying position و ايضا
+
+134
+00:09:25,560 --> 00:09:29,740
+الوضعية اللي هي ال bridging هذه او بنسميها اللي هو
+
+135
+00:09:29,740 --> 00:09:34,680
+الجسر او تمرين الجسر ايضا في عندى ال leg exercise
+
+136
+00:09:34,680 --> 00:09:39,220
+سواء كانت ال leg لاحظوا اللي هي ال leg اللي تحت
+
+137
+00:09:39,220 --> 00:09:43,400
+عاملة بوضع اللي هو ال flexion لل hip flexion لل
+
+138
+00:09:43,400 --> 00:09:47,940
+knee يعني to اللي هو stabilize وبرفع اللي هي اللي
+
+139
+00:09:47,940 --> 00:09:48,260
+فوق
+
+140
+00:09:51,100 --> 00:09:54,120
+أيضا في وضع لبران في وضع اللي هو هنا pumping
+
+141
+00:09:54,120 --> 00:09:58,440
+exercise ل اللي هو ال ankle نفس الأشي في وضع اللي
+
+142
+00:09:58,440 --> 00:10:02,920
+هو long sitting كلها هاد ال exercise مهمة ال
+
+143
+00:10:02,920 --> 00:10:05,980
+peripheral and autonomic neuropathy حكينا احنا على
+
+144
+00:10:05,980 --> 00:10:09,710
+موضوع ال neuropathyلأن في مريض Neuropathy هو يعتبر
+
+145
+00:10:09,710 --> 00:10:13,370
+مريض Neurology، إله علاقة بالأعصاب، المطلوب مني
+
+146
+00:10:13,370 --> 00:10:16,030
+أنه أنا ما أخليه يعمل non-weight bearing
+
+147
+00:10:16,030 --> 00:10:21,030
+activities، المطلوب مني أنه يعمل ال exercise non
+
+148
+00:10:21,030 --> 00:10:24,910
+-weight bearing، ما يحمل كل الوزن على القدمين مرة
+
+149
+00:10:24,910 --> 00:10:28,550
+واحدة، ال swimming، ال bicyclingالـ chair and arm
+
+150
+00:10:28,550 --> 00:10:31,850
+exercise تمام إن هو يحاول إنه يعمل stretching
+
+151
+00:10:31,850 --> 00:10:36,150
+exercise عن طريق الكرسي Contraindication ممنوع
+
+152
+00:10:36,150 --> 00:10:40,470
+لمريض من neuropathy إنه يركب أو يجري على ال
+
+153
+00:10:40,470 --> 00:10:44,590
+treadmill ممنوع إنه يظل ماشي بيه اللي هو prolonged
+
+154
+00:10:44,590 --> 00:10:48,970
+walking، jogging، ركض، step exercise هذه الشغلات
+
+155
+00:10:48,970 --> 00:10:53,810
+ممنوعة لمريض من neuropathy سواء كان peripheral أو
+
+156
+00:10:53,810 --> 00:11:00,240
+autonomicلنيرو بثي recommended إله أيضا اللي هو
+
+157
+00:11:00,240 --> 00:11:04,820
+low to moderate intensity من ال exercise يعني مش
+
+158
+00:11:04,820 --> 00:11:08,780
+intensity عالية جدا لإنه ممكن ترهقه وبالتالي هو
+
+159
+00:11:08,780 --> 00:11:11,940
+أصلا ممكن يكون عنده مشكلة في ال grasping أو مشكلة
+
+160
+00:11:11,940 --> 00:11:16,060
+في ال food sensation فما هيحس معايا إذا ال low ل
+
+161
+00:11:16,060 --> 00:11:20,380
+ال moderate okay مسموحي لكن ال high intensity مش
+
+162
+00:11:20,380 --> 00:11:23,840
+مسموحةالدايمة الـ Cretinopathy كلمة Cretinopathy
+
+163
+00:11:23,840 --> 00:11:26,660
+حكيت أنا من اللي هي الشبكية وحاكيناها شبكية
+
+164
+00:11:26,660 --> 00:11:30,780
+الاقتلال السكري هيالها دور كبير لمريضنا مريضنا
+
+165
+00:11:30,780 --> 00:11:34,460
+لازم يكون low impact في ال cardiovascular بسمحله
+
+166
+00:11:34,460 --> 00:11:38,020
+بالتمارين اللي هي بتأثر على ال cardiovascular
+
+167
+00:11:38,020 --> 00:11:41,180
+conditioning زي ال swimming زي ال walking ال low
+
+168
+00:11:41,180 --> 00:11:44,720
+impact aerobic exercise ال stationary cycling and
+
+169
+00:11:44,720 --> 00:11:48,170
+endurance exerciseهذه الأمور مسموحة إلي أنا لبريد
+
+170
+00:11:48,170 --> 00:11:52,230
+اللي هو السكري اللي عنده مشكلة في Erythropia أما
+
+171
+00:11:52,230 --> 00:11:55,810
+Contra Indication إن هي الحركات اللي فيها اهتزاز
+
+172
+00:11:55,810 --> 00:12:01,350
+زي النط والقفز وهذه الأمور هل بتأدي لأختلال في
+
+173
+00:12:01,350 --> 00:12:05,870
+توازنه فبالتالي ممكن أنا أثر على شبكية العين اللي
+
+174
+00:12:05,870 --> 00:12:11,710
+موجودة عليها Hypoglycemiaالان احنا كل كلام او لو
+
+175
+00:12:11,710 --> 00:12:15,410
+جيت على اي مريض سكري بيقولك انا بخاف اكتر اشي من
+
+176
+00:12:15,410 --> 00:12:21,420
+اللي هو ارتفاع السكر في الدم تمامانخفاض السكر في
+
+177
+00:12:21,420 --> 00:12:25,640
+الدم ايضا مصيبة و بعتبره حالة clinical حالة
+
+178
+00:12:25,640 --> 00:12:29,900
+pathological حالة سيئة جدا يعني لو دخل المرض عندى
+
+179
+00:12:29,900 --> 00:12:36,320
+في حالة غيبوبة في السكري حالة بعتبرها emergency و
+
+180
+00:12:36,320 --> 00:12:39,680
+على طول ممكن انا ادخل فيه لأنه لا سماح الله ممكن
+
+181
+00:12:39,680 --> 00:12:45,000
+يدخلي بعد هيك في مشاكل عديدة جدا ال person should
+
+182
+00:12:45,000 --> 00:12:48,630
+be instructed to stop exercisingعلى طول و أنا بعمل
+
+183
+00:12:48,630 --> 00:12:51,590
+exercise إجتوا hypoglycemia على طول بوقف ال
+
+184
+00:12:51,590 --> 00:12:54,950
+exercise لأن ال exercise أصلا بحاجة لجولوكوز و
+
+185
+00:12:54,950 --> 00:12:59,290
+glycogen و كل الأمور هذه فمبالكم أنه أظلني مستمرة
+
+186
+00:12:59,290 --> 00:13:02,270
+فيه في ال exerciseال people at risk الناس اللي
+
+187
+00:13:02,270 --> 00:13:06,630
+عندها يعني المخاطر أو الناس اللي تقع في دائرة
+
+188
+00:13:06,630 --> 00:13:10,050
+الخطر في الhypoglycemia لازم على الأقل يبقى شايل
+
+189
+00:13:10,050 --> 00:13:15,030
+فيه اللي هو في محفظته في جيبته يكون معاه drops
+
+190
+00:13:15,030 --> 00:13:18,930
+يكون معاه حبة شوكلت أو أي إشي من الجلوكوز خلال
+
+191
+00:13:18,930 --> 00:13:22,050
+دقائق يكون فاتحينله إياها وعلى طول ماتينه إياها
+
+192
+00:13:22,050 --> 00:13:25,530
+أهم إشي كمان هذا المريض لازم يكون معاه اللي هو
+
+193
+00:13:25,530 --> 00:13:31,330
+الهوية تبعته أو كرتإن البطاقة الطبية المعرفة إن
+
+194
+00:13:31,330 --> 00:13:35,110
+هذا مريض سكري حتى لو اللي سمح الله صار فيه عنده أي
+
+195
+00:13:35,110 --> 00:13:38,510
+hypoglycemia و هو في الشارع إن الناس تعرف كيف
+
+196
+00:13:38,510 --> 00:13:42,810
+تعمله ال first aid على طول مباشرة تمام؟ ممكن يكون
+
+197
+00:13:42,810 --> 00:13:46,230
+معاه قزازة عصير أو اللي هو بعض ال drops زي ما
+
+198
+00:13:46,230 --> 00:13:49,930
+حاكينا in order to treat hypoglycemia remember
+
+199
+00:13:49,930 --> 00:13:54,900
+it's a medical emergencyطبعا هي حالة طبية وخطيرة
+
+200
+00:13:54,900 --> 00:13:58,480
+جدا زى ما حكى هنا ليس السكري بالارتفاع ايضا
+
+201
+00:13:58,480 --> 00:14:02,640
+بالانخفاض اللى احنا بنحكى بعض ال snacks اللى ممكن
+
+202
+00:14:02,640 --> 00:14:07,580
+تمنعلى اللى هو ال hypoglycemia ممكن مريض ياخد بعض
+
+203
+00:14:07,580 --> 00:14:11,480
+ال snacks أي بعض البسكوتات البسيطة لحتى يمنع اللى
+
+204
+00:14:11,480 --> 00:14:17,470
+هو الالـ basic rules أو القواعد الأساسية لـ snacks
+
+205
+00:14:17,470 --> 00:14:22,170
+قبل ما تتاخد اللي هي لازم تكون قلائمة ومناسبة
+
+206
+00:14:22,170 --> 00:14:28,010
+لمرضى، مش صحيح أنه انا اعطي snacks و بس، لأ ال
+
+207
+00:14:28,010 --> 00:14:31,330
+snacks superior before activities or to activities
+
+208
+00:14:31,330 --> 00:14:34,470
+to prevent hypoglycemia are just a quantity based
+
+209
+00:14:34,470 --> 00:14:37,990
+in pre-activity blood glucose direction of blood
+
+210
+00:14:37,990 --> 00:14:42,270
+glucoseانه انا لازم اعرف هل هو جديش كان عنده
+
+211
+00:14:42,270 --> 00:14:46,390
+glucose جامن ال exercise و بعد الجلسة camp اللي هو
+
+212
+00:14:46,390 --> 00:14:51,730
+ال exercise ال blood glucose له or dropping على
+
+213
+00:14:51,730 --> 00:14:55,370
+طول انا بزيد اللي هو ال crabs او بزيد اللي هي ال
+
+214
+00:14:55,370 --> 00:15:00,380
+snacks اذا كان stableOkay بستخدم اشي عادي ومافيش
+
+215
+00:15:00,380 --> 00:15:03,500
+فيه اي نوع من الشوكولات او السكريات اما اذا كان
+
+216
+00:15:03,500 --> 00:15:08,560
+high بخفض كمية ال crabs اللي موجودة عندي ال snacks
+
+217
+00:15:08,560 --> 00:15:13,000
+at least once per hour during prolonged activities
+
+218
+00:15:13,000 --> 00:15:19,360
+للنشاط او ال exercise التويل سنة واحدة تكفي خلال
+
+219
+00:15:19,360 --> 00:15:24,430
+الساعةChoose a high glycemic form of carbohydrates
+
+220
+00:15:24,430 --> 00:15:29,370
+بستخدمله اللي هي بسعرات عالية جدا هنا useful tip
+
+221
+00:15:29,370 --> 00:15:32,630
+of exercise بعض ال exercise اللي انا بدي استخدمها
+
+222
+00:15:32,630 --> 00:15:38,830
+اهم اشي اللي في عندي نقاط مهمة انا لازم اعدي عليها
+
+223
+00:15:38,830 --> 00:15:41,870
+لمريض السكري اهم اشي حاكيناه معانا اللي هي البطاقة
+
+224
+00:15:41,870 --> 00:15:46,540
+الطبية والله هذا فلان تين و مريض سكريالعناية
+
+225
+00:15:46,540 --> 00:15:50,400
+بالقدمين، جابل ما أبدأ أي exercise لازم أنا أطلع
+
+226
+00:15:50,400 --> 00:15:54,880
+بالامراية عن الأصابع، فيهم لا سمح الله جروح، فيهم
+
+227
+00:15:54,880 --> 00:15:58,920
+خدش، فيهم اترومة، لازم أاخد ذالي، الحذاء اللي بدوا
+
+228
+00:15:58,920 --> 00:16:04,010
+يلبسوا لازم يكون مناسب ومشمحكم او مش ضيق على رجله
+
+229
+00:16:04,010 --> 00:16:07,990
+عشان مايصير فيه اي مشاكل عالطول لازم يكون معاه
+
+230
+00:16:07,990 --> 00:16:12,190
+اللي هي الماء لإنه ممكن اللي سمح الله يصير فيه
+
+231
+00:16:12,190 --> 00:16:16,490
+عنده اي مشاكل ماأشغلوش او ماجهدوش ب exercise او
+
+232
+00:16:16,490 --> 00:16:21,330
+activity طويلة جدا ايضا اللي هي الحرارة العالية مش
+
+233
+00:16:21,330 --> 00:16:26,050
+ضروري ان اعمل فيها exercise في الأجواء الحارة نبدأ
+
+234
+00:16:26,050 --> 00:16:28,450
+هم اللي هم ال always carry identification card
+
+235
+00:16:28,450 --> 00:16:32,040
+with youأيضا check your feet before walking,
+
+236
+00:16:32,660 --> 00:16:36,860
+choose good footwear and light clothes, drink of
+
+237
+00:16:36,860 --> 00:16:41,820
+water, don't exercise during hot seasons and when
+
+238
+00:16:41,820 --> 00:16:46,050
+not feeling wellالسماري ان ال physical activity
+
+239
+00:16:46,050 --> 00:16:49,130
+should be encourage all people with diabetes مهم
+
+240
+00:16:49,130 --> 00:16:53,670
+جدا الرياضة للناس اللي هم موجودين هنا على الكورة
+
+241
+00:16:53,670 --> 00:16:58,070
+الأرضية و بالذات اللي هم المرضى السكري ال people
+
+242
+00:16:58,070 --> 00:17:01,530
+need be educated about prevention and treatment
+
+243
+00:17:01,530 --> 00:17:07,480
+hypoglycemia people should be to planاو ال period
+
+244
+00:17:07,480 --> 00:17:11,080
+of دي هي for period for physical activities انه
+
+245
+00:17:11,080 --> 00:17:15,060
+بالنهاية انا بدي اعمل التمرين ولكن في عندى قواعد
+
+246
+00:17:15,060 --> 00:17:19,640
+وقانونين لازم امشي عليها مع هذا المريض هذا مش مريض
+
+247
+00:17:19,640 --> 00:17:23,200
+عادي لان هحكي على حالة طبية كنا حكينا عليها في
+
+248
+00:17:23,200 --> 00:17:26,640
+بداية اللي هو المحاضرة اللي هي حاجة بنسميها
+
+249
+00:17:26,640 --> 00:17:30,260
+هشوفوها او انه ممكن شوفتوها لناس اللي اتدربت في
+
+250
+00:17:30,260 --> 00:17:34,040
+أقصام الباطنة حاجة اسمها ال medical او diabetic
+
+251
+00:17:34,040 --> 00:17:41,710
+foodطبعا قدم السكري الاشي شائع جدا يعني كنت بسمع
+
+252
+00:17:41,710 --> 00:17:46,590
+على مستشفى كامل هيفتتحوها في اللي هو قطاع غزة فقط
+
+253
+00:17:46,590 --> 00:17:50,590
+خاصة بحاجة اسمها diabetic food على جد ما هي مليانة
+
+254
+00:17:50,590 --> 00:17:54,250
+و جد ما احنا في عندنا حالة amputation ديابتك food
+
+255
+00:17:54,250 --> 00:17:57,150
+can be defined as a group of syndrome in which
+
+256
+00:17:57,150 --> 00:18:02,220
+neuropathy, ischemic and infectionتمام؟ لاحظوا ال
+
+257
+00:18:02,220 --> 00:18:05,300
+stages اللى أنا بدى أمشي عليهم هي neuropathy
+
+258
+00:18:05,300 --> 00:18:09,820
+ischemic and infection lead to tissue breakdown
+
+259
+00:18:09,820 --> 00:18:14,380
+then ulceration and resulting to morbidity and
+
+260
+00:18:14,380 --> 00:18:19,780
+possible of amputation trauma صغيرةصار فيه على
+
+261
+00:18:19,780 --> 00:18:23,340
+سبيل المثال و الحجة بده قص إدفارها صار في عندها
+
+262
+00:18:23,340 --> 00:18:28,500
+جلح صغير على حافة الإصبع أهملته مرة على مرة و احنا
+
+263
+00:18:28,500 --> 00:18:31,580
+بنعرف لمرضى السكري في عندهم poor blood circulation
+
+264
+00:18:31,580 --> 00:18:36,120
+أدى إلى تعفن هذه المنطقة أدى إلى infection في هذه
+
+265
+00:18:36,120 --> 00:18:39,740
+المنطقة بعد شوية صار في breakdown لغشه بعد شوية
+
+266
+00:18:39,740 --> 00:18:45,800
+صارت تدخل الحالة في إذرقاق cyanosisللمنطقة بعدين
+
+267
+00:18:45,800 --> 00:18:50,640
+بيصير في عندي اللي هي ال amputation تمام؟ لإنه
+
+268
+00:18:50,640 --> 00:18:54,220
+خلاص بيكون دخلت في اللي هو poor blood circulation
+
+269
+00:18:54,220 --> 00:18:58,380
+أو poor blood supply لهذه المنطقة دي بتكفوت
+
+270
+00:18:58,380 --> 00:19:01,620
+pathology grouped into two broad categories ممكن
+
+271
+00:19:01,620 --> 00:19:06,000
+أنا أقسمها لحالتين تنتينالنيروباتيكو نيرو اسكيميك
+
+272
+00:19:06,000 --> 00:19:16,760
+تمام انه ال نيرو باتيكو نيرو اسكيميك
+
+273
+00:19:16,760 --> 00:19:19,060
+نيرو باتيكو نيرو نيرو نيرو نيرو نيرو نيرو نيرو
+
+274
+00:19:19,060 --> 00:19:19,060
+نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو
+
+275
+00:19:19,060 --> 00:19:19,560
+نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو
+
+276
+00:19:19,560 --> 00:19:21,760
+نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو
+
+277
+00:19:21,760 --> 00:19:21,760
+نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو
+
+278
+00:19:21,760 --> 00:19:21,800
+نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو نيرو
+
+279
+00:19:21,800 --> 00:19:31,080
+نيرو نيرو
+
+280
+00:19:31,080 --> 00:19:35,650
+نRoot sensation فقدان الإحساس في هذه الأجر may
+
+281
+00:19:35,650 --> 00:19:39,130
+result subsequent foot deformity causing abnormal
+
+282
+00:19:39,130 --> 00:19:41,650
+biomechanical loading in the feet and then a
+
+283
+00:19:41,650 --> 00:19:46,810
+breakdown of the skin and ulcersإنه أنا بدي أصير
+
+284
+00:19:46,810 --> 00:19:51,570
+في عندي فقدان بالإحساس في اللي هو القدم ممكن أكون
+
+285
+00:19:51,570 --> 00:19:57,350
+ماشيت و بطريقة خاطئة أدت لعوجاج القدم فبالتالي بعد
+
+286
+00:19:57,350 --> 00:20:00,450
+فترة من الفترات بدي أصير في عندي تحميل على منطقة
+
+287
+00:20:00,450 --> 00:20:05,090
+معينة من الفوت باللي هو الإضافة اللي أنا فوتت
+
+288
+00:20:05,090 --> 00:20:08,750
+المنطقة التانية اللي هي بالأصل في ال normal gate
+
+289
+00:20:08,750 --> 00:20:11,670
+اللي أنا مابماشيتش عليها صحيح بإن انتوا أدت لإن
+
+290
+00:20:11,670 --> 00:20:15,800
+يصير في عندي breakdown لل skin and ulcerationتمام؟
+
+291
+00:20:15,800 --> 00:20:19,260
+هذا الأشي في الـ Neuropathy .. إيه اللي عندنا؟ الـ
+
+292
+00:20:19,260 --> 00:20:26,020
+Neuropathic phase طبعا هيكون warm .. warm
+
+293
+00:20:26,020 --> 00:20:30,440
+and nonetheless dry usually painless and pulse
+
+294
+00:20:30,440 --> 00:20:35,920
+remain balanced طبعا الإجر ما زالت لسه فيها النبض
+
+295
+00:20:36,180 --> 00:20:40,200
+اللي ممكن يحس بخدلان تنميل بس جافة to make no
+
+296
+00:20:40,200 --> 00:20:44,960
+complication Quart اللي هي الـ neuropathic joint
+
+297
+00:20:44,960 --> 00:20:48,740
+طبعا نوع من أنواع الـ deformity اللي هتصير الـ
+
+298
+00:20:48,740 --> 00:20:52,600
+neuropathic ulcer found mainly on soles and feet
+
+299
+00:20:52,600 --> 00:20:57,290
+موجود طبعا في عندنا ulcer اللي هوعبارة عن تقرح في
+
+300
+00:20:57,290 --> 00:21:00,470
+باطن القدم Minority trauma على سبيل المثال بسبب
+
+301
+00:21:00,470 --> 00:21:04,450
+ليه المشكلة زي ما حكينا Walking اللي هو bar foot
+
+302
+00:21:04,450 --> 00:21:08,230
+or acute injury اللي هو طبعا إذا مشى ليه هذا الشخص
+
+303
+00:21:08,230 --> 00:21:12,810
+و هو حافي من غير ما يتخذ إجراءات الوقاية والسلامة
+
+304
+00:21:12,810 --> 00:21:17,630
+وممكن ينأذي بأي إصابة بسيطة Participated in a
+
+305
+00:21:17,630 --> 00:21:20,930
+chlorine attack؟ أه صح النوع التاني من adaptive
+
+306
+00:21:20,930 --> 00:21:25,150
+food اللي هو neuro ischemic fitالنيرو اسكيماك من
+
+307
+00:21:25,150 --> 00:21:28,250
+اسمها اسكيماك معناته ال preferal لل artery disease
+
+308
+00:21:28,250 --> 00:21:32,090
+إيه علاقة بالارتري؟ ال infection often complicated
+
+309
+00:21:32,090 --> 00:21:35,450
+أو often اللي هو neuropathy complicated and
+
+310
+00:21:35,450 --> 00:21:38,550
+ischemic coils considerably damaged ده بتكفور
+
+311
+00:21:38,550 --> 00:21:44,110
+المشكلة هنا هنا اسكيماكة معناه الكلاب تيجي تحس أجر
+
+312
+00:21:44,110 --> 00:21:49,170
+المريضة تبعتنا او المريض كال باردة و ال pulse مافي
+
+313
+00:21:49,170 --> 00:21:52,970
+pulseفبالتالي هنا المشكلة في الـ artery هنا أنا
+
+314
+00:21:52,970 --> 00:21:55,110
+تشهد نيرو بس ال complication intermediate
+
+315
+00:21:55,110 --> 00:21:58,610
+cloudation طبعا بدي يكون في عندي intermediate
+
+316
+00:21:58,610 --> 00:22:02,410
+cloudations اللي هو بشكل متقطع rest لل بين and
+
+317
+00:22:02,410 --> 00:22:07,010
+ganglia may occur ممكن تحدث الغلغانين كنهاية هاي
+
+318
+00:22:07,010 --> 00:22:10,630
+ال complication الـ neuro ischemic ulcer resulting
+
+319
+00:22:10,630 --> 00:22:15,380
+fromالـ Localized Pressure Damage بيصير فيه ضغط
+
+320
+00:22:15,380 --> 00:22:19,720
+معين على هذه المنطقة على سبيل المثال، عندي ديابتك
+
+321
+00:22:19,720 --> 00:22:23,060
+و stroke patient وموجود هو في وضع الـ Sublime
+
+322
+00:22:23,060 --> 00:22:26,560
+Position وما بيصيرش فيه له تغيير أو تقليب للفراش
+
+323
+00:22:26,560 --> 00:22:30,800
+ممكن وضعيته في الـ Sublime يصير في عندنا
+
+324
+00:22:30,800 --> 00:22:34,170
+Ulceration في منطقة الـ Calcaneusيعني ال calcane
+
+325
+00:22:34,170 --> 00:22:37,990
+area بيصير فيها نتيجة لهذا ال pressure بيصير في
+
+326
+00:22:37,990 --> 00:22:41,510
+عنا اللي هو ال alpha and found mainly at the edge
+
+327
+00:22:41,510 --> 00:22:45,450
+of foot اللي هو زي ما حكينا في هاية أطراف الأصابع
+
+328
+00:22:45,450 --> 00:22:49,110
+ممكن يصير أيضا ومنطقة ال calcane
+
+329
+00:22:51,820 --> 00:22:56,920
+هذه بعض الصور للحالات اللى انا ممكن اشوفها طبعا
+
+330
+00:22:56,920 --> 00:23:01,620
+لاحظوا كيف اللى أضافر هنا مافيه حناية بالأضافر فى
+
+331
+00:23:01,620 --> 00:23:04,960
+عندنا بعض ال trauma اللى موجودة لازم ناخد بالنا
+
+332
+00:23:04,960 --> 00:23:08,890
+منها ال symptomsLosses of predictive sensation للـ
+
+333
+00:23:08,890 --> 00:23:11,770
+pain and tingling sensation الـ sensation طبعا
+
+334
+00:23:11,770 --> 00:23:15,790
+بنقله في هذه الحالات ال patient may develop the
+
+335
+00:23:15,790 --> 00:23:22,510
+blister فقاعات و كأنه الاشي أو كأنه المشكلة بدأت
+
+336
+00:23:22,510 --> 00:23:27,670
+بالي هو زي حروق من الدرجة التانية اللي هي الفقاعات
+
+337
+00:23:27,670 --> 00:23:31,350
+اللي بتكون موجودة عندهم Ablation and wound may not
+
+338
+00:23:31,350 --> 00:23:35,640
+to feel any painبكون انتهت هذا المريض تبعنا باللي
+
+339
+00:23:35,640 --> 00:23:41,660
+هو على سبيل المثال ب shoes تبعته اللي مش مناسبة
+
+340
+00:23:41,660 --> 00:23:45,840
+وضلوا ماشي مشواره وماحس فيها و أغلب الحالات كانت
+
+341
+00:23:45,840 --> 00:23:48,040
+تجينا سراحة على المستشفى بهذه الطريقة
+
+342
+00:23:51,980 --> 00:23:55,540
+أيضا ال circulation لما يكون فيها مشاكل بتسبب انه
+
+343
+00:23:55,540 --> 00:23:59,880
+تكسير للجلد ال circulation و ال skin temperatures
+
+344
+00:23:59,880 --> 00:24:03,960
+ايضا بتختلف معانا في البناء يعني بتلاحظ ان المنطقة
+
+345
+00:24:03,960 --> 00:24:07,040
+لا لون الهارو يوم أسمر يوم أحمر يوم متلونة
+
+346
+00:24:07,040 --> 00:24:11,840
+فبالتالي هنا المشكلة تبقى مستمرة إلى أن ندخل في
+
+347
+00:24:11,840 --> 00:24:15,490
+اللي هي ال complication الأخرىDepending on a
+
+348
+00:24:15,490 --> 00:24:18,510
+specific problem, the developed patient may notice
+
+349
+00:24:18,510 --> 00:24:21,390
+swelling and discoloration.زي ما حكيت أنه أنا
+
+350
+00:24:21,390 --> 00:24:26,750
+بتتطور المشكلة يوم الأجر أزرق، أحمر، grey، white،
+
+351
+00:24:26,750 --> 00:24:30,270
+و بعدين خلاص بندخل في اللي غير غرينا، red streak
+
+352
+00:24:30,270 --> 00:24:34,030
+and increasingly warm and coldestطبعا ومازالة
+
+353
+00:24:34,030 --> 00:24:38,550
+الإجر عندي اللى هو قليلة درجة الحرارة لإنه باردة
+
+354
+00:24:38,550 --> 00:24:43,110
+جدا with no or minimal pain a wound without drage
+
+355
+00:24:43,110 --> 00:24:48,670
+ممكن البعض الأحيان أنه يكون في عندي خراج أو قيح من
+
+356
+00:24:48,670 --> 00:24:52,590
+هذه المنطقة وبعض الأحيان مايكون فيه طبعا نتيجة
+
+357
+00:24:52,590 --> 00:24:55,310
+taking on socks and tingling بين deformity
+
+358
+00:24:55,340 --> 00:25:00,720
+الpatient with infection may have fever ارتفاع
+
+359
+00:25:00,720 --> 00:25:07,080
+درجة الحرارة اللي هي الرعشة او القشعيرة اللي بتفير
+
+360
+00:25:07,080 --> 00:25:11,580
+checks of redness احمرار ودرناج طبعا وفي وجود اللي
+
+361
+00:25:11,580 --> 00:25:17,190
+هو قيحة الخراجBlood sugar control بيصير فيه عدم
+
+362
+00:25:17,190 --> 00:25:20,890
+تحكم في اللي هو السكري في الدم المرض ممكن يدخل فيه
+
+363
+00:25:20,890 --> 00:25:25,230
+حالة من اللي هو ال confused أندلبام الهديان و اللي
+
+364
+00:25:25,230 --> 00:25:28,670
+هو نتيجة ارتفاع الضغط الدم و ارتفاع ال blood
+
+365
+00:25:28,670 --> 00:25:34,750
+sugars اللي موجود في cost factors في عندي لدى بدي
+
+366
+00:25:34,750 --> 00:25:41,190
+اكفاتعوامل داخلية وعوامل خارجية خليني أشوف من إيش
+
+367
+00:25:41,190 --> 00:25:45,350
+ممكن يصير في ال extrinsic factor bad fitting طبعا
+
+368
+00:25:45,350 --> 00:25:50,110
+ل الفوت وير ال shoes هذا مش مناسب لبسته هاي الست
+
+369
+00:25:50,110 --> 00:25:54,270
+وماكنش مناسب إلها تماما قد ل injury very foot
+
+370
+00:25:54,270 --> 00:26:00,170
+walkingأتمشت مشورها أو اتمشت في أرجع منزلها و هي
+
+371
+00:26:00,170 --> 00:26:05,290
+مش لابسة في ال shoes تبعها falling أو accident صار
+
+372
+00:26:05,290 --> 00:26:09,650
+في عندها مشكلة accident و صار في عملية crashing
+
+373
+00:26:09,650 --> 00:26:14,040
+جري فادت إلى ال infected لهذا اللونال object
+
+374
+00:26:14,040 --> 00:26:18,300
+inside shows ما اهتمت انها تشوف لما قد تلمس حذاء
+
+375
+00:26:18,300 --> 00:26:22,040
+تبعها انه فيه على سبيل المثال بعض الأحيان ممكن
+
+376
+00:26:22,040 --> 00:26:27,780
+يكون قطعة صغيرة من ال plastic او ممكن تكون اي اشي
+
+377
+00:26:27,780 --> 00:26:33,100
+مؤلم او اشي مؤذىبننتبه الحاج انه في الحذاء تبعه
+
+378
+00:26:33,100 --> 00:26:38,020
+مشكلة Thermal Trauma بعض الأحيان خصوصا اللي هو
+
+379
+00:26:38,020 --> 00:26:43,520
+أثناء جول البرت بتلاقي أن السيدت جاعدة على الدفاية
+
+380
+00:26:43,520 --> 00:26:48,400
+و مدى إجريها طبعا تدفيهم و انشن حرجاته و شاقة طبعا
+
+381
+00:26:48,400 --> 00:26:53,040
+صار اللي صار و هي لسه مش حاسة بحالها Injury by
+
+382
+00:26:53,040 --> 00:26:59,490
+sharp objectsطبعا النتيجة انه المنتبه لما حكينا
+
+383
+00:26:59,490 --> 00:27:03,230
+السيد انه في وجود مصمار على سبيل المثال في داخل
+
+384
+00:27:03,230 --> 00:27:08,010
+الشوز هاي بالنسبة للعوامل ال eccentric العامل ال
+
+385
+00:27:08,010 --> 00:27:14,010
+intrinsic اللي هو limited لل joint mobility نفس ال
+
+386
+00:27:14,010 --> 00:27:16,970
+joint في الtarsal bone او الmetatarsal bone او
+
+387
+00:27:16,970 --> 00:27:22,010
+الفلانجيز فيهم مشكلةهذه ال deformity نفسها بتعمل
+
+388
+00:27:22,010 --> 00:27:25,030
+compression او pressure على منطقة معينة ال poly
+
+389
+00:27:25,030 --> 00:27:29,430
+prominence طبعا اللي هي زي ما حكينا بعض اللي هو ال
+
+390
+00:27:29,430 --> 00:27:32,050
+poly prominence خصوصا بال little finger او ال
+
+391
+00:27:32,050 --> 00:27:34,750
+fifth finger بترسها البون food deformity زي ما
+
+392
+00:27:34,750 --> 00:27:37,970
+حكينا بعض الأحيان في ناس بتمشي و في عندها اللي هو
+
+393
+00:27:37,970 --> 00:27:41,630
+ال hammer foot او بنسميه ال big toeالـ plantar
+
+394
+00:27:41,630 --> 00:27:45,270
+callus طبعا نتيجة لإن هو في عنده مشكلة في التكلث
+
+395
+00:27:45,270 --> 00:27:49,870
+الزيادة، ال skirtishه، صار في عنده skirtishه،
+
+396
+00:27:49,870 --> 00:27:54,670
+الفيشارز بعض، اللي هي الشروخ اللي بتصير، هذه عوامل
+
+397
+00:27:54,670 --> 00:27:58,190
+اللي هي علاقة بداخل القدم نفسها، يعني مافي إيش
+
+398
+00:27:58,190 --> 00:28:01,370
+إيجانة من برا، كله من نفس ال food تبعتنا و ال
+
+399
+00:28:01,370 --> 00:28:05,230
+anatomical و ال changes اللي بتصير داخل ال food،
+
+400
+00:28:05,230 --> 00:28:08,360
+شو ال complication؟النيرو باتي هي مرتبط بـ
+
+401
+00:28:08,360 --> 00:28:12,340
+metabolic abnormalities للديابتس، طبعا إشي أساسي،
+
+402
+00:28:12,340 --> 00:28:16,500
+الديابتس مع هذا الحاج إله حوالي 15 أو 20 سنة، إشي
+
+403
+00:28:16,500 --> 00:28:20,890
+طبيعي أن يجيله نيرو باتي، vascular diseaseطبعا is
+
+404
+00:28:20,890 --> 00:28:23,790
+a present mainly patient with time to diagnosis of
+
+405
+00:28:23,790 --> 00:28:26,330
+the disease وكمان بعد 21 سنة ممكن يجيله of
+
+406
+00:28:26,330 --> 00:28:29,170
+vascular disease ال ulcer may cause by external
+
+407
+00:28:29,170 --> 00:28:33,550
+pressure or rebound كمان بعد هيك عن طريق أي
+
+408
+00:28:33,550 --> 00:28:37,510
+pressure زي ما حكينا أن هو لبس الفوت وكان ضيق على
+
+409
+00:28:37,510 --> 00:28:43,260
+أصابع إجراءأدت له مشاكل بعد مشوار طويل مشى طبعا
+
+410
+00:28:43,260 --> 00:28:47,460
+إنه يمشي حافي اللي هي barefoot and find object in
+
+411
+00:28:47,460 --> 00:28:51,520
+the shoes, ruff and seams, stones or tail بعض
+
+412
+00:28:51,520 --> 00:28:55,540
+الأحيان ممكن يكون عنده فيه مشاكل كبيرة ناتجة عن
+
+413
+00:28:55,540 --> 00:29:00,190
+اللي هو عدم ارتداء وارتداء بشكلطيب، هاي كلها من ال
+
+414
+00:29:00,190 --> 00:29:02,930
+complicated أيضا ال infection usually لإن زي ما
+
+415
+00:29:02,930 --> 00:29:05,490
+حكينا هدول الناس على طول بيصير في عندهم ال wound
+
+416
+00:29:05,490 --> 00:29:09,450
+كنا حاكينا في بداية اللي هو ال chapter إن هذا
+
+417
+00:29:09,450 --> 00:29:12,550
+المرض السكري بتكون عنده ال immunity system ضعيفة
+
+418
+00:29:12,550 --> 00:29:15,750
+جدا، أيضا ال wound بياخد فترة طويلة لما يصير فيه
+
+419
+00:29:15,750 --> 00:29:18,090
+هناالشيء اللى بتقلل ال infection usually are
+
+420
+00:29:18,090 --> 00:29:21,770
+caused by entry of bacteria, direct throat wound
+
+421
+00:29:21,770 --> 00:29:25,570
+اللى هي break in the skin such as ulcer area and
+
+422
+00:29:25,570 --> 00:29:29,950
+toenail pressure اللى هو ingrowing للتونيل بعض
+
+423
+00:29:29,950 --> 00:29:36,070
+الأحيانالنمو غير طبيعي لهو الإدفار أدى لإن يكون
+
+424
+00:29:36,070 --> 00:29:39,850
+فيه infection تالي بيوصل لمرحلة الجانجلينة أو اللي
+
+425
+00:29:39,850 --> 00:29:44,350
+هي بعدها بتتم عملية ال amputation لهذا المريض
+
+426
+00:29:44,350 --> 00:29:47,290
+بنتجة losses of blood supply أو losses of
+
+427
+00:29:47,290 --> 00:29:48,090
+circulation
+
+428
+00:29:50,300 --> 00:29:55,320
+هحكي على شوية anatomy اللى اللى هي ال bottom of
+
+429
+00:29:55,320 --> 00:30:00,300
+fruit عشان أعرف من وين أنا بدي أشتغل مع هذه الحالة
+
+430
+00:30:00,300 --> 00:30:04,860
+typical places that answer come from include بديوا
+
+431
+00:30:04,860 --> 00:30:08,620
+يكونوا ال answer تبعنا أو التقرح along the bottom
+
+432
+00:30:08,620 --> 00:30:12,830
+of fruitعلى ما تاكلها ده هتتوضح بصورة القادمة بإذن
+
+433
+00:30:12,830 --> 00:30:16,590
+الله تعالى a long bottom of fruit at the base of
+
+434
+00:30:16,590 --> 00:30:21,730
+two في اللي هو القاعدة تبعت الأصابع in the mild
+
+435
+00:30:21,730 --> 00:30:25,490
+fruit in the mid in the mid fruit or in the heel
+
+436
+00:30:25,490 --> 00:30:29,210
+طبعا ال side is a long bottom وفي عندنا على ال
+
+437
+00:30:29,210 --> 00:30:33,630
+side كل هذا الاشي بحكي أنا من اللي هي السول من تحت
+
+438
+00:30:33,630 --> 00:30:36,910
+a long to little foot from rubbing in shoes back
+
+439
+00:30:36,910 --> 00:30:42,300
+side of heel fromlying in the bed و ال uncle bones
+
+440
+00:30:42,300 --> 00:30:46,320
+اللى هى ال rubbing تبعنا اللى هى in a boat lying
+
+441
+00:30:46,320 --> 00:30:49,640
+in the bed top foot لاحظوا أخدنا على ال long
+
+442
+00:30:49,640 --> 00:30:53,760
+bottom و ال side و ال medial و ال top foot اللى هى
+
+443
+00:30:53,760 --> 00:30:58,060
+ال toes rubbing and shoes تمامالinfection may
+
+444
+00:30:58,060 --> 00:31:01,920
+start in one location and then spread طبعا بيبدأ
+
+445
+00:31:01,920 --> 00:31:04,740
+في منطقة أو نقطة معينة وبعدين بيبلش بالانتشار
+
+446
+00:31:04,740 --> 00:31:08,020
+along tendon sheets such as infections that start
+
+447
+00:31:08,020 --> 00:31:11,100
+in the bottom of metatarsal head بلشلي من ال
+
+448
+00:31:11,100 --> 00:31:13,620
+bottom of metatarsal heads and then spread rapidly
+
+449
+00:31:13,620 --> 00:31:17,380
+along with tendon wall to ankles امتد من بداية
+
+450
+00:31:17,380 --> 00:31:20,520
+اللي هي ال metatarsal وامتد لعند اللي هي ال tendon
+
+451
+00:31:20,520 --> 00:31:25,710
+تبع ال ankle هاي اللي احنا حكينا عليهمال top of
+
+452
+00:31:25,710 --> 00:31:29,690
+foot هاي اللي هي ال pony marking أو اللي هو بعض
+
+453
+00:31:29,690 --> 00:31:32,330
+الأحيان ال pony prominance هذه بتبقى واضحة عنا
+
+454
+00:31:32,330 --> 00:31:37,330
+شايفين كيف صارت الأجر لاللي هو ال shoes اللي مكونش
+
+455
+00:31:37,330 --> 00:31:42,290
+مظبوط أدى لاللي هي ال deformity هاي ال bottom of
+
+456
+00:31:42,290 --> 00:31:45,930
+foot اللي هو بعض القدم هاد اللي هنا هاي بعتبرها
+
+457
+00:31:45,930 --> 00:31:49,290
+bad وهنا اللي هي منطقة ال calcaneus أو منطقة اللي
+
+458
+00:31:49,290 --> 00:31:53,990
+هي ل ال footال classification of ulcer طبعا هذا
+
+459
+00:31:53,990 --> 00:31:57,330
+موضوع ال ulcer موضوع كبير جدا طبعا هو عبارة عن
+
+460
+00:31:57,330 --> 00:32:02,790
+five degrees ان شاء الله رب العالمين هنشرحه و
+
+461
+00:32:02,790 --> 00:32:06,410
+نتكلم عنه في مواضيع تانية هنا بس هي صورة تعبيرية
+
+462
+00:32:06,410 --> 00:32:10,590
+عشان تشوفوا قداش يعني صفر ال grade صفر ولا إشي لكن
+
+463
+00:32:10,590 --> 00:32:13,110
+لاحظوا لما يكون ال grade خمسة لاحظوا لما يكون ال
+
+464
+00:32:13,110 --> 00:32:17,190
+grade أربعة الإشي ممكن يوصل ل ال bone عفنا الله و
+
+465
+00:32:17,190 --> 00:32:21,550
+إياكم ال problem diagnosisالـ nerve function may
+
+466
+00:32:21,550 --> 00:32:25,350
+abnormal so the patient may feel not feel of pain
+
+467
+00:32:25,350 --> 00:32:30,810
+في عندنا احتراقة الأجر ودخلنا في infection ومع هيك
+
+468
+00:32:30,810 --> 00:32:36,050
+الست مش قادرة تحس أو مش حاسة ان والله في مشكلة
+
+469
+00:32:36,050 --> 00:32:40,830
+بإصبع أجر غير الكبير لو ما إجا عليها حد على سبيل
+
+470
+00:32:40,830 --> 00:32:45,990
+المثال وشاف والله حجة انت الوضع عندك مش مظبوط أو
+
+471
+00:32:45,990 --> 00:32:49,550
+ممكن هي ترتفع درجة حرارتها و تدخل في ال infection
+
+472
+00:32:49,550 --> 00:32:53,780
+scienceعن symptoms بعدين يعرفوا أنه والله عندها
+
+473
+00:32:53,780 --> 00:32:57,920
+مشكلة نتيجة جروح معين في جرحهم this frequently
+
+474
+00:32:57,920 --> 00:33:01,420
+caused daily diagnosis وهذا السبب الأساسي اللي هو
+
+475
+00:33:01,420 --> 00:33:06,300
+يؤخر عملية ال LTM بالإضافة لووجود سببأساسي اللي هو
+
+476
+00:33:06,300 --> 00:33:10,020
+أنه أنا عندي هدول مرضى السكري هم بالأساس ضعيفي
+
+477
+00:33:10,020 --> 00:33:13,060
+المناعة and the patient made diagnosis at late
+
+478
+00:33:13,060 --> 00:33:16,100
+with limb or life treating infection as a result
+
+479
+00:33:16,100 --> 00:33:20,080
+بعد ما يكون دخلنا في مشاكل عميقة حددت حياته حتى
+
+480
+00:33:20,080 --> 00:33:23,280
+حددت حياته هذه ال infectionالـ diagnosis is based
+
+481
+00:33:23,280 --> 00:33:26,120
+in the symptoms unsigned not before and the
+
+482
+00:33:26,120 --> 00:33:28,940
+absence of protective sensation may confirm هدا
+
+483
+00:33:28,940 --> 00:33:33,320
+بيأكدلي أنه ال radiographs may show gas in soft
+
+484
+00:33:33,320 --> 00:33:36,860
+tissue طبعا بياخدوها للمرضى و بيعملوها x-ray
+
+485
+00:33:36,860 --> 00:33:40,580
+بيلاحظوا وجود ال gas اللي هو في قاعة بابلسن صغيرة
+
+486
+00:33:40,580 --> 00:33:44,220
+في ال soft tissueطبعا و ال soft tissue بتبقى
+
+487
+00:33:44,220 --> 00:33:48,260
+الريحة تبعتها سيئة جدا، ايضا ال swelling، defect،
+
+488
+00:33:48,260 --> 00:33:51,140
+ال changes ال consensus ل infection، ممكن أحيانا
+
+489
+00:33:51,140 --> 00:33:55,740
+تسببلي fractures and اللي هو dislocations للمفصل
+
+490
+00:33:55,740 --> 00:34:01,470
+نفسه، كل هذا بيصير مع الإهمان لمريض السكريالـ
+
+491
+00:34:01,470 --> 00:34:05,850
+ulcers are graded for sizes إن أنا بقيمه حسب ال
+
+492
+00:34:05,850 --> 00:34:09,950
+size تبعه و الحجم تبعه طبعا و الدبث أهم إيش الدبث
+
+493
+00:34:09,950 --> 00:34:13,450
+لأنه إذا بتذكروا في ال slide السابقة حكيت إنه أنا
+
+494
+00:34:13,450 --> 00:34:16,510
+ممكن ال ulcer أوصل فيه لل bone معناة الكلام أنا
+
+495
+00:34:16,510 --> 00:34:19,250
+اخترقت ال skin و ال muscles و ال facial و كل
+
+496
+00:34:19,250 --> 00:34:23,270
+الأمور هاي و دخلت على اللي هو ال bone additional
+
+497
+00:34:23,270 --> 00:34:27,270
+imaging study may helpful including لل boneطبعا
+
+498
+00:34:27,270 --> 00:34:30,450
+الأمر I و ال CT ممكن يبينولي لوين أنا عندي ال
+
+499
+00:34:30,450 --> 00:34:33,490
+infection لأنه لازم يتدخل معايا بهذه الحالة اللي
+
+500
+00:34:33,490 --> 00:34:36,890
+هو الدكتور الأوائد دموية حتى يحدد لوين الغيرين على
+
+501
+00:34:36,890 --> 00:34:39,990
+سبيل المثال واصلا ال culture of the chauvron base
+
+502
+00:34:39,990 --> 00:34:43,810
+in ulcer may or more reliable than sweep cultures
+
+503
+00:34:43,810 --> 00:34:47,130
+from ulcer هنا ليش أنا بدي ال cultures؟ ليش بدي
+
+504
+00:34:47,130 --> 00:34:50,630
+المزرعة من هذه المنطقة اللي infected؟ عشان أعرف
+
+505
+00:34:50,630 --> 00:34:54,850
+مدى حساسية هذا الشخص لل antibiotics اللي يعطيها
+
+506
+00:34:54,850 --> 00:34:58,630
+دكتور الباطنةيعني على سبيل المثال بيجيب معاه ال
+
+507
+00:34:58,630 --> 00:35:04,390
+antibiotic كذا ال body بتاعي مابجيبش فبالتالي أنا
+
+508
+00:35:04,390 --> 00:35:08,770
+بعمل اللي هي مزرعة في هذه المنطقة باختعينة صغيرة
+
+509
+00:35:08,770 --> 00:35:12,670
+vascular studies may help determine how will blood
+
+510
+00:35:12,670 --> 00:35:16,600
+circulatingطبعا which is improving للwand healing
+
+511
+00:35:16,600 --> 00:35:18,700
+أنا بتهمني ال circulation و ال vascular
+
+512
+00:35:18,700 --> 00:35:23,240
+circulation حتى أحسن من ال healing لإن المنطقة
+
+513
+00:35:23,240 --> 00:35:27,460
+بيأكملها ملتهبة قام الدكتور و عمل depredment كشت و
+
+514
+00:35:27,460 --> 00:35:33,360
+إزالة لبعض اللي هي الأنسجة فالمنطقة جوفت على سبيل
+
+515
+00:35:33,360 --> 00:35:36,760
+المثال و انشل منها حاجة كتيرة فبالتالي أنا بدي
+
+516
+00:35:36,760 --> 00:35:41,520
+مناعة عالية عشان يصير في عندنا wand healingوما
+
+517
+00:35:41,520 --> 00:35:46,380
+أدخل بـ later complications لـ treatment طبعا، يا
+
+518
+00:35:46,380 --> 00:35:50,220
+إما للـ non-surgical أو surgical للـ non-surgical
+
+519
+00:35:50,220 --> 00:35:53,700
+by drugs إذا كان الأمر بسيط وخفيف، لكن إذا كان
+
+520
+00:35:53,700 --> 00:35:57,680
+بحاجة لـ surgical، زي ما اتكلمت عنه سابقا، بتتم عن
+
+521
+00:35:57,680 --> 00:36:02,280
+طريق اللي هو استئصال كل المشاكل و الدتشة و اللي هو
+
+522
+00:36:02,280 --> 00:36:08,520
+بعد هيك بحسن المناعة، physical therapyالايمو
+
+523
+00:36:08,520 --> 00:36:11,600
+فيزيكال ثرابي ده dead pig foot clinical to control
+
+524
+00:36:11,600 --> 00:36:14,640
+شو احدافنا ان انا اعمل control and maintenance لل
+
+525
+00:36:14,640 --> 00:36:19,260
+blood glucose level احافظ على ال blood glucose
+
+526
+00:36:19,260 --> 00:36:24,700
+level high اهم خطوة عندي لمرضى السكري to teach لل
+
+527
+00:36:24,700 --> 00:36:29,640
+area at risk of food ulcer ان انا دائما اي منطقة
+
+528
+00:36:29,640 --> 00:36:36,010
+فيها مشكلة اعمل عليها مراقبة و ملاحظةalmost care
+
+529
+00:36:36,010 --> 00:36:38,850
+that risky area to educate لل food care and
+
+530
+00:36:38,850 --> 00:36:42,170
+prevention methods دائما أعطي نصائح، دائما أعطي
+
+531
+00:36:42,170 --> 00:36:46,010
+تعليمات to advise brother footwear، لبس حذاء
+
+532
+00:36:46,010 --> 00:36:51,710
+مناسب، مضيق سيبك منه، الحذاء اللي مفتوح من الأمام
+
+533
+00:36:51,710 --> 00:36:55,250
+كمان سيبك منه، كل الأمور هذه أنا بعطيها advice لل
+
+534
+00:36:55,250 --> 00:37:01,540
+patient تبعي to educate do and don'tاعمل قائمة بيه
+
+535
+00:37:01,540 --> 00:37:05,260
+اعمل هذه الأشياء وقائمة ما تعمل هذه الأشياء خصوصا
+
+536
+00:37:05,260 --> 00:37:08,740
+إذا كان ما عندها الحالة caregiver أو مقدم رعاية
+
+537
+00:37:08,740 --> 00:37:13,160
+during daily activities probably ايضا to advise
+
+538
+00:37:13,160 --> 00:37:16,680
+proper food supplant بعض الأحيان هدول الناس بحاجة
+
+539
+00:37:16,680 --> 00:37:19,600
+لsupplant to correct deformity to minimize
+
+540
+00:37:19,600 --> 00:37:23,100
+neuropathic pain أقلل ال neuropathic pain to
+
+541
+00:37:23,100 --> 00:37:27,320
+prevent deformity أمنع أي ألم to improve muscle
+
+542
+00:37:27,320 --> 00:37:31,670
+power and prevent muscle worseningالشي طبيعي بال
+
+543
+00:37:31,670 --> 00:37:34,570
+exercise لازم to increase the range of motion
+
+544
+00:37:34,570 --> 00:37:37,290
+strengthening and endurance to prevent limited
+
+545
+00:37:37,290 --> 00:37:42,110
+joint mobility ال objectives تبعتنا لاللي هو
+
+546
+00:37:42,110 --> 00:37:45,850
+derdic footwear أول إشي لازم أعمل relieve ل ال
+
+547
+00:37:45,850 --> 00:37:49,050
+excessive plantar pressure أي plantar pressure أنا
+
+548
+00:37:49,050 --> 00:37:52,990
+أمنعها لإنه مابديش أعمل pressure على منطقة معينة و
+
+549
+00:37:52,990 --> 00:37:58,020
+بعد كده أدخل في الأنصار reduction لل shockأقل من
+
+550
+00:37:58,020 --> 00:38:01,420
+كمية الصدمات الموجودة reduction لل share friction
+
+551
+00:38:01,420 --> 00:38:05,960
+forces إن أنا ما أعملش اللي هو قوة مشاركة تزيد من
+
+552
+00:38:05,960 --> 00:38:09,020
+الوزن على سبيل المثال والضغط على هذه المنطقة
+
+553
+00:38:09,020 --> 00:38:13,080
+accommodations of minimal deformity تمام
+
+554
+00:38:13,080 --> 00:38:16,140
+stabilization للـ deformity و preventing
+
+555
+00:38:16,140 --> 00:38:21,880
+لrecurrence ulcer أمنع أي recurrence ulceradvice
+
+556
+00:38:21,880 --> 00:38:25,660
+about shoes and socks shoes اللي هي بعض النصائح
+
+557
+00:38:25,660 --> 00:38:31,060
+لاللي هو مرضنا سكري في لبس الحذاء و الإجرابات
+
+558
+00:38:31,060 --> 00:38:35,780
+choose and wear your shoes carefully بهدوء بنلبس
+
+559
+00:38:35,780 --> 00:38:39,500
+اللي هو حذائنا اللي عندنا pay new shoes at late in
+
+560
+00:38:39,500 --> 00:38:42,880
+the day when your foot at late in the day when
+
+561
+00:38:42,880 --> 00:38:45,400
+your foot are larger buy shoes that are
+
+562
+00:38:45,400 --> 00:38:48,730
+comfortable without breaking the periodبعض الأحيان
+
+563
+00:38:48,730 --> 00:38:52,990
+احنا بحاجة لإنه احنا نشتري الحذاء في أخر النهار،
+
+564
+00:38:52,990 --> 00:38:56,230
+ليش؟ لإنه في أخر النهار بتبقى الأجر أكبر حجما،
+
+565
+00:38:56,230 --> 00:39:04,170
+فاحنا بحاجة إلى .. بحاجة إلى حذاء أوسع أو أكبر
+
+566
+00:39:04,170 --> 00:39:09,510
+نمرة، تمام؟ check how your shoe fits in width and
+
+567
+00:39:09,510 --> 00:39:13,430
+length، black للبطونطبعا اللي هو ال back و ال
+
+568
+00:39:13,430 --> 00:39:17,550
+bottoms of heel and sole لازم أنا أشارك على ال
+
+569
+00:39:17,550 --> 00:39:21,430
+shoes في كل الأماكن بعض الأحيان ممكن يكون في دبوس
+
+570
+00:39:21,430 --> 00:39:25,630
+ممكن يكون في حاجة مقلمة لهذا المرض Avoid pointed
+
+571
+00:39:25,630 --> 00:39:29,790
+toes اللي هي avoid لل pointing toe style and high
+
+572
+00:39:29,790 --> 00:39:33,890
+heels ممنوع تلبس اللي هو ال set اللي هو ال shoes
+
+573
+00:39:33,890 --> 00:39:38,990
+العالية بلاش يختي تطولي لك شوية و بعد هيك ندخل في
+
+574
+00:39:38,990 --> 00:39:43,530
+ulcer و amputationTry to get shoes made with
+
+575
+00:39:43,530 --> 00:39:47,650
+leather and upper material and deep toe boxes حاول
+
+576
+00:39:47,650 --> 00:39:51,530
+إن هو تستخدم اللي هو leather الجلد المطبخ طبعا
+
+577
+00:39:51,530 --> 00:39:55,410
+اللي هي المادة الخام مهمة جدا في صناعة ال shoes
+
+578
+00:39:55,410 --> 00:40:00,150
+عشان أنا ماأدخلش في ألصار و مشاكل don't wearthe
+
+579
+00:40:00,150 --> 00:40:04,930
+same pair everyday ما تظلك كل يوم لابس نفس اللي هو
+
+580
+00:40:04,930 --> 00:40:09,190
+shoes لإنه طبعا لازم تتهوأ و أنا أبدلها ب shoes
+
+581
+00:40:09,190 --> 00:40:13,550
+تانية حتى إنه تتشمس و تتعقم inspect the inside of
+
+582
+00:40:13,550 --> 00:40:17,140
+each shoes before putting in thefeel inside with
+
+583
+00:40:17,140 --> 00:40:21,560
+your hand طبعا شاك على اللي هو ال inside of what
+
+584
+00:40:21,560 --> 00:40:26,600
+بإيدك و تأكد من سلامته و خلوه من أي foreign body
+
+585
+00:40:26,600 --> 00:40:31,200
+don't lace your shoes too tightly or loosely دائما
+
+586
+00:40:31,200 --> 00:40:35,460
+شاك على أن الموضوع مايكون اللي هو ال shoesTights
+
+587
+00:40:35,460 --> 00:40:39,800
+أو اللي هو ضيق
+
+588
+00:40:39,800 --> 00:40:43,680
+أو واسع أنه يسقط من إجرك لإنه هاد الناس طبعا بتكون
+
+589
+00:40:43,680 --> 00:40:48,180
+النتيجة لنيروباطي مافي عندها تحكم أو إحساس بإنه ال
+
+590
+00:40:48,180 --> 00:40:51,000
+shoes وجعت من إجرها و هي ماشية و هو مش داري عن
+
+591
+00:40:51,000 --> 00:40:55,180
+حاله لإنه مافي عندهاحساس بيه اللي هو القدمين
+
+592
+00:40:55,180 --> 00:40:58,760
+choose little socks and stocking carefully طبعا
+
+593
+00:40:58,760 --> 00:41:02,240
+اختار اللي هو او اختيار الإجرابات مهم جدا انه يكون
+
+594
+00:41:02,240 --> 00:41:07,180
+مناسب wear .. wear .. wear clean طبعا اللي هو wear
+
+595
+00:41:07,180 --> 00:41:12,240
+clean and dry socks everyday مش ضروري انه كل أسبوع
+
+596
+00:41:12,240 --> 00:41:15,440
+مرة انا ألبس الإجرابات هما هما لأ لازم كل يوم يكون
+
+597
+00:41:15,440 --> 00:41:21,240
+في عنا أنظف تمام؟ و نلبس الأشيء لليل avoid less
+
+598
+00:41:21,240 --> 00:41:26,470
+sockswith holes or wrinkles ممنوع ألبس الشرابات
+
+599
+00:41:26,470 --> 00:41:31,290
+اللي فيهم فتحات أو اللي فيهم تجاعيد لأن هذا ممكن
+
+600
+00:41:31,290 --> 00:41:35,110
+يؤدي إلى مشاكل think cotton طبعا نوع الشرابات لازم
+
+601
+00:41:35,110 --> 00:41:38,630
+يكونوا cotton وفيها نجرابات خاصة بمرضى السكري
+
+602
+00:41:38,630 --> 00:41:41,830
+موجودين في السوق and absorb into summer wear بعض
+
+603
+00:41:41,830 --> 00:41:45,390
+الأحيان اللي هي نجرابات الصيف مهمة جدا secure للتو
+
+604
+00:41:45,390 --> 00:41:49,750
+socks will not squeeze your toes avoid للسكين with
+
+605
+00:41:49,750 --> 00:41:54,100
+elastic stopsseamless stockings are available for
+
+606
+00:41:54,100 --> 00:41:57,080
+this neuropathy consider using compression
+
+607
+00:41:57,080 --> 00:42:00,740
+stockings if your feet tend as well دايما ناخد
+
+608
+00:42:00,740 --> 00:42:05,260
+بالنا من أي إشي بيكون ضغط خصوصا اللي هو المطاط
+
+609
+00:42:05,260 --> 00:42:10,120
+اللي بيكون في نهاية ال socks الإجرابات بيقدّي لضغط
+
+610
+00:42:10,120 --> 00:42:14,720
+على ال circulationdo and don't for diabetic food
+
+611
+00:42:14,720 --> 00:42:19,480
+افعل ولا تفعل في اللي هو مرض السكري inspect your
+
+612
+00:42:19,480 --> 00:42:22,240
+feed daily هاي بعض النصائح اللي انت بديك تقدميها
+
+613
+00:42:22,240 --> 00:42:27,240
+او تقدمها لمرض السكري دائما افحص اللي هو القدمين
+
+614
+00:42:28,350 --> 00:42:32,630
+بالطبع الـ mirror especially at اللي هو بلو طول ال
+
+615
+00:42:32,630 --> 00:42:36,210
+pressure area بمراية صغيرة شوف في عنا على سبيل
+
+616
+00:42:36,210 --> 00:42:40,830
+المثال فطريات بين الأصابع في عنا جروح في عنا إشي
+
+617
+00:42:40,830 --> 00:42:44,870
+washing للفيت daily water apply lotions and oil
+
+618
+00:42:44,870 --> 00:42:48,970
+للفيت after drying حتى الإجرين مش لازم نظل خجافة
+
+619
+00:42:48,970 --> 00:42:54,690
+لازم أناأرطبها بأي لوشن avoid extreme temperatures
+
+620
+00:42:54,690 --> 00:42:58,630
+مقعرضها لدرجة حرارة عالية have your feet checked
+
+621
+00:42:58,630 --> 00:43:01,790
+with each clinic visit انسبكت للشوز daily and
+
+622
+00:43:01,790 --> 00:43:05,630
+affect foreign body change للشوز often regular of
+
+623
+00:43:05,630 --> 00:43:10,190
+skin and nail care تمام؟كل هذه الأمور لازم انا اخد
+
+624
+00:43:10,190 --> 00:43:15,570
+بالي منها don't walk barefoot مش لازم تمشي حافة ال
+
+625
+00:43:15,570 --> 00:43:19,030
+smoking هذا له مشاكله لانه ايضا بيأخر عملية
+
+626
+00:43:19,030 --> 00:43:22,850
+الالتئام في ال one step into ال bath before
+
+627
+00:43:22,850 --> 00:43:26,910
+checking ال water temperatures لازم خلال اللي هو
+
+628
+00:43:26,910 --> 00:43:31,030
+الشوار انا اعمل اللي هو فحص للماء اذا كان ساخن
+
+629
+00:43:31,030 --> 00:43:34,990
+كتير او مش قادر اتحمله ممكن يأدي لحروق و هو مش
+
+630
+00:43:34,990 --> 00:43:39,880
+ذاري عن حاله use heating padsاستخدم اللى هو بعض ال
+
+631
+00:43:39,880 --> 00:43:44,780
+beds اللى هي السخنة ولكن تكون ادافع مش سخنة خالص
+
+632
+00:43:44,780 --> 00:43:49,720
+perform اللى هو ال perform bathroom surgery we use
+
+633
+00:43:49,720 --> 00:43:54,260
+chemical agent to treat corns and callous wear new
+
+634
+00:43:54,260 --> 00:43:58,160
+shoes for more than an hour at a time طبعا اللى هو
+
+635
+00:43:58,160 --> 00:44:02,900
+بعض النظائح هذه ما لازم نعملها how to keep your
+
+636
+00:44:02,900 --> 00:44:07,760
+feet flexible بعض التمرين هنا اللى هعملهاأو هعلمها
+
+637
+00:44:07,760 --> 00:44:11,820
+للمريض التبعى، هيمشي على أطراف أصابعه ال two point
+
+638
+00:44:11,820 --> 00:44:16,820
+أو two كورال، hold each position for five seconds،
+
+639
+00:44:16,820 --> 00:44:20,600
+على الأقل خمس ثوانى، and repeat it ten minutes،
+
+640
+00:44:20,600 --> 00:44:24,700
+وعيده عشر مرات، recommended for people with hammer
+
+641
+00:44:24,700 --> 00:44:29,460
+toe اللى هى أصابع المطرقة بنسميهاR2 Crams هذا
+
+642
+00:44:29,460 --> 00:44:33,260
+مطلوب أو منصوح فيه للناس اللي عندها الhammer 2 هنا
+
+643
+00:44:33,260 --> 00:44:37,420
+واجف على أطراف أصابع و هي بوضع ال extension هنا
+
+644
+00:44:37,420 --> 00:44:41,620
+واجف على أطراف الأصابع و اللي هو الوضع plantar
+
+645
+00:44:41,620 --> 00:44:48,860
+plantar reflection هنا اللي هو عمل على كرل اللي هو
+
+646
+00:44:48,860 --> 00:44:55,040
+لتو انه اتناهم او خلاهم بوضع التعريج golf ballroll
+
+647
+00:44:55,040 --> 00:44:58,340
+أنه أجيب ال golf ball roll و أحطها تحت اللي هو ال
+
+648
+00:44:58,340 --> 00:45:03,280
+plantar area و أخلي دهرج فيها على أساس أعمل اللي
+
+649
+00:45:03,280 --> 00:45:06,020
+هي ال exercise هذا التمرين كتير كمان حلو سواء
+
+650
+00:45:06,020 --> 00:45:10,620
+لمرضى سكري أو لغيرهم لمرضى سكري أو غيرهم roll of
+
+651
+00:45:10,620 --> 00:45:15,310
+golfball under the ball of food for two minutes
+
+652
+00:45:15,310 --> 00:45:19,750
+this is a great message for bottom of food and is
+
+653
+00:45:19,750 --> 00:45:22,830
+recommended لل people with plantar fasciitis طبعا
+
+654
+00:45:22,830 --> 00:45:25,470
+الناس اللي عندها التهاب في الأخماصية اللي هي
+
+655
+00:45:25,470 --> 00:45:29,050
+بنسميها أو ال heel pain arc strain and foot cramps
+
+656
+00:45:29,050 --> 00:45:35,950
+تمام ال tool ال towel crawls اللي هو أنه بلف
+
+657
+00:45:35,950 --> 00:45:40,140
+البشكير و بحاول ياخده بأطراف أصابعهplace a small
+
+658
+00:45:40,140 --> 00:45:43,560
+towel in the floor and correlate و حاول اللي هو
+
+659
+00:45:43,560 --> 00:45:48,020
+انه ياخدو يجعدو towards using with your only foot
+
+660
+00:45:48,020 --> 00:45:50,920
+you can increase and resistance by putting weight
+
+661
+00:45:50,920 --> 00:45:55,040
+on the end of towel relax to repeat this exercise
+
+662
+00:45:55,040 --> 00:45:58,300
+five times يريح و بعدين يرجع يعمل التمرين
+
+663
+00:45:58,300 --> 00:46:01,700
+recommended for people with hammer toe, two cramps
+
+664
+00:46:01,700 --> 00:46:05,740
+and pain of ball اللي هي ال foot نفسها يعني ممكن
+
+665
+00:46:05,740 --> 00:46:11,290
+أستخدم ولا كذا حالة موجودة عنديالـ marble أو اللي
+
+666
+00:46:11,290 --> 00:46:14,690
+هو بنسميه marble pick-up أو لعب الباليه طبعا اللي
+
+667
+00:46:14,690 --> 00:46:19,390
+بلاقي still marble in the floor بعدين pick-up one
+
+668
+00:46:19,390 --> 00:46:23,070
+marble at a time you twist in with small bowl
+
+669
+00:46:23,070 --> 00:46:28,870
+تمام، do this exercise until هفبكد up all twenty
+
+670
+00:46:28,870 --> 00:46:33,810
+marbles اللي هي الكوريات الصغيرة أو الكورة الصغيرة
+
+671
+00:46:33,810 --> 00:46:35,710
+اللي بتكون زي ال marble recommended لل people with
+
+672
+00:46:35,710 --> 00:46:39,170
+pen of ball and footالـ Hammer To and Crams كمان
+
+673
+00:46:39,170 --> 00:46:43,030
+كويسة اللي هم هاي اللعبة Sand of Walking أنه يمشي
+
+674
+00:46:43,030 --> 00:46:47,810
+على شاطئ البحر كتير بنسمع من أمهاتنا وإجدادنا طبعا
+
+675
+00:46:47,810 --> 00:46:52,110
+أنه خليه يمشي حافي على شاطئ البحر any chance you
+
+676
+00:46:52,110 --> 00:46:55,330
+get to cuff your shoes and walking with sand at
+
+677
+00:46:55,330 --> 00:46:59,530
+beach طبعا ال exercise massage youفى heat of this
+
+678
+00:46:59,530 --> 00:47:02,590
+is melting your toes and provide good general food
+
+679
+00:47:02,590 --> 00:47:06,890
+condition ال watch طبعا لازم اكون هنا انا حريصة
+
+680
+00:47:06,890 --> 00:47:11,530
+لإنه انا شلحت المريض او خلّع المريض ال food تبعته
+
+681
+00:47:11,530 --> 00:47:17,190
+فانا لازم اكون حريصة او اكون مهتمة جدا لموضوع انه
+
+682
+00:47:17,190 --> 00:47:19,370
+فيه جذاز او لأ
+
+683
+00:47:23,030 --> 00:47:25,230
+السبلنتينج لإيش أنا بدي أستخدم السبلنتينج؟ بدي
+
+684
+00:47:25,230 --> 00:47:29,370
+أستخدمه لإيه هو correct deformity بدي أستخدمه لإنه
+
+685
+00:47:29,370 --> 00:47:33,230
+أنا أحافظ على ال food في وضع ال anatomical
+
+686
+00:47:33,230 --> 00:47:36,830
+position الصحيحة Total contact cost is the
+
+687
+00:47:36,830 --> 00:47:40,530
+appropriate way of resulting the food with
+
+688
+00:47:40,530 --> 00:47:44,910
+diameter بلنتر ألصق it is distribution لل weight
+
+689
+00:47:44,910 --> 00:47:48,210
+long in the inter of plantar aspects للfood it
+
+690
+00:47:48,210 --> 00:47:51,990
+reduce shareطبعا بيقلل ال share تبع ال force
+
+691
+00:47:51,990 --> 00:47:56,010
+normally present between foot and shoes it produce
+
+692
+00:47:56,010 --> 00:47:58,950
+shortening and straight length and decrease
+
+693
+00:47:58,950 --> 00:48:02,670
+walking velocity لازم انا طبعا لما انتوا شايفين
+
+694
+00:48:02,670 --> 00:48:05,730
+اللي هو بعض ال splendidات او بعض ال prosthesis
+
+695
+00:48:05,730 --> 00:48:09,530
+اللي موجودة ال orthosis اللي موجودة هنا مهم جدا
+
+696
+00:48:09,530 --> 00:48:14,190
+انا استخدمها مع هدول الناس حتى اعمل correct ل ال
+
+697
+00:48:14,190 --> 00:48:18,220
+deformity thank you for your attentionوألقاكم بإذن
+
+698
+00:48:18,220 --> 00:48:22,840
+الله تعالى في فيديو آخر بإذن الله تعالى يعطيكوا
+
+699
+00:48:22,840 --> 00:48:23,420
+الفافية
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/eNY187D88o0.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/eNY187D88o0.srt
new file mode 100644
index 0000000000000000000000000000000000000000..830105ba80e01d0ba9a859c496bf277c7aa48900
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/eNY187D88o0.srt
@@ -0,0 +1,1902 @@
+1
+00:00:00,880 --> 00:00:04,400
+السلام عليكم ورحمة الله وبركاته. اليوم بإذن الله
+
+2
+00:00:04,400 --> 00:00:10,540
+تعالوا، راح نشرح الجزء الثاني من مادة علاج قلب وصدر
+
+3
+00:00:10,540 --> 00:00:15,440
+وباطنته. هدخل اليوم بقسم القلب، physiotherapy for
+
+4
+00:00:15,440 --> 00:00:19,420
+cardiopulmonary disorders. هاخد اليوم اللي هو بداية
+
+5
+00:00:19,420 --> 00:00:23,560
+الـassessment تبع حالات القلب، زي ما كنا نشوف في
+
+6
+00:00:23,560 --> 00:00:27,440
+التدريب العملي. في عندنا اللي هو حالات القلب، سواء
+
+7
+00:00:27,440 --> 00:00:31,380
+كانت في الـICU أو في جراحة القلب، هندخل اليوم في
+
+8
+00:00:31,380 --> 00:00:35,840
+الـ physiotherapy assessments لهذه الحالات، نبدأ على
+
+9
+00:00:35,840 --> 00:00:44,720
+بركة الله. أولاً،
+
+10
+00:00:44,720 --> 00:00:49,040
+الـ adult cardiorespiratory assessment،  سيه أي
+
+11
+00:00:49,040 --> 00:00:52,530
+assessment اللي ناخده سواء في العظام، في الأطفال،
+
+12
+00:00:52,530 --> 00:00:57,950
+في أي department موجود عندنا في المستشفى. هاخد أنا
+
+13
+00:00:57,950 --> 00:01:01,930
+الـ history تبع المريض الموجود عنده، سواء كان الـ
+
+14
+00:01:01,930 --> 00:01:05,810
+present history أو الـ past history. الـ history of
+
+15
+00:01:05,810 --> 00:01:09,510
+present illness and review system. تمام؟ بدي أشوف
+
+16
+00:01:09,510 --> 00:01:14,070
+شو تاريخ المرض تبع هذا المريض. Generally, the
+
+17
+00:01:14,070 --> 00:01:16,490
+following characteristics of each symptom should be
+
+18
+00:01:16,490 --> 00:01:20,490
+illustrated and explored. لازم أنا أكتشف كل الحاجات
+
+19
+00:01:20,490 --> 00:01:24,950
+اللي أنا ضروري أعرفها في هاي الحالة. Honestly، هل
+
+20
+00:01:24,950 --> 00:01:30,720
+المرض بدأ بالتدريج، ولا فجأة؟ أغمى عليه وصار في
+
+21
+00:01:30,720 --> 00:01:34,500
+عنده مشاكل، وبعدين عرفنا إنه والله عنده قصور
+
+22
+00:01:34,500 --> 00:01:38,380
+تاجي. صار عنده ذبحة صدرية، صار عنده كذا
+
+23
+00:01:38,380 --> 00:01:43,920
+لازم نعرف إن هي فترة المرض، و كان الـ locations أو
+
+24
+00:01:43,920 --> 00:01:47,700
+الـ radiations تبع المرض. بنعرف على سبيل المثال إنه
+
+25
+00:01:47,700 --> 00:01:51,120
+لو كان في مثلاً في عندنا ذبحة صدرية، بدي يكون اللي هو
+
+26
+00:01:51,120 --> 00:01:55,100
+الكتف اليمين فيه مشكلة، على سبيل المثال. الـ duration،
+
+27
+00:01:55,100 --> 00:02:00,320
+كمان الـ frequency. قد إيش؟ كم مرة؟ لو كان مصحوب هذا
+
+28
+00:02:00,320 --> 00:02:04,480
+بيقحها؟ كم مرة بيقحه؟ إمتى بتشتد؟ هل أنها بتبطأ في
+
+29
+00:02:04,480 --> 00:02:07,380
+الليل، أو بتشتد عليه في الليل، أو بتبطأ في أثناء
+
+30
+00:02:07,380 --> 00:02:10,360
+النهار. أيضاً الـ characteristics اللي هي الـ quality
+
+31
+00:02:10,360 --> 00:02:15,810
+and severity. قد إيش كميتها؟ قد إيش حدتها؟ هل هي مصحوبة
+
+32
+00:02:15,810 --> 00:02:19,190
+على سبيل المثال بـ blood ولا لا؟ الـ aggravating
+
+33
+00:02:19,190 --> 00:02:23,570
+and alleviating factors. شو العوامل اللي بتزيدلي من
+
+34
+00:02:23,570 --> 00:02:27,730
+فعالية أو من سوء هذا المرض؟ على سبيل المثال، إذا كان
+
+35
+00:02:27,730 --> 00:02:32,230
+بيعاني من أزمة مثلاً، إيش الحاجات اللي هي بتفاقم
+
+36
+00:02:32,230 --> 00:02:36,940
+الحالة أو بتزيدها سوءاً؟ على سبيل المثال، إذا كان فيه
+
+37
+00:02:36,940 --> 00:02:42,020
+على سبيل المثال معطرات جو، إذا كان فيه عطور
+
+38
+00:02:42,020 --> 00:02:45,300
+عادية، هذه الأمور كلها بتجيب الحالة سوءاً، إذا
+
+39
+00:02:45,300 --> 00:02:49,440
+كانت الحالة على سبيل المثال حالة ربو. كمان نفس
+
+40
+00:02:49,440 --> 00:02:52,620
+الشيء، لو حكينا على حالة القلب، على سبيل المثال
+
+41
+00:02:52,620 --> 00:02:57,700
+ارتفاع الكوليسترول، ارتفاع مثلاً أكل أكل معين، إذا
+
+42
+00:02:57,700 --> 00:03:02,340
+كان على سبيل المثال فيه أدوية معينة بياخدها، زيادة
+
+43
+00:03:02,340 --> 00:03:07,000
+نسبة السكر في الدم. ياخد باله من هذه الحاجات. هذا
+
+44
+00:03:07,000 --> 00:03:11,280
+بالنسبة للـ history. أيضاً مكملين، relieving factors،
+
+45
+00:03:11,280 --> 00:03:13,920
+ما هي العوامل؟ لأنه لو أوقف مثلاً الأدوية الفلانية
+
+46
+00:03:13,920 --> 00:03:19,060
+كذا، لو كان هو مريض سكري، معاه الكرنيته تبعه، معاه
+
+47
+00:03:19,060 --> 00:03:22,200
+الروشتة تبعته، إنه لازم ياخد كذا. الآن، الـ current
+
+48
+00:03:22,200 --> 00:03:26,700
+situation، الحالة، هل هي في حالة improving وتحسن
+
+49
+00:03:26,700 --> 00:03:29,200
+ولا في حالة deterioration؟ إذا كان في حالة
+
+50
+00:03:29,200 --> 00:03:31,680
+deterioration، اللي هو تدهور للحالة، بدي أعرف إيش
+
+51
+00:03:31,680 --> 00:03:35,550
+الأسباب. الـ effect on daily activities، اللي هم
+
+52
+00:03:35,550 --> 00:03:40,230
+تأثيرات هذه الحالة على اللي هي أجزاء الحياة العامة.
+
+53
+00:03:40,230 --> 00:03:44,890
+يعني هل على سبيل المثال، إذا كان فيه عنده M.I.،
+
+54
+00:03:45,010 --> 00:03:49,130
+myocardial infarction، على سبيل المثال، هل أثرت على
+
+55
+00:03:49,130 --> 00:03:52,570
+حياته؟ هو أستاذ و بده يروح على المدرسة، هل
+
+56
+00:03:52,570 --> 00:03:56,550
+أثرت على جزء من حياته أو لا. previous diagnosis
+
+57
+00:03:56,550 --> 00:04:02,500
+أيضاً، لازم كمان نعرف إذا كان في عنده أي تشخيصات
+
+58
+00:04:02,500 --> 00:04:06,920
+سابقة مشابهة لهذا الحدث. previous treatment and
+
+59
+00:04:06,920 --> 00:04:10,980
+efficacy. كمان نفس الكلام، إذا أخذ علاجات سابقة، و
+
+60
+00:04:10,980 --> 00:04:16,260
+هل لها تأثير أو لا. أيضاً، مكملين في الـ cardio and
+
+61
+00:04:16,650 --> 00:04:20,130
+signs and symptoms، اللي هي العلامات الـ signs و
+
+62
+00:04:20,130 --> 00:04:24,010
+الـ symptoms. in addition، طبعاً بالإضافة للـ general
+
+63
+00:04:24,010 --> 00:04:25,890
+characteristics outlined above. additional
+
+64
+00:04:25,890 --> 00:04:29,470
+characteristics للـ symptoms نفسها، زي الـ cough، الـ
+
+65
+00:04:29,470 --> 00:04:34,280
+quality، الـ severity، الـ timing، كل كم فترة أو فترة
+
+66
+00:04:34,280 --> 00:04:38,040
+هو كان بيقح لـ duration greater than two weeks، إذا
+
+67
+00:04:38,040 --> 00:04:39,860
+كانت greater than two weeks، إذا كانت أكثر من
+
+68
+00:04:39,860 --> 00:04:44,320
+أسبوعين على سبيل المثال، بدنا نشوف تشخيص الـ TB اللي
+
+69
+00:04:44,320 --> 00:04:49,820
+هو السل، على سبيل المثال. إذا هاي كلها من اللي
+
+70
+00:04:49,820 --> 00:04:54,430
+هي الـ assessment اللي أنا بدي أشتغل عليه. الآن هذا
+
+71
+00:04:54,430 --> 00:04:59,170
+الـ sputum، بدي أشوف الـ color تبعه، الـ amount، الـ
+
+72
+00:04:59,170 --> 00:05:03,170
+consistency، كمان الـ purity. هل فيه دم ولا مش فيه دم؟
+
+73
+00:05:03,170 --> 00:05:06,450
+هل هو متعفن أو لا تحت الميكروسكوب؟ الـ time of
+
+74
+00:05:06,450 --> 00:05:10,290
+day. كل كم مرة في اليوم، ممكن إنه أنا أعمله على
+
+75
+00:05:10,290 --> 00:05:14,230
+سبيلي المثال physiotherapy session، ويقدر إنه يطلع
+
+76
+00:05:14,230 --> 00:05:19,220
+هذا اللي هو secretion. إذا لونه، كمية ونوعه، هل فيه
+
+77
+00:05:19,220 --> 00:05:23,640
+دم أو مش فيه دم، كمان هذا بيعطيني إشارة لإشي معين،
+
+78
+00:05:23,640 --> 00:05:27,460
+تمام؟ وخصوصاً بما إنه إحنا الآن في اللي هي جائحة
+
+79
+00:05:27,460 --> 00:05:33,130
+COVID-19، هذا مهم بالنسبة لنا.  الـ metabases الـ
+
+80
+00:05:33,130 --> 00:05:36,150
+hemo، من اسمها، hemo لحالها تعني blood،
+
+81
+00:05:36,150 --> 00:05:39,730
+hematopoiesis اللي هي الدم، وشو المشاكل اللي بتصدر
+
+82
+00:05:39,730 --> 00:05:43,590
+منه؟ كمية الدم اللي موجودة في هذا الـ sputum.
+
+83
+00:05:43,590 --> 00:05:48,050
+قد إيش؟ هل هي مجرد بس حاجات صغيرة، أو إنه في كمية
+
+84
+00:05:48,050 --> 00:05:50,470
+كبيرة من الـ blood، عشان أنا أقدر أفرّق في الـ
+
+85
+00:05:50,470 --> 00:05:54,150
+diagnosis، ما بين الـ TB وما بين اللي هي الـ
+
+86
+00:05:54,150 --> 00:05:57,300
+preliminary diseases الأخرى. Frank blood or mixed
+
+87
+00:05:57,300 --> 00:06:02,000
+with sputum؟ هل هو إن الدم هذا نتج عندي بشكل مباشر
+
+88
+00:06:02,000 --> 00:06:05,780
+ولا إنه كان مختلط مع الـ sputum؟ الـ associations
+
+89
+00:06:05,780 --> 00:06:11,840
+with leg pain؟ هل هو مصحوب هذا، المشاكل هذه؟ هل هي
+
+90
+00:06:11,840 --> 00:06:14,680
+كانت مصحوبة مع ألم في الـ calf muscle على سبيل
+
+91
+00:06:14,680 --> 00:06:17,280
+المثال، و chest pain، و shortness في الـ breathing
+
+92
+00:06:17,280 --> 00:06:21,060
+ولا لا؟ لأن هذا بياخدني في منحى أو اتجاه آخر، أنا
+
+93
+00:06:21,060 --> 00:06:23,960
+لازم آخد بالي منه. تمام؟
+
+94
+00:06:26,550 --> 00:06:30,670
+Shortness of breathing، قصر اللي هو التنفس، قصر
+
+95
+00:06:30,670 --> 00:06:34,250
+التنفس. هيكون ليش؟ ليش صار في عندنا shortness في الـ
+
+96
+00:06:34,250 --> 00:06:38,070
+breathing؟ هذا بيدلني على أشياء أخرى. في أثناء الـ
+
+97
+00:06:38,070 --> 00:06:41,630
+exercise tolerance، خلال اللي هو أداء الـ exercise.
+
+98
+00:06:41,630 --> 00:06:45,870
+عدد المرات اللي هو قادر الشخص على أداء التمرين
+
+99
+00:06:45,870 --> 00:06:49,230
+فيها. الـ number of stairs a client can climb، or
+
+100
+00:06:49,230 --> 00:06:53,810
+the distance a client can walk. قد إيش؟ كم مرة قادر هو يطلع
+
+101
+00:06:53,810 --> 00:06:57,300
+الدرج، وكم مرة قادر ينزل. الـ tolerance هذا، أو مدى
+
+102
+00:06:57,300 --> 00:07:02,060
+التحمل، أو قدرة المريض على التحمل مهم جداً. الـ
+
+103
+00:07:02,060 --> 00:07:07,340
+postural orthopnea, shortness، بيكون في عندنا
+
+104
+00:07:07,340 --> 00:07:12,200
+shortness اللي هي... شو تعريف الـ orthopnea؟ الـ
+
+105
+00:07:12,200 --> 00:07:14,800
+orthopnea اللي حكينا عليها، عبارة عن shortness لـ
+
+106
+00:07:14,800 --> 00:07:17,580
+breathing. بيصير في عندنا قصر في التنفس.
+
+107
+00:07:17,580 --> 00:07:21,280
+Tripodning، اللي هي use three points of support.
+
+108
+00:07:22,170 --> 00:07:24,290
+طبعاً اللي هي tripod support، اللي هو إنه
+
+109
+00:07:24,290 --> 00:07:28,210
+بيستخدم ثلاث نقاط للوقوف، اللي هو تعطي دعم خلال
+
+110
+00:07:28,210 --> 00:07:31,370
+اللي هو الـ coughing أو القحة اللي إجته فيه اللي هو
+
+111
+00:07:31,370 --> 00:07:35,010
+النفس القصير. Shortness of breathing at rest. طبعاً
+
+112
+00:07:35,010 --> 00:07:39,750
+إذا هو كان في عنده shortness، أو هذا shortness
+
+113
+00:07:39,750 --> 00:07:43,210
+اللي صار عنده، إذا كان هو بيبذل مجهود معين في أحيان
+
+114
+00:07:43,210 --> 00:07:45,390
+shortness بيصير أثناء الـ patient في وضع الـ rest،
+
+115
+00:07:45,390 --> 00:07:48,730
+اللي هو في وضع الراحة. هذا كمان لازم أعرف، حاجة لازم
+
+116
+00:07:48,730 --> 00:07:53,190
+أعرف سببها. الـ association with proximal necrosis،
+
+117
+00:07:53,190 --> 00:07:58,350
+which هو عبارة، هل إنه مصحوب على سبيل المثال بصعوبة
+
+118
+00:07:58,350 --> 00:08:02,200
+في التنفس في أثناء فترة اللي هو الإستلقاء على الظهر
+
+119
+00:08:02,200 --> 00:08:05,440
+أو لا. الـ associated with swelling in ankle or
+
+120
+00:08:05,440 --> 00:08:10,020
+recent weight gain. طبعاً هل هذا الشيء مصحوب معنا
+
+121
+00:08:10,020 --> 00:08:16,320
+بتورم في الـ ankle أو لا؟ أو إنه هل في فقدان للوزن زي
+
+122
+00:08:16,320 --> 00:08:19,600
+ما كنا نحكي مثلاً في الـ diabetes، إنه فيه فقدان للوزن
+
+123
+00:08:19,600 --> 00:08:23,560
+أو فيه اكتساب للوزن. معناته بإيش؟ غير معقول طبعاً،
+
+124
+00:08:23,560 --> 00:08:26,420
+بيكون هذا الكلام. مش إنه أي وزن يعني، لو أضفنا
+
+125
+00:08:26,420 --> 00:08:30,140
+غرام مثلاً، ونعمل مشكلة، لا، اللي بيكون إيش
+
+126
+00:08:30,140 --> 00:08:36,270
+واضح تمام. هذا بالنسبة لـ shortness of breathing. الـ
+
+127
+00:08:36,270 --> 00:08:39,730
+cyanosis، الإزرقاق، اللي كان أو الشيء اللي بيصير
+
+128
+00:08:39,730 --> 00:08:44,490
+نتيجة لإيش؟ لإنه فيه cyanosis نوعين، فيه central و
+
+129
+00:08:44,490 --> 00:08:47,610
+فيه peripheral. الـ cyanosis الناتج عن الـ central، و
+
+130
+00:08:47,610 --> 00:08:51,130
+هناخد فرق ما بينهم. و الـ peripheral ناتج عن سبب
+
+131
+00:08:51,130 --> 00:08:54,460
+معين. When does it occur؟ وما هو السبب بيصير على نفسه
+
+132
+00:08:54,460 --> 00:08:57,940
+يعني؟ وأساساً هل إنه لما يتعرض لمجهود معين، أو لما إنه
+
+133
+00:08:57,940 --> 00:09:03,100
+هذا الشخص على سبيل المثال بيفقد وعيه، أو إنه أنت
+
+134
+00:09:03,100 --> 00:09:06,820
+بالضبط بدي يصير الحدث هذا معاه إيش؟ مثلاً الـ change
+
+135
+00:09:06,820 --> 00:09:10,670
+in background؟ أي تغيرات جديدة صارت على الشكل العام
+
+136
+00:09:10,670 --> 00:09:13,550
+أو على الحالة كلها. الـ associated، هل الـ coughing هذه
+
+137
+00:09:13,550 --> 00:09:18,890
+كانت مصحوبة بـ wheezing أو اللي هو صفير بنسميه، أو
+
+138
+00:09:18,890 --> 00:09:24,730
+الصفير أو اللي هو الكحة اللي بتكون مع الصفير.
+
+139
+00:09:24,730 --> 00:09:27,790
+بالأغلب بتكون مع الأطفال طبعاً، وفيه موجود فيها مع
+
+140
+00:09:27,790 --> 00:09:31,950
+الكبار. فهذه الأشياء إحنا بنخاف منها. chest pain،
+
+141
+00:09:31,950 --> 00:09:36,170
+associated symptoms. طبعاً أكيد فيه على سبيل المثال
+
+142
+00:09:36,170 --> 00:09:38,230
+في الذبحة الصدرية، بيكون في عندهم associated
+
+143
+00:09:38,230 --> 00:09:42,240
+symptoms. Relation to effort. طبعاً إلها علاقة بالجهد،
+
+144
+00:09:42,240 --> 00:09:46,160
+بالـ exercise، بالـ diet، بنوع الـ diet اللي يأكله، إذا
+
+145
+00:09:46,160 --> 00:09:49,460
+كانت عالية، أو high fat أو high cholesterol. هذا مهم
+
+146
+00:09:49,460 --> 00:09:53,360
+جداً. Bending over، كمان إذا هو كان على سبيل المثال
+
+147
+00:09:53,360 --> 00:09:56,320
+عمل bending،  يجب شرح الـ words  that's beyond
+
+148
+00:09:56,580 --> 00:10:00,200
+carefully. Include quality, radiation, severity,
+
+149
+00:10:00,320 --> 00:10:04,640
+timing. تمام؟ لازم نعرف... نشوف الألم هذا هو وين
+
+150
+00:10:04,640 --> 00:10:08,500
+أساسه، أو وين بالضبط هو ناتج من وين؟ وين ممكن يتفرّع
+
+151
+00:10:08,500 --> 00:10:10,580
+عليه؟ هل الـ radiation كان على الـ right shoulder، أو
+
+152
+00:10:10,580 --> 00:10:14,360
+الـ left shoulder على سبيل المثال، في الـ back؟ الـ
+
+153
+00:10:14,360 --> 00:10:17,600
+leg فيها مشاكل ولا مشاكل؟ الـ severity، الحدة تبعته،
+
+154
+00:10:17,600 --> 00:10:21,860
+كان مؤلم؟ هل هو بسيط؟ بيزيد مثلاً على سبيل المثال في
+
+155
+00:10:21,860 --> 00:10:26,240
+أداء نشاط معين؟ في أداء exercise معين؟ والوقت تبعه،
+
+156
+00:10:26,240 --> 00:10:31,420
+والـ timing. تمام. fainting or thumbs، اللي هو
+
+157
+00:10:31,420 --> 00:10:35,460
+فقدان الوعي. الآن إحنا بنحكي على cardio pulmonary
+
+158
+00:10:35,460 --> 00:10:39,560
+disease. اليوم، الـ cardiac نفسها هي الـ machine تبعت
+
+159
+00:10:39,560 --> 00:10:43,050
+الـ blood pumping. إذا إنه على سبيل المثال ما كان في
+
+160
+00:10:43,050 --> 00:10:47,350
+عند الدم الكافي لإن يوصل لأعضاء الجسم، ممكن يتعرض
+
+161
+00:10:47,350 --> 00:10:52,870
+هذا الشخص لـ coma أو يتعرض لغيبوبة، طبعاً
+
+162
+00:10:52,870 --> 00:10:57,230
+نتيجة لفقدان الوعي اللي صار، نتيجة للتغيرات اللي
+
+163
+00:10:57,230 --> 00:11:00,510
+صارت في الجسم. Weakness، ممكن بدايتها تكون weakness،
+
+164
+00:11:00,510 --> 00:11:04,610
+ضعف عام. light headedness. Loss of consciousness. فقدان
+
+165
+00:11:04,610 --> 00:11:07,390
+للوعي. relation to the position or the change. ممكن
+
+166
+00:11:07,390 --> 00:11:11,770
+أحياناً أنا بيكون لسه نايم على الـ bed، وبمجرد
+
+167
+00:11:11,770 --> 00:11:15,850
+ما أنا بحاول أغيره أو أنقله لوضعية اللي هي long
+
+168
+00:11:15,850 --> 00:11:19,800
+sitting position، يحس بيألمه. هنا طبعاً لازم أنا
+
+169
+00:11:19,800 --> 00:11:23,380
+آخذ بالي، وأكون عامل له support من كل الاتجاهات.
+
+170
+00:11:23,380 --> 00:11:28,100
+طبعاً لإني عشان أنا أتأكد إن المريض عندي في وضع آمن.
+
+171
+00:11:28,100 --> 00:11:31,560
+طبعاً نتيجة الـ neurological symptoms، أو نتيجة ممكن
+
+172
+00:11:31,560 --> 00:11:35,300
+تكون الأشياء مش علاقة بالـ circulation، ممكن تكون
+
+173
+00:11:35,300 --> 00:11:39,740
+علاقة بالـ neuro، سواء في الـ brain أو في الـ spinal
+
+174
+00:11:39,740 --> 00:11:43,140
+cord. هذا لازم آخذ بالي منه. كمان في الـ assessment
+
+175
+00:11:43,140 --> 00:11:49,340
+تبع المريض تبعي. الـ extremities أو الأطراف، بدي ألاحظ
+
+176
+00:11:49,340 --> 00:11:54,190
+عليها. إيش
+
+223
+00:15:08,400 --> 00:15:11,160
+أشوف إذا بياخذها المريض عندي أو الـinhibitor زي
+
+224
+00:15:11,160 --> 00:15:15,240
+الـBeta Blockers وبعض الأدوية اللي هنا ذاكرليها هي
+
+225
+00:15:15,240 --> 00:15:18,340
+مش مطلوبة منها، في كمان أدوية خاصة بالـImmunity
+
+226
+00:15:18,340 --> 00:15:23,840
+System أو ما يسمى بجهاز المناعة، كمان كويس أني
+
+227
+00:15:24,160 --> 00:15:27,740
+أعطيها أو أكون عارفة مريضتي إيش بياخذها من أدوية.
+
+228
+00:15:27,740 --> 00:15:33,380
+الأدوية هنا مش مطلوبة معنا في الـmedical assessment ال
+
+229
+00:15:33,380 --> 00:15:36,360
+medical condition، frequency of colds and
+
+230
+00:15:36,360 --> 00:15:40,360
+respiratory infections، كام مرة بتجي في اليوم، اللي
+
+231
+00:15:40,360 --> 00:15:43,390
+هي الـinfluence العادية، خصوصا هذا الشيء مهم جداً
+
+232
+00:15:43,390 --> 00:15:46,070
+حاليا زي ما حكينا، أننا في إجائحة كورونا
+
+233
+00:15:46,070 --> 00:15:49,490
+فبالتالي لازم أعرف هل هو في عنده recent viral
+
+234
+00:15:49,490 --> 00:15:52,730
+infection أو لا، الـjoint pain and swelling، ال
+
+235
+00:15:52,730 --> 00:15:55,690
+history of rheumatic fever، هل عنده حمى روماتيزمية أو
+
+236
+00:15:55,690 --> 00:16:02,140
+لا؟ في عنده ورم في الـnasal أو لا؟ في الجهة في
+
+237
+00:16:02,140 --> 00:16:06,000
+الجيوب الأنفية أو لا، أزمة، Bronchitis، Pneumonia،
+
+238
+00:16:06,000 --> 00:16:10,660
+chronic obstructive pulmonary disease (COPD)، كمان هذا حلو نأخذ عنه شرح
+
+239
+00:16:10,660 --> 00:16:14,340
+كبير، طويل وعريض، كمان نفس الشيء في الـTB ومعظم
+
+240
+00:16:14,340 --> 00:16:19,080
+الحالات اللي هي respiratory
+
+241
+00:16:19,080 --> 00:16:23,540
+disease، الـdisability، هل في عندهم
+
+242
+00:16:23,540 --> 00:16:28,300
+مشاكل، طبعاً نفس الكلام، نكملها لـ cystic fibrosis، كلها
+
+243
+00:16:28,300 --> 00:16:31,560
+أمراض Respiratory، هل هو في عنده بالأصل
+
+244
+00:16:31,560 --> 00:16:35,060
+Hypertension و داء السكري، زي ما حكينا، نأخذ اللي هو ال
+
+245
+00:16:35,060 --> 00:16:37,780
+present و الـpast history، Thyroid disorders، في
+
+246
+00:16:37,780 --> 00:16:41,920
+عنده مشاكل في الغدة الدرقية أو لا، أيضاً مشاكل القلب
+
+247
+00:16:41,920 --> 00:16:45,300
+اللي هو الـ coronary heart disease، اللي هي artery
+
+248
+00:16:45,300 --> 00:16:49,300
+disease، أمراض القلب، و الـangina، و الـMI، و الـ
+
+249
+00:16:49,300 --> 00:16:52,920
+valvular heart disease، و Down syndrome، كل الأمور هذه
+
+250
+00:16:52,920 --> 00:16:56,260
+لازم أكون حاطتها عندي في عين الاعتبار بالـ
+
+251
+00:16:56,260 --> 00:16:59,700
+assessment اللي بعمله لهذا المريض تبعي
+
+252
+00:17:01,380 --> 00:17:04,740
+بالمناسبة أيضاً، اللي هو في حالة الـadmission لـ
+
+253
+00:17:04,740 --> 00:17:08,680
+hospitals، هل هو كان جايني بوضع طبيعي، ولا جايني فيه
+
+254
+00:17:08,680 --> 00:17:12,640
+مثلاً كان unconscious، ونقلوا أهله، لازم آخذ
+
+255
+00:17:12,640 --> 00:17:15,520
+بعين الاعتبار هذه الحاجات كلها، الـdate and result
+
+256
+00:17:15,520 --> 00:17:19,480
+of last context test and tuberculosis and chest x-
+
+257
+00:17:19,480 --> 00:17:24,180
+ray، بشوف التاريخ ونتائج التحاليل اللي هو الـTB
+
+258
+00:17:24,180 --> 00:17:28,820
+اللي هو السل، وكذلك التحاليل الإشعاعية أو
+
+259
+00:17:28,820 --> 00:17:32,920
+الأشعة التشخيصية تبع المريض، اللي هو في نفس اليوم
+
+260
+00:17:32,920 --> 00:17:36,940
+اللي وصل فيه، هل أخذ اللي هو blood transfusion، تم
+
+261
+00:17:36,940 --> 00:17:39,820
+نقله دم له أو لا، خصوصاً في حالات الـcardio
+
+262
+00:17:39,820 --> 00:17:44,340
+respiratory system disease، طبعاً هدول الناس لازم
+
+263
+00:17:44,340 --> 00:17:47,900
+أعرف إذا كان كمان في عندهم family history لبعض
+
+264
+00:17:47,900 --> 00:17:51,240
+الأمراض معينة، خصوصاً في حالات اللي هو الـcardio
+
+265
+00:17:51,240 --> 00:17:56,190
+disease، other at home with similar symptoms، طبعاً
+
+266
+00:17:56,190 --> 00:17:59,550
+ممكن في أشخاص موجودين في البيت عندهم نفس الأعراض
+
+267
+00:17:59,550 --> 00:18:02,570
+أو لا، الـallergies، أو الـtopic اللي هي certain
+
+268
+00:18:02,570 --> 00:18:05,570
+allergics، الـhypersensitivity reaction، هل عنده
+
+269
+00:18:05,570 --> 00:18:08,670
+حساسية من أي أدوية معينة، طبعاً هذه بنسأل عنها في الـ
+
+270
+00:18:08,670 --> 00:18:13,090
+assessment، هل هو بيعاني مثلاً من حساسية لدواء معين
+
+271
+00:18:13,090 --> 00:18:16,110
+مثلاً زي ما بتعرفوا في اللي هو الـtest تبع الإنسولين
+
+272
+00:18:16,110 --> 00:18:19,850
+الـpenicillin، هذا الـtest طبعاً بنعمله لحالات
+
+273
+00:18:19,850 --> 00:18:25,830
+معينة، أنه هل في عندهم حساسية penicillin أو لا، أيضاً
+
+274
+00:18:25,830 --> 00:18:28,970
+مكملين لباقي الـassessment، في حالة الـcardio
+
+275
+00:18:28,970 --> 00:18:32,250
+pulmonary disease، اللي هي الأزمة، هل في lung
+
+276
+00:18:32,250 --> 00:18:36,550
+cancers، في cystic fibrosis، تليف كيسي، أو
+
+277
+00:18:36,550 --> 00:18:40,090
+bronchitis، اللي هو التهاب الشعب الهوائية، منه نوعين
+
+278
+00:18:40,090 --> 00:18:43,810
+ممكن أحياناً يكون chronic، يعني مزمن، وطبعاً هنا
+
+279
+00:18:43,810 --> 00:18:47,570
+الوضع بيكون بحاجة إلى physiotherapy program، لإنه
+
+280
+00:18:47,570 --> 00:18:51,430
+بيكون في عندنا secretion كتيرة، وهو بحاجة إلى
+
+281
+00:18:51,430 --> 00:18:55,150
+physiotherapy sessions، ده، مريض سكري أو لا،
+
+282
+00:18:55,150 --> 00:18:58,370
+أو شو نوع اللي هو السكري اللي عنده، heart disease،
+
+283
+00:18:58,370 --> 00:19:03,890
+طبعاً الأمراض القلبية زي الـhypertension، الـischemic
+
+284
+00:19:03,890 --> 00:19:07,990
+الـchronic heart disease، و الـmyocardial infarction،
+
+285
+00:19:07,990 --> 00:19:13,130
+خصوصاً في females، لأن أعضاء females اللي هم طبعاً
+
+286
+00:19:13,460 --> 00:19:18,500
+أكثر عرضة من males لـsudden death، طبعاً بدي أشوف هل
+
+287
+00:19:18,500 --> 00:19:24,060
+في العائلة في تاريخ مرضي لها، اللي هو الحالات
+
+288
+00:19:24,060 --> 00:19:28,040
+اللي عندها أمراض قلب، طبعاً اللي هي dyslipidemia،
+
+289
+00:19:28,040 --> 00:19:33,960
+صعوبة اللي هو… صعوبة اللي هو ذوبان الـlipids
+
+290
+00:19:33,960 --> 00:19:36,560
+في الدم، ها طبعاً، أو تراكم الدهون في الدم،
+
+291
+00:19:36,560 --> 00:19:41,940
+hypertrophic cardiomyopathy، طبعاً هنا اتضخم عضلة
+
+292
+00:19:41,940 --> 00:19:45,880
+القلب، هذا اللي هو من الـcardiac disease،
+
+293
+00:19:45,880 --> 00:19:49,400
+اللي موجودة، أني آخذ بالي من اللي هو الـdiagnosis،
+
+294
+00:19:49,400 --> 00:19:53,320
+personal and social history، في هنا اللي هو الـ
+
+295
+00:19:53,320 --> 00:19:57,280
+personal and social history، اللي هو التاريخ
+
+296
+00:19:57,280 --> 00:20:02,940
+العائلي والشخصي والاجتماعي، هل هو smoking، كام مرة و
+
+297
+00:20:02,940 --> 00:20:06,620
+كام package في اليوم، هذا كمان بيأثر عليه، خصوصاً في
+
+298
+00:20:06,620 --> 00:20:09,840
+الـcardiac disease، Exposure to second-hand smoking،
+
+299
+00:20:09,840 --> 00:20:13,420
+أو إنه بتعرض لحد عنده… تاني في البيت عندكم حد أي
+
+300
+00:20:13,420 --> 00:20:17,460
+حاجة بيدخن في البيت غيره، إذا كان فيه أو لا، Crowded
+
+301
+00:20:17,460 --> 00:20:21,080
+living conditions، هل هو ساكن في أحياء على سبيل
+
+302
+00:20:21,080 --> 00:20:24,140
+المثال المزدحمة، Poor personal and environmental
+
+303
+00:20:24,140 --> 00:20:26,620
+life، اللي هو طبعاً environmental cleanliness،
+
+304
+00:20:26,620 --> 00:20:30,080
+الأحياء العشوائية تقريباً، أو الناس اللي ما بيكون في
+
+305
+00:20:30,080 --> 00:20:34,360
+عندها تهوية جيدة، ناس بتتعرض لمشاكل كتيرة،
+
+306
+00:20:34,360 --> 00:20:39,880
+High risk level، طبعاً high stress level، اللي هو وضع
+
+307
+00:20:39,880 --> 00:20:44,000
+أن نكون عايشين تحت ضغط، طبعاً سواء كان personal أو
+
+308
+00:20:44,000 --> 00:20:48,320
+occupational، الـinstitutional living، الوضع العام
+
+309
+00:20:48,320 --> 00:20:51,440
+للحالة تبعنا، الـoccupational and environmental
+
+310
+00:20:51,440 --> 00:20:54,780
+conditions and exposure، respiratory irritations،
+
+311
+00:20:54,780 --> 00:20:59,600
+substance use، وطبعاً اللي هي هل أنه على سبيل المثال
+
+312
+00:20:59,600 --> 00:21:04,280
+مدمن على الكحول أو لا، والكافيين، وبعض الأدوية، هل
+
+313
+00:21:04,280 --> 00:21:07,020
+بياخذها injections أو inhalations، على سبيل
+
+314
+00:21:07,020 --> 00:21:12,480
+المثال زي البخاخة تبع مرضى الربو، الأمراض المناعية
+
+315
+00:21:12,480 --> 00:21:16,940
+الذاتية زي الـHIV، هاي كمان مهم أني أعرفها، هل
+
+316
+00:21:16,940 --> 00:21:21,560
+الحالة اللي معي obese أو لا، الـ… طبعاً الـ
+
+317
+00:21:21,560 --> 00:21:24,480
+emigration أو travel abroad، بتعرفوا الناس اللي
+
+318
+00:21:24,480 --> 00:21:27,460
+بتسافر كثيراً، أو إيش زي هيك، بدي أعرف هل هي مثلاً
+
+319
+00:21:27,460 --> 00:21:32,620
+حاملة لمرض معين أو أنها مثلاً اكتسبته من اللي هو الـ
+
+320
+00:21:32,620 --> 00:21:36,520
+… طبعاً الاختلاط، والأماكن اللي crowded، اللي هي
+
+321
+00:21:36,520 --> 00:21:41,490
+الأماكن المزدحمة، كمان مكملين بالـPhysical
+
+322
+00:21:41,490 --> 00:21:45,710
+Assessment، اللي هو الـExamination تبعنا لـAir و
+
+323
+00:21:45,710 --> 00:21:48,670
+الـNose و الـThroat، اللي هو الأنف والأذن و
+
+324
+00:21:48,670 --> 00:21:53,650
+الحنجرة، should be carried out because interlinked
+
+325
+00:21:53,650 --> 00:21:56,370
+اللي هو between the symptoms and sexual and
+
+326
+00:21:56,370 --> 00:21:58,910
+function to the lower respiratory tract، طبعاً لأن
+
+327
+00:21:58,910 --> 00:22:02,570
+كلها متصلة مع بعضها البعض، فإن كان الأعلى الـ
+
+328
+00:22:02,570 --> 00:22:05,070
+respiratory tract أو الـlower respiratory tract،
+
+329
+00:22:05,500 --> 00:22:11,580
+الأعلى اللي هو بيشمل الأنف والبلعوم
+
+330
+00:22:11,580 --> 00:22:15,720
+واللي هو الـpharynx، وبينزل تحت على الـlower
+
+331
+00:22:15,720 --> 00:22:20,240
+بيشمل الـlungs و الـbronchi و الـbronchioles، و كل هذه
+
+332
+00:22:20,240 --> 00:22:23,060
+الحاجات اللي نسميها الـlower respiratory
+
+333
+00:22:23,060 --> 00:22:29,160
+tract، تمام، اللي هي أجزاء تنفسية سفلية، مهم جداً أني
+
+334
+00:22:29,160 --> 00:22:33,010
+أعرفها، شو الـvital signs تبعته؟ لازم أجيب، أرجع
+
+335
+00:22:33,010 --> 00:22:38,330
+الحرارة، الـpulse، النبض، الـrespiratory rate، مدى
+
+336
+00:22:38,330 --> 00:22:42,450
+تشبع الأكسجين، الـblood pressure، الـpeak flow،
+
+337
+00:22:42,450 --> 00:22:47,030
+التنفس، كم صار عندنا، اللي هو من هاي كلها الـ
+
+338
+00:22:47,030 --> 00:22:50,270
+vital signs اللي أنا لازم آخذها بعين الاعتبار
+
+339
+00:22:51,890 --> 00:22:56,590
+المظهر العام، هل هو جاين على المستشفى acutely أو
+
+340
+00:22:56,590 --> 00:22:59,710
+chronically، طبعاً يا إما بتكون لسه جديد على الوضع
+
+341
+00:22:59,710 --> 00:23:03,770
+أو ممكن تكون أجته اللي هي الذبحة مرة واثنتين، الـ
+
+342
+00:23:03,770 --> 00:23:06,910
+degree of discomfort أو comfort of distress، طبعاً
+
+343
+00:23:06,910 --> 00:23:11,070
+هي قد ايش هو قد ايش درجة الراحة أو قد ايش درجة شدة
+
+344
+00:23:11,070 --> 00:23:15,110
+الألم، بتكون واضحة على وجه المريض، الـposition
+
+345
+00:23:16,280 --> 00:23:21,700
+to aid respiration، اللي هو وضعية التنفس كيف من
+
+346
+00:23:21,700 --> 00:23:24,280
+أريح له، الـthree point مثلاً اللي حكينا عليها الـ
+
+347
+00:23:24,280 --> 00:23:27,700
+three point support، هل هو على سبيل المثال بيرتاح
+
+348
+00:23:27,700 --> 00:23:33,740
+عليها أو بيرتاح وهو في وضعيته الـsitting position،
+
+349
+00:23:33,740 --> 00:23:37,440
+إيش الوضعية اللي بيرتاح عليها في الـrespiration، الـ
+
+350
+00:23:37,440 --> 00:23:40,600
+ability to speak normally and tense without stopping
+
+351
+00:23:40,600 --> 00:23:44,070
+and to take a breath، قدرته على أو ماقدرته على
+
+352
+00:23:44,070 --> 00:23:48,150
+الكلام لجملة طويلة، أو أنه مثلاً بيجي يحكي كلمة و
+
+353
+00:23:48,150 --> 00:23:52,150
+بيستنى ياخذ نفس، وبعدين بيكمل باقي الجملة، وبيأخذ
+
+354
+00:23:52,150 --> 00:23:55,350
+نفس وهكذا، هذا بيدل على إيش؟ أنه أنا في عندي مشكلة
+
+355
+00:23:55,350 --> 00:24:01,810
+في الـsystem، الـcolor الوجه بشكل عام، هل هو
+
+356
+00:24:01,810 --> 00:24:07,090
+cyanosis، redness، pink، عادي، مش فيه أي مشاكل، الـ
+
+357
+00:24:07,090 --> 00:24:10,950
+nutritional status، وضعه بالنسبة لإيش هو التغذية
+
+358
+00:24:10,950 --> 00:24:15,770
+أو الغذاء، أكل كويس أو ما أكلش، مش فيه عنده مثلاً
+
+359
+00:24:15,770 --> 00:24:18,570
+على سبيل المثال، هذا بيدل على إن الـgeneral
+
+360
+00:24:18,570 --> 00:24:23,720
+appearance، أنه مثلاً مريض أو وضعه في اللي هو تدهور،
+
+361
+00:24:23,720 --> 00:24:27,060
+إذا عنده الـhydration status، هل في عنده جفاف
+
+362
+00:24:27,060 --> 00:24:31,140
+dehydration، أو وضع اللي هو ترطيب الجلد مثلاً، أو
+
+363
+00:24:31,140 --> 00:24:35,160
+رطوبة الجلد أشوفها وأعرفها، الـmental status، هل هو
+
+364
+00:24:35,160 --> 00:24:39,880
+conscious، unconscious، delirium، هذيان، أو إنه
+
+365
+00:24:39,880 --> 00:24:44,940
+تقريباً فقد للوعي تماماً، كل هذه الأمور مهم جداً أني
+
+366
+00:24:44,940 --> 00:24:51,110
+أعرفها بالـinspection، طبعاً بالمعاينة بيكون للـ
+
+367
+00:24:51,110 --> 00:24:54,890
+colors، cyanosis، هل في أنا عندي زرقة أو لا؟
+
+368
+00:24:54,890 --> 00:24:58,510
+shape of chest، طبعاً شكل الصدر، هل هو صدر طبيعي
+
+369
+00:24:58,510 --> 00:25:03,210
+ولا فيه على سبيل المثال مشاكل وانخفاض في اللي هو
+
+370
+00:25:03,210 --> 00:25:07,810
+الـsternum أو في الـribs نفسهم، في عندنا الـ
+
+371
+00:25:07,810 --> 00:25:10,490
+funnel chest، مثلاً، في عندنا الـbarrel
+
+372
+00:25:10,490 --> 00:25:14,490
+chest، اللي هو الصدر البرميلي، هذه الأمور مهم جداً
+
+373
+00:25:14,490 --> 00:25:18,930
+أعرفها، Symmetry of chest movement، هل في تماثل
+
+374
+00:25:18,930 --> 00:25:23,570
+لـright and left، ولا اللي هو بيكون في مشكلة معينة
+
+375
+00:25:23,570 --> 00:25:26,530
+في lung واحدة ما قدرت تعمل full inspiration،
+
+376
+00:25:26,530 --> 00:25:31,270
+فبالتالي راح يعمل اللي هو ارتفاع في منطقة وانخفاض في
+
+377
+00:25:31,270 --> 00:25:38,890
+منطقة أخرى، rate and rhythm، طبعاً معدل وانتظام
+
+378
+00:25:38,890 --> 00:25:42,690
+التنفس وعمقه، مهم جداً في حالة respiratory distress
+
+379
+00:25:42,690 --> 00:25:46,360
+syndrome، أو حالات اللي هي صعوبات التنفس، الـ
+
+380
+00:25:46,360 --> 00:25:50,080
+intercostal indrawing، طبعاً بحكينا عليها أنه
+
+381
+00:25:50,080 --> 00:25:52,460
+ممكن يكون فيه انهداب لبعض الـintercostal
+
+382
+00:25:52,460 --> 00:25:55,960
+muscles، أو الـintercostal spaces نفسها، هي الـcostal
+
+383
+00:25:55,960 --> 00:25:59,740
+أو الـrib بتكون منخفضة في بعض الـdiseases، والـrib
+
+384
+00:25:59,740 --> 00:26:02,960
+التانية بتكون عادية، أو ممكن اثنتين يكونوا منخفضين مع
+
+385
+00:26:02,960 --> 00:26:07,240
+بعض، هل بيستخدم التنفس وبيستخدم في الـmainly
+
+386
+00:26:07,240 --> 00:26:10,020
+respiratory muscles، اللي هي الـdiaphragm، ولا
+
+387
+00:26:10,020 --> 00:26:14,090
+بيستخدم العضلات الـaccessory، هنا لازم أكون
+
+388
+00:26:14,090 --> 00:26:19,470
+طبعاً مختصة بالي من هذا الموضوع المهم جداً، أيضاً بالذكر
+
+389
+00:26:19,470 --> 00:26:22,870
+بالـinspection لازم أشوف اللي هي الـprecordium
+
+390
+00:26:22,870 --> 00:26:25,690
+visible pulsation، بدي أشوف كيف هو الـ
+
+391
+00:26:25,690 --> 00:26:29,310
+pulsation، باجي بحط إيدي وبحسّ الـpulse، كيف وضعه،
+
+392
+00:26:29,310 --> 00:26:35,950
+أو كم هي عدد النبضات في الدقيقة وبحسبها، الـchest
+
+393
+00:26:35,950 --> 00:26:40,430
+wall scars، طبعاً، الـbruising signs of trauma، هل هو
+
+394
+00:26:40,430 --> 00:26:44,190
+أخذ مثلاً على سبيل المثال ضربة في الصدر، في scar
+
+395
+00:26:44,190 --> 00:26:49,810
+tissue أو لا، فيه عنده حكة أو لا، الـjugular و
+
+396
+00:26:49,810 --> 00:26:54,750
+venous pulsations، بحسّ اللي هو الـpulsations، أو بحسّ
+
+397
+00:26:54,
+
+445
+00:30:09,630 --> 00:30:12,910
+السبق clavicular أو ال cervical nodes  ال masses هل
+
+446
+00:30:12,910 --> 00:30:17,340
+إنه في كتل أو لأ، ال medical beats طبعا اللي هي
+
+447
+00:30:17,340 --> 00:30:22,820
+النبضة أو الـ beat اللي هي السطحية، هل في .. اللي
+
+448
+00:30:22,820 --> 00:30:28,700
+هو كيف على سبيل المثال بدي أفحص ضربات القلب الـ
+
+449
+00:30:28,700 --> 00:30:33,960
+hematoma، ال hepatomegaly اللي هو كبر حجم الكبد
+
+450
+00:30:33,960 --> 00:30:40,340
+في الربع الأعلى الأيمن right upper tenderness
+
+451
+00:30:40,340 --> 00:30:44,120
+طبعا بيكون في ألم في الرُبع الأعلى الأيمن، أساس للـ
+
+452
+00:30:44,120 --> 00:30:48,140
+peripheral، طبعا بقيّم كل شيء، و خصوصا الإديمة في
+
+453
+00:30:48,140 --> 00:30:52,240
+حالات ال cardio-pulmonary disease، تمام؟ هيك بيكون
+
+454
+00:30:52,240 --> 00:30:57,700
+طبعا أنا بال validation حسيت الأطراف مع كل إدمة
+
+455
+00:30:57,700 --> 00:31:02,820
+السماء هنا، percussions لل lung fields resonance،
+
+456
+00:31:02,820 --> 00:31:06,460
+بدي أسمع النغمة كيف؟ طبعا هل هي فيها هواء ولا مش
+
+457
+00:31:06,460 --> 00:31:10,420
+فيها هواء؟ Increasing loneliness over hyperinflated
+
+458
+00:31:10,420 --> 00:31:14,220
+area، طبعا زيادة النغمة أو زيادة اللي هو resonance
+
+459
+00:31:14,220 --> 00:31:18,340
+في الصوت اللي أنا بدي اسمعه معناه الكلام في حالات
+
+460
+00:31:18,340 --> 00:31:21,480
+الـ over hyperinflated area، الـ dullness to
+
+461
+00:31:21,480 --> 00:31:24,780
+percussion، الـ dullness اللي هو بدي يرتد الصوت مرة
+
+462
+00:31:24,780 --> 00:31:28,540
+أخرى over area consolidation location and
+
+463
+00:31:28,540 --> 00:31:34,350
+excursions، لدفرام موقع وانحراف العضلة الأساسية في
+
+464
+00:31:34,350 --> 00:31:38,390
+التنفس اللي هي diaphragmatic muscles، هل هي في موقعها
+
+465
+00:31:38,390 --> 00:31:45,230
+ولا ماخذة موقع آخر نتيجة ال respiratory problem ال
+
+466
+00:31:45,230 --> 00:31:48,790
+escalations of lung، تمام، بالسمع، listening to the
+
+467
+00:31:48,790 --> 00:31:49,510
+sound of air
+
+468
+00:31:54,680 --> 00:32:00,300
+عشان أنا أتعلم
+
+469
+00:32:00,300 --> 00:32:05,540
+عشان
+
+470
+00:32:05,540 --> 00:32:08,860
+أنا أتعلم
+
+471
+00:32:08,860 --> 00:32:14,580
+عشان
+
+472
+00:32:14,580 --> 00:32:17,440
+أنا أتعلم، عشان أنا أتعلم، عشان أنا أتعلم، عشان أنا
+
+473
+00:32:17,440 --> 00:32:18,780
+أتعلم، عشان أنا أتعلم، عشان أنا أتعلم، عشان أنا أتعلم
+
+474
+00:32:18,780 --> 00:32:20,180
+أنا أتعلم، عشان أنا أتعلم، عشان أنا أتعلم degree of air
+
+475
+00:32:20,180 --> 00:32:24,200
+entry throughout the chest،  جدا ش درجة دخول الهواء
+
+476
+00:32:24,200 --> 00:32:27,980
+أو كمية الهواء اللي ممكن تشوف، should be equal، لازم
+
+477
+00:32:27,980 --> 00:32:32,440
+تكون متساوية، ثم ال quality of breath sounds ratio
+
+478
+00:32:32,440 --> 00:32:38,200
+في ال inspiration و ال expiration، مدى اللي هو ratio
+
+479
+00:32:38,200 --> 00:32:43,200
+المعدل تبع دخول النفس أو ال corgio اللي هو المعدل ما
+
+480
+00:32:43,200 --> 00:32:47,520
+بين الشهيق و الزفير، ال advisors اللي هو الأصوات
+
+481
+00:32:47,520 --> 00:32:51,800
+العرضية زي اللي هو المصاحبة، على سبيل المثال زي
+
+482
+00:32:51,800 --> 00:32:55,680
+اللي هي wheezes الصفير و crackles طبعا اللي
+
+483
+00:32:55,680 --> 00:32:59,780
+هي rales و ال pleural rubs، بعض اللي هي الأصوات
+
+484
+00:32:59,780 --> 00:33:05,020
+الناتجة عن مشاكل في التنفس، الاسترداد طبعا بتقلل
+
+485
+00:33:05,020 --> 00:33:07,940
+ال breathing sound لإنه ممكن يكون في عناء اللي هو
+
+486
+00:33:07,940 --> 00:33:14,760
+إيش بيؤثر النفس الطبيعي، تمام، ال escalations of
+
+487
+00:33:14,760 --> 00:33:20,000
+heart sounds اللي هو اللهم صل على سيدنا محمد
+
+488
+00:33:20,000 --> 00:33:23,760
+سماع ضربات القلب زي ما حكينا بالنسبة للتنفس لازم
+
+489
+00:33:23,760 --> 00:33:27,620
+أنا أعرف ال normal عشان أحدد فيما بعد اللي هو ال
+
+490
+00:33:27,620 --> 00:33:32,090
+abnormal، ال escalated at a vertex، طبعا ال «Pulmonic
+
+491
+00:33:32,090 --> 00:33:38,130
+valve»، و «Tricuspid valve»، و «الصمام المترالي»
+
+492
+00:33:38,130 --> 00:33:42,050
+attempt to identify لازم أنا اللي هو بال
+
+493
+00:33:42,050 --> 00:33:46,790
+«auscultation» أو بالصناعة تبعتي أكون عارفة أسمع
+
+494
+00:33:46,790 --> 00:33:49,610
+كويس وين أو وين بدي أحطه أو إيش اللي بدي أحطه عشان
+
+495
+00:33:49,610 --> 00:33:55,190
+أسمعه، rate and rhythm، المعدل و الانتظام تبعه كيف
+
+496
+00:33:55,190 --> 00:33:59,860
+انغمه هل هي ال rhythm تبعه، نبضة بنبضتها، ولا ممكن
+
+497
+00:33:59,860 --> 00:34:03,920
+ينبض مرة و بعدين يسكت، S1 and S2 sounds of their
+
+498
+00:34:03,920 --> 00:34:09,400
+intensity، طبعا اللي هنا ventricle and atrium نحكي
+
+499
+00:34:09,400 --> 00:34:14,040
+عليهم اللي هو البطين و الأذين، و ال S1 في عنا S1 S2
+
+500
+00:34:14,040 --> 00:34:19,240
+S3 S4،  قادة لل heart sound اللي هو  taps و splitting
+
+501
+00:34:19,240 --> 00:34:23,780
+of S2، المرمرز إذا في عنده مرمرز أو لأ، طبعا و ال
+
+502
+00:34:23,780 --> 00:34:28,080
+auscultations، ال carotid artery و ال abdomen الأورطة و
+
+503
+00:34:28,080 --> 00:34:31,800
+الـ renal artery و الـ iliac arteries، بعض اللي هي
+
+504
+00:34:31,800 --> 00:34:36,440
+الشرايين المهمة جدا و ال femoral artery، طبعا لازم
+
+505
+00:34:36,440 --> 00:34:40,340
+هنا أشوفهم و أشيك عليهم و أسمعهم بيه، لإن هذه
+
+506
+00:34:40,340 --> 00:34:45,580
+الشرايين عبارة عن شرايين كبيرة و مهمة، ال
+
+507
+00:34:45,580 --> 00:34:50,380
+associated symptoms، بعض اللي هي الأعراض المصاحبة
+
+508
+00:34:50,380 --> 00:34:54,780
+complete respiratory assessment includes، air nose
+
+509
+00:34:54,780 --> 00:34:58,200
+سبعتهم ENT زي ما بتعرفوا، الدكتور قام في أذنه،
+
+510
+00:34:58,200 --> 00:35:01,900
+الحنجرة لازم يكمل، considers ال special interest
+
+511
+00:35:01,900 --> 00:35:06,340
+أو ال interest in ال gastrointestinal اللي هي مع
+
+512
+00:35:06,340 --> 00:35:10,440
+المعدة، أو ال genitourinary، أو ال genitourinary اللي
+
+513
+00:35:10,440 --> 00:35:13,940
+هو المسالك البولية، assistants if appropriated، إذا
+
+514
+00:35:13,940 --> 00:35:19,480
+أنا محتاجاهم، بقى استعين فيهم، symptoms، الفيقونتي
+
+515
+00:35:19,480 --> 00:35:25,000
+اللي هو الفيقونتي، referral to consultation، إيش هو
+
+516
+00:35:25,000 --> 00:35:29,060
+الأعراض اللي مهمة جدا أنه أنا لما بدي أشوفها على
+
+517
+00:35:29,060 --> 00:35:32,760
+طول بدي أحولها على ال consultation، severe
+
+518
+00:35:32,760 --> 00:35:36,780
+dyspnea and inability to lie flat، شخص جانبي
+
+519
+00:35:36,780 --> 00:35:40,850
+يعاني من صعوبات في التنفس، بالإضافة لأنه مش قادر
+
+520
+00:35:40,850 --> 00:35:43,970
+ينام على ظهره بتاعته، ليه؟ لأنه في صعوبة في
+
+521
+00:35:43,970 --> 00:35:48,050
+التنفس، inability to speak or fragmented speech، اللي
+
+522
+00:35:48,050 --> 00:35:52,310
+هم عدم القدرة على الكلام أو بيحكي كلمة و بيوقف دقيقة
+
+523
+00:35:52,310 --> 00:35:55,150
+على سبيل المثال، ال trachea فيها shifting، يا
+
+524
+00:35:55,150 --> 00:35:58,150
+على اليمين، يا على اليسار، هذه كمان علامة مميزة و مهمة جدا
+
+525
+00:35:58,150 --> 00:36:02,110
+إن أنا أحوله لأقرب استشارة، unrelieved chest pain
+
+526
+00:36:02,600 --> 00:36:07,840
+الـ chest pain ما صار فيه أي شفاء، ليش كان بيوجعه
+
+527
+00:36:07,840 --> 00:36:10,900
+مثلا أجاني الأسبوع الأول و بعد ذلك أجاني بعد أسبوع
+
+528
+00:36:10,900 --> 00:36:15,020
+ما زال اللي هو صدره بيوجعه، unable to maintain طبعا
+
+529
+00:36:15,020 --> 00:36:21,780
+اللي هو saturation of oxygen greater than 92% on
+
+530
+00:36:21,780 --> 00:36:25,440
+room air، severe increasing fatigue، طبعا لازم اللي
+
+531
+00:36:25,440 --> 00:36:29,480
+هو saturation of oxygen أو معدل تركيز ال oxygen في
+
+532
+00:36:29,480 --> 00:36:33,060
+الدم مهم جدا أنا دايما أكون أعرفه، ال cyanosis هل
+
+533
+00:36:33,060 --> 00:36:38,300
+هو central ولا peripheral؟ هل إنه ناتج عن شيء مهم
+
+534
+00:36:38,300 --> 00:36:42,160
+central cyanosis is not predictable until oxygen
+
+535
+00:36:42,160 --> 00:36:46,140
+طبعا إنه لازم أعرف إذا كان هذا الـ cyanosis أو هذا
+
+536
+00:36:46,140 --> 00:36:50,840
+الإزرقاق ناتج عن شيء central أو peripheral؟
+
+537
+00:36:53,510 --> 00:36:58,890
+الـ saturation is less than 85%، هذا أنا بخاف منه،
+
+538
+00:36:58,890 --> 00:37:02,430
+ليه؟ خصوصا الآن بتسمع أن فلان عايش عداء ال
+
+539
+00:37:02,430 --> 00:37:06,370
+oxygen نتيجة لإصابته بالـ COVID-19، فبنتبه عليه
+
+540
+00:37:06,370 --> 00:37:09,750
+كمية ال saturation أو مدة التشبع في ال oxygen مهم
+
+541
+00:37:09,750 --> 00:37:13,420
+جدا، silent chest or crackles without lung fields
+
+542
+00:37:13,420 --> 00:37:17,300
+طبعا اللي هو الـ silent chest اللي هو الصدر الغير
+
+543
+00:37:17,300 --> 00:37:21,140
+متحرك، و ما بيكون فيه حركة لل lungs في ال
+
+544
+00:37:21,140 --> 00:37:23,400
+inspiration و ال expiration، فبالتالي بتكون ضعيفة
+
+545
+00:37:23,400 --> 00:37:27,560
+جدا اللي هو دخول و خروج الهواء، decrease لل level of
+
+546
+00:37:27,560 --> 00:37:30,500
+consciousness، إذا كان في عندي مشكلة في درجة الوعي
+
+547
+00:37:30,500 --> 00:37:34,680
+يعني أنا بحكي مع الحالة و هي دخلت في أمور ثانية أو
+
+548
+00:37:34,680 --> 00:37:37,740
+بدأت تفقد الوعي أمامي، diminish the respiratory
+
+549
+00:37:37,740 --> 00:37:44,090
+effort، يعني مجهود يبدو ياخد نفس بس على الفاضي ما في
+
+550
+00:37:44,090 --> 00:37:48,850
+مجال ياخد هذا النفس، ليش؟ لإنه في عنده مشكلة في أخذ
+
+551
+00:37:48,850 --> 00:37:53,510
+النفس، nasal flaring أو tracheal tug، اللي هو تمدد
+
+552
+00:37:53,510 --> 00:37:56,670
+الأنف، هذا بيصير ليش؟ كعملية تعويضية أو لـ Tracheal
+
+553
+00:37:56,670 --> 00:38:00,090
+tug، بيصير عملية تعويضية على أساس إنه يقدر ياخد أو
+
+554
+00:38:00,090 --> 00:38:03,510
+يحصل أكبر كمية من الـ Oxygen، ولكن للأسف هي عبارة
+
+555
+00:38:03,510 --> 00:38:07,090
+عن compensatory process، عملية تعويضية، بيحاول ياخد
+
+556
+00:38:07,090 --> 00:38:11,190
+منها، بعرف إنه أنا هنا في عندي مشكلة و لازم أحلها، ال
+
+557
+00:38:11,190 --> 00:38:13,950
+intercostal retracting، زي اللي إحنا جاينها هو بيبين
+
+558
+00:38:13,950 --> 00:38:18,370
+بعض اللي هو ال intercostal طبعا، و اللي هي ال ribs
+
+559
+00:38:18,370 --> 00:38:20,930
+اللي موجودة عليها، recent hospitalization for
+
+560
+00:38:20,930 --> 00:38:24,090
+congestive heart failure، طبعا إنه طالع من المستشفى
+
+561
+00:38:24,090 --> 00:38:28,650
+الجديد مع اللي هو congestive heart failure اللي هو
+
+562
+00:38:28,650 --> 00:38:35,040
+فشل في عضلة القلب و احتقانها، تمام، هذا أنا بخاف عليه
+
+563
+00:38:35,040 --> 00:38:38,600
+و على طول أي signs أو symptoms أحوله على ال
+
+564
+00:38:38,600 --> 00:38:42,800
+consultation، يعطيكم ألف عافية و بهيك نكون خلصنا
+
+565
+00:38:42,800 --> 00:38:46,420
+أول chapter في ال cardio-pulmonary symptoms أو ال
+
+566
+00:38:46,420 --> 00:38:49,640
+cardio-pulmonary assessment، ألقاكم بإذن الله في
+
+567
+00:38:49,640 --> 00:38:53,600
+فيديو آخر في حالات ال cardiac disease و ال
+
+568
+00:38:53,600 --> 00:38:58,380
+physiotherapy sessions، سبعتهم، السلام عليكم و رحمة
+
+569
+00:38:58,380 --> 00:38:59,140
+الله و بركاته
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/eNY187D88o0_postprocess.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/eNY187D88o0_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..3527a84fdfd54d8fae397dbcdfaf04652212cb6d
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/eNY187D88o0_postprocess.srt
@@ -0,0 +1,2276 @@
+1
+00:00:00,880 --> 00:00:04,400
+السلام عليكم ورحمة الله وبركاته اليوم بإذن الله
+
+2
+00:00:04,400 --> 00:00:10,540
+تعالى راح نشرح الجزء التاني من مادة علاج قلب وصدر
+
+3
+00:00:10,540 --> 00:00:15,440
+وباطنه هدخل اليوم بقسم القلب physiotherapy for
+
+4
+00:00:15,440 --> 00:00:19,420
+cardiopulmonary disorders هاخد اليوم اللي هو بداية
+
+5
+00:00:19,420 --> 00:00:23,560
+ال assessment تبع حالات القلب زي ما كنا نشوف في
+
+6
+00:00:23,560 --> 00:00:27,440
+التدريب العملي في عندنا اللي هوحالات القلب سواء
+
+7
+00:00:27,440 --> 00:00:31,380
+كانت في الـICU أو في جراحة القلب، هندخل اليوم في
+
+8
+00:00:31,380 --> 00:00:35,840
+الـPhysotherapy Assessments لهذه الحالات، نبدأ على
+
+9
+00:00:35,840 --> 00:00:44,720
+بركة الله أولاً
+
+10
+00:00:44,720 --> 00:00:49,040
+الـAdult Cardiorespiratory Assessment، سيه أي
+
+11
+00:00:49,040 --> 00:00:52,530
+Assessment اللي ناخده سواء في العظام،في الأطفال،
+
+12
+00:00:52,530 --> 00:00:57,950
+في أي department موجود عندنا مش المستشفى هاخد أنا
+
+13
+00:00:57,950 --> 00:01:01,930
+الـhistory تبع المريض الموجود عنده سواء كان ال
+
+14
+00:01:01,930 --> 00:01:05,810
+present history أو ال past history الـhistory of
+
+15
+00:01:05,810 --> 00:01:09,510
+present illness and review system تمام؟ بدي أشوف
+
+16
+00:01:09,510 --> 00:01:14,070
+شو تاريخ المرضي تبع هذاالمرض generally the
+
+17
+00:01:14,070 --> 00:01:16,490
+following characteristic of each symptom should be
+
+18
+00:01:16,490 --> 00:01:20,490
+illustrated and explored لازم انا اكتشف كل الحاجات
+
+19
+00:01:20,490 --> 00:01:24,950
+اللي انا ضروري اعرفها في هاي الحالة honest هل
+
+20
+00:01:24,950 --> 00:01:30,720
+المرض بدأ بالتدريج معاهولا فجأة أغم عليه و صار في
+
+21
+00:01:30,720 --> 00:01:34,500
+عنده مشاكل وبعدين عرفنا إن هو والله عنده قصور
+
+22
+00:01:34,500 --> 00:01:38,380
+كشريان التاجي صار عنده ذبحة صدرية صار عنده كذا
+
+23
+00:01:38,380 --> 00:01:43,920
+لازم نعرف إن هي فترة المرض و كان ال locations أو
+
+24
+00:01:43,920 --> 00:01:47,700
+ال radiations تبع المرض بنعرف على سبيل المثالأنه
+
+25
+00:01:47,700 --> 00:01:51,120
+لو كان في مثلا في عنا ذبحة صدرية بدي يكون اللي هو
+
+26
+00:01:51,120 --> 00:01:55,100
+الكتف اليمين فيه مشكلة على سبيل المثال ال duration
+
+27
+00:01:55,100 --> 00:02:00,320
+كمان ال frequency جداش كم مرة لو كان مصحوب هذا
+
+28
+00:02:00,320 --> 00:02:04,480
+بيقحها كم مرة بيقحه أمتى بتشتد هل أنها بتبطأ في
+
+29
+00:02:04,480 --> 00:02:07,380
+الليل أو بتشتد عليه في الليل أو بتبطأ في أثناء
+
+30
+00:02:07,380 --> 00:02:10,360
+النهار أيضا ال characteristic اللي هي ال quality
+
+31
+00:02:10,360 --> 00:02:15,810
+and securityجدّش كميتها؟ جدّش حدّتها؟ هل هي مصحوبة
+
+32
+00:02:15,810 --> 00:02:19,190
+على سبيل المثال بـBlood ولا لا؟ الـ Aggravating
+
+33
+00:02:19,190 --> 00:02:23,570
+and Oxidating Factors شو العوانل اللي بتزيدلي من
+
+34
+00:02:23,570 --> 00:02:27,730
+فعالية أو من سوء هذا المرض على سبيل المثال إذا كان
+
+35
+00:02:27,730 --> 00:02:32,230
+بيعاني من أزمة مثلا إيش الحاجات اللي هي بتفاقم
+
+36
+00:02:32,230 --> 00:02:36,940
+الحالة أو بتزيدها سوء على سبيل المثال؟إذا كان فيه
+
+37
+00:02:36,940 --> 00:02:42,020
+على سبيل المثال معطيرات جوء، إذا كان فيه العطور
+
+38
+00:02:42,020 --> 00:02:45,300
+العادية، هذه الأمور كلها بتجيب الحالة سوءًا، إذا
+
+39
+00:02:45,300 --> 00:02:49,440
+كانت الحالة على سبيل المثال حالة رابو. كمان نفس
+
+40
+00:02:49,440 --> 00:02:52,620
+الاشي لو حكينا على حالة القلب، على سبيل المثال
+
+41
+00:02:52,620 --> 00:02:57,700
+ارتفاع الكوليسترول، ارتفاع مثلًا أكل أكل معين، إذا
+
+42
+00:02:57,700 --> 00:03:02,340
+كان على سبيل المثال فيهأدوية معينة بياخدها بإزديد
+
+43
+00:03:02,340 --> 00:03:07,000
+نسبة السكر في الدم ياخد باله من هذه الحاجات هذا
+
+44
+00:03:07,000 --> 00:03:11,280
+بالنسبة للـ Historyأيضًا مكملين relieving factors،
+
+45
+00:03:11,280 --> 00:03:13,920
+ما هي العوامل؟ لأنه لو أخر مثلًا الأدوية الفلانية
+
+46
+00:03:13,920 --> 00:03:19,060
+كذا، لو كان هو مريض سُكر، معاه الكرنيت تبعه، معاه
+
+47
+00:03:19,060 --> 00:03:22,200
+الروشيتا تبعته، أنه لازم ياخد كذا، الان ال current
+
+48
+00:03:22,200 --> 00:03:26,700
+situation، الحالة، هل هي في حالة improving وتحسن
+
+49
+00:03:26,700 --> 00:03:29,200
+ولا في حالة deterioration؟ إذا كان في حالة
+
+50
+00:03:29,200 --> 00:03:31,680
+deterioration، اللي هو تدهور للحالة، بدي أعرف إيش
+
+51
+00:03:31,680 --> 00:03:35,550
+الأسباب، ال effect on activity daily life،اللي هم
+
+52
+00:03:35,550 --> 00:03:40,230
+تأثيرات هذه الحالة على اللي هي جزء الحياة العامة
+
+53
+00:03:40,230 --> 00:03:44,890
+يعني هل على سبيل المثال إذا كان فيه عنده M.I.
+
+54
+00:03:45,010 --> 00:03:49,130
+Myocardial Infarction على سبيل المثال هل أثرت على
+
+55
+00:03:49,130 --> 00:03:52,570
+الحياة عنده هو أستاذ و بده يروح على المدرسة هل
+
+56
+00:03:52,570 --> 00:03:56,550
+أثرت على جزء الحياة عنده أو لأ previous diagnosis
+
+57
+00:03:56,550 --> 00:04:02,500
+أيضًا ofلازم كمان نعرف إذا كان في عنده أي تشخيصات
+
+58
+00:04:02,500 --> 00:04:06,920
+سابقة مشابهة لهذا الحدث previous treatment and
+
+59
+00:04:06,920 --> 00:04:10,980
+efficiency كمان نفس الكلام إذا أخد علاجات سابقة و
+
+60
+00:04:10,980 --> 00:04:16,260
+هل إلا تأثير أو لأ أيضا مكملين في الcardio and
+
+61
+00:04:16,650 --> 00:04:20,130
+signs and symptoms اللي هي العلامات الـ signs و
+
+62
+00:04:20,130 --> 00:04:24,010
+الـ symptoms in addition طبعا بالاضافة لل general
+
+63
+00:04:24,010 --> 00:04:25,890
+characteristic outlined above additional
+
+64
+00:04:25,890 --> 00:04:29,470
+characteristic لل symptoms نفسه زي ال cuff ال
+
+65
+00:04:29,470 --> 00:04:34,280
+quality ال severity ال timingكل كام فترة أو فترة
+
+66
+00:04:34,280 --> 00:04:38,040
+هو كان بيكوح ل duration greater than two weeks إذا
+
+67
+00:04:38,040 --> 00:04:39,860
+كانت greater than two weeks إذا كانت أكتر من
+
+68
+00:04:39,860 --> 00:04:44,320
+أسبوعين على سبيل المثال بدنا نشوف تشخيص ال TB اللي
+
+69
+00:04:44,320 --> 00:04:49,820
+هو السلر أوي على سبيل المثال إذا هاي كلها من اللي
+
+70
+00:04:49,820 --> 00:04:54,430
+هي ال assessment اللي أنا بدي أشتغل عليهالآن هذا
+
+71
+00:04:54,430 --> 00:04:59,170
+المخاطر بدي أشوف الـ Color تبعه الـ Amount الـ
+
+72
+00:04:59,170 --> 00:05:03,170
+Consistency كمال الـ Purity هل في بص ولا مش في بص؟
+
+73
+00:05:03,170 --> 00:05:06,450
+هل هو متعفن أو لأ تحت الميكروسكوب؟ الـ Time of
+
+74
+00:05:06,450 --> 00:05:10,290
+Days كل أكم مرة في اليوم ممكن أنه أنا أعمله على
+
+75
+00:05:10,290 --> 00:05:14,230
+سبيل المثال Physotherapy session ويقدر أنه يطلع
+
+76
+00:05:14,230 --> 00:05:19,220
+هذا اللي هو Secretionإذا لونه، كمية ونوعه، هل فيه
+
+77
+00:05:19,220 --> 00:05:23,640
+دم أو مش فيه دم، كمان هذا بيعطيني إشارة لإشي معين،
+
+78
+00:05:23,640 --> 00:05:27,460
+تمام؟ وخصوصا بما أنه إحنا الآن في اللي هي جائحة
+
+79
+00:05:27,460 --> 00:05:33,130
+COVID-19، هذا مهم بالنسبالنا، اللي هي metabasesالـ
+
+80
+00:05:33,130 --> 00:05:36,150
+Hemo من اسمها، Hemo لحالها تعني blood،
+
+81
+00:05:36,150 --> 00:05:39,730
+hematopoiesis اللي هي الدم وشوه المشاكل اللي تصدر
+
+82
+00:05:39,730 --> 00:05:43,590
+لي عنه كمية الدم اللي موجودة في هذا ال computer
+
+83
+00:05:43,590 --> 00:05:48,050
+جداش هل هي مجرد بس حاجات صغيرة أو انه في كمية
+
+84
+00:05:48,050 --> 00:05:50,470
+كبيرة من ال blood عشان انا اقدر افرج في ال
+
+85
+00:05:50,470 --> 00:05:54,150
+diagnoses ما بين ال TB وما بين اللي هي ال
+
+86
+00:05:54,150 --> 00:05:57,300
+preliminary disease الأخرىfrank blood or mixed
+
+87
+00:05:57,300 --> 00:06:02,000
+with sputum هل هو أن الدم هذا نتج عندي بشكل مباشر
+
+88
+00:06:02,000 --> 00:06:05,780
+ولا أنه كان مختلط مع ال sputum ال associations
+
+89
+00:06:05,780 --> 00:06:11,840
+with leg pain هل هو مصحوب هذا المشاكل هذه هل هي
+
+90
+00:06:11,840 --> 00:06:14,680
+كانت مصحوبة مع ألان في ال calf muscle على سبيل
+
+91
+00:06:14,680 --> 00:06:17,280
+المثال و chest pain و shortening في ال breathing
+
+92
+00:06:17,280 --> 00:06:21,060
+ولا لأ لأن هذا بياخدني في منحة او اتجاه اخر انا
+
+93
+00:06:21,060 --> 00:06:23,960
+لازم اخد بالي منه تمام؟
+
+94
+00:06:26,550 --> 00:06:30,670
+shortens of breathing قصر اللي هو التنفس قصر
+
+95
+00:06:30,670 --> 00:06:34,250
+التنفس هيكون ليش؟ ليش صار في عنا shortening في ال
+
+96
+00:06:34,250 --> 00:06:38,070
+breathing؟ هذا مبدل لي على أشياء أخرى في أثناء ال
+
+97
+00:06:38,070 --> 00:06:41,630
+exercise tolerance خلال اللي هو أداء ال exercise
+
+98
+00:06:41,630 --> 00:06:45,870
+عدد المرات اللي هو قادر الشخص على أداء التمرين
+
+99
+00:06:45,870 --> 00:06:49,230
+فيها ال number of stairs a client can be climb or
+
+100
+00:06:49,230 --> 00:06:53,810
+the same client can walk جداش كام مرة جادر هو يطلع
+
+101
+00:06:53,810 --> 00:06:57,300
+الدرج و كام مرة جادر ينزلهالـ Tolerance هذا أو مدى
+
+102
+00:06:57,300 --> 00:07:02,060
+التحمل أو قدرة المريض على التحمل مهم جدا الـ
+
+103
+00:07:02,060 --> 00:07:07,340
+Postural Orthopenia Shortens بيكون في عندنا
+
+104
+00:07:07,340 --> 00:07:12,200
+Shortens اللي هي .. شو تعريف ال Orthopenia؟ ال
+
+105
+00:07:12,200 --> 00:07:14,800
+Orthopenia اللي حكينا عليها عبارة عن Shortening ل
+
+106
+00:07:14,800 --> 00:07:17,580
+Breathing بيصير في عندنا قصر في التلفزور
+
+107
+00:07:17,580 --> 00:07:21,280
+Tripending اللي هي use three points of support
+
+108
+00:07:22,170 --> 00:07:24,290
+طبعاً اللي هي Tripoding support اللي هو إنه
+
+109
+00:07:24,290 --> 00:07:28,210
+بيستخدم ثلاث نقاط لزقلها اللي هو تعطي دعم خلال
+
+110
+00:07:28,210 --> 00:07:31,370
+اللي هو ال cuffing أو القحة اللي إجته فيه اللي هو
+
+111
+00:07:31,370 --> 00:07:35,010
+النفس القصنة Shortening of breathing at rest طبعا
+
+112
+00:07:35,010 --> 00:07:39,750
+إذا هو كان في عنده shortening أو هذا shortening
+
+113
+00:07:39,750 --> 00:07:43,210
+اللي صار عنده إذا كان هو بقد مجهود معين في أحيان
+
+114
+00:07:43,210 --> 00:07:45,390
+shortening بيصير أثناء ال patient في وضع ال rest
+
+115
+00:07:45,390 --> 00:07:48,730
+اللي هو في وضع الراحةهذا كمان لازم أعرف حاجة لازم
+
+116
+00:07:48,730 --> 00:07:53,190
+أعرف سببه ال association with proximal necrosis
+
+117
+00:07:53,190 --> 00:07:58,350
+which هو عبارة هل أنه مصحوب على سبيل المثال بصعوبة
+
+118
+00:07:58,350 --> 00:08:02,200
+في التنفسفي أثناء فترة اللي هو الإسرقاء على الظهر
+
+119
+00:08:02,200 --> 00:08:05,440
+أو لأ الـ Associated with swelling with ankle or
+
+120
+00:08:05,440 --> 00:08:10,020
+recent weight gain طبعا هل هذا الاشي مصحوب معانا
+
+121
+00:08:10,020 --> 00:08:16,320
+بتورم في الankle أو لأ أو إنه هل في فقدان للوزن زي
+
+122
+00:08:16,320 --> 00:08:19,600
+ما كنا نحكي مثلا في الدياديتسإنه فيه فقدان للوزن
+
+123
+00:08:19,600 --> 00:08:23,560
+أو فيه اكسب آخر للوزن، معناته بإيش غير معقول طبعا،
+
+124
+00:08:23,560 --> 00:08:26,420
+بيكون هذا الكلام، مش أنه أي وزن يعني، لو أضادي
+
+125
+00:08:26,420 --> 00:08:30,140
+Grammar نجوح مثلا ونعمل مشكلة، لأ اللي بيكون إيش
+
+126
+00:08:30,140 --> 00:08:36,270
+واضح تمام، هذا بالنسبة ل Shortening of Briefingالـ
+
+127
+00:08:36,270 --> 00:08:39,730
+cyanosis الإذرقاق اللي كان أو الاشي اللي هيصير
+
+128
+00:08:39,730 --> 00:08:44,490
+نتيجة لإيش لإنه فيه cyanosis نوعين فيه central و
+
+129
+00:08:44,490 --> 00:08:47,610
+فيه peripheral الـ cyanosis ناتج عن ال central و
+
+130
+00:08:47,610 --> 00:08:51,130
+هناخد فرق ما بينهم و ال peripheral ناتج عن سبب
+
+131
+00:08:51,130 --> 00:08:54,460
+معينWhen does it okay؟ ومافيش هدف يصير على نفسه
+
+132
+00:08:54,460 --> 00:08:57,940
+يعني واسس هل أنه لما يتعرض لمجهود معين أو لما أنه
+
+133
+00:08:57,940 --> 00:09:03,100
+هذا الشخص على سبيل المثال بيفقد وعيه أو أنه أنت
+
+134
+00:09:03,100 --> 00:09:06,820
+بالظبط بدي يصير الحدث هدا معاه إيه مثلا ال change
+
+135
+00:09:06,820 --> 00:09:10,670
+in background؟ أي تغيرات جديدة صارت علىالشكل العام
+
+136
+00:09:10,670 --> 00:09:13,550
+أو البطل الكله ال associated هل ال cuffing هذه
+
+137
+00:09:13,550 --> 00:09:18,890
+كانت مصوبة ب weaving أو اللي هو صفار بنسميه أو
+
+138
+00:09:18,890 --> 00:09:24,730
+الصفير أو اللي هو الكحة اللي بتكون مع الصفير
+
+139
+00:09:24,730 --> 00:09:27,790
+بالأغلب بتكون مع الأطفال طبعا وفيه موجود فيها مع
+
+140
+00:09:27,790 --> 00:09:31,950
+الأكبار فهذه الأشياء أحنا بنخاف منها chest pain
+
+141
+00:09:31,950 --> 00:09:36,170
+associated symptoms طبعا أكيد في على سبيل المثال
+
+142
+00:09:36,170 --> 00:09:38,230
+في الزبحة الفضرية بيكون في عندهم associated
+
+143
+00:09:38,230 --> 00:09:42,240
+symptomsRelation to effort طبعاً إلها علاقة بالجهد
+
+144
+00:09:42,240 --> 00:09:46,160
+بال exercise بال nails بنوع الوشبة اللي أكلها إذا
+
+145
+00:09:46,160 --> 00:09:49,460
+كانت عالية أو high fat أو high cholesterol هذا مهم
+
+146
+00:09:49,460 --> 00:09:53,360
+جدا، Bending over كمان إذا هو كان على سبيل المثال
+
+147
+00:09:53,360 --> 00:09:56,320
+عمل bending يداحد except ال word that's beyond
+
+148
+00:09:56,580 --> 00:10:00,200
+Carefully. Include quality, radiation, severity,
+
+149
+00:10:00,320 --> 00:10:04,640
+timing تمام؟ لازم نعرف .. نشوف الألم هذا هو وين
+
+150
+00:10:04,640 --> 00:10:08,500
+أساسه أو وين بالظبط هو ناتج من وين وين ممكن يتفرق
+
+151
+00:10:08,500 --> 00:10:10,580
+عليه هل ال radiation كان على ال right shoulder أو
+
+152
+00:10:10,580 --> 00:10:14,360
+ال left shoulder على سبيل المثال في ال back؟ ال
+
+153
+00:10:14,360 --> 00:10:17,600
+leg فيها مشاكل ولا مشاكل؟ ال severity الحدة تبعته
+
+154
+00:10:17,600 --> 00:10:21,860
+كان مؤلم؟ هل هو بسيط؟ بزيد مثلا على سبيل المثال في
+
+155
+00:10:21,860 --> 00:10:26,240
+أداء نشاط معين؟ في أداء exercise معين؟و الوقت تبعه
+
+156
+00:10:26,240 --> 00:10:31,420
+و ال timing تمام ال fitting or thumbs اللي هو
+
+157
+00:10:31,420 --> 00:10:35,460
+فقدان الوعي الآن احنا بنحكي على cardio pulmonary
+
+158
+00:10:35,460 --> 00:10:39,560
+disease اليوم ال cardiac نفسها هي ال machine تبعت
+
+159
+00:10:39,560 --> 00:10:43,050
+ال blood pumpingإذا أنه على سبيل المثال ما كان في
+
+160
+00:10:43,050 --> 00:10:47,350
+عند الدم الكافي لإن يوصل أعضاء الجسم ممكن يتعرض
+
+161
+00:10:47,350 --> 00:10:52,870
+لهذا الشخص اللي هو coma أو يتعرض لغيبوبة طبعا
+
+162
+00:10:52,870 --> 00:10:57,230
+نتيجة لفقدان الوعي اللي صار، نتيجة لتغيرات اللي
+
+163
+00:10:57,230 --> 00:11:00,510
+صارت في الجسمWeakness ممكن أبدايتها تكون weakness
+
+164
+00:11:00,510 --> 00:11:04,610
+ضعف عام Light hitting Loss of consciousness فقدان
+
+165
+00:11:04,610 --> 00:11:07,390
+للوعي relation to the boss or the change ممكن
+
+166
+00:11:07,390 --> 00:11:11,770
+أحيانا في أنا بيكون لسه تنايم على ال bed و بمجرد
+
+167
+00:11:11,770 --> 00:11:15,850
+ما أنا أحاوله على أو أنجله على وضعية اللي هي long
+
+168
+00:11:15,850 --> 00:11:19,800
+sitting position يحس لي بيأدوهاهنا طبعا لازم انا
+
+169
+00:11:19,800 --> 00:11:23,380
+اخد بالي و اكون عملاله support من كل الاتجاهات
+
+170
+00:11:23,380 --> 00:11:28,100
+طبعا لإنه عشان انا اتأكد ان المريض عندى في وضع آمن
+
+171
+00:11:28,100 --> 00:11:31,560
+طبعا نتيجة ال neurological symptoms او نتيجة ممكن
+
+172
+00:11:31,560 --> 00:11:35,300
+تكون الأشياء مش علاقة بال circulation ممكن تكون
+
+173
+00:11:35,300 --> 00:11:39,740
+علاقة بال neuro سواء في ال brain او في ال spinal
+
+174
+00:11:39,740 --> 00:11:43,140
+cord هذا لازم اخد بالي منه كمان في ال assessment
+
+175
+00:11:43,140 --> 00:11:49,340
+تبع المريض تبعى ال extremities او الأطرافبدي ألاحظ
+
+176
+00:11:49,340 --> 00:11:54,190
+عليها إشي القديمةهل في عندى قديمة فى الأطراف مثلا
+
+177
+00:11:54,190 --> 00:11:57,850
+فى ال hand، فى ال foot؟ وين ما كانها بالظبط؟ هل
+
+178
+00:11:57,850 --> 00:12:02,590
+إلها على سبيل المثال يوم، يومين؟ أمتى ظهرت؟ هل
+
+179
+00:12:02,590 --> 00:12:06,770
+كانت فى وضع معين أنه مثلا على سبيل المثال إذا بمشي
+
+180
+00:12:06,770 --> 00:12:10,070
+هذا المريض تبعى، بيصير فى عنده قديمة؟ ولا هى دايما
+
+181
+00:12:10,070 --> 00:12:13,430
+مستمرة معاه بشكل دائم على طول اليوم؟ ال
+
+182
+00:12:13,430 --> 00:12:16,310
+intermittent graduations اللى هى جداش ال exercise
+
+183
+00:12:16,310 --> 00:12:20,910
+including لجل البنت جداش التمرين بتعطينى مشاكلفي
+
+184
+00:12:20,910 --> 00:12:24,830
+cuff muscles distance clients can walking before
+
+185
+00:12:24,830 --> 00:12:28,410
+on a spin related periodations كمان جداش المسافة
+
+186
+00:12:28,410 --> 00:12:32,970
+المسموح إلي أنا أخلي المريض تبعي يمشي فيها تمام
+
+187
+00:12:32,970 --> 00:12:39,850
+جداش جداش اللي هو جداش اللي هو المسافة اللي أنا
+
+188
+00:12:39,850 --> 00:12:44,970
+بدي أخلي المريض تبعي يمشي فيها تمامTime needed to
+
+189
+00:12:44,970 --> 00:12:48,990
+rest and to relieve graduations كدهش انه انا بدي
+
+190
+00:12:48,990 --> 00:12:54,290
+وقت لحتى هذا المريض يخف عنه اللي هو التقلصات اللي
+
+191
+00:12:54,290 --> 00:12:57,870
+صارت في الكف مصر على سبيل المثال هل انا بحاجة
+
+192
+00:12:57,870 --> 00:13:01,310
+لساعة لتنتين او اكتر من الوقت ال temperatures of
+
+193
+00:13:01,310 --> 00:13:06,710
+affected patientsالدرجة الحرارة، هل هو مثلا بيكون
+
+194
+00:13:06,710 --> 00:13:11,850
+مساعده الوضع الدافع أو أنه مثلا دائما بيكون فيه
+
+195
+00:13:11,850 --> 00:13:16,490
+sweating ومتعرخ، بدي أحاول أعمله calling للمكان، و
+
+196
+00:13:16,490 --> 00:13:19,330
+ال tingling اللي هو الخدلان و ال leg cramps and
+
+197
+00:13:19,330 --> 00:13:24,850
+pain rest طبعا اللي هوإذا كانت فيه stiffness في
+
+198
+00:13:24,850 --> 00:13:29,570
+عنده «cramps» اللي هو تقلصات في الـ calf muscle
+
+199
+00:13:29,570 --> 00:13:34,070
+على سبيل المثال أو أي muscle هذا كمان لازم أخد
+
+200
+00:13:34,070 --> 00:13:38,070
+بالي منه وجود varicose veins أولاء طبعا مهم جدا في
+
+201
+00:13:38,070 --> 00:13:41,130
+حالات اللي هي ال female على سبيل المثال في حالة ال
+
+202
+00:13:41,130 --> 00:13:43,250
+cardio وكمان ال male ممكن يصير عندهم varicose
+
+203
+00:13:43,250 --> 00:13:48,970
+veins ولكن بنسب أقل من الستات أخد بالي من اللي هو
+
+204
+00:13:48,970 --> 00:13:52,040
+الvaricose veinsفيها الـ Other Associated Symptoms
+
+205
+00:13:52,040 --> 00:13:57,040
+زي الـ Fever، الـ Amnesia، الحُمّة طبعًا، الـ
+
+206
+00:13:57,040 --> 00:14:01,520
+Fatigue، الـضعف، الـ Night Sweating، الـ التعرُق
+
+207
+00:14:01,520 --> 00:14:03,620
+الليلي، الـ Weight Loss، الـ Weight Losses، اللي
+
+208
+00:14:03,620 --> 00:14:09,860
+هو فقدان، الوزن، الـ Pulpation طبعًا، الـ أنا أحس
+
+209
+00:14:09,860 --> 00:14:14,220
+بإيدي، الـ Nausea and vomiting، Gastric Intestinal
+
+210
+00:14:14,220 --> 00:14:17,880
+Reflexes، إنه أنا أشوف اللي هو رد الفعل العكسي تبع
+
+211
+00:14:17,880 --> 00:14:23,860
+المعيدي المعوي، كمان مهمجدا أيضا من الحاجات اللي
+
+212
+00:14:23,860 --> 00:14:27,560
+أنا لازم أشوفها في ال assessment تبع ال medical
+
+213
+00:14:27,560 --> 00:14:30,800
+history ال specific cardiorespiratory system ال
+
+214
+00:14:30,800 --> 00:14:34,680
+allergic including seasonal and environmentalطبعا
+
+215
+00:14:34,680 --> 00:14:37,800
+الحساسية لأن اللي هم مرضى الربيع على سبيل المثال
+
+216
+00:14:37,800 --> 00:14:41,660
+اللي هو فصل الخريفة أو فصل الربيع مؤذى جدا لهم
+
+217
+00:14:41,660 --> 00:14:46,220
+ليه؟ لأنه طبعا مع الهواء بيكون في عندنا اللي هي
+
+218
+00:14:46,220 --> 00:14:49,820
+البذور أو بيكون في عندنا الأشياء اللي بتعمل حساسية
+
+219
+00:14:49,820 --> 00:14:54,780
+فبالتالي هي بتعملي مشكلة كبيرة في التنفس ممكن تؤدي
+
+220
+00:14:54,780 --> 00:14:58,980
+لحساسية ويتضايق المريض وممكن أناأخلّيه موجود على
+
+221
+00:14:58,980 --> 00:15:03,700
+تبخيرة أو أخلّيه يأخذ اللي هو Bronchodilators
+
+222
+00:15:03,700 --> 00:15:08,400
+موسّع للشعب الهوائي بعض الأدوية تمام أنه أنا ممكن
+
+223
+00:15:08,400 --> 00:15:11,160
+أشوف إذا فياخدها المريض عندي أو الانهيبتور زي
+
+224
+00:15:11,160 --> 00:15:15,240
+الـBT Blockers وبعض الأدوية اللي هنا ذاكرليها هي
+
+225
+00:15:15,240 --> 00:15:18,340
+مش مطلوبة منها في كمان أدوية خاصة بالـ Immunity
+
+226
+00:15:18,340 --> 00:15:23,840
+System أو ما يسمى بجهاز المناعة كمان كويس أنه أنا
+
+227
+00:15:24,160 --> 00:15:27,740
+أعطيها أو أكون عارفة المريض تبعي إيش بياخدها
+
+228
+00:15:27,740 --> 00:15:33,380
+الأدوية هنا مش مطلوبة معانا في ال assessment ال
+
+229
+00:15:33,380 --> 00:15:36,360
+medical condition frequency of colds and
+
+230
+00:15:36,360 --> 00:15:40,360
+respiratory infections كام مرة بتجي في اليوم اللي
+
+231
+00:15:40,360 --> 00:15:43,390
+هي ال influence العاديةخصوصا هذا الاشي مهم جدا
+
+232
+00:15:43,390 --> 00:15:46,070
+حاليا زي ما حكينا ان احنا في إجائحة كورونا
+
+233
+00:15:46,070 --> 00:15:49,490
+فبالتالي لإن لازم أعرف هل هو في عنده recent viral
+
+234
+00:15:49,490 --> 00:15:52,730
+infection او لا لأ ال joint pain and swelling ال
+
+235
+00:15:52,730 --> 00:15:55,690
+history of rheumatic fever هل عنده حمروماتيزم او
+
+236
+00:15:55,690 --> 00:16:02,140
+لأ؟ في عنده ورم في ال nasal او لأ؟في الجهة في
+
+237
+00:16:02,140 --> 00:16:06,000
+الجيوب الأمسية أو لأ أزمة، bronchitis، pneumonia،
+
+238
+00:16:06,000 --> 00:16:10,660
+chronic obstructive COPD كمان هذا حلو يأخذ عنه شرح
+
+239
+00:16:10,660 --> 00:16:14,340
+كبير طويل و عريض كمان نفس الشيء في الـ TB ومعظم
+
+240
+00:16:14,340 --> 00:16:19,080
+حالات اللي هي respiratory
+
+241
+00:16:19,080 --> 00:16:23,540
+disease الـ disability media اللي هي هل في عندهم
+
+242
+00:16:23,540 --> 00:16:28,300
+مشاكل طبعا نفس الكلام نكملها لزي sick fibrosisكلها
+
+243
+00:16:28,300 --> 00:16:31,560
+أمراض Respiratory هل هو في عنده بالأصل
+
+244
+00:16:31,560 --> 00:16:35,060
+Hypertension وضيابيته زي ما حكينا ناخد اللي هو ال
+
+245
+00:16:35,060 --> 00:16:37,780
+present و ال past history Thyroid disorders في
+
+246
+00:16:37,780 --> 00:16:41,920
+عنده مشاكل في الغد الدراقية أو لأ أيضا مشاكل القلب
+
+247
+00:16:41,920 --> 00:16:45,300
+اللي هو ال coronary heart disease اللي هي artery
+
+248
+00:16:45,300 --> 00:16:49,300
+disease أمراض القلب و ال angina و ال MI و ال
+
+249
+00:16:49,300 --> 00:16:52,920
+valval heart disease و down syndrome كل الأمور هذه
+
+250
+00:16:52,920 --> 00:16:56,260
+لازم انا اكون حاطهة عندي في عين الاعتبار بال
+
+251
+00:16:56,260 --> 00:16:59,700
+assessment اللي انابعمله لهذا المريض التبعي
+
+252
+00:17:01,380 --> 00:17:04,740
+بالمناصل أيضًا اللي هو في حالة ال admission ل ال
+
+253
+00:17:04,740 --> 00:17:08,680
+hospitals هل هو كان جايني بوضع طبيعي ولا جايني فيه
+
+254
+00:17:08,680 --> 00:17:12,640
+مثلًا كان unconscious ونقلوا الأهل لازم أنا أخد
+
+255
+00:17:12,640 --> 00:17:15,520
+بعين الاعتبار هذه الحاجات كلها ال date and result
+
+256
+00:17:15,520 --> 00:17:19,480
+of last context test and tuberculosis and chest x
+
+257
+00:17:19,480 --> 00:17:24,180
+-ray بشوف التاريخ ونتائج الحوصات اللي هو ال TB
+
+258
+00:17:24,180 --> 00:17:28,820
+اللي هو السلري أوي وكذلك الحوصات الإشاعية أو
+
+259
+00:17:28,820 --> 00:17:32,920
+الأشعة التشخيصية تبعت المريضاللي هو في نفس اليوم
+
+260
+00:17:32,920 --> 00:17:36,940
+اللي وصل فيهم هل أخد اللي هو blood transfusion تم
+
+261
+00:17:36,940 --> 00:17:39,820
+نقله حد دمله أو لا خصوصا في حالات ال cardio
+
+262
+00:17:39,820 --> 00:17:44,340
+respiratory system ال disease طبعا هدول الناس لازم
+
+263
+00:17:44,340 --> 00:17:47,900
+اعرف اذا كان كمان في عندهم family history لبعض
+
+264
+00:17:47,900 --> 00:17:51,240
+أمراض معينة خصوصا في حالات اللي هو ال cardio
+
+265
+00:17:51,240 --> 00:17:56,190
+disease other at homewith similar symptoms طبعاً
+
+266
+00:17:56,190 --> 00:17:59,550
+ممكن في أشخاص موجودين في البيت عندهم نفس الأعراض
+
+267
+00:17:59,550 --> 00:18:02,570
+أو لأ ال allergies أو ال topic اللي هي certain
+
+268
+00:18:02,570 --> 00:18:05,570
+allergics الhypersensitivity reaction هل عنده
+
+269
+00:18:05,570 --> 00:18:08,670
+حساسية من أي أدوية معينة طبعا هذه بنسأل عنها في ال
+
+270
+00:18:08,670 --> 00:18:13,090
+assessment هل هو بيعاني مثلا من حساسية لدواء معين
+
+271
+00:18:13,090 --> 00:18:16,110
+مثلا زي ما بتعرفوا في اللي هو test تبع الانسولين
+
+272
+00:18:16,110 --> 00:18:19,850
+ال penicillin alpha هذا ال test طبعا بنعمله لحالات
+
+273
+00:18:19,850 --> 00:18:25,830
+معينة انه هل في عندهم حساسية penicillin او لأأيضا
+
+274
+00:18:25,830 --> 00:18:28,970
+مكملين لباقى ال assessment في حالة ال cardio
+
+275
+00:18:28,970 --> 00:18:32,250
+pulmonary disease اللى هى الأزمة هل فى lung
+
+276
+00:18:32,250 --> 00:18:36,550
+cancers فى cystic fibrosis تلايه فرق اوى
+
+277
+00:18:36,550 --> 00:18:40,090
+bronchitis اللى هو التهاب الشعب الهوائى منه نوعين
+
+278
+00:18:40,090 --> 00:18:43,810
+ممكن أحيانا يكون chronic يعنى القديم و طبعا هنا
+
+279
+00:18:43,810 --> 00:18:47,570
+الوضع بيكونبحاجة إلى physiotherapy program لإنه
+
+280
+00:18:47,570 --> 00:18:51,430
+بيكون في عندنا secretion كتيرة وهو بحاجة إلى
+
+281
+00:18:51,430 --> 00:18:55,150
+physiotherapy session ده بيتسهل هو مليد سكري أو لا
+
+282
+00:18:55,150 --> 00:18:58,370
+أو شو نوع اللي هو السكري اللي عنده heart disease
+
+283
+00:18:58,370 --> 00:19:03,890
+طبعا الأمراض القلب زي ال hypertension ال ischemic
+
+284
+00:19:03,890 --> 00:19:07,990
+ال chronic rear disease و ال myocardial infarction
+
+285
+00:19:07,990 --> 00:19:13,130
+خصوصا في الفيميل لإن أعضاء الفيميل اللي هم طبعا
+
+286
+00:19:13,460 --> 00:19:18,500
+أكتر بيرضة من المال sudden death طبعا بدي أشوف هل
+
+287
+00:19:18,500 --> 00:19:24,060
+في العيلة في تاريخ مرضي لها اللي هو الحالات
+
+288
+00:19:24,060 --> 00:19:28,040
+اللي عندها أمرض قلب طبعا اللي هي dyslipidemia
+
+289
+00:19:28,040 --> 00:19:33,960
+صعوبة اللي هو ال .. صعوبة اللي هو ذوبان ال lipids
+
+290
+00:19:33,960 --> 00:19:36,560
+في الدم ها طبعا أو تراكم الدهون في الدم
+
+291
+00:19:36,560 --> 00:19:41,940
+hypertrophic cardiomyopathyطبعا هنا اتخم عضلة
+
+292
+00:19:41,940 --> 00:19:45,880
+القلب الكاذب هذا اللي هو من ال cardiac disease
+
+293
+00:19:45,880 --> 00:19:49,400
+اللي موجودة ان انا اخد بالي من اللي هو diagnosis
+
+294
+00:19:49,400 --> 00:19:53,320
+personal and social history في هنا اللي هو ال
+
+295
+00:19:53,320 --> 00:19:57,280
+personal and social history اللي هو التاريخ
+
+296
+00:19:57,280 --> 00:20:02,940
+العائلي والشخصي الاجتماعي هل هو smoking كام مرة و
+
+297
+00:20:02,940 --> 00:20:06,620
+كام package في اليوم هذا كمان بيأثر علي خصوصا في
+
+298
+00:20:06,620 --> 00:20:09,840
+ال cardiac diseaseExposure to second-hand smoking
+
+299
+00:20:09,840 --> 00:20:13,420
+أو إنه بتعرض لحد عنده تاني في البيت عندكم حد أي
+
+300
+00:20:13,420 --> 00:20:17,460
+حاجة بيدخن في البيت غيرك إذا كان فيه أو لأ Crowded
+
+301
+00:20:17,460 --> 00:20:21,080
+living conditions هل هو ساكن في أحياء على سبيل
+
+302
+00:20:21,080 --> 00:20:24,140
+الميزة المزحمة Poor personal and environmental
+
+303
+00:20:24,140 --> 00:20:26,620
+life اللي هو طبعا environmental cleanliness
+
+304
+00:20:26,620 --> 00:20:30,080
+الأحياء العشوائية تقريبا أو الناس اللي ما بيكون في
+
+305
+00:20:30,080 --> 00:20:34,360
+عندها تهوية جيدة Fight ناس بتتعرض لمشاكل كتيرة
+
+306
+00:20:34,360 --> 00:20:39,880
+High risk levelطبعا high stress level اللي هو وضع
+
+307
+00:20:39,880 --> 00:20:44,000
+أن نكون عايشين تحت ضغط طبعا سواء كان personal أو
+
+308
+00:20:44,000 --> 00:20:48,320
+occupational ال institutional living الوضع العام
+
+309
+00:20:48,320 --> 00:20:51,440
+للحالة تبعتنا ال occupational and environmental
+
+310
+00:20:51,440 --> 00:20:54,780
+conditions and exposure respiratory irritations
+
+311
+00:20:54,780 --> 00:20:59,600
+substance use وطبعا اللي هي هل انه على سبيل المثال
+
+312
+00:20:59,600 --> 00:21:04,280
+مضمن على الكحول او لا و الكافين و بعض الأدوية هل
+
+313
+00:21:04,280 --> 00:21:07,020
+بياخدها injections و لا inhalations على سبيل
+
+314
+00:21:07,020 --> 00:21:12,480
+المثال زي البخاخة تبع مرضى الرضو الأمراض المناع
+
+315
+00:21:12,480 --> 00:21:16,940
+الذاتية زي ال HIV هاي كمان مهم ان انا عارفها هل
+
+316
+00:21:16,940 --> 00:21:21,560
+الحالة اللي معايا obese ولا لأالـ .. طبعا ال
+
+317
+00:21:21,560 --> 00:21:24,480
+emigrations أو travel bored بتعرفوا الناس اللي
+
+318
+00:21:24,480 --> 00:21:27,460
+بتسافر كتير أو إيش زي هيك بدي أعرف هل هي مثلا
+
+319
+00:21:27,460 --> 00:21:32,620
+حاملة لمرض معين أو أنه مثلا اكتسبته من اللي هو ال
+
+320
+00:21:32,620 --> 00:21:36,520
+.. طبعا الإختلاط و الأماكن اللي crowded اللي هي
+
+321
+00:21:36,520 --> 00:21:41,490
+الأماكن المزحمةكمان مكملين بالـ Physical
+
+322
+00:21:41,490 --> 00:21:45,710
+Assessment اللي هو الـ Examination تبعنا للـ Air و
+
+323
+00:21:45,710 --> 00:21:48,670
+الـ Nose و الـ Throat اللي هو الأنف والأذن و
+
+324
+00:21:48,670 --> 00:21:53,650
+الحنجرة should be carried out because interlinked
+
+325
+00:21:53,650 --> 00:21:56,370
+اللي هو between the symptoms and sexual and
+
+326
+00:21:56,370 --> 00:21:58,910
+function to the lower respiratory tract طبعا لإن
+
+327
+00:21:58,910 --> 00:22:02,570
+كلها متصلة مع بعضها البعض فوان كان الأعلى ال
+
+328
+00:22:02,570 --> 00:22:05,070
+respiratory tract أو الlower respiratory tract
+
+329
+00:22:05,500 --> 00:22:11,580
+القبر اللى هو بيشمل الانف و الاصفجاس
+
+330
+00:22:11,580 --> 00:22:15,720
+و اللى هو ال pharynx و بينزل تحت على ال lower
+
+331
+00:22:15,720 --> 00:22:20,240
+بيشمل ال lungs و ال bronchi و ال bronchi و كل هذه
+
+332
+00:22:20,240 --> 00:22:23,060
+الحاجات اللى نسميها ال lower tract respiratory
+
+333
+00:22:23,060 --> 00:22:29,160
+tract تمام اللى هى أجزاء تنفسية سفنية مهم جدا اللى
+
+334
+00:22:29,160 --> 00:22:33,010
+أنا عارفهاشو ال vital signs تبعتي؟ لازم أجيس ترجد
+
+335
+00:22:33,010 --> 00:22:38,330
+الحرارة، ال pulse، النبض، ال respiratory rate، مدى
+
+336
+00:22:38,330 --> 00:22:42,450
+تشبع الأكسجين، ال blood pressure، ال peaky flow،
+
+337
+00:22:42,450 --> 00:22:47,030
+التنفس، كام صار عندنا، اللي هو من هاي كلها ال
+
+338
+00:22:47,030 --> 00:22:50,270
+vital signs اللي أنا لازم أاخدها بعين الاعتبار
+
+339
+00:22:51,890 --> 00:22:56,590
+المظهر العام هل هو جاين على المستشفى acutely أو
+
+340
+00:22:56,590 --> 00:22:59,710
+chronically طبعا يا إما بتكون لسه جديد على الوضع
+
+341
+00:22:59,710 --> 00:23:03,770
+أو ممكن تكون أجته اللي هي الذبحة مرة وتنتين ال
+
+342
+00:23:03,770 --> 00:23:06,910
+degree of discomfort أو comfort of distress طبعا
+
+343
+00:23:06,910 --> 00:23:11,070
+هي جداش هو جداش درجة الأرياحية أو جداش درجة شدة
+
+344
+00:23:11,070 --> 00:23:15,110
+القلم تبقى واضحة على الوجه تبع المريض ال position
+
+345
+00:23:16,280 --> 00:23:21,700
+to aid respiration اللي هو وضعية التنفس كيف من
+
+346
+00:23:21,700 --> 00:23:24,280
+أريحله الـ three part مثلا اللي حكينا عليها الـ
+
+347
+00:23:24,280 --> 00:23:27,700
+three point support هل هو على سبيل المثال بيرتاح
+
+348
+00:23:27,700 --> 00:23:33,740
+عليها أو بيرتاح و هو في وضعيته ال sitting position
+
+349
+00:23:33,740 --> 00:23:37,440
+إيش الوضعية اللي بيرتاح عليها في ال respiration ال
+
+350
+00:23:37,440 --> 00:23:40,600
+ability to speak normal and tense without stopping
+
+351
+00:23:40,600 --> 00:23:44,070
+and to take a breathقدرته على او ماقدرته على
+
+352
+00:23:44,070 --> 00:23:48,150
+الكلام لجمال طويلة او انه مثلا بيجي يحكي كلمة و
+
+353
+00:23:48,150 --> 00:23:52,150
+بيستنى ياخد نفس و بعدين بيكمل باقي الجملة و باخد
+
+354
+00:23:52,150 --> 00:23:55,350
+نفس و هكذا هذا بدل على ايش؟ انه انا في عندى مشكلة
+
+355
+00:23:55,350 --> 00:24:01,810
+في ال systemالـ color الوجهة بشكل عام، هل هو
+
+356
+00:24:01,810 --> 00:24:07,090
+cyanosis، redness، pink، عادي، مش فيه أي مشاكل، ال
+
+357
+00:24:07,090 --> 00:24:10,950
+nutritional status، وضعه بالنسبة لإيه هو التخزين
+
+358
+00:24:10,950 --> 00:24:15,770
+أو الغذاء، أكلت كويسة أو ما أكلش، مش فيه عنده مثلا
+
+359
+00:24:15,770 --> 00:24:18,570
+على سبيل المثال، هذا بدل على إن ال general
+
+360
+00:24:18,570 --> 00:24:23,720
+appearance إن هو مثلا مريض أو وضعهفي اللي هو تدهور
+
+361
+00:24:23,720 --> 00:24:27,060
+إذا عنده الـhydration status هل في عنده جثث
+
+362
+00:24:27,060 --> 00:24:31,140
+dehydration أو وضع اللي هو ترطيب الجلد مثلا أو
+
+363
+00:24:31,140 --> 00:24:35,160
+رطوبة الجلد أشوفها و أعرفها الـmental status هل هو
+
+364
+00:24:35,160 --> 00:24:39,880
+conscious، unconscious، blurim، هذيان أو إن هو
+
+365
+00:24:39,880 --> 00:24:44,940
+تقريبا فقد للوعي تماما كل هذه الأمور مهم جدا أنا
+
+366
+00:24:44,940 --> 00:24:51,110
+أعرفها بال inspection طبعا بالمعينة هيكونللـ
+
+367
+00:24:51,110 --> 00:24:54,890
+Colors، Cyanosis، هل في أنا عندي ذرفاق ولا لأ؟
+
+368
+00:24:54,890 --> 00:24:58,510
+Shape of Chest، طبعا شكل الصدر، هل هو صدر طبيعي
+
+369
+00:24:58,510 --> 00:25:03,210
+ولا فيه على سبيل المثال مشاكل وانخفاض في اللي هو
+
+370
+00:25:03,210 --> 00:25:07,810
+الـ sternum أو في ال ribs نفسهم، في عندنا الـ
+
+371
+00:25:07,810 --> 00:25:10,490
+bygone chest مثلا لتجري المثال في عندنا ال barrel
+
+372
+00:25:10,490 --> 00:25:14,490
+chest اللي هو الصدر البرميني، هذه الأمور مهم جدا
+
+373
+00:25:14,490 --> 00:25:18,930
+أنا عارفها. Symmetry of Chest Movementهل في تماثل
+
+374
+00:25:18,930 --> 00:25:23,570
+لـ right and left ولا اللي هو بيكون في مشكلة معينة
+
+375
+00:25:23,570 --> 00:25:26,530
+في lung واحدة ماقدرت تعمل full inspiration
+
+376
+00:25:26,530 --> 00:25:31,270
+فبالتالي هيعملي اللي هو علو في منطقة وانخفاض في
+
+377
+00:25:31,270 --> 00:25:38,890
+منطقة أخرى rate and rhythm طبعا معدل وانتظام
+
+378
+00:25:38,890 --> 00:25:42,690
+التنفس وعمق مهم جدا في حالة respiratory distress
+
+379
+00:25:42,690 --> 00:25:46,360
+syndromeأو حالات اللي هي صعوبات التنفس الـ
+
+380
+00:25:46,360 --> 00:25:50,080
+intercostal end drawing طبعاً بحكينا عليها أنه
+
+381
+00:25:50,080 --> 00:25:52,460
+ممكن يكون فيها أندي هبوط لبعض الـ intercostal
+
+382
+00:25:52,460 --> 00:25:55,960
+muscles أو الـ intercostal أو نفسها هي الـ costal
+
+383
+00:25:55,960 --> 00:25:59,740
+أو الـ rib بتكون منخفضة في بعض ال disease و ال rib
+
+384
+00:25:59,740 --> 00:26:02,960
+التانية بتكوناش أو ممكن تنتين يكونوا منخفضين مع
+
+385
+00:26:02,960 --> 00:26:07,240
+بعض هل بيستخدم التنفس و بيستخدم في ال mainly
+
+386
+00:26:07,240 --> 00:26:10,020
+respiratory muscles اللي هي ال diaphragm ولا
+
+387
+00:26:10,020 --> 00:26:14,090
+بيستخدمالاعدلات الـ Accessories هنا لازم انا اكون
+
+388
+00:26:14,090 --> 00:26:19,470
+طبعا مختبالي من هذا الموضوع المهم جدا ايضا باللذك
+
+389
+00:26:19,470 --> 00:26:22,870
+بال inspection لازم اشوف اللي هي ال precardium
+
+390
+00:26:22,870 --> 00:26:25,690
+visible اللي هي بال pulsation بدي اشوف كيف هو ال
+
+391
+00:26:25,690 --> 00:26:29,310
+pulsation باجي بحط ايدي و بجيت ال pulse كيف وضعه
+
+392
+00:26:29,310 --> 00:26:35,950
+او كم هي عدد النبضات في الدقيقة و بحسبهاالـ chest
+
+393
+00:26:35,950 --> 00:26:40,430
+wall scars طبعا ال brushing signs of trauma هل هو
+
+394
+00:26:40,430 --> 00:26:44,190
+أخد مثلا على سبيل المثال ضربة في الصدر في scar
+
+395
+00:26:44,190 --> 00:26:49,810
+tissue ولا فيش في عنده حكة أو لأ ال jugulars و
+
+396
+00:26:49,810 --> 00:26:54,750
+venous brushers بنجيس اللي هو ال brushers أو بنجيس
+
+397
+00:26:54,750 --> 00:26:59,170
+ال vein طبعا ال venous brushers أو ال vein
+
+398
+00:26:59,170 --> 00:27:04,490
+brushers من اللي هو وريد ال jugulars و ال color
+
+399
+00:27:04,960 --> 00:27:08,720
+طبعاً اللون اللي هي الملتحمة مهم جداً في العين هل
+
+400
+00:27:08,720 --> 00:27:13,940
+هي حمراء أو هل هي طبيعية بلونها الطبيعي Skin طبعاً
+
+401
+00:27:13,940 --> 00:27:18,080
+هل في مشكلة في الجلد أو لأ طفح جلي أو في عنده
+
+402
+00:27:18,080 --> 00:27:21,740
+إحمرار أو في عنده حكة أو في عنده حساسية لإشي معين
+
+403
+00:27:21,740 --> 00:27:27,360
+أيضاً بالإنسبيكشن ال extreme hand قديمة sinuses
+
+404
+00:27:27,360 --> 00:27:30,660
+flubbingبعض الأداة اللى بيبين عليها اللى هو ال
+
+405
+00:27:30,660 --> 00:27:34,460
+clubbing fingers هنا لازم أنا ألاحظهم طبعا ليش لأن
+
+406
+00:27:34,460 --> 00:27:40,240
+هذا بيكشفلي على أمور كتيرة feet and legsChanges in
+
+407
+00:27:40,240 --> 00:27:43,380
+foot and leg colors كمان في الـ Leg position على
+
+408
+00:27:43,380 --> 00:27:47,680
+سبيل المثال إنه ال patient إذا كانت أجره على سبيل
+
+409
+00:27:47,680 --> 00:27:51,160
+المثال هو جاعد على كرسي و أجريه في وضع dependent
+
+410
+00:27:51,160 --> 00:27:54,580
+position هنا بيعمل ليه طبعا تغيير في اللون
+
+411
+00:27:54,580 --> 00:27:58,760
+بالإضافة ل increasing القديمة اللي موجودة في ال
+
+412
+00:27:58,760 --> 00:28:03,020
+foot Blanching و ال elevation إذا أنا رفعته و نيمت
+
+413
+00:28:03,020 --> 00:28:06,560
+في وضع سبعي position و حاطيت مخدتين تحت رجليه هذا
+
+414
+00:28:06,560 --> 00:28:10,870
+بيخفف من القديمةو أيضا بيخفف من ألم الferricose
+
+415
+00:28:10,870 --> 00:28:14,550
+vein اللى هى التوالي طبعا تشيك ل ساكران إذا كان
+
+416
+00:28:14,550 --> 00:28:18,590
+المريض بترددن أكيد طبعا إذا كان المريض بترددن لازم
+
+417
+00:28:18,590 --> 00:28:22,470
+أشيك إذا فى big sore خصوصا فى منطقة الساكران لإنها
+
+418
+00:28:22,470 --> 00:28:27,650
+بوني ماركنج فبالتالي ممكن يعملى اللى هو big sore و
+
+419
+00:28:27,650 --> 00:28:31,290
+هنا أدخل فى مشاكل تانية و أنا مابديها لإن الموقع
+
+420
+00:28:31,290 --> 00:28:33,850
+الحالى لسه أحب نعالج cardio pulmonary disease
+
+421
+00:28:35,160 --> 00:28:37,460
+بالنسبة لل colors ال pigmentation أو ال
+
+422
+00:28:37,460 --> 00:28:40,780
+discolorations اللي بيصير و distributions of hair
+
+423
+00:28:40,780 --> 00:28:45,060
+اللي هو بعض الأحيان في حالة ال varicose veins
+
+424
+00:28:45,060 --> 00:28:49,440
+بيصير في عنا عدم نمو لشعر القدم ليه؟ لإنه بيكون ال
+
+425
+00:28:49,440 --> 00:28:55,140
+skin shy، لامع، فبالتالي صعب إنه ينمو هنا شعر لإنه
+
+426
+00:28:55,140 --> 00:28:58,780
+في عنا varicose veins هنا أنا باخد بالي من ال foot
+
+427
+00:28:58,780 --> 00:29:04,160
+و ال legفده الوضع ال palpations اللي هو الإحساس
+
+428
+00:29:04,160 --> 00:29:07,780
+طبعا بدي أشوف بال palpations بالإحساس أشوف
+
+429
+00:29:07,780 --> 00:29:11,400
+التراكيا ال position هل التراكيا قصب الهوائية في
+
+430
+00:29:11,400 --> 00:29:14,920
+موقعها midline ولا جاية هيك أو رايحة هيك لأ لازم
+
+431
+00:29:14,920 --> 00:29:19,040
+أعرف كدهش اللي هي التراكيا وين موقعها chest wall
+
+432
+00:29:19,040 --> 00:29:23,480
+tenderness or crevitas هل في عندنا اللي هو
+
+433
+00:29:23,480 --> 00:29:27,800
+crevitas اللي هي تقطقة في السدر tenderness ألان بس
+
+434
+00:29:27,800 --> 00:29:31,490
+أنا مجرد ما أمسك السدريصير في عنده ألم المريض الـ
+
+435
+00:29:31,490 --> 00:29:35,450
+Respiratory Excretions طبعا اللي هي التنفس و
+
+436
+00:29:35,450 --> 00:29:38,910
+ثروبته هل أنا حاسه لما أحط أيدي على صدر المريض
+
+437
+00:29:38,910 --> 00:29:43,690
+حاسه ولا لأ التكتر ده Tectile Dermatosis خفقان
+
+438
+00:29:43,690 --> 00:29:46,970
+الصدر أثناء الكلام تلاحظ مثلا زي ما حكينا قبل شوق
+
+439
+00:29:46,970 --> 00:29:50,830
+أنه بيحكي كلمتين و بعدين بيواجهبيصير يلحث من اللي
+
+440
+00:29:50,830 --> 00:29:56,010
+هو الحكي مع اللي هو لإنه بيكون قدّى مجهود و هو مش
+
+441
+00:29:56,010 --> 00:29:59,630
+قادر ياخد النفس ال spinal abnormalities بتشوف إذا
+
+442
+00:29:59,630 --> 00:30:03,390
+في عندي scoliosis أو أي deformity أنا لازم أاخد
+
+443
+00:30:03,390 --> 00:30:07,050
+بالي منها بال probation ال nodes طبعا إذا كان في
+
+444
+00:30:07,050 --> 00:30:09,630
+عندي أي مشاكل في ال axillary nodes في
+
+445
+00:30:09,630 --> 00:30:12,910
+السبقravicular أو ال cervical nodes ال masses هل
+
+446
+00:30:12,910 --> 00:30:17,340
+إنه في كتل أو لأ ال medical beats طبعااللي هي
+
+447
+00:30:17,340 --> 00:30:22,820
+النبضة أو الـ beat اللي هي السطحية، هل في .. اللي
+
+448
+00:30:22,820 --> 00:30:28,700
+هو كيف على سبيل المثال بدي أفحص الدربات القلب الـ
+
+449
+00:30:28,700 --> 00:30:33,960
+hematoma الـ hepatomegaly اللي هو كبر حجم الكبد
+
+450
+00:30:33,960 --> 00:30:40,340
+right upper في الرُبع الأعلى الأيمن tenderness
+
+451
+00:30:40,340 --> 00:30:44,120
+طبعا بيكون في ألام الرُبع الأعلى الأيمنأساس للـ
+
+452
+00:30:44,120 --> 00:30:48,140
+peripheral طبعا بقيّم كل إشي و خصوصا الإديمة في
+
+453
+00:30:48,140 --> 00:30:52,240
+حالات ال cardio بالmonary disease تمام؟ هيك بيكون
+
+454
+00:30:52,240 --> 00:30:57,700
+طبعا أنا بال validation حسيت الأطراف مع كل إدم
+
+455
+00:30:57,700 --> 00:31:02,820
+السماء هنا percussions لل lung fields resonance،
+
+456
+00:31:02,820 --> 00:31:06,460
+بدي أسمع النغمة كيف؟ طبعا هل هي فيها هواء ولا مش
+
+457
+00:31:06,460 --> 00:31:10,420
+فيها هواء؟Increasing loneliness over hyperinflated
+
+458
+00:31:10,420 --> 00:31:14,220
+area طبعا زيادة النغمة أو زيادة اللي هو resonance
+
+459
+00:31:14,220 --> 00:31:18,340
+في الصوت اللي انا بدى اسمعه معناه الكلام في حالات
+
+460
+00:31:18,340 --> 00:31:21,480
+الـ over hyperinflated area الـ dullness to
+
+461
+00:31:21,480 --> 00:31:24,780
+percussion الـ dullness اللي هو بدى يرتد الصوت مرة
+
+462
+00:31:24,780 --> 00:31:28,540
+أخرى over area consolidation location and
+
+463
+00:31:28,540 --> 00:31:34,350
+excursions لدفرام موقع وانحرافالعضلة الأساسية في
+
+464
+00:31:34,350 --> 00:31:38,390
+التنفس اللي هي diaphrag muscles هل هي في موقعها
+
+465
+00:31:38,390 --> 00:31:45,230
+ولا ميخدة موقع آخر نتيجة ال respiratory problem ال
+
+466
+00:31:45,230 --> 00:31:48,790
+escalations of lung تمام بالسمعاء listening to the
+
+467
+00:31:48,790 --> 00:31:49,510
+sound of air
+
+468
+00:31:54,680 --> 00:32:00,300
+عشان انا اتعلم
+
+469
+00:32:00,300 --> 00:32:05,540
+عشان
+
+470
+00:32:05,540 --> 00:32:08,860
+انا اتعلم
+
+471
+00:32:08,860 --> 00:32:14,580
+عشان
+
+472
+00:32:14,580 --> 00:32:17,440
+انا اتعلم عشان انا اتعلم عشان انا اتعلم عشان انا
+
+473
+00:32:17,440 --> 00:32:18,780
+اتعلم عشان انا اتعلم عشان انا اتعلم عشان انا اتعلم
+
+474
+00:32:18,780 --> 00:32:20,180
+انا اتعلم عشان انا اتعلم عشان انا اتعdegree of air
+
+475
+00:32:20,180 --> 00:32:24,200
+entry throughout the chest جداش درجة دخول الهواء
+
+476
+00:32:24,200 --> 00:32:27,980
+أو كمية الهواء اللى ممكن تشوف should be equal لازم
+
+477
+00:32:27,980 --> 00:32:32,440
+تكون متساوية ثم ال quality of breath sounds ratio
+
+478
+00:32:32,440 --> 00:32:38,200
+في ال inspiration و ال expirationمدى اللى هو ratio
+
+479
+00:32:38,200 --> 00:32:43,200
+المعدل تبع دخول النفس او corgio اللى هو المعدل ما
+
+480
+00:32:43,200 --> 00:32:47,520
+بين الشهيق و الزفير ال advisors اللى هو الأصوات
+
+481
+00:32:47,520 --> 00:32:51,800
+العرضية زى اللى هو المصاحبة على سبيل المثال زى
+
+482
+00:32:51,800 --> 00:32:55,680
+اللى هى Hakana Louise الصفير و grackles طبعا اللى
+
+483
+00:32:55,680 --> 00:32:59,780
+هى rails و ال plural ups بعض اللى هى الأصوات
+
+484
+00:32:59,780 --> 00:33:05,020
+الناتجة عن مشاكل فى التنفس الاستردار طبعاو بتقلل
+
+485
+00:33:05,020 --> 00:33:07,940
+ال breathing sound لإنه ممكن يكون في عناء اللي هو
+
+486
+00:33:07,940 --> 00:33:14,760
+إيش بيأيق النفس الطبيعي تمام ال escalations of
+
+487
+00:33:14,760 --> 00:33:20,000
+hair of heart اللي هو اللهم صلي على سيدنا محمد
+
+488
+00:33:20,000 --> 00:33:23,760
+سماع ضربات القلب زي ما حكينا بالنسبة للتنخس لازم
+
+489
+00:33:23,760 --> 00:33:27,620
+أنا أعرف ال normal عشان أحدد فيما بعد اللي هو ال
+
+490
+00:33:27,620 --> 00:33:32,090
+abnormal ال escalated at a vertexطبعا ال «Balmanic
+
+491
+00:33:32,090 --> 00:33:38,130
+Airpoint» و «Tricuspid» و «الصمام المترالي»
+
+492
+00:33:38,130 --> 00:33:42,050
+attempt to identify لازم انا اللي هو بال
+
+493
+00:33:42,050 --> 00:33:46,790
+«Escalation» او بالصناعة تبعتي اكون عارفة اسمع
+
+494
+00:33:46,790 --> 00:33:49,610
+كويس وين او وين بدي احطه او ايش اللي بدي احطه عشان
+
+495
+00:33:49,610 --> 00:33:55,190
+اسمعه rate and rhythm المعدل و الانتظام تبعه كيف
+
+496
+00:33:55,190 --> 00:33:59,860
+انغمعت هل هي ال rhythm تبعه نبضة بنبضتها ولاممكن
+
+497
+00:33:59,860 --> 00:34:03,920
+ينبض مرة و بعدين يسكت S1 and S2 sounds of their
+
+498
+00:34:03,920 --> 00:34:09,400
+intensity طبعا اللي هنا ventricle and artrium نحكي
+
+499
+00:34:09,400 --> 00:34:14,040
+عليهم اللي هو البطين و الأذين و ال S1 في عنا S1 S2
+
+500
+00:34:14,040 --> 00:34:19,240
+S3 S4 قادة لل heart sound اللي هو raps و splinting
+
+501
+00:34:19,240 --> 00:34:23,780
+of S2 المرمرز إذا في عنده مرمرز أو لأ طبعا و ال
+
+502
+00:34:23,780 --> 00:34:28,080
+escalations ال carotid artery و الabdomen الأورطةو
+
+503
+00:34:28,080 --> 00:34:31,800
+الـ renal artery و الـ iliac arteries بعض اللي هي
+
+504
+00:34:31,800 --> 00:34:36,440
+الشرايين المهمة جدا و الفمورا الارتري طبعا لازم
+
+505
+00:34:36,440 --> 00:34:40,340
+هنا أشوفهم و أشيك عليهم و أسمعهم بيه لإن هذه
+
+506
+00:34:40,340 --> 00:34:45,580
+الشرايين عبارة عن شرايين كبيرة و مهمة ال
+
+507
+00:34:45,580 --> 00:34:50,380
+associated symptoms بعض اللي هي الأعراض المصاحبة
+
+508
+00:34:50,380 --> 00:34:54,780
+complete respiratory assessment include airنوز
+
+509
+00:34:54,780 --> 00:34:58,200
+سبعتيل ENT زى ما بتعرفوا الدكتور قام فى أذنه
+
+510
+00:34:58,200 --> 00:35:01,900
+الحنجرة لازم يكمل considers لال interest special
+
+511
+00:35:01,900 --> 00:35:06,340
+او ال interest in ال gastric intestinal اللى هى مع
+
+512
+00:35:06,340 --> 00:35:10,440
+دماغى او ال genitouria او ال genitourinary اللى
+
+513
+00:35:10,440 --> 00:35:13,940
+هوا المسالك البولية assistants if appropriated اذا
+
+514
+00:35:13,940 --> 00:35:19,480
+انا محتاجاهم بقى استعين فيهم symptoms الفيقونتي
+
+515
+00:35:19,480 --> 00:35:25,000
+اللى هوا الفيقونتينreferral to consultation إيش هو
+
+516
+00:35:25,000 --> 00:35:29,060
+الأعراض اللي مهمة جدا أنه أنا لما بدي أشوفها على
+
+517
+00:35:29,060 --> 00:35:32,760
+طول بدي أحاوله على ال consultation severe
+
+518
+00:35:32,760 --> 00:35:36,780
+discipline and inability to lie flat شخص جانبي
+
+519
+00:35:36,780 --> 00:35:40,850
+يعاني من صعوبات في التنفسبالإضافة لأنه مش قادر
+
+520
+00:35:40,850 --> 00:35:43,970
+ينام على ظهره بتاعته، ليه؟ لأنه في صعوبة في
+
+521
+00:35:43,970 --> 00:35:48,050
+التنفس، الابيضة to speak or fragmented speech اللي
+
+522
+00:35:48,050 --> 00:35:52,310
+هم عدم القطر على الكلام أو بيحكي كلمة وبيوجف دقيقة
+
+523
+00:35:52,310 --> 00:35:55,150
+على سبيل المثال، ال track يا فيها shifting، يا
+
+524
+00:35:55,150 --> 00:35:58,150
+علييمين، يا عليسار، هذه كمان علامة مميزة ومهمة جدا
+
+525
+00:35:58,150 --> 00:36:02,110
+إن أنا أحاوله لاقل استشارة، unrelieved chest pain
+
+526
+00:36:02,600 --> 00:36:07,840
+الـ chest pain ما صار فيه أي شفاء ليش كان بيجعوا
+
+527
+00:36:07,840 --> 00:36:10,900
+مثلا أجاني الأسبوع الأول و بعد ذلك أجاني بعد أسبوع
+
+528
+00:36:10,900 --> 00:36:15,020
+ما زال اللي هو صدره بيجعوا unable to maintain طبعا
+
+529
+00:36:15,020 --> 00:36:21,780
+اللي هو saturation of oxygen greater than 92% on
+
+530
+00:36:21,780 --> 00:36:25,440
+room air severe increasing fatigue طبعا لازم اللي
+
+531
+00:36:25,440 --> 00:36:29,480
+هو saturation of oxygen أو معدل تركيز ال oxygen في
+
+532
+00:36:29,480 --> 00:36:33,060
+الدم مهم جدا أنا دايما أكون أعرفهالـ cyanosis هل
+
+533
+00:36:33,060 --> 00:36:38,300
+هو central ولا peripheral؟ هل إنه ناتج عن إشي مهم
+
+534
+00:36:38,300 --> 00:36:42,160
+central cyanosis is not predictable until oxygen؟
+
+535
+00:36:42,160 --> 00:36:46,140
+طبعا إنه لازم أعرف إذا كان هذا الـ cyanosis أو هذا
+
+536
+00:36:46,140 --> 00:36:50,840
+الإزرقاق ناتج عن إشي central أو peripheral؟
+
+537
+00:36:53,510 --> 00:36:58,890
+الـ saturation is less than 85% هذا أنا بخافي منه،
+
+538
+00:36:58,890 --> 00:37:02,430
+ليش؟ خصوصا الآن بتسمع أن بولك فلان عايش عداء ال
+
+539
+00:37:02,430 --> 00:37:06,370
+oxygen نتيجة لا إقصابته بالـ COVID-19 فبنتي عليه
+
+540
+00:37:06,370 --> 00:37:09,750
+كمية ال saturation أو مدة تشبع في ال oxygen مهم
+
+541
+00:37:09,750 --> 00:37:13,420
+جداsilent chest or cricles without lung fields
+
+542
+00:37:13,420 --> 00:37:17,300
+طبعا اللي هو الـ silent chest اللي هو الصدر الغير
+
+543
+00:37:17,300 --> 00:37:21,140
+متحرك وما بيكون فيه حركة لل lungs في ال
+
+544
+00:37:21,140 --> 00:37:23,400
+inspiration و ال expiration فبالتالي بتكون ضعيفة
+
+545
+00:37:23,400 --> 00:37:27,560
+جدا اللي هو دخول وخروج الهواء decrease لل level of
+
+546
+00:37:27,560 --> 00:37:30,500
+consciousness إذا كان في عندي مشكلة في درجة الوعي
+
+547
+00:37:30,500 --> 00:37:34,680
+يعني أنا بحكي مع الحالة و هي دخلت في أمور تانية أو
+
+548
+00:37:34,680 --> 00:37:37,740
+بدت تفقد الوعي أمامي diminish the respiratory
+
+549
+00:37:37,740 --> 00:37:44,090
+effort يعنيمجهود يبدو ياخد نفس بس على الفاضي مافي
+
+550
+00:37:44,090 --> 00:37:48,850
+مجال ياخد هذا النفس ليش؟ لإنه في عنده مشكلة في أخذ
+
+551
+00:37:48,850 --> 00:37:53,510
+النفس nasal flaring أو tracheal tube اللي هو تمدد
+
+552
+00:37:53,510 --> 00:37:56,670
+الأنف هذا بيصير ليش؟ كعملية تعوضي أو لـ Tracheal
+
+553
+00:37:56,670 --> 00:38:00,090
+Tag بيصير عملية تعوضية على أساس إنه يقدر ياخد أو
+
+554
+00:38:00,090 --> 00:38:03,510
+يحصل أكبر كمية من الـ Oxygen ولكن للأسف هي عبارة
+
+555
+00:38:03,510 --> 00:38:07,090
+عن compensatory process عملية تعوضي بيحاول ياخد
+
+556
+00:38:07,090 --> 00:38:11,190
+منها بعرف إنه أنا هنا في عندي مشكلةو لازم حلها ال
+
+557
+00:38:11,190 --> 00:38:13,950
+intercostal in drawing زي اللي احنا جاينها هو ببوط
+
+558
+00:38:13,950 --> 00:38:18,370
+بعض اللي هو ال intercostal طبعا و اللي هي ال ribs
+
+559
+00:38:18,370 --> 00:38:20,930
+اللي موجودة عليها recent hospitalization for
+
+560
+00:38:20,930 --> 00:38:24,090
+congestive heart failure طبعا انه طالع من المستشفى
+
+561
+00:38:24,090 --> 00:38:28,650
+الجديد مع اللي هو congestive heart failure اللي هو
+
+562
+00:38:28,650 --> 00:38:35,040
+فشل في عضلة القلب و احتقانها تمام هذا انا بخافعليه
+
+563
+00:38:35,040 --> 00:38:38,600
+وعلى طول اي signs او symptoms تحوله على ال
+
+564
+00:38:38,600 --> 00:38:42,800
+consultation يعطيكوا ألف عافية وبهيك نكون خلصنا
+
+565
+00:38:42,800 --> 00:38:46,420
+أول chapter في ال cardio pulmonary symptoms او ال
+
+566
+00:38:46,420 --> 00:38:49,640
+cardio pulmonary assessment ألقاكم بإذن الله في
+
+567
+00:38:49,640 --> 00:38:53,600
+فيديو آخر في حالات ال cardiac disease و ال
+
+568
+00:38:53,600 --> 00:38:58,380
+physiotherapy sessions سبعتهم السلام عليكم ورحمة
+
+569
+00:38:58,380 --> 00:38:59,140
+الله وبركاته
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/eNY187D88o0_raw.json b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/eNY187D88o0_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..529d64e12c7a961fa9b5b30a41b871d209bf2e50
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/eNY187D88o0_raw.json
@@ -0,0 +1 @@
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2312.67, "word": " احتقانها", "probability": 0.9052734375}, {"start": 2312.67, "end": 2313.25, "word": " تمام", "probability": 0.712158203125}, {"start": 2313.25, "end": 2313.55, "word": " هذا", "probability": 0.45458984375}, {"start": 2313.55, "end": 2313.69, "word": " انا", "probability": 0.83740234375}, {"start": 2313.69, "end": 2314.21, "word": " بخاف", "probability": 0.9729817708333334}], "temperature": 1.0}, {"id": 101, "seek": 233914, "start": 2314.46, "end": 2339.14, "text": "عليه وعلى طول اي signs او symptoms تحوله على ال consultation يعطيكوا ألف عافية وبهيك نكون خلصنا أول chapter في ال cardio pulmonary symptoms او ال cardio pulmonary assessment ألقاكم بإذن الله في فيديو آخر في حالات ال cardiac disease و ال physiotherapy sessions سبعتهم السلام عليكم ورحمة الله وبركاته", "tokens": [3615, 20292, 3224, 4032, 3615, 23942, 23032, 12610, 1975, 1829, 7880, 1975, 2407, 8332, 6055, 5016, 12610, 3224, 15844, 2423, 20932, 37495, 9566, 1829, 4117, 14407, 5551, 46538, 6225, 31845, 10632, 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\ No newline at end of file
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/eNY187D88o0_raw.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/eNY187D88o0_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..745ad41775ba6a5b87cb45ac6399860293197eef
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/eNY187D88o0_raw.srt
@@ -0,0 +1,2292 @@
+1
+00:00:00,880 --> 00:00:04,400
+السلام عليكم ورحمة الله وبركاته اليوم بإذن الله
+
+2
+00:00:04,400 --> 00:00:10,540
+تعالى راح نشرح الجزء التاني من مادة علاج قلب وصدر
+
+3
+00:00:10,540 --> 00:00:15,440
+وباطنه هدخل اليوم بقسم القلب physiotherapy for
+
+4
+00:00:15,440 --> 00:00:19,420
+cardiopulmonary disorders هاخد اليوم اللي هو بداية
+
+5
+00:00:19,420 --> 00:00:23,560
+ال assessment تبع حالات القلب زي ما كنا نشوف في
+
+6
+00:00:23,560 --> 00:00:27,440
+التدريب العملي في عندنا اللي هوحالات القلب سواء
+
+7
+00:00:27,440 --> 00:00:31,380
+كانت في الـICU أو في جراحة القلب، هندخل اليوم في
+
+8
+00:00:31,380 --> 00:00:35,840
+الـPhysotherapy Assessments لهذه الحالات، نبدأ على
+
+9
+00:00:35,840 --> 00:00:44,720
+بركة الله أولاً
+
+10
+00:00:44,720 --> 00:00:49,040
+الـAdult Cardiorespiratory Assessment، سيه أي
+
+11
+00:00:49,040 --> 00:00:52,530
+Assessment اللي ناخده سواء في العظام،في الأطفال،
+
+12
+00:00:52,530 --> 00:00:57,950
+في أي department موجود عندنا مش المستشفى هاخد أنا
+
+13
+00:00:57,950 --> 00:01:01,930
+الـhistory تبع المريض الموجود عنده سواء كان ال
+
+14
+00:01:01,930 --> 00:01:05,810
+present history أو ال past history الـhistory of
+
+15
+00:01:05,810 --> 00:01:09,510
+present illness and review system تمام؟ بدي أشوف
+
+16
+00:01:09,510 --> 00:01:14,070
+شو تاريخ المرضي تبع هذاالمرض generally the
+
+17
+00:01:14,070 --> 00:01:16,490
+following characteristic of each symptom should be
+
+18
+00:01:16,490 --> 00:01:20,490
+illustrated and explored لازم انا اكتشف كل الحاجات
+
+19
+00:01:20,490 --> 00:01:24,950
+اللي انا ضروري اعرفها في هاي الحالة honest هل
+
+20
+00:01:24,950 --> 00:01:30,720
+المرض بدأ بالتدريج معاهولا فجأة أغم عليه و صار في
+
+21
+00:01:30,720 --> 00:01:34,500
+عنده مشاكل وبعدين عرفنا إن هو والله عنده قصور
+
+22
+00:01:34,500 --> 00:01:38,380
+كشريان التاجي صار عنده ذبحة صدرية صار عنده كذا
+
+23
+00:01:38,380 --> 00:01:43,920
+لازم نعرف إن هي فترة المرض و كان ال locations أو
+
+24
+00:01:43,920 --> 00:01:47,700
+ال radiations تبع المرض بنعرف على سبيل المثالأنه
+
+25
+00:01:47,700 --> 00:01:51,120
+لو كان في مثلا في عنا ذبحة صدرية بدي يكون اللي هو
+
+26
+00:01:51,120 --> 00:01:55,100
+الكتف اليمين فيه مشكلة على سبيل المثال ال duration
+
+27
+00:01:55,100 --> 00:02:00,320
+كمان ال frequency جداش كم مرة لو كان مصحوب هذا
+
+28
+00:02:00,320 --> 00:02:04,480
+بيقحها كم مرة بيقحه أمتى بتشتد هل أنها بتبطأ في
+
+29
+00:02:04,480 --> 00:02:07,380
+الليل أو بتشتد عليه في الليل أو بتبطأ في أثناء
+
+30
+00:02:07,380 --> 00:02:10,360
+النهار أيضا ال characteristic اللي هي ال quality
+
+31
+00:02:10,360 --> 00:02:15,810
+and securityجدّش كميتها؟ جدّش حدّتها؟ هل هي مصحوبة
+
+32
+00:02:15,810 --> 00:02:19,190
+على سبيل المثال بـBlood ولا لا؟ الـ Aggravating
+
+33
+00:02:19,190 --> 00:02:23,570
+and Oxidating Factors شو العوانل اللي بتزيدلي من
+
+34
+00:02:23,570 --> 00:02:27,730
+فعالية أو من سوء هذا المرض على سبيل المثال إذا كان
+
+35
+00:02:27,730 --> 00:02:32,230
+بيعاني من أزمة مثلا إيش الحاجات اللي هي بتفاقم
+
+36
+00:02:32,230 --> 00:02:36,940
+الحالة أو بتزيدها سوء على سبيل المثال؟إذا كان فيه
+
+37
+00:02:36,940 --> 00:02:42,020
+على سبيل المثال معطيرات جوء، إذا كان فيه العطور
+
+38
+00:02:42,020 --> 00:02:45,300
+العادية، هذه الأمور كلها بتجيب الحالة سوءًا، إذا
+
+39
+00:02:45,300 --> 00:02:49,440
+كانت الحالة على سبيل المثال حالة رابو. كمان نفس
+
+40
+00:02:49,440 --> 00:02:52,620
+الاشي لو حكينا على حالة القلب، على سبيل المثال
+
+41
+00:02:52,620 --> 00:02:57,700
+ارتفاع الكوليسترول، ارتفاع مثلًا أكل أكل معين، إذا
+
+42
+00:02:57,700 --> 00:03:02,340
+كان على سبيل المثال فيهأدوية معينة بياخدها بإزديد
+
+43
+00:03:02,340 --> 00:03:07,000
+نسبة السكر في الدم ياخد باله من هذه الحاجات هذا
+
+44
+00:03:07,000 --> 00:03:11,280
+بالنسبة للـ Historyأيضًا مكملين relieving factors،
+
+45
+00:03:11,280 --> 00:03:13,920
+ما هي العوامل؟ لأنه لو أخر مثلًا الأدوية الفلانية
+
+46
+00:03:13,920 --> 00:03:19,060
+كذا، لو كان هو مريض سُكر، معاه الكرنيت تبعه، معاه
+
+47
+00:03:19,060 --> 00:03:22,200
+الروشيتا تبعته، أنه لازم ياخد كذا، الان ال current
+
+48
+00:03:22,200 --> 00:03:26,700
+situation، الحالة، هل هي في حالة improving وتحسن
+
+49
+00:03:26,700 --> 00:03:29,200
+ولا في حالة deterioration؟ إذا كان في حالة
+
+50
+00:03:29,200 --> 00:03:31,680
+deterioration، اللي هو تدهور للحالة، بدي أعرف إيش
+
+51
+00:03:31,680 --> 00:03:35,550
+الأسباب، ال effect on activity daily life،اللي هم
+
+52
+00:03:35,550 --> 00:03:40,230
+تأثيرات هذه الحالة على اللي هي جزء الحياة العامة
+
+53
+00:03:40,230 --> 00:03:44,890
+يعني هل على سبيل المثال إذا كان فيه عنده M.I.
+
+54
+00:03:45,010 --> 00:03:49,130
+Myocardial Infarction على سبيل المثال هل أثرت على
+
+55
+00:03:49,130 --> 00:03:52,570
+الحياة عنده هو أستاذ و بده يروح على المدرسة هل
+
+56
+00:03:52,570 --> 00:03:56,550
+أثرت على جزء الحياة عنده أو لأ previous diagnosis
+
+57
+00:03:56,550 --> 00:04:02,500
+أيضًا ofلازم كمان نعرف إذا كان في عنده أي تشخيصات
+
+58
+00:04:02,500 --> 00:04:06,920
+سابقة مشابهة لهذا الحدث previous treatment and
+
+59
+00:04:06,920 --> 00:04:10,980
+efficiency كمان نفس الكلام إذا أخد علاجات سابقة و
+
+60
+00:04:10,980 --> 00:04:16,260
+هل إلا تأثير أو لأ أيضا مكملين في الcardio and
+
+61
+00:04:16,650 --> 00:04:20,130
+signs and symptoms اللي هي العلامات الـ signs و
+
+62
+00:04:20,130 --> 00:04:24,010
+الـ symptoms in addition طبعا بالاضافة لل general
+
+63
+00:04:24,010 --> 00:04:25,890
+characteristic outlined above additional
+
+64
+00:04:25,890 --> 00:04:29,470
+characteristic لل symptoms نفسه زي ال cuff ال
+
+65
+00:04:29,470 --> 00:04:34,280
+quality ال severity ال timingكل كام فترة أو فترة
+
+66
+00:04:34,280 --> 00:04:38,040
+هو كان بيكوح ل duration greater than two weeks إذا
+
+67
+00:04:38,040 --> 00:04:39,860
+كانت greater than two weeks إذا كانت أكتر من
+
+68
+00:04:39,860 --> 00:04:44,320
+أسبوعين على سبيل المثال بدنا نشوف تشخيص ال TB اللي
+
+69
+00:04:44,320 --> 00:04:49,820
+هو السلر أوي على سبيل المثال إذا هاي كلها من اللي
+
+70
+00:04:49,820 --> 00:04:54,430
+هي ال assessment اللي أنا بدي أشتغل عليهالآن هذا
+
+71
+00:04:54,430 --> 00:04:59,170
+المخاطر بدي أشوف الـ Color تبعه الـ Amount الـ
+
+72
+00:04:59,170 --> 00:05:03,170
+Consistency كمال الـ Purity هل في بص ولا مش في بص؟
+
+73
+00:05:03,170 --> 00:05:06,450
+هل هو متعفن أو لأ تحت الميكروسكوب؟ الـ Time of
+
+74
+00:05:06,450 --> 00:05:10,290
+Days كل أكم مرة في اليوم ممكن أنه أنا أعمله على
+
+75
+00:05:10,290 --> 00:05:14,230
+سبيل المثال Physotherapy session ويقدر أنه يطلع
+
+76
+00:05:14,230 --> 00:05:19,220
+هذا اللي هو Secretionإذا لونه، كمية ونوعه، هل فيه
+
+77
+00:05:19,220 --> 00:05:23,640
+دم أو مش فيه دم، كمان هذا بيعطيني إشارة لإشي معين،
+
+78
+00:05:23,640 --> 00:05:27,460
+تمام؟ وخصوصا بما أنه إحنا الآن في اللي هي جائحة
+
+79
+00:05:27,460 --> 00:05:33,130
+COVID-19، هذا مهم بالنسبالنا، اللي هي metabasesالـ
+
+80
+00:05:33,130 --> 00:05:36,150
+Hemo من اسمها، Hemo لحالها تعني blood،
+
+81
+00:05:36,150 --> 00:05:39,730
+hematopoiesis اللي هي الدم وشوه المشاكل اللي تصدر
+
+82
+00:05:39,730 --> 00:05:43,590
+لي عنه كمية الدم اللي موجودة في هذا ال computer
+
+83
+00:05:43,590 --> 00:05:48,050
+جداش هل هي مجرد بس حاجات صغيرة أو انه في كمية
+
+84
+00:05:48,050 --> 00:05:50,470
+كبيرة من ال blood عشان انا اقدر افرج في ال
+
+85
+00:05:50,470 --> 00:05:54,150
+diagnoses ما بين ال TB وما بين اللي هي ال
+
+86
+00:05:54,150 --> 00:05:57,300
+preliminary disease الأخرىfrank blood or mixed
+
+87
+00:05:57,300 --> 00:06:02,000
+with sputum هل هو أن الدم هذا نتج عندي بشكل مباشر
+
+88
+00:06:02,000 --> 00:06:05,780
+ولا أنه كان مختلط مع ال sputum ال associations
+
+89
+00:06:05,780 --> 00:06:11,840
+with leg pain هل هو مصحوب هذا المشاكل هذه هل هي
+
+90
+00:06:11,840 --> 00:06:14,680
+كانت مصحوبة مع ألان في ال calf muscle على سبيل
+
+91
+00:06:14,680 --> 00:06:17,280
+المثال و chest pain و shortening في ال breathing
+
+92
+00:06:17,280 --> 00:06:21,060
+ولا لأ لأن هذا بياخدني في منحة او اتجاه اخر انا
+
+93
+00:06:21,060 --> 00:06:23,960
+لازم اخد بالي منه تمام؟
+
+94
+00:06:26,550 --> 00:06:30,670
+shortens of breathing قصر اللي هو التنفس قصر
+
+95
+00:06:30,670 --> 00:06:34,250
+التنفس هيكون ليش؟ ليش صار في عنا shortening في ال
+
+96
+00:06:34,250 --> 00:06:38,070
+breathing؟ هذا مبدل لي على أشياء أخرى في أثناء ال
+
+97
+00:06:38,070 --> 00:06:41,630
+exercise tolerance خلال اللي هو أداء ال exercise
+
+98
+00:06:41,630 --> 00:06:45,870
+عدد المرات اللي هو قادر الشخص على أداء التمرين
+
+99
+00:06:45,870 --> 00:06:49,230
+فيها ال number of stairs a client can be climb or
+
+100
+00:06:49,230 --> 00:06:53,810
+the same client can walk جداش كام مرة جادر هو يطلع
+
+101
+00:06:53,810 --> 00:06:57,300
+الدرج و كام مرة جادر ينزلهالـ Tolerance هذا أو مدى
+
+102
+00:06:57,300 --> 00:07:02,060
+التحمل أو قدرة المريض على التحمل مهم جدا الـ
+
+103
+00:07:02,060 --> 00:07:07,340
+Postural Orthopenia Shortens بيكون في عندنا
+
+104
+00:07:07,340 --> 00:07:12,200
+Shortens اللي هي .. شو تعريف ال Orthopenia؟ ال
+
+105
+00:07:12,200 --> 00:07:14,800
+Orthopenia اللي حكينا عليها عبارة عن Shortening ل
+
+106
+00:07:14,800 --> 00:07:17,580
+Breathing بيصير في عندنا قصر في التلفزور
+
+107
+00:07:17,580 --> 00:07:21,280
+Tripending اللي هي use three points of support
+
+108
+00:07:22,170 --> 00:07:24,290
+طبعاً اللي هي Tripoding support اللي هو إنه
+
+109
+00:07:24,290 --> 00:07:28,210
+بيستخدم ثلاث نقاط لزقلها اللي هو تعطي دعم خلال
+
+110
+00:07:28,210 --> 00:07:31,370
+اللي هو ال cuffing أو القحة اللي إجته فيه اللي هو
+
+111
+00:07:31,370 --> 00:07:35,010
+النفس القصنة Shortening of breathing at rest طبعا
+
+112
+00:07:35,010 --> 00:07:39,750
+إذا هو كان في عنده shortening أو هذا shortening
+
+113
+00:07:39,750 --> 00:07:43,210
+اللي صار عنده إذا كان هو بقد مجهود معين في أحيان
+
+114
+00:07:43,210 --> 00:07:45,390
+shortening بيصير أثناء ال patient في وضع ال rest
+
+115
+00:07:45,390 --> 00:07:48,730
+اللي هو في وضع الراحةهذا كمان لازم أعرف حاجة لازم
+
+116
+00:07:48,730 --> 00:07:53,190
+أعرف سببه ال association with proximal necrosis
+
+117
+00:07:53,190 --> 00:07:58,350
+which هو عبارة هل أنه مصحوب على سبيل المثال بصعوبة
+
+118
+00:07:58,350 --> 00:08:02,200
+في التنفسفي أثناء فترة اللي هو الإسرقاء على الظهر
+
+119
+00:08:02,200 --> 00:08:05,440
+أو لأ الـ Associated with swelling with ankle or
+
+120
+00:08:05,440 --> 00:08:10,020
+recent weight gain طبعا هل هذا الاشي مصحوب معانا
+
+121
+00:08:10,020 --> 00:08:16,320
+بتورم في الankle أو لأ أو إنه هل في فقدان للوزن زي
+
+122
+00:08:16,320 --> 00:08:19,600
+ما كنا نحكي مثلا في الدياديتسإنه فيه فقدان للوزن
+
+123
+00:08:19,600 --> 00:08:23,560
+أو فيه اكسب آخر للوزن، معناته بإيش غير معقول طبعا،
+
+124
+00:08:23,560 --> 00:08:26,420
+بيكون هذا الكلام، مش أنه أي وزن يعني، لو أضادي
+
+125
+00:08:26,420 --> 00:08:30,140
+Grammar نجوح مثلا ونعمل مشكلة، لأ اللي بيكون إيش
+
+126
+00:08:30,140 --> 00:08:36,270
+واضح تمام، هذا بالنسبة ل Shortening of Briefingالـ
+
+127
+00:08:36,270 --> 00:08:39,730
+cyanosis الإذرقاق اللي كان أو الاشي اللي هيصير
+
+128
+00:08:39,730 --> 00:08:44,490
+نتيجة لإيش لإنه فيه cyanosis نوعين فيه central و
+
+129
+00:08:44,490 --> 00:08:47,610
+فيه peripheral الـ cyanosis ناتج عن ال central و
+
+130
+00:08:47,610 --> 00:08:51,130
+هناخد فرق ما بينهم و ال peripheral ناتج عن سبب
+
+131
+00:08:51,130 --> 00:08:54,460
+معينWhen does it okay؟ ومافيش هدف يصير على نفسه
+
+132
+00:08:54,460 --> 00:08:57,940
+يعني واسس هل أنه لما يتعرض لمجهود معين أو لما أنه
+
+133
+00:08:57,940 --> 00:09:03,100
+هذا الشخص على سبيل المثال بيفقد وعيه أو أنه أنت
+
+134
+00:09:03,100 --> 00:09:06,820
+بالظبط بدي يصير الحدث هدا معاه إيه مثلا ال change
+
+135
+00:09:06,820 --> 00:09:10,670
+in background؟ أي تغيرات جديدة صارت علىالشكل العام
+
+136
+00:09:10,670 --> 00:09:13,550
+أو البطل الكله ال associated هل ال cuffing هذه
+
+137
+00:09:13,550 --> 00:09:18,890
+كانت مصوبة ب weaving أو اللي هو صفار بنسميه أو
+
+138
+00:09:18,890 --> 00:09:24,730
+الصفير أو اللي هو الكحة اللي بتكون مع الصفير
+
+139
+00:09:24,730 --> 00:09:27,790
+بالأغلب بتكون مع الأطفال طبعا وفيه موجود فيها مع
+
+140
+00:09:27,790 --> 00:09:31,950
+الأكبار فهذه الأشياء أحنا بنخاف منها chest pain
+
+141
+00:09:31,950 --> 00:09:36,170
+associated symptoms طبعا أكيد في على سبيل المثال
+
+142
+00:09:36,170 --> 00:09:38,230
+في الزبحة الفضرية بيكون في عندهم associated
+
+143
+00:09:38,230 --> 00:09:42,240
+symptomsRelation to effort طبعاً إلها علاقة بالجهد
+
+144
+00:09:42,240 --> 00:09:46,160
+بال exercise بال nails بنوع الوشبة اللي أكلها إذا
+
+145
+00:09:46,160 --> 00:09:49,460
+كانت عالية أو high fat أو high cholesterol هذا مهم
+
+146
+00:09:49,460 --> 00:09:53,360
+جدا، Bending over كمان إذا هو كان على سبيل المثال
+
+147
+00:09:53,360 --> 00:09:56,320
+عمل bending يداحد except ال word that's beyond
+
+148
+00:09:56,580 --> 00:10:00,200
+Carefully. Include quality, radiation, severity,
+
+149
+00:10:00,320 --> 00:10:04,640
+timing تمام؟ لازم نعرف .. نشوف الألم هذا هو وين
+
+150
+00:10:04,640 --> 00:10:08,500
+أساسه أو وين بالظبط هو ناتج من وين وين ممكن يتفرق
+
+151
+00:10:08,500 --> 00:10:10,580
+عليه هل ال radiation كان على ال right shoulder أو
+
+152
+00:10:10,580 --> 00:10:14,360
+ال left shoulder على سبيل المثال في ال back؟ ال
+
+153
+00:10:14,360 --> 00:10:17,600
+leg فيها مشاكل ولا مشاكل؟ ال severity الحدة تبعته
+
+154
+00:10:17,600 --> 00:10:21,860
+كان مؤلم؟ هل هو بسيط؟ بزيد مثلا على سبيل المثال في
+
+155
+00:10:21,860 --> 00:10:26,240
+أداء نشاط معين؟ في أداء exercise معين؟و الوقت تبعه
+
+156
+00:10:26,240 --> 00:10:31,420
+و ال timing تمام ال fitting or thumbs اللي هو
+
+157
+00:10:31,420 --> 00:10:35,460
+فقدان الوعي الآن احنا بنحكي على cardio pulmonary
+
+158
+00:10:35,460 --> 00:10:39,560
+disease اليوم ال cardiac نفسها هي ال machine تبعت
+
+159
+00:10:39,560 --> 00:10:43,050
+ال blood pumpingإذا أنه على سبيل المثال ما كان في
+
+160
+00:10:43,050 --> 00:10:47,350
+عند الدم الكافي لإن يوصل أعضاء الجسم ممكن يتعرض
+
+161
+00:10:47,350 --> 00:10:52,870
+لهذا الشخص اللي هو coma أو يتعرض لغيبوبة طبعا
+
+162
+00:10:52,870 --> 00:10:57,230
+نتيجة لفقدان الوعي اللي صار، نتيجة لتغيرات اللي
+
+163
+00:10:57,230 --> 00:11:00,510
+صارت في الجسمWeakness ممكن أبدايتها تكون weakness
+
+164
+00:11:00,510 --> 00:11:04,610
+ضعف عام Light hitting Loss of consciousness فقدان
+
+165
+00:11:04,610 --> 00:11:07,390
+للوعي relation to the boss or the change ممكن
+
+166
+00:11:07,390 --> 00:11:11,770
+أحيانا في أنا بيكون لسه تنايم على ال bed و بمجرد
+
+167
+00:11:11,770 --> 00:11:15,850
+ما أنا أحاوله على أو أنجله على وضعية اللي هي long
+
+168
+00:11:15,850 --> 00:11:19,800
+sitting position يحس لي بيأدوهاهنا طبعا لازم انا
+
+169
+00:11:19,800 --> 00:11:23,380
+اخد بالي و اكون عملاله support من كل الاتجاهات
+
+170
+00:11:23,380 --> 00:11:28,100
+طبعا لإنه عشان انا اتأكد ان المريض عندى في وضع آمن
+
+171
+00:11:28,100 --> 00:11:31,560
+طبعا نتيجة ال neurological symptoms او نتيجة ممكن
+
+172
+00:11:31,560 --> 00:11:35,300
+تكون الأشياء مش علاقة بال circulation ممكن تكون
+
+173
+00:11:35,300 --> 00:11:39,740
+علاقة بال neuro سواء في ال brain او في ال spinal
+
+174
+00:11:39,740 --> 00:11:43,140
+cord هذا لازم اخد بالي منه كمان في ال assessment
+
+175
+00:11:43,140 --> 00:11:49,340
+تبع المريض تبعى ال extremities او الأطرافبدي ألاحظ
+
+176
+00:11:49,340 --> 00:11:54,190
+عليها إشي القديمةهل في عندى قديمة فى الأطراف مثلا
+
+177
+00:11:54,190 --> 00:11:57,850
+فى ال hand، فى ال foot؟ وين ما كانها بالظبط؟ هل
+
+178
+00:11:57,850 --> 00:12:02,590
+إلها على سبيل المثال يوم، يومين؟ أمتى ظهرت؟ هل
+
+179
+00:12:02,590 --> 00:12:06,770
+كانت فى وضع معين أنه مثلا على سبيل المثال إذا بمشي
+
+180
+00:12:06,770 --> 00:12:10,070
+هذا المريض تبعى، بيصير فى عنده قديمة؟ ولا هى دايما
+
+181
+00:12:10,070 --> 00:12:13,430
+مستمرة معاه بشكل دائم على طول اليوم؟ ال
+
+182
+00:12:13,430 --> 00:12:16,310
+intermittent graduations اللى هى جداش ال exercise
+
+183
+00:12:16,310 --> 00:12:20,910
+including لجل البنت جداش التمرين بتعطينى مشاكلفي
+
+184
+00:12:20,910 --> 00:12:24,830
+cuff muscles distance clients can walking before
+
+185
+00:12:24,830 --> 00:12:28,410
+on a spin related periodations كمان جداش المسافة
+
+186
+00:12:28,410 --> 00:12:32,970
+المسموح إلي أنا أخلي المريض تبعي يمشي فيها تمام
+
+187
+00:12:32,970 --> 00:12:39,850
+جداش جداش اللي هو جداش اللي هو المسافة اللي أنا
+
+188
+00:12:39,850 --> 00:12:44,970
+بدي أخلي المريض تبعي يمشي فيها تمامTime needed to
+
+189
+00:12:44,970 --> 00:12:48,990
+rest and to relieve graduations كدهش انه انا بدي
+
+190
+00:12:48,990 --> 00:12:54,290
+وقت لحتى هذا المريض يخف عنه اللي هو التقلصات اللي
+
+191
+00:12:54,290 --> 00:12:57,870
+صارت في الكف مصر على سبيل المثال هل انا بحاجة
+
+192
+00:12:57,870 --> 00:13:01,310
+لساعة لتنتين او اكتر من الوقت ال temperatures of
+
+193
+00:13:01,310 --> 00:13:06,710
+affected patientsالدرجة الحرارة، هل هو مثلا بيكون
+
+194
+00:13:06,710 --> 00:13:11,850
+مساعده الوضع الدافع أو أنه مثلا دائما بيكون فيه
+
+195
+00:13:11,850 --> 00:13:16,490
+sweating ومتعرخ، بدي أحاول أعمله calling للمكان، و
+
+196
+00:13:16,490 --> 00:13:19,330
+ال tingling اللي هو الخدلان و ال leg cramps and
+
+197
+00:13:19,330 --> 00:13:24,850
+pain rest طبعا اللي هوإذا كانت فيه stiffness في
+
+198
+00:13:24,850 --> 00:13:29,570
+عنده «cramps» اللي هو تقلصات في الـ calf muscle
+
+199
+00:13:29,570 --> 00:13:34,070
+على سبيل المثال أو أي muscle هذا كمان لازم أخد
+
+200
+00:13:34,070 --> 00:13:38,070
+بالي منه وجود varicose veins أولاء طبعا مهم جدا في
+
+201
+00:13:38,070 --> 00:13:41,130
+حالات اللي هي ال female على سبيل المثال في حالة ال
+
+202
+00:13:41,130 --> 00:13:43,250
+cardio وكمان ال male ممكن يصير عندهم varicose
+
+203
+00:13:43,250 --> 00:13:48,970
+veins ولكن بنسب أقل من الستات أخد بالي من اللي هو
+
+204
+00:13:48,970 --> 00:13:52,040
+الvaricose veinsفيها الـ Other Associated Symptoms
+
+205
+00:13:52,040 --> 00:13:57,040
+زي الـ Fever، الـ Amnesia، الحُمّة طبعًا، الـ
+
+206
+00:13:57,040 --> 00:14:01,520
+Fatigue، الـضعف، الـ Night Sweating، الـ التعرُق
+
+207
+00:14:01,520 --> 00:14:03,620
+الليلي، الـ Weight Loss، الـ Weight Losses، اللي
+
+208
+00:14:03,620 --> 00:14:09,860
+هو فقدان، الوزن، الـ Pulpation طبعًا، الـ أنا أحس
+
+209
+00:14:09,860 --> 00:14:14,220
+بإيدي، الـ Nausea and vomiting، Gastric Intestinal
+
+210
+00:14:14,220 --> 00:14:17,880
+Reflexes، إنه أنا أشوف اللي هو رد الفعل العكسي تبع
+
+211
+00:14:17,880 --> 00:14:23,860
+المعيدي المعوي، كمان مهمجدا أيضا من الحاجات اللي
+
+212
+00:14:23,860 --> 00:14:27,560
+أنا لازم أشوفها في ال assessment تبع ال medical
+
+213
+00:14:27,560 --> 00:14:30,800
+history ال specific cardiorespiratory system ال
+
+214
+00:14:30,800 --> 00:14:34,680
+allergic including seasonal and environmentalطبعا
+
+215
+00:14:34,680 --> 00:14:37,800
+الحساسية لأن اللي هم مرضى الربيع على سبيل المثال
+
+216
+00:14:37,800 --> 00:14:41,660
+اللي هو فصل الخريفة أو فصل الربيع مؤذى جدا لهم
+
+217
+00:14:41,660 --> 00:14:46,220
+ليه؟ لأنه طبعا مع الهواء بيكون في عندنا اللي هي
+
+218
+00:14:46,220 --> 00:14:49,820
+البذور أو بيكون في عندنا الأشياء اللي بتعمل حساسية
+
+219
+00:14:49,820 --> 00:14:54,780
+فبالتالي هي بتعملي مشكلة كبيرة في التنفس ممكن تؤدي
+
+220
+00:14:54,780 --> 00:14:58,980
+لحساسية ويتضايق المريض وممكن أناأخلّيه موجود على
+
+221
+00:14:58,980 --> 00:15:03,700
+تبخيرة أو أخلّيه يأخذ اللي هو Bronchodilators
+
+222
+00:15:03,700 --> 00:15:08,400
+موسّع للشعب الهوائي بعض الأدوية تمام أنه أنا ممكن
+
+223
+00:15:08,400 --> 00:15:11,160
+أشوف إذا فياخدها المريض عندي أو الانهيبتور زي
+
+224
+00:15:11,160 --> 00:15:15,240
+الـBT Blockers وبعض الأدوية اللي هنا ذاكرليها هي
+
+225
+00:15:15,240 --> 00:15:18,340
+مش مطلوبة منها في كمان أدوية خاصة بالـ Immunity
+
+226
+00:15:18,340 --> 00:15:23,840
+System أو ما يسمى بجهاز المناعة كمان كويس أنه أنا
+
+227
+00:15:24,160 --> 00:15:27,740
+أعطيها أو أكون عارفة المريض تبعي إيش بياخدها
+
+228
+00:15:27,740 --> 00:15:33,380
+الأدوية هنا مش مطلوبة معانا في ال assessment ال
+
+229
+00:15:33,380 --> 00:15:36,360
+medical condition frequency of colds and
+
+230
+00:15:36,360 --> 00:15:40,360
+respiratory infections كام مرة بتجي في اليوم اللي
+
+231
+00:15:40,360 --> 00:15:43,390
+هي ال influence العاديةخصوصا هذا الاشي مهم جدا
+
+232
+00:15:43,390 --> 00:15:46,070
+حاليا زي ما حكينا ان احنا في إجائحة كورونا
+
+233
+00:15:46,070 --> 00:15:49,490
+فبالتالي لإن لازم أعرف هل هو في عنده recent viral
+
+234
+00:15:49,490 --> 00:15:52,730
+infection او لا لأ ال joint pain and swelling ال
+
+235
+00:15:52,730 --> 00:15:55,690
+history of rheumatic fever هل عنده حمروماتيزم او
+
+236
+00:15:55,690 --> 00:16:02,140
+لأ؟ في عنده ورم في ال nasal او لأ؟في الجهة في
+
+237
+00:16:02,140 --> 00:16:06,000
+الجيوب الأمسية أو لأ أزمة، bronchitis، pneumonia،
+
+238
+00:16:06,000 --> 00:16:10,660
+chronic obstructive COPD كمان هذا حلو يأخذ عنه شرح
+
+239
+00:16:10,660 --> 00:16:14,340
+كبير طويل و عريض كمان نفس الشيء في الـ TB ومعظم
+
+240
+00:16:14,340 --> 00:16:19,080
+حالات اللي هي respiratory
+
+241
+00:16:19,080 --> 00:16:23,540
+disease الـ disability media اللي هي هل في عندهم
+
+242
+00:16:23,540 --> 00:16:28,300
+مشاكل طبعا نفس الكلام نكملها لزي sick fibrosisكلها
+
+243
+00:16:28,300 --> 00:16:31,560
+أمراض Respiratory هل هو في عنده بالأصل
+
+244
+00:16:31,560 --> 00:16:35,060
+Hypertension وضيابيته زي ما حكينا ناخد اللي هو ال
+
+245
+00:16:35,060 --> 00:16:37,780
+present و ال past history Thyroid disorders في
+
+246
+00:16:37,780 --> 00:16:41,920
+عنده مشاكل في الغد الدراقية أو لأ أيضا مشاكل القلب
+
+247
+00:16:41,920 --> 00:16:45,300
+اللي هو ال coronary heart disease اللي هي artery
+
+248
+00:16:45,300 --> 00:16:49,300
+disease أمراض القلب و ال angina و ال MI و ال
+
+249
+00:16:49,300 --> 00:16:52,920
+valval heart disease و down syndrome كل الأمور هذه
+
+250
+00:16:52,920 --> 00:16:56,260
+لازم انا اكون حاطهة عندي في عين الاعتبار بال
+
+251
+00:16:56,260 --> 00:16:59,700
+assessment اللي انابعمله لهذا المريض التبعي
+
+252
+00:17:01,380 --> 00:17:04,740
+بالمناصل أيضًا اللي هو في حالة ال admission ل ال
+
+253
+00:17:04,740 --> 00:17:08,680
+hospitals هل هو كان جايني بوضع طبيعي ولا جايني فيه
+
+254
+00:17:08,680 --> 00:17:12,640
+مثلًا كان unconscious ونقلوا الأهل لازم أنا أخد
+
+255
+00:17:12,640 --> 00:17:15,520
+بعين الاعتبار هذه الحاجات كلها ال date and result
+
+256
+00:17:15,520 --> 00:17:19,480
+of last context test and tuberculosis and chest x
+
+257
+00:17:19,480 --> 00:17:24,180
+-ray بشوف التاريخ ونتائج الحوصات اللي هو ال TB
+
+258
+00:17:24,180 --> 00:17:28,820
+اللي هو السلري أوي وكذلك الحوصات الإشاعية أو
+
+259
+00:17:28,820 --> 00:17:32,920
+الأشعة التشخيصية تبعت المريضاللي هو في نفس اليوم
+
+260
+00:17:32,920 --> 00:17:36,940
+اللي وصل فيهم هل أخد اللي هو blood transfusion تم
+
+261
+00:17:36,940 --> 00:17:39,820
+نقله حد دمله أو لا خصوصا في حالات ال cardio
+
+262
+00:17:39,820 --> 00:17:44,340
+respiratory system ال disease طبعا هدول الناس لازم
+
+263
+00:17:44,340 --> 00:17:47,900
+اعرف اذا كان كمان في عندهم family history لبعض
+
+264
+00:17:47,900 --> 00:17:51,240
+أمراض معينة خصوصا في حالات اللي هو ال cardio
+
+265
+00:17:51,240 --> 00:17:56,190
+disease other at homewith similar symptoms طبعاً
+
+266
+00:17:56,190 --> 00:17:59,550
+ممكن في أشخاص موجودين في البيت عندهم نفس الأعراض
+
+267
+00:17:59,550 --> 00:18:02,570
+أو لأ ال allergies أو ال topic اللي هي certain
+
+268
+00:18:02,570 --> 00:18:05,570
+allergics الhypersensitivity reaction هل عنده
+
+269
+00:18:05,570 --> 00:18:08,670
+حساسية من أي أدوية معينة طبعا هذه بنسأل عنها في ال
+
+270
+00:18:08,670 --> 00:18:13,090
+assessment هل هو بيعاني مثلا من حساسية لدواء معين
+
+271
+00:18:13,090 --> 00:18:16,110
+مثلا زي ما بتعرفوا في اللي هو test تبع الانسولين
+
+272
+00:18:16,110 --> 00:18:19,850
+ال penicillin alpha هذا ال test طبعا بنعمله لحالات
+
+273
+00:18:19,850 --> 00:18:25,830
+معينة انه هل في عندهم حساسية penicillin او لأأيضا
+
+274
+00:18:25,830 --> 00:18:28,970
+مكملين لباقى ال assessment في حالة ال cardio
+
+275
+00:18:28,970 --> 00:18:32,250
+pulmonary disease اللى هى الأزمة هل فى lung
+
+276
+00:18:32,250 --> 00:18:36,550
+cancers فى cystic fibrosis تلايه فرق اوى
+
+277
+00:18:36,550 --> 00:18:40,090
+bronchitis اللى هو التهاب الشعب الهوائى منه نوعين
+
+278
+00:18:40,090 --> 00:18:43,810
+ممكن أحيانا يكون chronic يعنى القديم و طبعا هنا
+
+279
+00:18:43,810 --> 00:18:47,570
+الوضع بيكونبحاجة إلى physiotherapy program لإنه
+
+280
+00:18:47,570 --> 00:18:51,430
+بيكون في عندنا secretion كتيرة وهو بحاجة إلى
+
+281
+00:18:51,430 --> 00:18:55,150
+physiotherapy session ده بيتسهل هو مليد سكري أو لا
+
+282
+00:18:55,150 --> 00:18:58,370
+أو شو نوع اللي هو السكري اللي عنده heart disease
+
+283
+00:18:58,370 --> 00:19:03,890
+طبعا الأمراض القلب زي ال hypertension ال ischemic
+
+284
+00:19:03,890 --> 00:19:07,990
+ال chronic rear disease و ال myocardial infarction
+
+285
+00:19:07,990 --> 00:19:13,130
+خصوصا في الفيميل لإن أعضاء الفيميل اللي هم طبعا
+
+286
+00:19:13,460 --> 00:19:18,500
+أكتر بيرضة من المال sudden death طبعا بدي أشوف هل
+
+287
+00:19:18,500 --> 00:19:24,060
+في العيلة في تاريخ مرضي لها اللي هو الحالات
+
+288
+00:19:24,060 --> 00:19:28,040
+اللي عندها أمرض قلب طبعا اللي هي dyslipidemia
+
+289
+00:19:28,040 --> 00:19:33,960
+صعوبة اللي هو ال .. صعوبة اللي هو ذوبان ال lipids
+
+290
+00:19:33,960 --> 00:19:36,560
+في الدم ها طبعا أو تراكم الدهون في الدم
+
+291
+00:19:36,560 --> 00:19:41,940
+hypertrophic cardiomyopathyطبعا هنا اتخم عضلة
+
+292
+00:19:41,940 --> 00:19:45,880
+القلب الكاذب هذا اللي هو من ال cardiac disease
+
+293
+00:19:45,880 --> 00:19:49,400
+اللي موجودة ان انا اخد بالي من اللي هو diagnosis
+
+294
+00:19:49,400 --> 00:19:53,320
+personal and social history في هنا اللي هو ال
+
+295
+00:19:53,320 --> 00:19:57,280
+personal and social history اللي هو التاريخ
+
+296
+00:19:57,280 --> 00:20:02,940
+العائلي والشخصي الاجتماعي هل هو smoking كام مرة و
+
+297
+00:20:02,940 --> 00:20:06,620
+كام package في اليوم هذا كمان بيأثر علي خصوصا في
+
+298
+00:20:06,620 --> 00:20:09,840
+ال cardiac diseaseExposure to second-hand smoking
+
+299
+00:20:09,840 --> 00:20:13,420
+أو إنه بتعرض لحد عنده تاني في البيت عندكم حد أي
+
+300
+00:20:13,420 --> 00:20:17,460
+حاجة بيدخن في البيت غيرك إذا كان فيه أو لأ Crowded
+
+301
+00:20:17,460 --> 00:20:21,080
+living conditions هل هو ساكن في أحياء على سبيل
+
+302
+00:20:21,080 --> 00:20:24,140
+الميزة المزحمة Poor personal and environmental
+
+303
+00:20:24,140 --> 00:20:26,620
+life اللي هو طبعا environmental cleanliness
+
+304
+00:20:26,620 --> 00:20:30,080
+الأحياء العشوائية تقريبا أو الناس اللي ما بيكون في
+
+305
+00:20:30,080 --> 00:20:34,360
+عندها تهوية جيدة Fight ناس بتتعرض لمشاكل كتيرة
+
+306
+00:20:34,360 --> 00:20:39,880
+High risk levelطبعا high stress level اللي هو وضع
+
+307
+00:20:39,880 --> 00:20:44,000
+أن نكون عايشين تحت ضغط طبعا سواء كان personal أو
+
+308
+00:20:44,000 --> 00:20:48,320
+occupational ال institutional living الوضع العام
+
+309
+00:20:48,320 --> 00:20:51,440
+للحالة تبعتنا ال occupational and environmental
+
+310
+00:20:51,440 --> 00:20:54,780
+conditions and exposure respiratory irritations
+
+311
+00:20:54,780 --> 00:20:59,600
+substance use وطبعا اللي هي هل انه على سبيل المثال
+
+312
+00:20:59,600 --> 00:21:04,280
+مضمن على الكحول او لا و الكافين و بعض الأدوية هل
+
+313
+00:21:04,280 --> 00:21:07,020
+بياخدها injections و لا inhalations على سبيل
+
+314
+00:21:07,020 --> 00:21:12,480
+المثال زي البخاخة تبع مرضى الرضو الأمراض المناع
+
+315
+00:21:12,480 --> 00:21:16,940
+الذاتية زي ال HIV هاي كمان مهم ان انا عارفها هل
+
+316
+00:21:16,940 --> 00:21:21,560
+الحالة اللي معايا obese ولا لأالـ .. طبعا ال
+
+317
+00:21:21,560 --> 00:21:24,480
+emigrations أو travel bored بتعرفوا الناس اللي
+
+318
+00:21:24,480 --> 00:21:27,460
+بتسافر كتير أو إيش زي هيك بدي أعرف هل هي مثلا
+
+319
+00:21:27,460 --> 00:21:32,620
+حاملة لمرض معين أو أنه مثلا اكتسبته من اللي هو ال
+
+320
+00:21:32,620 --> 00:21:36,520
+.. طبعا الإختلاط و الأماكن اللي crowded اللي هي
+
+321
+00:21:36,520 --> 00:21:41,490
+الأماكن المزحمةكمان مكملين بالـ Physical
+
+322
+00:21:41,490 --> 00:21:45,710
+Assessment اللي هو الـ Examination تبعنا للـ Air و
+
+323
+00:21:45,710 --> 00:21:48,670
+الـ Nose و الـ Throat اللي هو الأنف والأذن و
+
+324
+00:21:48,670 --> 00:21:53,650
+الحنجرة should be carried out because interlinked
+
+325
+00:21:53,650 --> 00:21:56,370
+اللي هو between the symptoms and sexual and
+
+326
+00:21:56,370 --> 00:21:58,910
+function to the lower respiratory tract طبعا لإن
+
+327
+00:21:58,910 --> 00:22:02,570
+كلها متصلة مع بعضها البعض فوان كان الأعلى ال
+
+328
+00:22:02,570 --> 00:22:05,070
+respiratory tract أو الlower respiratory tract
+
+329
+00:22:05,500 --> 00:22:11,580
+القبر اللى هو بيشمل الانف و الاصفجاس
+
+330
+00:22:11,580 --> 00:22:15,720
+و اللى هو ال pharynx و بينزل تحت على ال lower
+
+331
+00:22:15,720 --> 00:22:20,240
+بيشمل ال lungs و ال bronchi و ال bronchi و كل هذه
+
+332
+00:22:20,240 --> 00:22:23,060
+الحاجات اللى نسميها ال lower tract respiratory
+
+333
+00:22:23,060 --> 00:22:29,160
+tract تمام اللى هى أجزاء تنفسية سفنية مهم جدا اللى
+
+334
+00:22:29,160 --> 00:22:33,010
+أنا عارفهاشو ال vital signs تبعتي؟ لازم أجيس ترجد
+
+335
+00:22:33,010 --> 00:22:38,330
+الحرارة، ال pulse، النبض، ال respiratory rate، مدى
+
+336
+00:22:38,330 --> 00:22:42,450
+تشبع الأكسجين، ال blood pressure، ال peaky flow،
+
+337
+00:22:42,450 --> 00:22:47,030
+التنفس، كام صار عندنا، اللي هو من هاي كلها ال
+
+338
+00:22:47,030 --> 00:22:50,270
+vital signs اللي أنا لازم أاخدها بعين الاعتبار
+
+339
+00:22:51,890 --> 00:22:56,590
+المظهر العام هل هو جاين على المستشفى acutely أو
+
+340
+00:22:56,590 --> 00:22:59,710
+chronically طبعا يا إما بتكون لسه جديد على الوضع
+
+341
+00:22:59,710 --> 00:23:03,770
+أو ممكن تكون أجته اللي هي الذبحة مرة وتنتين ال
+
+342
+00:23:03,770 --> 00:23:06,910
+degree of discomfort أو comfort of distress طبعا
+
+343
+00:23:06,910 --> 00:23:11,070
+هي جداش هو جداش درجة الأرياحية أو جداش درجة شدة
+
+344
+00:23:11,070 --> 00:23:15,110
+القلم تبقى واضحة على الوجه تبع المريض ال position
+
+345
+00:23:16,280 --> 00:23:21,700
+to aid respiration اللي هو وضعية التنفس كيف من
+
+346
+00:23:21,700 --> 00:23:24,280
+أريحله الـ three part مثلا اللي حكينا عليها الـ
+
+347
+00:23:24,280 --> 00:23:27,700
+three point support هل هو على سبيل المثال بيرتاح
+
+348
+00:23:27,700 --> 00:23:33,740
+عليها أو بيرتاح و هو في وضعيته ال sitting position
+
+349
+00:23:33,740 --> 00:23:37,440
+إيش الوضعية اللي بيرتاح عليها في ال respiration ال
+
+350
+00:23:37,440 --> 00:23:40,600
+ability to speak normal and tense without stopping
+
+351
+00:23:40,600 --> 00:23:44,070
+and to take a breathقدرته على او ماقدرته على
+
+352
+00:23:44,070 --> 00:23:48,150
+الكلام لجمال طويلة او انه مثلا بيجي يحكي كلمة و
+
+353
+00:23:48,150 --> 00:23:52,150
+بيستنى ياخد نفس و بعدين بيكمل باقي الجملة و باخد
+
+354
+00:23:52,150 --> 00:23:55,350
+نفس و هكذا هذا بدل على ايش؟ انه انا في عندى مشكلة
+
+355
+00:23:55,350 --> 00:24:01,810
+في ال systemالـ color الوجهة بشكل عام، هل هو
+
+356
+00:24:01,810 --> 00:24:07,090
+cyanosis، redness، pink، عادي، مش فيه أي مشاكل، ال
+
+357
+00:24:07,090 --> 00:24:10,950
+nutritional status، وضعه بالنسبة لإيه هو التخزين
+
+358
+00:24:10,950 --> 00:24:15,770
+أو الغذاء، أكلت كويسة أو ما أكلش، مش فيه عنده مثلا
+
+359
+00:24:15,770 --> 00:24:18,570
+على سبيل المثال، هذا بدل على إن ال general
+
+360
+00:24:18,570 --> 00:24:23,720
+appearance إن هو مثلا مريض أو وضعهفي اللي هو تدهور
+
+361
+00:24:23,720 --> 00:24:27,060
+إذا عنده الـhydration status هل في عنده جثث
+
+362
+00:24:27,060 --> 00:24:31,140
+dehydration أو وضع اللي هو ترطيب الجلد مثلا أو
+
+363
+00:24:31,140 --> 00:24:35,160
+رطوبة الجلد أشوفها و أعرفها الـmental status هل هو
+
+364
+00:24:35,160 --> 00:24:39,880
+conscious، unconscious، blurim، هذيان أو إن هو
+
+365
+00:24:39,880 --> 00:24:44,940
+تقريبا فقد للوعي تماما كل هذه الأمور مهم جدا أنا
+
+366
+00:24:44,940 --> 00:24:51,110
+أعرفها بال inspection طبعا بالمعينة هيكونللـ
+
+367
+00:24:51,110 --> 00:24:54,890
+Colors، Cyanosis، هل في أنا عندي ذرفاق ولا لأ؟
+
+368
+00:24:54,890 --> 00:24:58,510
+Shape of Chest، طبعا شكل الصدر، هل هو صدر طبيعي
+
+369
+00:24:58,510 --> 00:25:03,210
+ولا فيه على سبيل المثال مشاكل وانخفاض في اللي هو
+
+370
+00:25:03,210 --> 00:25:07,810
+الـ sternum أو في ال ribs نفسهم، في عندنا الـ
+
+371
+00:25:07,810 --> 00:25:10,490
+bygone chest مثلا لتجري المثال في عندنا ال barrel
+
+372
+00:25:10,490 --> 00:25:14,490
+chest اللي هو الصدر البرميني، هذه الأمور مهم جدا
+
+373
+00:25:14,490 --> 00:25:18,930
+أنا عارفها. Symmetry of Chest Movementهل في تماثل
+
+374
+00:25:18,930 --> 00:25:23,570
+لـ right and left ولا اللي هو بيكون في مشكلة معينة
+
+375
+00:25:23,570 --> 00:25:26,530
+في lung واحدة ماقدرت تعمل full inspiration
+
+376
+00:25:26,530 --> 00:25:31,270
+فبالتالي هيعملي اللي هو علو في منطقة وانخفاض في
+
+377
+00:25:31,270 --> 00:25:38,890
+منطقة أخرى rate and rhythm طبعا معدل وانتظام
+
+378
+00:25:38,890 --> 00:25:42,690
+التنفس وعمق مهم جدا في حالة respiratory distress
+
+379
+00:25:42,690 --> 00:25:46,360
+syndromeأو حالات اللي هي صعوبات التنفس الـ
+
+380
+00:25:46,360 --> 00:25:50,080
+intercostal end drawing طبعاً بحكينا عليها أنه
+
+381
+00:25:50,080 --> 00:25:52,460
+ممكن يكون فيها أندي هبوط لبعض الـ intercostal
+
+382
+00:25:52,460 --> 00:25:55,960
+muscles أو الـ intercostal أو نفسها هي الـ costal
+
+383
+00:25:55,960 --> 00:25:59,740
+أو الـ rib بتكون منخفضة في بعض ال disease و ال rib
+
+384
+00:25:59,740 --> 00:26:02,960
+التانية بتكوناش أو ممكن تنتين يكونوا منخفضين مع
+
+385
+00:26:02,960 --> 00:26:07,240
+بعض هل بيستخدم التنفس و بيستخدم في ال mainly
+
+386
+00:26:07,240 --> 00:26:10,020
+respiratory muscles اللي هي ال diaphragm ولا
+
+387
+00:26:10,020 --> 00:26:14,090
+بيستخدمالاعدلات الـ Accessories هنا لازم انا اكون
+
+388
+00:26:14,090 --> 00:26:19,470
+طبعا مختبالي من هذا الموضوع المهم جدا ايضا باللذك
+
+389
+00:26:19,470 --> 00:26:22,870
+بال inspection لازم اشوف اللي هي ال precardium
+
+390
+00:26:22,870 --> 00:26:25,690
+visible اللي هي بال pulsation بدي اشوف كيف هو ال
+
+391
+00:26:25,690 --> 00:26:29,310
+pulsation باجي بحط ايدي و بجيت ال pulse كيف وضعه
+
+392
+00:26:29,310 --> 00:26:35,950
+او كم هي عدد النبضات في الدقيقة و بحسبهاالـ chest
+
+393
+00:26:35,950 --> 00:26:40,430
+wall scars طبعا ال brushing signs of trauma هل هو
+
+394
+00:26:40,430 --> 00:26:44,190
+أخد مثلا على سبيل المثال ضربة في الصدر في scar
+
+395
+00:26:44,190 --> 00:26:49,810
+tissue ولا فيش في عنده حكة أو لأ ال jugulars و
+
+396
+00:26:49,810 --> 00:26:54,750
+venous brushers بنجيس اللي هو ال brushers أو بنجيس
+
+397
+00:26:54,750 --> 00:26:59,170
+ال vein طبعا ال venous brushers أو ال vein
+
+398
+00:26:59,170 --> 00:27:04,490
+brushers من اللي هو وريد ال jugulars و ال color
+
+399
+00:27:04,960 --> 00:27:08,720
+طبعاً اللون اللي هي الملتحمة مهم جداً في العين هل
+
+400
+00:27:08,720 --> 00:27:13,940
+هي حمراء أو هل هي طبيعية بلونها الطبيعي Skin طبعاً
+
+401
+00:27:13,940 --> 00:27:18,080
+هل في مشكلة في الجلد أو لأ طفح جلي أو في عنده
+
+402
+00:27:18,080 --> 00:27:21,740
+إحمرار أو في عنده حكة أو في عنده حساسية لإشي معين
+
+403
+00:27:21,740 --> 00:27:27,360
+أيضاً بالإنسبيكشن ال extreme hand قديمة sinuses
+
+404
+00:27:27,360 --> 00:27:30,660
+flubbingبعض الأداة اللى بيبين عليها اللى هو ال
+
+405
+00:27:30,660 --> 00:27:34,460
+clubbing fingers هنا لازم أنا ألاحظهم طبعا ليش لأن
+
+406
+00:27:34,460 --> 00:27:40,240
+هذا بيكشفلي على أمور كتيرة feet and legsChanges in
+
+407
+00:27:40,240 --> 00:27:43,380
+foot and leg colors كمان في الـ Leg position على
+
+408
+00:27:43,380 --> 00:27:47,680
+سبيل المثال إنه ال patient إذا كانت أجره على سبيل
+
+409
+00:27:47,680 --> 00:27:51,160
+المثال هو جاعد على كرسي و أجريه في وضع dependent
+
+410
+00:27:51,160 --> 00:27:54,580
+position هنا بيعمل ليه طبعا تغيير في اللون
+
+411
+00:27:54,580 --> 00:27:58,760
+بالإضافة ل increasing القديمة اللي موجودة في ال
+
+412
+00:27:58,760 --> 00:28:03,020
+foot Blanching و ال elevation إذا أنا رفعته و نيمت
+
+413
+00:28:03,020 --> 00:28:06,560
+في وضع سبعي position و حاطيت مخدتين تحت رجليه هذا
+
+414
+00:28:06,560 --> 00:28:10,870
+بيخفف من القديمةو أيضا بيخفف من ألم الferricose
+
+415
+00:28:10,870 --> 00:28:14,550
+vein اللى هى التوالي طبعا تشيك ل ساكران إذا كان
+
+416
+00:28:14,550 --> 00:28:18,590
+المريض بترددن أكيد طبعا إذا كان المريض بترددن لازم
+
+417
+00:28:18,590 --> 00:28:22,470
+أشيك إذا فى big sore خصوصا فى منطقة الساكران لإنها
+
+418
+00:28:22,470 --> 00:28:27,650
+بوني ماركنج فبالتالي ممكن يعملى اللى هو big sore و
+
+419
+00:28:27,650 --> 00:28:31,290
+هنا أدخل فى مشاكل تانية و أنا مابديها لإن الموقع
+
+420
+00:28:31,290 --> 00:28:33,850
+الحالى لسه أحب نعالج cardio pulmonary disease
+
+421
+00:28:35,160 --> 00:28:37,460
+بالنسبة لل colors ال pigmentation أو ال
+
+422
+00:28:37,460 --> 00:28:40,780
+discolorations اللي بيصير و distributions of hair
+
+423
+00:28:40,780 --> 00:28:45,060
+اللي هو بعض الأحيان في حالة ال varicose veins
+
+424
+00:28:45,060 --> 00:28:49,440
+بيصير في عنا عدم نمو لشعر القدم ليه؟ لإنه بيكون ال
+
+425
+00:28:49,440 --> 00:28:55,140
+skin shy، لامع، فبالتالي صعب إنه ينمو هنا شعر لإنه
+
+426
+00:28:55,140 --> 00:28:58,780
+في عنا varicose veins هنا أنا باخد بالي من ال foot
+
+427
+00:28:58,780 --> 00:29:04,160
+و ال legفده الوضع ال palpations اللي هو الإحساس
+
+428
+00:29:04,160 --> 00:29:07,780
+طبعا بدي أشوف بال palpations بالإحساس أشوف
+
+429
+00:29:07,780 --> 00:29:11,400
+التراكيا ال position هل التراكيا قصب الهوائية في
+
+430
+00:29:11,400 --> 00:29:14,920
+موقعها midline ولا جاية هيك أو رايحة هيك لأ لازم
+
+431
+00:29:14,920 --> 00:29:19,040
+أعرف كدهش اللي هي التراكيا وين موقعها chest wall
+
+432
+00:29:19,040 --> 00:29:23,480
+tenderness or crevitas هل في عندنا اللي هو
+
+433
+00:29:23,480 --> 00:29:27,800
+crevitas اللي هي تقطقة في السدر tenderness ألان بس
+
+434
+00:29:27,800 --> 00:29:31,490
+أنا مجرد ما أمسك السدريصير في عنده ألم المريض الـ
+
+435
+00:29:31,490 --> 00:29:35,450
+Respiratory Excretions طبعا اللي هي التنفس و
+
+436
+00:29:35,450 --> 00:29:38,910
+ثروبته هل أنا حاسه لما أحط أيدي على صدر المريض
+
+437
+00:29:38,910 --> 00:29:43,690
+حاسه ولا لأ التكتر ده Tectile Dermatosis خفقان
+
+438
+00:29:43,690 --> 00:29:46,970
+الصدر أثناء الكلام تلاحظ مثلا زي ما حكينا قبل شوق
+
+439
+00:29:46,970 --> 00:29:50,830
+أنه بيحكي كلمتين و بعدين بيواجهبيصير يلحث من اللي
+
+440
+00:29:50,830 --> 00:29:56,010
+هو الحكي مع اللي هو لإنه بيكون قدّى مجهود و هو مش
+
+441
+00:29:56,010 --> 00:29:59,630
+قادر ياخد النفس ال spinal abnormalities بتشوف إذا
+
+442
+00:29:59,630 --> 00:30:03,390
+في عندي scoliosis أو أي deformity أنا لازم أاخد
+
+443
+00:30:03,390 --> 00:30:07,050
+بالي منها بال probation ال nodes طبعا إذا كان في
+
+444
+00:30:07,050 --> 00:30:09,630
+عندي أي مشاكل في ال axillary nodes في
+
+445
+00:30:09,630 --> 00:30:12,910
+السبقravicular أو ال cervical nodes ال masses هل
+
+446
+00:30:12,910 --> 00:30:17,340
+إنه في كتل أو لأ ال medical beats طبعااللي هي
+
+447
+00:30:17,340 --> 00:30:22,820
+النبضة أو الـ beat اللي هي السطحية، هل في .. اللي
+
+448
+00:30:22,820 --> 00:30:28,700
+هو كيف على سبيل المثال بدي أفحص الدربات القلب الـ
+
+449
+00:30:28,700 --> 00:30:33,960
+hematoma الـ hepatomegaly اللي هو كبر حجم الكبد
+
+450
+00:30:33,960 --> 00:30:40,340
+right upper في الرُبع الأعلى الأيمن tenderness
+
+451
+00:30:40,340 --> 00:30:44,120
+طبعا بيكون في ألام الرُبع الأعلى الأيمنأساس للـ
+
+452
+00:30:44,120 --> 00:30:48,140
+peripheral طبعا بقيّم كل إشي و خصوصا الإديمة في
+
+453
+00:30:48,140 --> 00:30:52,240
+حالات ال cardio بالmonary disease تمام؟ هيك بيكون
+
+454
+00:30:52,240 --> 00:30:57,700
+طبعا أنا بال validation حسيت الأطراف مع كل إدم
+
+455
+00:30:57,700 --> 00:31:02,820
+السماء هنا percussions لل lung fields resonance،
+
+456
+00:31:02,820 --> 00:31:06,460
+بدي أسمع النغمة كيف؟ طبعا هل هي فيها هواء ولا مش
+
+457
+00:31:06,460 --> 00:31:10,420
+فيها هواء؟Increasing loneliness over hyperinflated
+
+458
+00:31:10,420 --> 00:31:14,220
+area طبعا زيادة النغمة أو زيادة اللي هو resonance
+
+459
+00:31:14,220 --> 00:31:18,340
+في الصوت اللي انا بدى اسمعه معناه الكلام في حالات
+
+460
+00:31:18,340 --> 00:31:21,480
+الـ over hyperinflated area الـ dullness to
+
+461
+00:31:21,480 --> 00:31:24,780
+percussion الـ dullness اللي هو بدى يرتد الصوت مرة
+
+462
+00:31:24,780 --> 00:31:28,540
+أخرى over area consolidation location and
+
+463
+00:31:28,540 --> 00:31:34,350
+excursions لدفرام موقع وانحرافالعضلة الأساسية في
+
+464
+00:31:34,350 --> 00:31:38,390
+التنفس اللي هي diaphrag muscles هل هي في موقعها
+
+465
+00:31:38,390 --> 00:31:45,230
+ولا ميخدة موقع آخر نتيجة ال respiratory problem ال
+
+466
+00:31:45,230 --> 00:31:48,790
+escalations of lung تمام بالسمعاء listening to the
+
+467
+00:31:48,790 --> 00:31:49,510
+sound of air
+
+468
+00:31:54,680 --> 00:32:00,300
+عشان انا اتعلم
+
+469
+00:32:00,300 --> 00:32:05,540
+عشان
+
+470
+00:32:05,540 --> 00:32:08,860
+انا اتعلم
+
+471
+00:32:08,860 --> 00:32:14,580
+عشان
+
+472
+00:32:14,580 --> 00:32:17,440
+انا اتعلم عشان انا اتعلم عشان انا اتعلم عشان انا
+
+473
+00:32:17,440 --> 00:32:18,780
+اتعلم عشان انا اتعلم عشان انا اتعلم عشان انا اتعلم
+
+474
+00:32:18,780 --> 00:32:18,780
+عشان انا اتعلم عشان انا اتعلم عشان انا اتعلم عشان
+
+475
+00:32:18,780 --> 00:32:18,780
+انا اتعلم عشان انا اتعلم عشان انا اتعلم عشان انا
+
+476
+00:32:18,780 --> 00:32:18,780
+اتعلم عشان انا اتعلم عشان انا اتعلم عشان انا اتعلم
+
+477
+00:32:18,780 --> 00:32:18,780
+عشان انا اتعلم عشان انا اتعلم عشان انا اتعلم عشان
+
+478
+00:32:18,780 --> 00:32:20,180
+انا اتعلم عشان انا اتعلم عشان انا اتعdegree of air
+
+479
+00:32:20,180 --> 00:32:24,200
+entry throughout the chest جداش درجة دخول الهواء
+
+480
+00:32:24,200 --> 00:32:27,980
+أو كمية الهواء اللى ممكن تشوف should be equal لازم
+
+481
+00:32:27,980 --> 00:32:32,440
+تكون متساوية ثم ال quality of breath sounds ratio
+
+482
+00:32:32,440 --> 00:32:38,200
+في ال inspiration و ال expirationمدى اللى هو ratio
+
+483
+00:32:38,200 --> 00:32:43,200
+المعدل تبع دخول النفس او corgio اللى هو المعدل ما
+
+484
+00:32:43,200 --> 00:32:47,520
+بين الشهيق و الزفير ال advisors اللى هو الأصوات
+
+485
+00:32:47,520 --> 00:32:51,800
+العرضية زى اللى هو المصاحبة على سبيل المثال زى
+
+486
+00:32:51,800 --> 00:32:55,680
+اللى هى Hakana Louise الصفير و grackles طبعا اللى
+
+487
+00:32:55,680 --> 00:32:59,780
+هى rails و ال plural ups بعض اللى هى الأصوات
+
+488
+00:32:59,780 --> 00:33:05,020
+الناتجة عن مشاكل فى التنفس الاستردار طبعاو بتقلل
+
+489
+00:33:05,020 --> 00:33:07,940
+ال breathing sound لإنه ممكن يكون في عناء اللي هو
+
+490
+00:33:07,940 --> 00:33:14,760
+إيش بيأيق النفس الطبيعي تمام ال escalations of
+
+491
+00:33:14,760 --> 00:33:20,000
+hair of heart اللي هو اللهم صلي على سيدنا محمد
+
+492
+00:33:20,000 --> 00:33:23,760
+سماع ضربات القلب زي ما حكينا بالنسبة للتنخس لازم
+
+493
+00:33:23,760 --> 00:33:27,620
+أنا أعرف ال normal عشان أحدد فيما بعد اللي هو ال
+
+494
+00:33:27,620 --> 00:33:32,090
+abnormal ال escalated at a vertexطبعا ال «Balmanic
+
+495
+00:33:32,090 --> 00:33:38,130
+Airpoint» و «Tricuspid» و «الصمام المترالي»
+
+496
+00:33:38,130 --> 00:33:42,050
+attempt to identify لازم انا اللي هو بال
+
+497
+00:33:42,050 --> 00:33:46,790
+«Escalation» او بالصناعة تبعتي اكون عارفة اسمع
+
+498
+00:33:46,790 --> 00:33:49,610
+كويس وين او وين بدي احطه او ايش اللي بدي احطه عشان
+
+499
+00:33:49,610 --> 00:33:55,190
+اسمعه rate and rhythm المعدل و الانتظام تبعه كيف
+
+500
+00:33:55,190 --> 00:33:59,860
+انغمعت هل هي ال rhythm تبعه نبضة بنبضتها ولاممكن
+
+501
+00:33:59,860 --> 00:34:03,920
+ينبض مرة و بعدين يسكت S1 and S2 sounds of their
+
+502
+00:34:03,920 --> 00:34:09,400
+intensity طبعا اللي هنا ventricle and artrium نحكي
+
+503
+00:34:09,400 --> 00:34:14,040
+عليهم اللي هو البطين و الأذين و ال S1 في عنا S1 S2
+
+504
+00:34:14,040 --> 00:34:19,240
+S3 S4 قادة لل heart sound اللي هو raps و splinting
+
+505
+00:34:19,240 --> 00:34:23,780
+of S2 المرمرز إذا في عنده مرمرز أو لأ طبعا و ال
+
+506
+00:34:23,780 --> 00:34:28,080
+escalations ال carotid artery و الabdomen الأورطةو
+
+507
+00:34:28,080 --> 00:34:31,800
+الـ renal artery و الـ iliac arteries بعض اللي هي
+
+508
+00:34:31,800 --> 00:34:36,440
+الشرايين المهمة جدا و الفمورا الارتري طبعا لازم
+
+509
+00:34:36,440 --> 00:34:40,340
+هنا أشوفهم و أشيك عليهم و أسمعهم بيه لإن هذه
+
+510
+00:34:40,340 --> 00:34:45,580
+الشرايين عبارة عن شرايين كبيرة و مهمة ال
+
+511
+00:34:45,580 --> 00:34:50,380
+associated symptoms بعض اللي هي الأعراض المصاحبة
+
+512
+00:34:50,380 --> 00:34:54,780
+complete respiratory assessment include airنوز
+
+513
+00:34:54,780 --> 00:34:58,200
+سبعتيل ENT زى ما بتعرفوا الدكتور قام فى أذنه
+
+514
+00:34:58,200 --> 00:35:01,900
+الحنجرة لازم يكمل considers لال interest special
+
+515
+00:35:01,900 --> 00:35:06,340
+او ال interest in ال gastric intestinal اللى هى مع
+
+516
+00:35:06,340 --> 00:35:10,440
+دماغى او ال genitouria او ال genitourinary اللى
+
+517
+00:35:10,440 --> 00:35:13,940
+هوا المسالك البولية assistants if appropriated اذا
+
+518
+00:35:13,940 --> 00:35:19,480
+انا محتاجاهم بقى استعين فيهم symptoms الفيقونتي
+
+519
+00:35:19,480 --> 00:35:25,000
+اللى هوا الفيقونتينreferral to consultation إيش هو
+
+520
+00:35:25,000 --> 00:35:29,060
+الأعراض اللي مهمة جدا أنه أنا لما بدي أشوفها على
+
+521
+00:35:29,060 --> 00:35:32,760
+طول بدي أحاوله على ال consultation severe
+
+522
+00:35:32,760 --> 00:35:36,780
+discipline and inability to lie flat شخص جانبي
+
+523
+00:35:36,780 --> 00:35:40,850
+يعاني من صعوبات في التنفسبالإضافة لأنه مش قادر
+
+524
+00:35:40,850 --> 00:35:43,970
+ينام على ظهره بتاعته، ليه؟ لأنه في صعوبة في
+
+525
+00:35:43,970 --> 00:35:48,050
+التنفس، الابيضة to speak or fragmented speech اللي
+
+526
+00:35:48,050 --> 00:35:52,310
+هم عدم القطر على الكلام أو بيحكي كلمة وبيوجف دقيقة
+
+527
+00:35:52,310 --> 00:35:55,150
+على سبيل المثال، ال track يا فيها shifting، يا
+
+528
+00:35:55,150 --> 00:35:58,150
+علييمين، يا عليسار، هذه كمان علامة مميزة ومهمة جدا
+
+529
+00:35:58,150 --> 00:36:02,110
+إن أنا أحاوله لاقل استشارة، unrelieved chest pain
+
+530
+00:36:02,600 --> 00:36:07,840
+الـ chest pain ما صار فيه أي شفاء ليش كان بيجعوا
+
+531
+00:36:07,840 --> 00:36:10,900
+مثلا أجاني الأسبوع الأول و بعد ذلك أجاني بعد أسبوع
+
+532
+00:36:10,900 --> 00:36:15,020
+ما زال اللي هو صدره بيجعوا unable to maintain طبعا
+
+533
+00:36:15,020 --> 00:36:21,780
+اللي هو saturation of oxygen greater than 92% on
+
+534
+00:36:21,780 --> 00:36:25,440
+room air severe increasing fatigue طبعا لازم اللي
+
+535
+00:36:25,440 --> 00:36:29,480
+هو saturation of oxygen أو معدل تركيز ال oxygen في
+
+536
+00:36:29,480 --> 00:36:33,060
+الدم مهم جدا أنا دايما أكون أعرفهالـ cyanosis هل
+
+537
+00:36:33,060 --> 00:36:38,300
+هو central ولا peripheral؟ هل إنه ناتج عن إشي مهم
+
+538
+00:36:38,300 --> 00:36:42,160
+central cyanosis is not predictable until oxygen؟
+
+539
+00:36:42,160 --> 00:36:46,140
+طبعا إنه لازم أعرف إذا كان هذا الـ cyanosis أو هذا
+
+540
+00:36:46,140 --> 00:36:50,840
+الإزرقاق ناتج عن إشي central أو peripheral؟
+
+541
+00:36:53,510 --> 00:36:58,890
+الـ saturation is less than 85% هذا أنا بخافي منه،
+
+542
+00:36:58,890 --> 00:37:02,430
+ليش؟ خصوصا الآن بتسمع أن بولك فلان عايش عداء ال
+
+543
+00:37:02,430 --> 00:37:06,370
+oxygen نتيجة لا إقصابته بالـ COVID-19 فبنتي عليه
+
+544
+00:37:06,370 --> 00:37:09,750
+كمية ال saturation أو مدة تشبع في ال oxygen مهم
+
+545
+00:37:09,750 --> 00:37:13,420
+جداsilent chest or cricles without lung fields
+
+546
+00:37:13,420 --> 00:37:17,300
+طبعا اللي هو الـ silent chest اللي هو الصدر الغير
+
+547
+00:37:17,300 --> 00:37:21,140
+متحرك وما بيكون فيه حركة لل lungs في ال
+
+548
+00:37:21,140 --> 00:37:23,400
+inspiration و ال expiration فبالتالي بتكون ضعيفة
+
+549
+00:37:23,400 --> 00:37:27,560
+جدا اللي هو دخول وخروج الهواء decrease لل level of
+
+550
+00:37:27,560 --> 00:37:30,500
+consciousness إذا كان في عندي مشكلة في درجة الوعي
+
+551
+00:37:30,500 --> 00:37:34,680
+يعني أنا بحكي مع الحالة و هي دخلت في أمور تانية أو
+
+552
+00:37:34,680 --> 00:37:37,740
+بدت تفقد الوعي أمامي diminish the respiratory
+
+553
+00:37:37,740 --> 00:37:44,090
+effort يعنيمجهود يبدو ياخد نفس بس على الفاضي مافي
+
+554
+00:37:44,090 --> 00:37:48,850
+مجال ياخد هذا النفس ليش؟ لإنه في عنده مشكلة في أخذ
+
+555
+00:37:48,850 --> 00:37:53,510
+النفس nasal flaring أو tracheal tube اللي هو تمدد
+
+556
+00:37:53,510 --> 00:37:56,670
+الأنف هذا بيصير ليش؟ كعملية تعوضي أو لـ Tracheal
+
+557
+00:37:56,670 --> 00:38:00,090
+Tag بيصير عملية تعوضية على أساس إنه يقدر ياخد أو
+
+558
+00:38:00,090 --> 00:38:03,510
+يحصل أكبر كمية من الـ Oxygen ولكن للأسف هي عبارة
+
+559
+00:38:03,510 --> 00:38:07,090
+عن compensatory process عملية تعوضي بيحاول ياخد
+
+560
+00:38:07,090 --> 00:38:11,190
+منها بعرف إنه أنا هنا في عندي مشكلةو لازم حلها ال
+
+561
+00:38:11,190 --> 00:38:13,950
+intercostal in drawing زي اللي احنا جاينها هو ببوط
+
+562
+00:38:13,950 --> 00:38:18,370
+بعض اللي هو ال intercostal طبعا و اللي هي ال ribs
+
+563
+00:38:18,370 --> 00:38:20,930
+اللي موجودة عليها recent hospitalization for
+
+564
+00:38:20,930 --> 00:38:24,090
+congestive heart failure طبعا انه طالع من المستشفى
+
+565
+00:38:24,090 --> 00:38:28,650
+الجديد مع اللي هو congestive heart failure اللي هو
+
+566
+00:38:28,650 --> 00:38:35,040
+فشل في عضلة القلب و احتقانها تمام هذا انا بخافعليه
+
+567
+00:38:35,040 --> 00:38:38,600
+وعلى طول اي signs او symptoms تحوله على ال
+
+568
+00:38:38,600 --> 00:38:42,800
+consultation يعطيكوا ألف عافية وبهيك نكون خلصنا
+
+569
+00:38:42,800 --> 00:38:46,420
+أول chapter في ال cardio pulmonary symptoms او ال
+
+570
+00:38:46,420 --> 00:38:49,640
+cardio pulmonary assessment ألقاكم بإذن الله في
+
+571
+00:38:49,640 --> 00:38:53,600
+فيديو آخر في حالات ال cardiac disease و ال
+
+572
+00:38:53,600 --> 00:38:58,380
+physiotherapy sessions سبعتهم السلام عليكم ورحمة
+
+573
+00:38:58,380 --> 00:38:59,140
+الله وبركاته
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/f2ecvqQQ8us.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/f2ecvqQQ8us.srt
new file mode 100644
index 0000000000000000000000000000000000000000..aa0cc0efddbb6e9df64a00f23a51ad15f7357b0a
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/f2ecvqQQ8us.srt
@@ -0,0 +1,2021 @@
+1
+00:00:01,080 --> 00:00:03,660
+أحمد الرحيم والصلاة والسلام على أشرف الأنبياء
+
+2
+00:00:03,660 --> 00:00:08,760
+والمرسلين.  تكلّمنا في الـ ICU part 1 عن منهم المرضى
+
+3
+00:00:08,760 --> 00:00:14,460
+الذين يحق لهم دخول قسم العناية المركزة، وإيش دور الـ
+
+4
+00:00:14,460 --> 00:00:18,900
+physiotherapy في هذه المرحلة. الآن سأكمل role of
+
+5
+00:00:18,900 --> 00:00:23,140
+physiotherapy لحالات الـ ICU.  كذلك سأتحدث عن
+
+6
+00:00:23,140 --> 00:00:27,020
+أنواع وأشكال الـ catheters والـ tubes اللي ممكن
+
+7
+00:00:27,020 --> 00:00:32,370
+أتعامل معها. أكمل معكم في فيديو رقم 9 بإذن الله.
+
+8
+00:00:32,370 --> 00:00:34,610
+ننطلق على بركة الله.
+
+9
+00:00:42,290 --> 00:00:46,530
+الـ suction catheters. في منها أشكال مختلفة وأحجام
+
+10
+00:00:46,530 --> 00:00:51,470
+مختلفة. الـ tip design تبعها straight أو curved. أيضًا،
+
+11
+00:00:51,470 --> 00:00:55,570
+الـ material تبعتها مصنوعة من PVC، وكانت مرت علينا
+
+12
+00:00:55,570 --> 00:00:59,090
+قبل ذلك، أو من الـ rubber.  الـ number of side holes
+
+13
+00:00:59,090 --> 00:01:02,210
+اللي هو عدد الفتحات اللي موجودة في هذا التيوب، ممكن
+
+14
+00:01:02,210 --> 00:01:07,010
+تكون فتحة واحدة أو عدة فتحات. الـ size له أحجام مختلفة، و
+
+15
+00:01:07,010 --> 00:01:12,290
+طول مختلف، وحسب الهدف اللي أنا بدّي إياه. أيضًا، تبكيتِها
+
+16
+00:01:12,290 --> 00:01:15,630
+والـ packaging تبعتها، يا إما بتكون Straight أو
+
+17
+00:01:15,630 --> 00:01:21,050
+Curved، يا إما بتكون بشكل مستقيم أو جاية بشكل
+
+18
+00:01:21,050 --> 00:01:28,430
+حلزوني. موجودة في بكيتات، ومعقّمة، ومؤلّفة. بالنسبة للـ
+
+19
+00:01:28,430 --> 00:01:33,110
+design تبعها، بيحكي إن الـ curved is better than
+
+20
+00:01:33,110 --> 00:01:38,530
+straight. ليه؟ لأن الـ curved ممكن يدخلي إلى داخل الـ
+
+21
+00:01:38,530 --> 00:01:42,070
+term of bronchus، يعني إلى داخل جذع الشعيبات
+
+22
+00:01:42,070 --> 00:01:45,590
+الهوائية الموجودة داخل الـ lungs. هلأ، الـ catheters
+
+23
+00:01:45,590 --> 00:01:50,980
+اللي مصنوعة من الـ PVC أفضل من الـ rubber. ليه؟ أو
+
+24
+00:01:50,980 --> 00:01:54,820
+ممكن احنا كأخصائيين، أو ممكن احنا كأطباء بنفضّلها
+
+25
+00:01:54,820 --> 00:02:00,100
+للاتّالي: أول شيء، they are less likely to cause
+
+26
+00:02:00,100 --> 00:02:04,700
+irritation. بتسبب irritation ولكن بشكل بسيط جدًا، مش
+
+27
+00:02:04,700 --> 00:02:10,810
+مثل اللي هو الـ rubber. ثاني شيء، أنه أي شيء بيكون
+
+28
+00:02:10,810 --> 00:02:15,670
+داخلها ممكن ملاحظته. هلأ، إذا أنا بدي أسحب إفرازات، و
+
+29
+00:02:15,670 --> 00:02:19,270
+أعمل suction، لازم أشوف شو لون، أو الـ color تبع الـ
+
+30
+00:02:19,270 --> 00:02:22,470
+secretion، حتى أحدد، يعني إذا كان yellow، معناته فيه
+
+31
+00:02:22,470 --> 00:02:24,830
+infection. إذا كان فيه bleeding، بدي أخاف من حاجات
+
+32
+00:02:24,830 --> 00:02:30,870
+ثانية. إذا الـ color تبع الـ secretions
+
+33
+00:02:30,870 --> 00:02:36,130
+as they are clear، تمام. الـ issue الثالث والأخير، أنه
+
+34
+00:02:36,130 --> 00:02:40,130
+هذه الـ PVC easier in insertion and can be directed
+
+35
+00:02:40,130 --> 00:02:44,710
+more easily. طبعًا، سهولة استخدامها بتخلّينا احنا
+
+36
+00:02:44,710 --> 00:02:49,790
+نفضّلها دائمًا، وأبدًا في استخدامها، تمام. شو الـ
+
+37
+00:02:49,790 --> 00:02:53,630
+complications اللي أنا ممكن تصير عندي نتيجة الـ
+
+38
+00:02:53,630 --> 00:02:58,330
+tracheal suction؟ تمام. أنا الآن عندي مريض في الـ ICU
+
+39
+00:02:58,330 --> 00:03:04,530
+مركّب ترايكستومي. بدي أفتح أنبوب التراكستومي، وأعمل
+
+40
+00:03:04,530 --> 00:03:10,150
+suction، عشان أعمل remove. الآن، هذا الشيء
+
+41
+00:03:10,150 --> 00:03:14,370
+هيعمل لي مجموعة من الـ complications، اللي منها
+
+42
+00:03:14,370 --> 00:03:19,350
+Hypoxemia (نقص في الأكسجين)، Arrhythmia، Cardiac
+
+43
+00:03:19,350 --> 00:03:23,070
+Arrest. في حوالي خمسة من الـ complications. خليني
+
+44
+00:03:23,070 --> 00:03:25,810
+أشوفهم واحدة واحدة. الـ Hypoxemia، الـ pre-
+
+45
+00:03:25,810 --> 00:03:29,010
+oxygenation هي مرحلة انتقالية من الـ Hypoxemia
+
+46
+00:03:29,010 --> 00:03:34,330
+إلى مرحلة دماغية. وكل مرحلة من الانتقالات هي محدودة
+
+47
+00:03:34,330 --> 00:03:39,670
+لفترة من 15 ثانية. لأن الـ Hypoxemia ليش بده يصير؟
+
+48
+00:03:39,670 --> 00:03:42,810
+لأنه بيصير في عندنا كمية من الـ irritation. المريض
+
+49
+00:03:42,810 --> 00:03:48,150
+بيحبس نفسه، وبالتالي ممكن يحصل عندنا اختناق وقلة في
+
+50
+00:03:48,150 --> 00:03:52,930
+الـ oxygen saturation. بلاحظه مباشرة على المونيتور،
+
+51
+00:03:52,930 --> 00:03:56,140
+إذا كان المريض مشبوك على المونيتور. الـ Arrhythmia اللي هي
+
+52
+00:03:56,140 --> 00:04:00,520
+عبارة عن الـ atrial، أو بسمّيها increasing في الـ
+
+53
+00:04:00,520 --> 00:04:05,920
+atrial pumping. بدها تحصل في عندي أحيانًا during suction
+
+54
+00:04:05,920 --> 00:04:08,660
+process، from two sources. نتيجة الـ atrial
+
+55
+00:04:08,660 --> 00:04:13,220
+Hypoxemia، والـ vagal stimulation. لأن بدها تحصل
+
+56
+00:04:13,220 --> 00:04:18,260
+الـ Arrhythmia نتيجة الـ atrial Hypoxemia، leading
+
+57
+00:04:18,260 --> 00:04:22,670
+to myocardial hypoxia. الـ vagal stimulation
+
+58
+00:04:22,670 --> 00:04:27,490
+secondary to tracheal irritation، نتيجة للّي هو
+
+59
+00:04:27,490 --> 00:04:31,230
+الهياج أو الـ irritation، التأثير اللي أحدثه
+
+60
+00:04:31,230 --> 00:04:35,370
+دخول التيوب وخروجه. This complication can best be
+
+61
+00:04:35,370 --> 00:04:38,770
+avoided by appropriate technique. أنا ممكن أمنعها
+
+62
+00:04:38,770 --> 00:04:42,750
+بأن أحصل على تقنية أخرى، أعمل فيها suction، ولكن من
+
+63
+00:04:42,750 --> 00:04:47,950
+غير ما أفوت تيوب داخل الـ track. يعني، الـ complication
+
+64
+00:04:47,950 --> 00:04:51,730
+الثالثة، اللي هو في عندي high potential، بدها توصل
+
+65
+00:04:51,730 --> 00:04:56,370
+المريض إلى اللي هو ارتفاع في ضغط الدم تبعه، هيدخل في
+
+66
+00:04:56,370 --> 00:04:59,530
+high potential. ليه؟ إما بيكون ناتج عن الـ
+
+67
+00:04:59,530 --> 00:05:04,020
+profound bradycardia resulting، ناتجة عن الـ vagal
+
+68
+00:05:04,020 --> 00:05:07,120
+stimulation اللي أنا حكيت عليه قبل قليل، أو نتيجة
+
+69
+00:05:07,120 --> 00:05:09,500
+الـ prolonged coughing maneuver during suction
+
+70
+00:05:09,500 --> 00:05:13,060
+process. طبعًا، احنا حاولنا أن ندخل التيوب داخل
+
+71
+00:05:13,060 --> 00:05:16,820
+التراكيا، هذا هيعمل لي irritation، تمام؟ وأكيد شفته
+
+72
+00:05:16,820 --> 00:05:20,500
+طبعًا في التجارب العملية. كيف ممكن هذا المريض إنه
+
+73
+00:05:20,500 --> 00:05:23,900
+يعمل لي irritation، أو أي مريض في الـ ICU، بـ suction
+
+74
+00:05:23,900 --> 00:05:27,140
+الـ tube، وأنا بدخّل وبفوت فيها، بصير في عندنا
+
+75
+00:05:27,140 --> 00:05:29,600
+coughing. هذه الـ coughing نفسها بتعمل على
+
+76
+00:05:29,600 --> 00:05:34,390
+الـ Hypoxemia والـ Hypotension. الـ Hypoxemia والـ
+
+77
+00:05:34,390 --> 00:05:37,330
+Hypotension. هي أفضل تقنيات... تقنية... تقنية... تقنية...
+
+78
+00:05:37,330 --> 00:05:37,810
+تقنية... تقنية... تقنية... تقنية... تقنية... تقنية... تقنية...
+
+79
+00:05:37,810 --> 00:05:41,690
+تقنية... تقنية... تقنية... تقنية... تقنية... تقنية... تقنية...
+
+80
+00:05:41,690 --> 00:05:43,750
+تقنية... تقنية... تقنية... تقنية... تقنية... تقنية... تقنية...
+
+81
+00:05:43,750 --> 00:05:44,030
+تقنية... تقنية... تقنية... تقنية... تقنية... تقنية... تقنية...
+
+82
+00:05:44,030 --> 00:05:44,370
+تقنية... تقنية... تقنية... تقنية... تقنية... تقنية... تقنية...
+
+83
+00:05:44,370 --> 00:05:48,010
+تقنية... تقنية... تقنية...
+
+84
+00:05:48,010 --> 00:05:53,810
+تقنية... تقنية...  في البداية، أخليه ياخد كمية كافية من
+
+85
+00:05:53,810 --> 00:05:58,470
+الأكسجين، حتى ما تخبط عندي نسبة الأكسجين. ثاني شيء،
+
+86
+00:05:58,470 --> 00:06:01,750
+limit the suction process من 10 إلى 15 ثانية، مش
+
+87
+00:06:01,750 --> 00:06:05,870
+أكثر من هيك، عشان أنا ما بدّي أفوّت المريض في مضاعفات.
+
+88
+00:06:05,870 --> 00:06:11,180
+وبعد ذلك،  يُفضّل أن يكون هناك مراقبة دقيقة close للـ
+
+89
+00:06:11,180 --> 00:06:13,800
+cardiac monitoring. طبعًا، وأسّكر الـ cardiac
+
+90
+00:06:13,800 --> 00:06:18,400
+monitoring تبعي، عشان ما أضغطش دائمًا في tension، و
+
+91
+00:06:18,400 --> 00:06:23,460
+يصير هلقّد ويصير هلقّد. تمام. هذا الـ Hypotension. الآن، الـ
+
+92
+00:06:23,460 --> 00:06:26,510
+complication الرابع، اللي هو collapse. ماذا يعني lung
+
+93
+00:06:26,510 --> 00:06:31,470
+collapse؟ بيحصل في عندنا اللي هو أثناء الـ insertion
+
+94
+00:06:31,470 --> 00:06:35,970
+لهذا الـ suction، خصوصًا إذا كان الـ catheter large وكبير
+
+95
+00:06:35,970 --> 00:06:40,030
+في small diameter artificial airway، resulting in
+
+96
+00:06:40,030 --> 00:06:44,200
+obstructed space. يعني هو بده يكون الـ tube داخل في
+
+97
+00:06:44,200 --> 00:06:48,300
+tube ثاني، أحدُهما بده يكون الـ diameter تبعه أوسع
+
+98
+00:06:48,300 --> 00:06:51,860
+من الـ diameter الثاني، هذا هيفوّت الـ patient في
+
+99
+00:06:51,860 --> 00:06:56,380
+مشاكل. ليه؟ لأن أنا ساعة ما بيعمل الـ vacuum، عملية
+
+100
+00:06:56,380 --> 00:06:59,480
+الشفط is applied في الـ lungs كلها، بس معناته ما تحطش
+
+101
+00:06:59,480 --> 00:07:02,860
+فيه كل الهواء اللي موجود في الـ lungs، تمام؟ لأن
+
+102
+00:07:02,860 --> 00:07:05,920
+الهدف تبعي، يعني الهدف من الـ catheter، إنه أنا أعمل remove
+
+103
+00:07:05,920 --> 00:07:08,680
+للـ secretions، أو يصير في suction لهذا الـ secretions.
+
+104
+00:07:08,680 --> 00:07:13,360
+هنا لأ، عشان يعمل معادلة في الضغط. الـ SMOV هيشفط لي
+
+105
+00:07:13,360 --> 00:07:16,480
+كل الهواء اللي موجود في الـ lungs، فبالتالي بيصير في
+
+106
+00:07:16,480 --> 00:07:20,120
+عندي lung collapse. This is avoided by using
+
+107
+00:07:20,120 --> 00:07:23,440
+a catheter whose diameter is smaller than. بحل
+
+108
+00:07:23,440 --> 00:07:26,760
+المشكلة هذه في حالة إنه أنا جبت اللي هو القطر
+
+109
+00:07:26,760 --> 00:07:30,460
+تبعها أصغر من القطر اللي أنا هفوّته في الـ tube
+
+110
+00:07:30,460 --> 00:07:34,080
+الثاني.  the internal diameter of tube B intersection.
+
+111
+00:07:34,080 --> 00:07:38,000
+هذا طبعًا لازم. كل هذه التحضيرات أنا بحضّرها مع الـ
+
+112
+00:07:38,000 --> 00:07:40,800
+nurse. يعني احنا هنا we are a rehabilitative
+
+113
+00:07:40,800 --> 00:07:45,160
+team. احنا فريق كامل متكامل، بتعاون فيه مع الـ nurse،
+
+114
+00:07:45,160 --> 00:07:51,760
+بأخذ قراري من الدكتور، إنه هذا مسموح أشتغل له suction
+
+115
+00:07:51,760 --> 00:07:56,900
+ولا مش مسموح، تمام. في عندنا موضوع الـ bacterial
+
+116
+00:07:56,900 --> 00:08:01,140
+contaminations، إن هي عبارة عن العدوى البكتيرية.
+
+117
+00:08:01,140 --> 00:08:04,900
+احنا اليوم عندنا فتحة داخل التراكيا، وبدّي أفوّت
+
+118
+00:08:04,900 --> 00:08:08,040
+فيها suction، وأيّة هي  الاجراءات اللي أنا بدي أخذها؟
+
+119
+00:08:08,040 --> 00:08:10,880
+على الـ internal organs. The user should wear
+
+120
+00:08:10,880 --> 00:08:15,380
+gloves. أمر مفروغ منه. for traditional or self-
+
+121
+00:08:15,380 --> 00:08:19,700
+protection. تمام؟ لإنه بما إن كمان الأيام هذه في
+
+122
+00:08:19,700 --> 00:08:23,360
+جائحة COVID-19، معناته إنه أنا لازم أكون more
+
+123
+00:08:23,360 --> 00:08:26,740
+sterilized. لإنه الـ patient تبعي ممكن ينضر، وأنا
+
+124
+00:08:26,740 --> 00:08:30,860
+كمان ممكن أنضر. nasal tracheal suction، هذا اللي
+
+125
+00:08:30,860 --> 00:08:33,660
+كلّنا بنحكي عليه. الـ tracheal، هنا بدّي أحكي على الـ
+
+126
+00:08:33,660 --> 00:08:37,120
+nasal tracheal suction. nasal، معناته أنا هدخل على
+
+127
+00:08:37,120 --> 00:08:42,160
+الـ nose، وبعدين على الـ trachea. وهي تحتوي على:  Oxygenation،
+
+128
+00:08:42,160 --> 00:08:46,220
+بكتيريا،  Hypoxemia. أيضًا، فيه الـ complications:
+
+129
+00:08:46,220 --> 00:08:50,040
+severe cardiac arrhythmia، laryngeal spasm، and
+
+130
+00:08:50,040 --> 00:08:54,600
+bronchospasm. احنا هدفنا في الـ ICU، ما يدخل المريض عندنا
+
+131
+00:08:54,600 --> 00:09:00,480
+ نهائيًا في أي complication، حفاظًا على حياته واستمرارية
+
+132
+00:09:00,480 --> 00:09:05,840
+العيش داخل الـ ICU لحد ما يزول عنه الخطر. الآن، بدّي
+
+133
+00:09:05,840 --> 00:09:09,780
+أحكي على بعض الـ cuffing and suction procedures.  بعض
+
+134
+00:09:09,780 --> 00:09:14,020
+الإجراءات. في عندنا الـ lavage،  الـ lavage اسمها
+
+135
+00:09:14,020 --> 00:09:19,130
+lung washing (غسيل الرئة). The infusion of
+
+136
+00:09:19,130 --> 00:09:26,970
+saline مُعقّم، يدخل داخل الرئة، ينظّفها، ويطلع بعض
+
+137
+00:09:26,970 --> 00:09:29,810
+الـ mucus أو بعض الـ secretions اللي يكون عامل
+
+138
+00:09:29,810 --> 00:09:35,620
+plugs لبعض الـ centers أو البُنْكار. أنواعها، فيه منها
+
+139
+00:09:35,620 --> 00:09:39,200
+small وفيه منها large. إذا كانت الكمية أقل من عشرة
+
+140
+00:09:39,200 --> 00:09:43,160
+ملي، معناته هذا بسمّيه small amount of lavage، تمام.
+
+141
+00:09:43,160 --> 00:09:47,580
+أمّا إذا كانت large، يعني بين خمسين إلى مائة ملي،
+
+142
+00:09:47,580 --> 00:09:50,970
+اللي هو حجم الـ saline اللي أنا بدّي أستخدمه، معناته
+
+143
+00:09:50,970 --> 00:09:54,730
+الكلام هذا بيكون لـ Flexible Bronchoscope، يعني
+
+144
+00:09:54,730 --> 00:09:58,330
+اللي أنا بستخدم فيه شيء من الـ bronchoscope، حتى
+
+145
+00:09:58,330 --> 00:10:02,650
+أنظّف الرئتين بشكل كامل. The role of bronchoalveolar
+
+146
+00:10:02,650 --> 00:10:06,730
+lavage remains experimental. لسه ما زالت اللي هو
+
+147
+00:10:06,730 --> 00:10:10,370
+قيد التجربة in most diseases، and plays a more
+
+148
+00:10:10,370 --> 00:10:13,030
+important role in diagnosis than therapeutic
+
+149
+00:10:13,030 --> 00:10:16,490
+management for lung pathology. لسه ما زالت الأمور
+
+150
+00:10:16,490 --> 00:10:22,720
+قيد التجربة. الآن، خلّصنا من الـ lavage،  بدنا نأخذ الـ
+
+151
+00:10:22,720 --> 00:10:25,420
+lung lavage. بدنا نأخذ الـ bagging. الـ bagging هي عبارة
+
+152
+00:10:25,420 --> 00:10:28,000
+زي ما أنتم شايفين هنا في الصورة، اللي هي
+
+153
+00:10:28,000 --> 00:10:34,240
+عبارة عن وعاء، خليني أحكيه، أو بالونة، محتوية على
+
+154
+00:10:34,240 --> 00:10:37,500
+أكسجين، محتوية على هواء. أنا عن طريقها بفوت الـ
+
+155
+00:10:37,500 --> 00:10:39,980
+artificial ventilation، أو الـ artificial ventilation
+
+156
+00:10:39,980 --> 00:10:46,270
+إلى داخل اللي هو الأنف والفم للمريض. خليني أشوف الـ
+
+157
+00:10:46,270 --> 00:10:56,090
+bagging. هي عبارة عن...  أحيانًا
+
+158
+00:10:56,090 --> 00:11:00,290
+أو شيء manual، اللي هو بالـ hand، أنا ممكن أشتغله.
+
+159
+00:11:00,290 --> 00:11:03,830
+which is usually connected with oxygen supply، عشان
+
+160
+00:11:03,830 --> 00:11:08,190
+أنا أوصل كمية كافية من الـ oxygen. if patient is not
+
+161
+00:11:08,190 --> 00:11:15,790
+intubated، إذا ما كان tracheal أو nasal أو oral. معناته
+
+162
+00:11:15,790 --> 00:11:19,870
+الكلام على الـ mask هذا. أنا بحطّه على طول على الـ face
+
+163
+00:11:19,870 --> 00:11:22,970
+تبعه. over the patient face covering the nose and
+
+164
+00:11:22,970 --> 00:11:26,270
+mouth. يعني هياخد الـ oxygen من حاجتين، اللي هي الـ
+
+165
+00:11:26,270 --> 00:11:30,310
+nose والـ mouth. for the intubated patient، هذا إذا
+
+166
+00:11:30,310 --> 00:11:32,870
+كان الـ patient هنا not intubated. أمّا إذا كان
+
+167
+00:11:32,870 --> 00:11:38,120
+intubated، الـ mask تُزال. The mask is removed and
+
+168
+00:11:38,120 --> 00:11:41,580
+the bag is connected directly to the tracheal tube.
+
+169
+00:11:41,580 --> 00:11:45,900
+على طول بحطّ فيه الـ tracheal tube مباشرة، حتى يوصل
+
+170
+00:11:45,900 --> 00:11:49,740
+كمية الأكسجين للرئتين. لأن الـ bagging is
+
+171
+00:11:49,740 --> 00:11:53,520
+performed by squeezing the bag. رسميًا، أنا بضغط
+
+172
+00:11:53,520 --> 00:11:57,560
+عليها بشكل منتظم to deliver a volume of gas
+
+173
+00:11:57,560 --> 00:12:00,880
+للـ patient. الـ expiration على طول هيكون passively،
+
+174
+00:12:00,880 --> 00:12:06,74
+
+223
+00:15:30,540 --> 00:15:34,320
+fractures هاي الحالة صعبة علي جدا أن أعمله turning
+
+224
+00:15:34,590 --> 00:15:37,770
+obtain the patient history and diagnosis مهم جدا
+
+225
+00:15:37,770 --> 00:15:41,290
+أعرف اللي هو الملف الطبي تبعه تماما أكون
+
+226
+00:15:41,290 --> 00:15:44,990
+عارفة كيف بدي أشتغل معه identify the prevalence
+
+227
+00:15:44,990 --> 00:15:48,030
+of fractures, injury, catheters and monitoring
+
+228
+00:15:48,030 --> 00:15:51,640
+equipment كل الأمور هي ضروري أعرفها قبل ما أحطها
+
+229
+00:15:51,640 --> 00:15:55,440
+بأي وضعية move ال patient to the side of the bed
+
+230
+00:15:55,440 --> 00:15:59,200
+before حركيه على حرف سريره أو حركه على حرف
+
+231
+00:15:59,200 --> 00:16:03,280
+السرير حتى تقدر تعمل اللي هو ال rolling مثلا
+
+232
+00:16:03,280 --> 00:16:05,600
+أعطالي مثلاً، اللي كان في الـ IV line اللي أحوله على
+
+233
+00:16:05,600 --> 00:16:11,610
+البرون لازم أجيبه شوية على حرفة السرير، طبعاً الـ
+
+234
+00:16:11,610 --> 00:16:15,250
+moves للـ IV line و الـ ECG و wires و كل الأمور هاي
+
+235
+00:16:15,250 --> 00:16:18,270
+اللي أنا حكيت عليها أنتَ اليوم داخل الـ ICU
+
+236
+00:16:18,270 --> 00:16:21,730
+معناته تاخد في بالك أنّه أنا في عندي هذا المريض
+
+237
+00:16:21,730 --> 00:16:26,390
+مشبوك على كذا حاجة place one hand over the hip and
+
+238
+00:16:26,390 --> 00:16:29,710
+other hand shoulder rotated لل patient هذا في حالة
+
+239
+00:16:29,710 --> 00:16:33,390
+أنّه أنا بدي أجلبّه من الـ supine لـ ال prone position
+
+240
+00:16:33,390 --> 00:16:39,410
+roll behind حطي roll حول اللي هو جذر المريض أو خلف
+
+241
+00:16:39,410 --> 00:16:44,370
+المريض to prevent him
+
+242
+00:16:44,370 --> 00:16:47,570
+أنّه يرجع ثاني إذا أنت بدك تجعليه فقط على الـ side
+
+243
+00:16:47,570 --> 00:16:51,890
+-lying خلي في اللي هو roll أو إذا ما كان فيه على
+
+244
+00:16:51,890 --> 00:16:55,070
+roll ممكن تحط مخدات بحيث أنّه يضلّ على side
+
+245
+00:16:55,070 --> 00:17:00,550
+-lying position تمام؟ أيضاً من المشاكل ممكن يواجهيني
+
+246
+00:17:00,550 --> 00:17:04,490
+اللي هو turning لل patient into prone position صعب
+
+247
+00:17:04,490 --> 00:17:09,150
+جداً أن أحط ال patient هنا prone position و في بعض
+
+248
+00:17:09,150 --> 00:17:13,310
+الحالات طبعاً ممكن أتسبب في إذائهم إذا ما كنت ماخدة
+
+249
+00:17:13,310 --> 00:17:17,970
+بالي put the patient head on pillow to prevent
+
+250
+00:17:17,970 --> 00:17:21,860
+kinking of the tracheal and ventilator tube مهم
+
+251
+00:17:21,860 --> 00:17:26,520
+جداً، حتى بعض الوسائد عندنا بتكون هي أصلاً مصممة أن يكون
+
+252
+00:17:26,520 --> 00:17:31,080
+في فتحة لـ الـ head و الـ face لإنه بخاف أنا أعمل
+
+253
+00:17:31,080 --> 00:17:34,880
+اللي هي incident أو إغلاق لـ اللي هو respiratory
+
+254
+00:17:34,880 --> 00:17:40,340
+airway أو اللي هي الـ airway مجرى الهواء الـ patient
+
+255
+00:17:40,340 --> 00:17:44,360
+with lower limb traction أو external fixation and
+
+256
+00:17:44,360 --> 00:17:47,580
+an assistant is needed to position the affected limb
+
+257
+00:17:47,580 --> 00:17:52,640
+تمام؟ أي شيء مشبوك فيه المريض طبعاً لازم أنا أخد
+
+258
+00:17:52,640 --> 00:17:56,400
+بالي حتى إنّه ما أسبب له ألم أو ما أسبب له damage
+
+259
+00:17:56,400 --> 00:18:00,900
+لأي شيء أنا بدي أحرّكه فيه put a roll under chest to
+
+260
+00:18:00,900 --> 00:18:04,440
+prevent kinking or obstruction of the
+
+261
+00:18:04,440 --> 00:18:08,120
+tracheostomy tube حكينا عليها النقطة اللي قبل
+
+262
+00:18:08,120 --> 00:18:12,520
+السابقة after turning, check the reconnected
+
+263
+00:18:12,520 --> 00:18:15,880
+ventilator tubes and monitoring equipment عيني على
+
+264
+00:18:15,880 --> 00:18:20,040
+الـ equipment كلها سواء كانت في تابع الـ respiratory
+
+265
+00:18:20,040 --> 00:18:23,540
+أو الـ digestive أو الـ urinary كل الأسلاك أو كل الـ
+
+266
+00:18:23,540 --> 00:18:29,520
+tubes المشبوكة لازم أكون خبيرة فيها طبعاً هنا ورانا
+
+267
+00:18:29,520 --> 00:18:36,260
+كيف أنّه هو حاول اللي هو تغيير وضعية المريض وكيف
+
+268
+00:18:36,260 --> 00:18:42,900
+طبعاً تريبل الحماية كيف مع حد ثاني assistant و
+
+269
+00:18:42,900 --> 00:18:46,920
+عيونها على اللي هو الـ tubes اللي موجودة شايفين كم
+
+270
+00:18:46,920 --> 00:18:51,540
+شيء في عنده اللي هو الـ tubes التابعة للـ
+
+271
+00:18:51,540 --> 00:18:55,980
+respiratory في tubes تابعة للـ digestive طبعاً و
+
+272
+00:18:55,980 --> 00:18:59,300
+لازم أكيد طبعاً هيكون في cannula لهنا فبالتالي أنا
+
+273
+00:18:59,300 --> 00:19:03,660
+لازم آخذ حذري أيضاً من المشاكل الثالثة اللي هي الـ
+
+274
+00:19:03,660 --> 00:19:07,930
+patient with intravenous line الـ central
+
+275
+00:19:07,930 --> 00:19:11,070
+intravenous subclavian line هاي اللي موجودة هنا
+
+276
+00:19:11,070 --> 00:19:16,030
+تحت الـ subclavian تمام make sure it is parallel to
+
+277
+00:19:16,030 --> 00:19:19,250
+the patient's thorax مش لازم تكون رايحة يمين أو
+
+278
+00:19:19,250 --> 00:19:24,410
+يسار peripheral للـ intravenous الـ lines في أيضاً
+
+279
+00:19:24,410 --> 00:19:28,990
+مشاكل اللي هي usually do not interfere with turning
+
+280
+00:19:28,990 --> 00:19:34,050
+and should not cross a joint مش لازم أنا طبعاً
+
+281
+00:19:34,050 --> 00:19:37,010
+أجرب منها هذه اللي بتكون في الـ periphery يعني
+
+282
+00:19:37,010 --> 00:19:40,030
+ممكن كان يولا مركبة في الإيد أو كان يولا مركبة في
+
+283
+00:19:40,030 --> 00:19:43,770
+الرجَل لبيبي صغير فبالتالي أنا لازم آخذ بالي الـ
+
+284
+00:19:43,770 --> 00:19:47,910
+arterial line requires good positioning with secure
+
+285
+00:19:47,910 --> 00:19:53,270
+dressing or splint طبعاً تأكدي تماماً أنّه في عندي
+
+286
+00:19:53,270 --> 00:19:56,750
+اللي هو الحماية اللازمة لهذا المريض من أن أنا
+
+287
+00:19:56,750 --> 00:20:02,170
+ما أؤذيه في أي حالة turning the patient with chest
+
+288
+00:20:02,170 --> 00:20:08,740
+tube الـ tracheal tube و الـ feeding tube  with
+
+289
+00:20:08,740 --> 00:20:13,460
+positioning to prevent kinking أنّه أنا ما ألتويه أو
+
+290
+00:20:13,460 --> 00:20:18,400
+ما أسدّه and compression of chest tube tracheal
+
+291
+00:20:18,400 --> 00:20:24,070
+tube plays a large role. Avoid chest from bra line
+
+292
+00:20:24,070 --> 00:20:26,550
+position إذا أنا جئت غيّرت من الـ bra line
+
+293
+00:20:26,550 --> 00:20:29,810
+position لازم آخذ بالي أنّه ما يصير في أي انفداد
+
+294
+00:20:29,810 --> 00:20:34,470
+لـ الانجيتيوب أو الـ nasogastric tube بتسمّيه هنا لازم
+
+295
+00:20:34,470 --> 00:20:37,630
+أنا آخذ بالي أن هذا ال chest physical therapy
+
+296
+00:20:37,630 --> 00:20:40,550
+should be done 30 minutes after feeding break to prevent
+
+297
+00:20:40,550 --> 00:20:44,330
+vomiting مهم جداً زي أي جلسة مساج على سبيل المثال
+
+298
+00:20:44,330 --> 00:20:47,990
+لازم أنا أعمل جلسة و ما يكون مريضى جائعا لأني
+
+299
+00:20:47,990 --> 00:20:53,250
+أنا أخاف من الـ vomiting continuously. Feeding should
+
+300
+00:20:53,250 --> 00:20:56,530
+be stopped for physical therapy and resumed
+
+301
+00:20:56,530 --> 00:21:01,970
+لل patient not positioned with head down لأن في
+
+302
+00:21:01,970 --> 00:21:05,210
+حالات traumatic brain injury فعب جداً أن أنا أحط
+
+303
+00:21:05,210 --> 00:21:09,510
+المريض تبعي في وضعية رأس للأسفل ويقل head
+
+304
+00:21:09,510 --> 00:21:13,580
+down لأن هذا هيزيد من تفاقم المشكلة. The continuous
+
+305
+00:21:13,580 --> 00:21:16,700
+feeding should be stopped طبعاً أنا لازم أغلق الـ
+
+306
+00:21:16,700 --> 00:21:19,840
+nasogastric tube و أسكّره و بعدين أبلش أعمل physical
+
+307
+00:21:19,840 --> 00:21:24,500
+therapy session تبعتي عشان أمنع أي vomiting حيث
+
+308
+00:21:24,500 --> 00:21:29,430
+يحدث معايا الآن بعض الـ chest drains اللي هو بعض
+
+309
+00:21:29,430 --> 00:21:32,930
+الحاجات اللي بتكون عاملة زي مستنقع في الـ drains
+
+310
+00:21:32,930 --> 00:21:36,570
+usually chest drains do not interfere with patient
+
+311
+00:21:36,570 --> 00:21:42,090
+positioning هذه بعض الـ secretions مش لازم تعملي أو
+
+312
+00:21:42,090 --> 00:21:45,910
+تؤدي لمشاكل try not to pull disconnected intra
+
+313
+00:21:45,910 --> 00:21:49,110
+-abdominal tubes بدي أحاول أن أنا ما أسحب أي
+
+314
+00:21:49,110 --> 00:21:52,790
+abdominal tubes بتكون محطوطة في منطقة ال abdomen
+
+315
+00:21:52,790 --> 00:21:57,100
+dislodging the tubes leads to hemorrhage and
+
+316
+00:21:57,100 --> 00:22:04,580
+hypotension تمام؟ بدي أحاول أن أنا ما أفصلها عن
+
+317
+00:22:04,580 --> 00:22:09,960
+أي جهاز موجود فيه تمام؟ هذا بالنسبة لبعض المشاكل
+
+318
+00:22:09,960 --> 00:22:14,940
+اللي أنا ما زلت مكملة فيها لل patient اللي موجود
+
+319
+00:22:14,940 --> 00:22:19,280
+في الـ ICU لل patient أيضاً في عندنا الـ turning
+
+320
+00:22:19,280 --> 00:22:22,380
+أو الـ turning لل patient with urinary catheter
+
+321
+00:22:22,380 --> 00:22:26,480
+تعرفوا ال patient هنا صعب أنّه يروح تواليت أو يرجع
+
+322
+00:22:26,480 --> 00:22:29,900
+فبالتالي بيتركب له اللي هي الـ urine catheter
+
+323
+00:22:29,900 --> 00:22:33,820
+clamp the catheter between collection bag and patient before
+
+324
+00:22:33,820 --> 00:22:37,130
+turning لازم أحافظ عليها لأنّها painful literally
+
+325
+00:22:37,130 --> 00:22:41,910
+painful أن أنا أحركها أو صعب جداً أنّه أنا لو حركت
+
+326
+00:22:41,910 --> 00:22:46,370
+المريض أنّه تنشل معايا the collection bag is moved
+
+327
+00:22:46,940 --> 00:22:50,560
+to the side of the bed that the patient faces after turning
+
+328
+00:22:50,560 --> 00:22:54,980
+طبعاً أحطّها على اللي هو الـ rail تبع السرير اللي موجود
+
+329
+00:22:54,980 --> 00:22:57,320
+ال patient عليه keep the collection bag in
+
+330
+00:22:57,320 --> 00:23:01,920
+a dependent position مهم جداً حتى يصير اللي هو فيه
+
+331
+00:23:01,920 --> 00:23:07,520
+تصريف للـ bag  بعد اللي هو نهاية جلستك
+
+332
+00:23:07,520 --> 00:23:12,840
+يعني حطّه تحت أو ضعيه تحت اللي هو الـ rail أنّه يكون
+
+333
+00:23:12,840 --> 00:23:18,940
+مع الـ dependent position حتى ما يطلع من مكانه الآن
+
+334
+00:23:18,940 --> 00:23:21,500
+نأتي للـ physiotherapy  الـ percussion and
+
+335
+00:23:21,500 --> 00:23:23,940
+vibration they are maneuvers used in combination
+
+336
+00:23:23,940 --> 00:23:26,560
+with postural drainage أستخدمهم أيضاً مع الـ
+
+337
+00:23:26,560 --> 00:23:30,420
+postural drainage they facilitate large and small
+
+338
+00:23:30,420 --> 00:23:35,530
+airway clearance حكينا إنّ هما حركتين
+
+339
+00:23:35,530 --> 00:23:39,630
+مهمّتين جداً advancing circulation centrally so that
+
+340
+00:23:39,630 --> 00:23:45,890
+secretions can be expectorated and suctioned طبعاً المريض تبعنا
+
+341
+00:23:45,890 --> 00:23:51,490
+مهم جداً أنّه أنا أكون مُتحكّمة فيه و قادرة أعمل
+
+342
+00:23:51,490 --> 00:23:55,150
+الحركتين الصحيحين حتى أنّه أنا أعمل اللي هو remove
+
+343
+00:23:55,150 --> 00:24:02,580
+and اللي هي clear the airway الـ percussion it's
+
+344
+00:24:02,580 --> 00:24:06,480
+rhythmically طبعاً cupping أو cupping hand over
+
+345
+00:24:06,480 --> 00:24:11,660
+involved lung segment حكيت بالاشعة أو بالاستماع بعرف
+
+346
+00:24:11,660 --> 00:24:16,340
+أين أنا بالضبط أبدأ أشتغل فبالتالي بحط اللي هي الـ
+
+347
+00:24:16,340 --> 00:24:20,840
+cupping و ببدأ أشتغل عليه it adds to inspiration
+
+348
+00:24:20,840 --> 00:24:24,870
+and mobilization of secretions from wall and airways. It's best
+
+349
+00:24:24,870 --> 00:24:29,630
+applied during expiration and expiration بشتغلها
+
+350
+00:24:29,630 --> 00:24:33,450
+في الشهيق والزفير على حد سواء should not cause
+
+351
+00:24:33,450 --> 00:24:37,270
+pain or bruising مش لازم أنا في الـ vibration أكسر
+
+352
+00:24:37,270 --> 00:24:40,510
+أضلاع المريض لا ولا لازم في الـ percussion أكون  drill
+
+353
+00:24:40,510 --> 00:24:44,570
+لازم أكون careful لأنّي بشتغل مع مريض ICU
+
+354
+00:24:44,570 --> 00:24:50,880
+applied over the affected area of the thorax بدنا
+
+355
+00:24:50,880 --> 00:24:54,980
+نشتغل على المنطقة فقط اللي فيها secretion الـ
+
+356
+00:24:54,980 --> 00:24:57,680
+obesity and bulky dressings decrease the percussion
+
+357
+00:24:57,680 --> 00:25:01,080
+effect طبعاً إذا كان مريض تبعنا ما شاء الله
+
+358
+00:25:01,080 --> 00:25:06,020
+overweight فبالتالي لازم أنا أحسّن من وضع اللي هو
+
+359
+00:25:06,020 --> 00:25:08,540
+الـ cupping عشان أجيب نتيجة معايا
+
+360
+00:25:11,840 --> 00:25:15,540
+الأطفال الصغار بإيد واحدة حكيت ما علمتكم مثلاً مثلاً
+
+361
+00:25:15,540 --> 00:25:19,460
+بشتغل اللي هو الـ vibration و الـ percussion
+
+362
+00:25:23,930 --> 00:25:29,250
+بالاستماع بعرف بالضبط أنا ماشية تلاتين ملي من الـ
+
+363
+00:25:29,250 --> 00:25:35,030
+medicine cup with padded rim and rubber nibble بحط
+
+364
+00:25:35,030 --> 00:25:38,810
+اللي هو rubber nibble testing or tinting hand
+
+365
+00:25:38,810 --> 00:25:42,630
+overlapping the second finger and third with third
+
+366
+00:25:42,630 --> 00:25:45,370
+finger يعني بعض الأحيان ممكن أعمل trapping بس
+
+367
+00:25:45,370 --> 00:25:48,810
+بالثلاث أصابع هاي اللي موجودة معنا
+
+368
+00:25:51,100 --> 00:25:54,400
+الـ Vibration هذا بالنسبة للـ cupping الـ
+
+369
+00:25:54,400 --> 00:26:00,220
+Vibration اللي هي up and down أو side to side. It is
+
+370
+00:26:00,220 --> 00:26:03,760
+intermittent chest wall compression طبعاً أنا بعمل
+
+371
+00:26:03,760 --> 00:26:06,400
+ضغط على chest wall compression applied during
+
+372
+00:26:06,400 --> 00:26:09,560
+expiration. أما الـ cupping بيحصل في الـ expiration
+
+373
+00:26:09,560 --> 00:26:12,580
+أو الـ inspiration لما آخذ بالي هنا applied
+
+374
+00:26:12,580 --> 00:26:17,820
+during expiration over affected area applied in the
+
+375
+00:26:17,820 --> 00:26:21,200
+direction of chest motion. Used in combination with
+
+376
+00:26:21,200 --> 00:26:24,320
+postural drainage بالأغلب أستخدمه مع postural
+
+377
+00:26:24,320 --> 00:26:28,720
+drainage separates secretions from the walls of large
+
+378
+00:26:28,720 --> 00:26:33,620
+and small airways زي ما حكيت بتطلع اللي هي الـ
+
+379
+00:26:33,620 --> 00:26:37,620
+secretions أو ال amount of secretions على ال airway من
+
+380
+00:26:37,620 --> 00:26:42,700
+الـ lower lobes لتطلع major stem الـ frequency تبع
+
+381
+00:26:42,700 --> 00:26:46,960
+الـ vibration من 12 إلى 20 هرتز مش لازم أزيده لأنّه
+
+382
+00:26:46,960 --> 00:26:50,960
+أنا بشتغل مع مريض ICU بعدين ممكن أشتغل shaking
+
+383
+00:26:50,960 --> 00:26:55,520
+طبعاً side to side is gentler than vibration أخف
+
+384
+00:26:55,520 --> 00:27:00,920
+شوية على مريض الـ ICU الـ mainly high-frequency vibrators
+
+385
+00:27:00,920 --> 00:27:05,880
+and chest vests they produce vertical and rotatory
+
+386
+00:27:05,880 --> 00:27:08,140
+or rotatory movement in combination with them
+
+387
+00:27:08,140 --> 00:27:14,480
+recently introduced to ICU. Also used in home care in
+
+388
+00:27:14,480 --> 00:27:17,060
+patients with chronic chest disease الـ mechanical
+
+389
+00:27:17,060 --> 00:27:22,640
+vibrators يستخدموا في البيت ولكن يُحذّر مع الـ
+
+390
+00:27:22,640 --> 00:27:25,860
+chronic chest disease هنشوفه في اللي هو  chapter of الـ
+
+391
+00:27:25,860 --> 00:27:28,800
+chest physiotherapy بس هنا لازم أكون أنا حذرة جداً
+
+392
+00:27:28,800 --> 00:27:33,520
+وأعلم أحد من الأهل أنّه يشتغلوا الـ manual
+
+393
+00:27:33,520 --> 00:27:36,960
+vibration and percussion have the following advantages
+
+394
+00:27:36,960 --> 00:27:41,280
+over mechanical devices طبعاً دائماً اليدوي احنا بنحس
+
+395
+00:27:41,280 --> 00:27:44,740
+فيه بيكون أفضل و له مميزات عن الـ mechanical
+
+396
+00:27:44,740 --> 00:27:48,280
+خلينا نشوف شو هي المميزات can be modified for rib
+
+397
+00:27:48,280 --> 00:27:52,830
+fractures not detected with x-ray ممكن أنا أكشف إذا
+
+398
+00:27:52,830 --> 00:27:55,390
+كان لسوء الحظ في المريض هذا اللي أنا بين إيديا
+
+399
+00:27:55,390 --> 00:27:58,190
+عنده rib fractures ولا لأ في ال facial expression
+
+400
+00:27:58,190 --> 00:28:02,430
+إذا أنا لاحظت في وجود تعابير وجه أنّه بيتألم
+
+401
+00:28:02,430 --> 00:28:05,610
+لما بحط إيدي على ال middle lobe و بعدها بعرف أنّه
+
+402
+00:28:05,610 --> 00:28:08,110
+أنا في عندي مشكلة في ال ribs اللي جايه في هذا
+
+403
+00:28:08,110 --> 00:28:10,790
+المكان. الآن ال therapist can monitor ال patient
+
+404
+00:28:10,790 --> 00:28:13,830
+response by manual palpation and visual inspection
+
+405
+0
+
+445
+00:30:52,070 --> 00:30:55,090
+فيه منه ثلاث أنواع،  الـ intensive spirometer هو
+
+446
+00:30:55,090 --> 00:30:58,640
+عبارة عن جهاز، إن شاء الله رب العالمين، أكيد بتشوفوه
+
+447
+00:30:58,640 --> 00:31:02,620
+موجود على نفس المعمل، وموجود كمان لما تزوروا
+
+448
+00:31:02,620 --> 00:31:06,580
+المستشفيات، its therapeutic modalities rely on
+
+449
+00:31:06,580 --> 00:31:10,620
+patients' efforts to perform hyperventilation
+
+450
+00:31:10,620 --> 00:31:13,880
+طبعا، and provide bulk feedback to the patient
+
+451
+00:31:13,880 --> 00:31:18,520
+بيعطي نتيجة للمريض، وإن الـ patient observes their inspired volume and she can be encouraged to work by
+
+452
+00:31:18,520 --> 00:31:22,870
+inhaling, and she can encourage to work by
+
+453
+00:31:22,870 --> 00:31:26,190
+inhaling، طبعا inhaling اللي هو في الـ inspiration
+
+454
+00:31:26,190 --> 00:31:29,450
+more and more. It is an effective method to
+
+455
+00:31:29,450 --> 00:31:33,670
+prevention and reversal of lung collapse. بيمنع أن الـ lung
+
+456
+00:31:33,670 --> 00:31:37,910
+ترجع collapse من أول وجديد، and promotion of
+
+457
+00:31:37,910 --> 00:31:41,890
+postoperative cases، لما بعد اللي هم الـ
+
+458
+00:31:41,890 --> 00:31:46,760
+postoperative cases، يعني لما بعد العملية، مشوار طويل
+
+459
+00:31:46,760 --> 00:31:49,660
+طويل اللي هو الـ Intensive Care أو اللي هو بسميه
+
+460
+00:31:49,660 --> 00:31:53,860
+الـ Intensive Spirometers، طبعا الـ IF وهو خاص بالـ
+
+461
+00:31:53,860 --> 00:31:57,460
+Breathing، وبالـ Exercise، وبالـ Breathing Problems
+
+462
+00:31:57,460 --> 00:32:01,920
+أنواعه، فيه منه الـ Volume، فيه منه الـ Flu، فيه منه
+
+463
+00:32:01,920 --> 00:32:06,500
+الـ Photoelectric. الـ Volume-oriented... طبعا
+
+464
+00:32:06,500 --> 00:32:11,260
+oriented in incentive spirometer، في اللي هو منه
+
+465
+00:32:11,260 --> 00:32:15,680
+الـ Volidine و الـ Florex. أنواعه الـ Flu طبعا
+
+466
+00:32:15,680 --> 00:32:19,820
+oriented intensive spirometer، تريفلو أو ترفلو
+
+467
+00:32:19,820 --> 00:32:25,580
+الفوتوالكتريكال أيضا، اللي هو SpiroCare، أنواعه
+
+468
+00:32:25,580 --> 00:32:28,800
+اللي هي باسمها التجاري، على الـ clinical application
+
+469
+00:32:28,800 --> 00:32:32,160
+للـ intensive spirometer، evaluation and diagnosis
+
+470
+00:32:32,160 --> 00:32:36,140
+of respiratory disorders، بقيملي و بشخصلي الحالة
+
+471
+00:32:36,140 --> 00:32:40,240
+prevention and treatment of atelectasis and promotion
+
+472
+00:32:40,240 --> 00:32:44,280
+للـقفص in postoperative cases، وأيضا improvement للـ patient
+
+473
+00:32:44,280 --> 00:32:49,160
+exercise performance، بيعرف قد إيش الـ lung capacity و
+
+474
+00:32:49,160 --> 00:32:55,560
+بيحسن من نوعيتها وأدائها في مريض اللي هو في الـ ICU
+
+475
+00:32:55,560 --> 00:33:00,100
+الـ immobilization، و الـ method تبعتنا في الـ
+
+476
+00:33:00,100 --> 00:33:04,740
+mobilization in ICU، لأن الـ immobilization مريضي الـ
+
+477
+00:33:04,740 --> 00:33:10,470
+ICU، إذا كان RTA على سبيل المثال، عنده head injury
+
+478
+00:33:10,470 --> 00:33:14,990
+فمعناته الكلام هيدخل يبقى anesthesia، sedation، و
+
+479
+00:33:14,990 --> 00:33:19,470
+neuromuscular blockers، تمام، خصوصا إذا كان دي كومة
+
+480
+00:33:19,470 --> 00:33:22,990
+كله تفاعل ثلاثي، ممكن يكون محطوط له من الناس
+
+481
+00:33:22,990 --> 00:33:26,930
+طبعا اللي هيكون immobilized، ممكن يكون القصد اللي
+
+482
+00:33:26,930 --> 00:33:30,790
+هو supplant، في حالة neurological disorders، إذا كان
+
+483
+00:33:30,790 --> 00:33:35,150
+فيه عنده اللي هو cutting للـ spinal cord injury، والـ
+
+484
+00:33:35,150 --> 00:33:37,230
+pain طبعا، والـ general weakness، والـ
+
+485
+00:33:37,230 --> 00:33:41,110
+malnutrition، في حالات اللي هو بيكون immobilized
+
+486
+00:33:41,110 --> 00:33:45,710
+المريض فيها، use of monitoring equipment، تمام؟ هاي
+
+487
+00:33:45,710 --> 00:33:50,150
+الست حالات أو مجموعة اللي هو الناس اللي بيكون
+
+488
+00:33:50,150 --> 00:33:55,630
+immobilized داخل الـ ICU، خليني أشوفهم، شو تأثير الـ
+
+489
+00:33:55,630 --> 00:33:58,350
+immobilization، تأثير الـ immobilization هتأثر لي
+
+490
+00:33:58,350 --> 00:34:00,850
+على الـ cardiovascular system، و الـ respiratory
+
+491
+00:34:00,850 --> 00:34:06,700
+system، أيضا حنتكلم على other systems، بتقلل الـ blood
+
+492
+00:34:06,700 --> 00:34:10,120
+volume، أيضا decrease في الـ plasma volume، بتقلل الـ
+
+493
+00:34:10,120 --> 00:34:13,240
+hemoglobin concentration، الـ physical deconditioning
+
+494
+00:34:13,240 --> 00:34:16,520
+as aerobic work capacity and endurance، postural
+
+495
+00:34:16,520 --> 00:34:21,340
+hypotension، الـ venous thrombus، هاي كلها من تأثيرات
+
+496
+00:34:21,340 --> 00:34:24,660
+الـ immobilization، يعني هذا المريض اللي فاقد الوعي
+
+497
+00:34:24,660 --> 00:34:29,820
+ممكن يصير فيه عنده هذه المشاكل اللي هي ناتجة عن عدم
+
+498
+00:34:29,820 --> 00:34:33,320
+الحركة. الـ Respiratory System طبعا، هيقل الكاباسيتي
+
+499
+00:34:33,320 --> 00:34:36,080
+تبع الـ lung capacity، بيقل الـ antero-posterior
+
+500
+00:34:36,080 --> 00:34:41,100
+diameter and lateral chest diameter، طبعا، secretion
+
+501
+00:34:41,100 --> 00:34:44,500
+retention، بيصير في عندنا atelectasis، بيصير في عندنا
+
+502
+00:34:44,500 --> 00:34:49,420
+accumulation of secretions، بيصير في ضرورة إن لم يكن
+
+503
+00:34:49,420 --> 00:34:53,900
+عليها أيضا، artificial ventilation، بيأثر على الـ
+
+504
+00:34:53,900 --> 00:34:56,760
+metabolic system، ممكن يصير فيه عندنا osteoporosis
+
+505
+00:34:56,760 --> 00:35:00,380
+اللي هي due to immobilization، أو بيصير فيه عندنا
+
+506
+00:35:00,380 --> 00:35:04,800
+formation of kidney and ureteral stones، حصاوى للكلى
+
+507
+00:35:04,800 --> 00:35:08,100
+والكلى. الـ muscular system، بيصير فيه عندنا weakness و
+
+508
+00:35:08,100 --> 00:35:11,620
+atrophy، و الـ joint contractures، and pressure
+
+509
+00:35:11,620 --> 00:35:17,520
+ulcers،  خاصة إن لم يُقلّب كل ساعتين، ممكن كمان يصير فيه
+
+510
+00:35:17,520 --> 00:35:21,960
+مشاكل على الـ central nervous system، يعني الـ ... الـ
+
+511
+00:35:21,960 --> 00:35:25,880
+immobilization بحد ذاتها هي مؤلمة نفسيا، فبتؤدي
+
+512
+00:35:25,880 --> 00:35:29,440
+إلى الـ emotional and behavioral changes، هتغيرهم الـ
+
+513
+00:35:29,440 --> 00:35:33,580
+anxiety and depression، ممكن مريضنا يدخل في اللي هو
+
+514
+00:35:33,580 --> 00:35:37,800
+حالة من الاكتئاب، وحالة من القلق، نتيجة لوجوده
+
+515
+00:35:37,800 --> 00:35:42,800
+bedridden، أو وجوده immobilized داخل اللي هي سرير
+
+516
+00:35:42,800 --> 00:35:47,180
+الـ ICU. هلأ الـ method تبعتنا في الـ patient with
+
+517
+00:35:47,180 --> 00:35:51,340
+mobilization، لأن وردنا هذا كويس وبخير وبيمشي الـ
+
+518
+00:35:51,340 --> 00:35:53,800
+patient mobility should be initiated in ICU in
+
+519
+00:35:53,800 --> 00:35:56,880
+order to prevent complications of bed rest and
+
+520
+00:35:56,880 --> 00:36:00,500
+immobilization. As the patient progresses, the activity
+
+521
+00:36:00,500 --> 00:36:04,000
+can be modified accordingly. يعني أنا ببدأ معاه أول
+
+522
+00:36:04,000 --> 00:36:07,620
+أيام مثلا اللي هو sitting at the edge of bed، بعدين
+
+523
+00:36:07,620 --> 00:36:11,030
+بنمشي around the bed، بعدين بنمشي في الـ corridor
+
+524
+00:36:11,030 --> 00:36:16,410
+يعني الأمر بتتم تطويره حسب حالة الـ patient اللي
+
+525
+00:36:16,410 --> 00:36:19,590
+بين أيديك. Passive movement is always possible in
+
+526
+00:36:19,590 --> 00:36:22,930
+the presence of intravenous lines, life
+
+527
+00:36:22,930 --> 00:36:27,050
+sustaining and monitoring equipment. طبعا بستخدم الـ
+
+528
+00:36:27,050 --> 00:36:31,270
+passive exercise, range of motion، لمريض موجود فيه كل الـ
+
+529
+00:36:31,270 --> 00:36:35,070
+tubes، عليا ما أقدرش أنا أطلع وأنزل فيه، فبالتالي
+
+530
+00:36:35,070 --> 00:36:39,060
+بعمل passive exercise داخل الـ bed أو على الـ patient
+
+531
+00:36:39,060 --> 00:36:45,260
+هو على الـ bed. الـ bed-ridden patient، طبعا مرضي هنا
+
+532
+00:36:45,260 --> 00:36:49,540
+bed-ridden، بس في movement once there is active
+
+533
+00:36:49,540 --> 00:36:52,860
+participation. دي زي الـ active motion exercise
+
+534
+00:36:52,860 --> 00:36:56,880
+become possible. وقت ما مريض ما بيقدر يقم، ممكن أنا
+
+535
+00:36:56,880 --> 00:37:02,120
+أخليه يشتغل على الـ CBM أو اللي هو الـ CBM، اللي هو عبارة عن
+
+536
+00:37:02,120 --> 00:37:05,720
+continuous passive motion. Can be used in ICU to
+
+537
+00:37:05,720 --> 00:37:08,900
+improve range of motion and tissue healing and
+
+538
+00:37:08,900 --> 00:37:11,380
+decrease lumbar edema following joint surgery.
+
+539
+00:37:11,380 --> 00:37:16,780
+بستخدمه جهاز، بستخدمه داخل الـ ICU. Adding resistance
+
+540
+00:37:16,780 --> 00:37:20,160
+to movement improves strength by affecting
+
+541
+00:37:20,160 --> 00:37:23,610
+gravity. Manual resistance, weight, and balance. الـ
+
+542
+00:37:23,610 --> 00:37:27,130
+endurance can be improved by increasing the number
+
+543
+00:37:27,130 --> 00:37:30,610
+of repetitions and giving any exercise. هذا بالنسبة
+
+544
+00:37:30,610 --> 00:37:34,970
+لمريضنا اللي هو الـ bedridden، بحاول أنا أتحرك فيه
+
+545
+00:37:34,970 --> 00:37:40,170
+أو أعمله الـ exercise حسب اللي هو الحالة. Sustained
+
+546
+00:37:40,170 --> 00:37:44,310
+standing and ambulation، تمام؟ هنا الـ bedridden
+
+547
+00:37:44,310 --> 00:37:47,450
+patient، هنا standing، و الـ ambulation، sitting، للـ
+
+548
+00:37:47,450 --> 00:37:52,140
+balance is a prerequisite. للـ understanding، طبعا أكيد
+
+549
+00:37:52,140 --> 00:37:55,240
+لازم يكون في عندو الـ static و الـ dynamic balance
+
+550
+00:37:55,240 --> 00:37:59,120
+مهم جدا سواء كان في الـ sitting أو في الـ standing.
+
+551
+00:37:59,570 --> 00:38:02,790
+Standing balance is a prerequisite للـ walking، طبعا
+
+552
+00:38:02,790 --> 00:38:07,330
+شيء أساسي، prerequisite اللي هي شيء سابق أو حاجة
+
+553
+00:38:07,330 --> 00:38:10,510
+أساسية لإنه يصير في عندي walking. الـ walker and the
+
+554
+00:38:10,510 --> 00:38:13,750
+crutches may be used during walking, during
+
+555
+00:38:13,750 --> 00:38:17,430
+ambulation. Intravenous line may be attached to a
+
+556
+00:38:17,430 --> 00:38:21,730
+rolling IV pole. بدي أكون حاططهم على اللي هو الـ
+
+557
+00:38:21,730 --> 00:38:25,610
+pole هذه أو ما يسمى بالعلاقة، وأمشي أنا والمريض
+
+558
+00:38:25,610 --> 00:38:29,760
+في وجود هاي العلاقة الأساسية. والقطري اللي هو الـ
+
+559
+00:38:29,760 --> 00:38:31,840
+central venous pressure line، والـ chest tube، و
+
+560
+00:38:31,840 --> 00:38:37,780
+الـ abdominal drain، for example، اللي هو can be disconnected
+
+561
+00:38:37,780 --> 00:38:41,800
+temporarily with permission. يعني على سبيل المثال
+
+562
+00:38:41,800 --> 00:38:46,880
+مريض محطوط على monitor، ما عنده canula فيها مثلا
+
+563
+00:38:46,880 --> 00:38:52,310
+محلول، ممكن أن أستأذن من الدكتور تبعه، وأطلب أنه
+
+564
+00:38:52,310 --> 00:38:56,370
+أنا بدي أعمل اللي هو get training، وأخده طبعا، وأمشي
+
+565
+00:38:56,370 --> 00:39:00,090
+فيه، بس أنه أنا بأخذ إذن الدكتور والتمريض، علشان
+
+566
+00:39:00,090 --> 00:39:02,830
+أكون أنا بالـ safe side، والـ patient تبعي كمان بالـ
+
+567
+00:39:02,830 --> 00:39:08,000
+safe side، وأمشي فيه. طبعا الـ collection bag زي
+
+568
+00:39:08,000 --> 00:39:11,900
+الـ urinary catheter ما يتحرك، لازم تكون مثبتة حتى ما
+
+569
+00:39:11,900 --> 00:39:17,120
+يصير فيها، سمح الله، أي عمليات اللي هو سقوط أو تسريب
+
+570
+00:39:17,120 --> 00:39:20,700
+منها. الباكج، Oxygen tank with added
+
+571
+00:39:20,700 --> 00:39:23,940
+humidification can be secured under a standard
+
+572
+00:39:23,940 --> 00:39:27,360
+walking or IV pole. طبعا مهم جدا أخذ معايا الـ
+
+573
+00:39:27,360 --> 00:39:30,920
+oxygen، واللي هو الـ humidification، وأعلقه على
+
+574
+00:39:30,920 --> 00:39:33,620
+العلاج اللي أنا ماشية فيه مع مرضي. Early
+
+575
+00:39:33,620 --> 00:39:37,690
+mobilization often diminishes the need for long
+
+576
+00:39:37,690 --> 00:39:41,050
+and vigorous chest physical therapy. طبعا الـ early
+
+577
+00:39:41,050 --> 00:39:44,630
+mobilization منيح، وبيعطي نتائج جيدة جدا في
+
+578
+00:39:44,630 --> 00:39:48,030
+اللي هو المرضى اللي هم بيحتاجوا له. This therapy
+
+579
+00:39:48,030 --> 00:39:53,330
+program، خصوصا إني بمنع complications عديدة. الـ
+
+580
+00:39:53,330 --> 00:39:56,490
+equipment اللي أنا بستخدمها في الـ immobilization:
+
+581
+00:39:56,490 --> 00:40:03,150
+poly system with overhead traction units. الـ poly
+
+582
+00:40:03,150 --> 00:40:06,850
+أو الـ suspension room. الـ suspension room كمان مهمة،
+
+583
+00:40:06,850 --> 00:40:11,650
+ropes، و الـ weights، and poles، safety belt for patient
+
+584
+00:40:11,650 --> 00:40:16,140
+transferring، adjustable walker and crutches. كمان الـ
+
+585
+00:40:16,140 --> 00:40:20,320
+IV rolling pole، و الـ source of supplemental oxygen.
+
+586
+00:40:20,320 --> 00:40:24,420
+كل هذه الشغلات. يعني بكون محاضرة القائمة تبعتي: مرضى
+
+587
+00:40:24,420 --> 00:40:27,580
+بيحتاجوا لـ oxygen، بأخذ معايا الـ IV rolling، ومعالجة
+
+588
+00:40:27,580 --> 00:40:32,220
+عليه اللي هو الـ oxygen. مرضى بيحتاجوا لـ walker، بكون
+
+589
+00:40:32,220 --> 00:40:35,860
+محضرة الـ walker، وبشتغل معايا الـ mobilization
+
+590
+00:40:37,250 --> 00:40:40,550
+يعطيكم ألف عافية، وبهيك بيكون خلصنا الفيديو رقم 9
+
+591
+00:40:40,550 --> 00:40:45,510
+وآخر محاضرة في اللي هو الـ cardiac part، أو الـ
+
+592
+00:40:45,510 --> 00:40:48,910
+cardiology، وإن شاء الله رب العالمين، محاضرة القادمة
+
+593
+00:40:48,910 --> 00:40:52,670
+هتكون في chest physiotherapy. يعطيكم ألف عافية.
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/f2ecvqQQ8us_postprocess.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/f2ecvqQQ8us_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..f1a7d794883d6286e59d25d6634164e67c1c6f12
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/f2ecvqQQ8us_postprocess.srt
@@ -0,0 +1,2372 @@
+1
+00:00:01,080 --> 00:00:03,660
+أحمد الرحيم والصلاة والسلام على أشرف الأنبياء
+
+2
+00:00:03,660 --> 00:00:08,760
+والمرسلين اتكلمنا في ال ICU part 1 عن منهم المرضى
+
+3
+00:00:08,760 --> 00:00:14,460
+الذين يحق لهم دخول قسم العناية المركزة وإيش دور ال
+
+4
+00:00:14,460 --> 00:00:18,900
+physiotherapy في هذه المرحلة الآن سأكمل role of
+
+5
+00:00:18,900 --> 00:00:23,140
+physiotherapy لحالات ال ICU كم أيضا سأتحدث عن
+
+6
+00:00:23,140 --> 00:00:27,020
+أنواع وأشكال ال catheters و ال tube اللي ممكن
+
+7
+00:00:27,020 --> 00:00:32,370
+أتعامل معاهاكمل معاكم في فيديو رقم 9 بإذن الله
+
+8
+00:00:32,370 --> 00:00:34,610
+ننطلق على بركة الله
+
+9
+00:00:42,290 --> 00:00:46,530
+الـ suction catheters في منها أشكال مختلفة و أحجام
+
+10
+00:00:46,530 --> 00:00:51,470
+مختلفة ال tip design تبعها straight او curved ايضا
+
+11
+00:00:51,470 --> 00:00:55,570
+ال material تبعتها مصنوعة من EPVC و كانت مرت علينا
+
+12
+00:00:55,570 --> 00:00:59,090
+قبل هيك او من ال rubber ال number of side holes
+
+13
+00:00:59,090 --> 00:01:02,210
+اللي هو عدد الفتحات اللي موجودة في هذا التيوب ممكن
+
+14
+00:01:02,210 --> 00:01:07,010
+تكون فتحة او كذا فتحة ال size له أحجام مختلفة و
+
+15
+00:01:07,010 --> 00:01:12,290
+طول مختلف و حسب الهدف اللي انا بديهأيضًا تبكيتها
+
+16
+00:01:12,290 --> 00:01:15,630
+والـ Packaging تبعتها يا إما بيه تكون Straight أو
+
+17
+00:01:15,630 --> 00:01:21,050
+Collide يا إما بيه تكون بشكل مستقيم أو جاية بشكل
+
+18
+00:01:21,050 --> 00:01:28,430
+حلزوني موجودة في بكيتات ومعقمة ومؤلفةبالنسبة لديه
+
+19
+00:01:28,430 --> 00:01:33,110
+ال design تبعها بيحكي إن ال curved is better than
+
+20
+00:01:33,110 --> 00:01:38,530
+straight ليه؟ لأن ال curved ممكن يدخلي إلى داخل ال
+
+21
+00:01:38,530 --> 00:01:42,070
+term of bronchus يعني إلى داخل جذع الشعيبات
+
+22
+00:01:42,070 --> 00:01:45,590
+الهوائية الموجودة داخل ال lungs هلأ ال catheters
+
+23
+00:01:45,590 --> 00:01:50,980
+اللي مصنوعة من ال BBC أفضل من ال rubber ليه؟أو
+
+24
+00:01:50,980 --> 00:01:54,820
+ممكن احنا كخصائيين أو ممكن احنا كطبّا بنفضلها
+
+25
+00:01:54,820 --> 00:02:00,100
+للاتّالي أول إشي they are less likely to cause
+
+26
+00:02:00,100 --> 00:02:04,700
+irritation بتسبب irritation ولكن بشكل بسيط جدا مش
+
+27
+00:02:04,700 --> 00:02:10,810
+مثل اللي هو ال rubberتاني إشي أنه أي إشي بيكون
+
+28
+00:02:10,810 --> 00:02:15,670
+داخلها ممكن ملاحظته هلأ إذا أنا بدي أسحب لمريد و
+
+29
+00:02:15,670 --> 00:02:19,270
+أعمله suction لازم أشوف شو لون أو ال color تبع ال
+
+30
+00:02:19,270 --> 00:02:22,470
+secretion حتى أحدد يعني إذا كان yellow مايعنيد فيه
+
+31
+00:02:22,470 --> 00:02:24,830
+infection إذا كان في bleeding بدي أخاف من حاجات
+
+32
+00:02:24,830 --> 00:02:30,870
+تانية إذا allowed of relations للsecretion
+
+33
+00:02:30,870 --> 00:02:36,130
+as they are clear تمام ال issue التالت والأخير أنه
+
+34
+00:02:36,130 --> 00:02:40,130
+هذه ال PVCeasier in insertion and can be directed
+
+35
+00:02:40,130 --> 00:02:44,710
+more easily طبعا سهولة استخدامها بتخلينا احنا
+
+36
+00:02:44,710 --> 00:02:49,790
+نفضلها دائما و ابدا في استخدامها تمام شو ال
+
+37
+00:02:49,790 --> 00:02:53,630
+complication اللي انا ممكن تصير عندي نتيجة ال
+
+38
+00:02:53,630 --> 00:02:58,330
+tracheal suction تمام انا الآن عندي مريض في ال ICU
+
+39
+00:02:58,330 --> 00:03:04,530
+مركب التراكستومي بدي افتح ان هو مكان التراكستومي و
+
+40
+00:03:04,530 --> 00:03:10,150
+اعمل suction عشان اعمل removeالان هذا الاشي
+
+41
+00:03:10,150 --> 00:03:14,370
+هيعمللي مجموعة من ال complications اللي منها
+
+42
+00:03:14,370 --> 00:03:19,350
+Hypoxemia نقص في الأكسجيل Arthrosemia Cardic
+
+43
+00:03:19,350 --> 00:03:23,070
+Arrest في خمسة حوالي من ال complications خليني
+
+44
+00:03:23,070 --> 00:03:25,810
+أشوفهم واحدة واحدةالـ hypoxemia، الـ pre
+
+45
+00:03:25,810 --> 00:03:29,010
+-oxygenation هي مفيدة من الانتقال من الـ hypoxemia
+
+46
+00:03:29,010 --> 00:03:34,330
+في مرحلة دماغية وكل مرحلة من الانتقالات هي محدودة
+
+47
+00:03:34,330 --> 00:03:39,670
+لفترة من 15 ثانية لان الـ hypoxemia ليش بده يصير؟
+
+48
+00:03:39,670 --> 00:03:42,810
+لأنه بيصير في عندنا كمية من الـ irritation المريض
+
+49
+00:03:42,810 --> 00:03:48,150
+بيحبط النفسفبالتالي ممكن يحصل عندنا اختناق وقلة في
+
+50
+00:03:48,150 --> 00:03:52,930
+الـ Oxygen saturation بلاحظه مباشرة على المونيتور
+
+51
+00:03:52,930 --> 00:03:56,140
+إذا كان مريض مشبوك بالمونيتورالارثميا اللي هي
+
+52
+00:03:56,140 --> 00:04:00,520
+عبارة عن الـ atrial أو بسميها increasing في الـ
+
+53
+00:04:00,520 --> 00:04:05,920
+atrial pumping بدي يحصل في عنيا أخر during suction
+
+54
+00:04:05,920 --> 00:04:08,660
+process from two sources نتيجة الـ atrial
+
+55
+00:04:08,660 --> 00:04:13,220
+hypoxemia و ال vagal stimulation لأن بدي تحصل
+
+56
+00:04:13,220 --> 00:04:18,260
+الارثميا نتيجة اللي هي ال atrial hypoxemia leading
+
+57
+00:04:18,260 --> 00:04:22,670
+to myocardial hypoxiaالـ vagal stimulation
+
+58
+00:04:22,670 --> 00:04:27,490
+secondary to tracheal irritation لنتيجة لأ اللي هو
+
+59
+00:04:27,490 --> 00:04:31,230
+الهياجان أو ال irritation التأثير اللي أثار في
+
+60
+00:04:31,230 --> 00:04:35,370
+دخول التيوب و خروجه this complication can best be
+
+61
+00:04:35,370 --> 00:04:38,770
+avoided by appropriate technique أنا ممكن أمنحها
+
+62
+00:04:38,770 --> 00:04:42,750
+بأن أحصل على تقنيك أخر أعمل فيه suction ولكن من
+
+63
+00:04:42,750 --> 00:04:47,950
+غير ما أفوت تيوب داخل ال track يعنيالكمبليكاشن
+
+64
+00:04:47,950 --> 00:04:51,730
+التالتة اللي هو في عندي high potential بدنا يوصل
+
+65
+00:04:51,730 --> 00:04:56,370
+المريض علنا اللي هو ال blood pressure تبعه هيدخلي
+
+66
+00:04:56,370 --> 00:04:59,530
+في high potential ليش؟ إما بيكون ناتج عن ال
+
+67
+00:04:59,530 --> 00:05:04,020
+profound للberdicardiumresulting ناتجة عن الـvegan
+
+68
+00:05:04,020 --> 00:05:07,120
+stimulation اللي أنا حكيت عليه قبل قليل أو نتيجة
+
+69
+00:05:07,120 --> 00:05:09,500
+الـprolonged coughing maneuver during suction
+
+70
+00:05:09,500 --> 00:05:13,060
+process طبعا احنا حاولنا أن ندخل لثيوب داخل
+
+71
+00:05:13,060 --> 00:05:16,820
+التراكيا هذا هيعمللي irritation تمام؟ وأكيد شوفته
+
+72
+00:05:16,820 --> 00:05:20,500
+طبعا في التجربات العملية كيف ممكن هذا المريض انه
+
+73
+00:05:20,500 --> 00:05:23,900
+يعمللي irritation او اي مريض في ال ICU بسuction
+
+74
+00:05:23,900 --> 00:05:27,140
+هاي لثيوب وانا بدخل و بفوت فيها بصير في عنا
+
+75
+00:05:27,140 --> 00:05:29,600
+coughing هاي ال coughing نفسها بتعمل على
+
+76
+00:05:29,600 --> 00:05:34,390
+الhypoxemiaوالـ Hypotension الـ Hypoxemia و الـ
+
+77
+00:05:34,390 --> 00:05:37,330
+Hypotension هي أفضل تقنيات تقنية تقنية تقنية تقنية
+
+78
+00:05:37,330 --> 00:05:37,810
+تقنية تقنية تقنية تقنية تقنية تقنية تقنية تقنية
+
+79
+00:05:37,810 --> 00:05:41,690
+تقنية تقنية تقنية تقنية تقنية تقنية تقنية تقنية
+
+80
+00:05:41,690 --> 00:05:43,750
+تقنية تقنية تقنية تقنية تقنية تقنية تقنية تقنية
+
+81
+00:05:43,750 --> 00:05:44,030
+تقنية تقنية تقنية تقنية تقنية تقنية تقنية تقنية
+
+82
+00:05:44,030 --> 00:05:44,370
+تقنية تقنية تقنية تقنية تقنية تقنية تقنية تقنية
+
+83
+00:05:44,370 --> 00:05:48,010
+تقنية تقنية تقنية
+
+84
+00:05:48,010 --> 00:05:53,810
+تقنية تقنية تقفي البداية أخليه ياخد كمية كافية من
+
+85
+00:05:53,810 --> 00:05:58,470
+الأكسجين حتى ما تخبط عندي نسبة الأكسجين تاني إشي،
+
+86
+00:05:58,470 --> 00:06:01,750
+limit the suction process من 10 إلى 15 ثانية مش
+
+87
+00:06:01,750 --> 00:06:05,870
+أكتر من هيك عشان أنا بديش أفوت المريض في مضاعفات
+
+88
+00:06:05,870 --> 00:06:11,180
+وبعد كده ونستطيع نحكي ياريت اللي جراء حصارclose لل
+
+89
+00:06:11,180 --> 00:06:13,800
+cardiac monitoring طبعا و أسكر ال cardiac
+
+90
+00:06:13,800 --> 00:06:18,400
+monitoring تبعي عشان ما أضميش دائما في tension و
+
+91
+00:06:18,400 --> 00:06:23,460
+صار هلقد و صار هلقد تمام هذا الhypotension الأن ال
+
+92
+00:06:23,460 --> 00:06:26,510
+complicated الرابع لن collapseماذا يعني long
+
+93
+00:06:26,510 --> 00:06:31,470
+collapse؟ بيحصل في عنا اللي هو الوقت ال insertion
+
+94
+00:06:31,470 --> 00:06:35,970
+لهذا ال suction خصوصا إذا كان الكفيتر large وكبير
+
+95
+00:06:35,970 --> 00:06:40,030
+في small diameter artificial airway result in
+
+96
+00:06:40,030 --> 00:06:44,200
+educated spaceيعني هو بدى يكون ال tube داخل في
+
+97
+00:06:44,200 --> 00:06:48,300
+tube تانى، حد فيهم بدى يكون ال diameter تبعه أوسع
+
+98
+00:06:48,300 --> 00:06:51,860
+من ال diameter التانى، هذا هيفوتلي ال patient في
+
+99
+00:06:51,860 --> 00:06:56,380
+مشاكل، ليه؟ لإن أنا ساعت ما بيعمل ال vacuum عملية
+
+100
+00:06:56,380 --> 00:06:59,480
+الشفط is applied في ال lungs كلها، بس معناه تحطش
+
+101
+00:06:59,480 --> 00:07:02,860
+فيه كل الهواء اللى موجود في ال lungs، تمام؟ لإن
+
+102
+00:07:02,860 --> 00:07:05,920
+الهدف تبعى، يعني الهدف الكاتبترإنه أنا أعمل remove
+
+103
+00:07:05,920 --> 00:07:08,680
+للـsecretion أو يصير في suction لهذا الـsecretion
+
+104
+00:07:08,680 --> 00:07:13,360
+هنا لأ، عشان يعمل معادلة في الضغط الـSMOV هيشفطلي
+
+105
+00:07:13,360 --> 00:07:16,480
+كل الهواء اللي موجود في الـlungs فبالتالي بيصير في
+
+106
+00:07:16,480 --> 00:07:20,120
+عندي lung collapsethis is avoided by using
+
+107
+00:07:20,120 --> 00:07:23,440
+catheter whose diameter is smaller than بحل
+
+108
+00:07:23,440 --> 00:07:26,760
+المشكلة هاي في حالة أنه أنا جبت اللي هو القطر
+
+109
+00:07:26,760 --> 00:07:30,460
+تبعها أصغر من القطر اللي أنا هفوته في ال tube
+
+110
+00:07:30,460 --> 00:07:34,080
+التاني لل internal diameters tube B intersection
+
+111
+00:07:34,080 --> 00:07:38,000
+هذا طبعا لازم كل التحضيرات هذه أنا بحضرها مع ال
+
+112
+00:07:38,000 --> 00:07:40,800
+nurse يعني احنا حاكي هنا we are rehabilitative
+
+113
+00:07:40,800 --> 00:07:45,160
+team احنا فريق كامل متكامل بتعاون فيه مع ال nurse
+
+114
+00:07:45,160 --> 00:07:51,760
+باخد قراري من الدكتور انه هذامسموح اشتغله suction
+
+115
+00:07:51,760 --> 00:07:56,900
+ولا مش مسموح تمام في عندنا موضوع ال bacterial
+
+116
+00:07:56,900 --> 00:08:01,140
+contaminations ان هي عبارة عن العدوى البكتيريا
+
+117
+00:08:01,140 --> 00:08:04,900
+احنا اليوم عندنا فتحة داخل التراكيا و بدي افوت
+
+118
+00:08:04,900 --> 00:08:08,040
+فيها suction و ايه يعنيت الكلام اللي انا هدخلها
+
+119
+00:08:08,040 --> 00:08:10,880
+على ال internal organs the user should be wear
+
+120
+00:08:10,880 --> 00:08:15,380
+glovesأمر مفروغ منه for traditional or self
+
+121
+00:08:15,380 --> 00:08:19,700
+-protection تمام؟ لإنه بما إن كمان الأيام هذه في
+
+122
+00:08:19,700 --> 00:08:23,360
+جائحة COVID-19 معناته إنه أنا لازم أكون more
+
+123
+00:08:23,360 --> 00:08:26,740
+sterilized لإنه ال patient تبعي ممكن ينئذي و أنا
+
+124
+00:08:26,740 --> 00:08:30,860
+كمان ممكن أنئذي nasal tracheal suction هذا اللي
+
+125
+00:08:30,860 --> 00:08:33,660
+كلنا بنحكي عليه ال tracheal هنا بدي أحكي على ال
+
+126
+00:08:33,660 --> 00:08:37,120
+nasal tracheal suction nasal معناته أنا هدخل على
+
+127
+00:08:37,120 --> 00:08:42,160
+ال nose و بعدين على ال tracheaوهي تحتوي على اكسجين
+
+128
+00:08:42,160 --> 00:08:46,220
+بكتوريشن، عيبوكسيميا، أيضًا فيه الوكمبليكاشن،
+
+129
+00:08:46,220 --> 00:08:50,040
+severe cardiac arrhythmia، laryngeal spasm، and
+
+130
+00:08:50,040 --> 00:08:54,600
+bronchospasm إحنا هدفنا الـ ICU ما يدخل المرض عنا
+
+131
+00:08:54,600 --> 00:09:00,480
+نهائي في أي كومبليكاشنحفاظا على حياته واستمرارية
+
+132
+00:09:00,480 --> 00:09:05,840
+العيش داخل ال ICU لحد ما يزول عنه الخطر الآن بدي
+
+133
+00:09:05,840 --> 00:09:09,780
+أحكي على بعض ال cuffing and suction addresses بعض
+
+134
+00:09:09,780 --> 00:09:14,020
+الملحقات للقحة والشرف في عند اللفاج اللفاج اسمها
+
+135
+00:09:14,020 --> 00:09:19,130
+lung washing غسيل اللي هي الرئةThe infusion of
+
+136
+00:09:19,130 --> 00:09:26,970
+saline مُعقّم يدخل داخل الرئة، ينظفها، ويطلع بعض
+
+137
+00:09:26,970 --> 00:09:29,810
+الـmucous أو بعض الـsecretion اللي يكون عامل
+
+138
+00:09:29,810 --> 00:09:35,620
+الـplugs لبعض الـcenters أو البنكارأنواع وفي منه
+
+139
+00:09:35,620 --> 00:09:39,200
+small وفي منه large إذا كانت الكمية أقل من عشرة
+
+140
+00:09:39,200 --> 00:09:43,160
+ملي معناته هذا بسمي small amount of levage تمام
+
+141
+00:09:43,160 --> 00:09:47,580
+أما إذا كانت large يعني بين خمسين إلى مائة ملي
+
+142
+00:09:47,580 --> 00:09:50,970
+اللي هو حجم السلاين اللي أنا بدي استخدمهمعناة
+
+143
+00:09:50,970 --> 00:09:54,730
+الكلام هذا بيكون لـ Flexible Bronchoscope يعني
+
+144
+00:09:54,730 --> 00:09:58,330
+اللي أنا بستخدم فيه إشي من الـ Bronchoscope حتى
+
+145
+00:09:58,330 --> 00:10:02,650
+أنظف الرؤى بشكل كامل The role of bronchoalveolar's
+
+146
+00:10:02,650 --> 00:10:06,730
+lavage remained experimental لسه ما زالت اللي هو
+
+147
+00:10:06,730 --> 00:10:10,370
+قيد التجربة in most diseases and plays a more
+
+148
+00:10:10,370 --> 00:10:13,030
+important role in diagnosis than therapeutic
+
+149
+00:10:13,030 --> 00:10:16,490
+management for lung pathology لسه ما زالت الأمور
+
+150
+00:10:16,490 --> 00:10:22,720
+قيد التجربةالأنف خلّفنا من الـ lavage بدأ أخد الـ
+
+151
+00:10:22,720 --> 00:10:25,420
+lung lavage بدأ أخد ال bagging ال bagging هي عبارة
+
+152
+00:10:25,420 --> 00:10:28,000
+زي ما انتوا شايفين هنا عندي في الصورة اللي هي
+
+153
+00:10:28,000 --> 00:10:34,240
+عبارة عن وعاء خليني أحكيه أو بلونة محتوية على
+
+154
+00:10:34,240 --> 00:10:37,500
+أكسوجين محتوية على هواء أنا عن طريقها بفوت ال
+
+155
+00:10:37,500 --> 00:10:39,980
+atrial ventilation أو ال artificial ventilation
+
+156
+00:10:39,980 --> 00:10:46,270
+إلى داخل اللي هو الأنف و الفم للمريضخلّيني أشوف ال
+
+157
+00:10:46,270 --> 00:10:56,090
+backing هي عبارة عن عشرة أوي
+
+158
+00:10:56,090 --> 00:11:00,290
+أو إشي manual بيه اللي هو بال hand أنا ممكن أشتغله
+
+159
+00:11:00,290 --> 00:11:03,830
+which is usually connected with oxygen supply عشان
+
+160
+00:11:03,830 --> 00:11:08,190
+أنا أوصل كمية كافية من ال oxygen if patient is not
+
+161
+00:11:08,190 --> 00:11:15,790
+intubated إذا ما كان trachel أو naso أو oroفمعناة
+
+162
+00:11:15,790 --> 00:11:19,870
+الكلام ال mask هذا انا بحطه على طول على ال face
+
+163
+00:11:19,870 --> 00:11:22,970
+تبعه over the patient face covering the nose and
+
+164
+00:11:22,970 --> 00:11:26,270
+mouth يعني هياخد ال oxygen من حاجتين اللي هي ال
+
+165
+00:11:26,270 --> 00:11:30,310
+nose و ال mouth for the intubated patient هذا إذا
+
+166
+00:11:30,310 --> 00:11:32,870
+كان ال patient هنا not intubated أما إذا كان
+
+167
+00:11:32,870 --> 00:11:38,120
+intubated ال mask removeThe mask is removed and
+
+168
+00:11:38,120 --> 00:11:41,580
+the bag is connected directly to the tracheal tube
+
+169
+00:11:41,580 --> 00:11:45,900
+على طول بحط فيه ال tracheal tube مباشرة حتى يوصل
+
+170
+00:11:45,900 --> 00:11:49,740
+كمية الأكسجين لالريأتين لأن ال bagging is
+
+171
+00:11:49,740 --> 00:11:53,520
+performed by squeezing the bag رسميكالي أنا بضغط
+
+172
+00:11:53,520 --> 00:11:57,560
+عليها بشكل منتظم to deliver a volume of gas
+
+173
+00:11:57,560 --> 00:12:00,880
+للpatient ال expiration على طول هيكون passively
+
+174
+00:12:00,880 --> 00:12:06,740
+فورالاشعوري المريض بيكون إيهش بيعمل اللي هي ال
+
+175
+00:12:06,740 --> 00:12:11,200
+expiration ال bagging is the most frequently used
+
+176
+00:12:11,200 --> 00:12:16,200
+for resuctions طبعا transportation لل patient
+
+177
+00:12:16,200 --> 00:12:18,640
+require mechanical ventilation and conjunction
+
+178
+00:12:18,640 --> 00:12:22,720
+with suctioning unsteadily breathing patient تمام
+
+179
+00:12:22,720 --> 00:12:27,320
+هذا بالنسبة لل bagging اللي أنا بدي أفوت اللي هو
+
+180
+00:12:27,320 --> 00:12:33,230
+عليها ال oxygen لارئتهمفي عندي طريقة أخرى وهنا
+
+181
+00:12:33,230 --> 00:12:36,690
+هدخل في الفيزيو ثيرابي أو في عمق الفيزيو ثيرابي
+
+182
+00:12:36,690 --> 00:12:42,590
+حاجة هدخل فيها في اللي هو القسم التالت من المساق
+
+183
+00:12:42,590 --> 00:12:46,170
+هذا اللي هي shift physiotherapy هدخل في حاجة اسمها
+
+184
+00:12:46,170 --> 00:12:49,250
+البوسترالدرنياج الآن هذا البوسترالدرنياج موضوع
+
+185
+00:12:49,250 --> 00:12:53,710
+كبير وإن شاء الله رب العالمين هيتم تغطيته هنا أيضا
+
+186
+00:12:53,710 --> 00:12:57,710
+بدي أدخل مع المريض في بوسترالدرنياج ليه؟ عشان أنا
+
+187
+00:12:57,710 --> 00:13:02,650
+كمان أعمل remove لهاللي هو situation they are
+
+188
+00:13:02,650 --> 00:13:05,830
+positions that are promote شو هو البصرة الدرنيش هو
+
+189
+00:13:05,830 --> 00:13:09,730
+عبارة عن عدة أوضاع أنا بسمح فيها للجاذبية الأرضية
+
+190
+00:13:09,730 --> 00:13:14,450
+أنها تساعد في خروج اللي هو أو تصريف ال situation
+
+191
+00:13:14,450 --> 00:13:19,070
+يا إما طبعا احنا أخدتوا في ال anatomy ال lungs في
+
+192
+00:13:19,070 --> 00:13:21,410
+عن ال right lungs و في ال left lungs هلأ ال right
+
+193
+00:13:21,410 --> 00:13:24,610
+lungs فيها three lobes أما ال left فيها two lobes
+
+194
+00:13:24,610 --> 00:13:29,430
+الأن ال lower ال middle ال upperOkay أنا بس شوية
+
+195
+00:13:29,430 --> 00:13:34,050
+بدى أعمل مراجعة على ال anatomy فبالتالي أنا وقتى
+
+196
+00:13:34,050 --> 00:13:38,550
+بشوف الأشعة أو بحدد بالسمعة وين هذا secretion
+
+197
+00:13:38,550 --> 00:13:43,310
+موجود بحاول أحط المريض في وضعية بحيث أن الجاذبية
+
+198
+00:13:43,310 --> 00:13:48,650
+تستطيع اللي هو إزاحة هذا secretion طبعا مع other
+
+199
+00:13:48,650 --> 00:13:55,220
+modalities إزاحة هذا secretion إلى الأبرTrachea أو
+
+200
+00:13:55,220 --> 00:13:58,700
+الـ upper tract respiratory يعني الجزء الأعلى من
+
+201
+00:13:58,700 --> 00:14:03,220
+الجهاز التنفسي حتى يتم طرده عن طريق ال cuffing عن
+
+202
+00:14:03,220 --> 00:14:07,560
+طريق ال suction حسب حالة المرضى ال lung segments
+
+203
+00:14:07,560 --> 00:14:11,610
+receiving drainage are positioned upper mostطبعا
+
+204
+00:14:11,610 --> 00:14:16,490
+بحاول اعرف وين انا بالظبط بدي اشتغل على اي lung
+
+205
+00:14:16,490 --> 00:14:20,230
+بالظبط وين موجود في اي part سواء كانت ال upper او
+
+206
+00:14:20,230 --> 00:14:23,450
+ال lower في ال left او في ال right اللي هو upper
+
+207
+00:14:23,450 --> 00:14:27,150
+middle lower طبعا بين قصيا ال basals the majority
+
+208
+00:14:27,150 --> 00:14:31,450
+of ICU treatment is for lower lobes اكتر الناس
+
+209
+00:14:31,450 --> 00:14:34,150
+اللي بيكونوا في ال ICU بيكون عادة عندهم في ال
+
+210
+00:14:34,150 --> 00:14:39,870
+basal lung يعني في قاعدة الرقامهلأ في عندي بعض
+
+211
+00:14:39,870 --> 00:14:44,810
+المشاكل اللى انا ممكن اشتغل عليها او ممكن اواجهها
+
+212
+00:14:44,810 --> 00:14:48,210
+في حالة انه انا بدى اشتغل مع مريض فى ال ICU بتعرف
+
+213
+00:14:48,210 --> 00:14:51,990
+مريض ال ICU ممكن يكون Traumatic Brain Injury ممكن
+
+214
+00:14:51,990 --> 00:14:56,850
+يكون مريض قلب ممكن يكون مريض ميت كتير ترزم ركّباله
+
+215
+00:14:56,850 --> 00:15:02,910
+سواء urine bag سواء ال respiration سواء ال stomach
+
+216
+00:15:02,910 --> 00:15:08,000
+كذاتيوبز موجودة عليه فانا هنا لازم اخد بالي اول
+
+217
+00:15:08,000 --> 00:15:12,920
+اشي من اهم المشاكل او من اهم اللي هي الحاجات اللي
+
+218
+00:15:12,920 --> 00:15:16,340
+انا ممكن الاحظها انه انا مش هقدر اعمله training لل
+
+219
+00:15:16,340 --> 00:15:20,240
+patient turning لل patient ألفه زي ما بدى خصوصا
+
+220
+00:15:20,240 --> 00:15:23,480
+اذا كان مثلا RTA عنده multiple injury عنده على
+
+221
+00:15:23,480 --> 00:15:27,080
+سبيل المثال pelvic fractures عنده تيبيا عنده femur
+
+222
+00:15:27,080 --> 00:15:30,540
+fractures او على سبيل المثال chest او ال ribs
+
+223
+00:15:30,540 --> 00:15:34,320
+fractures هاي الحالة صعبة علي جدا ان اعمله turning
+
+224
+00:15:34,590 --> 00:15:37,770
+obtain the patient history and diagnosis مهم جدا
+
+225
+00:15:37,770 --> 00:15:41,290
+أعرف اللي هو ال medical file تبعته تماما أكون
+
+226
+00:15:41,290 --> 00:15:44,990
+عارفة كيف بدي أشتغل معاه identify the prevalence
+
+227
+00:15:44,990 --> 00:15:48,030
+of fractures, injury, catheters and monitoring
+
+228
+00:15:48,030 --> 00:15:51,640
+equipmentكل الأمور هي ضروري أعرفها قبل ما أحطها
+
+229
+00:15:51,640 --> 00:15:55,440
+بأي وضعية move ال patient to the side of the bed
+
+230
+00:15:55,440 --> 00:15:59,200
+before حركيه على حرفة ال سرير أو حركه على حرفة
+
+231
+00:15:59,200 --> 00:16:03,280
+السرير حتى تقدر تعمل اللي هو ال rolling مثلا
+
+232
+00:16:03,280 --> 00:16:05,600
+أعطالي مثلًا، اللي كان في السبين اللي أحوله على
+
+233
+00:16:05,600 --> 00:16:11,610
+البرون لازم أجيبه شوية على حرفة السريرطبعا ال
+
+234
+00:16:11,610 --> 00:16:15,250
+moves لل line و ال ECG و wires و كل الأمور هاية
+
+235
+00:16:15,250 --> 00:16:18,270
+اللي أنا حكيت عليها انت اليوم داخل اللي هو ICU
+
+236
+00:16:18,270 --> 00:16:21,730
+معناته تاخد في بالك انه انا في عندي هذا المريض
+
+237
+00:16:21,730 --> 00:16:26,390
+مشبوك على كذا حاجة place one hand over the hip and
+
+238
+00:16:26,390 --> 00:16:29,710
+other hand shoulder rotated لل patient هذا في حالة
+
+239
+00:16:29,710 --> 00:16:33,390
+انه انا بدي اجلبه من ال sublime ل ال prone place
+
+240
+00:16:33,390 --> 00:16:39,410
+roll behindحطي roll حول اللى هو دهر المريض او خلف
+
+241
+00:16:39,410 --> 00:16:44,370
+المريض to prevent him
+
+242
+00:16:44,370 --> 00:16:47,570
+انه يرجع تانى اذا انت بدك تجاعدى فقط على ال side
+
+243
+00:16:47,570 --> 00:16:51,890
+-lying خلي في اللى هو roll او اذا ماكان فيه على
+
+244
+00:16:51,890 --> 00:16:55,070
+roll ممكن تحط مخدات ب lord انه يضلوا على side
+
+245
+00:16:55,070 --> 00:17:00,550
+-lying position تمام؟أيضا من المشاكل ممكن يواجهيني
+
+246
+00:17:00,550 --> 00:17:04,490
+اللي هو turning لل patient into prone position صعب
+
+247
+00:17:04,490 --> 00:17:09,150
+جدا أن أحط ال patient هنا prone position و في بعض
+
+248
+00:17:09,150 --> 00:17:13,310
+الحالات طبعا ممكن أتسبب في إذائهم إذا ما كنت ماخدة
+
+249
+00:17:13,310 --> 00:17:17,970
+بالي put the patient head on pillow to prevent
+
+250
+00:17:17,970 --> 00:17:21,860
+necking of the tracheal and ventilator tubeمهم
+
+251
+00:17:21,860 --> 00:17:26,520
+جدا، حتى بعض الأثر عنا بتكون هي أصلا مصممة ان يكون
+
+252
+00:17:26,520 --> 00:17:31,080
+في فتحة ل ال head و ال face لإنه بخاف أنا أعمل
+
+253
+00:17:31,080 --> 00:17:34,880
+اللي هي incident أو إغلاق لاللي هو respiratory
+
+254
+00:17:34,880 --> 00:17:40,340
+airway أو اللي هي ال airway مجرى الهواء ال patient
+
+255
+00:17:40,340 --> 00:17:44,360
+with lower limb traction أو external fixation and
+
+256
+00:17:44,360 --> 00:17:47,580
+assistant is need to position of the affected limb
+
+257
+00:17:47,580 --> 00:17:52,640
+تمام؟أي إشي مشبوك فيه المريض طبعا لازم أنا أخد
+
+258
+00:17:52,640 --> 00:17:56,400
+بالي حتى إنه ما أسبب له ألم أو ما أسبب له damage
+
+259
+00:17:56,400 --> 00:18:00,900
+لأي إشي أنا بدي أحرقه فيه put larol under chest to
+
+260
+00:18:00,900 --> 00:18:04,440
+prevent occlusions or obstruction of the
+
+261
+00:18:04,440 --> 00:18:08,120
+tracheostomy tube حكينا عليها النقطة اللي قبل
+
+262
+00:18:08,120 --> 00:18:12,520
+السابقة after turning check the reconnected
+
+263
+00:18:12,520 --> 00:18:15,880
+ventilator tubes and monitoring equipment عيني على
+
+264
+00:18:15,880 --> 00:18:20,040
+ال equipment كلها سواء كانتفي تابع ال respiratory
+
+265
+00:18:20,040 --> 00:18:23,540
+او ال digestive او ال urinary كل الأسلاك او كل ال
+
+266
+00:18:23,540 --> 00:18:29,520
+tubes المشبوكة لازم اكون خبالي منها طبعا هنا ورانا
+
+267
+00:18:29,520 --> 00:18:36,260
+كيف ان هو حاول اللي هو تغيير وضعيت المريض وكيف
+
+268
+00:18:36,260 --> 00:18:42,900
+طبعا تربل الحمايةكيف معاه حد تاني assistant و
+
+269
+00:18:42,900 --> 00:18:46,920
+أعينها على اللي هو ال tubes اللي موجودة شايفين كام
+
+270
+00:18:46,920 --> 00:18:51,540
+إشي في عنده اللي هو ال tubes التابعة لل
+
+271
+00:18:51,540 --> 00:18:55,980
+respiratory في tubes تابعة لل digestive طبعا و
+
+272
+00:18:55,980 --> 00:18:59,300
+لازم أكيد طبعا هيكون في can you لهنا فبالتالي أنا
+
+273
+00:18:59,300 --> 00:19:03,660
+لازم أاخد حذري أيضا من المشاكل التالتة اللي هي ال
+
+274
+00:19:03,660 --> 00:19:07,930
+patient with intravenous lineالـ central
+
+275
+00:19:07,930 --> 00:19:11,070
+intravenous subclavian line هاي اللي موجودة هنا
+
+276
+00:19:11,070 --> 00:19:16,030
+تحت الـ subclavian تمام sure it to be parallel to
+
+277
+00:19:16,030 --> 00:19:19,250
+the patient thoracic مش لازم تكون رايحة يمين او
+
+278
+00:19:19,250 --> 00:19:24,410
+يسارة peripheral لل intravenous الأيات في ايضا
+
+279
+00:19:24,410 --> 00:19:28,990
+مشاكل اللي هي usually not interfere with turning
+
+280
+00:19:28,990 --> 00:19:34,050
+and should not cross the joint مش لازم اناطبعا
+
+281
+00:19:34,050 --> 00:19:37,010
+أجرب منها هذه اللي بتكون في الـ Periphery يعني
+
+282
+00:19:37,010 --> 00:19:40,030
+ممكن كان يولا مركبة في الإيد أو كان يولا مركبة في
+
+283
+00:19:40,030 --> 00:19:43,770
+الإجر لبيبي صغير فبالتالي أنا لازم أخذ باليه ال
+
+284
+00:19:43,770 --> 00:19:47,910
+Adrenal line required good position with secure
+
+285
+00:19:47,910 --> 00:19:53,270
+dressing or splint طبعا تأكدي تماما أنه في عندي
+
+286
+00:19:53,270 --> 00:19:56,750
+اللي هو الحماية اللازمة لهذا المريض من أن أنا
+
+287
+00:19:56,750 --> 00:20:02,170
+ماأزيه في أي حلقة turning the patient with chest
+
+288
+00:20:02,170 --> 00:20:08,740
+tubeالـ Tracheal tube و الفيدينج تيوب تبعا with
+
+289
+00:20:08,740 --> 00:20:13,460
+positioning to prevent necking أنه أنا ما أتني أو
+
+290
+00:20:13,460 --> 00:20:18,400
+ما أسدده and compression of chest tube Tracheal
+
+291
+00:20:18,400 --> 00:20:24,070
+tube plays a large roleAndroid chest from bra line
+
+292
+00:20:24,070 --> 00:20:26,550
+position اذا انا اتيت اغيرت من ال bra line
+
+293
+00:20:26,550 --> 00:20:29,810
+position لازم اخد بالي انه مايصير في اي انفداد
+
+294
+00:20:29,810 --> 00:20:34,470
+الانجيتيوب او ال nasogastric tube بتسميه هنا لازم
+
+295
+00:20:34,470 --> 00:20:37,630
+انا اخد بالي ان هذا ال chest physical therapy
+
+296
+00:20:37,630 --> 00:20:40,550
+before 30 minutes after feeding break into
+
+297
+00:20:40,550 --> 00:20:44,330
+vomiting مهم جدا زي اي جلسة مساج على سبيل المثال
+
+298
+00:20:44,330 --> 00:20:47,990
+لازم انا اعمل جلسة و مايكون مريضي ناحد و أجمع لانه
+
+299
+00:20:47,990 --> 00:20:53,250
+انا بخاف من ال vomiting continuouslyFeeding should
+
+300
+00:20:53,250 --> 00:20:56,530
+be stopped for physical therapy and resumed
+
+301
+00:20:56,530 --> 00:21:01,970
+للpatient not positioned with head down لأن في
+
+302
+00:21:01,970 --> 00:21:05,210
+حالات traumatic brain injury فعب جدا ان انا احط
+
+303
+00:21:05,210 --> 00:21:09,510
+المريض تبعي في وضعي البصري الدمانياج ويقل head
+
+304
+00:21:09,510 --> 00:21:13,580
+down لأن هذا هيزيد وفاق المشكلةال continuous
+
+305
+00:21:13,580 --> 00:21:16,700
+feeling should be stopped طبعا أنا لازم أغلق ال
+
+306
+00:21:16,700 --> 00:21:19,840
+angiotube و أسكتره و بعدين أبلش أعمل physical
+
+307
+00:21:19,840 --> 00:21:24,500
+therapy session تبعتي عشان أملأ أي vomiting حيث
+
+308
+00:21:24,500 --> 00:21:29,430
+يحصل معاياالان بعض الـ thump drains اللي هو بعض
+
+309
+00:21:29,430 --> 00:21:32,930
+الحاجات اللي بتكون عاملة زي مستنقة في الـ drains
+
+310
+00:21:32,930 --> 00:21:36,570
+usually thump drain not interferes with patient
+
+311
+00:21:36,570 --> 00:21:42,090
+positioning هذه بعض ال secretion مش لازم تعملي او
+
+312
+00:21:42,090 --> 00:21:45,910
+تتأدي لمشاكل try not to pull disconnected intra
+
+313
+00:21:45,910 --> 00:21:49,110
+-abdominal tubes بدي احاول ان انا ما اسحب اي
+
+314
+00:21:49,110 --> 00:21:52,790
+abdominal tubes بتكون محطوطة في منطقة ال abdomen
+
+315
+00:21:52,790 --> 00:21:57,100
+disloading للthumpleads to hemorrhage and
+
+316
+00:21:57,100 --> 00:22:04,580
+preposition تمام؟ بدي أحاول أنه أنا ما أفصلها عن
+
+317
+00:22:04,580 --> 00:22:09,960
+أي جهاز موجود فيه تمام؟ هذا بالنسبة لبعض المشاكل
+
+318
+00:22:09,960 --> 00:22:14,940
+اللي أنا ما زلت مكملة فيها لل patient اللي موجود
+
+319
+00:22:14,940 --> 00:22:19,280
+في ال ICUللبصر الدراجة أيضا في عندنا ال training
+
+320
+00:22:19,280 --> 00:22:22,380
+أو ال turning لل patient with urinary catheter
+
+321
+00:22:22,380 --> 00:22:26,480
+تعرفوا ال patient هنا صعب أنه يروح توالت أو يرجع
+
+322
+00:22:26,480 --> 00:22:29,900
+فبالتالي بيتركبله اللي هي ال urine catheter
+
+323
+00:22:29,900 --> 00:22:33,820
+clamped between collection bed and patient before
+
+324
+00:22:33,820 --> 00:22:37,130
+turningلازم احافظ عليها لان انا painful literally
+
+325
+00:22:37,130 --> 00:22:41,910
+painful انه انا احركها او صعب جدا انه انا لو حركت
+
+326
+00:22:41,910 --> 00:22:46,370
+المريض انها تنشل معايا the collection bag is moved
+
+327
+00:22:46,940 --> 00:22:50,560
+to side of the bed that patient face after turning
+
+328
+00:22:50,560 --> 00:22:54,980
+طبعا حطها على اللي هو الرايل تبع السرير اللي موجود
+
+329
+00:22:54,980 --> 00:22:57,320
+ال patient عليه keep the collection bag in
+
+330
+00:22:57,320 --> 00:23:01,920
+dependent position مهم جدا حتى يصير اللي هو فيه
+
+331
+00:23:01,920 --> 00:23:07,520
+تصريف لل ball اكرمكم الله بعد اللي هو نهاية جلستك
+
+332
+00:23:07,520 --> 00:23:12,840
+يعني حطه تحت او ضايهي تحت اللي هو الرايل انه يكون
+
+333
+00:23:12,840 --> 00:23:18,940
+مع ال dependent position حتى مايطلع من مكانه الآن
+
+334
+00:23:18,940 --> 00:23:21,500
+إيجينا للـ Physotherapy رول ال percussion and
+
+335
+00:23:21,500 --> 00:23:23,940
+vibration they are maneuvers used in combination
+
+336
+00:23:23,940 --> 00:23:26,560
+with postural drainage بستخدمهم أيضًا مع الـ
+
+337
+00:23:26,560 --> 00:23:30,420
+postural drainage they facilitated large and small
+
+338
+00:23:30,420 --> 00:23:35,530
+airway clearnessحكينا إن هما عاملين أو حركتين
+
+339
+00:23:35,530 --> 00:23:39,630
+مهمين جدا advancing circulation centrally so that
+
+340
+00:23:39,630 --> 00:23:45,890
+can be expirated and suctioned طبعا المريض تبعنا
+
+341
+00:23:45,890 --> 00:23:51,490
+مهم جدا إنه أنا أكون متحكمة فيه و قادر أعمل
+
+342
+00:23:51,490 --> 00:23:55,150
+الحركتين الصحيحين حتى إنه أنا أعمل اللي هو remove
+
+343
+00:23:55,150 --> 00:24:02,580
+and اللي هي clear way ال percussionit's
+
+344
+00:24:02,580 --> 00:24:06,480
+rhythmically طبعا clubbing أو cupping hand over
+
+345
+00:24:06,480 --> 00:24:11,660
+involved long segment حكيت بالاشعة أو بالسمعة بعرف
+
+346
+00:24:11,660 --> 00:24:16,340
+أين أنا بالضبط بدأ أشتغل فبالتالي بحط اللي هي ال
+
+347
+00:24:16,340 --> 00:24:20,840
+clubbing و ببدأ أشتغل عليه it adds to inspiration
+
+348
+00:24:20,840 --> 00:24:24,870
+and secretion from wall and airways it's bloodit's
+
+349
+00:24:24,870 --> 00:24:29,630
+applied during expiration and expiration بشتغلها
+
+350
+00:24:29,630 --> 00:24:33,450
+في الشهيق والذفير على حد الذوق should not cause
+
+351
+00:24:33,450 --> 00:24:37,270
+pain in elevation مش لازم انا في ال vibration اكسر
+
+352
+00:24:37,270 --> 00:24:40,510
+ضلوع المريض لا ولا لازم في ال plumbing اكون drill
+
+353
+00:24:40,510 --> 00:24:44,570
+لازم اكون careful لان انا بشتغل مع مريض ICU
+
+354
+00:24:44,570 --> 00:24:50,880
+applied over اللي هيPart area of the thoracic بدنا
+
+355
+00:24:50,880 --> 00:24:54,980
+نشتغل على المنطقة فقط اللي فيها decretion ال
+
+356
+00:24:54,980 --> 00:24:57,680
+obesity and bulk dressing decrease ال percussion
+
+357
+00:24:57,680 --> 00:25:01,080
+effect طبعا إذا كان مريض تبعنا ما شاء الله
+
+358
+00:25:01,080 --> 00:25:06,020
+overweight فبالتالي لازم أنا أحسن من وضع اللي هو
+
+359
+00:25:06,020 --> 00:25:08,540
+ال clubbing عشان أجيب لتيجة معايا
+
+360
+00:25:11,840 --> 00:25:15,540
+الأطفال الصغار بإيد واحدة حكيت ما علمتكم مثل مثلًا
+
+361
+00:25:15,540 --> 00:25:19,460
+بشتغل اللي هو ال vibration و ال percussion
+
+362
+00:25:23,930 --> 00:25:29,250
+بالسمعة بعرفون بالظبط انا ماشية تلاتين ملي من ال
+
+363
+00:25:29,250 --> 00:25:35,030
+medicine cup with padded rim و rubber nibble بحط
+
+364
+00:25:35,030 --> 00:25:38,810
+اللي هو rubber nibble testing or tinting hand
+
+365
+00:25:38,810 --> 00:25:42,630
+overlapping second finger and third with third
+
+366
+00:25:42,630 --> 00:25:45,370
+finger يعني بعض الأحيان ممكن اعمل trapping بس
+
+367
+00:25:45,370 --> 00:25:48,810
+بالثلاث أصابع هاي اللي موجودة معنا
+
+368
+00:25:51,100 --> 00:25:54,400
+الـ Vibration هذا بالنسبة للـ clubbing الـ
+
+369
+00:25:54,400 --> 00:26:00,220
+Vibration اللي هي up to down أو side to side it is
+
+370
+00:26:00,220 --> 00:26:03,760
+intermittent chest wall compression طبعا أنا بعمل
+
+371
+00:26:03,760 --> 00:26:06,400
+ضغطة على chest wall compression applied during
+
+372
+00:26:06,400 --> 00:26:09,560
+expiration أما ال clubbing بيحصل في ال expiration
+
+373
+00:26:09,560 --> 00:26:12,580
+و لا ال expiration لما أخد بالنا هنا applied
+
+374
+00:26:12,580 --> 00:26:17,820
+during expiration over affected area appliedin the
+
+375
+00:26:17,820 --> 00:26:21,200
+direction of chest motion used combination with
+
+376
+00:26:21,200 --> 00:26:24,320
+postural drainage بالأغلب بستخدمه مع postural
+
+377
+00:26:24,320 --> 00:26:28,720
+drainage separated secretion from wall of large
+
+378
+00:26:28,720 --> 00:26:33,620
+and small airways زي ما حكيت بتطلع اللي هي ال
+
+379
+00:26:33,620 --> 00:26:37,620
+bases أو ال amount of secretion على ال airway من
+
+380
+00:26:37,620 --> 00:26:42,700
+ال lower loops لتطلع major stemالـ frequency تبع
+
+381
+00:26:42,700 --> 00:26:46,960
+الـ vibration من 12 إلى 20 هرتز مش لازم أزيده لإنه
+
+382
+00:26:46,960 --> 00:26:50,960
+أنا بشتغل مع مريض ICU بعدين ممكن أشتغل shacking
+
+383
+00:26:50,960 --> 00:26:55,520
+طبعا side to side is gentle from vibration أخف
+
+384
+00:26:55,520 --> 00:27:00,920
+شوية عليه لمريض ال ICU ال mainly nickel vibrators
+
+385
+00:27:00,920 --> 00:27:05,880
+and brassiers they produce vertical and rotatory
+
+386
+00:27:05,880 --> 00:27:08,140
+or rotatory movement combination with them
+
+387
+00:27:08,140 --> 00:27:14,480
+recently introduced لICUAlso used in home care in
+
+388
+00:27:14,480 --> 00:27:17,060
+patients with chronic chest الـ mechanical
+
+389
+00:27:17,060 --> 00:27:22,640
+vibrators باستخدموه في البيت ولكن بيحذر مع الـ
+
+390
+00:27:22,640 --> 00:27:25,860
+chronic chest disease هنشوفه في اللي هو شبكر الـ
+
+391
+00:27:25,860 --> 00:27:28,800
+chest في الtherapy بس هنا لازم أكون أنا حذرة جدا
+
+392
+00:27:28,800 --> 00:27:33,520
+وأعلم حدا من الأهل أنه يشتغلوا الـ manual
+
+393
+00:27:33,520 --> 00:27:36,960
+vibration and percussion have following advantage
+
+394
+00:27:36,960 --> 00:27:41,280
+over mechanical deviceطبعا دائما اليدوي احنا بنحس
+
+395
+00:27:41,280 --> 00:27:44,740
+فيه بيكون أفضل ويكون له مميزات من ال mechanical
+
+396
+00:27:44,740 --> 00:27:48,280
+خلينا نشوف شو هي المميزات can be modified from rib
+
+397
+00:27:48,280 --> 00:27:52,830
+fractures not detected with x-rayممكن أنا أكشف إذا
+
+398
+00:27:52,830 --> 00:27:55,390
+كان لصمح الله في المريض هذا اللي أنا بين إيديا
+
+399
+00:27:55,390 --> 00:27:58,190
+عنده rib fractures ولا لأ في ال face expression
+
+400
+00:27:58,190 --> 00:28:02,430
+إذا أنا لاحظت في وجود تعابير الوجه إن هو بيتألم
+
+401
+00:28:02,430 --> 00:28:05,610
+لما بحط إيدي على ال middle lobe و بعده بعرف إنه
+
+402
+00:28:05,610 --> 00:28:08,110
+أنا في عندي مشكلة في ال ribs اللي جاية في هذا
+
+403
+00:28:08,110 --> 00:28:10,790
+المكان هلأ ال therapist can monitor ال patient
+
+404
+00:28:10,790 --> 00:28:13,830
+response by manual palpation and visual inspection
+
+405
+00:28:13,830 --> 00:28:18,030
+بيحس بإيده، بيشعر بالمرض اللي تحت إيده، can be
+
+406
+00:28:18,030 --> 00:28:23,240
+adjustedto suit patient needs ممكن انا اعدل من على
+
+407
+00:28:23,240 --> 00:28:26,900
+سبيل المثال قوة ال vibration نتيجة على مدى تحمل
+
+408
+00:28:26,900 --> 00:28:29,960
+المريض لهذا ال vibration اما بال vibrator ال
+
+409
+00:28:29,960 --> 00:28:34,920
+mechanical مافي مجال اعرف اذا هو المريض متحمله او
+
+410
+00:28:34,920 --> 00:28:38,560
+لأ او انه على سبيل المثال غير لما اكون انا حاسة
+
+411
+00:28:38,560 --> 00:28:41,580
+بايده many benefits can be obtained with manual
+
+412
+00:28:41,580 --> 00:28:42,140
+techniques
+
+413
+00:28:44,930 --> 00:28:48,630
+الشعور اللي هو شعورك في المريض او ان انت تحط ايدك
+
+414
+00:28:48,630 --> 00:28:53,070
+على المريض هيلها خواص لحالها،يلها فائدة لحالها
+
+415
+00:28:53,070 --> 00:28:55,850
+there is no advantage ال mechanical device over
+
+416
+00:28:55,850 --> 00:29:00,650
+manual مافي عندنا اي مميزات تابعة لال mechanical
+
+417
+00:29:00,650 --> 00:29:07,230
+مقارنة بال manual دائما ال manual افضل من اي اشياء
+
+418
+00:29:07,230 --> 00:29:10,610
+الان في عندي method هحكي عليها to improving
+
+419
+00:29:10,610 --> 00:29:14,440
+ventilationbreathing exercise و ال incentive
+
+420
+00:29:14,440 --> 00:29:17,580
+spirometer هذا الجهاز ال inspirometer ان شاء الله
+
+421
+00:29:17,580 --> 00:29:21,120
+هنشرح عنه فيه اللي هو shift فيزيو ثيرابي خليني
+
+422
+00:29:21,120 --> 00:29:24,740
+أشوف ال breathing exercise أحداثي أنا ك فيزيو
+
+423
+00:29:24,740 --> 00:29:28,360
+ثيرابيست assist in removal secretion improve
+
+424
+00:29:28,360 --> 00:29:31,900
+respiratory muscle strength and endurance increase
+
+425
+00:29:31,900 --> 00:29:34,940
+lateral saccage mobility and expansion promote la
+
+426
+00:29:34,940 --> 00:29:39,640
+relaxation عندي أربع أحداث بكون حاطهم في باليرايحة
+
+427
+00:29:39,640 --> 00:29:44,100
+على ال ICU و بدي أعمل breathing exercise شو أنواع
+
+428
+00:29:44,100 --> 00:29:48,160
+ال breathing exercise؟ في عنديه اللي هي ال deep
+
+429
+00:29:48,160 --> 00:29:52,440
+breathing exercise طبعا أو ال deep breathing في
+
+430
+00:29:52,440 --> 00:29:57,440
+segmental اللي بدي يكون فقط لهذه segment نفسها يا
+
+431
+00:29:57,440 --> 00:30:00,520
+upper يا middle يا base أو ال exercise connecting
+
+432
+00:30:00,520 --> 00:30:04,320
+with breathing اللي هو ال forebell exercise خليني
+
+433
+00:30:04,320 --> 00:30:07,700
+أشوف ال deep breathing exerciseاللي هو بيشمل دافره
+
+434
+00:30:07,700 --> 00:30:12,320
+مثل الـ Breathing الـ Burst Lab Breathing and Nose
+
+435
+00:30:12,320 --> 00:30:15,800
+Exercise طبعا بيشمل دافره احنا حكينا عنها اللي هي
+
+436
+00:30:15,800 --> 00:30:21,020
+mainly في ال respiratory muscle في بريثنغ خاص فيها
+
+437
+00:30:21,020 --> 00:30:24,980
+ال Burst Lab اللي هو كيف انه يغلق شفاك ويقض عليهم
+
+438
+00:30:24,980 --> 00:30:28,930
+و ال Nose Exerciseحنتكلم على breathing exercise
+
+439
+00:30:28,930 --> 00:30:34,430
+محاضرات كاملة ونشرح عنه الآن في اللي هو ال ICU يا
+
+440
+00:30:34,430 --> 00:30:37,050
+بستخدم ال deep breathing يا إما هستخدم ال
+
+441
+00:30:37,050 --> 00:30:40,790
+segmental أو ال localized أو ال coastal اللي هو ال
+
+442
+00:30:40,790 --> 00:30:44,470
+coastal breathing في ال abical اللي هي قمة الرؤى
+
+443
+00:30:44,470 --> 00:30:49,090
+أو ال sternal breathing exercise تمام هذا ال
+
+444
+00:30:49,090 --> 00:30:52,070
+exercise طبعا اللي هو ال breathing exercise حكينا
+
+445
+00:30:52,070 --> 00:30:55,090
+فيه منه ثلاث أنواع ال intensive spirometer هو
+
+446
+00:30:55,090 --> 00:30:58,640
+عبارة عن جهازإن شاء الله رب العالمين أكيد بتشوفوه
+
+447
+00:30:58,640 --> 00:31:02,620
+موجود على نفس المعمل وموجود كمان لما تزوروا
+
+448
+00:31:02,620 --> 00:31:06,580
+المستشفيات its therapeutic modalities relies on
+
+449
+00:31:06,580 --> 00:31:10,620
+patients on efforts to perform hyperventilation
+
+450
+00:31:10,620 --> 00:31:13,880
+طبعا and provide bulk feedback to the patient
+
+451
+00:31:13,880 --> 00:31:18,520
+بيعطي نتيجة للمريض وإن ال patient observe hair
+
+452
+00:31:18,520 --> 00:31:22,870
+inspired volumeand she can encourage to work by
+
+453
+00:31:22,870 --> 00:31:26,190
+inhaling طبعا inhaling اللي هو في ال inspiration
+
+454
+00:31:26,190 --> 00:31:29,450
+more and more it is an effective method to
+
+455
+00:31:29,450 --> 00:31:33,670
+prevention reversal lung collapse بيمنع ان ال lung
+
+456
+00:31:33,670 --> 00:31:37,910
+ترجع collapse من أول و جديد and promotion لكاف
+
+457
+00:31:37,910 --> 00:31:41,890
+postoperative cases لما بعد اللي هم ال
+
+458
+00:31:41,890 --> 00:31:46,760
+postoperative cases يعني لما بعد العمليةمشوار نمعه
+
+459
+00:31:46,760 --> 00:31:49,660
+طويل اللي هو الـ Intensive Care أو اللي هو بسميه
+
+460
+00:31:49,660 --> 00:31:53,860
+الـ Intensive Spirometers طبعا الـ IF وهو خاص بالـ
+
+461
+00:31:53,860 --> 00:31:57,460
+Breathing و بالـ Exercise و الـ Breathing Problems
+
+462
+00:31:57,460 --> 00:32:01,920
+أنواعه، في منه الـ Volume، في منه الـ Flu، في منه
+
+463
+00:32:01,920 --> 00:32:06,500
+الـ Photoelectric الـ Volume oriented in .. طبعا
+
+464
+00:32:06,500 --> 00:32:11,260
+oriented in incentive spirometer في اللي هو منه
+
+465
+00:32:11,260 --> 00:32:15,680
+الـ Volidine و الـ Florex أنواعهالـ Flu طبعا
+
+466
+00:32:15,680 --> 00:32:19,820
+oriented intensive spirometer تريفلو أو ترفلو
+
+467
+00:32:19,820 --> 00:32:25,580
+الفوتوالكتريكال أيضا اللي هو SpiroCare انواعها
+
+468
+00:32:25,580 --> 00:32:28,800
+اللي هي باسمها تجارية على ال clinical application
+
+469
+00:32:28,800 --> 00:32:32,160
+لل intensive spirometer evaluation and diagnosis
+
+470
+00:32:32,160 --> 00:32:36,140
+of respiratory disorders بقيملي و بشخصلي الحالة
+
+471
+00:32:36,140 --> 00:32:40,240
+prevention and treatment للathlaxis and promotion
+
+472
+00:32:40,240 --> 00:32:44,280
+للقف in postoperative caseوأيضا امبروف لل patient
+
+473
+00:32:44,280 --> 00:32:49,160
+exercise performance بيعرف كداش ال lung capacity و
+
+474
+00:32:49,160 --> 00:32:55,560
+بيحسن من نوعيتها و أدائها في مريض اللي هو ال ICU
+
+475
+00:32:55,560 --> 00:33:00,100
+ال immobilization و ال method تبعتنا في ال
+
+476
+00:33:00,100 --> 00:33:04,740
+mobilization in ICU لأن ال immobilization مريضي ال
+
+477
+00:33:04,740 --> 00:33:10,470
+ICU إذا كان RTA على سبيل المثالو عنده head injury
+
+478
+00:33:10,470 --> 00:33:14,990
+فمعناة الكلام هيدخل يبقى anesthesia، sedation و
+
+479
+00:33:14,990 --> 00:33:19,470
+neuromuscular blockers تمام خصوصا إذا كان دي بكومه
+
+480
+00:33:19,470 --> 00:33:22,990
+كله تلت reaction ممكن يكون محطوط له منهم الناس
+
+481
+00:33:22,990 --> 00:33:26,930
+طبعا اللي هيكون immobilized ممكن يكون القصد اللي
+
+482
+00:33:26,930 --> 00:33:30,790
+هو supplant في حالة neurological disorders إذا كان
+
+483
+00:33:30,790 --> 00:33:35,150
+في عنده اللي هو cutting للصبين ال cord injuryوالـ
+
+484
+00:33:35,150 --> 00:33:37,230
+pain طبعا و الـ general weakness و الـ
+
+485
+00:33:37,230 --> 00:33:41,110
+malnutrition في حالات اللي هو بيكون immobilized
+
+486
+00:33:41,110 --> 00:33:45,710
+المريض فيها use لل monitoring equipment تمام؟ هاي
+
+487
+00:33:45,710 --> 00:33:50,150
+الست حالات أو مجموعة اللي هو الناس اللي بيكون
+
+488
+00:33:50,150 --> 00:33:55,630
+immobilized داخل ال ICU خليني أشوفهم شو تأثير ال
+
+489
+00:33:55,630 --> 00:33:58,350
+immobilization تأثير ال immobilization هتأثر لي
+
+490
+00:33:58,350 --> 00:34:00,850
+على ال cardiovascular system و ال respiratory
+
+491
+00:34:00,850 --> 00:34:06,700
+system أيضاحنتكلم على other systems بتقلل ال blood
+
+492
+00:34:06,700 --> 00:34:10,120
+volume ايضا decrease لل plasma volume بتقلل ال
+
+493
+00:34:10,120 --> 00:34:13,240
+homoglobin concentration ال physical decongestion
+
+494
+00:34:13,240 --> 00:34:16,520
+as aerobic work capacity and endurance postural
+
+495
+00:34:16,520 --> 00:34:21,340
+hypotension ال venous thrombus هاي كلها من تأثيرات
+
+496
+00:34:21,340 --> 00:34:24,660
+ال immobilization يعني هذا المريض اللي فاقد الوعي
+
+497
+00:34:24,660 --> 00:34:29,820
+ممكن يصير في عنده هذه المشاكل اللي هي ناتجة عن عدم
+
+498
+00:34:29,820 --> 00:34:33,320
+الحركةالـ Respiratory System طبعاً هيقل الكباسيتي
+
+499
+00:34:33,320 --> 00:34:36,080
+تبع ال lung capacity بيقل ال antib-steroid
+
+500
+00:34:36,080 --> 00:34:41,100
+diameter and lateral لال chest طبعاً Secretion
+
+501
+00:34:41,100 --> 00:34:44,500
+retention بيصير في عندنا atlaxis بيصير في عندنا
+
+502
+00:34:44,500 --> 00:34:49,420
+accumulation of secretion بيصير في ضرورة إن لم يكن
+
+503
+00:34:49,420 --> 00:34:53,900
+على ايضا Artificial ventilation بيأثر علىالـ
+
+504
+00:34:53,900 --> 00:34:56,760
+metabolic system ممكن يصير فيه عنا osteoporosis
+
+505
+00:34:56,760 --> 00:35:00,380
+اللي هي due to immobilization أو بيصير فيه عنا
+
+506
+00:35:00,380 --> 00:35:04,800
+formation للكدن and urethral stones حصاوي لهذه
+
+507
+00:35:04,800 --> 00:35:08,100
+الكيلة ال muscular system بيصير فيه عنا weakness و
+
+508
+00:35:08,100 --> 00:35:11,620
+atrophy و ال joint contractures and pressure
+
+509
+00:35:11,620 --> 00:35:17,520
+ulcers خصر إن لم يقلب كل ساعتينممكن كمان يصير فيه
+
+510
+00:35:17,520 --> 00:35:21,960
+مشاكل على الـ central nervous system يعني ال .. ال
+
+511
+00:35:21,960 --> 00:35:25,880
+immobilization بحد ذاتها هي مؤلمة سيكولوجيا فبتليق
+
+512
+00:35:25,880 --> 00:35:29,440
+على ال emotional behavioral change هتغيرهم ال
+
+513
+00:35:29,440 --> 00:35:33,580
+anxiety and depression ممكن مريضنا يدخل في اللي هو
+
+514
+00:35:33,580 --> 00:35:37,800
+حالة من الاكتئاب وحالة من القلق نتيجة لوجوده
+
+515
+00:35:37,800 --> 00:35:42,800
+bedridden أو وجوده immobilized داخل اللي هي سرير
+
+516
+00:35:42,800 --> 00:35:47,180
+ال ICUهلأ ال method استبعتنا في ال patient with
+
+517
+00:35:47,180 --> 00:35:51,340
+mobilization لأن وردنا هذا كويس و بخير و بيمشي ال
+
+518
+00:35:51,340 --> 00:35:53,800
+patient mobility should be initiated in ICU in
+
+519
+00:35:53,800 --> 00:35:56,880
+order to prevent complications bed rest and
+
+520
+00:35:56,880 --> 00:36:00,500
+immobilization as patient progressed ال activity
+
+521
+00:36:00,500 --> 00:36:04,000
+كان modified accordingly يعني أنا ببدأ معاه أول
+
+522
+00:36:04,000 --> 00:36:07,620
+أيام مثلا اللي هو sitting at the edge of bed بعدين
+
+523
+00:36:07,620 --> 00:36:11,030
+بنمشي around to the bed بعدينبنمشي في ال corridor
+
+524
+00:36:11,030 --> 00:36:16,410
+يعني الأمر بتتم تطويره حسب حالة ال patient اللي
+
+525
+00:36:16,410 --> 00:36:19,590
+بين أيديك passive movement is always possible in
+
+526
+00:36:19,590 --> 00:36:22,930
+spectrum maneuvers, intravascular lines, life
+
+527
+00:36:22,930 --> 00:36:27,050
+sustaining and monitoring equipment طبعا بستخدم ال
+
+528
+00:36:27,050 --> 00:36:31,270
+passive exercise range of motion لمريض بدردن كل ال
+
+529
+00:36:31,270 --> 00:36:35,070
+tubes عليا ماقدرش أنا أطلع و أنزل فيه فبالتالي
+
+530
+00:36:35,070 --> 00:36:39,060
+بعمل passive exercise داخلال bed أو على ال patient
+
+531
+00:36:39,060 --> 00:36:45,260
+هو على ال bed ال bed-ridden patient طبعا مرضي هنا
+
+532
+00:36:45,260 --> 00:36:49,540
+bed-ridden بس في movement once there is active
+
+533
+00:36:49,540 --> 00:36:52,860
+participation دي زي ال motion active exercise
+
+534
+00:36:52,860 --> 00:36:56,880
+become possible وقتش مرضي ما بقدر يجوم ممكن انا
+
+535
+00:36:56,880 --> 00:37:02,120
+اخليه يشتغل ال CBMأو اللي هو CBM اللي هو عبارة عن
+
+536
+00:37:02,120 --> 00:37:05,720
+continuous passive motion can be used in ICU to
+
+537
+00:37:05,720 --> 00:37:08,900
+improve range of motion and tissue healing and
+
+538
+00:37:08,900 --> 00:37:11,380
+decrease lumbar edema following joint surgery
+
+539
+00:37:11,380 --> 00:37:16,780
+بستخدمه جهاز بستخدمه داخل ال ICU Adding resistance
+
+540
+00:37:16,780 --> 00:37:20,160
+to movement improves strength by affecting
+
+541
+00:37:20,160 --> 00:37:23,610
+gravity, manual resistance, weight and balanceالـ
+
+542
+00:37:23,610 --> 00:37:27,130
+endurance can be improved by increasing the number
+
+543
+00:37:27,130 --> 00:37:30,610
+of repetitions and giving any exercise هذا بالنسبة
+
+544
+00:37:30,610 --> 00:37:34,970
+لمريضنا اللي هو ال bedridden بحاول انا اتحرك فيه
+
+545
+00:37:34,970 --> 00:37:40,170
+او اعمله ال exercise حسب اللي هو الحالة sustained
+
+546
+00:37:40,170 --> 00:37:44,310
+standing and ambulation تمام؟ هنا ال bedridden
+
+547
+00:37:44,310 --> 00:37:47,450
+patient هنا standing و الambulation sitting لل
+
+548
+00:37:47,450 --> 00:37:52,140
+balance isprerequesting لل understanding طبعا أكيد
+
+549
+00:37:52,140 --> 00:37:55,240
+لازم يكون في عند ال aesthetic و ال dynamic balance
+
+550
+00:37:55,240 --> 00:37:59,120
+مهم جدا سواء كان في ال sitting أو في ال survive
+
+551
+00:37:59,570 --> 00:38:02,790
+Standing balance is a prerequisite لل walking طبعا
+
+552
+00:38:02,790 --> 00:38:07,330
+إشي أساسي prerequisite اللي هي إشي ثابق أو حاجة
+
+553
+00:38:07,330 --> 00:38:10,510
+أساسية لإنه يصير في عندي walking ال walker and the
+
+554
+00:38:10,510 --> 00:38:13,750
+crutches may be used to during walking during
+
+555
+00:38:13,750 --> 00:38:17,430
+ambulation intravenous line may be attached to a
+
+556
+00:38:17,430 --> 00:38:21,730
+rolling IV ball بدي أكون حاطاهم على اللي هو ال
+
+557
+00:38:21,730 --> 00:38:25,610
+ball هذه أو ما يسمى بالعلاقة و أمشي أنا و المريض
+
+558
+00:38:25,610 --> 00:38:29,760
+في وجود هاي العلاقة الأساسيوالقطري اللي هو الـ
+
+559
+00:38:29,760 --> 00:38:31,840
+central venous pressure line و الـ chest tube و
+
+560
+00:38:31,840 --> 00:38:37,780
+الـ abdominal example اللي هو can be disconnected
+
+561
+00:38:37,780 --> 00:38:41,800
+temporarily with permission يعني على سبيل المثال
+
+562
+00:38:41,800 --> 00:38:46,880
+مرضي محطوط على monitor ماعنده canula فيها مثلا
+
+563
+00:38:46,880 --> 00:38:52,310
+محلول ممكن أن أستأذن منهالدكتور تبعه و اطلب انه
+
+564
+00:38:52,310 --> 00:38:56,370
+انا بدي اعمل اللي هو get training و اخده طبعا امشي
+
+565
+00:38:56,370 --> 00:39:00,090
+فيه بس انه انا باخد اذن الدكتور و التمريد علشان
+
+566
+00:39:00,090 --> 00:39:02,830
+اكون انا بال safe side و ال patient تبعي كمان بال
+
+567
+00:39:02,830 --> 00:39:08,000
+safe side و امشي فيهطبعا ال collection bag زي
+
+568
+00:39:08,000 --> 00:39:11,900
+الوريناليكاتيتار ما يتكفت لازم تكون مثبتة حتى ما
+
+569
+00:39:11,900 --> 00:39:17,120
+يصير فيها سمح الله أي عمليات اللي هو سقوط أو تسريب
+
+570
+00:39:17,120 --> 00:39:20,700
+من هبقى البكاشن Oxygen tank with added
+
+571
+00:39:20,700 --> 00:39:23,940
+humidification can be secured under standard
+
+572
+00:39:23,940 --> 00:39:27,360
+walking or IP pole طبعا مهم جدا أخذ معايا ال
+
+573
+00:39:27,360 --> 00:39:30,920
+oxygen و اللي هو ال humidification و أعلجه على
+
+574
+00:39:30,920 --> 00:39:33,620
+العلاجة اللي أنا ماشية فيها مع مرضى early
+
+575
+00:39:33,620 --> 00:39:37,690
+mobilizationoften diminished that need for long
+
+576
+00:39:37,690 --> 00:39:41,050
+and vigorous chest physical therapy طبعا الـ Air
+
+577
+00:39:41,050 --> 00:39:44,630
+Immobilization بتير منيح وبيعطي نتائج جيدة جدا في
+
+578
+00:39:44,630 --> 00:39:48,030
+اللي هو المرضى اللي هم بيحاجة لفيه this therapy
+
+579
+00:39:48,030 --> 00:39:53,330
+program خصوصا إن أنا بمنع complication عديدة ال
+
+580
+00:39:53,330 --> 00:39:56,490
+equipment اللي أنا بستخدمها في ال immobilization
+
+581
+00:39:56,490 --> 00:40:03,150
+poly systemwith overhead traction units الـ poly
+
+582
+00:40:03,150 --> 00:40:06,850
+أو ال suspension room ال suspension room كمان مهمة
+
+583
+00:40:06,850 --> 00:40:11,650
+ropes وال weight and poles safety belt of patient
+
+584
+00:40:11,650 --> 00:40:16,140
+transferring adjustable walker and crutchesكمان ال
+
+585
+00:40:16,140 --> 00:40:20,320
+IV rolling ball و ال source of supplemental oxygen
+
+586
+00:40:20,320 --> 00:40:24,420
+كل هذه الشغلات يعني بكون محاضرة القائمة تبعتي مرضى
+
+587
+00:40:24,420 --> 00:40:27,580
+بحاجة ل oxygen باخد معايا ال IV rolling و معالجة
+
+588
+00:40:27,580 --> 00:40:32,220
+عليه اللى هو ال oxygen مرضى بحاجة ل Walker بكون
+
+589
+00:40:32,220 --> 00:40:35,860
+محاضرة ال Walker و بشتغل معايا ال mobilization
+
+590
+00:40:37,250 --> 00:40:40,550
+يعطيكوا ألف عافية وبهيك بيكون خلصنا الفيديو رقم 9
+
+591
+00:40:40,550 --> 00:40:45,510
+و آخر محاضرة في اللي هو ال cardiac part أو ال
+
+592
+00:40:45,510 --> 00:40:48,910
+cardiology وإن شاء الله رب العالمين محاضرة القادمة
+
+593
+00:40:48,910 --> 00:40:52,670
+هتكون في chest physiotherapy يعطيكوا ألف عافية
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/r6-xQ1NaUtM.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/r6-xQ1NaUtM.srt
new file mode 100644
index 0000000000000000000000000000000000000000..ba895844a0500d9811c026b390000dc75f67c00f
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/r6-xQ1NaUtM.srt
@@ -0,0 +1,1451 @@
+1
+00:00:00,890 --> 00:00:03,730
+اليوم إن شاء الله رب العالمين، هكمل معاكم ال
+
+2
+00:00:03,730 --> 00:00:07,890
+cardiac rehabilitation part 2، وهتكون  هاي إن شاء
+
+3
+00:00:07,890 --> 00:00:12,150
+الله رب العالمين. أول فيديو بعد الـ midterm، هنكمل شو
+
+4
+00:00:12,150 --> 00:00:15,830
+الـ exercise اللي أنا ممكن أشتغلها مع مريض القلب في
+
+5
+00:00:15,830 --> 00:00:20,370
+اللي هو الـ cardiac rehabilitation. نبدأ على بركة
+
+6
+00:00:20,370 --> 00:00:23,330
+الله. بدي أشرح اليوم في المحاضرة إن شاء الله رب
+
+7
+00:00:23,330 --> 00:00:27,350
+العالمين، شو الـ outcomes اللي أنا ممكن احصل عليهم في
+
+8
+00:00:27,350 --> 00:00:29,890
+الـ cardiac rehabilitation training، الـ exercise
+
+9
+00:00:29,890 --> 00:00:33,390
+prescriptions لـ cardiac patient، و الـ border
+
+10
+00:00:33,390 --> 00:00:36,410
+scales. طبعا هتاخدوه معايا نظري، وإن شاء الله في
+
+11
+00:00:36,410 --> 00:00:40,130
+المعامل هتشتغلوه أيضاً. الـ exercises، stress risk
+
+12
+00:00:40,130 --> 00:00:44,510
+هناخدها. نبدأ على بركة الله. شو هما الـ Outcomes of
+
+13
+00:00:44,510 --> 00:00:48,670
+Cardiac Rehabilitation؟ هأتحدث عن عشرة Outcomes. أول
+
+14
+00:00:48,670 --> 00:00:51,430
+واحدة، الـ Improve Exercise Tolerance.
+
+15
+00:00:51,430 --> 00:00:54,630
+حكينا هي عبارة عن قدرة الشخص على عمل الـ Exercise
+
+16
+00:00:54,630 --> 00:00:57,470
+على سبيل المثال، Cardiac Rehabilitation Patient
+
+17
+00:00:57,470 --> 00:01:00,390
+Training for Patients with Coronary Heart Disease
+
+18
+00:01:00,390 --> 00:01:03,220
+أو الـ Congestive Heart Failure، leads to
+
+19
+00:01:03,220 --> 00:01:06,580
+objectively variable. تختلف الـ improvement في الـ
+
+20
+00:01:06,580 --> 00:01:10,100
+exercise capacity. يعني في قدرة الشخص على أداء الـ
+
+21
+00:01:10,100 --> 00:01:13,500
+exercise، في الـ man و الـ woman، regardless of age
+
+22
+00:01:13,500 --> 00:01:17,740
+طبعاً بغض النظر عن العمر، لأن this beneficial effect
+
+23
+00:01:17,740 --> 00:01:21,880
+doesn't persist in long term after competitions،
+
+24
+00:01:21,880 --> 00:01:26,020
+لالـ cardiac rehabilitation، لأن هاي الـ endurance
+
+25
+00:01:26,020 --> 00:01:30,320
+اللي احنا بنحكي عليها هي عبارة عن قدرة اللي هو
+
+26
+00:01:30,320 --> 00:01:33,420
+المريض على أداء التمرين كذا مرة. Therefore،
+
+27
+00:01:33,420 --> 00:01:37,160
+exercise training must be maintained long term for
+
+28
+00:01:37,160 --> 00:01:40,160
+sustained improvement للـ exercise capacity. كام
+
+29
+00:01:40,160 --> 00:01:45,380
+قدرة له على أداء الـ exercise. الـ outcome الثانية
+
+30
+00:01:45,380 --> 00:01:48,880
+اللي هي الـ control of symptoms. أنا أتحكم بالـ
+
+31
+00:01:48,880 --> 00:01:51,980
+symptoms اللي موجودة عندهم. على سبيل المثال، إذا كان
+
+32
+00:01:51,980 --> 00:01:55,760
+ديابتس equation.  جدي أنا قدرتي على أنه أنا أتحكم في
+
+33
+00:01:55,760 --> 00:01:59,490
+الـ diabetes. كذا كان عنده hypertension كمان، كم قدر
+
+34
+00:01:59,490 --> 00:02:03,010
+دي على إن أنا أعمل control لـ hypertension في الـ
+
+35
+00:02:03,010 --> 00:02:05,790
+patient تبع الـ coronary heart disease و الانجينة.
+
+36
+00:02:05,790 --> 00:02:08,430
+significantly improved during cardiac
+
+37
+00:02:08,430 --> 00:02:11,290
+rehabilitation exercise program. و الـ patient اللي
+
+38
+00:02:11,290 --> 00:02:14,790
+عنده في left ventricle failure and dysfunctions
+
+39
+00:02:14,790 --> 00:02:19,050
+improved symptoms in heart failure. تمام؟ يعني كل
+
+40
+00:02:19,050 --> 00:02:23,390
+diagnosis، إيه تشخيص لحاله، إيه تحكم بالـ symptoms
+
+41
+00:02:23,390 --> 00:02:27,450
+لحالها. الـ Outcomes الثالثة، الـ Improvement في الـ
+
+42
+00:02:27,450 --> 00:02:31,330
+blood level of lipids. الآن اللي بتعرفوا الـ lipids
+
+43
+00:02:31,330 --> 00:02:34,390
+و الكوليسترول و الأمور اللي زي هذه. مهم جداً أنا
+
+44
+00:02:34,390 --> 00:02:37,670
+دائماً أعمل تحليل للـ patient عشان أعرف أديه نسبتها
+
+45
+00:02:37,670 --> 00:02:40,870
+في الدم. الـ improvement in lipid and lipid protein
+
+46
+00:02:40,870 --> 00:02:43,690
+levels are observed when the patient undergoing
+
+47
+00:02:43,690 --> 00:02:47,470
+rehabilitation exercise program. طبعاً مهم جداً لأنه
+
+48
+00:02:47,470 --> 00:02:49,810
+لو كان سمح الله الـ Triglyceride عالي، أنا ممكن
+
+49
+00:02:49,810 --> 00:02:54,750
+أعمل exercise يزيد ويفاقم من المشكلة، و تنتقل لـthrombosis
+
+50
+00:02:54,750 --> 00:02:58,670
+أو تنتقل لـ Fatty embolism من مكان إلى آخر. الـ
+
+51
+00:02:58,670 --> 00:03:01,930
+exercise must be combined with dietary and medical
+
+52
+00:03:01,930 --> 00:03:05,830
+intervention to require lipid control. طبعاً نعمل
+
+53
+00:03:05,830 --> 00:03:08,470
+control عن طريق الأكل، عن طريق أخده لعلاجاته
+
+54
+00:03:08,470 --> 00:03:12,430
+المناسبة لتذويب الـ high أو لتخفيض الـ cholesterol
+
+55
+00:03:12,430 --> 00:03:17,410
+level. الـ outcomes الرابعة، إنه الـ effect on body
+
+56
+00:03:17,410 --> 00:03:20,510
+weight. الـ optimal للـ management في الـ obesity
+
+57
+00:03:20,510 --> 00:03:22,690
+required beneficial rehabilitation include
+
+58
+00:03:22,690 --> 00:03:25,590
+nutritional education and counseling، و الـ
+
+59
+00:03:25,590 --> 00:03:28,770
+behavioral. الـ obesity مش كتير منيحة في هذه الحالات.
+
+60
+00:03:28,770 --> 00:03:31,950
+لازم أنا أعمل counseling، أعمل استشارات، أعمل
+
+61
+00:03:31,950 --> 00:03:37,090
+ارشادات، إن أنت لازم يا حاجة، اتخفضي من اللي هو الـ
+
+62
+00:03:37,090 --> 00:03:42,370
+weight. تبع الـ Outcomes الخامسة، اللي هو effect on
+
+63
+00:03:42,370 --> 00:03:44,910
+blood pressure. الهيبوتنسن في exercise و training زي
+
+64
+00:03:44,910 --> 00:03:49,410
+ما حكينا، مهم جداً إن أنا أعمل minimal effect، و أقلل
+
+65
+00:03:49,410 --> 00:03:52,730
+blood pressure، و أيضاً أعمل control عليه، as a
+
+66
+00:03:52,730 --> 00:03:55,930
+symptom reduction. في الـ smoking، إذا كان عندنا
+
+67
+00:03:55,930 --> 00:03:59,930
+cardiac rehabilitation patients، smoker person will
+
+68
+00:03:59,930 --> 00:04:03,790
+be should be، يجب عليه أنه أنا أعمل stopping لهذه
+
+69
+00:04:03,790 --> 00:04:06,830
+اللي هي الـ habits. educational and counseling،
+
+70
+00:04:06,830 --> 00:04:09,570
+behavioral modification of the ground resulting in
+
+71
+00:04:09,570 --> 00:04:13,090
+cessation of smoking، insignificant of number من الـ
+
+72
+00:04:13,090 --> 00:04:18,470
+patient. الـ outcomes السابعة، أنه أنا أحسن psycho
+
+73
+00:04:18,470 --> 00:04:22,030
+social wellbeing. حالة نفسية مهمة جداً في حالات الـ
+
+74
+00:04:22,030 --> 00:04:24,670
+cardiac patient، لأنه أي زعل ممكن يعملي على غفلة
+
+75
+00:04:24,670 --> 00:04:29,600
+ضغط الدم، وبالتالي المريض ممكن يروح فيه. الآن الـ
+
+76
+00:04:29,600 --> 00:04:32,920
+Cardiac Patient Exercise، خلال الـ Education تبعته،
+
+77
+00:04:32,920 --> 00:04:36,380
+enhanced major psychosocial and social function.
+
+78
+00:04:36,380 --> 00:04:39,860
+أنه أنت راح تكون كويس، أنت بخير، راح ترجع لحياتك
+
+79
+00:04:39,860 --> 00:04:43,300
+طبيعي بإذن الله تعالى. الـ Outcomes التامن، اللي هو
+
+80
+00:04:43,300 --> 00:04:46,480
+هو enhanced للـ social adjustment and function.
+
+81
+00:04:46,480 --> 00:04:49,850
+احنا كنا وحكينا على الـ Rehabilitative Team، أو الـ
+
+82
+00:04:49,850 --> 00:04:52,030
+Rehabilitation Team، كانت في عندنا اللي هو الـ
+
+83
+00:04:52,030 --> 00:04:55,170
+Vocational Training، اللي هو تبع التدريب المهني، أو
+
+84
+00:04:55,170 --> 00:04:59,390
+إنه نرجع الشخص اللي هو صار عنده مشكلة في القلب، as
+
+85
+00:04:59,390 --> 00:05:02,770
+much as possible للوضع السابق. هلأ الـ Cardiac
+
+86
+00:05:02,770 --> 00:05:06,250
+Rehabilitation Exercise Training، improve الـ
+
+87
+00:05:06,250 --> 00:05:08,990
+social adjustment and function. أيضاً الـ Exercise
+
+88
+00:05:08,990 --> 00:05:12,730
+Training is recommended to improve social outcome.
+
+89
+00:05:13,300 --> 00:05:17,060
+الـ "I return to work"، زي ما حكينا في النقطة
+
+90
+00:05:17,060 --> 00:05:19,800
+السابقة، أنه أنا بدي عن طريق الـ "functional
+
+91
+00:05:19,800 --> 00:05:23,160
+training"، أنه أنا أرجع هذا الشخص لـ أداء وظيفته
+
+92
+00:05:23,160 --> 00:05:26,980
+السابقة، إذا كان العمل، أو إذا كان هذا يتناسب مع
+
+93
+00:05:26,980 --> 00:05:31,600
+وظيفة القلب، أو إنه وظيفة أو شكل المريض بشكل عام.
+
+94
+00:05:31,600 --> 00:05:34,960
+فأنا ممكن أرجعه. إذا كان، لو الله، هو كان عامل بناء
+
+95
+00:05:34,960 --> 00:05:40,180
+و الـ work heavy عليه، وإنه مش قادر يكمل، بنحاول إنه
+
+96
+00:05:40,180 --> 00:05:44,410
+احنا نشوف وظيفة ثانية. mini أو mini a non-exercise
+
+97
+00:05:44,410 --> 00:05:47,790
+variable effect in outcomes، زي الـ period
+
+98
+00:05:47,790 --> 00:05:50,410
+employment statements and angular attitude،
+
+99
+00:05:50,410 --> 00:05:55,950
+و الـ income. طبعاً إن شاء الله، الإشي بيرجع as much as
+
+100
+00:05:55,950 --> 00:05:59,490
+possible، حسب الظروف و الأوضاع اللي احنا بنكون فيها
+
+101
+00:05:59,490 --> 00:06:03,300
+في الدائرة. الآن الـ Outcomes الأخيرة اللي هي مهمة
+
+102
+00:06:03,300 --> 00:06:06,900
+جداً، أنه أنا أقلل الـ mortality. الـ mortality معناته
+
+103
+00:06:06,900 --> 00:06:11,200
+هي عبارة عن نسبة الوفيات اللي بيصير، أو ناجمة عن
+
+104
+00:06:11,200 --> 00:06:14,200
+هذا الحدث. it's significant data for survival
+
+105
+00:06:14,200 --> 00:06:17,060
+benefits for patients who participate in cardiac
+
+106
+00:06:17,060 --> 00:06:20,000
+rehabilitation exercise training، but it's not
+
+107
+00:06:20,000 --> 00:06:24,920
+attributed، الترتيب اللي هو، to exercise a lot. تمام؟
+
+108
+00:06:24,920 --> 00:06:29,280
+الشيء بيتعلق قد إيه severity of disease؟ قد إيه حتة
+
+109
+00:06:29,280 --> 00:06:32,760
+المرض؟ هل هو صار فيه blockage كامل، أو block كاملة
+
+110
+00:06:32,760 --> 00:06:35,900
+للـ coronary artery، على سبيل المثال؟ شو نوع الـ embolism
+
+111
+00:06:35,900 --> 00:06:40,280
+اللي صارت؟ و بيعتمد على نفس الحالة التشخيصية، هيك
+
+112
+00:06:40,280 --> 00:06:44,040
+بيكون. أنا حكيت عن عشرة من الـ outcomes للـ cardiac
+
+113
+00:06:44,040 --> 00:06:47,880
+patient، في اللي هو الـ rehabilitation program. الآن
+
+114
+00:06:47,880 --> 00:06:52,420
+بدي أتحدث عن الـ physiotherapy exercise. في هنا الـ
+
+115
+00:06:52,420 --> 00:06:56,480
+Exercise Prescriptions لـ Cardiac Patient. هأحكي أي
+
+116
+00:06:56,480 --> 00:06:59,980
+تمرين أنا بدي أشتغله مع اللي هو الـ Cardiac
+
+117
+00:06:59,980 --> 00:07:04,840
+Patient. هأحكي عن الـ mode، النمط الـ exercise. هأحكي عن
+
+118
+00:07:04,840 --> 00:07:08,640
+الـ frequency. هأتكلم عن كمية الـ oxygen اللي أنا بدي
+
+119
+00:07:08,640 --> 00:07:12,220
+أستهلكها في خلال الـ exercise. أنا بأتكلم اليوم أو
+
+120
+00:07:12,220 --> 00:07:16,120
+بأتحدث مع مريض Cardiac Patient. الـ machine pump هي
+
+121
+00:07:16,120 --> 00:07:20,520
+تبعته. هي مهمة جداً. الآن في الـ mode أو النمط تبعنا، الـ
+
+122
+00:07:20,520 --> 00:07:24,640
+aerobic exercise، أو اللي هو التمرين الهوائي. really
+
+123
+00:07:24,640 --> 00:07:28,220
+include walking, jogging, running and swimming، و
+
+124
+00:07:28,220 --> 00:07:31,040
+الـ bicycling. أيضاً مهم جداً. الـ combination of these
+
+125
+00:07:31,040 --> 00:07:34,040
+activities. هذا هو عبارة عن الـ mode، شلون النمط اللي
+
+126
+00:07:34,040 --> 00:07:38,040
+أنا بدي اشتغله مع هذا الـ cardiac patient. الآن الـ
+
+127
+00:07:38,040 --> 00:07:42,440
+frequency، كان عدد المرات. الـ individuals with less
+
+128
+00:07:42,440 --> 00:07:47,970
+than 100، الشخص الـ cardiac اللي عنده كمية الأكسجين
+
+129
+00:07:47,970 --> 00:07:52,970
+المستهلكة لكل دقيقة أقل من ثلاثة ملليلترات، أو الكابستي دي
+
+130
+00:07:52,970 --> 00:07:56,270
+تبعته، هذا إله تعامل خاص، لأن الـ METs، أنا
+
+131
+00:07:56,270 --> 00:07:59,650
+هأعرفكم شو اسمها أو شو تعريفها في الـ slide القادمة،
+
+132
+00:07:59,650 --> 00:08:02,910
+هي عبارة عن كمية الأكسجين اللي أنا بدي أستهلكها
+
+133
+00:08:02,910 --> 00:08:07,890
+خلال الدقيقة. أما الـ individuals من ثلاثة لخمسة
+
+134
+00:08:07,890 --> 00:08:10,910
+تبعته، الـ capacity should be engaged in one to
+
+135
+00:08:10,910 --> 00:08:15,110
+session per day. هأعطيه جلسة لجلسةين في اليوم. إذا كان
+
+136
+00:08:15,110 --> 00:08:18,410
+الـ individual أكثر من خمسة تبعته، كمية الـ Oxygen
+
+137
+00:08:18,410 --> 00:08:22,530
+فأنا بأعطيه اللي هو الـ Exercise من ثلاث لخمس مرات
+
+138
+00:08:22,530 --> 00:08:26,290
+أسبوعياً. هنا هذه الأرقام مهمة جداً، لأنه إذا شغلنا
+
+139
+00:08:26,290 --> 00:08:28,270
+في الـ ICU أو في الـ Cardiac Rehabilitation
+
+140
+00:08:28,270 --> 00:08:31,670
+Program، كويس إنه أنا أكون عارف إيش هو الـ Exercise
+
+141
+00:08:31,670 --> 00:08:35,330
+الآن. شو تعريفنا للميت؟ هو عبارة عن الـ Metabolic
+
+142
+00:08:35,330 --> 00:08:42,040
+Equivalent Treatment، معامل اللي هو بيحسب لي كمية
+
+143
+00:08:42,040 --> 00:08:46,400
+الأكسجين المستهلكة من هذا الشخص في خلال الدقيقة
+
+144
+00:08:46,400 --> 00:08:50,280
+الواحدة. its amount of oxygen consumed by
+
+145
+00:08:50,280 --> 00:08:55,200
+myocardium each minute، حوالي ثلاثة و نصف milliliter
+
+146
+00:08:55,200 --> 00:08:59,740
+لـ لتر الأكسجين في كل كيلو من الـ body weight، لكل
+
+147
+00:08:59,740 --> 00:09:04,520
+دقيقة. تمام؟ كم هي مدة الأكسجين؟ كم هي كمية
+
+148
+00:09:04,520 --> 00:09:08,560
+الأكسجين المستهلكة؟ الآن أيضاً زي ما حكينا عن الـ
+
+149
+00:09:08,560 --> 00:09:12,600
+mode و الـ frequency، هأحكي على duration. هل أنا هأستمر
+
+150
+00:09:12,600 --> 00:09:15,040
+معاه في الـ exercise على الـ bicycle، على سبيل المثال،
+
+151
+00:09:15,040 --> 00:09:18,800
+أو الـ treadmill، ساعة، نص ساعة، عشر دقائق؟ لأ، كل حالة
+
+152
+00:09:18,800 --> 00:09:23,180
+المرضية لها وقتها و لها شغلها الخاص فيها. الـ
+
+153
+00:09:23,180 --> 00:09:26,880
+patient usually needs allowed to 30-60 minutes. يعني
+
+154
+00:09:26,880 --> 00:09:30,500
+من نص لـ ساعة، for each session، which include warm
+
+155
+00:09:30,500 --> 00:09:34,600
+up، at least 10 minutes. في حاجة اسمها الـ warm-up، زي
+
+156
+00:09:34,600 --> 00:09:38,440
+ما أخدنا، عبارة عن عمل الإحماء، و الـ cooling down،
+
+157
+00:09:38,440 --> 00:09:42,540
+اللي هو التبريد. هذه بأول الجلسة، وهذه بآخر الجلسة.
+
+158
+00:09:42,980 --> 00:09:47,980
+الـ Factors الرابع، اللي هو الـ intensity. كم هي شدة
+
+159
+00:09:47,980 --> 00:09:51,000
+التدريب؟ الـ intensity prescribed according to
+
+160
+00:09:51,000 --> 00:09:54,820
+ممكن أوصفها أنا للـ target heart rate. كم هو عضلة
+
+161
+00:09:54,820 --> 00:09:58,320
+القلب بتشتغل؟ كم هو الـ training تبعها؟ which
+
+162
+00:09:58,320 --> 00:10:02,060
+determined according to Carvelon formula. اللي هو
+
+163
+00:10:02,060 --> 00:10:05,760
+الـ target heart rate. هنا مسألة حساب بتكون أغلب
+
+164
+00:10:05,760 --> 00:10:10,650
+اللي هو الـ الـ Bicycle أو الـ Treadmill كلها بتكون
+
+165
+00:10:10,650 --> 00:10:14,430
+مبرمجة. أنت بس أدخل الأرقام. الـ resting heart rate
+
+166
+00:10:14,430 --> 00:10:18,250
+زائد 60% لـ 80% من الـ maximum heart rate اللي
+
+167
+00:10:18,250 --> 00:10:22,730
+بيعطيني طبعاً، و الـ maximum heart rate 220 ناقص
+
+168
+00:10:22,730 --> 00:10:26,890
+يعني هذه formula معينة، أو معادلة ثابتة أنا بشتغل
+
+169
+00:10:26,890 --> 00:10:30,330
+عليها. الـ based on result of exercise stress test،
+
+170
+00:10:30,330 --> 00:10:33,650
+طبعاً اللي هو عنده، هنحكي عليه إن شاء الله بآخر هذه
+
+171
+00:10:33,650 --> 00:10:38,550
+الـ chapter. هنحكي عليه هنا. هنعطينا example. الآن في
+
+172
+00:10:38,550 --> 00:10:43,290
+عندي شاب عمره 25 سنة، الـ resting heart rate تبعته
+
+173
+00:10:43,290 --> 00:10:48,190
+65، و الـ wanting now training heart rate، الـ
+
+174
+00:10:48,190 --> 00:10:52,690
+intensity level من 60 لـ 70%. الحسبة هذه زي ما أنتو
+
+175
+00:10:52,690 --> 00:10:56,270
+شايفينها، بتم حسابها يا إما إلكترونياً زي ما حكيتلكم
+
+176
+00:10:56,270 --> 00:11:00,830
+أو أنت ممكن بالقلم و الورقة، و تحسبها في الآخر، عشان
+
+177
+00:11:00,830 --> 00:11:05,830
+يعطيني كام؟ أنا ممكن أشتغل اللي هو، أو كام ضربة في
+
+178
+00:11:05,830 --> 00:11:12,370
+الدقيقة الواحدة. ممكن أنا أحسبها أيضاً، الـ "Borg Rate
+
+179
+00:11:12,370 --> 00:11:15,250
+Perceived Exertion"، اللي هي "Borg
+
+180
+00:11:15
+
+223
+00:14:22,080 --> 00:14:25,880
+هي عبارة عن عمليات الإحماء اللي بتصير
+
+224
+00:14:25,880 --> 00:14:29,840
+في بداية الجلسة حوالي 10 دقائق من بداية الجلسة ليش
+
+225
+00:14:29,840 --> 00:14:32,820
+أنا بدي أعملها؟ بدي أعملها avoid muscle injury مش
+
+226
+00:14:32,820 --> 00:14:35,800
+على طول أنا باجي اليوم على سبيل المثال فينا سباق
+
+227
+00:14:35,800 --> 00:14:38,540
+جري مش على طول أنا بفوت و بجري مرة واحدة لأ في
+
+228
+00:14:38,540 --> 00:14:41,700
+exercise عشان أعمل ال training للمصل أهيئها والله
+
+229
+00:14:41,700 --> 00:14:45,670
+في جيكي exercise كبير Prepare للكارديو بالمونري
+
+230
+00:14:45,670 --> 00:14:49,870
+system to exercise اليوم انت عندك اللي هو سباق
+
+231
+00:14:49,870 --> 00:14:53,470
+جريه فانا لازم احضر عضلة القلب انه جايكي exercise
+
+232
+00:14:53,470 --> 00:14:57,190
+لازم تدخ فيه دم كفاية لازم تدخ فيه كمية من ال
+
+233
+00:14:57,190 --> 00:15:00,750
+oxygen كفاية عشان انت تقدر تكملي باقي المشوار
+
+234
+00:15:01,020 --> 00:15:04,880
+reduce ال incidence of Arrhythmia طبعا بدي أقلل من
+
+235
+00:15:04,880 --> 00:15:09,040
+حدوث ال Arrhythmias اللي هي التوقف القلب فبالتالي
+
+236
+00:15:09,040 --> 00:15:14,060
+أنا بال warming up بهيي الجسم نفسيا وجسديا ان انت
+
+237
+00:15:14,060 --> 00:15:18,620
+وراك exercise لازم تعمله الآن هذا كله ايش في ال
+
+238
+00:15:18,620 --> 00:15:22,640
+exercise? aerobic exercise اللي هو applied to 40
+
+239
+00:15:22,640 --> 00:15:25,240
+minutes in the form of walking, jogging and
+
+240
+00:15:25,240 --> 00:15:28,780
+bicycling هذا aerobic exercise اللي هو تمارين
+
+241
+00:15:28,780 --> 00:15:32,380
+هوائية زي ما في عنا warming up في عنا cooling down
+
+242
+00:15:32,380 --> 00:15:36,060
+ال cooling down ايضا 10 minutes لان لاحظوا 10 في
+
+243
+00:15:36,060 --> 00:15:40,120
+الأول و 40 و هي كمان 10 هيك بكون أنا خلصت ساعة مع
+
+244
+00:15:40,120 --> 00:15:42,740
+مرض ال cardiac rehabilitation ال applied 10
+
+245
+00:15:42,740 --> 00:15:45,460
+minutes same form applied aerobic exercise during
+
+246
+00:15:45,460 --> 00:15:49,160
+a training ال cool down أنا الأن بدي أبرد خلاص
+
+247
+00:15:49,160 --> 00:15:53,600
+اشتغلت التمرين 40 دقيقة فبدي أخفف من اللي هو
+
+248
+00:15:53,600 --> 00:15:56,720
+الحركة تبعتي عشان أعمل cooling down to prevent
+
+249
+00:15:56,720 --> 00:16:00,740
+ventricular arrhythmia and prevent pooling of
+
+250
+00:16:00,740 --> 00:16:04,520
+blood in lower limbs بدي أمنع تجمع الدم مرة واحدة
+
+251
+00:16:04,520 --> 00:16:08,380
+في ال lower limbs هاي فائدة اللي هي ال cooling
+
+252
+00:16:08,380 --> 00:16:12,820
+down تمام؟ هاي بعض الصور على ال warming up and
+
+253
+00:16:12,820 --> 00:16:16,420
+cooling down exercises عادية ال head tilt side to
+
+254
+00:16:16,420 --> 00:16:19,460
+side بعدين ال arms و ال twist و ال shoulder
+
+255
+00:16:19,460 --> 00:16:23,580
+shrugs اللي هو يهز الكتف و ال quadriceps طبعا و
+
+256
+00:16:23,580 --> 00:16:27,300
+ال side to reach انه يوصل طبعا static exercises هذا
+
+257
+00:16:27,300 --> 00:16:31,000
+كله اللي هو عبارة عن warming exercises and cooling
+
+258
+00:16:31,000 --> 00:16:35,100
+down exercises ال Exercise Stress هذا كتير بتسمعوا
+
+259
+00:16:35,100 --> 00:16:37,860
+عنه، هنشرحه إن شاء الله في الـ lecture اللي بتاخدوه هو
+
+260
+00:16:37,860 --> 00:16:41,420
+عبارة عن إيش؟ It's a safe, relatively non-invasive
+
+261
+00:16:41,420 --> 00:16:44,920
+and sensitive method to measuring cardiovascular
+
+262
+00:16:44,920 --> 00:16:49,720
+and pulmonary response to increasing activity طبعا
+
+263
+00:16:49,720 --> 00:16:54,140
+الشيء هنا هو عبارة عن test اسمه اللي هو Exercise
+
+264
+00:16:54,140 --> 00:17:00,200
+Stress Test. Non-invasive, sensitive method طريقة
+
+265
+00:17:00,200 --> 00:17:04,200
+حساسة جدا لقياس ال cardiovascular and pulmonary
+
+266
+00:17:04,200 --> 00:17:07,600
+response استجابة الجهاز اللي هو الوعائي أو ال
+
+267
+00:17:07,600 --> 00:17:10,660
+cardiovascular system للاستجابة لهذه ال
+
+268
+00:17:10,660 --> 00:17:15,510
+activities ال Indications، لمين أنا بدي أستخدمه أو
+
+269
+00:17:15,510 --> 00:17:19,050
+لشو بدي أستخدمه؟ Evaluation of chest pain suggests
+
+270
+00:17:19,050 --> 00:17:22,790
+to be related to coronary artery disease بدي أستخدمه عشان
+
+271
+00:17:22,790 --> 00:17:26,150
+أعمل determination لل prognosis and severity of
+
+272
+00:17:26,150 --> 00:17:29,530
+coronary artery disease أنا بشتغل، برجع و بحكي، أنا بشتغل
+
+273
+00:17:29,530 --> 00:17:32,650
+مع cardiac patients مهم جدا إنه أنا أعرف هل هو
+
+274
+00:17:32,650 --> 00:17:35,910
+هيشتغل معي ولا لأ ال Evaluation لل effect of
+
+275
+00:17:35,910 --> 00:17:39,750
+medical, surgical, and surgical treatment بدي أقيم
+
+276
+00:17:39,750 --> 00:17:44,410
+الحالة Evaluation للأرثميزيا and hypertension  of
+
+277
+00:17:44,410 --> 00:17:47,850
+exercise assessment لل functional capacity كام هي
+
+278
+00:17:47,850 --> 00:17:50,670
+القدرة الوظيفية لهذا الشخص هي اللي هتكمل معايا
+
+279
+00:17:50,670 --> 00:17:56,750
+التمرين ولا مش هتكمل ال Preparation تحضير ال
+
+280
+00:17:56,750 --> 00:18:00,610
+patient are usually instructed not to be eating أو
+
+281
+00:18:00,610 --> 00:18:04,030
+smoking several hours before this test يعني مايجي
+
+282
+00:18:04,030 --> 00:18:07,870
+الشخص يأكل ويشرب ويجي عندي يعمل ال exercise زي أي
+
+283
+00:18:07,870 --> 00:18:10,850
+حالة  مثلا مثلا مثلا مثلا مثلا مثلا مثلا
+
+284
+00:18:10,850 --> 00:18:18,290
+مثلا
+
+285
+00:18:18,290 --> 00:18:19,910
+مثلا مثلا مثلا مثلا مثلا مثلا مثلا مثلا
+
+286
+00:18:19,910 --> 00:18:28,430
+مثلا
+
+287
+00:18:28,430 --> 00:18:30,470
+مثلا مثلا مثلا مثلا مثلا مثلا مثلا مثلا مثلا مثلا
+
+288
+00:18:30,470 --> 00:18:30,970
+مثلا مثلا مثلا مثلا مثلا مثلا مثلا مثلا مثلا مثلا
+
+289
+00:18:30,970 --> 00:18:35,050
+مثلا مثلا مثلا مثلا مثلا مثلا مثلا and
+
+290
+00:18:35,050 --> 00:18:39,170
+sneakers and exercise clothes طبعا ال clothes مهم جدا تكون
+
+291
+00:18:39,170 --> 00:18:43,270
+comfortable كمان اللي هو ال shoes مهم جدا اللي
+
+292
+00:18:43,270 --> 00:18:47,470
+هتكون comfortable لهذا الشخص Description of this
+
+293
+00:18:47,470 --> 00:18:52,700
+technique. Running resting ECG طبعا لازم يكون عندي
+
+294
+00:18:52,700 --> 00:18:57,020
+ال ECG رسمتها كويسة و في normal pictures ال
+
+295
+00:18:57,020 --> 00:19:01,160
+patient lying down, then standing up, and then
+
+296
+00:19:01,160 --> 00:19:05,880
+breathing heavily for half a minute تمام هو lying
+
+297
+00:19:05,880 --> 00:19:09,040
+down في supine position بعدين بخليه يعمل standing
+
+298
+00:19:09,040 --> 00:19:14,080
+up بعدين ياخد نص دقيقة من النفس this test كان
+
+299
+00:19:14,080 --> 00:19:18,260
+later compared with the ECG test performed while
+
+300
+00:19:18,260 --> 00:19:22,240
+the patient is exercising طبعا إنه أنا لازم أعمل ال ECG
+
+301
+00:19:22,240 --> 00:19:26,840
+قبل وبعد ال patient's blood pressure is taken and
+
+302
+00:19:26,840 --> 00:19:30,800
+a blood pressure cuff is left in place بحطها على
+
+303
+00:19:30,800 --> 00:19:35,620
+ال إيد الشمال اللي هي ال pressure cuff طبعا so that
+
+304
+00:19:35,620 --> 00:19:38,800
+blood pressure can be measured perfectly throughout
+
+305
+00:19:38,800 --> 00:19:44,020
+the test هذا بالنسبة لوصف ال exercise ال patient begins
+
+306
+00:19:44,020 --> 00:19:47,030
+riding a stationary bicycle or walking on the
+
+307
+00:19:47,030 --> 00:19:50,810
+treadmill gradually طبعاً هيمشي على اللي هو يعمل
+
+308
+00:19:50,810 --> 00:19:53,670
+bicycling على ال bicycle أو ال bicycle يكون ال
+
+309
+00:19:53,670 --> 00:19:56,150
+stationary أو يمشي على ال treadmill gradually
+
+310
+00:19:56,150 --> 00:20:00,970
+increasing the intensity of exercise gradually بحكي أنه تدريجيا
+
+311
+00:20:00,970 --> 00:20:04,230
+أنا بقدر أجريها for example, if the patient is walking
+
+312
+00:20:04,230 --> 00:20:07,690
+on a treadmill, the speed will increase gradually,
+
+313
+00:20:07,690 --> 00:20:11,170
+and the treadmill is tilted upward, simulating an
+
+314
+00:20:11,170 --> 00:20:15,400
+inclined plane لازم أكون حريصة أو أكون واقفة بجانب هذا
+
+315
+00:20:15,400 --> 00:20:18,760
+المريض حتى ألاحظ أي signs أو symptoms تكون خاطئة
+
+316
+00:20:18,760 --> 00:20:22,280
+If the patient is exercising on a bicycle, his resistance
+
+317
+00:20:22,280 --> 00:20:26,360
+to pedaling is gradually increased أي شيء بدي أزيده ال
+
+318
+00:20:26,360 --> 00:20:29,040
+speed أو ال intensity أو أي شيء بدي أزيده في ال
+
+319
+00:20:29,040 --> 00:20:33,220
+program لازم أزيدها gradually لأنه أنا حكيت أنا بس
+
+320
+00:20:33,220 --> 00:20:38,560
+أشتغل مع cardiac patients تمام؟ ال patient continues
+
+321
+00:20:38,560 --> 00:20:42,940
+exercising, increasing the intensity until he or she
+
+322
+00:20:42,940 --> 00:20:47,380
+reaches their target heart rate لحد ما أوصل لحد اللي
+
+323
+00:20:47,380 --> 00:20:52,480
+أنا كنت محددة على الأغلب في العموم بيكون 85% من ال
+
+324
+00:20:52,480 --> 00:20:55,920
+maximum predicted heart rate based on the patient's
+
+325
+00:20:55,920 --> 00:21:00,400
+age, or experiences severe fatigue, dizziness, or
+
+326
+00:21:00,400 --> 00:21:03,860
+chest pain. During this time, the patient's heart
+
+327
+00:21:03,860 --> 00:21:07,220
+rate, ECG pattern, and blood pressure are
+
+328
+00:21:07,220 --> 00:21:08,620
+continuously monitored.
+
+329
+00:21:18,540 --> 00:21:22,540
+Aftercare بعد ما أنا خلصته هذا ال test ال patient
+
+330
+00:21:22,540 --> 00:21:25,420
+should be allowed to rest until their blood pressure and heart rate
+
+331
+00:21:25,420 --> 00:21:28,440
+return to normal لأن احنا كنا بنعمل نشاط أكيد ال
+
+332
+00:21:28,440 --> 00:21:32,480
+heart rate عالي أكيد ال heart beat كمان زادت if
+
+333
+00:21:32,480 --> 00:21:37,200
+all goes well لو كل شيء goes well يعني مش الوضع
+
+334
+00:21:37,200 --> 00:21:39,940
+الطبيعي and there are no signs of distress ال
+
+335
+00:21:39,940 --> 00:21:43,900
+patient may return to their normal daily
+
+336
+00:21:43,900 --> 00:21:48,810
+activities تمام؟ الأمر بيكون سهل جدا عليه وإن أمره
+
+337
+00:21:48,810 --> 00:21:53,560
+تمام مافي عندنا أي شيء أو dangerous points/risks
+
+338
+00:21:53,560 --> 00:21:56,960
+there is a very low risk or very slight risk of heart
+
+339
+00:21:56,960 --> 00:21:59,960
+attack from exercise as well as cardiac arrhythmias
+
+340
+00:21:59,960 --> 00:22:03,200
+يعني ال irregular heart beat إذا صار عندي cardiac
+
+341
+00:22:03,200 --> 00:22:06,620
+arrest لازم أوقف، إذا صار عندي مشكلة كمان لازم
+
+342
+00:22:06,620 --> 00:22:10,420
+أوقف Normal results إذا هو عمل ال exercise و كل
+
+343
+00:22:10,420 --> 00:22:14,420
+الأمور تمام، no angina, no dizziness, no vertigo،
+
+344
+00:22:14,420 --> 00:22:16,360
+مافي عنده أي دوخة، مافي عنده أي شيء و ال
+
+345
+00:22:16,360 --> 00:22:20,180
+electrocardiogram كويسة، أنا بستمر في ال
+
+346
+00:22:20,180 --> 00:22:24,410
+exercise ال Abnormal results إذا صار عندي فيه عندي
+
+347
+00:22:24,410 --> 00:22:28,550
+abnormalities في ال ECG طبعا indicated a lack of oxygen-rich
+
+348
+00:22:28,550 --> 00:22:32,350
+blood مهم جدا ال ST wave depression كمان ما تكونش 
+
+349
+00:22:32,350 --> 00:22:36,610
+heart rhythm disturbances لو كان أنا في cardiac
+
+350
+00:22:36,610 --> 00:22:40,310
+arrest مهم جدا أنا أوقف ال program ال Structural
+
+351
+00:22:40,310 --> 00:22:43,430
+abnormalities of the heart such as muscle overgrowth
+
+352
+00:22:43,430 --> 00:22:46,550
+or hypertrophy كمان هذا من المخاطر اللي أنا منبهة
+
+353
+00:22:46,550 --> 00:22:51,910
+عليها "إذا ارتفع حرارة الدم أعلى من الطبيعي، يجب أن
+
+354
+00:22:51,910 --> 00:23:01,630
+توقف هذا الاختبار" "Table 6" هنا أو فيها مكان عبارة
+
+355
+00:23:01,630 --> 00:23:06,730
+عن table بيشرح لمين أنا ممنوع أشتغل exercise
+
+356
+00:23:06,730 --> 00:23:10,690
+testing "Absolute contraindications" للحالات اللي
+
+357
+00:23:10,690 --> 00:23:15,690
+عندها recent significant changes في ال ECG يعني لسه
+
+358
+00:23:15,690 --> 00:23:21,130
+عملت ECG جديدة وما كانت normal للحالات اللي هي
+
+359
+00:23:21,130 --> 00:23:27,260
+myocardial infarction طبعا ال unstable angina لأن
+
+360
+00:23:27,260 --> 00:23:31,720
+بخاف أي embolism بخاف أي thrombus تروح على مكان لو
+
+361
+00:23:31,720 --> 00:23:34,020
+راحت على ال brain بده تعمل stroke لو راحت على ال
+
+362
+00:23:34,020 --> 00:23:37,520
+heart ومازالت مستمرة في ال heart ودخلت في أي artery
+
+363
+00:23:37,520 --> 00:23:41,580
+بتعمل myocardial infarction ال uncontrolled
+
+364
+00:23:41,580 --> 00:23:45,660
+ventricular arrhythmia إذا صار في عندي عدم انتظام
+
+365
+00:23:45,660 --> 00:23:48,800
+في ال ventricular ال uncontrolled atrial
+
+366
+00:23:48,800 --> 00:23:53,890
+arrhythmia. Compromised Third AV Block
+
+367
+00:23:53,890 --> 00:23:59,210
+إذا صار في عندي مشكلة في ال ECG كمان هذه مشكلة
+
+368
+00:23:59,210 --> 00:24:03,290
+تابعة للي هي ال cardiac arrest هنا ممنوع أشتغل
+
+369
+00:24:03,290 --> 00:24:08,310
+مع هذه الحالات الستة إطلاقا أي exercise في عند ال
+
+370
+00:24:08,310 --> 00:24:12,550
+Contraindications أيضاً بنكمل لل slide اللي
+
+371
+00:24:12,550 --> 00:24:16,390
+جاي بعدها ال acute congestive heart failure لأن
+
+372
+00:24:16,390 --> 00:24:20,520
+لسه acute الوضع Severe aortic stenosis، انسداد
+
+373
+00:24:20,520 --> 00:24:24,100
+والصمام الأورطي، ال active suspected
+
+374
+00:24:24,100 --> 00:24:27,340
+myocarditis and pericarditis، thrombophlebitis
+
+375
+00:24:27,340 --> 00:24:31,170
+and intracardiac thrombi في حالات ال recent
+
+376
+00:24:31,170 --> 00:24:34,570
+systemic أو ال pulmonary embolism كنا بنحكي عليها
+
+377
+00:24:34,570 --> 00:24:38,870
+قبل قليل اللي هو خوفنا من انتقال هذه ال embolism
+
+378
+00:24:38,870 --> 00:24:44,990
+لأي مكان أو أي مكان في الجسم بتعمل انسداد في
+
+379
+00:24:44,990 --> 00:24:47,370
+حالات ال acute infection لأن هيك بيكون عندهم
+
+380
+00:24:47,370 --> 00:24:50,810
+ال high fever على سبيل المثال فانا مابدي أزيد ال
+
+381
+00:24:50,810 --> 00:24:57,030
+cardiac output ال Relative contraindications هناك
+
+382
+00:24:57,030 --> 00:25:00,390
+إطلاقا ممنوع أنا أشتغل مع الحالات الإثنتي عشرة اللي
+
+383
+00:25:00,390 --> 00:25:03,390
+أنا حكيت عليها هنا أيضًا ممنوع أشتغل لكن ممكن
+
+384
+00:25:03,390 --> 00:25:07,130
+أشتغل في الحالة إذا كانت تعافت أو شفيت من اللي
+
+385
+00:25:07,130 --> 00:25:10,350
+هو ال symptoms اللي فيها زي على سبيل المثال اللي في ال
+
+386
+00:25:10,350 --> 00:25:15,490
+arresting. لدي story كبيرة بشرحها طبعا احنا بنعرف
+
+387
+00:25:15,490 --> 00:25:20,890
+اللي هو ال Normal Blood Pressure 120 على 80
+
+388
+00:25:20,890 --> 00:25:24,090
+الملمتر
+
+389
+00:25:24,090 --> 00:25:28,650
+Valvular Heart Disease أي مشاكل في ال Valve. No
+
+390
+00:25:28,650 --> 00:25:32,370
+Electrolyte Abnormalities زي اللي هو بعض ال ECG اللي
+
+391
+00:25:32,370 --> 00:25:36,770
+مش مظبوطة ال Hypomagnesemia أو ال Hypoglycemia
+
+392
+00:25:36,770 --> 00:25:40,870
+Frequent Complex Ventricular Ectopic beats كمان هذه
+
+393
+00:25:40,870 --> 00:25:44,550
+Relative أيضا في عندي ال cardiomyopathy including
+
+394
+00:25:44,550 --> 00:25:48,510
+hypertrophic cardiomyopathy ال uncontrolled
+
+395
+00:25:48,510 --> 00:25:54,350
+metabolic diseases زي الديابيتس زي ال hyperthyroidism
+
+396
+00:25:54,350 --> 00:25:58,970
+و hypothyroidism كل هذه الأمور ممنوع أنا أشتغل معها
+
+397
+00:25:58,970 --> 00:26:03,190
+relatively ال Chronic infectious diseases زي ال
+
+398
+00:26:03,190 --> 00:26:06,350
+hepatitis ال AIDS الأمور اللي زي هذه إذا كان في
+
+399
+00:26:06,350 --> 00:26:08,590
+عندي neuromuscular أو musculoskeletal
+
+400
+00:26:08,590 --> 00:26:12,690
+complications أو problems طبعا و ال rheumatoid
+
+401
+00:26:12,690 --> 00:26:17,170
+arthritis and complicated pregnancy طبعا هذا الشيء
+
+402
+00:26:17,170 --> 00:26:21,790
+مهم جدا إنه أنا ما أشتغل معها وبهيك بيكون خلصنا ال
+
+403
+00:26:21,790 --> 00:26:25,510
+cardiac rehabilitation patients part 2 ألقاكم بإذن
+
+404
+00:26:25,510 --> 00:26:30,210
+الله تعالى في فيديو رقم 8 في ال ICU ل cardiac
+
+405
+00:26:30,210 --> 00:26:32,550
+patients يعطيكم ألف عافية
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/r6-xQ1NaUtM_postprocess.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/r6-xQ1NaUtM_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..f072225ff5d66a46d6a46a8272ab1d3a5e827dbd
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/r6-xQ1NaUtM_postprocess.srt
@@ -0,0 +1,1620 @@
+1
+00:00:00,890 --> 00:00:03,730
+اليوم إن شاء الله رب العالمين هكمل معاكم ال
+
+2
+00:00:03,730 --> 00:00:07,890
+cardiac rehabilitation part 2 و هتكون هاي إن شاء
+
+3
+00:00:07,890 --> 00:00:12,150
+الله رب العالمين أول فيديو بعد ال midterm هنكمل شو
+
+4
+00:00:12,150 --> 00:00:15,830
+ال exercise اللي أنا ممكن أشتغلها مع مريض القلب في
+
+5
+00:00:15,830 --> 00:00:20,370
+اللي هو ال cardiac rehabilitation نبدأ على بركة
+
+6
+00:00:20,370 --> 00:00:23,330
+الله بدي أشرح اليوم في المحاضرة إن شاء الله رب
+
+7
+00:00:23,330 --> 00:00:27,350
+العالمين شو ال outcomesاللي انا ممكن احصل عليهم في
+
+8
+00:00:27,350 --> 00:00:29,890
+ال cardiac rehabilitation training ال exercise
+
+9
+00:00:29,890 --> 00:00:33,390
+prescriptions ل ال cardiac patient و ال border
+
+10
+00:00:33,390 --> 00:00:36,410
+scales طبعا هتاخدوه معايا نظري و ان شاء الله في
+
+11
+00:00:36,410 --> 00:00:40,130
+المعامل هتشتغلوه ايضا ال exercises stress risk
+
+12
+00:00:40,130 --> 00:00:44,510
+هناخدها نبدأ على بركة اللهشو هما الـ Outcomes of
+
+13
+00:00:44,510 --> 00:00:48,670
+Cardiac Rehabilitation؟ هتحدث عن عشرة Outcomes أول
+
+14
+00:00:48,670 --> 00:00:51,430
+واحدة الـ Improve Exercise Tolerance Tolerance
+
+15
+00:00:51,430 --> 00:00:54,630
+حكينا هي عبارة عن قدرة الشخص على عمل الـ Exercise
+
+16
+00:00:54,630 --> 00:00:57,470
+على سبيل المثال Cardiac Rehabilitation Patient
+
+17
+00:00:57,470 --> 00:01:00,390
+Training for Patients with Coronary Heart Disease
+
+18
+00:01:00,390 --> 00:01:03,220
+أو الـ Congestive Heart Failureleads to
+
+19
+00:01:03,220 --> 00:01:06,580
+objectively variable تختلف ال improvement في ال
+
+20
+00:01:06,580 --> 00:01:10,100
+exercise capacity يعني في قدرة الشخص على أداء ال
+
+21
+00:01:10,100 --> 00:01:13,500
+exercise في ال man و ال woman regardless of age
+
+22
+00:01:13,500 --> 00:01:17,740
+طبعا بغض النظر عن العمر لأن this beneficial effect
+
+23
+00:01:17,740 --> 00:01:21,880
+doesn't persist in long term after competitions
+
+24
+00:01:21,880 --> 00:01:26,020
+لال cardiac rehabilitation لأن هاي ال endurance
+
+25
+00:01:26,020 --> 00:01:30,320
+اللي احنا بنحكي عليهاهي عبارة عن قدرة اللي هو
+
+26
+00:01:30,320 --> 00:01:33,420
+المريض على أداءه للتمرين كذا مرة Therefore
+
+27
+00:01:33,420 --> 00:01:37,160
+exercise training must be maintained long term for
+
+28
+00:01:37,160 --> 00:01:40,160
+sustained improvement لل exercise capacity كام
+
+29
+00:01:40,160 --> 00:01:45,380
+قدرتله على أداء ال exercise ال outcome التانية
+
+30
+00:01:45,380 --> 00:01:48,880
+اللي هي ال control of symptoms أنا أتحكم بال
+
+31
+00:01:48,880 --> 00:01:51,980
+symptoms اللي موجودة عندهم على سبيل المثال إذا كان
+
+32
+00:01:51,980 --> 00:01:55,760
+ديابت equation جدي أنا قدرتي على أنه أنا أتحكم في
+
+33
+00:01:55,760 --> 00:01:59,490
+ال diabetesكإذا كان عنده hypertension كمان كم قدر
+
+34
+00:01:59,490 --> 00:02:03,010
+دي على إن أنا أعمل control لـhypertension في ال
+
+35
+00:02:03,010 --> 00:02:05,790
+patient تبع الـ coronary heart disease و الانجينة
+
+36
+00:02:05,790 --> 00:02:08,430
+significantly improved during cardiac
+
+37
+00:02:08,430 --> 00:02:11,290
+rehabilitation exercise program و ال patient اللي
+
+38
+00:02:11,290 --> 00:02:14,790
+عنده في left ventricle failure and dysfunctions
+
+39
+00:02:14,790 --> 00:02:19,050
+improved symptoms in heart failure تمام؟ يعني كل
+
+40
+00:02:19,050 --> 00:02:23,390
+diagnosis إيه تشخيص لحاله، إيه تحكم بالـ symptoms
+
+41
+00:02:23,390 --> 00:02:27,450
+لحالهاالـ Outcomes التالتة الـ Improvement في ال
+
+42
+00:02:27,450 --> 00:02:31,330
+blood level of lipids الان اللي بتعرفوا ال lipids
+
+43
+00:02:31,330 --> 00:02:34,390
+و الكوليسترول و الأمور اللي زي هذه مهم جدا أنا
+
+44
+00:02:34,390 --> 00:02:37,670
+دائما أعمل تحليل لل patient عشان أعرف أديه نسبتها
+
+45
+00:02:37,670 --> 00:02:40,870
+في الدم ال improvement in lipid and lipid protein
+
+46
+00:02:40,870 --> 00:02:43,690
+levels are observed when the patient undergoing
+
+47
+00:02:43,690 --> 00:02:47,470
+rehabilitation exercise programطبعا مهم جدا لأنه
+
+48
+00:02:47,470 --> 00:02:49,810
+لو كان سمح الله الـ Triglyceride عالي أنا ممكن
+
+49
+00:02:49,810 --> 00:02:54,750
+أعمل exercise يزيد ويفاقق من المشكلة وتنتقل لثرمبس
+
+50
+00:02:54,750 --> 00:02:58,670
+أو تنتقل لـ Fatty embolism من مكان إلى أخر ال
+
+51
+00:02:58,670 --> 00:03:01,930
+exercise must be combined with dietary and medical
+
+52
+00:03:01,930 --> 00:03:05,830
+intervention to require lipid control طبعا نعمل
+
+53
+00:03:05,830 --> 00:03:08,470
+control عن طريق الأكل عن طريق أخده لعلاجاته
+
+54
+00:03:08,470 --> 00:03:12,430
+المناسبة لتذويب high أو لتخفيد ال cholesterol
+
+55
+00:03:12,430 --> 00:03:17,410
+levelال outcomes الرابعة انه ال effect on body
+
+56
+00:03:17,410 --> 00:03:20,510
+weight الoptimals لل management في ال obesity
+
+57
+00:03:20,510 --> 00:03:22,690
+required beneficial rehabilitation include
+
+58
+00:03:22,690 --> 00:03:25,590
+nutritional education and counseling و ال
+
+59
+00:03:25,590 --> 00:03:28,770
+behavioral ال obesity مش كتير منيحة في هذه الحالات
+
+60
+00:03:28,770 --> 00:03:31,950
+لازم انا اعمل counseling اعمل استشارات اعمل
+
+61
+00:03:31,950 --> 00:03:37,090
+ارشادات ان انت لازم يا حاجة اتخفضي من اللي هو ال
+
+62
+00:03:37,090 --> 00:03:42,370
+weight تبعكالـ Outcomes الخامسة اللي هو effect on
+
+63
+00:03:42,370 --> 00:03:44,910
+blood pressure الهيبوتية في exercise و training زي
+
+64
+00:03:44,910 --> 00:03:49,410
+ما حكينا مهم جدا ان انا اعمل minimal effect و اقلل
+
+65
+00:03:49,410 --> 00:03:52,730
+blood pressure و ايضا اعمل control عليه as a
+
+66
+00:03:52,730 --> 00:03:55,930
+symptoms reduction في ال smoking اذا كان عندنا
+
+67
+00:03:55,930 --> 00:03:59,930
+cardiac rehabilitation patientsmoker person will
+
+68
+00:03:59,930 --> 00:04:03,790
+be should be يجب عليه أنه أنا أعمل stopping لهذه
+
+69
+00:04:03,790 --> 00:04:06,830
+اللي هي ال habits educational and counseling
+
+70
+00:04:06,830 --> 00:04:09,570
+behavioral modification of the ground resulting in
+
+71
+00:04:09,570 --> 00:04:13,090
+cessation of smoking insignificant of number من ال
+
+72
+00:04:13,090 --> 00:04:18,470
+patient ال outcomes السابع أنه أنا أحسن psycho
+
+73
+00:04:18,470 --> 00:04:22,030
+social wellbeing حالة نفسية مهمة جدا في حالات ال
+
+74
+00:04:22,030 --> 00:04:24,670
+cardiac patient لأنه أي زعل ممكن يعملي على غافة
+
+75
+00:04:24,670 --> 00:04:29,600
+ضغط الدم وبالتالي المريض ممكن يروح فيهالأن الـ
+
+76
+00:04:29,600 --> 00:04:32,920
+Cardiac Patient Exercise خلال الـ Education تبعته
+
+77
+00:04:32,920 --> 00:04:36,380
+enhanced major psychosocial and social function
+
+78
+00:04:36,380 --> 00:04:39,860
+أنه أنت راح تكون كويس، أنت بخير، راح ترجع لحياتك
+
+79
+00:04:39,860 --> 00:04:43,300
+طبيعي بإذن الله تعالى الـ Outcomes اللي تمنا اللي
+
+80
+00:04:43,300 --> 00:04:46,480
+هو enhanced للـ social adjustment and function
+
+81
+00:04:46,480 --> 00:04:49,850
+أحنا كنا و حكينا على الـ Rehabilitative Teamأو الـ
+
+82
+00:04:49,850 --> 00:04:52,030
+Rehabilitation Team كانت في عنا اللي هو الـ
+
+83
+00:04:52,030 --> 00:04:55,170
+Vocational Training اللي هو تبع التدريب المهني أو
+
+84
+00:04:55,170 --> 00:04:59,390
+إنه نرجع الشخص اللي هو صار عنده مشكلة في القلب as
+
+85
+00:04:59,390 --> 00:05:02,770
+much as possible للوضع السابق هلأ الـ Cardiac
+
+86
+00:05:02,770 --> 00:05:06,250
+Rehabilitation Exercise Training improve الـ
+
+87
+00:05:06,250 --> 00:05:08,990
+social adjustment and function أيضا الـ Exercise
+
+88
+00:05:08,990 --> 00:05:12,730
+Training is recommended to improve social outcome
+
+89
+00:05:13,300 --> 00:05:17,060
+الـ «I return to work» زي ما حكينا في النقطة
+
+90
+00:05:17,060 --> 00:05:19,800
+السابقة أنه أنا بدي عن طريق الـ «functional
+
+91
+00:05:19,800 --> 00:05:23,160
+training» أنه أنا أرجع هذا الشخص لو أدعو ووظيفته
+
+92
+00:05:23,160 --> 00:05:26,980
+السابقة إذا كان العمل أو إذا كان هذا يتناسب مع
+
+93
+00:05:26,980 --> 00:05:31,600
+وظيفة القلب أو إنه وظيفة أو شكل المريض بشكل عام
+
+94
+00:05:31,600 --> 00:05:34,960
+فأنا ممكن أرجع إذا كان لأ و الله هو كان عامل بناء
+
+95
+00:05:34,960 --> 00:05:40,180
+و ال work heavy عليه وإنه مش قادر يكمل بنحاول إنه
+
+96
+00:05:40,180 --> 00:05:44,410
+إحنا نشوف وظيفة تانيةmini أو mini a non-exercise
+
+97
+00:05:44,410 --> 00:05:47,790
+variable effect in outcomes زي ال period
+
+98
+00:05:47,790 --> 00:05:50,410
+employment statements and angular attitude
+
+99
+00:05:50,410 --> 00:05:55,950
+والincoming طبعا انكسف طبعا الإشي بيرجع as much as
+
+100
+00:05:55,950 --> 00:05:59,490
+possible حسب الظروف والأوضاع اللي احنا بنكون فيها
+
+101
+00:05:59,490 --> 00:06:03,300
+في الدائرةالأن الـ Outcomes الأخيرة اللي هي مهم
+
+102
+00:06:03,300 --> 00:06:06,900
+جدا أنه أنا أقلل ال mortality ال mortality معناته
+
+103
+00:06:06,900 --> 00:06:11,200
+هي عبارة عن نسبة الوفيات اللي بيصير أو ناجمة عن
+
+104
+00:06:11,200 --> 00:06:14,200
+هذا الحدث it's significant data for survival
+
+105
+00:06:14,200 --> 00:06:17,060
+benefits for patients who participate in cardiac
+
+106
+00:06:17,060 --> 00:06:20,000
+rehabilitation exercise training but it's not
+
+107
+00:06:20,000 --> 00:06:24,920
+attributedالترتيب اللى هو to exercise a lot تمام؟
+
+108
+00:06:24,920 --> 00:06:29,280
+الاشي بتعلق قدى severity of disease؟ كم هي حتة
+
+109
+00:06:29,280 --> 00:06:32,760
+المرض؟ هل هو صار فيه blockage كامل أو block كاملة
+
+110
+00:06:32,760 --> 00:06:35,900
+للكرنري ارتي ع سبيل المثال؟ شو نوع ال embolism
+
+111
+00:06:35,900 --> 00:06:40,280
+اللى صارت؟ وبيعتمد على نفس الحالة التشخيصية هيك
+
+112
+00:06:40,280 --> 00:06:44,040
+بيكون أنا حكيت على عشرة من ال outcomes لل cardiac
+
+113
+00:06:44,040 --> 00:06:47,880
+patient في اللى هو ال rehabilitation program الآن
+
+114
+00:06:47,880 --> 00:06:52,420
+بدي أتحدث عن ال physiotherapy exerciseفى هنا الـ
+
+115
+00:06:52,420 --> 00:06:56,480
+Exercise Prescriptions لـ Cardiac Patient هحكى أي
+
+116
+00:06:56,480 --> 00:06:59,980
+تمرين أنا بدي أشتغله مع اللى هو الـ Cardiac
+
+117
+00:06:59,980 --> 00:07:04,840
+Patient هحكى عن ال mood النمط ال exercise هحكى عن
+
+118
+00:07:04,840 --> 00:07:08,640
+ال frequency هتكلم ع كمية ال oxygen اللى أنا بدي
+
+119
+00:07:08,640 --> 00:07:12,220
+أستهلكها في خلال ال exercise أنا بتكلم اليوم أو
+
+120
+00:07:12,220 --> 00:07:16,120
+بتحدث مع مريض Cardiac Patient ال machine pump هي
+
+121
+00:07:16,120 --> 00:07:20,520
+تبعتي هي مهمة جداالان في ال mood أو النمر تبعنا ال
+
+122
+00:07:20,520 --> 00:07:24,640
+aerobic exercise أو اللي هو التمرين الهوائي really
+
+123
+00:07:24,640 --> 00:07:28,220
+include walking, jogging, running and swimming و
+
+124
+00:07:28,220 --> 00:07:31,040
+ال bicycling أيضا مهم جدا ال combination of these
+
+125
+00:07:31,040 --> 00:07:34,040
+activities هذا هو عبارة عن ال mood شون النمط اللي
+
+126
+00:07:34,040 --> 00:07:38,040
+انا بدي اشتغله مع هذا ال cardiac patient الان ال
+
+127
+00:07:38,040 --> 00:07:42,440
+frequency كان عدد المرات ال individuals with less
+
+128
+00:07:42,440 --> 00:07:47,970
+than 100الشخص الـ cardiac اللي عنده كمية الأكسجين
+
+129
+00:07:47,970 --> 00:07:52,970
+مستهلكة لكل دقيقة أقل من ثلاث ثواني أو الكبسي دي
+
+130
+00:07:52,970 --> 00:07:56,270
+تبعته، هذا إله تعامل خاص، لأن الـMethadine، أنا
+
+131
+00:07:56,270 --> 00:07:59,650
+هعرفكم شو اسمها أو شو تعريفها في الـslide القادمة،
+
+132
+00:07:59,650 --> 00:08:02,910
+هي عبارة عن كمية الأكسجين اللي أنا بدي أستهلكها
+
+133
+00:08:02,910 --> 00:08:07,890
+خلال الدقيقةأما ال individuals من تلاتة لخمسة
+
+134
+00:08:07,890 --> 00:08:10,910
+تبعته ال capacity should be engaged in one to
+
+135
+00:08:10,910 --> 00:08:15,110
+session per day هعطيه جلسة لجلسين في اليومإذا كان
+
+136
+00:08:15,110 --> 00:08:18,410
+الـ Individual أكثر من خمس تبعته كمية الـ Oxygen
+
+137
+00:08:18,410 --> 00:08:22,530
+فأنا بعطيه اللي هو الـ Exercise من تلت لخمس مرات
+
+138
+00:08:22,530 --> 00:08:26,290
+أسبوعياً هنا هذه الأرقام مهمة جداً لأنه إذا شغلنا
+
+139
+00:08:26,290 --> 00:08:28,270
+في الـ ICU أو في الـ Cardiac Rehabilitation
+
+140
+00:08:28,270 --> 00:08:31,670
+Program كويس إنه أنا أكون عارف إيش هو الـ Exercise
+
+141
+00:08:31,670 --> 00:08:35,330
+الآن شو تعريفنا للماد؟ هو عبارة عن الـ Metabolic
+
+142
+00:08:35,330 --> 00:08:42,040
+Equivalent Treatmentمعامل اللي هو بيحسبلي كمية
+
+143
+00:08:42,040 --> 00:08:46,400
+الأكسجين المستهلكة من هذا الشخص في خلال الدقيقة
+
+144
+00:08:46,400 --> 00:08:50,280
+الواحدة its amount of oxygen consumed by
+
+145
+00:08:50,280 --> 00:08:55,200
+myocardium each minute حوالي تلاتة و نص milliliter
+
+146
+00:08:55,200 --> 00:08:59,740
+لذرة الأكسجين في كل كيلو من ال body weight لكل
+
+147
+00:08:59,740 --> 00:09:04,520
+دقيقة تمام؟ كم هي مدة الأكسجين؟ كم هي كمية
+
+148
+00:09:04,520 --> 00:09:08,560
+الأكسجين المستهلكة؟الان ايضا زي ما حكينا عن ال
+
+149
+00:09:08,560 --> 00:09:12,600
+mood و ال frequency هحكي على duration هل انا هستمر
+
+150
+00:09:12,600 --> 00:09:15,040
+معاه في ال exercise على ال bicycle على سبيل المثال
+
+151
+00:09:15,040 --> 00:09:18,800
+او ال treadmill ساعة نص ساعة عشر دقائق لأ كل حالة
+
+152
+00:09:18,800 --> 00:09:23,180
+المرضية لها وقتها و لها شغلها الخاص فيها ال
+
+153
+00:09:23,180 --> 00:09:26,880
+patient usually need allowed to 30-60 minutes يعني
+
+154
+00:09:26,880 --> 00:09:30,500
+من نص ل ساعة for each session which include warm
+
+155
+00:09:30,500 --> 00:09:34,600
+upat least 10 minutes في حاجة اسمها الـ warm-up زي
+
+156
+00:09:34,600 --> 00:09:38,440
+ما أخدنا عبارة عن عمل الإحماء و ال cooling down
+
+157
+00:09:38,440 --> 00:09:42,540
+اللي هو التبريد هذه بأول الجلسة وهذه بآخر الجلسة
+
+158
+00:09:42,980 --> 00:09:47,980
+الـ Factors الرابع اللي هو ال intensity كم هي شدة
+
+159
+00:09:47,980 --> 00:09:51,000
+التدبيرين ال intensity prescribed according to
+
+160
+00:09:51,000 --> 00:09:54,820
+ممكن أوصفها أنا لل target heart rate كم هو عضلة
+
+161
+00:09:54,820 --> 00:09:58,320
+القلب بتشتغل كم هو ال training تبعها which
+
+162
+00:09:58,320 --> 00:10:02,060
+determined according to Carvelon formula اللي هو
+
+163
+00:10:02,060 --> 00:10:05,760
+ال target heart rate هنا مسألة حساب بتكون أغلب
+
+164
+00:10:05,760 --> 00:10:10,650
+اللي هو الالـ Bicycle أو الـ Treadmill كلها بتكون
+
+165
+00:10:10,650 --> 00:10:14,430
+مبرمجة انت بس ادخل الأرقام ال resting heart rate
+
+166
+00:10:14,430 --> 00:10:18,250
+زائد 60% ل 80% من ال maximum heart rate اللي
+
+167
+00:10:18,250 --> 00:10:22,730
+بيعطينيا طبعا و ال maximum heart rate 220 ناقص
+
+168
+00:10:22,730 --> 00:10:26,890
+يعني هذه formula معينة او معادلة ثابتة انا بشتغل
+
+169
+00:10:26,890 --> 00:10:30,330
+عليها ال based on result of exercise stress test
+
+170
+00:10:30,330 --> 00:10:33,650
+طبعا اللي هو عنده هنحكي عليه ان شاء الله بآخر هذه
+
+171
+00:10:33,650 --> 00:10:38,550
+ال chapter هنحكي عليه هنا هنعطينا exampleالان في
+
+172
+00:10:38,550 --> 00:10:43,290
+عندى شاب عمره 25 سنة ال resting heart rate تبعته
+
+173
+00:10:43,290 --> 00:10:48,190
+65 و ال wanting now training heart rate ال
+
+174
+00:10:48,190 --> 00:10:52,690
+intensity level من 60 م 70% الحسبة هذه زى ما انتوا
+
+175
+00:10:52,690 --> 00:10:56,270
+شايفينها بتم حسابها يا اما إلكترونيا زى ما حكيتلكم
+
+176
+00:10:56,270 --> 00:11:00,830
+أو انت ممكن بالقلم الورقة و تحسبها في الآخر عشان
+
+177
+00:11:00,830 --> 00:11:05,830
+يعطينى كام انا ممكن اشتغل اللى هو او كام ضربة في
+
+178
+00:11:05,830 --> 00:11:12,370
+الدقيقة الواحدةممكن انا احسبها ايضا ال «Borg Rate
+
+179
+00:11:12,370 --> 00:11:15,250
+Perceived Edulary Excretions» اللي هي «Borg
+
+180
+00:11:15,250 --> 00:11:20,730
+Exercise» هنحكي عليه او اللي هو ال level تبعت ال
+
+181
+00:11:20,730 --> 00:11:23,830
+exercise intensity كمان هيهمنا هذا الاشي في «Borg
+
+182
+00:11:23,830 --> 00:11:26,970
+Exercise» «Borg's original intention was
+
+183
+00:11:26,970 --> 00:11:31,470
+structural أو construct لكتجاريز من 6 ل20»خلال ال
+
+184
+00:11:31,470 --> 00:11:35,030
+exercise you overwrite your perception expressions
+
+185
+00:11:35,030 --> 00:11:39,430
+كم هو الجهد المستهلك use these skills where 6
+
+186
+00:11:39,430 --> 00:11:45,050
+means المعامل أو الوسيط 6 not 20 means totally
+
+187
+00:11:45,050 --> 00:11:48,130
+maximum effort جدّي بيعطينا الجهد اللي عنه هذا ان
+
+188
+00:11:48,130 --> 00:11:52,270
+شاء الله في انتجاهي ممكن يكون أفضل ان احنا نشرح ال
+
+189
+00:11:52,270 --> 00:11:58,100
+example واحدة واحدة بارج skillsفيه burger scales
+
+190
+00:11:58,100 --> 00:12:01,760
+من 6 ل20 زي ما حكينا في ال slide السابقة سبعة
+
+191
+00:12:01,760 --> 00:12:05,100
+بيكون very light، إشي خفيف، exercise خفيف، تسعة
+
+192
+00:12:05,100 --> 00:12:10,840
+بيكون very light، 11 light، و13 hard، بعدين 15،
+
+193
+00:12:10,840 --> 00:12:14,240
+يعني كل ما أنا عليت بالرقم، كل ما كان الإشي أكبر و
+
+194
+00:12:14,240 --> 00:12:17,800
+أصعب في الجهود، لحد ما نوصل ل 20، بيكون عندنا
+
+195
+00:12:17,800 --> 00:12:23,870
+exhibitions، يعني كمية جهود عظيمةالـ Alberguer's
+
+196
+00:12:23,870 --> 00:12:27,210
+exercise equivalent value should be treated أو
+
+197
+00:12:27,210 --> 00:12:30,690
+should be rated as a follow إذا كان أقل من 12،
+
+198
+00:12:30,690 --> 00:12:33,730
+perceive fairly light، زي ما شرحنا من 40 إلى 60
+
+199
+00:12:33,730 --> 00:12:39,090
+heart rate من 12 و 13، بيكون somewhat hard، 14 و
+
+200
+00:12:39,090 --> 00:12:43,170
+16، perceive hard أو high intensity، لكن إذا كان
+
+201
+00:12:43,170 --> 00:12:45,450
+بعد هيكة، بيكون أعلى في القيم
+
+202
+00:13:02,230 --> 00:13:07,050
+مهم جدا الحركة هذه أو الـ exercise لو كان انا
+
+203
+00:13:07,050 --> 00:13:10,530
+حقيته مثلا على سبيل المثال الـ swimming كويس ان هو
+
+204
+00:13:10,530 --> 00:13:13,050
+يعمل improvement للcirculation فبالتالي هيتحسن
+
+205
+00:13:13,050 --> 00:13:16,290
+عندى الجلوكولز leveldecrease للـ blood pressure كل
+
+206
+00:13:16,290 --> 00:13:19,830
+ما بحرك كل ما كان أفضل في تقليل كمية ال systolic
+
+207
+00:13:19,830 --> 00:13:23,250
+والdiastolic blood pressure increasing لل high
+
+208
+00:13:23,250 --> 00:13:27,370
+density of lipoprotein levels كمان بالـ
+
+209
+00:13:27,370 --> 00:13:31,790
+lipoproteins أو اللي هو بيسميه البروتين الدهني مهم
+
+210
+00:13:31,790 --> 00:13:35,490
+جدا إنه أنا أحافظ عليه بنفس المستوى الصحي تبعه
+
+211
+00:13:35,490 --> 00:13:39,410
+decrease لل low intensityأنا بدي أخفف من
+
+212
+00:13:39,410 --> 00:13:41,890
+الـdenicity للـ lipoprotein و للـ triglycerides زي
+
+213
+00:13:41,890 --> 00:13:46,610
+ما حكيتلكم إشي ضرب الجسم أنا هرجع لوضعه الطبيعي ال
+
+214
+00:13:46,610 --> 00:13:50,050
+exercise may decrease mortality طبعا أكيد الشخص
+
+215
+00:13:50,050 --> 00:13:52,750
+اللي بيتحرك و بيروح و بيجي أقل ما فيها أنا ممكن
+
+216
+00:13:52,750 --> 00:13:57,110
+أمنع ال DVT إذا كان هو لا سمح الله بدردن و مابدو
+
+217
+00:13:57,110 --> 00:14:00,010
+يتحرك فبالتالي ممكن تجي بدردن ممكن تجي air
+
+218
+00:14:00,010 --> 00:14:04,710
+embolism ممكن يجي أي إشي complicated يحدث الوفاة
+
+219
+00:14:04,710 --> 00:14:08,990
+بسببها فبالتالي أنا هي كما حافظت علىإن أنا أقلل
+
+220
+00:14:08,990 --> 00:14:13,710
+الـ mortality الـ exercise session consist of ال
+
+221
+00:14:13,710 --> 00:14:18,680
+warming up applied for about10 minutes in the form
+
+222
+00:14:18,680 --> 00:14:22,080
+of light, clenched and muscular stretching
+
+223
+00:14:22,080 --> 00:14:25,880
+performed to هي عبارة عن عمليات الإحماء اللي بتصير
+
+224
+00:14:25,880 --> 00:14:29,840
+في بداية الجلسة حوالي 10 دقائق من بداية الجلسة ليش
+
+225
+00:14:29,840 --> 00:14:32,820
+أنا بدي أعملها؟ بدي أعملها avoid muscle injury مش
+
+226
+00:14:32,820 --> 00:14:35,800
+على طول أنا باجي اليوم على سبيل المثال فينا سباق
+
+227
+00:14:35,800 --> 00:14:38,540
+جري مش على طول أنا بفوت و بجري مرة واحدة لأ في
+
+228
+00:14:38,540 --> 00:14:41,700
+exercise عشان أعمل ال training للمصل أهيئها والله
+
+229
+00:14:41,700 --> 00:14:45,670
+في جيكي exercise كبيرPrepare للكارديو بالمونري
+
+230
+00:14:45,670 --> 00:14:49,870
+system to exercise اليوم انت عندك اللي هو سباق
+
+231
+00:14:49,870 --> 00:14:53,470
+جريه فانا لازم احضر عضلة القلب انه جايكي exercise
+
+232
+00:14:53,470 --> 00:14:57,190
+لازم تدخ فيه دم كفاية لازم تدخ فيه كمية من ال
+
+233
+00:14:57,190 --> 00:15:00,750
+oxygen كفاية عشان انت تقدر تكملي باقي المشوار
+
+234
+00:15:01,020 --> 00:15:04,880
+reduce ال incidence of Arrhythmia طبعا بدي أقلل من
+
+235
+00:15:04,880 --> 00:15:09,040
+حدوث ال Arrhythmias اللي هي التوقف القلب فبالتالي
+
+236
+00:15:09,040 --> 00:15:14,060
+أنا بال warming up بهيي الجسم نفسيا وجسديا ان انت
+
+237
+00:15:14,060 --> 00:15:18,620
+وراك exercise لازم تعمله الآن هذا كله ايش في ال
+
+238
+00:15:18,620 --> 00:15:22,640
+exercise? aerobic exercise اللي هو applied to 40
+
+239
+00:15:22,640 --> 00:15:25,240
+minutes in the form of walking, jogging and
+
+240
+00:15:25,240 --> 00:15:28,780
+bicycling هذا aerobic exercise اللي هو تمارين
+
+241
+00:15:28,780 --> 00:15:32,380
+هوائيةزي ما فى عنا warming up فى عنا cooling down
+
+242
+00:15:32,380 --> 00:15:36,060
+ال cooling down ايضا 10 minutes لان لاحظوا 10 في
+
+243
+00:15:36,060 --> 00:15:40,120
+الأول و 40 و هي كمان 10 هيك بكون أنا خلصت ساعة مع
+
+244
+00:15:40,120 --> 00:15:42,740
+مرض ال cardiac rehabilitation ال applied 10
+
+245
+00:15:42,740 --> 00:15:45,460
+minutes same form applied aerobic exercise during
+
+246
+00:15:45,460 --> 00:15:49,160
+a training ال cool down أنا الأن بدى أبرد خلاص
+
+247
+00:15:49,160 --> 00:15:53,600
+اشتغلت التمرين 40 دقيقة فبدى أخفف من اللى هو
+
+248
+00:15:53,600 --> 00:15:56,720
+الحركة تبعتي عشان أعمل cooling down to prevent
+
+249
+00:15:56,720 --> 00:16:00,740
+ventricular artemisiaand prevent boiling down لـ
+
+250
+00:16:00,740 --> 00:16:04,520
+blood in lower limbs بدي أمنع تجمع الدم مرة واحدة
+
+251
+00:16:04,520 --> 00:16:08,380
+في الـ lower limb هاي فائدة اللي هي ال cooling
+
+252
+00:16:08,380 --> 00:16:12,820
+down تمام؟ هاي بعض الصور على ال warming up and
+
+253
+00:16:12,820 --> 00:16:16,420
+cooling downExercise عادية ال head tilt side to
+
+254
+00:16:16,420 --> 00:16:19,460
+side بعدين ال arms و ال twist و ال shoulder
+
+255
+00:16:19,460 --> 00:16:23,580
+shrinking اللي هو يهز الكتف و ال quadriceps طبعا و
+
+256
+00:16:23,580 --> 00:16:27,300
+ال side to reach انه يوصل طبعا static exercise هذا
+
+257
+00:16:27,300 --> 00:16:31,000
+كله اللي هو عبارة عن warming exercise and cooling
+
+258
+00:16:31,000 --> 00:16:35,100
+down exerciseالـ Exercise Stress هذا كتير بتسمعوا
+
+259
+00:16:35,100 --> 00:16:37,860
+عنه، هنشرحه إن شاء الله في العمل اللي بتاخدوه هو
+
+260
+00:16:37,860 --> 00:16:41,420
+عبارة عن إيش؟ It's a safe, relative, non-invasive
+
+261
+00:16:41,420 --> 00:16:44,920
+and sensitive method to measuring cardiovascular
+
+262
+00:16:44,920 --> 00:16:49,720
+and pulmonary response to increasing activity طبعا
+
+263
+00:16:49,720 --> 00:16:54,140
+الإشي هنا هو عبارة عن test اسمه اللي هو Exercise
+
+264
+00:16:54,140 --> 00:17:00,200
+Stress TestNon-invasive Sinistive methods طريقة
+
+265
+00:17:00,200 --> 00:17:04,200
+حساسة جدا لقياس الـ cardiovascular and pulmonary
+
+266
+00:17:04,200 --> 00:17:07,600
+response استجابة الجهاز اللي هو الوعائي أو الـ
+
+267
+00:17:07,600 --> 00:17:10,660
+cardiovascular system للاستجابة لهذه الـ
+
+268
+00:17:10,660 --> 00:17:15,510
+activitiesالـ Indication، لمين أنا بدي أستخدمه أو
+
+269
+00:17:15,510 --> 00:17:19,050
+لشو بدي أستخدمه؟ evaluation of chest pain suggests
+
+270
+00:17:19,050 --> 00:17:22,790
+to be a related coronary disease بدي أستخدمه عشان
+
+271
+00:17:22,790 --> 00:17:26,150
+أعمل determination للـ prognosis and severity of
+
+272
+00:17:26,150 --> 00:17:29,530
+coronary disease أنا بشتغل، برجع و بحكي، أنا بشتغل
+
+273
+00:17:29,530 --> 00:17:32,650
+مع cardiac patient مهم جدا إنه أنا أعرف هل هو
+
+274
+00:17:32,650 --> 00:17:35,910
+هيشتغل معي ولا لأ ال evaluation لل effect of
+
+275
+00:17:35,910 --> 00:17:39,750
+medical surgical and surgical treatmentبدي أقيم
+
+276
+00:17:39,750 --> 00:17:44,410
+الحالة evaluation للأرثميزيا and hypertension of
+
+277
+00:17:44,410 --> 00:17:47,850
+exercise assessment لل functional capacity كام هي
+
+278
+00:17:47,850 --> 00:17:50,670
+القدر الوضني فيها لهذا الشخص هى اللى هيتكمل معايا
+
+279
+00:17:50,670 --> 00:17:56,750
+التمرين ولا مش هيتكمل ال preparation تحضير ال
+
+280
+00:17:56,750 --> 00:18:00,610
+patient are usually instructed not be eating او
+
+281
+00:18:00,610 --> 00:18:04,030
+smoking several hours before this task يعني مايجي
+
+282
+00:18:04,030 --> 00:18:07,870
+الشخص يأكل وشبة ويجي عندى يعمل ال exerciseزي أي
+
+283
+00:18:07,870 --> 00:18:10,850
+حالة مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا
+
+284
+00:18:10,850 --> 00:18:18,290
+مثلًا
+
+285
+00:18:18,290 --> 00:18:19,910
+مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا
+
+286
+00:18:19,910 --> 00:18:28,430
+مثلن
+
+287
+00:18:28,430 --> 00:18:30,470
+مثلن مثلن مثلن مثلن مثلن مثلن مثلن مثلن مثلن مثلن
+
+288
+00:18:30,470 --> 00:18:30,970
+مثلن مثلن مثلن مثلن مثلن مثلن مثلن مثلن مثلن مثلن
+
+289
+00:18:30,970 --> 00:18:35,050
+مثلن مثلن مثلن مثلن مثلن مثلن مثلنsnackers and
+
+290
+00:18:35,050 --> 00:18:39,170
+exercise clothes طبعا ال clothes مهم جدا تكون
+
+291
+00:18:39,170 --> 00:18:43,270
+comfortable كمان اللي هو ال shoes مهم جدا اللي
+
+292
+00:18:43,270 --> 00:18:47,470
+هتكون comfortable لهذا الشخص description this
+
+293
+00:18:47,470 --> 00:18:52,700
+technique runningresting ECG طبعا لازم يكون عندى
+
+294
+00:18:52,700 --> 00:18:57,020
+ال ECG رسمتها كويسة و في normal pictures ال
+
+295
+00:18:57,020 --> 00:19:01,160
+patient lying down then standing up and then
+
+296
+00:19:01,160 --> 00:19:05,880
+breathing heavily for half a minute تمام هو lying
+
+297
+00:19:05,880 --> 00:19:09,040
+down في sublime position بعدين بخليه يعمل standing
+
+298
+00:19:09,040 --> 00:19:14,080
+up بعدين ياخد نص دقيقة من النفس this test كان
+
+299
+00:19:14,080 --> 00:19:18,260
+later compared withECG test performed while
+
+300
+00:19:18,260 --> 00:19:22,240
+patient exercising طبعا إنه أنا لازم أعمل ال ECG
+
+301
+00:19:22,240 --> 00:19:26,840
+قبل واء بعد ال patient blood pressure is taken and
+
+302
+00:19:26,840 --> 00:19:30,800
+blood pressure cuff is left in place بحطها على
+
+303
+00:19:30,800 --> 00:19:35,620
+الإيد الشمال اللي هي ال pressure cuff طبعا so that
+
+304
+00:19:35,620 --> 00:19:38,800
+blood pressure can measured perfectly throughout
+
+305
+00:19:38,800 --> 00:19:44,020
+test هذا بالنسبة لوصف ال exercise ال patient begin
+
+306
+00:19:44,020 --> 00:19:47,030
+ridingالـ Sessionary Bicycles أو Walking The
+
+307
+00:19:47,030 --> 00:19:50,810
+Treadmill Gradually طبعاً هيمشي على اللي هو يعمل
+
+308
+00:19:50,810 --> 00:19:53,670
+bicycling ال bicycle أو ال bicycle يكون ال
+
+309
+00:19:53,670 --> 00:19:56,150
+sessionary أو يمشي على ال treadmill gradual
+
+310
+00:19:56,150 --> 00:20:00,970
+intensity of exercise gradually بحكي أنه تدريجيا
+
+311
+00:20:00,970 --> 00:20:04,230
+أنا بقدر أجريها for example if patient is walking
+
+312
+00:20:04,230 --> 00:20:07,690
+with a treadmill and speed will increase gradually
+
+313
+00:20:07,690 --> 00:20:11,170
+the treadmill is tilt upward stimulating and
+
+314
+00:20:11,170 --> 00:20:15,400
+inclinedلازم أكون حريصة أو أكون واقفة بجانب هذا
+
+315
+00:20:15,400 --> 00:20:18,760
+المريض حتى ألاحظ أي signs أو symptoms تكون خاطرة
+
+316
+00:20:18,760 --> 00:20:22,280
+if patient is an exercise bicycling his resistance
+
+317
+00:20:22,280 --> 00:20:26,360
+to drag is gradually increased أي إشي بدي أزيده ال
+
+318
+00:20:26,360 --> 00:20:29,040
+speed أو ال intensity أو أي إشي بدي أزيده في ال
+
+319
+00:20:29,040 --> 00:20:33,220
+program لازم أزيدها gradually لأنه أنا حكيت أنا بس
+
+320
+00:20:33,220 --> 00:20:38,560
+أشتغل مع cardiac patient تمام؟الpatient continue
+
+321
+00:20:38,560 --> 00:20:42,940
+exercise increasing ال intensity until he or she
+
+322
+00:20:42,940 --> 00:20:47,380
+reaches her target heart rate لحد ما أوصل لحد اللي
+
+323
+00:20:47,380 --> 00:20:52,480
+أنا كنت محددة على الأغلب في العموم بيكون 85% من ال
+
+324
+00:20:52,480 --> 00:20:55,920
+maximum predictable heart rate based on patient
+
+325
+00:20:55,920 --> 00:21:00,400
+ageor experience severe fatigue, dizziness or
+
+326
+00:21:00,400 --> 00:21:03,860
+chest pain. During this time, the patient's heart
+
+327
+00:21:03,860 --> 00:21:07,220
+rate, ECG pattern, and blood pressure are
+
+328
+00:21:07,220 --> 00:21:08,620
+continually monitoring
+
+329
+00:21:18,540 --> 00:21:22,540
+after care بعد ما أنا خلصته هذا ال test ال patient
+
+330
+00:21:22,540 --> 00:21:25,420
+should be rest until blood pressure and heart rate
+
+331
+00:21:25,420 --> 00:21:28,440
+return to normal لإن احنا كنا بنعمل نشاط أكيد ال
+
+332
+00:21:28,440 --> 00:21:32,480
+heart rate عالي أكيد ال heart beat كمان زادت if
+
+333
+00:21:32,480 --> 00:21:37,200
+all goes well لو كل شيء goes to well يعني مش الوضع
+
+334
+00:21:37,200 --> 00:21:39,940
+الطبيعي and there are no signs to distress ال
+
+335
+00:21:39,940 --> 00:21:43,900
+patient may return to this or her normal daily
+
+336
+00:21:43,900 --> 00:21:48,810
+activities تمام؟الأمر بيكون سهل جدا عليه وإن أمره
+
+337
+00:21:48,810 --> 00:21:53,560
+تمام مافي عندنا أي إشي أو dangerous pointrisk
+
+338
+00:21:53,560 --> 00:21:56,960
+there are very risk او very slight risk لل heart
+
+339
+00:21:56,960 --> 00:21:59,960
+attack from exercise as well as cardiac arrhythmia
+
+340
+00:21:59,960 --> 00:22:03,200
+يعني ال irregular heart beat إذا صار عندي cardiac
+
+341
+00:22:03,200 --> 00:22:06,620
+arrest لازم أوقف، إذا صار عندي مشكلة كمان لازم
+
+342
+00:22:06,620 --> 00:22:10,420
+أوقف normal result إذا هو عمل ال exercise و كل
+
+343
+00:22:10,420 --> 00:22:14,420
+الأمور تمام، no angina, no dizziness, no vertigo،
+
+344
+00:22:14,420 --> 00:22:16,360
+مافي عنده أي دوخة، مافي عنده أي إشي و ال
+
+345
+00:22:16,360 --> 00:22:20,180
+electrocardiographic كويسة، أنا بستمر في ال
+
+346
+00:22:20,180 --> 00:22:24,410
+exerciseالـ Abnormal result إذا صار عندى فيه عندى
+
+347
+00:22:24,410 --> 00:22:28,550
+abnormal في ال ECG طبعا indicated لال oxygen rich
+
+348
+00:22:28,550 --> 00:22:32,350
+blood مهم جدا ال ST wave كمان ما تكونش depression
+
+349
+00:22:32,350 --> 00:22:36,610
+ال heart rhythm disturbance لو كان أنا في cardiac
+
+350
+00:22:36,610 --> 00:22:40,310
+arrest مهم جدا أنا أوقف ال program ال structural
+
+351
+00:22:40,310 --> 00:22:43,430
+abnormalities لل heart such as overgrowth muscle
+
+352
+00:22:43,430 --> 00:22:46,550
+hyper atrophy كمان هذا من المخاطر اللى أنا منوع
+
+353
+00:22:46,550 --> 00:22:51,910
+أوصل لها«إذا ارتفع حرارة الدم أعلى للطبيعي، يجب أن
+
+354
+00:22:51,910 --> 00:23:01,630
+توقف هذا التجارب» «Table 6» هنا أو فيها مكان عبارة
+
+355
+00:23:01,630 --> 00:23:06,730
+عن تابل بيشرح لمين أنا ممنوع أشتغل exercise
+
+356
+00:23:06,730 --> 00:23:10,690
+testing «absolutely contraindication» للحالات اللي
+
+357
+00:23:10,690 --> 00:23:15,690
+عندها recent significant change في الـ ECGيعني لسه
+
+358
+00:23:15,690 --> 00:23:21,130
+تعمل ECG جديدة وما كانت normal للحالات اللي هي
+
+359
+00:23:21,130 --> 00:23:27,260
+myocardial infarction طبعاالـ unstable angina لأنه
+
+360
+00:23:27,260 --> 00:23:31,720
+بخاف أى embolism بخاف أى thrombus تروح على مكان لو
+
+361
+00:23:31,720 --> 00:23:34,020
+راحت على ال brain بده تعملى stroke لو راحت على ال
+
+362
+00:23:34,020 --> 00:23:37,520
+heart مازالت مستمرة فى ال heart ودخلت فى أى artery
+
+363
+00:23:37,520 --> 00:23:41,580
+تعملى myocardial infarction ال uncontrolled
+
+364
+00:23:41,580 --> 00:23:45,660
+ventricular dysarthria إذا صار فى عنى عدم انتظام
+
+365
+00:23:45,660 --> 00:23:48,800
+فى ال ventricular ال uncontrolled arterial
+
+366
+00:23:48,800 --> 00:23:53,890
+dysarthria compromisedطبعاً والـ Third AV Block
+
+367
+00:23:53,890 --> 00:23:59,210
+إذا صار في عندي مشكلة في الـ ECG كمان هذه مشكلة
+
+368
+00:23:59,210 --> 00:24:03,290
+تابعة لاللي هي الـ cardiac arrest هنا ممنوع أشتغل
+
+369
+00:24:03,290 --> 00:24:08,310
+مع هذه الحالات الستة إطلاقا أي exercise في عن الـ
+
+370
+00:24:08,310 --> 00:24:12,550
+Contra Indication أيضاً بنكمل للـ slide اللي
+
+371
+00:24:12,550 --> 00:24:16,390
+جابلها الـ acute congestive heart failure لأنه
+
+372
+00:24:16,390 --> 00:24:20,520
+لساته acute الوضعSevere aortic stenosis، انسداد
+
+373
+00:24:20,520 --> 00:24:24,100
+وإطلاق السينيان الأوارطي، الـ active suspected
+
+374
+00:24:24,100 --> 00:24:27,340
+myocardites and brachioradites، thrombophlebites
+
+375
+00:24:27,340 --> 00:24:31,170
+and intercardiac thrombiفي حالات الـ recent
+
+376
+00:24:31,170 --> 00:24:34,570
+systemic أو الـ pulmonary embolism كنا بنحكي عليها
+
+377
+00:24:34,570 --> 00:24:38,870
+قبل قليل اللي هو خوفنا من انتقال هذه الـ embolism
+
+378
+00:24:38,870 --> 00:24:44,990
+لأي مكان أو أي مكان في الجسم بتعملي انسداد في
+
+379
+00:24:44,990 --> 00:24:47,370
+حالات الـ acute infection لأنه هيكيك بيكون عندهم
+
+380
+00:24:47,370 --> 00:24:50,810
+الـ high fever على سبيل المثال فانا مابدي أزيد ال
+
+381
+00:24:50,810 --> 00:24:57,030
+cardiac outputالـ relative contraindication هناك
+
+382
+00:24:57,030 --> 00:25:00,390
+إطلاقًا ممنوع أنا أشتغل مع الحالات الأتناشر اللي
+
+383
+00:25:00,390 --> 00:25:03,390
+أنا حكيت عليها هنا أيضًا ممنوع أشتغل لكن ممكن
+
+384
+00:25:03,390 --> 00:25:07,130
+أشتغل في الحالة إذا كانت اتعافت أو اتشافت من اللي
+
+385
+00:25:07,130 --> 00:25:10,350
+هو ال symptoms اللي فيها زي على سبيل اللي في ال
+
+386
+00:25:10,350 --> 00:25:15,490
+arresting لدي story كبيرة برشار طبعًااحنا بنعرف
+
+387
+00:25:15,490 --> 00:25:20,890
+اللي هو الـ Normal Blood Pressure 120 على 80
+
+388
+00:25:20,890 --> 00:25:24,090
+المدلة
+
+389
+00:25:24,090 --> 00:25:28,650
+Vulvar Heart Disease أي مشاكل في الـ Valve No
+
+390
+00:25:28,650 --> 00:25:32,370
+Erectoid Abnormalities زي اللي هو بعض الـ ECG اللي
+
+391
+00:25:32,370 --> 00:25:36,770
+مش مظبوطة الـ Hypomagnesium أو الـ Hypoglycemia
+
+392
+00:25:36,770 --> 00:25:40,870
+Frequent Complex للـ Ventricular Ectopy كمان هذه
+
+393
+00:25:40,870 --> 00:25:44,550
+Relativeأيضا في عندي الـcardiomyopathy including
+
+394
+00:25:44,550 --> 00:25:48,510
+hyper atrophic cardiomyopathy الـ uncontrolled
+
+395
+00:25:48,510 --> 00:25:54,350
+metabolic disease زي الديابيتا زي الthyrotoxicosis
+
+396
+00:25:54,350 --> 00:25:58,970
+والمكزيديميا كل هذه الأمور ممنوع أنا أشتغللها
+
+397
+00:25:58,970 --> 00:26:03,190
+relatively ال chronic infection disease زي ال
+
+398
+00:26:03,190 --> 00:26:06,350
+hepatitis ال AIDS الأمور اللي زي هذهإذا كان في
+
+399
+00:26:06,350 --> 00:26:08,590
+عندى neuromuscular أو musculoskeletal
+
+400
+00:26:08,590 --> 00:26:12,690
+complications أو problems طبعا و ال rheumatoid
+
+401
+00:26:12,690 --> 00:26:17,170
+advanced and complicated pregnancy طبعا هذا الاشي
+
+402
+00:26:17,170 --> 00:26:21,790
+مهم جدا أنه أنا ماشتغل معاه وبهيك بيكون خلصنا ال
+
+403
+00:26:21,790 --> 00:26:25,510
+cardiac rehabilitation patient part 2 ألقاكم بإذن
+
+404
+00:26:25,510 --> 00:26:30,210
+الله تعالى في فيديو رقم 8 في ال ICU ل cardiac
+
+405
+00:26:30,210 --> 00:26:32,550
+patient يعطيكوا ألف عافية
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/r6-xQ1NaUtM_raw.json b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/r6-xQ1NaUtM_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..cc48a81f2997900c9017b3b806ac51f3a8a24152
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/r6-xQ1NaUtM_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 2503, "start": 0.89, "end": 25.03, "text": "اليوم إن شاء الله رب العالمين هكمل معاكم ال cardiac rehabilitation part 2 و هتكون هاي إن شاء الله رب العالمين أول فيديو بعد ال midterm هنكمل شو ال exercise اللي أنا ممكن أشتغلها مع مريض القلب في اللي هو ال cardiac rehabilitation نبدأ على بركة الله بدي أشرح اليوم في المحاضرة إن شاء الله رب العالمين شو ال outcomes", "tokens": [6027, 1829, 20498, 36145, 13412, 16606, 21984, 12602, 3555, 18863, 45340, 9957, 8032, 24793, 1211, 20449, 995, 24793, 2423, 32129, 33700, 644, 568, 4032, 8032, 2655, 30544, 8032, 47302, 36145, 13412, 16606, 21984, 12602, 3555, 18863, 45340, 9957, 5551, 12610, 8978, 16254, 2407, 39182, 2423, 2062, 7039, 8032, 1863, 24793, 1211, 13412, 2407, 2423, 5380, 13672, 1829, 41850, 3714, 43020, 5551, 8592, 2655, 17082, 1211, 11296, 20449, 3714, 16572, 11242, 25062, 46152, 8978, 13672, 1829, 31439, 2423, 32129, 33700, 8717, 44510, 10721, 15844, 4724, 31747, 3660, 21984, 4724, 16254, 5551, 46309, 5016, 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"probability": 0.9404296875}, {"start": 1535.55, "end": 1536.77, "word": " Hypoglycemia", "probability": 0.79266357421875}, {"start": 1536.77, "end": 1537.65, "word": " Frequent", "probability": 0.820556640625}, {"start": 1537.65, "end": 1538.23, "word": " Complex", "probability": 0.8740234375}, {"start": 1538.23, "end": 1538.51, "word": " للـ", "probability": 0.4580078125}, {"start": 1538.51, "end": 1539.05, "word": " Ventricular", "probability": 0.783447265625}, {"start": 1539.05, "end": 1539.67, "word": " Ectopy", "probability": 0.7410481770833334}, {"start": 1539.67, "end": 1540.53, "word": " كمان", "probability": 0.9484049479166666}, {"start": 1540.53, "end": 1540.87, "word": " هذه", "probability": 0.307373046875}, {"start": 1540.87, "end": 1541.31, "word": " Relative", "probability": 0.702392578125}], "temperature": 1.0}, {"id": 67, "seek": 156529, "start": 1541.87, "end": 1565.29, "text": "أيضا في عندي الـcardiomyopathy including hyper atrophic cardiomyopathy الـ uncontrolled metabolic disease زي الديابيتا زي الthyrotoxicosis والمكزيديميا كل هذه الأمور ممنوع أنا أشتغللها relatively ال chronic infection disease زي ال hepatitis ال AIDS الأمور اللي زي هذه", "tokens": [10721, 1829, 11242, 995, 8978, 18871, 16254, 2423, 39184, 22259, 72, 8488, 404, 9527, 3009, 9848, 412, 11741, 299, 37051, 8488, 404, 9527, 2423, 39184, 36019, 28850, 36464, 4752, 30767, 1829, 2423, 16254, 16758, 36081, 995, 30767, 1829, 2423, 28433, 10536, 5230, 299, 8211, 16070, 2304, 4117, 11622, 1829, 16254, 2304, 25528, 28242, 29538, 16247, 2304, 13063, 3714, 27842, 45367, 41850, 5551, 8592, 2655, 17082, 1211, 1211, 11296, 7226, 2423, 14493, 11764, 4752, 30767, 1829, 2423, 48372, 16074, 2423, 27929, 16247, 2304, 13063, 13672, 1829, 30767, 1829, 29538], "avg_logprob": -0.2910814740684595, "compression_ratio": 1.5254237288135593, "no_speech_prob": 0.0, "words": [{"start": 1541.87, "end": 1542.27, "word": "أيضا", "probability": 0.8258056640625}, {"start": 1542.27, "end": 1542.39, "word": " في", "probability": 0.60107421875}, {"start": 1542.39, "end": 1542.67, "word": " عندي", "probability": 0.817626953125}, {"start": 1542.67, "end": 1543.81, "word": " الـcardiomyopathy", "probability": 0.7467389787946429}, {"start": 1543.81, "end": 1544.55, "word": " including", "probability": 0.64013671875}, {"start": 1544.55, "end": 1545.39, "word": " hyper", "probability": 0.796875}, {"start": 1545.39, "end": 1546.43, "word": " atrophic", "probability": 0.7850748697916666}, {"start": 1546.43, "end": 1547.21, "word": " cardiomyopathy", "probability": 0.9583740234375}, {"start": 1547.21, "end": 1547.61, "word": " الـ", "probability": 0.5682373046875}, {"start": 1547.61, "end": 1548.51, "word": " uncontrolled", "probability": 0.8642578125}, {"start": 1548.51, "end": 1549.25, "word": " metabolic", "probability": 0.91943359375}, {"start": 1549.25, "end": 1549.85, "word": " disease", "probability": 0.865234375}, {"start": 1549.85, "end": 1550.43, "word": " زي", "probability": 0.910400390625}, {"start": 1550.43, "end": 1551.13, "word": " الديابيتا", "probability": 0.703564453125}, {"start": 1551.13, "end": 1551.73, "word": " زي", "probability": 0.6622314453125}, {"start": 1551.73, "end": 1554.35, "word": " الthyrotoxicosis", "probability": 0.575927734375}, {"start": 1554.35, "end": 1555.51, "word": " والمكزيديميا", "probability": 0.6787109375}, {"start": 1555.51, "end": 1556.07, "word": " كل", "probability": 0.76171875}, {"start": 1556.07, "end": 1556.57, "word": " هذه", "probability": 0.8720703125}, {"start": 1556.57, "end": 1557.25, "word": " الأمور", "probability": 0.9903971354166666}, {"start": 1557.25, "end": 1558.01, "word": " ممنوع", "probability": 0.81005859375}, {"start": 1558.01, "end": 1558.17, "word": " أنا", "probability": 0.75}, {"start": 1558.17, "end": 1558.97, "word": " أشتغللها", "probability": 0.92431640625}, {"start": 1558.97, "end": 1559.69, "word": " relatively", "probability": 0.7763671875}, {"start": 1559.69, "end": 1560.45, "word": " ال", "probability": 0.4052734375}, {"start": 1560.45, "end": 1560.77, "word": " chronic", "probability": 0.79833984375}, {"start": 1560.77, "end": 1561.35, "word": " infection", "probability": 0.83349609375}, {"start": 1561.35, "end": 1562.03, "word": " disease", "probability": 0.87548828125}, {"start": 1562.03, "end": 1563.09, "word": " زي", "probability": 0.979736328125}, {"start": 1563.09, "end": 1563.19, "word": " ال", "probability": 0.98583984375}, {"start": 1563.19, "end": 1563.79, "word": " hepatitis", "probability": 0.79248046875}, {"start": 1563.79, "end": 1564.03, "word": " ال", "probability": 0.5947265625}, {"start": 1564.03, "end": 1564.31, "word": " AIDS", "probability": 0.5185546875}, {"start": 1564.31, "end": 1564.73, "word": " الأمور", "probability": 0.9371744791666666}, {"start": 1564.73, "end": 1564.85, "word": " اللي", "probability": 0.710693359375}, {"start": 1564.85, "end": 1564.99, "word": " زي", "probability": 0.95263671875}, {"start": 1564.99, "end": 1565.29, "word": " هذه", "probability": 0.85400390625}], "temperature": 1.0}, {"id": 68, "seek": 159255, "start": 1565.69, "end": 1592.55, "text": "إذا كان في عندى neuromuscular أو musculoskeletal complications أو problems طبعا و ال rheumatoid advanced and complicated pregnancy طبعا هذا الاشي مهم جدا أنه أنا ماشتغل معاه وبهيك بيكون خلصنا ال cardiac rehabilitation patient part 2 ألقاكم بإذن الله تعالى في فيديو رقم 8 في ال ICU ل cardiac patient يعطيكوا ألف عافية", "tokens": [28814, 15730, 25961, 8978, 43242, 7578, 12087, 298, 301, 17792, 34051, 1038, 32397, 330, 2631, 304, 26566, 34051, 2740, 23032, 3555, 3615, 995, 4032, 2423, 50100, 449, 2513, 327, 7339, 293, 6179, 16120, 23032, 3555, 3615, 995, 23758, 2423, 33599, 1829, 3714, 16095, 10874, 28259, 14739, 3224, 41850, 3714, 33599, 2655, 17082, 1211, 20449, 40294, 46599, 3224, 1829, 4117, 4724, 1829, 30544, 16490, 1211, 9381, 8315, 2423, 32129, 33700, 4537, 644, 568, 5551, 1211, 4587, 995, 24793, 4724, 28814, 8848, 1863, 21984, 37279, 6027, 7578, 8978, 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"word": " أو", "probability": 0.78271484375}, {"start": 1570.23, "end": 1571.09, "word": " problems", "probability": 0.783203125}, {"start": 1571.09, "end": 1571.95, "word": " طبعا", "probability": 0.88671875}, {"start": 1571.95, "end": 1572.09, "word": " و", "probability": 0.336181640625}, {"start": 1572.09, "end": 1572.17, "word": " ال", "probability": 0.461181640625}, {"start": 1572.17, "end": 1572.69, "word": " rheumatoid", "probability": 0.8607177734375}, {"start": 1572.69, "end": 1573.41, "word": " advanced", "probability": 0.58740234375}, {"start": 1573.41, "end": 1573.67, "word": " and", "probability": 0.86572265625}, {"start": 1573.67, "end": 1574.23, "word": " complicated", "probability": 0.94873046875}, {"start": 1574.23, "end": 1575.07, "word": " pregnancy", "probability": 0.69091796875}, {"start": 1575.07, "end": 1576.29, "word": " طبعا", "probability": 0.975830078125}, {"start": 1576.29, "end": 1576.65, "word": " هذا", "probability": 0.833984375}, {"start": 1576.65, "end": 1577.17, "word": " الاشي", "probability": 0.7511393229166666}, {"start": 1577.17, "end": 1577.93, "word": " مهم", "probability": 0.920166015625}, {"start": 1577.93, "end": 1578.37, "word": " جدا", "probability": 0.992431640625}, {"start": 1578.37, "end": 1578.93, "word": " أنه", "probability": 0.576171875}, {"start": 1578.93, "end": 1579.05, "word": " أنا", "probability": 0.6455078125}, {"start": 1579.05, "end": 1579.55, "word": " ماشتغل", "probability": 0.8615234375}, {"start": 1579.55, "end": 1580.03, "word": " معاه", "probability": 0.987548828125}, {"start": 1580.03, "end": 1580.71, "word": " وبهيك", "probability": 0.76171875}, {"start": 1580.71, "end": 1581.03, "word": " بيكون", "probability": 0.8709309895833334}, {"start": 1581.03, "end": 1581.61, "word": " خلصنا", "probability": 0.9888916015625}, {"start": 1581.61, "end": 1581.79, "word": " ال", "probability": 0.85546875}, {"start": 1581.79, "end": 1582.13, "word": " cardiac", "probability": 0.923828125}, {"start": 1582.13, "end": 1582.75, "word": " rehabilitation", "probability": 0.75341796875}, {"start": 1582.75, "end": 1583.45, "word": " patient", "probability": 0.83544921875}, {"start": 1583.45, "end": 1583.83, "word": " part", "probability": 0.95556640625}, {"start": 1583.83, "end": 1584.31, "word": " 2", "probability": 0.81201171875}, {"start": 1584.31, "end": 1585.19, "word": " ألقاكم", "probability": 0.88564453125}, {"start": 1585.19, "end": 1585.51, "word": " بإذن", "probability": 0.9771728515625}, {"start": 1585.51, "end": 1585.73, "word": " الله", "probability": 0.94921875}, {"start": 1585.73, "end": 1586.15, "word": " تعالى", "probability": 0.7916666666666666}, {"start": 1586.15, "end": 1586.37, "word": " في", "probability": 0.9404296875}, {"start": 1586.37, "end": 1586.71, "word": " فيديو", "probability": 0.8699544270833334}, {"start": 1586.71, "end": 1587.05, "word": " رقم", "probability": 0.9886067708333334}, {"start": 1587.05, "end": 1587.51, "word": " 8", "probability": 0.75390625}, {"start": 1587.51, "end": 1588.19, "word": " في", "probability": 0.97119140625}, {"start": 1588.19, "end": 1588.45, "word": " ال", "probability": 0.91259765625}, {"start": 1588.45, "end": 1589.01, "word": " ICU", "probability": 0.939453125}, {"start": 1589.01, "end": 1589.59, "word": " ل", "probability": 0.8642578125}, {"start": 1589.59, "end": 1590.21, "word": " cardiac", "probability": 0.24951171875}, {"start": 1590.21, "end": 1591.05, "word": " patient", "probability": 0.88818359375}, {"start": 1591.05, "end": 1591.91, "word": " يعطيكوا", "probability": 0.88857421875}, {"start": 1591.91, "end": 1592.11, "word": " ألف", "probability": 0.794189453125}, {"start": 1592.11, "end": 1592.55, "word": " عافية", "probability": 0.90283203125}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1627.4401875, "duration_after_vad": 1571.9693749999979}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/r6-xQ1NaUtM_raw.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/r6-xQ1NaUtM_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..fd3855dfc9534432a25534fcafbdec76102f4f4e
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/r6-xQ1NaUtM_raw.srt
@@ -0,0 +1,1624 @@
+1
+00:00:00,890 --> 00:00:03,730
+اليوم إن شاء الله رب العالمين هكمل معاكم ال
+
+2
+00:00:03,730 --> 00:00:07,890
+cardiac rehabilitation part 2 و هتكون هاي إن شاء
+
+3
+00:00:07,890 --> 00:00:12,150
+الله رب العالمين أول فيديو بعد ال midterm هنكمل شو
+
+4
+00:00:12,150 --> 00:00:15,830
+ال exercise اللي أنا ممكن أشتغلها مع مريض القلب في
+
+5
+00:00:15,830 --> 00:00:20,370
+اللي هو ال cardiac rehabilitation نبدأ على بركة
+
+6
+00:00:20,370 --> 00:00:23,330
+الله بدي أشرح اليوم في المحاضرة إن شاء الله رب
+
+7
+00:00:23,330 --> 00:00:27,350
+العالمين شو ال outcomesاللي انا ممكن احصل عليهم في
+
+8
+00:00:27,350 --> 00:00:29,890
+ال cardiac rehabilitation training ال exercise
+
+9
+00:00:29,890 --> 00:00:33,390
+prescriptions ل ال cardiac patient و ال border
+
+10
+00:00:33,390 --> 00:00:36,410
+scales طبعا هتاخدوه معايا نظري و ان شاء الله في
+
+11
+00:00:36,410 --> 00:00:40,130
+المعامل هتشتغلوه ايضا ال exercises stress risk
+
+12
+00:00:40,130 --> 00:00:44,510
+هناخدها نبدأ على بركة اللهشو هما الـ Outcomes of
+
+13
+00:00:44,510 --> 00:00:48,670
+Cardiac Rehabilitation؟ هتحدث عن عشرة Outcomes أول
+
+14
+00:00:48,670 --> 00:00:51,430
+واحدة الـ Improve Exercise Tolerance Tolerance
+
+15
+00:00:51,430 --> 00:00:54,630
+حكينا هي عبارة عن قدرة الشخص على عمل الـ Exercise
+
+16
+00:00:54,630 --> 00:00:57,470
+على سبيل المثال Cardiac Rehabilitation Patient
+
+17
+00:00:57,470 --> 00:01:00,390
+Training for Patients with Coronary Heart Disease
+
+18
+00:01:00,390 --> 00:01:03,220
+أو الـ Congestive Heart Failureleads to
+
+19
+00:01:03,220 --> 00:01:06,580
+objectively variable تختلف ال improvement في ال
+
+20
+00:01:06,580 --> 00:01:10,100
+exercise capacity يعني في قدرة الشخص على أداء ال
+
+21
+00:01:10,100 --> 00:01:13,500
+exercise في ال man و ال woman regardless of age
+
+22
+00:01:13,500 --> 00:01:17,740
+طبعا بغض النظر عن العمر لأن this beneficial effect
+
+23
+00:01:17,740 --> 00:01:21,880
+doesn't persist in long term after competitions
+
+24
+00:01:21,880 --> 00:01:26,020
+لال cardiac rehabilitation لأن هاي ال endurance
+
+25
+00:01:26,020 --> 00:01:30,320
+اللي احنا بنحكي عليهاهي عبارة عن قدرة اللي هو
+
+26
+00:01:30,320 --> 00:01:33,420
+المريض على أداءه للتمرين كذا مرة Therefore
+
+27
+00:01:33,420 --> 00:01:37,160
+exercise training must be maintained long term for
+
+28
+00:01:37,160 --> 00:01:40,160
+sustained improvement لل exercise capacity كام
+
+29
+00:01:40,160 --> 00:01:45,380
+قدرتله على أداء ال exercise ال outcome التانية
+
+30
+00:01:45,380 --> 00:01:48,880
+اللي هي ال control of symptoms أنا أتحكم بال
+
+31
+00:01:48,880 --> 00:01:51,980
+symptoms اللي موجودة عندهم على سبيل المثال إذا كان
+
+32
+00:01:51,980 --> 00:01:55,760
+ديابت equation جدي أنا قدرتي على أنه أنا أتحكم في
+
+33
+00:01:55,760 --> 00:01:59,490
+ال diabetesكإذا كان عنده hypertension كمان كم قدر
+
+34
+00:01:59,490 --> 00:02:03,010
+دي على إن أنا أعمل control لـhypertension في ال
+
+35
+00:02:03,010 --> 00:02:05,790
+patient تبع الـ coronary heart disease و الانجينة
+
+36
+00:02:05,790 --> 00:02:08,430
+significantly improved during cardiac
+
+37
+00:02:08,430 --> 00:02:11,290
+rehabilitation exercise program و ال patient اللي
+
+38
+00:02:11,290 --> 00:02:14,790
+عنده في left ventricle failure and dysfunctions
+
+39
+00:02:14,790 --> 00:02:19,050
+improved symptoms in heart failure تمام؟ يعني كل
+
+40
+00:02:19,050 --> 00:02:23,390
+diagnosis إيه تشخيص لحاله، إيه تحكم بالـ symptoms
+
+41
+00:02:23,390 --> 00:02:27,450
+لحالهاالـ Outcomes التالتة الـ Improvement في ال
+
+42
+00:02:27,450 --> 00:02:31,330
+blood level of lipids الان اللي بتعرفوا ال lipids
+
+43
+00:02:31,330 --> 00:02:34,390
+و الكوليسترول و الأمور اللي زي هذه مهم جدا أنا
+
+44
+00:02:34,390 --> 00:02:37,670
+دائما أعمل تحليل لل patient عشان أعرف أديه نسبتها
+
+45
+00:02:37,670 --> 00:02:40,870
+في الدم ال improvement in lipid and lipid protein
+
+46
+00:02:40,870 --> 00:02:43,690
+levels are observed when the patient undergoing
+
+47
+00:02:43,690 --> 00:02:47,470
+rehabilitation exercise programطبعا مهم جدا لأنه
+
+48
+00:02:47,470 --> 00:02:49,810
+لو كان سمح الله الـ Triglyceride عالي أنا ممكن
+
+49
+00:02:49,810 --> 00:02:54,750
+أعمل exercise يزيد ويفاقق من المشكلة وتنتقل لثرمبس
+
+50
+00:02:54,750 --> 00:02:58,670
+أو تنتقل لـ Fatty embolism من مكان إلى أخر ال
+
+51
+00:02:58,670 --> 00:03:01,930
+exercise must be combined with dietary and medical
+
+52
+00:03:01,930 --> 00:03:05,830
+intervention to require lipid control طبعا نعمل
+
+53
+00:03:05,830 --> 00:03:08,470
+control عن طريق الأكل عن طريق أخده لعلاجاته
+
+54
+00:03:08,470 --> 00:03:12,430
+المناسبة لتذويب high أو لتخفيد ال cholesterol
+
+55
+00:03:12,430 --> 00:03:17,410
+levelال outcomes الرابعة انه ال effect on body
+
+56
+00:03:17,410 --> 00:03:20,510
+weight الoptimals لل management في ال obesity
+
+57
+00:03:20,510 --> 00:03:22,690
+required beneficial rehabilitation include
+
+58
+00:03:22,690 --> 00:03:25,590
+nutritional education and counseling و ال
+
+59
+00:03:25,590 --> 00:03:28,770
+behavioral ال obesity مش كتير منيحة في هذه الحالات
+
+60
+00:03:28,770 --> 00:03:31,950
+لازم انا اعمل counseling اعمل استشارات اعمل
+
+61
+00:03:31,950 --> 00:03:37,090
+ارشادات ان انت لازم يا حاجة اتخفضي من اللي هو ال
+
+62
+00:03:37,090 --> 00:03:42,370
+weight تبعكالـ Outcomes الخامسة اللي هو effect on
+
+63
+00:03:42,370 --> 00:03:44,910
+blood pressure الهيبوتية في exercise و training زي
+
+64
+00:03:44,910 --> 00:03:49,410
+ما حكينا مهم جدا ان انا اعمل minimal effect و اقلل
+
+65
+00:03:49,410 --> 00:03:52,730
+blood pressure و ايضا اعمل control عليه as a
+
+66
+00:03:52,730 --> 00:03:55,930
+symptoms reduction في ال smoking اذا كان عندنا
+
+67
+00:03:55,930 --> 00:03:59,930
+cardiac rehabilitation patientsmoker person will
+
+68
+00:03:59,930 --> 00:04:03,790
+be should be يجب عليه أنه أنا أعمل stopping لهذه
+
+69
+00:04:03,790 --> 00:04:06,830
+اللي هي ال habits educational and counseling
+
+70
+00:04:06,830 --> 00:04:09,570
+behavioral modification of the ground resulting in
+
+71
+00:04:09,570 --> 00:04:13,090
+cessation of smoking insignificant of number من ال
+
+72
+00:04:13,090 --> 00:04:18,470
+patient ال outcomes السابع أنه أنا أحسن psycho
+
+73
+00:04:18,470 --> 00:04:22,030
+social wellbeing حالة نفسية مهمة جدا في حالات ال
+
+74
+00:04:22,030 --> 00:04:24,670
+cardiac patient لأنه أي زعل ممكن يعملي على غافة
+
+75
+00:04:24,670 --> 00:04:29,600
+ضغط الدم وبالتالي المريض ممكن يروح فيهالأن الـ
+
+76
+00:04:29,600 --> 00:04:32,920
+Cardiac Patient Exercise خلال الـ Education تبعته
+
+77
+00:04:32,920 --> 00:04:36,380
+enhanced major psychosocial and social function
+
+78
+00:04:36,380 --> 00:04:39,860
+أنه أنت راح تكون كويس، أنت بخير، راح ترجع لحياتك
+
+79
+00:04:39,860 --> 00:04:43,300
+طبيعي بإذن الله تعالى الـ Outcomes اللي تمنا اللي
+
+80
+00:04:43,300 --> 00:04:46,480
+هو enhanced للـ social adjustment and function
+
+81
+00:04:46,480 --> 00:04:49,850
+أحنا كنا و حكينا على الـ Rehabilitative Teamأو الـ
+
+82
+00:04:49,850 --> 00:04:52,030
+Rehabilitation Team كانت في عنا اللي هو الـ
+
+83
+00:04:52,030 --> 00:04:55,170
+Vocational Training اللي هو تبع التدريب المهني أو
+
+84
+00:04:55,170 --> 00:04:59,390
+إنه نرجع الشخص اللي هو صار عنده مشكلة في القلب as
+
+85
+00:04:59,390 --> 00:05:02,770
+much as possible للوضع السابق هلأ الـ Cardiac
+
+86
+00:05:02,770 --> 00:05:06,250
+Rehabilitation Exercise Training improve الـ
+
+87
+00:05:06,250 --> 00:05:08,990
+social adjustment and function أيضا الـ Exercise
+
+88
+00:05:08,990 --> 00:05:12,730
+Training is recommended to improve social outcome
+
+89
+00:05:13,300 --> 00:05:17,060
+الـ «I return to work» زي ما حكينا في النقطة
+
+90
+00:05:17,060 --> 00:05:19,800
+السابقة أنه أنا بدي عن طريق الـ «functional
+
+91
+00:05:19,800 --> 00:05:23,160
+training» أنه أنا أرجع هذا الشخص لو أدعو ووظيفته
+
+92
+00:05:23,160 --> 00:05:26,980
+السابقة إذا كان العمل أو إذا كان هذا يتناسب مع
+
+93
+00:05:26,980 --> 00:05:31,600
+وظيفة القلب أو إنه وظيفة أو شكل المريض بشكل عام
+
+94
+00:05:31,600 --> 00:05:34,960
+فأنا ممكن أرجع إذا كان لأ و الله هو كان عامل بناء
+
+95
+00:05:34,960 --> 00:05:40,180
+و ال work heavy عليه وإنه مش قادر يكمل بنحاول إنه
+
+96
+00:05:40,180 --> 00:05:44,410
+إحنا نشوف وظيفة تانيةmini أو mini a non-exercise
+
+97
+00:05:44,410 --> 00:05:47,790
+variable effect in outcomes زي ال period
+
+98
+00:05:47,790 --> 00:05:50,410
+employment statements and angular attitude
+
+99
+00:05:50,410 --> 00:05:55,950
+والincoming طبعا انكسف طبعا الإشي بيرجع as much as
+
+100
+00:05:55,950 --> 00:05:59,490
+possible حسب الظروف والأوضاع اللي احنا بنكون فيها
+
+101
+00:05:59,490 --> 00:06:03,300
+في الدائرةالأن الـ Outcomes الأخيرة اللي هي مهم
+
+102
+00:06:03,300 --> 00:06:06,900
+جدا أنه أنا أقلل ال mortality ال mortality معناته
+
+103
+00:06:06,900 --> 00:06:11,200
+هي عبارة عن نسبة الوفيات اللي بيصير أو ناجمة عن
+
+104
+00:06:11,200 --> 00:06:14,200
+هذا الحدث it's significant data for survival
+
+105
+00:06:14,200 --> 00:06:17,060
+benefits for patients who participate in cardiac
+
+106
+00:06:17,060 --> 00:06:20,000
+rehabilitation exercise training but it's not
+
+107
+00:06:20,000 --> 00:06:24,920
+attributedالترتيب اللى هو to exercise a lot تمام؟
+
+108
+00:06:24,920 --> 00:06:29,280
+الاشي بتعلق قدى severity of disease؟ كم هي حتة
+
+109
+00:06:29,280 --> 00:06:32,760
+المرض؟ هل هو صار فيه blockage كامل أو block كاملة
+
+110
+00:06:32,760 --> 00:06:35,900
+للكرنري ارتي ع سبيل المثال؟ شو نوع ال embolism
+
+111
+00:06:35,900 --> 00:06:40,280
+اللى صارت؟ وبيعتمد على نفس الحالة التشخيصية هيك
+
+112
+00:06:40,280 --> 00:06:44,040
+بيكون أنا حكيت على عشرة من ال outcomes لل cardiac
+
+113
+00:06:44,040 --> 00:06:47,880
+patient في اللى هو ال rehabilitation program الآن
+
+114
+00:06:47,880 --> 00:06:52,420
+بدي أتحدث عن ال physiotherapy exerciseفى هنا الـ
+
+115
+00:06:52,420 --> 00:06:56,480
+Exercise Prescriptions لـ Cardiac Patient هحكى أي
+
+116
+00:06:56,480 --> 00:06:59,980
+تمرين أنا بدي أشتغله مع اللى هو الـ Cardiac
+
+117
+00:06:59,980 --> 00:07:04,840
+Patient هحكى عن ال mood النمط ال exercise هحكى عن
+
+118
+00:07:04,840 --> 00:07:08,640
+ال frequency هتكلم ع كمية ال oxygen اللى أنا بدي
+
+119
+00:07:08,640 --> 00:07:12,220
+أستهلكها في خلال ال exercise أنا بتكلم اليوم أو
+
+120
+00:07:12,220 --> 00:07:16,120
+بتحدث مع مريض Cardiac Patient ال machine pump هي
+
+121
+00:07:16,120 --> 00:07:20,520
+تبعتي هي مهمة جداالان في ال mood أو النمر تبعنا ال
+
+122
+00:07:20,520 --> 00:07:24,640
+aerobic exercise أو اللي هو التمرين الهوائي really
+
+123
+00:07:24,640 --> 00:07:28,220
+include walking, jogging, running and swimming و
+
+124
+00:07:28,220 --> 00:07:31,040
+ال bicycling أيضا مهم جدا ال combination of these
+
+125
+00:07:31,040 --> 00:07:34,040
+activities هذا هو عبارة عن ال mood شون النمط اللي
+
+126
+00:07:34,040 --> 00:07:38,040
+انا بدي اشتغله مع هذا ال cardiac patient الان ال
+
+127
+00:07:38,040 --> 00:07:42,440
+frequency كان عدد المرات ال individuals with less
+
+128
+00:07:42,440 --> 00:07:47,970
+than 100الشخص الـ cardiac اللي عنده كمية الأكسجين
+
+129
+00:07:47,970 --> 00:07:52,970
+مستهلكة لكل دقيقة أقل من ثلاث ثواني أو الكبسي دي
+
+130
+00:07:52,970 --> 00:07:56,270
+تبعته، هذا إله تعامل خاص، لأن الـMethadine، أنا
+
+131
+00:07:56,270 --> 00:07:59,650
+هعرفكم شو اسمها أو شو تعريفها في الـslide القادمة،
+
+132
+00:07:59,650 --> 00:08:02,910
+هي عبارة عن كمية الأكسجين اللي أنا بدي أستهلكها
+
+133
+00:08:02,910 --> 00:08:07,890
+خلال الدقيقةأما ال individuals من تلاتة لخمسة
+
+134
+00:08:07,890 --> 00:08:10,910
+تبعته ال capacity should be engaged in one to
+
+135
+00:08:10,910 --> 00:08:15,110
+session per day هعطيه جلسة لجلسين في اليومإذا كان
+
+136
+00:08:15,110 --> 00:08:18,410
+الـ Individual أكثر من خمس تبعته كمية الـ Oxygen
+
+137
+00:08:18,410 --> 00:08:22,530
+فأنا بعطيه اللي هو الـ Exercise من تلت لخمس مرات
+
+138
+00:08:22,530 --> 00:08:26,290
+أسبوعياً هنا هذه الأرقام مهمة جداً لأنه إذا شغلنا
+
+139
+00:08:26,290 --> 00:08:28,270
+في الـ ICU أو في الـ Cardiac Rehabilitation
+
+140
+00:08:28,270 --> 00:08:31,670
+Program كويس إنه أنا أكون عارف إيش هو الـ Exercise
+
+141
+00:08:31,670 --> 00:08:35,330
+الآن شو تعريفنا للماد؟ هو عبارة عن الـ Metabolic
+
+142
+00:08:35,330 --> 00:08:42,040
+Equivalent Treatmentمعامل اللي هو بيحسبلي كمية
+
+143
+00:08:42,040 --> 00:08:46,400
+الأكسجين المستهلكة من هذا الشخص في خلال الدقيقة
+
+144
+00:08:46,400 --> 00:08:50,280
+الواحدة its amount of oxygen consumed by
+
+145
+00:08:50,280 --> 00:08:55,200
+myocardium each minute حوالي تلاتة و نص milliliter
+
+146
+00:08:55,200 --> 00:08:59,740
+لذرة الأكسجين في كل كيلو من ال body weight لكل
+
+147
+00:08:59,740 --> 00:09:04,520
+دقيقة تمام؟ كم هي مدة الأكسجين؟ كم هي كمية
+
+148
+00:09:04,520 --> 00:09:08,560
+الأكسجين المستهلكة؟الان ايضا زي ما حكينا عن ال
+
+149
+00:09:08,560 --> 00:09:12,600
+mood و ال frequency هحكي على duration هل انا هستمر
+
+150
+00:09:12,600 --> 00:09:15,040
+معاه في ال exercise على ال bicycle على سبيل المثال
+
+151
+00:09:15,040 --> 00:09:18,800
+او ال treadmill ساعة نص ساعة عشر دقائق لأ كل حالة
+
+152
+00:09:18,800 --> 00:09:23,180
+المرضية لها وقتها و لها شغلها الخاص فيها ال
+
+153
+00:09:23,180 --> 00:09:26,880
+patient usually need allowed to 30-60 minutes يعني
+
+154
+00:09:26,880 --> 00:09:30,500
+من نص ل ساعة for each session which include warm
+
+155
+00:09:30,500 --> 00:09:34,600
+upat least 10 minutes في حاجة اسمها الـ warm-up زي
+
+156
+00:09:34,600 --> 00:09:38,440
+ما أخدنا عبارة عن عمل الإحماء و ال cooling down
+
+157
+00:09:38,440 --> 00:09:42,540
+اللي هو التبريد هذه بأول الجلسة وهذه بآخر الجلسة
+
+158
+00:09:42,980 --> 00:09:47,980
+الـ Factors الرابع اللي هو ال intensity كم هي شدة
+
+159
+00:09:47,980 --> 00:09:51,000
+التدبيرين ال intensity prescribed according to
+
+160
+00:09:51,000 --> 00:09:54,820
+ممكن أوصفها أنا لل target heart rate كم هو عضلة
+
+161
+00:09:54,820 --> 00:09:58,320
+القلب بتشتغل كم هو ال training تبعها which
+
+162
+00:09:58,320 --> 00:10:02,060
+determined according to Carvelon formula اللي هو
+
+163
+00:10:02,060 --> 00:10:05,760
+ال target heart rate هنا مسألة حساب بتكون أغلب
+
+164
+00:10:05,760 --> 00:10:10,650
+اللي هو الالـ Bicycle أو الـ Treadmill كلها بتكون
+
+165
+00:10:10,650 --> 00:10:14,430
+مبرمجة انت بس ادخل الأرقام ال resting heart rate
+
+166
+00:10:14,430 --> 00:10:18,250
+زائد 60% ل 80% من ال maximum heart rate اللي
+
+167
+00:10:18,250 --> 00:10:22,730
+بيعطينيا طبعا و ال maximum heart rate 220 ناقص
+
+168
+00:10:22,730 --> 00:10:26,890
+يعني هذه formula معينة او معادلة ثابتة انا بشتغل
+
+169
+00:10:26,890 --> 00:10:30,330
+عليها ال based on result of exercise stress test
+
+170
+00:10:30,330 --> 00:10:33,650
+طبعا اللي هو عنده هنحكي عليه ان شاء الله بآخر هذه
+
+171
+00:10:33,650 --> 00:10:38,550
+ال chapter هنحكي عليه هنا هنعطينا exampleالان في
+
+172
+00:10:38,550 --> 00:10:43,290
+عندى شاب عمره 25 سنة ال resting heart rate تبعته
+
+173
+00:10:43,290 --> 00:10:48,190
+65 و ال wanting now training heart rate ال
+
+174
+00:10:48,190 --> 00:10:52,690
+intensity level من 60 م 70% الحسبة هذه زى ما انتوا
+
+175
+00:10:52,690 --> 00:10:56,270
+شايفينها بتم حسابها يا اما إلكترونيا زى ما حكيتلكم
+
+176
+00:10:56,270 --> 00:11:00,830
+أو انت ممكن بالقلم الورقة و تحسبها في الآخر عشان
+
+177
+00:11:00,830 --> 00:11:05,830
+يعطينى كام انا ممكن اشتغل اللى هو او كام ضربة في
+
+178
+00:11:05,830 --> 00:11:12,370
+الدقيقة الواحدةممكن انا احسبها ايضا ال «Borg Rate
+
+179
+00:11:12,370 --> 00:11:15,250
+Perceived Edulary Excretions» اللي هي «Borg
+
+180
+00:11:15,250 --> 00:11:20,730
+Exercise» هنحكي عليه او اللي هو ال level تبعت ال
+
+181
+00:11:20,730 --> 00:11:23,830
+exercise intensity كمان هيهمنا هذا الاشي في «Borg
+
+182
+00:11:23,830 --> 00:11:26,970
+Exercise» «Borg's original intention was
+
+183
+00:11:26,970 --> 00:11:31,470
+structural أو construct لكتجاريز من 6 ل20»خلال ال
+
+184
+00:11:31,470 --> 00:11:35,030
+exercise you overwrite your perception expressions
+
+185
+00:11:35,030 --> 00:11:39,430
+كم هو الجهد المستهلك use these skills where 6
+
+186
+00:11:39,430 --> 00:11:45,050
+means المعامل أو الوسيط 6 not 20 means totally
+
+187
+00:11:45,050 --> 00:11:48,130
+maximum effort جدّي بيعطينا الجهد اللي عنه هذا ان
+
+188
+00:11:48,130 --> 00:11:52,270
+شاء الله في انتجاهي ممكن يكون أفضل ان احنا نشرح ال
+
+189
+00:11:52,270 --> 00:11:58,100
+example واحدة واحدة بارج skillsفيه burger scales
+
+190
+00:11:58,100 --> 00:12:01,760
+من 6 ل20 زي ما حكينا في ال slide السابقة سبعة
+
+191
+00:12:01,760 --> 00:12:05,100
+بيكون very light، إشي خفيف، exercise خفيف، تسعة
+
+192
+00:12:05,100 --> 00:12:10,840
+بيكون very light، 11 light، و13 hard، بعدين 15،
+
+193
+00:12:10,840 --> 00:12:14,240
+يعني كل ما أنا عليت بالرقم، كل ما كان الإشي أكبر و
+
+194
+00:12:14,240 --> 00:12:17,800
+أصعب في الجهود، لحد ما نوصل ل 20، بيكون عندنا
+
+195
+00:12:17,800 --> 00:12:23,870
+exhibitions، يعني كمية جهود عظيمةالـ Alberguer's
+
+196
+00:12:23,870 --> 00:12:27,210
+exercise equivalent value should be treated أو
+
+197
+00:12:27,210 --> 00:12:30,690
+should be rated as a follow إذا كان أقل من 12،
+
+198
+00:12:30,690 --> 00:12:33,730
+perceive fairly light، زي ما شرحنا من 40 إلى 60
+
+199
+00:12:33,730 --> 00:12:39,090
+heart rate من 12 و 13، بيكون somewhat hard، 14 و
+
+200
+00:12:39,090 --> 00:12:43,170
+16، perceive hard أو high intensity، لكن إذا كان
+
+201
+00:12:43,170 --> 00:12:45,450
+بعد هيكة، بيكون أعلى في القيم
+
+202
+00:13:02,230 --> 00:13:07,050
+مهم جدا الحركة هذه أو الـ exercise لو كان انا
+
+203
+00:13:07,050 --> 00:13:10,530
+حقيته مثلا على سبيل المثال الـ swimming كويس ان هو
+
+204
+00:13:10,530 --> 00:13:13,050
+يعمل improvement للcirculation فبالتالي هيتحسن
+
+205
+00:13:13,050 --> 00:13:16,290
+عندى الجلوكولز leveldecrease للـ blood pressure كل
+
+206
+00:13:16,290 --> 00:13:19,830
+ما بحرك كل ما كان أفضل في تقليل كمية ال systolic
+
+207
+00:13:19,830 --> 00:13:23,250
+والdiastolic blood pressure increasing لل high
+
+208
+00:13:23,250 --> 00:13:27,370
+density of lipoprotein levels كمان بالـ
+
+209
+00:13:27,370 --> 00:13:31,790
+lipoproteins أو اللي هو بيسميه البروتين الدهني مهم
+
+210
+00:13:31,790 --> 00:13:35,490
+جدا إنه أنا أحافظ عليه بنفس المستوى الصحي تبعه
+
+211
+00:13:35,490 --> 00:13:39,410
+decrease لل low intensityأنا بدي أخفف من
+
+212
+00:13:39,410 --> 00:13:41,890
+الـdenicity للـ lipoprotein و للـ triglycerides زي
+
+213
+00:13:41,890 --> 00:13:46,610
+ما حكيتلكم إشي ضرب الجسم أنا هرجع لوضعه الطبيعي ال
+
+214
+00:13:46,610 --> 00:13:50,050
+exercise may decrease mortality طبعا أكيد الشخص
+
+215
+00:13:50,050 --> 00:13:52,750
+اللي بيتحرك و بيروح و بيجي أقل ما فيها أنا ممكن
+
+216
+00:13:52,750 --> 00:13:57,110
+أمنع ال DVT إذا كان هو لا سمح الله بدردن و مابدو
+
+217
+00:13:57,110 --> 00:14:00,010
+يتحرك فبالتالي ممكن تجي بدردن ممكن تجي air
+
+218
+00:14:00,010 --> 00:14:04,710
+embolism ممكن يجي أي إشي complicated يحدث الوفاة
+
+219
+00:14:04,710 --> 00:14:08,990
+بسببها فبالتالي أنا هي كما حافظت علىإن أنا أقلل
+
+220
+00:14:08,990 --> 00:14:13,710
+الـ mortality الـ exercise session consist of ال
+
+221
+00:14:13,710 --> 00:14:18,680
+warming up applied for about10 minutes in the form
+
+222
+00:14:18,680 --> 00:14:22,080
+of light, clenched and muscular stretching
+
+223
+00:14:22,080 --> 00:14:25,880
+performed to هي عبارة عن عمليات الإحماء اللي بتصير
+
+224
+00:14:25,880 --> 00:14:29,840
+في بداية الجلسة حوالي 10 دقائق من بداية الجلسة ليش
+
+225
+00:14:29,840 --> 00:14:32,820
+أنا بدي أعملها؟ بدي أعملها avoid muscle injury مش
+
+226
+00:14:32,820 --> 00:14:35,800
+على طول أنا باجي اليوم على سبيل المثال فينا سباق
+
+227
+00:14:35,800 --> 00:14:38,540
+جري مش على طول أنا بفوت و بجري مرة واحدة لأ في
+
+228
+00:14:38,540 --> 00:14:41,700
+exercise عشان أعمل ال training للمصل أهيئها والله
+
+229
+00:14:41,700 --> 00:14:45,670
+في جيكي exercise كبيرPrepare للكارديو بالمونري
+
+230
+00:14:45,670 --> 00:14:49,870
+system to exercise اليوم انت عندك اللي هو سباق
+
+231
+00:14:49,870 --> 00:14:53,470
+جريه فانا لازم احضر عضلة القلب انه جايكي exercise
+
+232
+00:14:53,470 --> 00:14:57,190
+لازم تدخ فيه دم كفاية لازم تدخ فيه كمية من ال
+
+233
+00:14:57,190 --> 00:15:00,750
+oxygen كفاية عشان انت تقدر تكملي باقي المشوار
+
+234
+00:15:01,020 --> 00:15:04,880
+reduce ال incidence of Arrhythmia طبعا بدي أقلل من
+
+235
+00:15:04,880 --> 00:15:09,040
+حدوث ال Arrhythmias اللي هي التوقف القلب فبالتالي
+
+236
+00:15:09,040 --> 00:15:14,060
+أنا بال warming up بهيي الجسم نفسيا وجسديا ان انت
+
+237
+00:15:14,060 --> 00:15:18,620
+وراك exercise لازم تعمله الآن هذا كله ايش في ال
+
+238
+00:15:18,620 --> 00:15:22,640
+exercise? aerobic exercise اللي هو applied to 40
+
+239
+00:15:22,640 --> 00:15:25,240
+minutes in the form of walking, jogging and
+
+240
+00:15:25,240 --> 00:15:28,780
+bicycling هذا aerobic exercise اللي هو تمارين
+
+241
+00:15:28,780 --> 00:15:32,380
+هوائيةزي ما فى عنا warming up فى عنا cooling down
+
+242
+00:15:32,380 --> 00:15:36,060
+ال cooling down ايضا 10 minutes لان لاحظوا 10 في
+
+243
+00:15:36,060 --> 00:15:40,120
+الأول و 40 و هي كمان 10 هيك بكون أنا خلصت ساعة مع
+
+244
+00:15:40,120 --> 00:15:42,740
+مرض ال cardiac rehabilitation ال applied 10
+
+245
+00:15:42,740 --> 00:15:45,460
+minutes same form applied aerobic exercise during
+
+246
+00:15:45,460 --> 00:15:49,160
+a training ال cool down أنا الأن بدى أبرد خلاص
+
+247
+00:15:49,160 --> 00:15:53,600
+اشتغلت التمرين 40 دقيقة فبدى أخفف من اللى هو
+
+248
+00:15:53,600 --> 00:15:56,720
+الحركة تبعتي عشان أعمل cooling down to prevent
+
+249
+00:15:56,720 --> 00:16:00,740
+ventricular artemisiaand prevent boiling down لـ
+
+250
+00:16:00,740 --> 00:16:04,520
+blood in lower limbs بدي أمنع تجمع الدم مرة واحدة
+
+251
+00:16:04,520 --> 00:16:08,380
+في الـ lower limb هاي فائدة اللي هي ال cooling
+
+252
+00:16:08,380 --> 00:16:12,820
+down تمام؟ هاي بعض الصور على ال warming up and
+
+253
+00:16:12,820 --> 00:16:16,420
+cooling downExercise عادية ال head tilt side to
+
+254
+00:16:16,420 --> 00:16:19,460
+side بعدين ال arms و ال twist و ال shoulder
+
+255
+00:16:19,460 --> 00:16:23,580
+shrinking اللي هو يهز الكتف و ال quadriceps طبعا و
+
+256
+00:16:23,580 --> 00:16:27,300
+ال side to reach انه يوصل طبعا static exercise هذا
+
+257
+00:16:27,300 --> 00:16:31,000
+كله اللي هو عبارة عن warming exercise and cooling
+
+258
+00:16:31,000 --> 00:16:35,100
+down exerciseالـ Exercise Stress هذا كتير بتسمعوا
+
+259
+00:16:35,100 --> 00:16:37,860
+عنه، هنشرحه إن شاء الله في العمل اللي بتاخدوه هو
+
+260
+00:16:37,860 --> 00:16:41,420
+عبارة عن إيش؟ It's a safe, relative, non-invasive
+
+261
+00:16:41,420 --> 00:16:44,920
+and sensitive method to measuring cardiovascular
+
+262
+00:16:44,920 --> 00:16:49,720
+and pulmonary response to increasing activity طبعا
+
+263
+00:16:49,720 --> 00:16:54,140
+الإشي هنا هو عبارة عن test اسمه اللي هو Exercise
+
+264
+00:16:54,140 --> 00:17:00,200
+Stress TestNon-invasive Sinistive methods طريقة
+
+265
+00:17:00,200 --> 00:17:04,200
+حساسة جدا لقياس الـ cardiovascular and pulmonary
+
+266
+00:17:04,200 --> 00:17:07,600
+response استجابة الجهاز اللي هو الوعائي أو الـ
+
+267
+00:17:07,600 --> 00:17:10,660
+cardiovascular system للاستجابة لهذه الـ
+
+268
+00:17:10,660 --> 00:17:15,510
+activitiesالـ Indication، لمين أنا بدي أستخدمه أو
+
+269
+00:17:15,510 --> 00:17:19,050
+لشو بدي أستخدمه؟ evaluation of chest pain suggests
+
+270
+00:17:19,050 --> 00:17:22,790
+to be a related coronary disease بدي أستخدمه عشان
+
+271
+00:17:22,790 --> 00:17:26,150
+أعمل determination للـ prognosis and severity of
+
+272
+00:17:26,150 --> 00:17:29,530
+coronary disease أنا بشتغل، برجع و بحكي، أنا بشتغل
+
+273
+00:17:29,530 --> 00:17:32,650
+مع cardiac patient مهم جدا إنه أنا أعرف هل هو
+
+274
+00:17:32,650 --> 00:17:35,910
+هيشتغل معي ولا لأ ال evaluation لل effect of
+
+275
+00:17:35,910 --> 00:17:39,750
+medical surgical and surgical treatmentبدي أقيم
+
+276
+00:17:39,750 --> 00:17:44,410
+الحالة evaluation للأرثميزيا and hypertension of
+
+277
+00:17:44,410 --> 00:17:47,850
+exercise assessment لل functional capacity كام هي
+
+278
+00:17:47,850 --> 00:17:50,670
+القدر الوضني فيها لهذا الشخص هى اللى هيتكمل معايا
+
+279
+00:17:50,670 --> 00:17:56,750
+التمرين ولا مش هيتكمل ال preparation تحضير ال
+
+280
+00:17:56,750 --> 00:18:00,610
+patient are usually instructed not be eating او
+
+281
+00:18:00,610 --> 00:18:04,030
+smoking several hours before this task يعني مايجي
+
+282
+00:18:04,030 --> 00:18:07,870
+الشخص يأكل وشبة ويجي عندى يعمل ال exerciseزي أي
+
+283
+00:18:07,870 --> 00:18:10,850
+حالة مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا
+
+284
+00:18:10,850 --> 00:18:18,290
+مثلًا
+
+285
+00:18:18,290 --> 00:18:19,910
+مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا مثلًا
+
+286
+00:18:19,910 --> 00:18:28,430
+مثلن
+
+287
+00:18:28,430 --> 00:18:30,470
+مثلن مثلن مثلن مثلن مثلن مثلن مثلن مثلن مثلن مثلن
+
+288
+00:18:30,470 --> 00:18:30,970
+مثلن مثلن مثلن مثلن مثلن مثلن مثلن مثلن مثلن مثلن
+
+289
+00:18:30,970 --> 00:18:30,970
+مثلن مثلن مثلن مثلن مثلن مثلن مثلن مثلن مثلن مثلن
+
+290
+00:18:30,970 --> 00:18:35,050
+مثلن مثلن مثلن مثلن مثلن مثلن مثلنsnackers and
+
+291
+00:18:35,050 --> 00:18:39,170
+exercise clothes طبعا ال clothes مهم جدا تكون
+
+292
+00:18:39,170 --> 00:18:43,270
+comfortable كمان اللي هو ال shoes مهم جدا اللي
+
+293
+00:18:43,270 --> 00:18:47,470
+هتكون comfortable لهذا الشخص description this
+
+294
+00:18:47,470 --> 00:18:52,700
+technique runningresting ECG طبعا لازم يكون عندى
+
+295
+00:18:52,700 --> 00:18:57,020
+ال ECG رسمتها كويسة و في normal pictures ال
+
+296
+00:18:57,020 --> 00:19:01,160
+patient lying down then standing up and then
+
+297
+00:19:01,160 --> 00:19:05,880
+breathing heavily for half a minute تمام هو lying
+
+298
+00:19:05,880 --> 00:19:09,040
+down في sublime position بعدين بخليه يعمل standing
+
+299
+00:19:09,040 --> 00:19:14,080
+up بعدين ياخد نص دقيقة من النفس this test كان
+
+300
+00:19:14,080 --> 00:19:18,260
+later compared withECG test performed while
+
+301
+00:19:18,260 --> 00:19:22,240
+patient exercising طبعا إنه أنا لازم أعمل ال ECG
+
+302
+00:19:22,240 --> 00:19:26,840
+قبل واء بعد ال patient blood pressure is taken and
+
+303
+00:19:26,840 --> 00:19:30,800
+blood pressure cuff is left in place بحطها على
+
+304
+00:19:30,800 --> 00:19:35,620
+الإيد الشمال اللي هي ال pressure cuff طبعا so that
+
+305
+00:19:35,620 --> 00:19:38,800
+blood pressure can measured perfectly throughout
+
+306
+00:19:38,800 --> 00:19:44,020
+test هذا بالنسبة لوصف ال exercise ال patient begin
+
+307
+00:19:44,020 --> 00:19:47,030
+ridingالـ Sessionary Bicycles أو Walking The
+
+308
+00:19:47,030 --> 00:19:50,810
+Treadmill Gradually طبعاً هيمشي على اللي هو يعمل
+
+309
+00:19:50,810 --> 00:19:53,670
+bicycling ال bicycle أو ال bicycle يكون ال
+
+310
+00:19:53,670 --> 00:19:56,150
+sessionary أو يمشي على ال treadmill gradual
+
+311
+00:19:56,150 --> 00:20:00,970
+intensity of exercise gradually بحكي أنه تدريجيا
+
+312
+00:20:00,970 --> 00:20:04,230
+أنا بقدر أجريها for example if patient is walking
+
+313
+00:20:04,230 --> 00:20:07,690
+with a treadmill and speed will increase gradually
+
+314
+00:20:07,690 --> 00:20:11,170
+the treadmill is tilt upward stimulating and
+
+315
+00:20:11,170 --> 00:20:15,400
+inclinedلازم أكون حريصة أو أكون واقفة بجانب هذا
+
+316
+00:20:15,400 --> 00:20:18,760
+المريض حتى ألاحظ أي signs أو symptoms تكون خاطرة
+
+317
+00:20:18,760 --> 00:20:22,280
+if patient is an exercise bicycling his resistance
+
+318
+00:20:22,280 --> 00:20:26,360
+to drag is gradually increased أي إشي بدي أزيده ال
+
+319
+00:20:26,360 --> 00:20:29,040
+speed أو ال intensity أو أي إشي بدي أزيده في ال
+
+320
+00:20:29,040 --> 00:20:33,220
+program لازم أزيدها gradually لأنه أنا حكيت أنا بس
+
+321
+00:20:33,220 --> 00:20:38,560
+أشتغل مع cardiac patient تمام؟الpatient continue
+
+322
+00:20:38,560 --> 00:20:42,940
+exercise increasing ال intensity until he or she
+
+323
+00:20:42,940 --> 00:20:47,380
+reaches her target heart rate لحد ما أوصل لحد اللي
+
+324
+00:20:47,380 --> 00:20:52,480
+أنا كنت محددة على الأغلب في العموم بيكون 85% من ال
+
+325
+00:20:52,480 --> 00:20:55,920
+maximum predictable heart rate based on patient
+
+326
+00:20:55,920 --> 00:21:00,400
+ageor experience severe fatigue, dizziness or
+
+327
+00:21:00,400 --> 00:21:03,860
+chest pain. During this time, the patient's heart
+
+328
+00:21:03,860 --> 00:21:07,220
+rate, ECG pattern, and blood pressure are
+
+329
+00:21:07,220 --> 00:21:08,620
+continually monitoring
+
+330
+00:21:18,540 --> 00:21:22,540
+after care بعد ما أنا خلصته هذا ال test ال patient
+
+331
+00:21:22,540 --> 00:21:25,420
+should be rest until blood pressure and heart rate
+
+332
+00:21:25,420 --> 00:21:28,440
+return to normal لإن احنا كنا بنعمل نشاط أكيد ال
+
+333
+00:21:28,440 --> 00:21:32,480
+heart rate عالي أكيد ال heart beat كمان زادت if
+
+334
+00:21:32,480 --> 00:21:37,200
+all goes well لو كل شيء goes to well يعني مش الوضع
+
+335
+00:21:37,200 --> 00:21:39,940
+الطبيعي and there are no signs to distress ال
+
+336
+00:21:39,940 --> 00:21:43,900
+patient may return to this or her normal daily
+
+337
+00:21:43,900 --> 00:21:48,810
+activities تمام؟الأمر بيكون سهل جدا عليه وإن أمره
+
+338
+00:21:48,810 --> 00:21:53,560
+تمام مافي عندنا أي إشي أو dangerous pointrisk
+
+339
+00:21:53,560 --> 00:21:56,960
+there are very risk او very slight risk لل heart
+
+340
+00:21:56,960 --> 00:21:59,960
+attack from exercise as well as cardiac arrhythmia
+
+341
+00:21:59,960 --> 00:22:03,200
+يعني ال irregular heart beat إذا صار عندي cardiac
+
+342
+00:22:03,200 --> 00:22:06,620
+arrest لازم أوقف، إذا صار عندي مشكلة كمان لازم
+
+343
+00:22:06,620 --> 00:22:10,420
+أوقف normal result إذا هو عمل ال exercise و كل
+
+344
+00:22:10,420 --> 00:22:14,420
+الأمور تمام، no angina, no dizziness, no vertigo،
+
+345
+00:22:14,420 --> 00:22:16,360
+مافي عنده أي دوخة، مافي عنده أي إشي و ال
+
+346
+00:22:16,360 --> 00:22:20,180
+electrocardiographic كويسة، أنا بستمر في ال
+
+347
+00:22:20,180 --> 00:22:24,410
+exerciseالـ Abnormal result إذا صار عندى فيه عندى
+
+348
+00:22:24,410 --> 00:22:28,550
+abnormal في ال ECG طبعا indicated لال oxygen rich
+
+349
+00:22:28,550 --> 00:22:32,350
+blood مهم جدا ال ST wave كمان ما تكونش depression
+
+350
+00:22:32,350 --> 00:22:36,610
+ال heart rhythm disturbance لو كان أنا في cardiac
+
+351
+00:22:36,610 --> 00:22:40,310
+arrest مهم جدا أنا أوقف ال program ال structural
+
+352
+00:22:40,310 --> 00:22:43,430
+abnormalities لل heart such as overgrowth muscle
+
+353
+00:22:43,430 --> 00:22:46,550
+hyper atrophy كمان هذا من المخاطر اللى أنا منوع
+
+354
+00:22:46,550 --> 00:22:51,910
+أوصل لها«إذا ارتفع حرارة الدم أعلى للطبيعي، يجب أن
+
+355
+00:22:51,910 --> 00:23:01,630
+توقف هذا التجارب» «Table 6» هنا أو فيها مكان عبارة
+
+356
+00:23:01,630 --> 00:23:06,730
+عن تابل بيشرح لمين أنا ممنوع أشتغل exercise
+
+357
+00:23:06,730 --> 00:23:10,690
+testing «absolutely contraindication» للحالات اللي
+
+358
+00:23:10,690 --> 00:23:15,690
+عندها recent significant change في الـ ECGيعني لسه
+
+359
+00:23:15,690 --> 00:23:21,130
+تعمل ECG جديدة وما كانت normal للحالات اللي هي
+
+360
+00:23:21,130 --> 00:23:27,260
+myocardial infarction طبعاالـ unstable angina لأنه
+
+361
+00:23:27,260 --> 00:23:31,720
+بخاف أى embolism بخاف أى thrombus تروح على مكان لو
+
+362
+00:23:31,720 --> 00:23:34,020
+راحت على ال brain بده تعملى stroke لو راحت على ال
+
+363
+00:23:34,020 --> 00:23:37,520
+heart مازالت مستمرة فى ال heart ودخلت فى أى artery
+
+364
+00:23:37,520 --> 00:23:41,580
+تعملى myocardial infarction ال uncontrolled
+
+365
+00:23:41,580 --> 00:23:45,660
+ventricular dysarthria إذا صار فى عنى عدم انتظام
+
+366
+00:23:45,660 --> 00:23:48,800
+فى ال ventricular ال uncontrolled arterial
+
+367
+00:23:48,800 --> 00:23:53,890
+dysarthria compromisedطبعاً والـ Third AV Block
+
+368
+00:23:53,890 --> 00:23:59,210
+إذا صار في عندي مشكلة في الـ ECG كمان هذه مشكلة
+
+369
+00:23:59,210 --> 00:24:03,290
+تابعة لاللي هي الـ cardiac arrest هنا ممنوع أشتغل
+
+370
+00:24:03,290 --> 00:24:08,310
+مع هذه الحالات الستة إطلاقا أي exercise في عن الـ
+
+371
+00:24:08,310 --> 00:24:12,550
+Contra Indication أيضاً بنكمل للـ slide اللي
+
+372
+00:24:12,550 --> 00:24:16,390
+جابلها الـ acute congestive heart failure لأنه
+
+373
+00:24:16,390 --> 00:24:20,520
+لساته acute الوضعSevere aortic stenosis، انسداد
+
+374
+00:24:20,520 --> 00:24:24,100
+وإطلاق السينيان الأوارطي، الـ active suspected
+
+375
+00:24:24,100 --> 00:24:27,340
+myocardites and brachioradites، thrombophlebites
+
+376
+00:24:27,340 --> 00:24:31,170
+and intercardiac thrombiفي حالات الـ recent
+
+377
+00:24:31,170 --> 00:24:34,570
+systemic أو الـ pulmonary embolism كنا بنحكي عليها
+
+378
+00:24:34,570 --> 00:24:38,870
+قبل قليل اللي هو خوفنا من انتقال هذه الـ embolism
+
+379
+00:24:38,870 --> 00:24:44,990
+لأي مكان أو أي مكان في الجسم بتعملي انسداد في
+
+380
+00:24:44,990 --> 00:24:47,370
+حالات الـ acute infection لأنه هيكيك بيكون عندهم
+
+381
+00:24:47,370 --> 00:24:50,810
+الـ high fever على سبيل المثال فانا مابدي أزيد ال
+
+382
+00:24:50,810 --> 00:24:57,030
+cardiac outputالـ relative contraindication هناك
+
+383
+00:24:57,030 --> 00:25:00,390
+إطلاقًا ممنوع أنا أشتغل مع الحالات الأتناشر اللي
+
+384
+00:25:00,390 --> 00:25:03,390
+أنا حكيت عليها هنا أيضًا ممنوع أشتغل لكن ممكن
+
+385
+00:25:03,390 --> 00:25:07,130
+أشتغل في الحالة إذا كانت اتعافت أو اتشافت من اللي
+
+386
+00:25:07,130 --> 00:25:10,350
+هو ال symptoms اللي فيها زي على سبيل اللي في ال
+
+387
+00:25:10,350 --> 00:25:15,490
+arresting لدي story كبيرة برشار طبعًااحنا بنعرف
+
+388
+00:25:15,490 --> 00:25:20,890
+اللي هو الـ Normal Blood Pressure 120 على 80
+
+389
+00:25:20,890 --> 00:25:24,090
+المدلة
+
+390
+00:25:24,090 --> 00:25:28,650
+Vulvar Heart Disease أي مشاكل في الـ Valve No
+
+391
+00:25:28,650 --> 00:25:32,370
+Erectoid Abnormalities زي اللي هو بعض الـ ECG اللي
+
+392
+00:25:32,370 --> 00:25:36,770
+مش مظبوطة الـ Hypomagnesium أو الـ Hypoglycemia
+
+393
+00:25:36,770 --> 00:25:40,870
+Frequent Complex للـ Ventricular Ectopy كمان هذه
+
+394
+00:25:40,870 --> 00:25:44,550
+Relativeأيضا في عندي الـcardiomyopathy including
+
+395
+00:25:44,550 --> 00:25:48,510
+hyper atrophic cardiomyopathy الـ uncontrolled
+
+396
+00:25:48,510 --> 00:25:54,350
+metabolic disease زي الديابيتا زي الthyrotoxicosis
+
+397
+00:25:54,350 --> 00:25:58,970
+والمكزيديميا كل هذه الأمور ممنوع أنا أشتغللها
+
+398
+00:25:58,970 --> 00:26:03,190
+relatively ال chronic infection disease زي ال
+
+399
+00:26:03,190 --> 00:26:06,350
+hepatitis ال AIDS الأمور اللي زي هذهإذا كان في
+
+400
+00:26:06,350 --> 00:26:08,590
+عندى neuromuscular أو musculoskeletal
+
+401
+00:26:08,590 --> 00:26:12,690
+complications أو problems طبعا و ال rheumatoid
+
+402
+00:26:12,690 --> 00:26:17,170
+advanced and complicated pregnancy طبعا هذا الاشي
+
+403
+00:26:17,170 --> 00:26:21,790
+مهم جدا أنه أنا ماشتغل معاه وبهيك بيكون خلصنا ال
+
+404
+00:26:21,790 --> 00:26:25,510
+cardiac rehabilitation patient part 2 ألقاكم بإذن
+
+405
+00:26:25,510 --> 00:26:30,210
+الله تعالى في فيديو رقم 8 في ال ICU ل cardiac
+
+406
+00:26:30,210 --> 00:26:32,550
+patient يعطيكوا ألف عافية
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/vUMjemmmFOo.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/vUMjemmmFOo.srt
new file mode 100644
index 0000000000000000000000000000000000000000..40363ab9f22eb346fcd18526ed91adf56413220a
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/vUMjemmmFOo.srt
@@ -0,0 +1,1390 @@
+1
+00:00:01,350 --> 00:00:05,090
+بنكمل معاكم إن شاء الله رب العالمين في الـ
+
+2
+00:00:05,090 --> 00:00:08,750
+Physiotherapy role and Cardiopulmonary disease
+
+3
+00:00:08,750 --> 00:00:12,970
+اليوم هنتحدث عن  الـ physical therapy role في موضوع
+
+4
+00:00:12,970 --> 00:00:17,250
+الـ breathing exercise هنتحدث عن الـ indications، الـ
+
+5
+00:00:17,250 --> 00:00:21,330
+contraindications، الـ goals، الـ repercussions، و types
+
+6
+00:00:21,330 --> 00:00:25,370
+of breathing exercise بإذن الله تعالى نبدأ
+
+7
+00:00:25,370 --> 00:00:27,250
+محاضرتنا لهذا اليوم
+
+8
+00:00:35,760 --> 00:00:39,040
+الـ Breathing exercise زي ما احنا شايفين في عندنا
+
+9
+00:00:39,040 --> 00:00:44,880
+هنا inspiration، وهنا في عندنا expiration، تمام؟
+
+10
+00:00:44,880 --> 00:00:48,100
+الان، الـ definition لـ الـ breathing exercise: it's an
+
+11
+00:00:48,100 --> 00:00:52,560
+exercise intended to promote effective and healthy
+
+12
+00:00:52,560 --> 00:00:56,260
+breathing and breath control، عشان أنا أحصل على
+
+13
+00:00:56,260 --> 00:01:01,700
+breathing جيد، لازم أعمل هذا الـ breath بشكل منتظم
+
+14
+00:01:01,700 --> 00:01:07,160
+بشكل جيد، حتى تدخل كمية مناسبة من الأكسجين إلى
+
+15
+00:01:07,160 --> 00:01:11,960
+الرئتين، ويخرج الـ waste product اللي هو CO2 خارج
+
+16
+00:01:11,960 --> 00:01:15,930
+الجسم. It's a therapeutic form of exercise
+
+17
+00:01:15,930 --> 00:01:21,330
+aimed to deepen inspiration or expiration، or even
+
+18
+00:01:21,330 --> 00:01:25,310
+both. يا إما هيكون الـ deep في الـ inspiration أو في
+
+19
+00:01:25,310 --> 00:01:29,930
+الـ expiration أو كلاهما معاً. Learn the rhythm and
+
+20
+00:01:29,930 --> 00:01:34,750
+rhythm of respiration، بغير الـ rate، إذا كان في عندي
+
+21
+00:01:34,750 --> 00:01:38,490
+tachycardia، إذا كان في عندي bradycardia، كمان الـ
+
+22
+00:01:38,490 --> 00:01:42,670
+rhythm تبع الـ respiration يجب أن يكون في حدود الـ
+
+23
+00:01:42,670 --> 00:01:47,230
+normal، تمام؟ هلأ، مين اللي أنا لازم أعمل لهم، أو من
+
+24
+00:01:47,230 --> 00:01:51,370
+هم الناس اللي لازم نعمل لهم الـ indications بتاعت الـ
+
+25
+00:01:51,370 --> 00:01:54,270
+breathing exercise: الـ acute و الـ chronic lung
+
+26
+00:01:54,270 --> 00:02:00,170
+diseases in general، سواء كان COPD،  التهاب رئوي، الـ atelectasis،
+
+27
+00:02:00,600 --> 00:02:03,120
+الـ pulmonary embolism، الـ acute respiratory
+
+28
+00:02:03,120 --> 00:02:07,720
+failure، كل هذه الناس من اللي هو ضمن القائمة اللي
+
+29
+00:02:07,720 --> 00:02:11,520
+أنا بدي أعمل لهم breathing exercise. الـ pain in
+
+30
+00:02:11,520 --> 00:02:15,460
+the thoracic or abdominal area because of surgery or
+
+31
+00:02:15,460 --> 00:02:20,700
+trauma. الـ airway obstruction secondary to
+
+32
+00:02:20,700 --> 00:02:25,700
+bronchospasm or retained secretions.  Diffuse weakness in central
+
+33
+00:02:25,700 --> 00:02:30,230
+nervous system leading to muscle weakness. كمان، severe
+
+34
+00:02:30,230 --> 00:02:34,330
+orthopedic abnormalities زي حالات الـ scoliosis أو
+
+35
+00:02:34,330 --> 00:02:37,870
+الـ kyphosis، ده بيأثر في الـ respiratory function،
+
+36
+00:02:37,870 --> 00:02:41,690
+بيأثرلي في عملية الـ respiration. في حالات الـ stress
+
+37
+00:02:41,690 --> 00:02:44,890
+management and relaxation procedures، الناس اللي
+
+38
+00:02:44,890 --> 00:02:47,130
+عندها depression، الناس اللي عندها stress، الناس
+
+39
+00:02:47,130 --> 00:02:49,910
+اللي عندها psychological problems، بنعلمهم كيف
+
+40
+00:02:49,910 --> 00:02:56,730
+يعملوا breathing exercise، تمام؟ شو أهدافي أنا؟
+
+41
+00:02:56,730 --> 00:02:59,850
+أهدافي أنا من الـ breathing exercise: أول شيء لازم
+
+42
+00:02:59,850 --> 00:03:05,190
+يكون في عندي good ventilation، حتى أنا أقدر، أو أعلم
+
+43
+00:03:05,190 --> 00:03:08,310
+الـ patients تبعي الـ breathing exercise. هدفي هنا
+
+44
+00:03:08,310 --> 00:03:12,970
+إنه أنا أترك مجال للـ lung إنه تاخد full range في
+
+45
+00:03:12,970 --> 00:03:16,490
+الـ expansion تبعها، عشان هيك هيصير في عندي improve
+
+46
+00:03:16,490 --> 00:03:19,870
+للـ ventilation، increase effectiveness of cough
+
+47
+00:03:19,870 --> 00:03:24,070
+mechanism. بدي أحسن عملية الـ cough mechanism عشان
+
+48
+00:03:24,070 --> 00:03:28,120
+أعمل expectoration للـ secretions. الـ Prevent
+
+49
+00:03:28,120 --> 00:03:32,460
+for Pulmonary Impairment. بدي أمنع أي مشاكل ممكن
+
+50
+00:03:32,460 --> 00:03:38,220
+تظهر عليها بعد كده as a complication. Improvement
+
+51
+00:03:38,220 --> 00:03:42,780
+للـ Strength and Endurance and Coordination of
+
+52
+00:03:42,780 --> 00:03:46,260
+Respiratory Muscles. مهمة جداً هذه، سواء كانت الـ mainly
+
+53
+00:03:46,260 --> 00:03:50,940
+muscles أو الـ accessory muscles. أيضا، من الـ goals: correct
+
+54
+00:03:50,940 --> 00:03:53,960
+الـ insufficient or abnormal breathing
+
+55
+00:03:53,960 --> 00:03:58,120
+patterns. بدي أحسن أي abnormal breathing
+
+56
+00:03:58,120 --> 00:04:02,060
+pattern. Promote relaxation، إذا كان في أنا عندي
+
+57
+00:04:02,060 --> 00:04:06,500
+مشكلة في اللي هو psychologically أو مشكلة ناتجة عن
+
+58
+00:04:06,500 --> 00:04:10,520
+الألم، أنا بحسن نفس المريض، فبالتالي بتتحسن عندي
+
+59
+00:04:10,520 --> 00:04:13,940
+اللي هي الـ psychological status in general. Teach
+
+60
+00:04:13,940 --> 00:04:17,120
+للـ patients how to deal with shortness of breathing in
+
+61
+00:04:17,120 --> 00:04:20,760
+attacks. بعلم الـ patient كيف إنه ياخد نفس عميق، على
+
+62
+00:04:20,760 --> 00:04:26,160
+سبيل المثال، في حالة أنه صار عنده attack، نوبة لقصر
+
+63
+00:04:26,160 --> 00:04:29,320
+نفس، أو لمشكلة معينة. Improve the patient's overall
+
+64
+00:04:29,320 --> 00:04:34,280
+functional capacity. مهم جداً إنه أنا أحسن اللي هي
+
+65
+00:04:34,280 --> 00:04:37,500
+الـ health status in general. في حالات اللي هي
+
+66
+00:04:37,500 --> 00:04:41,820
+الصدرية، أو في قسم الصدرية. الـ repercussions اللي
+
+67
+00:04:41,820 --> 00:04:46,800
+أنا لازم آخد بالي منها: أمنع منع البطن، إنه المريض
+
+68
+00:04:47,090 --> 00:04:51,990
+يعمل اللي هو الـ forced expiration. مش شيء بييجي
+
+69
+00:04:51,990 --> 00:04:55,910
+بالقوة. Forced expiration، هذه من الممنوع، تنعمل. Don't
+
+70
+00:04:55,910 --> 00:04:59,230
+allow the patient to take very prolonged expiration.
+
+71
+00:04:59,230 --> 00:05:03,430
+ما يطول في عملية الـ expiration، عملية الزفير، خروج
+
+72
+00:05:03,430 --> 00:05:08,150
+الهواء لبرا، ما تطول، أو يبتدي الـ inspiration في
+
+73
+00:05:08,150 --> 00:05:11,430
+الـ accessory muscles. لأ، مش لازم يبدأها، لأن هذا
+
+74
+00:05:11,430 --> 00:05:15,130
+الشيء مش صحيح. Allow the patient to practice deep
+
+75
+00:05:15,130 --> 00:05:19,190
+breathing for only three to four inspirations and
+
+76
+00:05:19,190 --> 00:05:23,070
+expirations at a time، to avoid hyperventilation.
+
+77
+00:05:23,070 --> 00:05:27,950
+خليني أسمح للمريض بشكل عملي، إنه يعمل deep
+
+78
+00:05:27,950 --> 00:05:34,590
+breathing في حوالي من ثلاثة لأربعة شهيق وزفير، مرة
+
+79
+00:05:34,590 --> 00:05:38,630
+واحدة، at a time، to avoid hyperventilation، عشان
+
+80
+00:05:38,630 --> 00:05:42,350
+أمنع الـ hyperventilation. Allow the breathing pattern
+
+81
+00:05:42,350 --> 00:05:45,750
+to be... الـ pattern should be deep، voluntary،
+
+82
+00:05:45,750 --> 00:05:49,930
+controlled، and relaxed. أن يكون تحت السيطرة، وعميق،
+
+83
+00:05:49,930 --> 00:05:55,050
+وكذلك relaxed. الـ contraindications: ممنوع هنا، منع
+
+84
+00:05:55,050 --> 00:06:00,110
+الـ pattern. أنا أمنع لهذه الناس breathing exercise
+
+85
+00:06:00,110 --> 00:06:04,150
+في حالات زيادة الـ intracranial pressure، يعني
+
+86
+00:06:04,150 --> 00:06:06,390
+حالات الـ traumatic brain injury، حالات الـ head
+
+87
+00:06:06,390 --> 00:06:09,350
+injury in general. ممنوع أنا أعمل لهم breathing
+
+88
+00:06:09,350 --> 00:06:13,590
+exercise. في حالات الـ unstable head and neck injury،
+
+89
+00:06:13,590 --> 00:06:17,250
+في حالات الـ active hemorrhage with hemodynamic
+
+90
+00:06:17,250 --> 00:06:21,410
+instability. في حالات الـ recent spinal injury، لسه
+
+91
+00:06:21,410 --> 00:06:26,310
+أنا مش عارفة شو الحالة، لسه الـ spinal cord injury
+
+92
+00:06:26,310 --> 00:06:31,450
+مش stable. بمنع أعمل لها التنبييم. وجود pus داخل الـ
+
+93
+00:06:31,450 --> 00:06:34,750
+tissue، معناته في infected tissue. ليش أني أعمل
+
+94
+00:06:34,750 --> 00:06:39,260
+breathing exercise وأقعد المنطقة كلها؟ في حالات
+
+95
+00:06:39,260 --> 00:06:42,540
+الـ bronchopleural fistula، في حالات الـ flail
+
+96
+00:06:42,540 --> 00:06:45,660
+chest، وحكينا عليه، في حالات الـ uncontrolled
+
+97
+00:06:45,660 --> 00:06:50,800
+hypertension. هذه الحالات، حوالي ثمانية حالات، اللي هي
+
+98
+00:06:50,800 --> 00:06:54,660
+حالات ممنوعة من عمليات، إني أنا اشتغل عليها. briefing،
+
+99
+00:06:54,660 --> 00:06:58,000
+exercise. أيضا، بكمل بعد الثمانية اللي هم في الـ
+
+100
+00:06:58,000 --> 00:07:03,380
+slide السابقة، رقم 9. الـ rib vertebral fractures
+
+101
+00:07:03,380 --> 00:07:06,520
+in osteoporosis cases. في حالات الـ osteoporosis
+
+102
+00:07:06,520 --> 00:07:09,500
+cases، لأن،  بعدين هنشوف كمان شوية، في الـ breathing
+
+103
+00:07:09,500 --> 00:07:14,280
+exercise، لازم أنا أحط اللي هو my hands in general
+
+104
+00:07:14,280 --> 00:07:18,440
+position at or around the ribs. فبالتالي، في
+
+105
+00:07:18,440 --> 00:07:22,240
+حالات الـ osteoporosis، ما بيكون المريض يقدر يتحمل
+
+106
+00:07:22,240 --> 00:07:25,660
+إني أنا أعمل أي ضغط. في حالات الـ acute asthma، أو
+
+107
+00:07:25,660 --> 00:07:29,540
+في حالات الـ TB، ممنوع أعمل breathing exercise. في
+
+108
+00:07:29,540 --> 00:07:33,100
+حالات الـ patient who have recently experienced
+
+109
+00:07:33,100 --> 00:07:37,360
+a heart attack، لسه جاية نوبة قلبية جديدة، ممنوع أن
+
+110
+00:07:37,360 --> 00:07:40,620
+أعمل breathing exercise، لأن هيك هعمل جهد على
+
+111
+00:07:40,620 --> 00:07:44,460
+المريض. في حالات الـ recent، within one hour of a meal
+
+112
+00:07:44,460 --> 00:07:47,980
+or tube feeding، سواء كان اللي هو الشخص معتمد على
+
+113
+00:07:47,980 --> 00:07:52,820
+الأكل العادي، بعد ساعة أقل من الوجبة، أنا بعمله عشان
+
+114
+00:07:52,820 --> 00:07:58,300
+أتجنب موضوع اللي هو الـ vomiting. في حالات الـ
+
+115
+00:07:58,300 --> 00:08:02,000
+nasogastric tube، أو المرضى اللي هم على اللي هو الأنبوب
+
+116
+00:08:02,000 --> 00:08:05,580
+الرغامي. هذا معناه الكلام، إني أنا بعد الوجبة اللي
+
+117
+00:08:05,580 --> 00:08:09,380
+بياخدها من الـ nurse، بعمله الـ breathing exercise. في
+
+118
+00:08:09,380 --> 00:08:12,990
+حالات الـ untreated pneumothorax، في عندنا هواء في
+
+119
+00:08:12,990 --> 00:08:17,010
+الـ thorax، هنا ممنوع أنا اشتغل، في حالات اللي هو
+
+120
+00:08:17,010 --> 00:08:21,490
+chest tube، بيشيلوا من العمليات، وفي عندنا كذا tube
+
+121
+00:08:21,490 --> 00:08:24,630
+في الـ lungs، فبالتالي هنا ده هيقل حركة الـ
+
+122
+00:08:24,630 --> 00:08:29,310
+breathing exercise. شو الـ guidelines اللي أنا لازم
+
+123
+00:08:29,310 --> 00:08:35,470
+أتعلّمهم  to perform breathing exercise؟ للـ acute أو الـ
+
+124
+00:08:35,470 --> 00:08:39,230
+chronic cases.  Choose a quiet area، طبعاً، in which you can interact with
+
+125
+00:08:39,230 --> 00:08:42,830
+the patient with minimal distractions. نختار منطقة
+
+126
+00:08:42,830 --> 00:08:46,190
+الهادئة، أو الشيء اللي يكون قادر الـ patient اللي
+
+127
+00:08:46,190 --> 00:08:51,210
+ياخد تعليماته. Explain the aims and rationales of
+
+128
+00:08:51,210 --> 00:08:54,610
+the breathing exercise specific to his or her particular
+
+129
+00:08:54,610 --> 00:09:00,210
+impairment. طبعاً، لازم نبرّر ونوضح تعليماتنا، ونوضح
+
+130
+00:09:00,210 --> 00:09:03,890
+أهدافنا من هذا التمرين للمريض، حتى ياخدوه على
+
+131
+00:09:03,890 --> 00:09:08,470
+محمل الجد. ما في مجال آجي أنا وأقول: يلا، خذ نفس، طلع
+
+132
+00:09:08,470 --> 00:09:13,090
+نفس. لأ، احنا هدفنا يا جماعة، إنه واحد، اثنين، ثلاثة،
+
+133
+00:09:13,090 --> 00:09:17,130
+يبَدأ يصير معانا واحد، اثنين، ثلاثة. فبالتالي، هو بياخد
+
+134
+00:09:17,130 --> 00:09:21,010
+الشيء على محمل الجد، معناته هيلتزم بـ exercise.
+
+135
+00:09:21,650 --> 00:09:24,350
+Have the patient assume a comfortable, relaxed
+
+136
+00:09:24,350 --> 00:09:28,190
+position، and loose, non-restrictive clothing.  A
+
+137
+00:09:28,190 --> 00:09:31,810
+semi-Fowler's position، اللي هي الـ head and the trunk
+
+138
+00:09:31,810 --> 00:09:36,670
+elevated حوالي 45 درجة. فده بسميه semi-Fowler's if
+
+139
+00:09:36,670 --> 00:09:41,110
+described. طبعاً، or desirable، مطلوب في هذه الحالات،
+
+140
+00:09:41,110 --> 00:09:44,990
+تمام، اللي هو supporting للـ head وللـ trunk، زي ما
+
+141
+00:09:44,990 --> 00:09:49,250
+حكينا في حالة المحاضرة اللي فاتت، حكينا أو
+
+142
+00:09:49,250 --> 00:09:53,220
+الفيديو السابق. حكينا إنه إحنا، اللي هو حالة الـ
+
+143
+00:09:53,220 --> 00:09:57,780
+orthopnea، إذا كان هذا completely، اللي هو 180 درجة،
+
+144
+00:09:57,780 --> 00:10:00,540
+بيكون صعب على الـ patient، أو بتيجي حالة الـ
+
+145
+00:10:00,540 --> 00:10:02,920
+orthopnea، اللي هي difficulty in breathing in the
+
+146
+00:10:02,920 --> 00:10:07,740
+supine position. فحكينا، بنرفع الـ back والـ head 45
+
+147
+00:10:07,740 --> 00:10:11,840
+درجة. هذه بسميها semi-Fowler's، طبعاً، and the flexing
+
+148
+00:10:11,840 --> 00:10:16,140
+of the hips and knees to a comfortable position. للـ trunk ولـ
+
+149
+00:10:16,140 --> 00:10:19,580
+اللي هو الـ back، من الـ abdominal muscles. The
+
+150
+00:10:19,580 --> 00:10:22,600
+abdominal muscles remain relaxed. هذا الـ position
+
+151
+00:10:22,600 --> 00:10:26,880
+كثير مريح لهذه الناس. Other positions that are also
+
+152
+00:10:26,880 --> 00:10:30,040
+acceptable are lying, sitting, or standing. كمان، مهم جداً إنه أنا
+
+153
+00:10:30,040 --> 00:10:32,860
+أعرف إيش الـ position اللي أنا بدي اشتغل عليه، يعني
+
+154
+00:10:32,860 --> 00:10:35,180
+لو أنا قرأت الـ medical record، يا جماعة، ده الصح، معناته
+
+155
+00:10:35,180 --> 00:10:38,920
+الحكي، إنه أنا بدي أعرف كيف أحط الـ patient تبعي. If
+
+156
+00:10:38,920 --> 00:10:41,660
+necessary، teach the patient relaxation techniques.
+
+157
+00:10:41,660 --> 00:10:45,100
+مهم جداً، أعلم الـ patient ما يكون stressed. أول جلسة
+
+158
+00:10:45,100 --> 00:10:50,200
+بتكون لها خصوصية خاصة. طبعاً، الـ patient لسه أول مرة
+
+159
+00:10:50,200 --> 00:10:54,420
+بتعرف عليك. الـ patient أول مرة بتحس بيدك على ظهرها،
+
+160
+00:10:54,420 --> 00:10:56,540
+فيه اللي هو، مثلاً، على سبيل المثال، إذا بدي أعمل
+
+161
+00:10:56,540 --> 00:11:01,240
+vibration أو percussion، فبالتالي هنا هيكون stress.
+
+162
+00:11:01,240 --> 00:11:04,220
+لأ، أنا أعلمه كيف يعمل اللي هو relaxation techniques.
+
+163
+00:11:04,220 --> 00:11:07,300
+This relaxation of muscles... الـ relaxation of muscles will be
+
+164
+00:11:07,300 --> 00:11:10,260
+للـ upper thoracic والـ neck والـ shoulder، to
+
+165
+00:11:10,260 --> 00:11:13,950
+minimize use of accessory muscles. Pay particular
+
+166
+00:11:13,950 --> 00:11:17,190
+attention to relaxation of the sternocleidomastoid muscles.
+
+167
+00:11:17,190 --> 00:11:21,210
+والـ scalenes والـ levatores costarum muscles. هذه الـ muscles should be relaxed، لازم تكون
+
+168
+00:11:24,090 --> 00:11:29,830
+في وضعية الـ relaxed، تمام؟ أيضا، بيعتمد اللي هو
+
+169
+00:11:29,830 --> 00:11:33,470
+الشيء على الـ pathology and empowerment، to
+
+170
+00:11:33,470 --> 00:11:35,690
+determine whether to emphasize inspiration and
+
+171
+00:11:35,690 --> 00:11:39,230
+expiration phases in the ventilation. لازم أوضح الـ
+
+172
+00:11:39,230 --> 00:11:41,830
+desired breathing pattern للـ patient. اليوم، الـ
+
+173
+00:11:41,830 --> 00:11:44,510
+patient، إذا عنده فيه accumulation of secretions في
+
+174
+00:11:44,510 --> 00:11:47,050
+الـ basal lobes، معناته أنا هحكيله إيش الوضعية اللي
+
+175
+00:11:47,050 --> 00:11:49,750
+هيكون قاعد فيها. الـ postural drainage اللي أنا بدي
+
+176
+00:11:49,750 --> 00:11:53,930
+أعمله. كل هذه الأمور لازم أنا أوضحها. Have the
+
+178
+00:11:53,930 --> 00:11:57,920
+patient practice the correct breathing pattern in
+
+179
+00:11:57,920 --> 00:12:01,460
+various positions، at rest and with activity، تمام؟
+
+180
+00:12:01,460 --> 00:12:05,560
+أوضح للمريض، إن هذه الوضعية بتخليك بشكل أفضل في
+
+181
+00:12:05,560 --> 00:12:10,000
+حالة الـ rest، وكذلك في حالة الـ activity، تمام؟
+
+182
+00:12:10,000 --> 00:12:14,040
+هتكلم الآن على أنواع الـ breathing exercise. في عندي
+
+183
+00:12:14,040 --> 00:12:17,38
+
+223
+00:14:42,970 --> 00:14:46,810
+following thoracic surgery, when it's important to
+
+224
+00:14:46,810 --> 00:14:50,990
+emphasize expansion أو ال problem area الموجودة في
+
+225
+00:14:50,990 --> 00:14:54,470
+منطقة معينة، معناه الكلام إن أنا بدي أحط المريض
+
+226
+00:14:54,470 --> 00:14:58,230
+في وضعية معينة عشان أعمل remove ل
+
+227
+00:14:58,230 --> 00:15:03,770
+segregation منه. أنواع زي ما أنتم شايفين، في عندنا
+
+228
+00:15:03,770 --> 00:15:07,530
+ال right lung،  في ال left lung. ال right lung
+
+229
+00:15:07,530 --> 00:15:10,470
+فيه three lobes زي ما إحنا شايفين، أما ال right
+
+230
+00:15:10,470 --> 00:15:15,610
+فيه اللي هي two lobes في  الأنتريرور والبوستيريور.
+
+231
+00:15:15,610 --> 00:15:19,810
+الانتريور ممكن أقسمها إلى medially، laterally،
+
+232
+00:15:19,810 --> 00:15:24,450
+superior. هاي ال segmental اللي أنا لازم أعرفها، إن
+
+233
+00:15:24,450 --> 00:15:27,790
+ال lateral course. هالأول شيء هبدأ فيه، sometimes
+
+234
+00:15:27,790 --> 00:15:31,890
+called lateral basal expansion. طبعا لإنّه موجود تحت
+
+235
+00:15:31,890 --> 00:15:36,750
+على القاعدة. ميدان unilaterally، ممكن أعملها على جهة
+
+236
+00:15:36,750 --> 00:15:40,150
+واحدة، وممكن أعملها على الجهتين bilaterally.
+
+237
+00:15:40,560 --> 00:15:44,300
+The patient may be sitting or in hook-lying position.
+
+238
+00:15:44,300 --> 00:15:47,440
+اللي هو دائماً أنتم شايفينه، هذا ال hook-lying
+
+239
+00:15:47,440 --> 00:15:50,240
+position أو ال hooking-lying position. Place your
+
+240
+00:15:50,240 --> 00:15:54,780
+hand along the lateral aspect of the lower ribs هنا.
+
+241
+00:15:54,780 --> 00:15:58,440
+شايفين ال hand بتاعت ال therapist تيجي على نهاية ال
+
+242
+00:15:58,440 --> 00:16:02,820
+ribs. Ask the patient to breathe out (expiration) and
+
+243
+00:16:02,820 --> 00:16:07,120
+feel the rib cage move downward and inward. تنزل
+
+244
+00:16:07,120 --> 00:16:14,140
+اللي هي ال ribs downward and inward للداخل، زي ما
+
+245
+00:16:14,140 --> 00:16:16,200
+إحنا شايفين. ممكن أعمله في supine position، ممكن
+
+246
+00:16:16,200 --> 00:16:21,240
+أعمله الآن في sitting position. هنا اللي هي ال
+
+247
+00:16:21,240 --> 00:16:26,100
+basal costal expiration. ال posterior deep
+
+248
+00:16:26,100 --> 00:16:28,700
+breathing and posterior basal expansion.
+
+249
+00:16:28,700 --> 00:16:32,600
+أنا من الخلف بدي أعمله. Posterior expansion. It's
+
+250
+00:16:32,600 --> 00:16:36,060
+important في حالات ال post-surgical patient who
+
+251
+00:16:36,060 --> 00:16:39,390
+are confined to the bed in a semi-reclined position for
+
+252
+00:16:39,390 --> 00:16:42,830
+extended periods of time, because secretions often
+
+253
+00:16:42,830 --> 00:16:46,650
+accumulate in the posterior segments and lower lobes.
+
+254
+00:16:46,650 --> 00:16:50,990
+تمام. بستخدمه في حالات ال post-surgical، لإنه بيكون
+
+255
+00:16:50,990 --> 00:16:55,230
+اللي هو secretion اتجمع أو accumulated in the
+
+256
+00:16:55,230 --> 00:16:59,470
+basal and posterior areas. هاي اللي هي طبعاً زي ما
+
+257
+00:16:59,470 --> 00:17:04,890
+أنتم شايفين، ال therapist حط اللي هو ال thumbs على
+
+258
+00:17:04,890 --> 00:17:09,830
+الـ ribs، والـ hand around the ribs زي ما إحنا
+
+259
+00:17:09,830 --> 00:17:14,310
+شايفين. طبعاً هنا أخد ال expiration، بعدين طلع الـ
+
+260
+00:17:14,310 --> 00:17:18,210
+expiration. ال procedure، لـ ال practical part، ال
+
+261
+00:17:18,210 --> 00:17:22,710
+apical، اللي هي النوع الثالث من segmental. ال apical
+
+262
+00:17:22,710 --> 00:17:27,350
+معناته شيء هيكون في القمة. وين حاطط هنا ال
+
+263
+00:17:27,350 --> 00:17:31,610
+patient إيده؟ يعني معناته الحاجة إن هو قريب من
+
+264
+00:17:31,610 --> 00:17:35,750
+ال clavicle. شيء موجود في ال apical segment of the
+
+265
+00:17:35,750 --> 00:17:40,670
+lungs. تمام. النوع الثالث من ال breathing exercise
+
+266
+00:17:40,670 --> 00:17:44,770
+الـ Bears Lips Breathing، اللي هي ال BLB. To prevent
+
+267
+00:17:44,770 --> 00:17:49,070
+collapse of the airway during expiration due to
+
+268
+00:17:49,070 --> 00:17:52,710
+maintaining positive pressure in the airway during
+
+269
+00:17:52,710 --> 00:17:57,790
+expiration (prolonged expiration). طبعاً في نفس اللي
+
+270
+00:17:57,790 --> 00:18:01,910
+هو ال expiration. في ال Bears Lips lead to decrease
+
+271
+00:18:01,910 --> 00:18:06,610
+في air trapping and residual volume. لاحظوا هنا ضغط
+
+272
+00:18:06,610 --> 00:18:11,590
+على شفته. أخد inspiration، بعدين طلعوا في ال ex-
+
+273
+00:18:11,590 --> 00:18:15,130
+piration. In addition, it recruits more
+
+274
+00:18:15,130 --> 00:18:21,230
+alveolar units at the lung bases. طبعاً هنا اللي هو
+
+275
+00:18:21,230 --> 00:18:25,630
+هذا النوع أحياناً بيكون مصاحب للنوع الأول اللي إحنا
+
+276
+00:18:25,630 --> 00:18:29,990
+حكينا عليه. شو أهداف ال Bears Lips Breathing؟ بساعد
+
+277
+00:18:29,990 --> 00:18:33,590
+على ال ventilation، وهو كويس ومفيد جداً للمرضى.
+
+278
+00:18:33,590 --> 00:18:39,330
+To release trapped air of the lung. أيضاً اللي هو يعني بيفرغ
+
+279
+00:18:39,330 --> 00:18:43,030
+الهواء، أو بيزيل الهواء اللي بيكون متفرج أو موجود
+
+280
+00:18:43,030 --> 00:18:47,190
+داخل ال lungs. Keeps، يعني بيجدد المنطقة. Keeps the
+
+281
+00:18:47,190 --> 00:18:51,720
+airway open longer and decreases the work of
+
+282
+00:18:51,720 --> 00:18:55,700
+breathing (prolonged exhalation to slow breathing
+
+283
+00:18:55,700 --> 00:18:59,460
+rate). ومهم جداً، وبيحسن ال breathing. By moving
+
+284
+00:18:59,460 --> 00:19:02,960
+old air out of the lung and allowing new air. يعني
+
+285
+00:19:02,960 --> 00:19:07,320
+بيجدد اللي هو عملية الهواء داخل أو التهوية داخل
+
+286
+00:19:07,320 --> 00:19:11,720
+الرئتين. To relieve shortness of breath. وبيسبب اللي هو
+
+287
+00:19:11,720 --> 00:19:16,180
+causes general relaxation. هذه أهداف ال Bears Lips
+
+288
+00:19:16,180 --> 00:19:20,220
+Breathing. النوع الثالث. هنا في هذه ال slide كان
+
+289
+00:19:20,220 --> 00:19:26,480
+موضوع ال procedure، وأنا تركته لجزء العملية. لاحظوا
+
+290
+00:19:26,480 --> 00:19:29,160
+هنا ال set case. عملت breathing in أو ال
+
+291
+00:19:29,160 --> 00:19:32,220
+inspiration. بتضغط على ال lips، بعدين ال
+
+292
+00:19:32,220 --> 00:19:37,840
+breathing out from the mouth. من الفم، لأن في عندي
+
+293
+00:19:37,840 --> 00:19:41,620
+precautions لازم أنا آخذ بالي منها. أمنع أي
+
+294
+00:19:41,620 --> 00:19:45,340
+forceful expiration في أي حالة أو في أي نوع من
+
+295
+00:19:45,340 --> 00:19:48,880
+أنواع ال breathing. ضروري إنّ أنا أمنع اللي هو ال
+
+296
+00:19:48,880 --> 00:19:53,960
+expiration. تمام. Forceful expiration while lips are
+
+297
+00:19:53,960 --> 00:19:58,760
+pursed can increase turbulence of the airways and
+
+298
+00:19:58,760 --> 00:20:01,880
+cause further restriction of the small bronchioles.
+
+299
+00:20:01,880 --> 00:20:07,660
+طبعاً إذا أنا خليتّه يعمل على طول expiration بقوة،
+
+300
+00:20:07,660 --> 00:20:13,220
+هذا الشيء هيعمل له مشكلة، tripling  اللي هو ال
+
+301
+00:20:13,220 --> 00:20:15,760
+airway، خصوصاً في ال bronchioles اللي هي الشعيبات
+
+302
+00:20:15,760 --> 00:20:19,160
+الهوائية الصغيرة. It's important to emphasize the
+
+303
+00:20:19,160 --> 00:20:22,740
+expiration should be performed in a controlled manner, but not
+
+304
+00:20:22,740 --> 00:20:28,360
+forcefully. المهم إن هو يعمل expiration، ولكن ليس بقوة.
+
+305
+00:20:28,670 --> 00:20:34,250
+نعلّم المريض أنه يغير ال control بتاعه للأفضل،
+
+306
+00:20:34,250 --> 00:20:38,090
+أن يعملها بـ control، بنظام معين. النوع الرابع
+
+307
+00:20:38,090 --> 00:20:40,990
+والأخير من أنواع ال breathing exercises اللي هو
+
+308
+00:20:40,990 --> 00:20:44,610
+ال glossopharyngeal breathing. It's used primarily
+
+309
+00:20:44,610 --> 00:20:49,310
+by patients who are on a ventilator, because
+
+310
+00:20:49,310 --> 00:20:53,010
+of absent or incomplete innervation of the
+
+311
+00:20:53,010 --> 00:20:56,710
+diaphragm as a result of a high cervical level spinal cord injury. تمام. باستخدمه لحالات اللي هي ال
+
+312
+00:20:56,710 --> 00:21:01,190
+spinal cord injury، وخصوصاً ال high cervical level
+
+313
+00:21:01,190 --> 00:21:05,090
+أو other neuromuscular disorders. It also can be
+
+314
+00:21:05,090 --> 00:21:10,330
+used to improve the force and therefore the effectiveness
+
+315
+00:21:10,330 --> 00:21:14,370
+of coughing. طبعاً مهم جداً هنا، أنا أحسن اللي هو ال effectiveness
+
+316
+00:21:14,370 --> 00:21:20,070
+بتاعة ال coughing، و increasing the volume of the voice.
+
+317
+00:21:20,070 --> 00:21:24,770
+كمان، لأن أنا بحكي عن Glossopharyngeal، معناته له
+
+318
+00:21:24,770 --> 00:21:28,870
+علاقة بالـ voice، بالصوت. ال procedure بتاعته
+
+319
+00:21:28,870 --> 00:21:33,650
+الجزئية العملية. وننتقل لـ biofeedback respiratory
+
+320
+00:21:33,650 --> 00:21:37,770
+muscle training. تمام. في عندنا تلات طرق هحكي عليهم. ال
+
+321
+00:21:37,770 --> 00:21:41,890
+biofeedback مهم جداً حتى للمريض، أنّه ممكن يعملها
+
+322
+00:21:41,890 --> 00:21:45,590
+عشان هو يتأكد من أن فعالية ال muscles لديه. Self-
+
+323
+00:21:45,590 --> 00:21:50,270
+control of physiological function. طبعاً، the result
+
+324
+00:21:50,270 --> 00:21:54,190
+of ventilatory muscles training is building strength and
+
+325
+00:21:54,190 --> 00:21:57,690
+endurance in the respiratory muscles. ال application
+
+326
+00:22:00,990 --> 00:22:04,350
+ممكن أنا أحسن ال biofeedback بتاعتي عن طريق ال
+
+327
+00:22:04,350 --> 00:22:08,430
+incentive spirometer. هذا هو عبارة عن جهاز موجود
+
+328
+00:22:08,430 --> 00:22:13,290
+عندنا. ال peak expiratory flow meter، وال oximetry.
+
+329
+00:22:13,290 --> 00:22:17,170
+Biofeedback; incentive spirometer; Bears Lips breathing training.
+
+330
+00:22:17,170 --> 00:22:21,120
+هي عبارة عن أجهزة. ال Incentive Respiratory
+
+331
+00:22:21,120 --> 00:22:25,960
+Spirometer. A form of ventilatory
+
+332
+00:22:25,960 --> 00:22:29,940
+muscle training. It's a form of persistence
+
+333
+00:22:29,940 --> 00:22:33,360
+training that involves sustained maximal
+
+334
+00:22:33,360 --> 00:22:37,720
+inspiration into the spirometer, with
+
+335
+00:22:37,720 --> 00:22:41,720
+the device or provider giving visual and auditory feedback
+
+336
+00:22:41,720 --> 00:22:51,210
+للpatient. تمام. بيعطي قراءة بصرية وسمعية للمريض. بياخد
+
+337
+00:22:51,210 --> 00:22:55,090
+نفسه عميق. To increase the volume of air inspiration.
+
+338
+00:22:55,090 --> 00:22:59,410
+Used to prevent alveolar
+
+339
+00:22:59,410 --> 00:23:02,970
+collapse. ما بدي يصير في عندي collapse (انضمام أو
+
+340
+00:23:02,970 --> 00:23:08,830
+التصاق) لل alveoli in the postoperative conditions.
+
+341
+00:23:08,830 --> 00:23:12,890
+بستخدمه عشان أعمل strengthening لل weak inspiratory
+
+342
+00:23:12,890 --> 00:23:16,830
+muscles in patients with neuromuscular disorders.
+
+343
+00:23:16,830 --> 00:23:20,650
+تمام. هي استخدامات ال Incentive Respiratory
+
+344
+00:23:20,650 --> 00:23:25,230
+Spirometers. الآن، ال repercussions بتاعته: ممنوع
+
+345
+00:23:25,230 --> 00:23:29,850
+استخدمه لـ prolonged periods، ما نستخدمه لفترة طويلة
+
+346
+00:23:29,850 --> 00:23:33,050
+at any firm resistance; training the inspiratory
+
+347
+00:23:33,050 --> 00:23:37,480
+muscles; Use of accessory muscles. آخذ بالي إنّ
+
+348
+00:23:37,480 --> 00:23:40,400
+المريض بتاعي هيستخدم هذه لزمن. أنتم شايفين ال
+
+349
+00:23:40,400 --> 00:23:44,600
+accessory muscles بتاعته، في ال neck muscles، طبعاً as
+
+350
+00:23:44,600 --> 00:23:47,420
+a sign that the diaphragm is beginning to fatigue.
+
+351
+00:23:47,420 --> 00:23:51,360
+فبالتالي، هتشتغل ال accessory muscles، ونترك ال
+
+352
+00:23:51,360 --> 00:23:55,870
+main one اللي هي عبارة عن ال diaphragm. هنا التكنيك
+
+353
+00:23:55,870 --> 00:23:58,450
+بتاعه إنّ أنا بدي أحط ال patient في comfortable
+
+354
+00:23:58,450 --> 00:24:03,130
+position زي ما شفتوا هنا في هذه الصورة، جاي في semi-
+
+355
+00:24:03,130 --> 00:24:05,970
+sitting position أو sitting position. خليني أحكي
+
+356
+00:24:05,970 --> 00:24:10,370
+have the patient take three to four slow
+
+357
+00:24:10,370 --> 00:24:15,580
+breaths only. The patient maximally inhales at the end of
+
+358
+00:24:15,580 --> 00:24:19,520
+the fourth breath. Then have
+
+359
+00:24:19,520 --> 00:24:23,800
+the patient inhale maximally into the spirometer and hold
+
+360
+00:24:23,800 --> 00:24:27,260
+the inspiration for several seconds. Repeat the sequence from
+
+361
+00:24:27,260 --> 00:24:32,780
+five to ten times per day. تمام. هذا ال incentive spirometer. النوع
+
+362
+00:24:32,780 --> 00:24:37,600
+الثاني. حاجة اسمها ال peak expiratory. تمام؟ زي ما
+
+363
+00:24:37,600 --> 00:24:40,560
+أنتم شايفينه هنا، هو عبارة عن ال Peak Expiratory
+
+364
+00:24:40,560 --> 00:24:44,640
+Flow Meter. Have the patient assume a comfortable
+
+365
+00:24:44,640 --> 00:24:48,340
+position. Inhale and
+
+366
+00:24:48,340 --> 00:24:52,120
+exhale three to four times. ياخد نفس ويطلع من
+
+367
+00:24:52,120 --> 00:24:56,100
+ثلاثة لأربعة أنفاس. And then exhale maximally with
+
+368
+00:24:56,100 --> 00:25:00,280
+the fourth breath. Then have
+
+369
+00:25:00,280 --> 00:25:05,160
+the patient place the spirometer in their mouth and exhale
+
+370
+00:25:05,160 --> 00:25:09,630
+into the mouthpiece. The sequence is repeated five to ten
+
+371
+00:25:09,630 --> 00:25:13,250
+times several times per day. من خمس لعشر مرات
+
+372
+00:25:13,250 --> 00:25:18,550
+يعملها في اليوم. تمام. النوع الأخير اللي هو الثالث،
+
+373
+00:25:18,550 --> 00:25:21,810
+ال oximetry. زي ما أنتم شايفين هنا، هو عبارة عن
+
+374
+00:25:21,810 --> 00:25:26,250
+إيش؟ ال patient can use oximetry by feedback. اسمها
+
+375
+00:25:27,440 --> 00:25:31,540
+بيستخدم ال Pulse Oximetry اللي هو قياس ال Pulse
+
+376
+00:25:31,540 --> 00:25:34,300
+اللي هو نبض القلب. As a biofeedback guide to teach
+
+377
+00:25:34,300 --> 00:25:38,000
+them to increase their oxygen saturation، عشان يزيد
+
+378
+00:25:38,000 --> 00:25:42,080
+اللي هو تشبع الأكسجين خلال ال performance. ال
+
+379
+00:25:42,080 --> 00:25:46,340
+performance هذا اللي بيكون مسحوب مع ال Bears Lips
+
+380
+00:25:46,340 --> 00:25:50,080
+Breathing، ال BLB. Which is to relieve dyspnea and
+
+381
+00:25:50,080 --> 00:25:53,160
+improve gas exchange. كمان which results in
+
+382
+00:25:53,160 --> 00:25:56,640
+improvement in oxygenation and oxygen saturation.
+
+383
+00:25:56,640 --> 00:26:01,860
+هذا مهم جداً، إنّه أنا بيكون مصاحب أو بعلّم ال
+
+384
+00:26:01,860 --> 00:26:05,460
+patient بتاعي، أو بعلّمه، أنه يكون مصاحب، أنه في
+
+385
+00:26:05,460 --> 00:26:08,980
+عندنا pulse rate. فبالتالي، هنا هو مهم جداً في حالات
+
+386
+00:26:08,980 --> 00:26:14,510
+ال dyspnea. وبهيك، يعطيكم العافية، ونلتقي بإذن الله في
+
+387
+00:26:14,510 --> 00:26:17,550
+ال part الثاني من role of physiotherapy in
+
+388
+00:26:17,550 --> 00:26:19,650
+pulmonary case studies.
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/vUMjemmmFOo_raw.json b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/vUMjemmmFOo_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..9085dbb5977a9b9a98b43ecfc4b5c60791202362
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/vUMjemmmFOo_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 2725, "start": 1.35, "end": 27.25, "text": "بنكمل معاكم ان شاء الله رب العالمين في الـ Physiotherapy role and Cardiopulmonary disease اليوم هنتحدث عن ال physical therapy role في موضوع ال breathing exercise هنتحدث عن ال indication ال control indication ال goals ال repercussions types of breathing exercise بإذن الله تعالى نبدأ محاضرتنا لهذا اليوم", "tokens": [3555, 1863, 24793, 1211, 20449, 995, 24793, 16472, 13412, 16606, 21984, 12602, 3555, 18863, 45340, 9957, 8978, 2423, 39184, 15542, 72, 23208, 3090, 293, 11877, 72, 404, 425, 46386, 4752, 45595, 20498, 8032, 29399, 24401, 12984, 18871, 2423, 4001, 9492, 3090, 8978, 3714, 2407, 11242, 45367, 2423, 9570, 5380, 8032, 29399, 24401, 12984, 18871, 2423, 18877, 2423, 1969, 18877, 2423, 5493, 2423, 28946, 38899, 3467, 295, 9570, 5380, 4724, 28814, 8848, 1863, 21984, 37279, 6027, 7578, 8717, 44510, 10721, 3714, 5016, 46958, 43500, 8315, 46740, 15730, 45595, 20498], "avg_logprob": -0.16581812467467918, 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Increase the force in the diaphragm as in respiratory muscles. بعمل improve لل ventilation في ال small airway and paces in lungs. It's often used combination with bear's lip. أيضا مصحوب هذا ال program أو هذا النوع من ال breathing exercise مع ال bear's lip breathing and relaxation techniques.", "tokens": [3224, 1829, 6225, 11242, 1211, 9307, 11296, 39894, 39237, 6055, 17082, 1829, 19913, 11296, 18871, 23032, 16572, 4587, 27188, 2288, 1863, 4117, 1863, 13546, 5172, 37037, 1829, 6225, 11242, 37977, 5551, 3794, 32277, 10632, 8978, 2423, 39184, 27038, 1185, 13, 682, 14066, 651, 264, 3464, 294, 264, 46711, 76, 382, 294, 27038, 9530, 13, 4724, 25957, 1211, 3470, 24976, 29553, 8978, 2423, 1359, 1988, 676, 293, 15165, 279, 294, 19467, 13, 467, 311, 2049, 1143, 6562, 365, 6155, 311, 8280, 13, 36632, 11242, 995, 3714, 9381, 5016, 37746, 23758, 2423, 1461, 34051, 23758, 28239, 45367, 9154, 2423, 9570, 5380, 20449, 2423, 6155, 311, 8280, 9570, 293, 30315, 7512, 13], "avg_logprob": -0.35340908061374315, "compression_ratio": 1.5225806451612902, "no_speech_prob": 2.384185791015625e-07, "words": [{"start": 766.8, "end": 767.22, 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Glossopharyngeal معناته له علاقة بالـ voice بالصوت ال procedure تبعته بتاعتها الجزئية العملية و ننتقل لل biofeedback respiratory muscle training تمام في عند تلت طرق هحكي عليهم ال biofeedback مهم جدا حتى المريض أنه ممكن يعملها عشان هو يتأكد من أن فعالية ال muscle لديه", "tokens": [1211, 33456, 41850, 4724, 5016, 4117, 1829, 18871, 5209, 772, 5317, 39008, 432, 304, 20449, 8315, 47395, 46740, 11203, 995, 28671, 20666, 39184, 3177, 20666, 9381, 35473, 2423, 10747, 6055, 3555, 34268, 3224, 39894, 995, 34268, 11296, 25724, 11622, 19986, 10632, 18863, 42213, 10632, 4032, 8717, 29399, 4587, 1211, 24976, 12198, 37036, 3207, 27038, 8679, 3097, 46811, 10943, 8978, 43242, 6055, 1211, 2655, 23032, 2288, 4587, 8032, 5016, 4117, 1829, 25894, 16095, 2423, 12198, 37036, 3207, 3714, 16095, 10874, 28259, 11331, 49975, 9673, 16572, 11242, 14739, 3224, 3714, 43020, 7251, 25957, 1211, 11296, 6225, 8592, 7649, 31439, 7251, 2655, 10721, 4117, 3215, 9154, 14739, 6156, 3615, 6027, 10632, 2423, 8679, 5296, 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زمان", "probability": 0.684326171875}, {"start": 1419.12, "end": 1419.32, "word": " أنتوا", "probability": 0.7897135416666666}, {"start": 1419.32, "end": 1419.8, "word": " شايفين", "probability": 0.9903564453125}, {"start": 1419.8, "end": 1420.4, "word": " ال", "probability": 0.94482421875}, {"start": 1420.4, "end": 1420.96, "word": " accessory", "probability": 0.58056640625}, {"start": 1420.96, "end": 1421.42, "word": " muscles", "probability": 0.94287109375}, {"start": 1421.42, "end": 1421.92, "word": " تبعته", "probability": 0.8026123046875}, {"start": 1421.92, "end": 1422.06, "word": " في", "probability": 0.8837890625}, {"start": 1422.06, "end": 1422.14, "word": " ال", "probability": 0.8837890625}, {"start": 1422.14, "end": 1422.3, "word": " neck", "probability": 0.8828125}, {"start": 1422.3, "end": 1422.78, "word": " muscles", "probability": 0.91796875}, {"start": 1422.78, "end": 1423.58, "word": " طبعا", "probability": 0.980224609375}, {"start": 1423.58, "end": 1424.6, "word": " as", "probability": 0.85400390625}, {"start": 1424.6, "end": 1424.78, "word": " a", "probability": 0.87841796875}, {"start": 1424.78, "end": 1425.08, "word": " sign", "probability": 0.751953125}, {"start": 1425.08, "end": 1425.6, "word": " that", "probability": 0.896484375}, {"start": 1425.6, "end": 1426.26, "word": " diaphragm", "probability": 0.814697265625}, {"start": 1426.26, "end": 1426.58, "word": " beginning", "probability": 0.9052734375}, {"start": 1426.58, "end": 1426.88, "word": " to", "probability": 0.98095703125}, {"start": 1426.88, "end": 1427.42, "word": " fatigue", "probability": 0.95263671875}, {"start": 1427.42, "end": 1428.16, "word": " فبالتالي", "probability": 0.985107421875}, {"start": 1428.16, "end": 1429.12, "word": " هتشتغل", "probability": 0.987548828125}, {"start": 1429.12, "end": 1429.44, "word": " ال", "probability": 0.984375}, {"start": 1429.44, "end": 1429.8, "word": " accessory", "probability": 0.91845703125}, {"start": 1429.8, "end": 1430.28, "word": " muscles", "probability": 0.82373046875}, {"start": 1430.28, "end": 1431.2, "word": " ونترك", "probability": 0.8707682291666666}, {"start": 1431.2, "end": 1431.36, "word": " ال", "probability": 0.90380859375}, {"start": 1431.36, "end": 1431.7, "word": " mainly", "probability": 0.97265625}, {"start": 1431.7, "end": 1432.1, "word": " اللي", "probability": 0.92333984375}, {"start": 1432.1, "end": 1432.36, "word": " هي", "probability": 0.84423828125}, {"start": 1432.36, "end": 1432.74, "word": " عبارة", "probability": 0.987060546875}, {"start": 1432.74, "end": 1432.96, "word": " عن", "probability": 0.99609375}, {"start": 1432.96, "end": 1433.14, "word": " ال", "probability": 0.9140625}, {"start": 1433.14, "end": 1433.7, "word": " diaphragm", "probability": 0.94873046875}], "temperature": 1.0}, {"id": 57, "seek": 145189, "start": 1435.03, "end": 1451.89, "text": "هنا التكنيكى تبعه انه انا بدى احط ال patient في comfortable position زى ما شفته هنا في هى الصورة جاى في semi sitting position او sitting position خلينى احكى have لل patient to take three to four slow breathing فقط", "tokens": [3224, 8315, 16712, 19452, 1829, 4117, 7578, 6055, 3555, 3615, 3224, 16472, 3224, 1975, 8315, 47525, 7578, 1975, 5016, 9566, 2423, 4537, 8978, 4619, 2535, 30767, 7578, 19446, 13412, 5172, 47395, 34105, 8978, 8032, 7578, 31767, 13063, 3660, 10874, 995, 7578, 8978, 12909, 3798, 2535, 1975, 2407, 3798, 2535, 16490, 1211, 9957, 7578, 1975, 5016, 4117, 7578, 362, 24976, 4537, 281, 747, 1045, 281, 1451, 2964, 9570, 6156, 47432], "avg_logprob": -0.24129464775323867, "compression_ratio": 1.5294117647058822, "no_speech_prob": 0.0, "words": [{"start": 1435.03, "end": 1435.33, "word": "هنا", "probability": 0.809326171875}, {"start": 1435.33, "end": 1435.87, "word": " التكنيكى", "probability": 0.7388671875}, {"start": 1435.87, "end": 1436.27, "word": " تبعه", "probability": 0.798583984375}, {"start": 1436.27, "end": 1436.61, "word": " انه", "probability": 0.558837890625}, {"start": 1436.61, "end": 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1441.01, "word": " في", "probability": 0.7822265625}, {"start": 1441.01, "end": 1441.29, "word": " هى", "probability": 0.548828125}, {"start": 1441.29, "end": 1442.09, "word": " الصورة", "probability": 0.9295247395833334}, {"start": 1442.09, "end": 1442.77, "word": " جاى", "probability": 0.7610677083333334}, {"start": 1442.77, "end": 1442.89, "word": " في", "probability": 0.62353515625}, {"start": 1442.89, "end": 1443.13, "word": " semi", "probability": 0.5712890625}, {"start": 1443.13, "end": 1443.45, "word": " sitting", "probability": 0.483642578125}, {"start": 1443.45, "end": 1444.03, "word": " position", "probability": 0.982421875}, {"start": 1444.03, "end": 1444.35, "word": " او", "probability": 0.933837890625}, {"start": 1444.35, "end": 1444.71, "word": " sitting", "probability": 0.67529296875}, {"start": 1444.71, "end": 1445.15, "word": " position", "probability": 0.986328125}, {"start": 1445.15, "end": 1445.51, "word": " خلينى", "probability": 0.9058837890625}, {"start": 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"temperature": 1.0}, {"id": 58, "seek": 147656, "start": 1452.48, "end": 1476.56, "text": "الpatient maximally healed at end of fourth breathing بينهي في النفس الرابع then have patient inhaled maximally لال spirometer and hold inspiration several seconds repeat sequence من خمسة لعشرة في اليوم تمام هذا ال inspirometer النوع التاني حاجة اسمها ال peak expiratory", "tokens": [6027, 29752, 5138, 379, 20482, 412, 917, 295, 6409, 9570, 4724, 9957, 3224, 1829, 8978, 28239, 36178, 34892, 16758, 3615, 550, 362, 4537, 43157, 292, 5138, 379, 5296, 6027, 10733, 13606, 293, 1797, 10249, 2940, 3949, 7149, 8310, 9154, 16490, 2304, 3794, 3660, 5296, 3615, 8592, 25720, 8978, 45595, 20498, 46811, 10943, 23758, 2423, 17432, 13606, 28239, 45367, 16712, 7649, 1829, 11331, 26108, 3660, 24525, 2304, 11296, 2423, 10651, 1278, 347, 4745], "avg_logprob": -0.19071061643835616, "compression_ratio": 1.5132743362831858, "no_speech_prob": 0.0, "words": [{"start": 1452.48, "end": 1453.24, "word": "الpatient", "probability": 0.5799560546875}, {"start": 1453.24, "end": 1454.08, "word": " maximally", "probability": 0.7255859375}, {"start": 1454.08, "end": 1454.64, "word": " healed", "probability": 0.6826171875}, {"start": 1454.64, "end": 1455.0, "word": " at", "probability": 0.982421875}, {"start": 1455.0, "end": 1455.32, "word": " end", "probability": 0.87109375}, {"start": 1455.32, "end": 1455.58, "word": " of", "probability": 0.9677734375}, {"start": 1455.58, "end": 1455.94, "word": " fourth", "probability": 0.7783203125}, {"start": 1455.94, "end": 1456.56, "word": " breathing", "probability": 0.93701171875}, {"start": 1456.56, "end": 1457.14, "word": " بينهي", "probability": 0.8348388671875}, {"start": 1457.14, "end": 1457.38, "word": " في", "probability": 0.94970703125}, {"start": 1457.38, "end": 1457.92, "word": " النفس", "probability": 0.95654296875}, {"start": 1457.92, "end": 1458.54, "word": " الرابع", "probability": 0.98876953125}, {"start": 1458.54, "end": 1459.22, "word": " then", "probability": 0.53466796875}, {"start": 1459.22, "end": 1459.52, "word": " have", "probability": 0.9423828125}, {"start": 1459.52, "end": 1459.92, "word": " patient", "probability": 0.89599609375}, {"start": 1459.92, "end": 1460.68, "word": " inhaled", "probability": 0.8623046875}, {"start": 1460.68, "end": 1461.46, "word": " maximally", "probability": 0.819091796875}, {"start": 1461.46, "end": 1462.36, "word": " لال", "probability": 0.4403076171875}, {"start": 1462.36, "end": 1463.06, "word": " spirometer", "probability": 0.619873046875}, {"start": 1463.06, "end": 1463.48, "word": " and", "probability": 0.95166015625}, {"start": 1463.48, "end": 1463.8, "word": " hold", "probability": 0.90966796875}, {"start": 1463.8, "end": 1464.42, "word": " inspiration", "probability": 0.65966796875}, {"start": 1464.42, "end": 1464.84, "word": " several", "probability": 0.9111328125}, {"start": 1464.84, "end": 1465.42, "word": " seconds", "probability": 0.78955078125}, {"start": 1465.42, "end": 1466.28, "word": " repeat", "probability": 0.712890625}, {"start": 1466.28, "end": 1467.04, "word": " sequence", "probability": 0.98046875}, {"start": 1467.04, "end": 1467.26, "word": " من", "probability": 0.9931640625}, {"start": 1467.26, "end": 1467.68, "word": " خمسة", "probability": 0.9483642578125}, {"start": 1467.68, "end": 1468.3, "word": " لعشرة", "probability": 0.921142578125}, {"start": 1468.3, "end": 1468.72, "word": " في", "probability": 0.970703125}, {"start": 1468.72, "end": 1469.36, "word": " اليوم", "probability": 0.982177734375}, {"start": 1469.36, "end": 1470.46, "word": " تمام", "probability": 0.910400390625}, {"start": 1470.46, "end": 1470.88, "word": " هذا", "probability": 0.389404296875}, {"start": 1470.88, "end": 1471.04, "word": " ال", "probability": 0.9599609375}, {"start": 1471.04, "end": 1471.86, "word": " inspirometer", "probability": 0.6884765625}, {"start": 1471.86, "end": 1472.78, "word": " النوع", "probability": 0.96630859375}, {"start": 1472.78, "end": 1473.4, "word": " التاني", "probability": 0.94873046875}, {"start": 1473.4, "end": 1473.8, "word": " حاجة", "probability": 0.9931640625}, {"start": 1473.8, "end": 1474.32, "word": " اسمها", "probability": 0.9599609375}, {"start": 1474.32, "end": 1474.94, "word": " ال", "probability": 0.9560546875}, {"start": 1474.94, "end": 1475.42, "word": " peak", "probability": 0.53955078125}, {"start": 1475.42, "end": 1476.56, "word": " expiratory", "probability": 0.8893229166666666}], "temperature": 1.0}, {"id": 59, "seek": 150642, "start": 1476.9, "end": 1506.42, "text": "تمام؟ زي ما انتوا شايفينه هنا هو عبارة عن الـ Peak Expiratory Sinopharmometer Have للpatient assume comfortable لازم يكون في comfortable position Inhaled and exhaled three to four times أخد نفس و يطلع من تلاتة لاربعة نفس And then exhaled maximally with fourth breathing في الرابعة يزيد Then have للpatient place spirometer in mouth and exhaled mouth piece", "tokens": [39237, 10943, 22807, 30767, 1829, 19446, 16472, 2655, 14407, 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-0.13425164905033612, "compression_ratio": 1.1653543307086613, "no_speech_prob": 0.0, "words": [{"start": 1570.47, "end": 1571.11, "word": "وبهك", "probability": 0.79833984375}, {"start": 1571.11, "end": 1571.55, "word": " يعطيكوا", "probability": 0.85439453125}, {"start": 1571.55, "end": 1572.63, "word": " العافية", "probability": 0.8994140625}, {"start": 1572.63, "end": 1573.79, "word": " ونلتقي", "probability": 0.94013671875}, {"start": 1573.79, "end": 1574.15, "word": " بإذن", "probability": 0.9554443359375}, {"start": 1574.15, "end": 1574.35, "word": " الله", "probability": 0.9482421875}, {"start": 1574.35, "end": 1574.51, "word": " في", "probability": 0.94140625}, {"start": 1574.51, "end": 1574.61, "word": " ال", "probability": 0.708984375}, {"start": 1574.61, "end": 1574.89, "word": " part", "probability": 0.91455078125}, {"start": 1574.89, "end": 1575.55, "word": " التاني", "probability": 0.9285481770833334}, {"start": 1575.55, "end": 1575.83, "word": " من", "probability": 0.97021484375}, {"start": 1575.83, "end": 1576.17, "word": " role", "probability": 0.49365234375}, {"start": 1576.17, "end": 1576.33, "word": " of", "probability": 0.978515625}, {"start": 1576.33, "end": 1576.99, "word": " physiotherapy", "probability": 0.835693359375}, {"start": 1576.99, "end": 1577.55, "word": " in", "probability": 0.92529296875}, {"start": 1577.55, "end": 1577.99, "word": " pulmonary", "probability": 0.76953125}, {"start": 1577.99, "end": 1578.85, "word": " case", "probability": 0.94140625}, {"start": 1578.85, "end": 1579.65, "word": " study", "probability": 0.98828125}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1591.9833125, "duration_after_vad": 1555.8612499999974}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/vUMjemmmFOo_raw.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/vUMjemmmFOo_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..8a271043c5e17ef4e0f1b897fc628cfba4c21a0e
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/vUMjemmmFOo_raw.srt
@@ -0,0 +1,1556 @@
+1
+00:00:01,350 --> 00:00:05,090
+بنكمل معاكم ان شاء الله رب العالمين في الـ
+
+2
+00:00:05,090 --> 00:00:08,750
+Physiotherapy role and Cardiopulmonary disease
+
+3
+00:00:08,750 --> 00:00:12,970
+اليوم هنتحدث عن ال physical therapy role في موضوع
+
+4
+00:00:12,970 --> 00:00:17,250
+ال breathing exercise هنتحدث عن ال indication ال
+
+5
+00:00:17,250 --> 00:00:21,330
+control indication ال goals ال repercussions types
+
+6
+00:00:21,330 --> 00:00:25,370
+of breathing exercise بإذن الله تعالى نبدأ
+
+7
+00:00:25,370 --> 00:00:27,250
+محاضرتنا لهذا اليوم
+
+8
+00:00:35,760 --> 00:00:39,040
+الـ Breathing exercise زي ما احنا شايفين في عندنا
+
+9
+00:00:39,040 --> 00:00:44,880
+هنا inspiration و هنا في عندنا expiration تمام؟
+
+10
+00:00:44,880 --> 00:00:48,100
+الان ال definition ل ال breathing exercise it's an
+
+11
+00:00:48,100 --> 00:00:52,560
+exercise intended to promote effective and healthy
+
+12
+00:00:52,560 --> 00:00:56,260
+breathingand breath control عشان انا احصل على
+
+13
+00:00:56,260 --> 00:01:01,700
+breathing جيد لازم اعمل هذا ال breath بشكل منتظم
+
+14
+00:01:01,700 --> 00:01:07,160
+بشكل جيد حتى تدخل كمية مناسبة من الأكسجين إلى
+
+15
+00:01:07,160 --> 00:01:11,960
+الرئتين و يخرج ال waste product اللي هو CO2 خارج
+
+16
+00:01:11,960 --> 00:01:15,930
+الجسمIt's an therapeutic form من الـ exercise
+
+17
+00:01:15,930 --> 00:01:21,330
+aimed to deepen inspiration or expiration or even
+
+18
+00:01:21,330 --> 00:01:25,310
+two، يا إما هيكون الـ deep في الinspiration أو في
+
+19
+00:01:25,310 --> 00:01:29,930
+ال expiration أو كلاهما معاً، learn the rhythm and
+
+20
+00:01:29,930 --> 00:01:34,750
+rhythmللـ respiration بغير ال rate إذا كان في عندي
+
+21
+00:01:34,750 --> 00:01:38,490
+tachycardia إذا كان في عندي bradycardia كمان ال
+
+22
+00:01:38,490 --> 00:01:42,670
+rhythm تبع ال respiration يجب أن يكون في حدود ال
+
+23
+00:01:42,670 --> 00:01:47,230
+normal تمام؟ هلأ مين اللي أنا لازم أعمللهم أو من
+
+24
+00:01:47,230 --> 00:01:51,370
+هم الناس اللي لازم نعمللهم ال indication تبعت ال
+
+25
+00:01:51,370 --> 00:01:54,270
+breathing exercise ال acute و ال chronic lung
+
+26
+00:01:54,270 --> 00:02:00,170
+disease in general سواء كان COPD نمونيا ال atlaxis
+
+27
+00:02:00,600 --> 00:02:03,120
+الـ pulmonary embolism الـ acute respiratory
+
+28
+00:02:03,120 --> 00:02:07,720
+failure كل هذه الناس من اللي هو ضمن القائمة اللي
+
+29
+00:02:07,720 --> 00:02:11,520
+أنا بدي أعمل لهم breathing exercise الـ pain in
+
+30
+00:02:11,520 --> 00:02:15,460
+thoracic or abdominal area because of surgery or
+
+31
+00:02:15,460 --> 00:02:20,700
+trauma الـ airway obstruction لسكندري to
+
+32
+00:02:20,700 --> 00:02:25,700
+bronchostasm or retained secretion دفست in central
+
+33
+00:02:25,700 --> 00:02:30,230
+nervous system led to muscle weaknessكمان severe
+
+34
+00:02:30,230 --> 00:02:34,330
+orthopedic abnormalities زي حالات الـ scoliosis أو
+
+35
+00:02:34,330 --> 00:02:37,870
+الكيفوسيز ده effect في ال respiratory function
+
+36
+00:02:37,870 --> 00:02:41,690
+بتأثرلي في عملية ال respiration في حالات ال stress
+
+37
+00:02:41,690 --> 00:02:44,890
+management and relaxation procedure الناس اللي
+
+38
+00:02:44,890 --> 00:02:47,130
+عندها depression، الناس اللي عندها stress، الناس
+
+39
+00:02:47,130 --> 00:02:49,910
+اللي عندها psychological problems بعلمهم كيف
+
+40
+00:02:49,910 --> 00:02:56,730
+يعملوا breathing exercise تمام؟ شو أهدافي أنا؟
+
+41
+00:02:56,730 --> 00:02:59,850
+أهدافي أنا من ال breathing exerciseأول إشي لازم
+
+42
+00:02:59,850 --> 00:03:05,190
+يكون في عندي good ventilation حتى أنا أقدي أو أعلم
+
+43
+00:03:05,190 --> 00:03:08,310
+ال patients تبعي ال breathing exercise هدفي هنا
+
+44
+00:03:08,310 --> 00:03:12,970
+إنه أنا أترك مجال للـ lung إنه تاخد full range في
+
+45
+00:03:12,970 --> 00:03:16,490
+ال expansion تبعها عشان هيك هيصير في عندي improve
+
+46
+00:03:16,490 --> 00:03:19,870
+لل ventilation increase effectiveness of cuffing
+
+47
+00:03:19,870 --> 00:03:24,070
+mechanism بدي أحسن عملية ال cuff mechanism عشان
+
+48
+00:03:24,070 --> 00:03:28,120
+أعمل expectorating لأ اللي هو secretionالـ Prevent
+
+49
+00:03:28,120 --> 00:03:32,460
+for Pulmonary Impairment بدي أمنع أي مشاكل ممكن
+
+50
+00:03:32,460 --> 00:03:38,220
+ترود عليها بعد كده as a complication Improvement
+
+51
+00:03:38,220 --> 00:03:42,780
+للـ Strength and Endurance and Coordinate لـ
+
+52
+00:03:42,780 --> 00:03:46,260
+Respiratory Muscles مهمة ان دي سواء كانت ال mainly
+
+53
+00:03:46,260 --> 00:03:50,940
+muscles أو ال accessory muscles أيضا من الالـ
+
+54
+00:03:50,940 --> 00:03:53,960
+goals correct للـ insufficient abnormal breathing
+
+55
+00:03:53,960 --> 00:03:58,120
+pattern بدي أحسن أي abnormal بس ال breathing
+
+56
+00:03:58,120 --> 00:04:02,060
+pattern promote ال relaxation إذا كان في أنا عندي
+
+57
+00:04:02,060 --> 00:04:06,500
+مشكلة في اللي هو psychologically أو مشكلة ناتجة عن
+
+58
+00:04:06,500 --> 00:04:10,520
+البين أنا بحسن نفس المريض فبالتالي بتتحسن عندي
+
+59
+00:04:10,520 --> 00:04:13,940
+اللي هي ال psychological status in general teach
+
+60
+00:04:13,940 --> 00:04:17,120
+لل patients how to deal with shortens breathing in
+
+61
+00:04:17,120 --> 00:04:20,760
+attacksبعلم ال patient كيف أنه ياخد نفس عميق على
+
+62
+00:04:20,760 --> 00:04:26,160
+سبيل المثال في حالة أنه صار عنده attack نوبة لقصر
+
+63
+00:04:26,160 --> 00:04:29,320
+نفس أو لمشكلة معينة improve لل patient overall
+
+64
+00:04:29,320 --> 00:04:34,280
+functional capacity مهم جدا أنه أنا أحسن اللي هي
+
+65
+00:04:34,280 --> 00:04:37,500
+ال health in general status في حالات اللي هي
+
+66
+00:04:37,500 --> 00:04:41,820
+الصدرية أو في قسم الصدرية ال repercussions اللي
+
+67
+00:04:41,820 --> 00:04:46,800
+أنا لازم أخد بالي منها أمنع منع البطن أنه المريض
+
+68
+00:04:47,090 --> 00:04:51,990
+يعمل اللي هو الـ Force Expiration مش إشي بييجي
+
+69
+00:04:51,990 --> 00:04:55,910
+بالقوة Force Expiration هذه من الممنوع تنعمل Don't
+
+70
+00:04:55,910 --> 00:04:59,230
+allow للpatient to take very prolonged expiration
+
+71
+00:04:59,230 --> 00:05:03,430
+ما يطول في عملية الـ Expiration عملية الذفير، خروج
+
+72
+00:05:03,430 --> 00:05:08,150
+الهواء لبرا، ما تطول أو يبتدأ الـinspiration في
+
+73
+00:05:08,150 --> 00:05:11,430
+الـaccessory muscles لأ، مش لازم يبدأها لأن هذا
+
+74
+00:05:11,430 --> 00:05:15,130
+الإشي مش صحيحallow للpatient to practice deep
+
+75
+00:05:15,130 --> 00:05:19,190
+breathing for only three to four inspiration and
+
+76
+00:05:19,190 --> 00:05:23,070
+expiration at a time to avoid hyperventilation
+
+77
+00:05:23,070 --> 00:05:27,950
+خليني أسمح للمريض بشكل عملي أنه يعمل deep
+
+78
+00:05:27,950 --> 00:05:34,590
+breathing في حوالي من تلت لأربعة شهيق وذافير مرة
+
+79
+00:05:34,590 --> 00:05:38,630
+واحدة at a time to avoid hyperventilation عشان
+
+80
+00:05:38,630 --> 00:05:42,350
+أمنع ال hyperoxidationallow ال breathing pattern
+
+81
+00:05:42,350 --> 00:05:45,750
+أسمح لل pattern should be deep voluntary
+
+82
+00:05:45,750 --> 00:05:49,930
+controlled and relaxed أن يكون تحت السيطرة وعميق
+
+83
+00:05:49,930 --> 00:05:55,050
+وكذلك relaxed ال contra indication ممنوع هنا منع
+
+84
+00:05:55,050 --> 00:06:00,110
+ال pattern أنا أمنع لهذه الناس breathing exercise
+
+85
+00:06:00,110 --> 00:06:04,150
+في حالات زيادة ال inter cranial pressure يعني
+
+86
+00:06:04,150 --> 00:06:06,390
+حالات ال traumatic brain injury حالات ال head
+
+87
+00:06:06,390 --> 00:06:09,350
+injury in general ممنوع أنا أعمل لهم breathing
+
+88
+00:06:09,350 --> 00:06:13,590
+exerciseفي حالات الـ Unstable Head and Neck Injury
+
+89
+00:06:13,590 --> 00:06:17,250
+في حالات الـ Active Hemorrhage with Hemodynamic
+
+90
+00:06:17,250 --> 00:06:21,410
+Instability في حالات الـ Recent Spinal Injury لسه
+
+91
+00:06:21,410 --> 00:06:26,310
+أنا مش عارفة شو الحالة لسه الـ Spinal Cord Injury
+
+92
+00:06:26,310 --> 00:06:31,450
+مش stable بمنوع أعمللها الإنبعيمة وجود بف داخل ال
+
+93
+00:06:31,450 --> 00:06:34,750
+fluid معناته في infected tissue ليش أن أعمل
+
+94
+00:06:34,750 --> 00:06:39,260
+breathing exercise و أقعد المنطقة كلها؟في حالات
+
+95
+00:06:39,260 --> 00:06:42,540
+الـ bronchopulolar fistula في حالات الـ filial
+
+96
+00:06:42,540 --> 00:06:45,660
+chest وحكينا عليه في حالات الـ uncontrolled
+
+97
+00:06:45,660 --> 00:06:50,800
+hypertension هذه الحالات حوالينا اللي هي تمان
+
+98
+00:06:50,800 --> 00:06:54,660
+حالات ممنوعة من عنبات ان انا اشتغل اليها briefing،
+
+99
+00:06:54,660 --> 00:06:58,000
+exercise ايضا بكمل بعد التمانية اللي هم في ال
+
+100
+00:06:58,000 --> 00:07:03,380
+slide السابقة رقم 9 ال ribor vertebral fractures
+
+101
+00:07:03,380 --> 00:07:06,520
+in osteoporosis cases في حالات الـ osteoporosis
+
+102
+00:07:06,520 --> 00:07:09,500
+cases لأن عدوا هنشوف كمان شوية في الـ breathing
+
+103
+00:07:09,500 --> 00:07:14,280
+exercise لازم أنا أحط اللي هو my hands in general
+
+104
+00:07:14,280 --> 00:07:18,440
+position at أو around to the ribs فبالتالي في
+
+105
+00:07:18,440 --> 00:07:22,240
+حالات الـ osteoporosis ما بيكون المريض يقدر يتحمل
+
+106
+00:07:22,240 --> 00:07:25,660
+أنه أنا أعمل أي براشرة في حالات الـ acute أزمة أو
+
+107
+00:07:25,660 --> 00:07:29,540
+في حالات الـ TB ممنوع أعمل breathing exerciseفي
+
+108
+00:07:29,540 --> 00:07:33,100
+حالات ال patient who have recently experienced
+
+109
+00:07:33,100 --> 00:07:37,360
+heart attack لسه جاية نوبة قلبية جديدة ممنوع أن
+
+110
+00:07:37,360 --> 00:07:40,620
+أعمل breathing exercise لأن هيك هعمل جهد على
+
+111
+00:07:40,620 --> 00:07:44,460
+المريض في حالات ال recent within a narrower meal
+
+112
+00:07:44,460 --> 00:07:47,980
+or tube field سواء كان اللي هو الشخص مقتمد على
+
+113
+00:07:47,980 --> 00:07:52,820
+الأكل العادي بعد ساعة أقل من الوشبة أنا بعمله عشان
+
+114
+00:07:52,820 --> 00:07:58,300
+أتفادى موضوع اللي هوالـ vomiting في حالات الـ
+
+115
+00:07:58,300 --> 00:08:02,000
+Angiotube أو المرضى اللى هم على اللى هو الأنبوب
+
+116
+00:08:02,000 --> 00:08:05,580
+الرغامى هذا معناه الكلام ان انا بعد الواجبة اللى
+
+117
+00:08:05,580 --> 00:08:09,380
+بياخدها من ال nurse بعمله ال breathing exercise في
+
+118
+00:08:09,380 --> 00:08:12,990
+حالات ال untreated pneumothoraxفي عندنا هواء في
+
+119
+00:08:12,990 --> 00:08:17,010
+الـ thorax هنا ممنوع انا اشتغله في حالات اللي هو
+
+120
+00:08:17,010 --> 00:08:21,490
+chest tube بيش نطلع من العمليات وفي عندنا كذا tube
+
+121
+00:08:21,490 --> 00:08:24,630
+في ال lungs فبالتالي هنا ده هيقلي حركة ال
+
+122
+00:08:24,630 --> 00:08:29,310
+breathing exercise شو ال guidelines اللي انا لازم
+
+123
+00:08:29,310 --> 00:08:35,470
+اتعلمهم to breathing exerciseللـ acute أو الـ
+
+124
+00:08:35,470 --> 00:08:39,230
+quiet area طبعا in which you can interact with
+
+125
+00:08:39,230 --> 00:08:42,830
+patient with minimal distraction نختار المنطقة
+
+126
+00:08:42,830 --> 00:08:46,190
+الهادئة أو الاشي اللي يكون قادر ال patient اللي
+
+127
+00:08:46,190 --> 00:08:51,210
+ياخد تعليمته explain the aims and rationales of
+
+128
+00:08:51,210 --> 00:08:54,610
+breathing exercise specific his or her particular
+
+129
+00:08:54,610 --> 00:09:00,210
+impairment طبعا لازمنبرر ونوضح تعليماتنا ونوضح
+
+130
+00:09:00,210 --> 00:09:03,890
+أهدافنا من هذا التنبيين لالمريض حتى ياخدوا على
+
+131
+00:09:03,890 --> 00:09:08,470
+محمل الجد مافي مجال أجي أنا و أقول يلا اخد نفس طلع
+
+132
+00:09:08,470 --> 00:09:13,090
+نفس لأ احنا هدفنا يا حاجة أنه واحد اتنين تلاتة
+
+133
+00:09:13,090 --> 00:09:17,130
+بدوا يصير معانا واحد اتنين تلاتة فبالتالي هو بياخد
+
+134
+00:09:17,130 --> 00:09:21,010
+الاشي على محمل الجد معناته هيلتزم ليه بال exercise
+
+135
+00:09:21,650 --> 00:09:24,350
+have للpatient assume a comfortable relaxed
+
+136
+00:09:24,350 --> 00:09:28,190
+position and loose and restrictive clothes a
+
+137
+00:09:28,190 --> 00:09:31,810
+semiflowers position اللي هي ال head and the trunk
+
+138
+00:09:31,810 --> 00:09:36,670
+elevated حوالي 45 درجة فده بسميه a semiflowers if
+
+139
+00:09:36,670 --> 00:09:41,110
+described طبعا او desirable مطلوب في هاي الحالات
+
+140
+00:09:41,110 --> 00:09:44,990
+تمام اللي هو supporting للhead و للtrunk زي ما
+
+141
+00:09:44,990 --> 00:09:49,250
+حكينا في حالة الأسفل المحاضرة اللي فاتت حكينا او
+
+142
+00:09:49,250 --> 00:09:53,220
+الفيديو السابقحكينا إنه إحنا اللي هو حالة الـ
+
+143
+00:09:53,220 --> 00:09:57,780
+Orthopenia إذا كان هذا completely اللي هو 180 درجة
+
+144
+00:09:57,780 --> 00:10:00,540
+بيكون صعب على ال patient أو بتيجي حالة ال
+
+145
+00:10:00,540 --> 00:10:02,920
+Orthopenia اللي هي difficulty in breathing and
+
+146
+00:10:02,920 --> 00:10:07,740
+spine position فحكينا بنرفع ال back و ال head 45
+
+147
+00:10:07,740 --> 00:10:11,840
+درجة، هاي بسميها semi-flowers طبعا و the flexing
+
+148
+00:10:11,840 --> 00:10:16,140
+للهبس and knee to comfortable position لل trunk و
+
+149
+00:10:16,140 --> 00:10:19,580
+اللي هو ال back من ال abdominal musclethe
+
+150
+00:10:19,580 --> 00:10:22,600
+abdominal muscles remain relaxed هذا ال position
+
+151
+00:10:22,600 --> 00:10:26,880
+كتير مريح لهاي الناس ال positions that are also
+
+152
+00:10:26,880 --> 00:10:30,040
+lying, sitting او standing كمان مهم جدا انه انا
+
+153
+00:10:30,040 --> 00:10:32,860
+اعرف ايش ال position اللي انا بدي اشتغل عليه يعني
+
+154
+00:10:32,860 --> 00:10:35,180
+لو انا قرأت ال medical ده يا جماعة ده الصح معناته
+
+155
+00:10:35,180 --> 00:10:38,920
+الحكي انه انا بدي اعرف كيف احط ال patient تبعي if
+
+156
+00:10:38,920 --> 00:10:41,660
+necessary teach the patient relaxation technique
+
+157
+00:10:41,660 --> 00:10:45,100
+مهم جدا اعلم ال patient مايكون stressedأول جلسة
+
+158
+00:10:45,100 --> 00:10:50,200
+بتكون لها قلية خاصة طبعا ال patient لسه أول مرة
+
+159
+00:10:50,200 --> 00:10:54,420
+بتعرف عليك ال patient أول مرة بتحس بيدك على ظهرها
+
+160
+00:10:54,420 --> 00:10:56,540
+فيه اللي هو مثلا على سبيل المثال إذا بدي أعمل
+
+161
+00:10:56,540 --> 00:11:01,240
+vibration أو percussion فبالتالي هنا هيكون stress
+
+162
+00:11:01,240 --> 00:11:04,220
+لأ أنا أعلمه كيف يعمل اللي هو relaxation technique
+
+163
+00:11:04,220 --> 00:11:07,300
+this relaxation muscle ال relaxation muscle هيكون
+
+164
+00:11:07,300 --> 00:11:10,260
+لل upper thoracic و ال neck و ال shoulder to
+
+165
+00:11:10,260 --> 00:11:13,950
+minimize use of accessory musclesPay Articular
+
+166
+00:11:13,950 --> 00:11:17,190
+Attention by Relaxation to Sternocolloid Mustached
+
+167
+00:11:17,190 --> 00:11:21,210
+Muscles والعبارة ربيزياس والليفاتوريس كابيولا
+
+168
+00:11:21,210 --> 00:11:24,090
+Muscles هاي ال muscle should be relaxed لازم تكون
+
+169
+00:11:24,090 --> 00:11:29,830
+في وضعية ال relaxed تمام؟ أيضا بيعتمد اللي هو
+
+170
+00:11:29,830 --> 00:11:33,470
+الاشي على ال pathology and empowerment to
+
+171
+00:11:33,470 --> 00:11:35,690
+determine whether emphys inspiration and
+
+172
+00:11:35,690 --> 00:11:39,230
+expiration phase في ال ventilationلازم اوضح الـ
+
+173
+00:11:39,230 --> 00:11:41,830
+diesel breathing pattern للـ patient اليوم ال
+
+174
+00:11:41,830 --> 00:11:44,510
+patient إذا عنده فيه communication of secretion في
+
+175
+00:11:44,510 --> 00:11:47,050
+ال basil loop معناته أنا هحكيله إيش الوضع اللي
+
+176
+00:11:47,050 --> 00:11:49,750
+هيكون قاعد فيها ال postural drainage اللي أنا بدي
+
+177
+00:11:49,750 --> 00:11:53,930
+أعمله، كل هذه الأمور لازم أنا أوضحليها، have لل
+
+178
+00:11:53,930 --> 00:11:57,920
+patient practice andcorrect breathing pattern in
+
+179
+00:11:57,920 --> 00:12:01,460
+vitro position to rest and with activity تمام؟
+
+180
+00:12:01,460 --> 00:12:05,560
+اوضح للمريض ان هذه الوضعية بتخليك بشكل افضل في
+
+181
+00:12:05,560 --> 00:12:10,000
+حالة ال rest و كذلك في حالة ال activity تمام؟
+
+182
+00:12:10,000 --> 00:12:14,040
+هتكلم الآن على أنواع ال breathing exercise في عندي
+
+183
+00:12:14,040 --> 00:12:17,380
+أربع أنواع هنتحدث عليهم أول نوع اللي هو
+
+184
+00:12:17,380 --> 00:12:21,140
+diaphragmatic breathing segmental breathing وين
+
+185
+00:12:21,140 --> 00:12:24,790
+المشكلة موجودة بالظلطةسواء كانت في الـ Anterior،
+
+186
+00:12:24,790 --> 00:12:27,550
+الـ Posterior، الـ Lateral، الـ Arical و الـ
+
+187
+00:12:27,550 --> 00:12:31,310
+Paralepal Breathing الـ BLB و الـ Glucopharyngeal
+
+188
+00:12:31,310 --> 00:12:35,450
+Breathing هذه أربع أنواع أساسية للـ Breathing
+
+189
+00:12:35,450 --> 00:12:39,110
+exercise نبدأ على بركة الله في الـ Defragmentic
+
+190
+00:12:39,110 --> 00:12:41,810
+Breathing زي ما أنتوا عارفين الـ Defrag هو عبارة
+
+191
+00:12:41,810 --> 00:12:44,930
+عن الـ mainly muscles أو الـ main muscles which
+
+192
+00:12:44,930 --> 00:12:48,500
+innervated by frank nervesهي عضلاتها بتتم تغيظها
+
+193
+00:12:48,500 --> 00:12:51,940
+عن طريق الفرنكنيرف وهي عضلة أساسية في الـ
+
+194
+00:12:51,940 --> 00:12:55,060
+respiratory system. Increase the force in the
+
+195
+00:12:55,060 --> 00:12:59,540
+diaphragm as in respiratory muscles. بعمل improve
+
+196
+00:12:59,540 --> 00:13:02,780
+لل ventilation في ال small airway and paces in
+
+197
+00:13:02,780 --> 00:13:07,020
+lungs. It's often used combination with bear's
+
+198
+00:13:07,020 --> 00:13:11,840
+lip. أيضا مصحوب هذا ال program أو هذا النوع من ال
+
+199
+00:13:11,840 --> 00:13:15,340
+breathing exercise مع ال bear's lip breathing and
+
+200
+00:13:15,340 --> 00:13:18,620
+relaxation techniques.Are used during postural
+
+201
+00:13:18,620 --> 00:13:20,960
+drainage طبعا إذا أنا بدأ أستخدم الـ postural
+
+202
+00:13:20,960 --> 00:13:24,400
+drainage و هناخد فيه إن شاء الله محاضرة مهمة عن ال
+
+203
+00:13:24,400 --> 00:13:27,240
+postural drainage و الوضعيات to mobilize lung
+
+204
+00:13:27,240 --> 00:13:32,180
+secretion حتى أقدي اللي هو لخروج هذا ال secretion
+
+205
+00:13:32,180 --> 00:13:37,500
+برا الجسم طبعا هنا الاشي ال practical أنا تركته لل
+
+206
+00:13:37,500 --> 00:13:41,340
+practice أو للعملي وهنا بس هوريكم اللي هو بعض
+
+207
+00:13:41,340 --> 00:13:45,050
+الأشكالهي rectus abdominus muscles هو هنا اللي هو
+
+208
+00:13:45,050 --> 00:13:48,790
+بحط أيدي في اللي هو diaphragmatic breathing هذا ال
+
+209
+00:13:48,790 --> 00:13:52,170
+exercise لو شوفنا هذه الصورة بنعرف أن هي عبارة عن
+
+210
+00:13:52,170 --> 00:13:57,830
+diaphragmatic breathing الآن ممكن هو يعملها بنفسه
+
+211
+00:13:57,830 --> 00:14:02,300
+autoselfطبعا هى هنا حاط اليد على diaphragmatic هنا
+
+212
+00:14:02,300 --> 00:14:06,760
+عمل inspiration ونفخ ال abdomen أو عمل امتلأ
+
+213
+00:14:06,760 --> 00:14:09,620
+للهواء فى منطقة ال abdomen لاحظوا ال pillows اللى
+
+214
+00:14:09,620 --> 00:14:13,520
+موجودة crook line position وهنا عمل exhale او ال
+
+215
+00:14:13,520 --> 00:14:19,540
+expiration وفرغ الهواء من البطن النوع التانى من ال
+
+216
+00:14:19,540 --> 00:14:22,140
+breathing exercise هو عبارة عن ال segmental
+
+217
+00:14:22,140 --> 00:14:24,880
+breathing لان ال segmental breathing من كل ال
+
+218
+00:14:24,880 --> 00:14:28,110
+segment معناته فى جزئية معينةit's a question of
+
+219
+00:14:28,110 --> 00:14:31,790
+whether patient can be taught اللي هو أو expand
+
+220
+00:14:31,790 --> 00:14:36,490
+localized area أنا شغالة على منطقة محددة في ال
+
+221
+00:14:36,490 --> 00:14:39,390
+lungs while keeping other areas acute there is
+
+222
+00:14:39,390 --> 00:14:42,970
+certain instance such as during post-resonance or
+
+223
+00:14:42,970 --> 00:14:46,810
+following thoracic surgery when it's important to
+
+224
+00:14:46,810 --> 00:14:50,990
+emphasis expansionأو ال problem area في موجودة في
+
+225
+00:14:50,990 --> 00:14:54,470
+منطقة معينة معناه الكلام إن أنا بدي أحط المرضي
+
+226
+00:14:54,470 --> 00:14:58,230
+بتبعي في وضعية معينة عشان أعمل remove ل
+
+227
+00:14:58,230 --> 00:15:03,770
+-segregation منه أنواع زي ما أنتوا شايفين في عندنا
+
+228
+00:15:03,770 --> 00:15:07,530
+ال right lungs في ال left lungs ال right lungs
+
+229
+00:15:07,530 --> 00:15:10,470
+فيها three loops زي ما أحنا شايفين أما ال right
+
+230
+00:15:10,470 --> 00:15:15,610
+فيها اللي هي two loopsفي عنائبكال بوستيريور
+
+231
+00:15:15,610 --> 00:15:19,810
+انتريور ممكن اقسمها الى medially، laterally،
+
+232
+00:15:19,810 --> 00:15:24,450
+superior هاي ال segmental اللي انا لازم اعرفها ان
+
+233
+00:15:24,450 --> 00:15:27,790
+ال lateral course هالأول اشي هبدأ فيه sometimes
+
+234
+00:15:27,790 --> 00:15:31,890
+called lateral basal expansion طبعا لإن موجود تحت
+
+235
+00:15:31,890 --> 00:15:36,750
+على القاعدة ميدان unilaterally ممكن اعملها على جهة
+
+236
+00:15:36,750 --> 00:15:40,150
+واحدة وممكن اعملها على الجهتين bilaterally
+
+237
+00:15:40,560 --> 00:15:44,300
+الpatient may sitting or in hook line position
+
+238
+00:15:44,300 --> 00:15:47,440
+اللي هو دايما انتوا شايفينه هذا ال hook line
+
+239
+00:15:47,440 --> 00:15:50,240
+position او ال hooking line position place your
+
+240
+00:15:50,240 --> 00:15:54,780
+hand along with lateral aspect للlower ribs هنا
+
+241
+00:15:54,780 --> 00:15:58,440
+شايفين ال hand تبت ال therapist تيجي على نهاية ال
+
+242
+00:15:58,440 --> 00:16:02,820
+ribs ask لل patient to breathe out expiration and
+
+243
+00:16:02,820 --> 00:16:07,120
+feel the ribs cage move downward and inward تنزل
+
+244
+00:16:07,120 --> 00:16:14,140
+اللي هي ال ribs downward تحتوinward للداخل زي ما
+
+245
+00:16:14,140 --> 00:16:16,200
+احنا شايفين ممكن اعمله في sublime position ممكن
+
+246
+00:16:16,200 --> 00:16:21,240
+اعمله الان في sitting position هنا اللي هي ال
+
+247
+00:16:21,240 --> 00:16:26,100
+basal costal expiration ال posterior deep
+
+248
+00:16:26,100 --> 00:16:28,700
+breathing and freezing posterior basal expansion
+
+249
+00:16:28,700 --> 00:16:32,600
+انا من الخلف بدي اعمله posterior expansion it's
+
+250
+00:16:32,600 --> 00:16:36,060
+important في حالات ال post surgical patient who
+
+251
+00:16:36,060 --> 00:16:39,390
+convince the bedsemi-reclined position for
+
+252
+00:16:39,390 --> 00:16:42,830
+extended period of time because secretions often
+
+253
+00:16:42,830 --> 00:16:46,650
+accumulate in posterior segments and lower lobes
+
+254
+00:16:46,650 --> 00:16:50,990
+تمام بستخدمه في حالات الـ post-surgical لإنه بيكون
+
+255
+00:16:50,990 --> 00:16:55,230
+اللي هو secretion اتجمع او accumulated in the
+
+256
+00:16:55,230 --> 00:16:59,470
+basal وفي ال posterior هاي اللي هي طبعا زي ما
+
+257
+00:16:59,470 --> 00:17:04,890
+انتوا شايفين ال therapist حط اللي هو ال thumbs على
+
+258
+00:17:04,890 --> 00:17:09,830
+البرتبريهو الـ hand around to the ribs زي ما احنا
+
+259
+00:17:09,830 --> 00:17:14,310
+شايفين طبعا هنا أخد الـ expiration بعدين طلع الـ
+
+260
+00:17:14,310 --> 00:17:18,210
+expiration ال procedure ل ال practical part ال
+
+261
+00:17:18,210 --> 00:17:22,710
+Epical اللي هي النوع التالت من segmental ال Epical
+
+262
+00:17:22,710 --> 00:17:27,350
+معناته إشي هيكون في القمة لحظة وين حاطت هنا ال
+
+263
+00:17:27,350 --> 00:17:31,610
+patient إيده يعني معناته الحاجة إن هو على قريب من
+
+264
+00:17:31,610 --> 00:17:35,750
+ال clavicle إشي موجود في ال Epical ال segment لالـ
+
+265
+00:17:35,750 --> 00:17:40,670
+lungs تمام النوع التالت من ال breathing exercise
+
+266
+00:17:40,670 --> 00:17:44,770
+ال bears labs breathing اللي هي ال BLB prevent
+
+267
+00:17:44,770 --> 00:17:49,070
+collapse of airway during expiration due to
+
+268
+00:17:49,070 --> 00:17:52,710
+maintain positive pressure in airway during
+
+269
+00:17:52,710 --> 00:17:57,790
+expiration prolonged expiration طبعا في نفس اللي
+
+270
+00:17:57,790 --> 00:18:01,910
+هو ال expiration في ال bears lab lead to decrease
+
+271
+00:18:01,910 --> 00:18:06,610
+لل air trapping and residual volumeلاحظوا هنا ضغط
+
+272
+00:18:06,610 --> 00:18:11,590
+على شفته أخد inspiration بعدين طلعوا في ال X
+
+273
+00:18:11,590 --> 00:18:15,130
+biration in addition Enrictus اللي هي more
+
+274
+00:18:15,130 --> 00:18:21,230
+alveolar units at the lung bases طبعا هنا اللي هو
+
+275
+00:18:21,230 --> 00:18:25,630
+هذا النوع أحيانا بيكون مصاحب للنوع الأول اللي احنا
+
+276
+00:18:25,630 --> 00:18:29,990
+حكينا عليه شو أهداف ال biosleep breathing؟بساعد
+
+277
+00:18:29,990 --> 00:18:33,590
+على ال ventilation وهو كويس ومفيد جدا للمرضى
+
+278
+00:18:33,590 --> 00:18:39,330
+release لتبرد air of lung ايضا اللي هو يعني بيفرغ
+
+279
+00:18:39,330 --> 00:18:43,030
+الهواء او بزيل الهواء اللي بيكون متفرج او موجود
+
+280
+00:18:43,030 --> 00:18:47,190
+داخل ال lungs keeps يعني بيجدد المنطقة keeps ال
+
+281
+00:18:47,190 --> 00:18:51,720
+airway open longer and decreaseللـ work of
+
+282
+00:18:51,720 --> 00:18:55,700
+breathing prolonged exhalation to slow breathing
+
+283
+00:18:55,700 --> 00:18:59,460
+rate ومهم جدا وبيحسن ال breathing بترن لـ moving
+
+284
+00:18:59,460 --> 00:19:02,960
+old air out to the lung and allowing new air يعني
+
+285
+00:19:02,960 --> 00:19:07,320
+بيجدد اللي هو عملية الهواء داخل أو التهوية داخل
+
+286
+00:19:07,320 --> 00:19:11,720
+الرئتين relief لل shorten breathing وبيسبب اللي هو
+
+287
+00:19:11,720 --> 00:19:16,180
+causes لل general relaxation هذه أهداف الbert lab
+
+288
+00:19:16,180 --> 00:19:20,220
+breathing النوع التالتهنا في هذه ال slide كان
+
+289
+00:19:20,220 --> 00:19:26,480
+موضوع ال procedure و انا تركته لجزء العملية لاحظوا
+
+290
+00:19:26,480 --> 00:19:29,160
+هنا ال set case عملت breathing in او ال
+
+291
+00:19:29,160 --> 00:19:32,220
+inspiration بتضغط على ال bears lip بعدين ال
+
+292
+00:19:32,220 --> 00:19:37,840
+breathing out from mouth من الثم لأن في عندي
+
+293
+00:19:37,840 --> 00:19:41,620
+precautions لازم انا اخد بالي منها امنع اي
+
+294
+00:19:41,620 --> 00:19:45,340
+forceful expiration في اي حالة او في اي نوع من
+
+295
+00:19:45,340 --> 00:19:48,880
+انواع ال breathingضروري أنه انا امنع اللي هو ال
+
+296
+00:19:48,880 --> 00:19:53,960
+expiration تمام forceful expiration while labs are
+
+297
+00:19:53,960 --> 00:19:58,760
+birthed can increase turbulence of airways and
+
+298
+00:19:58,760 --> 00:20:01,880
+causes further restriction لل small bronchiolosis
+
+299
+00:20:01,880 --> 00:20:07,660
+طبعا إذا أنا خلّيت أنه يعملعلى طول expiration بقوة
+
+300
+00:20:07,660 --> 00:20:13,220
+هذا الاشي هيعمل ليه مشكلة tripling اللي هو ال
+
+301
+00:20:13,220 --> 00:20:15,760
+airway خصوصا في البرنكولز اللي هي الشعيبات
+
+302
+00:20:15,760 --> 00:20:19,160
+الهوائية الصغيرة it's important to emphasis ال
+
+303
+00:20:19,160 --> 00:20:22,740
+expiration should performed control manner but not
+
+304
+00:20:22,740 --> 00:20:28,360
+force المهم ان هو يعمل expiration ولكن ليس بقوة
+
+305
+00:20:28,670 --> 00:20:34,250
+تجعل المريض أنه يتغير الـ control تبعه لأ الأفضل
+
+306
+00:20:34,250 --> 00:20:38,090
+أن يعملها بـ control لنظام معين النوع الرابع
+
+307
+00:20:38,090 --> 00:20:40,990
+والأخير من أنواع الـ Breathing Exercise اللي هو
+
+308
+00:20:40,990 --> 00:20:44,610
+الـ Grossopharyngeal Breathing it's used primarily
+
+309
+00:20:44,610 --> 00:20:49,310
+by patients whose heart ventilator depends because
+
+310
+00:20:49,310 --> 00:20:53,010
+of absent or incomplete intervention in the
+
+311
+00:20:53,010 --> 00:20:56,710
+diaphragm as a result of high cervical level from
+
+312
+00:20:56,710 --> 00:21:01,190
+spinal cord injuryتمام باستخدمه لحالات اللى هى ال
+
+313
+00:21:01,190 --> 00:21:05,090
+spinal cord injury وخصوصا ال high cervical level
+
+314
+00:21:05,090 --> 00:21:10,330
+او other neuromuscular disorders it also can be
+
+315
+00:21:10,330 --> 00:21:14,370
+used improve the force and therefore effectiveness
+
+316
+00:21:14,370 --> 00:21:20,070
+طبعا مهم جدا هنا انا احسن اللى هو ال effectiveness
+
+317
+00:21:20,070 --> 00:21:24,770
+تبع ال coughing and increasing لل volume to voice
+
+318
+00:21:24,770 --> 00:21:28,870
+كمانلأن أنا بحكي عن Glossopharyngeal معناته له
+
+319
+00:21:28,870 --> 00:21:33,650
+علاقة بالـ voice بالصوت ال procedure تبعته بتاعتها
+
+320
+00:21:33,650 --> 00:21:37,770
+الجزئية العملية و ننتقل لل biofeedback respiratory
+
+321
+00:21:37,770 --> 00:21:41,890
+muscle training تمام في عند تلت طرق هحكي عليهم ال
+
+322
+00:21:41,890 --> 00:21:45,590
+biofeedback مهم جدا حتى المريض أنه ممكن يعملها
+
+323
+00:21:45,590 --> 00:21:50,270
+عشان هو يتأكد من أن فعالية ال muscle لديهself
+
+324
+00:21:50,270 --> 00:21:54,190
+-control للـ physiological function طبعا ل result
+
+325
+00:21:54,190 --> 00:21:57,690
+of ventilatory muscles training build strength and
+
+326
+00:21:57,690 --> 00:22:00,990
+endurance in respiratory muscles ال application
+
+327
+00:22:00,990 --> 00:22:04,350
+ممكن أنا أحسن ال biofeedback تبعتي عن طريق ال
+
+328
+00:22:04,350 --> 00:22:08,430
+intensive spirometer هذا هو عبارة عن جهاز موجود
+
+329
+00:22:08,430 --> 00:22:13,290
+عندنا ال peak expiratory flow meter و ال oximetry
+
+330
+00:22:13,290 --> 00:22:17,170
+biofeedback argument pairs lab breathing training
+
+331
+00:22:17,170 --> 00:22:21,120
+هي عبارة عن أجهزةالـ Intensive Respiratory
+
+332
+00:22:21,120 --> 00:22:25,960
+Spirometer Form Of شكل من أشكال Ventilatory
+
+333
+00:22:25,960 --> 00:22:29,940
+Training It's from أو بشكل الـ persistence
+
+334
+00:22:29,940 --> 00:22:33,360
+training that infuses sustained maximal
+
+335
+00:22:33,360 --> 00:22:37,720
+inspiration البشنط انهيل للـ Spirometer ذات
+
+336
+00:22:37,720 --> 00:22:41,720
+البرومود أو provider visual auditory feedback
+
+337
+00:22:41,720 --> 00:22:51,210
+للبشنط تمام بيعطي قراءةبصرية وسمعية للمريض بياخد
+
+338
+00:22:51,210 --> 00:22:55,090
+نفسه عميق increase لل volume and air inspiration
+
+339
+00:22:55,090 --> 00:22:59,410
+used to prevent بستخدمه حتى أمنع ال alveolar
+
+340
+00:22:59,410 --> 00:23:02,970
+collapse مابدي يصير في عندي collapse انضمام أو
+
+341
+00:23:02,970 --> 00:23:08,830
+التصاق لل alveoli in the postoperative conditions
+
+342
+00:23:08,830 --> 00:23:12,890
+بستخدمه عشان أعمل strengthening لل weakInspiratory
+
+343
+00:23:12,890 --> 00:23:16,830
+muscles in patients with neuromuscular disorders
+
+344
+00:23:16,830 --> 00:23:20,650
+تمام، هي استخدامات الـ Intensive Respiratory
+
+345
+00:23:20,650 --> 00:23:25,230
+Spirometers الآن الـ repercussions تبعته ممنوع
+
+346
+00:23:25,230 --> 00:23:29,850
+استخدم فيه prolonged periods مستخدموهش لفترة طويلة
+
+347
+00:23:29,850 --> 00:23:33,050
+at any firm resistance training in inspiratory
+
+348
+00:23:33,050 --> 00:23:37,480
+musclesUse للـ accessory muscles أخد بالي أن
+
+349
+00:23:37,480 --> 00:23:40,400
+المريض تبعي هيستخدم هاي زمان أنتوا شايفين ال
+
+350
+00:23:40,400 --> 00:23:44,600
+accessory muscles تبعته في ال neck muscles طبعا as
+
+351
+00:23:44,600 --> 00:23:47,420
+a sign that diaphragm beginning to fatigue
+
+352
+00:23:47,420 --> 00:23:51,360
+فبالتالي هتشتغل ال accessory muscles ونترك ال
+
+353
+00:23:51,360 --> 00:23:55,870
+mainly اللي هي عبارة عن ال diaphragmهنا التكنيكى
+
+354
+00:23:55,870 --> 00:23:58,450
+تبعه انه انا بدى احط ال patient في comfortable
+
+355
+00:23:58,450 --> 00:24:03,130
+position زى ما شفته هنا في هى الصورة جاى في semi
+
+356
+00:24:03,130 --> 00:24:05,970
+sitting position او sitting position خلينى احكى
+
+357
+00:24:05,970 --> 00:24:10,370
+have لل patient to take three to four slow
+
+358
+00:24:10,370 --> 00:24:15,580
+breathing فقطالpatient maximally healed at end of
+
+359
+00:24:15,580 --> 00:24:19,520
+fourth breathing بينهي في النفس الرابع then have
+
+360
+00:24:19,520 --> 00:24:23,800
+patient inhaled maximally لال spirometer and hold
+
+361
+00:24:23,800 --> 00:24:27,260
+inspiration several seconds repeat sequence من
+
+362
+00:24:27,260 --> 00:24:32,780
+خمسة لعشرة في اليوم تمام هذا ال inspirometer النوع
+
+363
+00:24:32,780 --> 00:24:37,600
+التاني حاجة اسمها ال peak expiratoryتمام؟ زي ما
+
+364
+00:24:37,600 --> 00:24:40,560
+انتوا شايفينه هنا هو عبارة عن الـ Peak Expiratory
+
+365
+00:24:40,560 --> 00:24:44,640
+Sinopharmometer Have للpatient assume comfortable
+
+366
+00:24:44,640 --> 00:24:48,340
+لازم يكون في comfortable position Inhaled and
+
+367
+00:24:48,340 --> 00:24:52,120
+exhaled three to four times أخد نفس و يطلع من
+
+368
+00:24:52,120 --> 00:24:56,100
+تلاتة لاربعة نفس And then exhaled maximally with
+
+369
+00:24:56,100 --> 00:25:00,280
+fourth breathing في الرابعة يزيد Then have
+
+370
+00:25:00,280 --> 00:25:05,160
+للpatient place spirometer in mouth and exhaled
+
+371
+00:25:05,160 --> 00:25:09,630
+mouth pieceفي الـ sequence repeated five to ten
+
+372
+00:25:09,630 --> 00:25:13,250
+times several times per days من خمس لعشر مرات
+
+373
+00:25:13,250 --> 00:25:18,550
+يعملها في اليوم تمام النوع الأخير اللي هو التالت
+
+374
+00:25:18,550 --> 00:25:21,810
+ال auxometer زي ما أنتوا شايفين هنا هو عبارة عن
+
+375
+00:25:21,810 --> 00:25:26,250
+إيش ال patient can use auxometer by feedback اسمها
+
+376
+00:25:27,440 --> 00:25:31,540
+بيستخدم الـ Pulse Oximetry اللي هو قياس الـ Pulse
+
+377
+00:25:31,540 --> 00:25:34,300
+اللي هو نبض القلب as a biofeedback guide to teach
+
+378
+00:25:34,300 --> 00:25:38,000
+them increase their oxygen saturation عشان يزيد
+
+379
+00:25:38,000 --> 00:25:42,080
+اللي هو تشبع الأكسجين خلال ال performance ال
+
+380
+00:25:42,080 --> 00:25:46,340
+performance هذا اللي بيكون مسحوب مع ال pairsLips
+
+381
+00:25:46,340 --> 00:25:50,080
+Breathing الـ BLB which is relief dyspnea and
+
+382
+00:25:50,080 --> 00:25:53,160
+improvement للجذكس تشانج كمان which result
+
+383
+00:25:53,160 --> 00:25:56,640
+improvement لل Oxygenation and Oxygen saturation
+
+384
+00:25:56,640 --> 00:26:01,860
+هذا مهم جدا أنه أنا بكون مصحوبة أو بكون علم ال
+
+385
+00:26:01,860 --> 00:26:05,460
+patient تبعي أو مدربة على أنه يكون مصاحب أنه في
+
+386
+00:26:05,460 --> 00:26:08,980
+عندنا pulse rate فبالتالي هنا هو مهم جدا في حالات
+
+387
+00:26:08,980 --> 00:26:14,510
+ال dyspneaوبهك يعطيكوا العافية ونلتقي بإذن الله في
+
+388
+00:26:14,510 --> 00:26:17,550
+ال part التاني من role of physiotherapy in
+
+389
+00:26:17,550 --> 00:26:19,650
+pulmonary case study
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/wNb3Lpr7VxM.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/wNb3Lpr7VxM.srt
new file mode 100644
index 0000000000000000000000000000000000000000..615e3518092681ff5dbeec2eb9763a9da89105df
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/wNb3Lpr7VxM.srt
@@ -0,0 +1,1400 @@
+1
+00:00:01,700 --> 00:00:04,720
+الرحمن الرحيم والصلاة والسلام على أشرف الأنبياء
+
+2
+00:00:04,720 --> 00:00:09,960
+والمرسلين سأتحدث في هذا اللقاء عن العلاج الطبيعي
+
+3
+00:00:09,960 --> 00:00:14,900
+لأمراض الباطنة والقلب والصدر تمامًا، فهي عبارة عن
+
+4
+00:00:14,900 --> 00:00:19,800
+ثلاث محاور أساسية سنتطرق في البداية لمحور أمراض
+
+5
+00:00:19,800 --> 00:00:23,200
+الباطنة، هذه المحاضرة بعنوان Introduction of
+
+6
+00:00:23,200 --> 00:00:28,100
+Internal Medicine، أي مقدمة لأمراض أو العلاج
+
+7
+00:00:28,100 --> 00:00:32,580
+الطبيعي لأمراض الباطنة والمسنين. سأتحدث فيها عن من
+
+8
+00:00:32,580 --> 00:00:36,340
+هو، أو من هو الذي يزاول الـ Internal Medicine، أو من
+
+9
+00:00:36,340 --> 00:00:40,940
+هو الأخصائي الباطني، وكذلك سأتطرق إلى الـ
+
+10
+00:00:40,940 --> 00:00:44,200
+Physiotherapy Assessments in Internal Medicine
+
+11
+00:00:44,200 --> 00:00:48,920
+Conditions، للحالات اللي هي اللي لنا دور فيها في قسم
+
+12
+00:00:48,920 --> 00:00:54,600
+الباطنة. نبدأ على بركة الله، الـ Internist اللي هي
+
+13
+00:00:54,600 --> 00:00:58,940
+من هو الـ Internist؟ هو عبارة عن Specialist، طبيب
+
+14
+00:00:58,940 --> 00:01:01,980
+متخصص في الـ Adult Medicine, who provide the majority
+
+15
+00:01:01,980 --> 00:01:05,760
+of health care to adults in hospital or in the
+
+16
+00:01:05,760 --> 00:01:09,640
+office. لذا هو عبارة عن طبيب متخصص موجود في قسم
+
+17
+00:01:09,640 --> 00:01:12,940
+الباطنة، وهو عبارة عن الشريان الرئيسي في المستشفى
+
+18
+00:01:12,940 --> 00:01:16,880
+ومن بعد ذلك يتم توزيع وتصنيف الحالات.
+
+19
+00:01:19,110 --> 00:01:23,330
+الـ Internist عرفنا أن دوره
+
+20
+00:01:23,330 --> 00:01:27,570
+Provide comprehensive and continuity of care، اللي
+
+21
+00:01:27,570 --> 00:01:32,480
+هو primary care to adults and elderly. بيقدم رعاية
+
+22
+00:01:32,480 --> 00:01:36,520
+شاملة وكاملة، لـ women healthcare، depression and
+
+23
+00:01:36,520 --> 00:01:40,280
+anxiety. بيعالج حالات  acute and chronic medical
+
+24
+00:01:40,280 --> 00:01:43,820
+conditions، وأيضًا بيعمل treatment لـ episodic،
+
+25
+00:01:43,820 --> 00:01:47,140
+urgent and emergency conditions، arrange a
+
+26
+00:01:47,140 --> 00:01:50,900
+consultation with other physicians. بينسق مع
+
+27
+00:01:50,900 --> 00:01:54,340
+الأطباء الآخرين، preoperative and
+
+28
+00:01:54,340 --> 00:01:58,340
+evaluation for surgical colleagues. تمام؟ هذا دور
+
+29
+00:01:58,340 --> 00:02:02,700
+اللي هو أخصائي الباطنة. هم Specialists
+
+30
+00:02:02,700 --> 00:02:06,720
+متخصصون في كذا مجال، في عندنا الأدوية
+
+31
+00:02:06,720 --> 00:02:11,200
+medicine، في عندنا الـ allergy and immunology،
+
+32
+00:02:11,200 --> 00:02:14,340
+cardiovascular، الـ endocrine، infectious disease،
+
+33
+00:02:14,610 --> 00:02:17,570
+الـ gastroenterology، و الـ geriatric
+
+34
+00:02:17,570 --> 00:02:21,190
+hematology، وأيضًا اللي هو الـ hepatology، اللي له
+
+35
+00:02:21,190 --> 00:02:24,070
+علاقة بالـ hepatitis أو الـ hepatology،
+
+36
+00:02:24,070 --> 00:02:26,950
+اللي هو له علاقة بالـ liver، وأيضًا الـ nephrology،
+
+37
+00:02:26,950 --> 00:02:29,650
+اللي له علاقة بالـ kidney، الـ oncology اللي له
+
+38
+00:02:29,650 --> 00:02:32,790
+علاقة بالـ gynecology كمان، و الـ pulmonary disease
+
+39
+00:02:32,790 --> 00:02:36,750
+and care medicines، و الـ rheumatology، علم الأورام
+
+40
+00:02:36,750 --> 00:02:43,730
+أيضًا، في علم اللي هو الـ rheumatology، هو عبارة عن الـ
+
+41
+00:02:43,730 --> 00:02:46,650
+Rheumatism، علم الـ Rheumatism، وأيضًا في عندنا ناس
+
+42
+00:02:46,650 --> 00:02:53,010
+متخصصون في sleep medicine. هكذا، سأتحدث الآن عن الـ
+
+43
+00:02:53,010 --> 00:02:55,810
+health assessment أو الـ physiological assessment،
+
+44
+00:02:55,810 --> 00:03:00,610
+اللي هيكون موجود في قسم الباطنة، اللي موجود في أي
+
+45
+00:03:00,610 --> 00:03:04,910
+مريض، من بعض  تبع الـ diagnosis، اللي هي في عندنا الـ
+
+46
+00:03:04,910 --> 00:03:08,310
+pathological، etiological، anatomical، and
+
+47
+00:03:08,310 --> 00:03:11,900
+prognostic. إذن سأتحدث على الـ pathological، هذا المرض،
+
+48
+00:03:11,900 --> 00:03:15,280
+لماذا دخل المستشفى؟ ما السبب الذي جعله يكون عنده
+
+49
+00:03:15,280 --> 00:03:18,400
+الزائدة على سبيل المثال، الـ anatomical، وضع الزائدة، ما
+
+50
+00:03:18,400 --> 00:03:21,920
+هي، وما دورها، وما حدث بعد العملية الجراحية، الـ
+
+51
+00:03:21,920 --> 00:03:27,240
+prognosis، هل هو تحسن أم لا؟ في عند الـ patient
+
+52
+00:03:27,240 --> 00:03:29,900
+history، في عند الـ physical examination، و الـ
+
+53
+00:03:29,900 --> 00:03:32,740
+laboratory and instrumental examination. بدي أشوف
+
+54
+00:03:32,740 --> 00:03:34,880
+في الـ patient history، في عند الـ birth history، في
+
+55
+00:03:34,880 --> 00:03:38,200
+عند الـ medical history، اللي هو الـ present history،
+
+56
+00:03:38,550 --> 00:03:41,490
+الـ physical examination، كل الاختبارات الفيزيائية،
+
+57
+00:03:41,490 --> 00:03:44,490
+على سبيل المثال، اللي أخذناها في tests and
+
+58
+00:03:44,490 --> 00:03:46,870
+measurements، وأيضًا في laboratory and instrumental
+
+59
+00:03:46,870 --> 00:03:51,250
+examination، بعض اللي هو التحاليل اللي تُطلب من
+
+60
+00:03:51,250 --> 00:03:56,470
+قبل الأخصائي والدكتور، guidelines established a
+
+61
+00:03:56,470 --> 00:03:58,730
+physical patient relationship. لازم أنا أحدد
+
+62
+00:03:58,730 --> 00:04:01,670
+العلاقة بيني وبين الـ patient، عشان أبدأ أشتغل على
+
+63
+00:04:01,670 --> 00:04:05,610
+قاعدة سليمة. بدي أجمع المعلومات physiological أو
+
+64
+00:04:05,610 --> 00:04:08,830
+psychological أو cognitive أو psycho-cultural،
+
+65
+00:04:08,830 --> 00:04:12,450
+developmental and spiritual. كل هذه الأمور سواء
+
+66
+00:04:12,450 --> 00:04:16,550
+فيسيولوجية أو سيكولوجية أو روحانية، لازم أنا أجمعها
+
+67
+00:04:16,550 --> 00:04:20,890
+وأبدأ بالشغل عليها، identify patient stress. بدي
+
+68
+00:04:20,890 --> 00:04:24,610
+أشوف مقاييس القوة عنده اليوم، هو على سبيل
+
+69
+00:04:24,610 --> 00:04:28,230
+المثال، إذا كان لديه بتر في قدمه، amputation لقدم، معناه
+
+70
+00:04:28,230 --> 00:04:30,670
+أن الكلام، بدي أشوف هل الـ upper limb قوية أم لا.
+
+71
+00:04:30,670 --> 00:04:33,700
+إذا كانت قوية، معناته أنا بدي أركز عليها وأزيد من
+
+72
+00:04:33,700 --> 00:04:36,840
+قوتها، Identification of Actual and Potential
+
+73
+00:04:36,840 --> 00:04:40,700
+Health Problems. وأيضًا بدي أشوف اللي هو هل في عندي
+
+74
+00:04:40,700 --> 00:04:44,440
+نقاط قوة حقيقية موجودة أم لا، القوي بدي أقويه وأزيد من
+
+75
+00:04:44,440 --> 00:04:48,800
+قوته، والضعيف بدي أحاول أتغلب على المشاكل
+
+76
+00:04:48,800 --> 00:04:52,040
+الموجودة فيه، Established for the case of patient
+
+77
+00:04:52,040 --> 00:04:56,100
+of Physiotherapy Assessment Process. لازم أحط قاعدة
+
+78
+00:04:56,100 --> 00:04:58,480
+لعملية اللي هي الـ assessment process.
+
+79
+00:05:04,690 --> 00:05:10,050
+الـ instrument، هل اللي هو فيه form موجودة عندي معينة و
+
+80
+00:05:10,050 --> 00:05:14,080
+جاهزة، أم أنا لسه بدي أعمل الـ format، الـ positioning،
+
+81
+00:05:14,080 --> 00:05:16,200
+أنا، أنا، أي الـ position بدي أعمل الـ assessment،
+
+82
+00:05:16,200 --> 00:05:19,760
+للمريض تبعي؟ قادر يكون بوضع supine position، إذا مش
+
+83
+00:05:19,760 --> 00:05:23,020
+قادر، هل هو في supine، هل هو في side lying، الـ grabbing،
+
+84
+00:05:23,020 --> 00:05:27,600
+كذا، هل هو قادر يتحمل تقييمي له؟ الـ preparation of
+
+85
+00:05:27,600 --> 00:05:30,760
+environment، تحضير البيئة، سواء اللي هو موجود فيها
+
+86
+00:05:30,760 --> 00:05:33,880
+في المستشفى أو في ما بعد، لما بده يروح على البيت، في
+
+87
+00:05:33,880 --> 00:05:36,800
+الـ home adaptation، الـ patient preparation، وتحضير
+
+88
+00:05:36,800 --> 00:05:40,930
+المريض، techniques اللي أنا ممكن أستخدمها، طبعًا بعض الـ
+
+89
+00:05:40,930 --> 00:05:44,030
+exercises، اللي هي إن شاء الله رب العالمين في العمل
+
+90
+00:05:44,030 --> 00:05:47,330
+اللي هتشوفوها، زي على سبيل المثال، كيف techniques اللي
+
+91
+00:05:47,330 --> 00:05:50,410
+أنا بدي أعلمه إياها، وأقدر أحصل عليه.
+
+92
+00:05:59,520 --> 00:06:02,140
+إذا، إذا أنا بدأت أستخدم الـ sitting position، هيكون
+
+93
+00:06:02,140 --> 00:06:06,160
+المريض تبعي في upright position، مع وضع طاولة تحت
+
+94
+00:06:06,160 --> 00:06:08,900
+اللي هو الـ foot، حتى نأتيك الـ foot في وضع الـ
+
+95
+00:06:08,900 --> 00:06:10,800
+dependent position، لأنه إذا كانت الـ foot في وضع الـ
+
+96
+00:06:10,800 --> 00:06:13,040
+dependent position، معناته الكلام أن أنا بدأت أعمل
+
+97
+00:06:13,040 --> 00:06:17,480
+اللي هو increase الـ swelling، وأدخل في مشاكل ثانية
+
+98
+00:06:17,480 --> 00:06:20,820
+من أول وجديد، الـ spine، اللي هو lying in a flat
+
+99
+00:06:20,820 --> 00:06:24,960
+back، الـ dorsal recumbent، اللي هو lying in back with
+
+100
+00:06:24,960 --> 00:06:29,950
+knee bent، طبعًا الرجلين بيكونوا، اللي هي ركبتين مثنيتين.
+
+101
+00:06:29,950 --> 00:06:33,550
+Sim's، اللي هي lying in either right or left side،
+
+102
+00:06:33,550 --> 00:06:37,230
+للـ lower arm behind of the body and upper arm bent
+
+103
+00:06:37,230 --> 00:06:40,710
+to shoulder and elbow، knee both bent، يعني على سبيل
+
+104
+00:06:40,710 --> 00:06:43,890
+المثال، هذا التعريف تقريبًا، احنا بنسميه ربع أو
+
+105
+00:06:43,890 --> 00:06:47,750
+النوم، اللي هي بنسميها ربع... ربع supine أو ربع
+
+106
+00:06:47,750 --> 00:06:50,650
+prone. هنشوفها إن شاء الله رب العالمين في الصور
+
+107
+00:06:50,650 --> 00:06:55,050
+القادمة، وهتكون واضحة بشكل أفضل. prone، طبعًا الـ
+
+108
+00:06:55,050 --> 00:06:59,600
+patient lying on abdomen، طبعًا على اللي هو على بطنه،
+
+109
+00:06:59,880 --> 00:07:02,680
+lying on me، الـ patient بيكون في وضع the
+
+110
+00:07:02,680 --> 00:07:05,100
+recumbent position، و الـ buttocks at edge of
+
+111
+00:07:05,100 --> 00:07:08,880
+examination table and the foot board by traps، يعني
+
+112
+00:07:08,880 --> 00:07:13,100
+المريض نايم على حافة اللي هو السرير، واللي هو
+
+113
+00:07:13,100 --> 00:07:18,180
+رجليه طالعين لبرا على طاولة لوحدها. هنشوفها أيضًا كمان
+
+114
+00:07:18,180 --> 00:07:21,640
+بالصور، الـ knee to chest، اللي هي using الـ knee
+
+115
+00:07:21,640 --> 00:07:25,860
+as to chest and the weight of body، بيسحب اللي هو
+
+116
+00:07:25,860 --> 00:07:28,600
+الـ crocular imposition، خليني أحكي عنه بعدين، أنه الـ
+
+117
+00:07:28,600 --> 00:07:33,810
+knee، بدي أشوفها، الـ standing position، هي موجودة في
+
+118
+00:07:33,810 --> 00:07:36,870
+الـ standing أم لا، هي دور the recumbent position،
+
+119
+00:07:36,870 --> 00:07:40,350
+طبعًا زي ما أنتم شايفين، نايم في الـ supine position،
+
+120
+00:07:40,350 --> 00:07:46,370
+واللي هي الـ knee اللي هي bent، و الـ foot at the
+
+121
+00:07:46,370 --> 00:07:51,870
+bed، هي الـ Sims position اللي أنا حكيت عليه، شبه ربع
+
+122
+00:07:51,870 --> 00:07:58,440
+supine أو ربع prone، طبعًا بيكون موجود في الـ Low
+
+123
+00:07:58,440 --> 00:08:01,420
+Latency، اللي هو طبعًا زي ما أنتم شايفين المريض هنا
+
+124
+00:08:01,420 --> 00:08:05,820
+عندي على حافة اللي هو الـ bed، واللي هو الـ legs
+
+125
+00:08:05,820 --> 00:08:09,980
+outside of the bed. تمام، طبعًا فيه منه low، فيه the
+
+126
+00:08:09,980 --> 00:08:14,200
+standard، وفيه اللي هي the chest، اللي هو أنه بدي
+
+127
+00:08:14,200 --> 00:08:17,680
+يكون عن الـ kneeling، يعني عن اللي هي الـ crack
+
+128
+00:08:17,680 --> 00:08:19,100
+position، الأربع.
+
+129
+00:08:26,500 --> 00:08:30,060
+and keep the patient warm during physical exam، إنه
+
+130
+00:08:30,060 --> 00:08:34,120
+أنا بدي أحاول أخلي المريض تبعي في نفس البيئة أو في
+
+131
+00:08:34,120 --> 00:08:37,200
+نفس الجو، اللي هو careful. تمام؟ إذا الـ preparation
+
+132
+00:08:37,200 --> 00:08:40,380
+and examination table، أحضر الطاولة، تكون كل شيء تمام،
+
+133
+00:08:40,380 --> 00:08:44,440
+الخصوصية تبع المريض هنا مهمة جدًا، مش لازم أنا أعدي
+
+134
+00:08:44,440 --> 00:08:47,640
+عنها، أو لازم أنا أسيبها وأقول يلا معلش، هذا شيء
+
+135
+00:08:47,640 --> 00:08:51,780
+كبير، وخلاص، مش مشكلة. لا، خصوصية المريض مهمة جدًا،
+
+136
+00:08:51,780 --> 00:08:55,460
+أنه أنا أعمل close لـ door of exam room، أنه أحسسه
+
+137
+00:08:55,460 --> 00:08:59,280
+بالأمان، أنه أنا بعمل الـ assessments داخل بيئة
+
+138
+00:08:59,280 --> 00:09:04,460
+آمنة، وأيضًا الـ tests of examination، الـ inspection، و
+
+139
+00:09:04,460 --> 00:09:07,500
+الـ palpation، و الـ percussion، و الـ auscultation.
+
+140
+00:09:07,500 --> 00:09:12,000
+الـ inspection، طبعًا بالملاحظة، ما
+
+141
+00:09:12,000 --> 00:09:14,500
+الـ techniques اللي أنا بدي أستخدمهم، بالملاحظة، أنا إيش
+
+142
+00:09:14,500 --> 00:09:17,540
+بدي أشوف؟ الـ observation، و listening and smelling
+
+143
+00:09:17,540 --> 00:09:20,320
+to the gathering data. بدي أستخدمهم في تجميع
+
+144
+00:09:20,320 --> 00:09:23,440
+معلوماتي. والله أنا شايفة بعيني، أنه على سبيل المثال،
+
+145
+00:09:23,440 --> 00:09:26,940
+الـ right hand more swelling than left hand. سامع
+
+146
+00:09:26,940 --> 00:09:30,760
+مثلًا، على سبيل المثال، في عندي قرقعة في الـ بطن، علشان
+
+147
+00:09:30,760 --> 00:09:34,320
+ما أن فيه شيء غير مضبوط في خلال اللي هو العملية
+
+148
+00:09:34,320 --> 00:09:37,360
+الجراحية اللي سويتها. الـ palpation، اللي هو عن طريق
+
+149
+00:09:37,360 --> 00:09:41,710
+الـ touch، كيف أنا بدي أحس الـ patient؟ هل في عنده، على
+
+150
+00:09:41,710 --> 00:09:44,850
+سبي المثال، في muscle shortening أم لا؟ الـ
+
+151
+00:09:44,850 --> 00:09:47,790
+percussion، اللي هو acting striking an object
+
+152
+00:09:47,790 --> 00:09:51,430
+against another to produce sound، أنه أنا على سبيل
+
+153
+00:09:51,430 --> 00:09:56,310
+المثال، لو عملت وخبطت على بطن هذا الشخص، هل هو في
+
+154
+00:09:56,310 --> 00:09:59,890
+هناك مثلًا، على سبيل المثال، air، هواء، أم لا موجود؟
+
+155
+00:09:59,890 --> 00:10:03,430
+بحسب اللي هو الـ auscultation، اللي هي عبارة عن
+
+156
+00:10:03,430 --> 00:10:06,390
+السماعة، أنه أنا بدي اسمع الصوت عن طريق
+
+157
+00:10:06,390 --> 00:10:10,250
+الـ stethoscope، sound to produce within the body. كل
+
+158
+00:10:10,250 --> 00:10:14,770
+هذه الأشياء، سأشرحها واحدة واحدة. الـ inspection is a
+
+159
+00:10:14,770 --> 00:10:17,210
+declarative and purposeful observation in
+
+160
+00:10:17,210 --> 00:10:20,870
+scientific manners. هي عبارة عن حاجات مهمة ودقيقة
+
+161
+00:10:20,870 --> 00:10:24,490
+ممكن أنا أشوفها بعيني، use the physical sense. طبعًا
+
+162
+00:10:24,490 --> 00:10:28,350
+عن طريق الـ visual، hearing and smell. طبعًا بالملاحظة
+
+163
+00:10:28,350 --> 00:10:32,030
+أنا ممكن أشوف بعيني، أحس بإيدي، وأيضًا أسمع بأذني، و
+
+164
+00:10:32,030 --> 00:10:37,290
+أشم بأنفي. Examination and Equipment used to
+
+165
+00:10:37,290 --> 00:10:40,410
+inspection، طبعًا، ما الأجهزة اللي أنا ممكن أستخدمها؟
+
+166
+00:10:40,410 --> 00:10:45,230
+العين لها أجهزة خاصة فيها، الأنفل، وأجهزة خاصة فيه،
+
+167
+00:10:45,230 --> 00:10:48,750
+وكذلك الفم، الـ ophthalmoscope أو الفيوناسكوب، اللي هي الـ
+
+168
+00:10:48,750 --> 00:10:51,590
+examination اللي بعمله للـ eyes. طبعًا هذا بخص
+
+169
+00:10:51,590 --> 00:10:55,950
+إخواننا في البصريات، فبيشتغلوا عليه. الـ otoscope، شيء
+
+170
+00:10:55,950 --> 00:10:59,270
+خاص، طالما قلنا، حكينا عنه، للـ ear، mouth and nose،
+
+171
+00:10:59,270 --> 00:11:03,310
+trails. الـ Tuning Fork، اللي هي عبارة عن الـ Hearing
+
+172
+00:11:03,310 --> 00:11:07,390
+Nose، اللي هي الشوكة الرنانة اللي احنا بنعمل و
+
+173
+00:11:07,390 --> 00:11:11,190
+بنشتغل فيها واحنا في ابتدائي، الـ Nasal Speculum،
+
+174
+00:11:11,190 --> 00:11:14,810
+الـ فیزیوز and Treatments of the Nose، والفيوناسكوب، اللي
+
+175
+00:11:14,810 --> 00:11:20,730
+هو عبارة عن السماعة اللي موجودة عند الطبلة. الـ
+
+176
+00:11:20,730 --> 00:11:24,370
+instruments أيضًا، لاستخدامنا أو لبحثنا على اللي
+
+177
+00:11:24,370 --> 00:11:28,770
+هو الـ vision أو اللي هو الرؤية، اللي هو الـ chart،
+
+178
+00:11:28,770 --> 00:11:33,130
+هذا اللي بيبقى موجود عند أخصائي البصريات عشان أنه
+
+179
+00:11:33,130 --> 00:1
+
+223
+00:14:30,390 --> 00:14:34,590
+لكن مش هيبان عليه إيجابي الترم الترم ومافيش
+
+224
+00:14:34,590 --> 00:14:37,430
+عنده مشكلة بدي أشوف في الفيلم الـ history إذا عنده
+
+225
+00:14:37,430 --> 00:14:41,370
+مثلا على سبيل المثال أمراض سكري في العيلة في عندهم
+
+226
+00:14:41,370 --> 00:14:44,790
+أمراض مزمنة في عندهم شيء بتورثوه أو لا، الـ review
+
+227
+00:14:44,790 --> 00:14:48,490
+للـ organ system بدي أشوف كل الـ organ system و
+
+228
+00:14:48,490 --> 00:14:52,200
+الأعضاء، الـ patient illness بدي أحكي على الـ
+
+229
+00:14:52,200 --> 00:14:57,460
+location بدي أحكي على الـ quality، جدّي كمية الألم و
+
+230
+00:14:57,460 --> 00:15:00,860
+الـ severity تبع الألم، الـ timing هل هو أنه بيجي
+
+231
+00:15:00,860 --> 00:15:04,900
+يروح الألم، ولا مستمر، ولا كم مرة في اليوم بيجيها
+
+232
+00:15:04,900 --> 00:15:09,870
+المغص، لهذه السنة، sitting and watching to develop أنه
+
+233
+00:15:09,870 --> 00:15:14,550
+طبعا جدّي اللي هو بتطور الألم عندها، شو العوامل اللي
+
+234
+00:15:14,550 --> 00:15:18,450
+بتزيد الألم، على سبيل المثال هي اجتمعت بمغص ملاحي
+
+235
+00:15:18,450 --> 00:15:22,150
+دخلت قسم الباطنة، معناه الكلام، إذا حسيت أنه أنا
+
+236
+00:15:22,150 --> 00:15:26,010
+فعلا هي الست اجتمع اليوم وحالتها كانت سيئة جداً
+
+237
+00:15:26,010 --> 00:15:30,630
+معناه نسألها إذا هي أكلت أكل بسم أو ما أكلتش عشان
+
+238
+00:15:30,630 --> 00:15:31,590
+يزيد المغص
+
+239
+00:15:38,740 --> 00:15:41,820
+most important disease chronologically، disease زي
+
+240
+00:15:41,820 --> 00:15:45,260
+على سبيل المثال الـ diabetes و الـ hypertension، الـ
+
+241
+00:15:45,260 --> 00:15:48,580
+operations، بدأ أشوف هل عملت عملية جديدة كده أو هذا
+
+242
+00:15:48,580 --> 00:15:52,840
+الشخص اللي جاي عندي، عمل car accident ولا لا
+
+243
+00:15:52,840 --> 00:15:56,600
+allergic، هل عندك حساسية من بعض الأدوية اللي احنا
+
+244
+00:15:56,600 --> 00:16:01,260
+مثلاً هنعطيها إياها، على سبيل المثال، في عندها أخذت
+
+245
+00:16:01,260 --> 00:16:04,420
+بعض اللقاحات، طبعاً هل اتحسست منهم أو لا، الـ
+
+246
+00:16:04,420 --> 00:16:07,650
+transfusions، عملت نقل مثلاً، على سبيل المثال، إذا
+
+247
+00:16:07,650 --> 00:16:10,550
+أنا بدي أعملها نقل لدم أو نقل لشيء، هل في عندها
+
+248
+00:16:10,550 --> 00:16:14,330
+مشكلة أو لا، استخدمنا test، طبعاً اللي هو الـ
+
+249
+00:16:14,330 --> 00:16:16,630
+comprehensive test أخذناه في system measurement
+
+250
+00:16:16,630 --> 00:16:21,350
+اللي هو عبارة عن شيء تقييم شامل و كامل في
+
+251
+00:16:21,350 --> 00:16:25,070
+البرنامج، current health status أو الحالة الصحية
+
+252
+00:16:25,070 --> 00:16:29,210
+الحالية، social circumstances، هل هو على سبيل المثال
+
+253
+00:16:29,210 --> 00:16:33,790
+متزوج، أعزب، مطلق، هذا لازم يهمني لأنه بدنا نشوف إذا
+
+254
+00:16:33,790 --> 00:16:37,680
+كان على سبيل المثال في عنده مشاكل في البيت أو لا؟
+
+255
+00:16:37,680 --> 00:16:40,820
+وأيضاً الـ occupations اللي هي عبارة عن الوظيفة، أنه
+
+256
+00:16:40,820 --> 00:16:44,300
+هل كان مثلاً موظف ومازال على رأس عمله، ولا كان موظف
+
+257
+00:16:44,300 --> 00:16:47,460
+واتقاعد؟ حد بيفرق معايا كمان في التعامل، الـ
+
+258
+00:16:47,460 --> 00:16:50,120
+environmental hazard، هل هو في عنده مخاطر بيئية
+
+259
+00:16:50,120 --> 00:16:53,100
+اللي هو فيها، في الـ school، في الـ workplace؟ هل أنه
+
+260
+00:16:53,100 --> 00:16:57,760
+صحّي، يضلّ أو لا؟ اتبعت اللي هم الأكل، طبعاً واللي هم
+
+261
+00:16:57,760 --> 00:17:02,860
+عملية تنظيم و control of feeding، الكحول، and illicit
+
+262
+00:17:02,860 --> 00:17:07,380
+طبعاً الـ drugs، بعض اللي هو، هل هو ممكن يكون مدمنين
+
+263
+00:17:07,380 --> 00:17:10,020
+لكحول، زي ما هذا الشيء مش موجود عندنا، طبعاً موجود
+
+264
+00:17:10,020 --> 00:17:14,280
+برا، اتباعه هو، هل هو مستخدم، أو هو هل هو مدخن أو لا
+
+265
+00:17:14,280 --> 00:17:17,640
+الـ current medications اللي هي الأدوية الحالية
+
+266
+00:17:17,640 --> 00:17:20,980
+اللي بياخذها، أدوية للسكري، أدوية للضغط، أدوية لأي
+
+267
+00:17:20,980 --> 00:17:24,660
+أمراض مزمنة أخرى، exercise and leisure activities
+
+268
+00:17:24,660 --> 00:17:28,320
+هيك كيف بيقضي نهاره، هل هو بيلعب رياضة ولا بيلعبش
+
+269
+00:17:28,320 --> 00:17:32,900
+رياضة، sexual history طبعاً، و الـ sleep patterns مهم
+
+270
+00:17:32,900 --> 00:17:37,310
+جداً، history طبعاً بدي أشوف الـ parents، الـ siblings، الـ
+
+271
+00:17:37,310 --> 00:17:40,870
+children، هل الآباء موجودين، مش موجودين؟ الأطفال في
+
+272
+00:17:40,870 --> 00:17:43,950
+عندهم أطفال ولا ما عندهم؟ أعمارهم، و الـ health
+
+273
+00:17:43,950 --> 00:17:47,040
+status بتاعتهم؟ بدي أشوف في الـ family history هل في
+
+274
+00:17:47,040 --> 00:17:49,460
+ديابتس ولا لا زي ما حكينا، في hypertension،
+
+275
+00:17:49,940 --> 00:17:53,280
+infection disease، malignancy، coagulation
+
+276
+00:17:53,280 --> 00:17:56,160
+disorders، بعض الحالات اللي هي الـ hematology طبعاً
+
+277
+00:17:56,160 --> 00:17:59,580
+اللي موجودة عندنا، بعض أمراض الدم، و الـ psychiatric
+
+278
+00:17:59,580 --> 00:18:02,400
+disease على سبيل المثال، و الـ symptoms of those
+
+279
+00:18:02,400 --> 00:18:05,020
+patients، و بدنا نشوف طبعاً كل
+
+280
+00:18:10,330 --> 00:18:14,350
+general status and gender and race، بدي أشوف الحالة
+
+281
+00:18:14,350 --> 00:18:17,950
+بشكل عام، الـ body built، الـ postural، الـ usual weight
+
+282
+00:18:17,950 --> 00:18:20,770
+الـ weight change، هل أنه صار فيه تغيير بسبب المرض
+
+283
+00:18:20,770 --> 00:18:24,170
+مثلاً على الوزن أو لا، according to organs، على سبيل
+
+284
+00:18:24,170 --> 00:18:28,030
+المثال بدنا نشوف الـ skin، و الـ head، و الـ ear، لأنه
+
+285
+00:18:28,030 --> 00:18:31,990
+احنا في قسم الباطنة اللي هو قسم الأمراض طبعاً، وبعده
+
+286
+00:18:31,990 --> 00:18:34,390
+زي ما حكينا بتتوزع الحالات
+
+287
+00:18:36,950 --> 00:18:40,270
+الـ appearance، بعض الحالات زي ما حكيت لكم بكون عندها
+
+288
+00:18:40,270 --> 00:18:45,390
+بلاوي كتيرة، ولكن بتجيني بمظهر قوي وكويس، وكأنه ما في
+
+289
+00:18:45,390 --> 00:18:49,030
+عندهم شيء، لكن بعض الحالات ممكن تكون تشتكي من ألم
+
+290
+00:18:49,030 --> 00:18:53,210
+بسيط، ولكن وضعها سيء، الـ Appearance طبعاً
+
+291
+00:18:53,210 --> 00:18:56,170
+الـ hygiene، بدي أشوف الـ grooming، هل هو أنه قادر على
+
+292
+00:18:56,170 --> 00:19:00,110
+سبيل المثال ينظف نفسه بنفسه ولا بده مساعدة، Signs
+
+293
+00:19:00,110 --> 00:19:04,010
+of illness، أعراض المرض، هل واضح عليه ولا لا، الـ
+
+294
+00:19:04,010 --> 00:19:06,850
+affect، و الـ mood، و الـ attitude، طبعاً هذه الحالات
+
+295
+00:19:06,850 --> 00:19:10,770
+الأشياء اللي هي psychological موجودة عنده، الـ reach
+
+296
+00:19:10,770 --> 00:19:15,290
+and social expression، الـ cognitive process طبعاً
+
+297
+00:19:15,290 --> 00:19:19,890
+اللي هي الأمور الإدراكية، زي الـ speech content، الـ
+
+298
+00:19:19,890 --> 00:19:23,010
+pattern، الـ orientation، و الـ appropriated verbal
+
+299
+00:19:23,010 --> 00:19:27,090
+response، كل الأمور اللي موجودة في الـ cognitive، هل
+
+300
+00:19:27,090 --> 00:19:31,810
+إنها سليمة أو ممتازة، different signs، طبعاً الـ vital
+
+301
+00:19:31,810 --> 00:19:34,650
+signs اللي موجودين، احنا عارفين الـ vital signs هي
+
+302
+00:19:34,650 --> 00:19:39,570
+عبارة عن العلامات الحيوية اللي بتكون موجودة، الـ height
+
+303
+00:19:39,570 --> 00:19:42,450
+and weight كمان، هحكي عليهم، الـ vital signs اللي
+
+304
+00:19:42,450 --> 00:19:44,790
+إنتوا بتشوفوا التمريض بييجوا بياخدوهم، هو عبارة عن
+
+305
+00:19:45,030 --> 00:19:48,590
+خمسة vital signs، الـ heart rate، و الـ temperature، و
+
+306
+00:19:48,590 --> 00:19:53,110
+الأمور الأخرى، هتحددها للـ normal أو abnormal، هل هي
+
+307
+00:19:53,110 --> 00:19:56,390
+طبيعية اليوم كانت في أثناء المرور الصباحي ولا لا
+
+308
+00:19:56,390 --> 00:20:00,450
+الـ height and weight decrement، طبعاً شكل الـ height
+
+309
+00:20:00,450 --> 00:20:02,930
+and weight decrement، بعد اللي هو الـ patient under
+
+310
+00:20:02,930 --> 00:20:07,450
+normal or under weight، لازم أحس أنه تمام ولا لا
+
+311
+00:20:07,450 --> 00:20:11,030
+بدي أعمل أيضاً assessment لـ الـ head and neck، الـ
+
+312
+00:20:11,030 --> 00:20:14,050
+head، بتشوف الـ skin، و الـ face، و الـ skull، و الـ scalp
+
+313
+00:20:14,050 --> 00:20:17,450
+أيضاً الـ nose، و الـ senses، و الـ mouth، و الـ pharynx
+
+314
+00:20:17,450 --> 00:20:21,750
+و الـ cranial nerve، كل هذه الأمور أنا بقيمها لأنه
+
+315
+00:20:21,750 --> 00:20:25,270
+بدي أشوف المشكلة من وين اجت، الـ neck بدي أشوف فيه
+
+316
+00:20:25,270 --> 00:20:27,990
+عندي الـ skin، و الـ lymph nodes، و الـ muscle، هل في
+
+317
+00:20:27,990 --> 00:20:34,010
+muscle shortening، هل في muscle contractures ولا لا
+
+318
+00:20:34,010 --> 00:20:37,530
+الـ thyroid، و الـ trachea، و الـ carotid طبعاً، arteries
+
+319
+00:20:37,530 --> 00:20:43,340
+and neck veins، بدي أشوف فيهم مشاكل، أشوف الـ skull و
+
+320
+00:20:43,340 --> 00:20:46,780
+الـ face، إيش طبعاً بدي أشوف فيهم inspected للـ size
+
+321
+00:20:46,780 --> 00:20:49,300
+and shape، و الـ symmetry، بدي أشوف هل الـ right نفس
+
+322
+00:20:49,300 --> 00:20:53,600
+الـ left ولا فيها مشكلة، الـ Face، بدي أشوف هل هو الـ
+
+323
+00:20:53,600 --> 00:20:57,120
+exam للـ colors، هل هو ماشاء الله عليه، مورد المريض
+
+324
+00:20:57,120 --> 00:21:01,660
+تبعي، وبنكو، والأمور تمام تمام، ولا pale و شاحب
+
+325
+00:21:01,660 --> 00:21:04,380
+الـ symmetry، هل الـ right نفس الـ left ولا في عندنا
+
+326
+00:21:04,380 --> 00:21:08,020
+مشكلة، الـ distribution للـ facial hair طبعاً، و الـ
+
+327
+00:21:08,020 --> 00:21:11,920
+assessment للـ facial nerve and facial muscle، بدي
+
+328
+00:21:11,920 --> 00:21:17,330
+أشوف وأقيم كمان بشكل عام الوجه، trachea طبعاً، not
+
+329
+00:21:17,330 --> 00:21:20,350
+displaced، بدي أشوف ليه trachea في وضعها ولا مش
+
+330
+00:21:20,350 --> 00:21:25,250
+وضعها، الـ midline in suprasternal notch طبعاً بتكون
+
+331
+00:21:25,250 --> 00:21:30,170
+في المنتصف، هل فيها مشكلة للـ trachea ولا لا، طبعاً الـ
+
+332
+00:21:30,170 --> 00:21:33,750
+thyroid لازم أشوف إذا فيها مشكلة أو لا، normal، not
+
+333
+00:21:33,750 --> 00:21:36,790
+elevation، و الـ elevation of size، و الـ symmetry
+
+334
+00:21:36,790 --> 00:21:39,870
+تبعها، هل فيها tenderness أو لا، الـ lymph nodes زي
+
+335
+00:21:39,870 --> 00:21:42,390
+ما إنتوا بتعرفوا، جهاز lymphatic system هو عبارة
+
+336
+00:21:42,390 --> 00:21:46,670
+عن جهاز مهم جداً، أنا كمان لازم أقيمه وأشوفه، فيه
+
+337
+00:21:46,670 --> 00:21:49,990
+أمراض الباطنة، generally not palpable، its
+
+338
+00:21:49,990 --> 00:21:53,470
+palpation should be small، mobile، small، not tender
+
+339
+00:21:53,470 --> 00:21:56,930
+طبعاً أنا بحس أحياناً اللي هي أسامي الميتال
+
+340
+00:21:56,930 --> 00:21:59,610
+الـ small، ممكن تحسها هي بالـ palpation، لكن بالعادة
+
+341
+00:21:59,610 --> 00:22:03,610
+ما بنحس، ولكن بعض الأجزاء البسيطة منه أو المكونات
+
+342
+00:22:03,610 --> 00:22:05,590
+اللي هي الـ lymphatic system ممكن أنا أحسها
+
+343
+00:22:05,590 --> 00:22:08,650
+abnormal and enlarged indicated، معناته infection
+
+344
+00:22:08,650 --> 00:22:13,210
+و الـ autoimmune، و metastases of cancer، على سبيل
+
+345
+00:22:13,210 --> 00:22:16,270
+المثال، لما بيجي بيحس اللوز لأي طفل صغير، إذا كانت
+
+346
+00:22:16,270 --> 00:22:20,650
+كبيرة ومضخمة بنقول هذا بداية influenza أو أنه هو
+
+347
+00:22:20,650 --> 00:22:25,330
+لوزة، ميزة أيضاً الـ eye و الـ ears، لما أنا بدي أجي
+
+348
+00:22:25,330 --> 00:22:28,830
+أقيمهم، inspection للـ External و الـ Structural و
+
+349
+00:22:28,830 --> 00:22:33,610
+بدي أشوف الـ eyelids and ears، اللي هي العدسة و
+
+350
+00:22:33,610 --> 00:22:37,630
+القرنية، وكل المكونات اللي موجودة عندي في الـ eyes
+
+351
+00:22:37,630 --> 00:22:41,920
+بدي أشوف هل في احمرار، فيش احمرار، هل متسعة، ولا على سبيل
+
+352
+00:22:41,920 --> 00:22:44,760
+المثال فيها مشكلة، الـ internal structure اللي
+
+353
+00:22:44,760 --> 00:22:49,280
+موجودة، والرؤية هل هي مناسبة ولا مش مناسبة، أيضاً في
+
+354
+00:22:49,280 --> 00:22:52,640
+الـ assessment للـ ear، بدي أشوف المريض تبعي في
+
+355
+00:22:52,640 --> 00:22:57,560
+الأذن الخارجية، هل هو سامعني مريضي أو مش سامعني، طبعاً
+
+356
+00:22:57,560 --> 00:23:01,060
+و الـ location bilaterally، ear should be smooth
+
+357
+00:23:01,060 --> 00:23:05,000
+gently palpation، و check للـ hearing، وأيضاً بنحس و
+
+358
+00:23:05,000 --> 00:23:09,800
+بنشوف هل هو قادر أن يتواصل معنا ولا بس سامعنا و
+
+359
+00:23:09,800 --> 00:23:11,040
+مش قادر يردّ عليّ
+
+360
+00:23:20,710 --> 00:23:25,690
+هنا الـ Vagoma طبعاً هي عبارة عن وجود ماء أو نسميها
+
+361
+00:23:25,690 --> 00:23:29,350
+الماء الأبيض اللي موجودة في العين، الـ healthy ear
+
+362
+00:23:29,350 --> 00:23:34,270
+اللي هي أذن سليمة، وهنشوف الـ otitis media، التهاب
+
+363
+00:23:34,270 --> 00:23:39,510
+في الأذن، الوصف كيف؟ طبعاً بتكون مؤلمة، و زي ما
+
+364
+00:23:39,510 --> 00:23:43,250
+بتعرفوا بتأثر على الـ equilibrium، و إن هو الـ balance
+
+365
+00:23:43,250 --> 00:23:47,170
+اللي موجود عند المريض، الـ chronic otitis media
+
+366
+00:23:47,170 --> 00:23:55,300
+طبعاً هذه، طبعاً اللي هي التهابات الأذن الوسطى، بدي
+
+367
+00:23:55,300 --> 00:23:58,880
+أشوف الـ noise، هل في مشاكل أو لا، بدي أشوف هل الـ
+
+368
+00:23:58,880 --> 00:24:02,280
+right فتحة الـ right نفس فتحة الـ left أو لا، بدي
+
+369
+00:24:02,280 --> 00:24:05,540
+أشوف الـ button في الـ open button away، هل إنه قادر
+
+370
+00:24:05,540 --> 00:24:08,840
+يأخذ نفسه مباشرة من غير أي وسائط ولا لازم يكون في
+
+371
+00:24:08,840 --> 00:24:13,280
+عندي اللي هو وسائط أخرى زي التنفس الصناعي على سبيل
+
+372
+00:24:13,280 --> 00:24:16,410
+المثال، الـ senses اللي هي عبارة عن الجيوب الأنفية
+
+373
+00:24:16,410 --> 00:24:18,710
+وكلكم بتعرفوا أن الجيوب الأنفية هي عبارة عن أربع
+
+374
+00:24:18,710 --> 00:24:21,730
+أزواج موجودة عندنا، طبعاً هذه الجيوب الأنفية
+
+375
+00:24:21,730 --> 00:24:24,490
+infection of the senses and gentle palpation of
+
+376
+00:24:24,490 --> 00:24:28,790
+maxillary، بدي أشوف طبعاً بإحساسي إنهم في الـ
+
+377
+00:24:28,790 --> 00:24:32,390
+maxilla bone، زي ما بتعرفوا في اللي هو الـ head bone
+
+378
+00:24:32,390 --> 00:24:35,150
+اللي موجودة عندنا، normally the senses are not
+
+379
+00:24:35,150 --> 00:24:39,030
+tender، إذا كان هو، اللي حأطب إيدي على أعلى اللي
+
+380
+00:24:39,030 --> 00:24:43,170
+هو الأنف، ما أحس المريض بوجع، معناته احنا كالسليم، لكن
+
+381
+00:24:43,170 --> 00:24:47,350
+إذا حسّ واتألم بيكون في عنده مشكلة في جيوب الأنفية
+
+382
+00:24:47,350 --> 00:24:51,430
+الهيمات هم طبعاً إذا كان في عنده مشكلة في جيوب
+
+383
+00:24:51,430 --> 00:24:56,070
+الأنفية، هنا طبعاً الـ الـ bodies اللي هو انحراف و
+
+384
+00:24:56,070 --> 00:25:01,710
+عوجاج في اللي هو الأنف، الـ mouth and pharynx اللي
+
+385
+00:25:01,710 --> 00:25:05,670
+هو الفم والحلق، لازم أنا أشوف طبعاً هذا باعتبار
+
+386
+00:25:05,670 --> 00:25:07,810
+عن الفم، هو عبارة عن الـ entrance للـ digestive
+
+387
+00:25:07,810 --> 00:25:12,210
+system، مدخل الجهاز الهضمي، لازم أشوف هل هو سليم ولا
+
+388
+00:25:12,210 --> 00:25:15,170
+مش سليم، الـ lips، و الـ tongue، و الـ teeth، و كل هذه
+
+389
+00:25:15,170 --> 00:25:18,920
+الأمور لازم أنا أشوفها، الـ equipment needed، طبعاً بدي
+
+390
+00:25:18,920 --> 00:25:22,580
+أشوف إذا في عندي tongue depressors، في عندي اللي هو
+
+391
+00:25:22,580 --> 00:25:26,660
+الـ pink light، و الـ gauze، و الـ sponge، and gloves، طبعاً
+
+392
+00:25:26,660 --> 00:25:31,060
+ليش؟ لأن هذه الشغلات لازم عشان أقيم اللي هو فم
+
+393
+00:25:31,060 --> 00:25:36,560
+المريض، شايفين في tonsillitis، التهاب للوزتين زي ما هو
+
+394
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/wNb3Lpr7VxM_postprocess.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/wNb3Lpr7VxM_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..a9e76a268b818b52eede246b70d0cc85195c8a98
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/wNb3Lpr7VxM_postprocess.srt
@@ -0,0 +1,1676 @@
+1
+00:00:01,700 --> 00:00:04,720
+الرحمن الرحيم والصلاة والسلام على أشرف الأبيعي
+
+2
+00:00:04,720 --> 00:00:09,960
+والمرسلين سأتحدث في هذا المثاق عن العلاج الطبيعي
+
+3
+00:00:09,960 --> 00:00:14,900
+لأمراض الباطنة والقلب والصدر تمام فهي عبارة عن
+
+4
+00:00:14,900 --> 00:00:19,800
+ثلاث محاور أساسية سنتطرق في البداية لنحور أمراض
+
+5
+00:00:19,800 --> 00:00:23,200
+الباطنة هذه المحاضرة بعنوان introduction of
+
+6
+00:00:23,200 --> 00:00:28,100
+internal medicine أي مقدمة لأمراض أو العلاج
+
+7
+00:00:28,100 --> 00:00:32,580
+الطبيعي لأمراض الباطنة والمسنينسأتحدث فيها عن من
+
+8
+00:00:32,580 --> 00:00:36,340
+هو أو من هو الذي يزاول الـ Internal Medicine أو من
+
+9
+00:00:36,340 --> 00:00:40,940
+هو الأخصاء الباطني وكذلك سأتطرق إلى الـ
+
+10
+00:00:40,940 --> 00:00:44,200
+Physiotherapy Assessments in Internal Medicine
+
+11
+00:00:44,200 --> 00:00:48,920
+Conditions لحالات اللي هي اللي لنا دور فيها في قسم
+
+12
+00:00:48,920 --> 00:00:54,600
+الباطنة نبدأ على بركة الله الـ Internist اللي هي
+
+13
+00:00:54,600 --> 00:00:58,940
+من هو الـ Internist هو عبارة عن Specialistطبيب
+
+14
+00:00:58,940 --> 00:01:01,980
+متخصص في الـ Adult Medicine who provide majority
+
+15
+00:01:01,980 --> 00:01:05,760
+of health care to adults in hospital or in the
+
+16
+00:01:05,760 --> 00:01:09,640
+office لذا هو عبارة عن طبيب متخصص موجود في قسم
+
+17
+00:01:09,640 --> 00:01:12,940
+الباطنة وهو عبارة عن الشريان الرئيسي في المستشفى
+
+18
+00:01:12,940 --> 00:01:16,880
+ومن بعد ذلك بتتم توزيع وتصنيع الحالات
+
+19
+00:01:19,110 --> 00:01:23,330
+الـ Intrinsic عرفنا إن أنا عرفش شو الدور تبعه
+
+20
+00:01:23,330 --> 00:01:27,570
+Provide comprehensive and continuity caring اللي
+
+21
+00:01:27,570 --> 00:01:32,480
+هو primary care to adults and elderlyبيقدّم رعاية
+
+22
+00:01:32,480 --> 00:01:36,520
+شاملة و كاملة ل ال woman healthcare depression and
+
+23
+00:01:36,520 --> 00:01:40,280
+anxiety بيعالج دي ل acute and chronic medical
+
+24
+00:01:40,280 --> 00:01:43,820
+conditions أيضا بيعمل treatment ل الepisodic
+
+25
+00:01:43,820 --> 00:01:47,140
+urgent and emergency conditions arrange a
+
+26
+00:01:47,140 --> 00:01:50,900
+consultation with other physicians بينسق مع
+
+27
+00:01:50,900 --> 00:01:54,340
+الأطباء الآخرين الموجودين preoperative and
+
+28
+00:01:54,340 --> 00:01:58,340
+evaluation for surgical colleagues تمام؟ هاي دور
+
+29
+00:01:58,340 --> 00:02:02,700
+اللي هو أخصائيالأقصاء الباطنة هما specialists
+
+30
+00:02:02,700 --> 00:02:06,720
+field متخصصين في كذا مجال، في عندنا الأدوية
+
+31
+00:02:06,720 --> 00:02:11,200
+medicine، في عندنا ال allergy and immunology،
+
+32
+00:02:11,200 --> 00:02:14,340
+cardiovascular، ال endocrine، infectious disease
+
+33
+00:02:14,610 --> 00:02:17,570
+الـ gastric endocrinology و الـ geriatric
+
+34
+00:02:17,570 --> 00:02:21,190
+hematology أيضا اللي هو الـ hepatology اللي له
+
+35
+00:02:21,190 --> 00:02:24,070
+علاقة بالـ hepatites أو الـ hepat .. hepatology
+
+36
+00:02:24,070 --> 00:02:26,950
+اللي هو له علاقة بالـ liver أيضا الـ nephrology
+
+37
+00:02:26,950 --> 00:02:29,650
+اللي له علاقة بالـ kidney الـ ochronology اللي له
+
+38
+00:02:29,650 --> 00:02:32,790
+علاقة بالـ gynecology كمان و الـ pulmonary disease
+
+39
+00:02:32,790 --> 00:02:36,750
+and care medicines و ال rheumatology علم الأورام
+
+40
+00:02:36,750 --> 00:02:43,730
+as في علم اللي هو ال rheumatology هو عبارة عنالـ
+
+41
+00:02:43,730 --> 00:02:46,650
+Rheumatism علم الـ Rheumatism و أيضا في عندنا ناس
+
+42
+00:02:46,650 --> 00:02:53,010
+متخصصة بنسليب medicine هيكلها سأتحدث الآن عن ال
+
+43
+00:02:53,010 --> 00:02:55,810
+health assessment او ال physiological assessment
+
+44
+00:02:55,810 --> 00:03:00,610
+اللي هيكون موجود في قسم الباطنة اللي موجود في اي
+
+45
+00:03:00,610 --> 00:03:04,910
+موضوع من بعض تبع ال diagnosis اللي هي في عندنا ال
+
+46
+00:03:04,910 --> 00:03:08,310
+pathological, etiological, anatomically and
+
+47
+00:03:08,310 --> 00:03:11,900
+prognosticإذن هتحدث على ال pathological هذا المرض
+
+48
+00:03:11,900 --> 00:03:15,280
+ليش داخل المستشفى؟ شو السبب اللي خلى يكون عنده
+
+49
+00:03:15,280 --> 00:03:18,400
+الزايدة على سبيل المثال ال anatomical وضع زايدة شو
+
+50
+00:03:18,400 --> 00:03:21,920
+هي و شو دورها و شو صار بعد العملية الجراحية ال
+
+51
+00:03:21,920 --> 00:03:27,240
+prognosis هل هو اتحسن ولا لأ؟ في عند ال patient
+
+52
+00:03:27,240 --> 00:03:29,900
+history في عند ال physical examination و ال
+
+53
+00:03:29,900 --> 00:03:32,740
+laboratory and instrumental examination بدي أشوف
+
+54
+00:03:32,740 --> 00:03:34,880
+في ال patient history في عند ال birth history في
+
+55
+00:03:34,880 --> 00:03:38,200
+عند ال medical history اللي هو ال present history
+
+56
+00:03:38,550 --> 00:03:41,490
+الـ physical examination كل الأختبارات الفيزيائية
+
+57
+00:03:41,490 --> 00:03:44,490
+على سبيل المثال اللي أخدناها في test and
+
+58
+00:03:44,490 --> 00:03:46,870
+measurement وأيضا في liberty and instrument
+
+59
+00:03:46,870 --> 00:03:51,250
+examination بعض اللي هو التحاليل اللي بتنطلبها من
+
+60
+00:03:51,250 --> 00:03:56,470
+قبل الأخصائي والدكتورة guidelines established a
+
+61
+00:03:56,470 --> 00:03:58,730
+physical patient relationship لازم أنا أحدد
+
+62
+00:03:58,730 --> 00:04:01,670
+العلاقة بيني وبين ال patient عشان أبدأ أشتغل على
+
+63
+00:04:01,670 --> 00:04:05,610
+قاعدة سليمةبدي أجمع المعلومات physiological أو
+
+64
+00:04:05,610 --> 00:04:08,830
+psychologically أو cognitive أو psycho-cultural
+
+65
+00:04:08,830 --> 00:04:12,450
+developmental and spiritual كل هذه الأمور سواء
+
+66
+00:04:12,450 --> 00:04:16,550
+فيسيولوجية أو سيكولوجية أو روحانية لازم أنا أجمعها
+
+67
+00:04:16,550 --> 00:04:20,890
+و أبدأ بالشغل عليها identify لل patient stress بدي
+
+68
+00:04:20,890 --> 00:04:24,610
+أشوف قداش مقاييس القوة عنده اليوم هو على سبيل
+
+69
+00:04:24,610 --> 00:04:28,230
+المثال ده بتكفوت فارثي عنه amputation لقفوت معناه
+
+70
+00:04:28,230 --> 00:04:30,670
+ان الكلام بدي أشوف هل ال upper limb قوية ولا مش
+
+71
+00:04:30,670 --> 00:04:33,700
+قويةإذا قوية معناته أنا بدي أركز عليها و أزيد من
+
+72
+00:04:33,700 --> 00:04:36,840
+قوتها Identification للـ Actual and Potential
+
+73
+00:04:36,840 --> 00:04:40,700
+Health Problems أيضًا بدي أشوف اللي هو هل في عندي
+
+74
+00:04:40,700 --> 00:04:44,440
+نقاط قوة حقيقية موجودة ولا لأ القوي بدي أقوي و
+
+75
+00:04:44,440 --> 00:04:48,800
+أزيد من سعالته و لظيف بدي أحاول أتغلب على المشاكل
+
+76
+00:04:48,800 --> 00:04:52,040
+الموجودة فيه Established for the case of patient
+
+77
+00:04:52,040 --> 00:04:56,100
+of Physiotherapy Assessment Process لازم أحط قاعدة
+
+78
+00:04:56,100 --> 00:04:58,480
+لعملية اللي هي ال assessment process
+
+79
+00:05:04,690 --> 00:05:10,050
+الانسترمنت هل اللي هو فيه form موجودة عندى معينة و
+
+80
+00:05:10,050 --> 00:05:14,080
+جاهزةولا أنا لسه بدي أعمل ال format ال positioning
+
+81
+00:05:14,080 --> 00:05:16,200
+انا انا ايه ال position بدي اعمل ال assessment
+
+82
+00:05:16,200 --> 00:05:19,760
+المريض تبعي جادر يكون بوضع stink position اذا مش
+
+83
+00:05:19,760 --> 00:05:23,020
+جادر هل هو في subine هل هو في sideline ال grabbing
+
+84
+00:05:23,020 --> 00:05:27,600
+كدهش هو جادر يتحمل تقييمي له ال preparation of
+
+85
+00:05:27,600 --> 00:05:30,760
+environment تحضير البيئة سواء اللي هو موجود فيها
+
+86
+00:05:30,760 --> 00:05:33,880
+في المستشفى او في ما بعد لما بده يلوح على البيت في
+
+87
+00:05:33,880 --> 00:05:36,800
+ال home adaptation ال patient preparation وتحضير
+
+88
+00:05:36,800 --> 00:05:40,930
+المريضالتكنيكز اللى انا ممكن استخدمها طبعا بعض ال
+
+89
+00:05:40,930 --> 00:05:44,030
+exercise اللى هى ان شاء الله رب العالمين في العمل
+
+90
+00:05:44,030 --> 00:05:47,330
+اللى هتشوفوها زى على سبيل المثال كيف التكنيكز اللى
+
+91
+00:05:47,330 --> 00:05:50,410
+انا بدى اعلمله ياها و اقدر احصل عليه
+
+92
+00:05:59,520 --> 00:06:02,140
+أذا اذا انا بدأ أستخدم ال setting position هيكون
+
+93
+00:06:02,140 --> 00:06:06,160
+المريض تبعي في upright position مع وضع طاولة تحت
+
+94
+00:06:06,160 --> 00:06:08,900
+اللي هو ال foot حتى نأتك ال foot في وضع ال
+
+95
+00:06:08,900 --> 00:06:10,800
+dependent position لإنه اذا كانت ال foot في وضع ال
+
+96
+00:06:10,800 --> 00:06:13,040
+dependent position معناته الكلام ان انا بدأ اعمل
+
+97
+00:06:13,040 --> 00:06:17,480
+اللي هو increase ال swelling و ادخل في مشاكل تانية
+
+98
+00:06:17,480 --> 00:06:20,820
+من أول و جديد ال spine اللي هو lying in a flat
+
+99
+00:06:20,820 --> 00:06:24,960
+back ال dorsal underarm اللي هو lying in back with
+
+100
+00:06:24,960 --> 00:06:29,950
+knee bent طبعا الإجرين بتكوناللي هي ركبتين متنية
+
+101
+00:06:29,950 --> 00:06:33,550
+Similes اللي هي lines in either right or left side
+
+102
+00:06:33,550 --> 00:06:37,230
+لل lower arm behind of the body and upper arm bent
+
+103
+00:06:37,230 --> 00:06:40,710
+to shoulder and elbow knee both bent يعني على سبيل
+
+104
+00:06:40,710 --> 00:06:43,890
+المثال هذا التعريف تقريبا احنا بنسميه ربع او
+
+105
+00:06:43,890 --> 00:06:47,750
+النومة اللي هي بنسميها ربع .. ربع السبين او ربع
+
+106
+00:06:47,750 --> 00:06:50,650
+لبرون هنشوفها ان شاء الله رب العالمين في الصور
+
+107
+00:06:50,650 --> 00:06:55,050
+القادمة و هتكون واضحة بشكل افضل لبرون طبعا ال
+
+108
+00:06:55,050 --> 00:06:59,600
+patient name in abdomen طبعاعلى اللي هو على بطنه
+
+109
+00:06:59,880 --> 00:07:02,680
+letting to me ال patient بيكون في دور the
+
+110
+00:07:02,680 --> 00:07:05,100
+recumbent position و ال batox at edge of
+
+111
+00:07:05,100 --> 00:07:08,880
+examination table and the foot board by traps يعني
+
+112
+00:07:08,880 --> 00:07:13,100
+المرض نايم لي على حافة اللي هو السرير و اللي هو
+
+113
+00:07:13,100 --> 00:07:18,180
+إجري طالعين لبرا على تابل لوحدها هنشوفها أيضا كمان
+
+114
+00:07:18,180 --> 00:07:21,640
+بالصور ال knee to the chest اللي هي using ال knee
+
+115
+00:07:21,640 --> 00:07:25,860
+as to chest and the weight of body بيسحب اللي هو
+
+116
+00:07:25,860 --> 00:07:28,600
+ال crocolar imposition خليني أحكي عنه بعد أنه ال
+
+117
+00:07:28,600 --> 00:07:33,810
+knee بدي يقدمهاالـ standing position هى موجود فى
+
+118
+00:07:33,810 --> 00:07:36,870
+ال standing ولا لأ هى دور the recumbent position
+
+119
+00:07:36,870 --> 00:07:40,350
+طبعا زى ما انتوا شايفين نايم فى ال subine position
+
+120
+00:07:40,350 --> 00:07:46,370
+و اللى هى ال knee اللى هى bent و ال foot at the
+
+121
+00:07:46,370 --> 00:07:51,870
+bed هى ال sims position اللى أنا حكيت عليه شبه ربع
+
+122
+00:07:51,870 --> 00:07:58,440
+subine او ربع prone طبعا بيكون موجود فىالـLow
+
+123
+00:07:58,440 --> 00:08:01,420
+Latency اللى هو طبعا زى ما انتوا شايفين المريض هنا
+
+124
+00:08:01,420 --> 00:08:05,820
+عندى على حافة اللى هو ال bed و اللى هو ال legs
+
+125
+00:08:05,820 --> 00:08:09,980
+outside of the bed تمام طبعا فى منه low فى the
+
+126
+00:08:09,980 --> 00:08:14,200
+standard و فى اللى هى the chest اللى هو انه بدى
+
+127
+00:08:14,200 --> 00:08:17,680
+يكون عن ال kneeling يعنى عن اللى هى ال cack
+
+128
+00:08:17,680 --> 00:08:19,100
+position الأربع
+
+129
+00:08:26,500 --> 00:08:30,060
+and keep the patient warm during physical exam إنه
+
+130
+00:08:30,060 --> 00:08:34,120
+أنا بدي أحاول أخلي المريض تبعي في نفس البيئة أو في
+
+131
+00:08:34,120 --> 00:08:37,200
+نفس الجو اللي هو careful تمام؟ إذا ال preparation
+
+132
+00:08:37,200 --> 00:08:40,380
+and examination تابل أحضر الطاولة تكون كل إشي تمام
+
+133
+00:08:40,380 --> 00:08:44,440
+الخصوصية تبع المريض هنا مهمة جدا مش لازم أنا أعدي
+
+134
+00:08:44,440 --> 00:08:47,640
+عنها أو لازم أنا أسيبها و أقول يالا معلش هذا ستة
+
+135
+00:08:47,640 --> 00:08:51,780
+كبيرة و خلاص مش مشكلة لأ خصوصية المريض مهمة جدا
+
+136
+00:08:51,780 --> 00:08:55,460
+إنه أنا أعمل close ل door of exam roomإنهي أحاسسها
+
+137
+00:08:55,460 --> 00:08:59,280
+بالأمان إنه أنا بعملها ال assessments داخل بيئة
+
+138
+00:08:59,280 --> 00:09:04,460
+آمنة أيضا ال test of examination ال inspection و
+
+139
+00:09:04,460 --> 00:09:07,500
+ال palpation و ال percussions و ال percussions أثر
+
+140
+00:09:07,500 --> 00:09:12,000
+و ال isolation ال inspection طبعا بالملاحظة شو
+
+141
+00:09:12,000 --> 00:09:14,500
+التكنيكز اللي أنا بدي أستخدمهم بالملاحظة أنا إيش
+
+142
+00:09:14,500 --> 00:09:17,540
+بدي أشوف ال observation و listening and smelling
+
+143
+00:09:17,540 --> 00:09:20,320
+to the gathering dataبدي أستخدمهم في تجميع
+
+144
+00:09:20,320 --> 00:09:23,440
+معلوماتي والله أنا شايفة بعيني أنه على سبيل المثال
+
+145
+00:09:23,440 --> 00:09:26,940
+ال right hand more swelling than left hand سامع
+
+146
+00:09:26,940 --> 00:09:30,760
+مثلا على سبيل المثال في عناق قرقعة في ال بطن علشان
+
+147
+00:09:30,760 --> 00:09:34,320
+ما أنه في إشي مش مظبوط في الخلال اللي هو العملية
+
+148
+00:09:34,320 --> 00:09:37,360
+الجراحية اللي سويتها ال palpation اللي هو عن طريق
+
+149
+00:09:37,360 --> 00:09:41,710
+ال touch كيف أنا بدي أحس ال patient هل في عنديعلى
+
+150
+00:09:41,710 --> 00:09:44,850
+سبيل المثال في muscle shortening ولا لأ ال
+
+151
+00:09:44,850 --> 00:09:47,790
+percussion اللي هو acting stricken in the object
+
+152
+00:09:47,790 --> 00:09:51,430
+against another to produce sound انه انا على سبيل
+
+153
+00:09:51,430 --> 00:09:56,310
+المثال لو عملت وخبطت على بطن هذا الشخص هل هو في
+
+154
+00:09:56,310 --> 00:09:59,890
+هناك مثلا على سبيل المثال air حواء ولا مش موجود
+
+155
+00:09:59,890 --> 00:10:03,430
+بحسب اللي هو ال escalations اللي هي عبارة عن
+
+156
+00:10:03,430 --> 00:10:06,390
+السماعة انه انا بدي اسمع الدنيا عن طريق
+
+157
+00:10:06,390 --> 00:10:10,250
+الastroscope sound to produce within the body كل
+
+158
+00:10:10,250 --> 00:10:14,770
+هذه الشغلاتسحنها واحدة واحدة الinspection is a
+
+159
+00:10:14,770 --> 00:10:17,210
+declarative and purposeful observation in
+
+160
+00:10:17,210 --> 00:10:20,870
+scientific manners هي عبارة عن حاجات مهمة ودقيقة
+
+161
+00:10:20,870 --> 00:10:24,490
+ممكن أنا أشوفها بعيني use the physical sense طبعا
+
+162
+00:10:24,490 --> 00:10:28,350
+عن طريق ال visual hearing and smell طبعا بالملاحظة
+
+163
+00:10:28,350 --> 00:10:32,030
+أنا ممكن أشوف بعيني أحس بإيدي أيضا أسمع بودني و
+
+164
+00:10:32,030 --> 00:10:37,290
+أشم بأنفيExamination and Equipment used to
+
+165
+00:10:37,290 --> 00:10:40,410
+inspection طبعا شو الأجهزة اللي أنا ممكن أستخدمها
+
+166
+00:10:40,410 --> 00:10:45,230
+العين إلها أجهزة خاصة فيها الأنفل و أجهزة خاصة فيه
+
+167
+00:10:45,230 --> 00:10:48,750
+و كذلك الفم الopto أو الفيوناسكوبيه اللي هي ال
+
+168
+00:10:48,750 --> 00:10:51,590
+examination اللي بعمله لل eyes طبعا هذا بخص
+
+169
+00:10:51,590 --> 00:10:55,950
+أخواتنا في البصريات فبيشتغلوا عليه الوتوسكوب إشي
+
+170
+00:10:55,950 --> 00:10:59,270
+خاص طالما قلتوا حكينا عنه لل air mouth and nose
+
+171
+00:10:59,270 --> 00:11:03,310
+trailsالـ Tongue Fork اللي هي عبارة عن الـ Hearing
+
+172
+00:11:03,310 --> 00:11:07,390
+Nose اللي هي الشوكة الرنانة اللي احنا بنعمل و
+
+173
+00:11:07,390 --> 00:11:11,190
+بنشتغل فيها و احنا فيه ابدائي الـ Nasal Spectrums
+
+174
+00:11:11,190 --> 00:11:14,810
+الفيزيوز and Trements of the Nose و الفسيسكوب اللي
+
+175
+00:11:14,810 --> 00:11:20,730
+هو عبارة عن السماعة اللي موجودة عند الطبلةالـ
+
+176
+00:11:20,730 --> 00:11:24,370
+instruments أيضًا لاستخدامنا أو لابحثنا على اللي
+
+177
+00:11:24,370 --> 00:11:28,770
+هو ال vision أو اللي هو الرؤية اللي هو ال chart
+
+178
+00:11:28,770 --> 00:11:33,130
+هذا اللي بيبقى موجود عند أخصائي البصرية عشان أنه
+
+179
+00:11:33,130 --> 00:11:36,790
+أنا بدي أعمل ال touching بدي أحس بإيدي طبعًا هحكي
+
+180
+00:11:36,790 --> 00:11:40,930
+على ال techniques using ل a sense of touch بالإيد
+
+181
+00:11:40,930 --> 00:11:44,970
+أنا بدي أحس إذا في عندي temperatures هل هي درجة
+
+182
+00:11:44,970 --> 00:11:48,980
+الحرارة للمريضباردة او سخنة، التورم، triggers، ال
+
+183
+00:11:48,980 --> 00:11:52,940
+textures، الملمس تبعها، هل في عندي muscle tone
+
+184
+00:11:52,940 --> 00:11:55,960
+عالية ولا المصل عادية، ال moisture، الرتوبة، ال
+
+185
+00:11:55,960 --> 00:11:59,840
+vibration، ايضا الشيء دائما خده في عين الاعتبار
+
+186
+00:11:59,840 --> 00:12:03,560
+انه انا لازم احس بال palmar aspect of hand وليس
+
+187
+00:12:03,560 --> 00:12:09,570
+الدولزر، بحس بال palmar aspect، تمام؟البركاشينز
+
+188
+00:12:09,570 --> 00:12:18,130
+اللي هو الطريقة الثالثة لاللي هو الفحص البركاشينز
+
+189
+00:12:18,130 --> 00:12:21,970
+طبعا تونز are used for location طبعا زي ما كنا
+
+190
+00:12:21,970 --> 00:12:26,410
+ناخده في المتاج البركاشينز shape of sky البركاشينز
+
+191
+00:12:26,410 --> 00:12:30,450
+تونز ممكن يكون flat ممكن يكون الصوت طبعا دل ممكن
+
+192
+00:12:30,450 --> 00:12:34,510
+يكون في عنده ال resonance اللي هو الصدر لهذا الصوت
+
+193
+00:12:34,510 --> 00:12:38,020
+ال hyper resonance يمكن يكون الصدر عالي جدازي ما
+
+194
+00:12:38,020 --> 00:12:41,220
+الحالات اللى هى التنبني التنبني اللى هى حالات
+
+195
+00:12:41,220 --> 00:12:45,940
+النفاخ طبعا اللى هى عبارة عن ال technique اللى
+
+196
+00:12:45,940 --> 00:12:50,240
+أخير اللى أنا بدي استخدمه لفحص مريض الباطنة act of
+
+197
+00:12:50,240 --> 00:12:53,620
+listening with physical to sound produced within
+
+198
+00:12:53,620 --> 00:12:56,620
+the body اللى أنا بستخدمه لسماع الair على سبيل
+
+199
+00:12:56,620 --> 00:13:00,260
+المثال في ال lungs بستخدمه أيضا لسماع ال heart
+
+200
+00:13:00,260 --> 00:13:04,190
+rate لأسمع أشوف شو ال pumping اللى صارFor
+
+201
+00:13:04,190 --> 00:13:07,090
+Characteristic Assessing للأسئوليشن طبعا
+
+202
+00:13:07,090 --> 00:13:11,350
+لاستخدامها لأربع نقاط أساسية ال pitch النغمة ال
+
+203
+00:13:11,350 --> 00:13:14,530
+loudness الصوت و ال quality of the reading الغرغرة
+
+204
+00:13:14,530 --> 00:13:18,330
+و ال duration طبعا كام فترتها هل هي short ولا
+
+205
+00:13:18,330 --> 00:13:24,180
+medium ولا long طبعا هاي كلهبدي أخد طبعا من ال
+
+206
+00:13:24,180 --> 00:13:27,120
+assessment تبعي أو أهم أهدافي في عندي ال patient
+
+207
+00:13:27,120 --> 00:13:30,260
+history طبعا هيكون في عندي ال chief compliment
+
+208
+00:13:30,260 --> 00:13:34,060
+لإيش هو دخل القسم هل هو دخل القسم على سبيل المثال
+
+209
+00:13:34,060 --> 00:13:38,780
+مثلا بمغس مراري أو دخل القسم في مغس ناتج عن زائدة
+
+210
+00:13:38,780 --> 00:13:41,900
+دودية والتهادل زائدة دودية لازم أشوف شو ال chief
+
+211
+00:13:41,900 --> 00:13:45,660
+compliment تبعته present illness طبعا اللي هو
+
+212
+00:13:45,660 --> 00:13:49,970
+المرض الحالي اللي هو دخلي فيههل هو دخل على سبيل
+
+213
+00:13:49,970 --> 00:13:54,630
+المثال بمغص ب vomiting بدياريا كل هذا الأشي لازم
+
+214
+00:13:54,630 --> 00:13:58,530
+أسجله ال past history أو ما يسمى بالتاريخ المرض
+
+215
+00:13:58,530 --> 00:14:03,310
+القديم هذا المرض المرض القديم زي على سبيل المثال
+
+216
+00:14:03,310 --> 00:14:06,010
+إذا كان بيعاني من diabetic إذا كان بيعاني من
+
+217
+00:14:06,010 --> 00:14:09,530
+hypertension كل الأشي هذا لازم أنا أسجله ال
+
+218
+00:14:09,530 --> 00:14:13,710
+current health status اللي هو طبعا الحالة الصحية
+
+219
+00:14:13,710 --> 00:14:17,770
+الموجودة حاليا هل هو مازال يعاني من هذه الألم ولا
+
+220
+00:14:17,770 --> 00:14:22,890
+خلاصتم تسكينهاظبط الوضع لإذن أنا بحكي في ال
+
+221
+00:14:22,890 --> 00:14:26,310
+assessment تبعي أنه على سبيل المثال شاحب الوجه لو
+
+222
+00:14:26,310 --> 00:14:30,390
+مريض مثلا فيه عنا مرضى ممكن يكون يعانى من كذا قلم
+
+223
+00:14:30,390 --> 00:14:34,590
+لكن مش هينبين عليه إيجانى التران الترما ومافيش
+
+224
+00:14:34,590 --> 00:14:37,430
+عنده مشكلة بدي أشوف في الفيلم ال history إذا عنده
+
+225
+00:14:37,430 --> 00:14:41,370
+مثلا على سبيل المثال أمراض سكري في العيلة في عندهم
+
+226
+00:14:41,370 --> 00:14:44,790
+أمراض مظمنة في عندهم إشي بتورثوه أو لأ ال review
+
+227
+00:14:44,790 --> 00:14:48,490
+لل organ system بدي أشوف كل ال organ system و
+
+228
+00:14:48,490 --> 00:14:52,200
+الأعضاءالـ patient illness بدي أحكي على ال
+
+229
+00:14:52,200 --> 00:14:57,460
+location بدي أحكي على ال quality جدّي كمية الألم و
+
+230
+00:14:57,460 --> 00:15:00,860
+ال severity تبع الألم ال timing هل هو أنه بيجي
+
+231
+00:15:00,860 --> 00:15:04,900
+بروح الألم ولا مستمر ولا كمرة في اليوم بيجيها
+
+232
+00:15:04,900 --> 00:15:09,870
+المغص لهذه السنةsitting and watch to develop انه
+
+233
+00:15:09,870 --> 00:15:14,550
+طبعا جدي اللى هو بتطور القلم عندها شو العوامل اللى
+
+234
+00:15:14,550 --> 00:15:18,450
+بتزيد القلم على سبيل المثال هى اجتنى بمغس ملارى
+
+235
+00:15:18,450 --> 00:15:22,150
+دخلت قسم الباطنة معناه الكلام اذا حسيت أنه انا
+
+236
+00:15:22,150 --> 00:15:26,010
+فعلا هى الست اجتنى اليوم وحالتها كانت هيه جدا
+
+237
+00:15:26,010 --> 00:15:30,630
+معناه تبنسألها اذا هى أكلت اكل بسم او مااكلتش عشان
+
+238
+00:15:30,630 --> 00:15:31,590
+يزيد المغس
+
+239
+00:15:38,740 --> 00:15:41,820
+most important disease chronologically disease زي
+
+240
+00:15:41,820 --> 00:15:45,260
+على سبيل المثال ال diabetes و ال hypertension ال
+
+241
+00:15:45,260 --> 00:15:48,580
+operations بدأ اشوف هل عملت عملية جدد كده او هذا
+
+242
+00:15:48,580 --> 00:15:52,840
+الشخص اللى جاى عندي اعمل car accident ولا لأ
+
+243
+00:15:52,840 --> 00:15:56,600
+allergic هل عندك الحساسية من بعض الأدوية اللى احنا
+
+244
+00:15:56,600 --> 00:16:01,260
+مثلا هنعطيها اياها على سبيل المثال في عندها اخدت
+
+245
+00:16:01,260 --> 00:16:04,420
+بعض اللقاحات طبعا هل اتحسست منهم او لأ ال
+
+246
+00:16:04,420 --> 00:16:07,650
+transfusionsتعملت إنه نقل مثلا على سبيل المثال إذا
+
+247
+00:16:07,650 --> 00:16:10,550
+أنا بدي أعملها نقل لدم أو نقل لإشي هل في عندها
+
+248
+00:16:10,550 --> 00:16:14,330
+مشكلة أو لأ استقرينج test طبعا اللي هو ال
+
+249
+00:16:14,330 --> 00:16:16,630
+comprehensive test أخدناه في system measurement
+
+250
+00:16:16,630 --> 00:16:21,350
+اللي هو عبارة عن إشي التقريم الشامل والكامل في
+
+251
+00:16:21,350 --> 00:16:25,070
+البرنامج current health status أو الحالة الصحية
+
+252
+00:16:25,070 --> 00:16:29,210
+الحالية social circumstances هل هو على سبيل المثال
+
+253
+00:16:29,210 --> 00:16:33,790
+متزوج أعزب مطلق هذا لازم يهمني لإنه بدنا نشوف إذا
+
+254
+00:16:33,790 --> 00:16:37,680
+كان على سبيل المثالفي عنده مشاكل في البيت أو لأ؟
+
+255
+00:16:37,680 --> 00:16:40,820
+وأيضا ال occupations اللي هى عبارة عن الوظيفة انه
+
+256
+00:16:40,820 --> 00:16:44,300
+هل كان مثلا موظف ومازال على رأس عمله ولا كان موظف
+
+257
+00:16:44,300 --> 00:16:47,460
+واتقعد؟ حد بيفرج معايا كمان في التعامل ال
+
+258
+00:16:47,460 --> 00:16:50,120
+environmental hazard هل هو في عنده مخاطر البيئة
+
+259
+00:16:50,120 --> 00:16:53,100
+اللى هو فيها في ال school، في ال workplace؟ هل انه
+
+260
+00:16:53,100 --> 00:16:57,760
+صح يظلوا ولا لأ؟ اتبعت اللى هم الأكل طبعا واللى هم
+
+261
+00:16:57,760 --> 00:17:02,860
+عملية تنظيم وcontrol of feeding الكحول and illicit
+
+262
+00:17:02,860 --> 00:17:07,380
+طبعا ال drugsبعض اللي هو هل هو ممكن يكون مدمنين
+
+263
+00:17:07,380 --> 00:17:10,020
+لكحول زي ما هذا الاشي مش موجود عندنا طبعا موجود
+
+264
+00:17:10,020 --> 00:17:14,280
+برا اتباعك هو هل هو مستخدم او هو هل هو مدخن او لا
+
+265
+00:17:14,280 --> 00:17:17,640
+ال current medications اللي هي الأدوية الحالية
+
+266
+00:17:17,640 --> 00:17:20,980
+اللي بياخدها أدوية للسكري أدوية للضغط أدوية لأي
+
+267
+00:17:20,980 --> 00:17:24,660
+أمراض chronic أخرى exercise and leisure activities
+
+268
+00:17:24,660 --> 00:17:28,320
+هيكيك بيقضي نهاره هل هو بيلعب رياضة ولا بيلعبش
+
+269
+00:17:28,320 --> 00:17:32,900
+رياضة sexual history طبعا و ال sleep patterns مهم
+
+270
+00:17:32,900 --> 00:17:37,310
+جداهistory طبعا بدي أشوف ال parents ال banks ال
+
+271
+00:17:37,310 --> 00:17:40,870
+bars هل الأباء موجودين مش موجودين؟ الأطفال في
+
+272
+00:17:40,870 --> 00:17:43,950
+عندهم أطفال ولا ماعندوش؟ أعمارهم و ال health
+
+273
+00:17:43,950 --> 00:17:47,040
+status بتاعتهم؟بدي أشوف في ال family history هل في
+
+274
+00:17:47,040 --> 00:17:49,460
+ديابتس ولا لأ زي ما حكينا في hypertension,
+
+275
+00:17:49,940 --> 00:17:53,280
+infection disease, malignancy, coagulation
+
+276
+00:17:53,280 --> 00:17:56,160
+disorders بعض الحالات اللي هي ال hematology طبعا
+
+277
+00:17:56,160 --> 00:17:59,580
+اللي موجودة عندنا بعض أمراض الدم و ال psychiatric
+
+278
+00:17:59,580 --> 00:18:02,400
+disease على سبيل المثال و ال symptoms of those
+
+279
+00:18:02,400 --> 00:18:05,020
+patients و بدنا نشوف طبعا كل
+
+280
+00:18:10,330 --> 00:18:14,350
+general status and gender and race بدي اشوف الحالة
+
+281
+00:18:14,350 --> 00:18:17,950
+بشكل عام ال body built ال postural ال usual weight
+
+282
+00:18:17,950 --> 00:18:20,770
+ال weight change هل انه صار فيه تغير بسبب المرض
+
+283
+00:18:20,770 --> 00:18:24,170
+مثلا على الوزن او لأ according organs على سبيل
+
+284
+00:18:24,170 --> 00:18:28,030
+المثال بدنا نشوف ال skin و ال head و ال air و لأنه
+
+285
+00:18:28,030 --> 00:18:31,990
+احنا في قسم الباطنة اللي هو قسم الأم طبعا و بعده
+
+286
+00:18:31,990 --> 00:18:34,390
+زي ما حكينا بتتوزع الحالات
+
+287
+00:18:36,950 --> 00:18:40,270
+ال appearance بعض الحالات زى ما حكيتلكم بكون عندها
+
+288
+00:18:40,270 --> 00:18:45,390
+بلاوي كتيرة ولكن بتجينى بمظهر قوي وكويس وكأنه مافي
+
+289
+00:18:45,390 --> 00:18:49,030
+عندهم إشي لكن بعض الحالات ممكن تكون تشتكى من ألم
+
+290
+00:18:49,030 --> 00:18:53,210
+بسيط ولكن وضعها يرتقلهمالـ Appearance طبعا
+
+291
+00:18:53,210 --> 00:18:56,170
+الهياجين بدي أشوف الـ grooming هل هو إنه قادر على
+
+292
+00:18:56,170 --> 00:19:00,110
+سبيل المثال ينظف حاله من حاله ولا بده مساعدة Signs
+
+293
+00:19:00,110 --> 00:19:04,010
+of illness، أعراض المرض هل واضح عليه ولا لأ ال
+
+294
+00:19:04,010 --> 00:19:06,850
+affected و ال mood و ال attitude طبعا هذه الحالات
+
+295
+00:19:06,850 --> 00:19:10,770
+الأشياء اللي هي psychological موجودة عنده ال reach
+
+296
+00:19:10,770 --> 00:19:15,290
+and social expression ال cognitive process طبعا
+
+297
+00:19:15,290 --> 00:19:19,890
+اللي هي الأمور الإدراكيةزي ال speech content ال
+
+298
+00:19:19,890 --> 00:19:23,010
+pattern ال orientation و ال appropriated verbal
+
+299
+00:19:23,010 --> 00:19:27,090
+response كل الأمور اللي موجودة في ال cognitive هل
+
+300
+00:19:27,090 --> 00:19:31,810
+انها سليمة او ممتازة different signs طبعا ال vital
+
+301
+00:19:31,810 --> 00:19:34,650
+signs اللي موجودين احنا عارفين ال vital signs هي
+
+302
+00:19:34,650 --> 00:19:39,570
+عبارة عن العلمات الحيوية اللي بتكون موجود ال high
+
+303
+00:19:39,570 --> 00:19:42,450
+and weight كمان هحكي عليهم ال vital signs اللي
+
+304
+00:19:42,450 --> 00:19:44,790
+انتوا بتشوفوا التمريدة بييجوا بياخدوهم هو عبارة عن
+
+305
+00:19:45,030 --> 00:19:48,590
+خمسة vital signs ال heart rate و ال temperature و
+
+306
+00:19:48,590 --> 00:19:53,110
+الأمور الأخرى هتدرمي لل normal أو abnormal هل هي
+
+307
+00:19:53,110 --> 00:19:56,390
+طبيعية اليوم كانت في أثناء المرور الصباحي و لا لأ
+
+308
+00:19:56,390 --> 00:20:00,450
+ال height and weight decrement طبعا شكل ال height
+
+309
+00:20:00,450 --> 00:20:02,930
+and weight decrement بعد اللي هو ال patient under
+
+310
+00:20:02,930 --> 00:20:07,450
+normal or under weight لازم أحس أنه متمام و لا لأ
+
+311
+00:20:07,450 --> 00:20:11,030
+بدي أعمل أيضا assessment ل ال head and neck ال
+
+312
+00:20:11,030 --> 00:20:14,050
+head بتشوف ال skin و ال face و ال skull و ال scalp
+
+313
+00:20:14,050 --> 00:20:17,450
+أيضاو ال nose و ال senses و ال mouth و ال pharynx
+
+314
+00:20:17,450 --> 00:20:21,750
+و ال cranial nerve كل هذه الأمور أنا بقيمها لإنه
+
+315
+00:20:21,750 --> 00:20:25,270
+بدي أشوف المشكلة من وين إجتني ال neck بدي أشوف فيه
+
+316
+00:20:25,270 --> 00:20:27,990
+عندي ال skin و ال lymph nodes و ال muscle هل في
+
+317
+00:20:27,990 --> 00:20:34,010
+muscle shortening هل في muscle contractures ولا لأ
+
+318
+00:20:34,010 --> 00:20:37,530
+ال thyroid و التراكيا و ال cortoid طبعا arteries
+
+319
+00:20:37,530 --> 00:20:43,340
+and neck veins بدي أشوف فيهم مشاكلأشوف ال skull و
+
+320
+00:20:43,340 --> 00:20:46,780
+ال face إيش طبعا بدي أشوف فيهم inspected لل size
+
+321
+00:20:46,780 --> 00:20:49,300
+and shape و ال symmetry بدي أشوف هل ال right نفس
+
+322
+00:20:49,300 --> 00:20:53,600
+ال left ولا فيها مشكلةالـ Face بدي أشوف هل هو ال
+
+323
+00:20:53,600 --> 00:20:57,120
+exam لل colors هل هو ماشاء الله عليه مورد المريض
+
+324
+00:20:57,120 --> 00:21:01,660
+تبعي و بنكو و الأمور تمام تمام و لا pale و شاحب
+
+325
+00:21:01,660 --> 00:21:04,380
+السيمتري هل ال right نفس ال left و لا في عندنا
+
+326
+00:21:04,380 --> 00:21:08,020
+مشكلة ال distribution لل facial hair طبعا و ال
+
+327
+00:21:08,020 --> 00:21:11,920
+assessment لل facial nerve and facial muscle بدي
+
+328
+00:21:11,920 --> 00:21:17,330
+أشوف و أقيم كمان بشكل عام الوجهتراكيا طبعا not
+
+329
+00:21:17,330 --> 00:21:20,350
+locations بدي أشوف ليه تراكيا في وضعها و لا مش
+
+330
+00:21:20,350 --> 00:21:25,250
+وضعها ال midline in suprasternal notch طبعا بتكون
+
+331
+00:21:25,250 --> 00:21:30,170
+في المنتصف هل فيها مشكلة لتراكيا ولا لأ طبعا ال
+
+332
+00:21:30,170 --> 00:21:33,750
+thyroid لازم أشوف إذا فيها مشكلة أو لأ normal not
+
+333
+00:21:33,750 --> 00:21:36,790
+elevation و ال elevation of size و ال symmetry
+
+334
+00:21:36,790 --> 00:21:39,870
+تبعها هل فيها tenderness أو لأ ال lymph nodes زي
+
+335
+00:21:39,870 --> 00:21:42,390
+ما انتوا مش تعرفوه جهاز lymphatic system هو عبارة
+
+336
+00:21:42,390 --> 00:21:46,670
+عن جهاز مهم جدا انا كمان لازم أقيمهوأشوفه فيه
+
+337
+00:21:46,670 --> 00:21:49,990
+أمراض الباطنة generally not palpation its
+
+338
+00:21:49,990 --> 00:21:53,470
+palpation should be small mobile small not tender
+
+339
+00:21:53,470 --> 00:21:56,930
+طبعا أنا بحس بعض الأحيان اللي هي أسامي الميتال
+
+340
+00:21:56,930 --> 00:21:59,610
+الوز ممكن تلحسها هي بال palpation لكن بالعادة
+
+341
+00:21:59,610 --> 00:22:03,610
+مابنحس ولكن بعض الأجزاء البسيطة منه أو المكوناة
+
+342
+00:22:03,610 --> 00:22:05,590
+اللي هي ال lymphatic system ممكن أنا أحسها
+
+343
+00:22:05,590 --> 00:22:08,650
+abnormal and enlarged indicated معناته infection
+
+344
+00:22:08,650 --> 00:22:13,210
+وال autoimmune and metastases of cancerعلى سبيل
+
+345
+00:22:13,210 --> 00:22:16,270
+المثال لما بيجي بيحس اللواز لأي طفل صغير إذا كانت
+
+346
+00:22:16,270 --> 00:22:20,650
+كبيرة ومضخمة بنقول هذا بداية influenza أو انه هو
+
+347
+00:22:20,650 --> 00:22:25,330
+لوازه ميزة ايضا ال eye و ال ears لما انا بدي أجي
+
+348
+00:22:25,330 --> 00:22:28,830
+أقيمهم inspection لل External و ال Structural و
+
+349
+00:22:28,830 --> 00:22:33,610
+بدي أشوف ال bulbs and ears اللي هي العدسة و
+
+350
+00:22:33,610 --> 00:22:37,630
+القرنية و كل المكونات اللي موجودة عندى في ال eyes
+
+351
+00:22:37,630 --> 00:22:41,920
+بدي أشوف هل في حمار فيش حمار هل متسعةولا على سبيل
+
+352
+00:22:41,920 --> 00:22:44,760
+المثال فيها مشكلة ال internal structure اللي
+
+353
+00:22:44,760 --> 00:22:49,280
+موجودة و الرؤية هل هي مناسبة ولا مش مناسبة ايضا في
+
+354
+00:22:49,280 --> 00:22:52,640
+ال assessment لائل air بدي اشوف المريض تبعي في
+
+355
+00:22:52,640 --> 00:22:57,560
+الأذن الخارجية هل هو سامعني مريضي او مش سامعنيطبعا
+
+356
+00:22:57,560 --> 00:23:01,060
+و ال location bilaterally air should be smooth
+
+357
+00:23:01,060 --> 00:23:05,000
+gently palpation و check لل hearing و أيضا بنحس و
+
+358
+00:23:05,000 --> 00:23:09,800
+بنشوف هل هو قادر ان يتواصل معنا و لا بس سامعنا و
+
+359
+00:23:09,800 --> 00:23:11,040
+مش قادر يرد على
+
+360
+00:23:20,710 --> 00:23:25,690
+هنا ال Vagoma طبعا هي عبارة عن وجود ماء او نسميها
+
+361
+00:23:25,690 --> 00:23:29,350
+الماء البيضا اللي موجودة في العين ال healthy air
+
+362
+00:23:29,350 --> 00:23:34,270
+اللي هي أذن صليمة و هنشوف ال otitis media التهابة
+
+363
+00:23:34,270 --> 00:23:39,510
+في الأذن الوصفة كيف طبعا بتكون مؤلمة و زي ما
+
+364
+00:23:39,510 --> 00:23:43,250
+بتعرفه بتأثر على ال equilibrium و ان هو ال balance
+
+365
+00:23:43,250 --> 00:23:47,170
+اللي موجود عند المجتمع ال chronic otitis media
+
+366
+00:23:47,170 --> 00:23:55,300
+طبعا هذهطبعا اللي هي التهابات الأذن الوسطى بدي
+
+367
+00:23:55,300 --> 00:23:58,880
+أشوف ال noise هل في مشاكل أو لأ بدي أشوف هل ال
+
+368
+00:23:58,880 --> 00:24:02,280
+right فتحة ال right نفس فتحة ال left أو لأ بدي
+
+369
+00:24:02,280 --> 00:24:05,540
+أشوف ال button في ال open button away هل إنه جادر
+
+370
+00:24:05,540 --> 00:24:08,840
+ياخد نفسه مباشرة من غير أي وسائط ولا لازم يكون في
+
+371
+00:24:08,840 --> 00:24:13,280
+عندى اللي هو وسائط أخرى زي التنفس الصناعي على سبيل
+
+372
+00:24:13,280 --> 00:24:16,410
+المثالال senses اللي هي عبارة عن الجيوب الأنفية
+
+373
+00:24:16,410 --> 00:24:18,710
+وكلكوا بتعرفوا أن الجيوب الأنفية هي عبارة عن أربع
+
+374
+00:24:18,710 --> 00:24:21,730
+أزواج موجودة عندنا طبعا هذه الجيوب الأنفية
+
+375
+00:24:21,730 --> 00:24:24,490
+infection of the senses and gentle palpation of
+
+376
+00:24:24,490 --> 00:24:28,790
+maxillary بدي أشوف طبعا بإحساسي إنهام في ال
+
+377
+00:24:28,790 --> 00:24:32,390
+maxilla bone زي ما بتعرفوا في اللي هو ال head bone
+
+378
+00:24:32,390 --> 00:24:35,150
+اللي موجودة عندنا normally the senses are not
+
+379
+00:24:35,150 --> 00:24:39,030
+being formedإذا كان هو اللي غطب إيدي على أعلى اللي
+
+380
+00:24:39,030 --> 00:24:43,170
+هو الأنف ماحس المريض بوجع معناته إحنا كالسليم لكن
+
+381
+00:24:43,170 --> 00:24:47,350
+إذا حس و اتألم بيكون في عنده مشكلة في جيوب الأنفية
+
+382
+00:24:47,350 --> 00:24:51,430
+الهيمت هم طبعا إذا كان في عنده مشكلة في جيوب
+
+383
+00:24:51,430 --> 00:24:56,070
+الأنفية هنا طبعا ال ال bodies اللي هو انحراف و
+
+384
+00:24:56,070 --> 00:25:01,710
+عوجاج في اللي هو الأنفالـ mouth and pharynx اللي
+
+385
+00:25:01,710 --> 00:25:05,670
+هو الفم وقلب العمل لازم انا اشوف طبعا هذا باعبار
+
+386
+00:25:05,670 --> 00:25:07,810
+عن الفم هو عبارة عن ال entrance لل digestive
+
+387
+00:25:07,810 --> 00:25:12,210
+system مدخل الجهاز الحظمي لازم اشوف هل هو سليم ولا
+
+388
+00:25:12,210 --> 00:25:15,170
+مش سليم ال lips و ال tongue و ال teeth و كل هذه
+
+389
+00:25:15,170 --> 00:25:18,920
+الأمور لازم انا اشوفها ال equipment neededطبعا بدي
+
+390
+00:25:18,920 --> 00:25:22,580
+اشوف اذا في عندى tongue depressors في عندى اللى هو
+
+391
+00:25:22,580 --> 00:25:26,660
+ال pink light و ال gas و ال sponge and gloves طبعا
+
+392
+00:25:26,660 --> 00:25:31,060
+ليش لإن هذى الشغلات لازم عشان اقيام اللى هو فم
+
+393
+00:25:31,060 --> 00:25:36,560
+المريض شايفين فى tonsilites التهاب لللواز زى ما هو
+
+394
+00:25:36,560 --> 00:25:40,040
+شايفينه وزى ما شايفينه واضح فى الصورة اللى واز
+
+395
+00:25:40,040 --> 00:25:45,910
+كبيرالـ Hairy Tongue طبعا بعض اللي هو اللسان فيها
+
+396
+00:25:45,910 --> 00:25:48,750
+geographical tongue و فيها hairy tongue طبعا هي
+
+397
+00:25:48,750 --> 00:25:52,440
+على أشكالهاالـ integrimental system أو الـ
+
+398
+00:25:52,440 --> 00:25:55,900
+integrimental structure اللي هو بيشمل ال skin و ال
+
+399
+00:25:55,900 --> 00:25:59,320
+nails هنحكي عليه و ال hair و ال scalp كل هذه
+
+400
+00:25:59,320 --> 00:26:03,100
+الأمور انا هقيمها ايضا من احنا مثلا أولا بنحكي ال
+
+401
+00:26:03,100 --> 00:26:06,320
+integrimental system ابتيا لل history of rashes
+
+402
+00:26:06,320 --> 00:26:10,900
+and lesions طبعا الاشي اللي بتعلق بالجند و الأضافر
+
+403
+00:26:10,900 --> 00:26:16,200
+و الشعر كل هذا الاشي لازم انا اقيمه طبعا في ال
+
+404
+00:26:16,200 --> 00:26:19,580
+integrimental system ال skin بدي اشوف ال color
+
+405
+00:26:19,580 --> 00:26:24,630
+تبعههل هو طبيعي و بنكو كويس ولا في عنابل و شحوب
+
+406
+00:26:24,630 --> 00:26:28,670
+وفي مشاكل نتجة عن ال cardiovascular system
+
+407
+00:26:31,400 --> 00:26:33,960
+في ال assessment area تبع فيه إذا كان في عندنا
+
+408
+00:26:33,960 --> 00:26:37,920
+redness وإذا كان في عندنا blushing, cyanosis ويلش
+
+409
+00:26:37,920 --> 00:26:41,700
+معناته في جلدس اللي هو اليارقان وvetigars اللي هو
+
+410
+00:26:41,700 --> 00:26:46,060
+الباشر area أو اللي هو عديم اللون بنسميه أو انه
+
+411
+00:26:46,060 --> 00:26:49,040
+autoimmune disease بيكون المرض فيه tanned or
+
+412
+00:26:49,040 --> 00:26:52,460
+browned sun exposures اللي هو حروق الدرجة الأولى
+
+413
+00:26:52,460 --> 00:26:55,320
+إذا احنا روحنا على البحر واتعرضنا لأشهر شمس عالية
+
+414
+00:26:55,320 --> 00:27:01,270
+بيكون في عندنا tanned أو browned skinSensory motor
+
+415
+00:27:01,270 --> 00:27:03,910
+and function بدي أحكي على ال motor على ال balance
+
+416
+00:27:03,910 --> 00:27:07,270
+of gaze هل في أنا عندي مشكلة في ال coordination؟
+
+417
+00:27:07,270 --> 00:27:11,170
+هل في عندي مشكلة في ال sensory؟ ال six طبعا بدي
+
+418
+00:27:11,170 --> 00:27:15,310
+أفحصها لقبل من ال reflex ال biceps و ال triceps و
+
+419
+00:27:15,310 --> 00:27:17,290
+ال patellar و ال achilles tendon
+
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/wNb3Lpr7VxM_raw.json b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/wNb3Lpr7VxM_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..5f25b023488559398ed9a78689a87168200a618d
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/wNb3Lpr7VxM_raw.json
@@ -0,0 +1 @@
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\ No newline at end of file
diff --git a/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/wNb3Lpr7VxM_raw.srt b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/wNb3Lpr7VxM_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..a9e76a268b818b52eede246b70d0cc85195c8a98
--- /dev/null
+++ b/PL9fwy3NUQKwajL7TdAZNgCWXknPDDCkLe/wNb3Lpr7VxM_raw.srt
@@ -0,0 +1,1676 @@
+1
+00:00:01,700 --> 00:00:04,720
+الرحمن الرحيم والصلاة والسلام على أشرف الأبيعي
+
+2
+00:00:04,720 --> 00:00:09,960
+والمرسلين سأتحدث في هذا المثاق عن العلاج الطبيعي
+
+3
+00:00:09,960 --> 00:00:14,900
+لأمراض الباطنة والقلب والصدر تمام فهي عبارة عن
+
+4
+00:00:14,900 --> 00:00:19,800
+ثلاث محاور أساسية سنتطرق في البداية لنحور أمراض
+
+5
+00:00:19,800 --> 00:00:23,200
+الباطنة هذه المحاضرة بعنوان introduction of
+
+6
+00:00:23,200 --> 00:00:28,100
+internal medicine أي مقدمة لأمراض أو العلاج
+
+7
+00:00:28,100 --> 00:00:32,580
+الطبيعي لأمراض الباطنة والمسنينسأتحدث فيها عن من
+
+8
+00:00:32,580 --> 00:00:36,340
+هو أو من هو الذي يزاول الـ Internal Medicine أو من
+
+9
+00:00:36,340 --> 00:00:40,940
+هو الأخصاء الباطني وكذلك سأتطرق إلى الـ
+
+10
+00:00:40,940 --> 00:00:44,200
+Physiotherapy Assessments in Internal Medicine
+
+11
+00:00:44,200 --> 00:00:48,920
+Conditions لحالات اللي هي اللي لنا دور فيها في قسم
+
+12
+00:00:48,920 --> 00:00:54,600
+الباطنة نبدأ على بركة الله الـ Internist اللي هي
+
+13
+00:00:54,600 --> 00:00:58,940
+من هو الـ Internist هو عبارة عن Specialistطبيب
+
+14
+00:00:58,940 --> 00:01:01,980
+متخصص في الـ Adult Medicine who provide majority
+
+15
+00:01:01,980 --> 00:01:05,760
+of health care to adults in hospital or in the
+
+16
+00:01:05,760 --> 00:01:09,640
+office لذا هو عبارة عن طبيب متخصص موجود في قسم
+
+17
+00:01:09,640 --> 00:01:12,940
+الباطنة وهو عبارة عن الشريان الرئيسي في المستشفى
+
+18
+00:01:12,940 --> 00:01:16,880
+ومن بعد ذلك بتتم توزيع وتصنيع الحالات
+
+19
+00:01:19,110 --> 00:01:23,330
+الـ Intrinsic عرفنا إن أنا عرفش شو الدور تبعه
+
+20
+00:01:23,330 --> 00:01:27,570
+Provide comprehensive and continuity caring اللي
+
+21
+00:01:27,570 --> 00:01:32,480
+هو primary care to adults and elderlyبيقدّم رعاية
+
+22
+00:01:32,480 --> 00:01:36,520
+شاملة و كاملة ل ال woman healthcare depression and
+
+23
+00:01:36,520 --> 00:01:40,280
+anxiety بيعالج دي ل acute and chronic medical
+
+24
+00:01:40,280 --> 00:01:43,820
+conditions أيضا بيعمل treatment ل الepisodic
+
+25
+00:01:43,820 --> 00:01:47,140
+urgent and emergency conditions arrange a
+
+26
+00:01:47,140 --> 00:01:50,900
+consultation with other physicians بينسق مع
+
+27
+00:01:50,900 --> 00:01:54,340
+الأطباء الآخرين الموجودين preoperative and
+
+28
+00:01:54,340 --> 00:01:58,340
+evaluation for surgical colleagues تمام؟ هاي دور
+
+29
+00:01:58,340 --> 00:02:02,700
+اللي هو أخصائيالأقصاء الباطنة هما specialists
+
+30
+00:02:02,700 --> 00:02:06,720
+field متخصصين في كذا مجال، في عندنا الأدوية
+
+31
+00:02:06,720 --> 00:02:11,200
+medicine، في عندنا ال allergy and immunology،
+
+32
+00:02:11,200 --> 00:02:14,340
+cardiovascular، ال endocrine، infectious disease
+
+33
+00:02:14,610 --> 00:02:17,570
+الـ gastric endocrinology و الـ geriatric
+
+34
+00:02:17,570 --> 00:02:21,190
+hematology أيضا اللي هو الـ hepatology اللي له
+
+35
+00:02:21,190 --> 00:02:24,070
+علاقة بالـ hepatites أو الـ hepat .. hepatology
+
+36
+00:02:24,070 --> 00:02:26,950
+اللي هو له علاقة بالـ liver أيضا الـ nephrology
+
+37
+00:02:26,950 --> 00:02:29,650
+اللي له علاقة بالـ kidney الـ ochronology اللي له
+
+38
+00:02:29,650 --> 00:02:32,790
+علاقة بالـ gynecology كمان و الـ pulmonary disease
+
+39
+00:02:32,790 --> 00:02:36,750
+and care medicines و ال rheumatology علم الأورام
+
+40
+00:02:36,750 --> 00:02:43,730
+as في علم اللي هو ال rheumatology هو عبارة عنالـ
+
+41
+00:02:43,730 --> 00:02:46,650
+Rheumatism علم الـ Rheumatism و أيضا في عندنا ناس
+
+42
+00:02:46,650 --> 00:02:53,010
+متخصصة بنسليب medicine هيكلها سأتحدث الآن عن ال
+
+43
+00:02:53,010 --> 00:02:55,810
+health assessment او ال physiological assessment
+
+44
+00:02:55,810 --> 00:03:00,610
+اللي هيكون موجود في قسم الباطنة اللي موجود في اي
+
+45
+00:03:00,610 --> 00:03:04,910
+موضوع من بعض تبع ال diagnosis اللي هي في عندنا ال
+
+46
+00:03:04,910 --> 00:03:08,310
+pathological, etiological, anatomically and
+
+47
+00:03:08,310 --> 00:03:11,900
+prognosticإذن هتحدث على ال pathological هذا المرض
+
+48
+00:03:11,900 --> 00:03:15,280
+ليش داخل المستشفى؟ شو السبب اللي خلى يكون عنده
+
+49
+00:03:15,280 --> 00:03:18,400
+الزايدة على سبيل المثال ال anatomical وضع زايدة شو
+
+50
+00:03:18,400 --> 00:03:21,920
+هي و شو دورها و شو صار بعد العملية الجراحية ال
+
+51
+00:03:21,920 --> 00:03:27,240
+prognosis هل هو اتحسن ولا لأ؟ في عند ال patient
+
+52
+00:03:27,240 --> 00:03:29,900
+history في عند ال physical examination و ال
+
+53
+00:03:29,900 --> 00:03:32,740
+laboratory and instrumental examination بدي أشوف
+
+54
+00:03:32,740 --> 00:03:34,880
+في ال patient history في عند ال birth history في
+
+55
+00:03:34,880 --> 00:03:38,200
+عند ال medical history اللي هو ال present history
+
+56
+00:03:38,550 --> 00:03:41,490
+الـ physical examination كل الأختبارات الفيزيائية
+
+57
+00:03:41,490 --> 00:03:44,490
+على سبيل المثال اللي أخدناها في test and
+
+58
+00:03:44,490 --> 00:03:46,870
+measurement وأيضا في liberty and instrument
+
+59
+00:03:46,870 --> 00:03:51,250
+examination بعض اللي هو التحاليل اللي بتنطلبها من
+
+60
+00:03:51,250 --> 00:03:56,470
+قبل الأخصائي والدكتورة guidelines established a
+
+61
+00:03:56,470 --> 00:03:58,730
+physical patient relationship لازم أنا أحدد
+
+62
+00:03:58,730 --> 00:04:01,670
+العلاقة بيني وبين ال patient عشان أبدأ أشتغل على
+
+63
+00:04:01,670 --> 00:04:05,610
+قاعدة سليمةبدي أجمع المعلومات physiological أو
+
+64
+00:04:05,610 --> 00:04:08,830
+psychologically أو cognitive أو psycho-cultural
+
+65
+00:04:08,830 --> 00:04:12,450
+developmental and spiritual كل هذه الأمور سواء
+
+66
+00:04:12,450 --> 00:04:16,550
+فيسيولوجية أو سيكولوجية أو روحانية لازم أنا أجمعها
+
+67
+00:04:16,550 --> 00:04:20,890
+و أبدأ بالشغل عليها identify لل patient stress بدي
+
+68
+00:04:20,890 --> 00:04:24,610
+أشوف قداش مقاييس القوة عنده اليوم هو على سبيل
+
+69
+00:04:24,610 --> 00:04:28,230
+المثال ده بتكفوت فارثي عنه amputation لقفوت معناه
+
+70
+00:04:28,230 --> 00:04:30,670
+ان الكلام بدي أشوف هل ال upper limb قوية ولا مش
+
+71
+00:04:30,670 --> 00:04:33,700
+قويةإذا قوية معناته أنا بدي أركز عليها و أزيد من
+
+72
+00:04:33,700 --> 00:04:36,840
+قوتها Identification للـ Actual and Potential
+
+73
+00:04:36,840 --> 00:04:40,700
+Health Problems أيضًا بدي أشوف اللي هو هل في عندي
+
+74
+00:04:40,700 --> 00:04:44,440
+نقاط قوة حقيقية موجودة ولا لأ القوي بدي أقوي و
+
+75
+00:04:44,440 --> 00:04:48,800
+أزيد من سعالته و لظيف بدي أحاول أتغلب على المشاكل
+
+76
+00:04:48,800 --> 00:04:52,040
+الموجودة فيه Established for the case of patient
+
+77
+00:04:52,040 --> 00:04:56,100
+of Physiotherapy Assessment Process لازم أحط قاعدة
+
+78
+00:04:56,100 --> 00:04:58,480
+لعملية اللي هي ال assessment process
+
+79
+00:05:04,690 --> 00:05:10,050
+الانسترمنت هل اللي هو فيه form موجودة عندى معينة و
+
+80
+00:05:10,050 --> 00:05:14,080
+جاهزةولا أنا لسه بدي أعمل ال format ال positioning
+
+81
+00:05:14,080 --> 00:05:16,200
+انا انا ايه ال position بدي اعمل ال assessment
+
+82
+00:05:16,200 --> 00:05:19,760
+المريض تبعي جادر يكون بوضع stink position اذا مش
+
+83
+00:05:19,760 --> 00:05:23,020
+جادر هل هو في subine هل هو في sideline ال grabbing
+
+84
+00:05:23,020 --> 00:05:27,600
+كدهش هو جادر يتحمل تقييمي له ال preparation of
+
+85
+00:05:27,600 --> 00:05:30,760
+environment تحضير البيئة سواء اللي هو موجود فيها
+
+86
+00:05:30,760 --> 00:05:33,880
+في المستشفى او في ما بعد لما بده يلوح على البيت في
+
+87
+00:05:33,880 --> 00:05:36,800
+ال home adaptation ال patient preparation وتحضير
+
+88
+00:05:36,800 --> 00:05:40,930
+المريضالتكنيكز اللى انا ممكن استخدمها طبعا بعض ال
+
+89
+00:05:40,930 --> 00:05:44,030
+exercise اللى هى ان شاء الله رب العالمين في العمل
+
+90
+00:05:44,030 --> 00:05:47,330
+اللى هتشوفوها زى على سبيل المثال كيف التكنيكز اللى
+
+91
+00:05:47,330 --> 00:05:50,410
+انا بدى اعلمله ياها و اقدر احصل عليه
+
+92
+00:05:59,520 --> 00:06:02,140
+أذا اذا انا بدأ أستخدم ال setting position هيكون
+
+93
+00:06:02,140 --> 00:06:06,160
+المريض تبعي في upright position مع وضع طاولة تحت
+
+94
+00:06:06,160 --> 00:06:08,900
+اللي هو ال foot حتى نأتك ال foot في وضع ال
+
+95
+00:06:08,900 --> 00:06:10,800
+dependent position لإنه اذا كانت ال foot في وضع ال
+
+96
+00:06:10,800 --> 00:06:13,040
+dependent position معناته الكلام ان انا بدأ اعمل
+
+97
+00:06:13,040 --> 00:06:17,480
+اللي هو increase ال swelling و ادخل في مشاكل تانية
+
+98
+00:06:17,480 --> 00:06:20,820
+من أول و جديد ال spine اللي هو lying in a flat
+
+99
+00:06:20,820 --> 00:06:24,960
+back ال dorsal underarm اللي هو lying in back with
+
+100
+00:06:24,960 --> 00:06:29,950
+knee bent طبعا الإجرين بتكوناللي هي ركبتين متنية
+
+101
+00:06:29,950 --> 00:06:33,550
+Similes اللي هي lines in either right or left side
+
+102
+00:06:33,550 --> 00:06:37,230
+لل lower arm behind of the body and upper arm bent
+
+103
+00:06:37,230 --> 00:06:40,710
+to shoulder and elbow knee both bent يعني على سبيل
+
+104
+00:06:40,710 --> 00:06:43,890
+المثال هذا التعريف تقريبا احنا بنسميه ربع او
+
+105
+00:06:43,890 --> 00:06:47,750
+النومة اللي هي بنسميها ربع .. ربع السبين او ربع
+
+106
+00:06:47,750 --> 00:06:50,650
+لبرون هنشوفها ان شاء الله رب العالمين في الصور
+
+107
+00:06:50,650 --> 00:06:55,050
+القادمة و هتكون واضحة بشكل افضل لبرون طبعا ال
+
+108
+00:06:55,050 --> 00:06:59,600
+patient name in abdomen طبعاعلى اللي هو على بطنه
+
+109
+00:06:59,880 --> 00:07:02,680
+letting to me ال patient بيكون في دور the
+
+110
+00:07:02,680 --> 00:07:05,100
+recumbent position و ال batox at edge of
+
+111
+00:07:05,100 --> 00:07:08,880
+examination table and the foot board by traps يعني
+
+112
+00:07:08,880 --> 00:07:13,100
+المرض نايم لي على حافة اللي هو السرير و اللي هو
+
+113
+00:07:13,100 --> 00:07:18,180
+إجري طالعين لبرا على تابل لوحدها هنشوفها أيضا كمان
+
+114
+00:07:18,180 --> 00:07:21,640
+بالصور ال knee to the chest اللي هي using ال knee
+
+115
+00:07:21,640 --> 00:07:25,860
+as to chest and the weight of body بيسحب اللي هو
+
+116
+00:07:25,860 --> 00:07:28,600
+ال crocolar imposition خليني أحكي عنه بعد أنه ال
+
+117
+00:07:28,600 --> 00:07:33,810
+knee بدي يقدمهاالـ standing position هى موجود فى
+
+118
+00:07:33,810 --> 00:07:36,870
+ال standing ولا لأ هى دور the recumbent position
+
+119
+00:07:36,870 --> 00:07:40,350
+طبعا زى ما انتوا شايفين نايم فى ال subine position
+
+120
+00:07:40,350 --> 00:07:46,370
+و اللى هى ال knee اللى هى bent و ال foot at the
+
+121
+00:07:46,370 --> 00:07:51,870
+bed هى ال sims position اللى أنا حكيت عليه شبه ربع
+
+122
+00:07:51,870 --> 00:07:58,440
+subine او ربع prone طبعا بيكون موجود فىالـLow
+
+123
+00:07:58,440 --> 00:08:01,420
+Latency اللى هو طبعا زى ما انتوا شايفين المريض هنا
+
+124
+00:08:01,420 --> 00:08:05,820
+عندى على حافة اللى هو ال bed و اللى هو ال legs
+
+125
+00:08:05,820 --> 00:08:09,980
+outside of the bed تمام طبعا فى منه low فى the
+
+126
+00:08:09,980 --> 00:08:14,200
+standard و فى اللى هى the chest اللى هو انه بدى
+
+127
+00:08:14,200 --> 00:08:17,680
+يكون عن ال kneeling يعنى عن اللى هى ال cack
+
+128
+00:08:17,680 --> 00:08:19,100
+position الأربع
+
+129
+00:08:26,500 --> 00:08:30,060
+and keep the patient warm during physical exam إنه
+
+130
+00:08:30,060 --> 00:08:34,120
+أنا بدي أحاول أخلي المريض تبعي في نفس البيئة أو في
+
+131
+00:08:34,120 --> 00:08:37,200
+نفس الجو اللي هو careful تمام؟ إذا ال preparation
+
+132
+00:08:37,200 --> 00:08:40,380
+and examination تابل أحضر الطاولة تكون كل إشي تمام
+
+133
+00:08:40,380 --> 00:08:44,440
+الخصوصية تبع المريض هنا مهمة جدا مش لازم أنا أعدي
+
+134
+00:08:44,440 --> 00:08:47,640
+عنها أو لازم أنا أسيبها و أقول يالا معلش هذا ستة
+
+135
+00:08:47,640 --> 00:08:51,780
+كبيرة و خلاص مش مشكلة لأ خصوصية المريض مهمة جدا
+
+136
+00:08:51,780 --> 00:08:55,460
+إنه أنا أعمل close ل door of exam roomإنهي أحاسسها
+
+137
+00:08:55,460 --> 00:08:59,280
+بالأمان إنه أنا بعملها ال assessments داخل بيئة
+
+138
+00:08:59,280 --> 00:09:04,460
+آمنة أيضا ال test of examination ال inspection و
+
+139
+00:09:04,460 --> 00:09:07,500
+ال palpation و ال percussions و ال percussions أثر
+
+140
+00:09:07,500 --> 00:09:12,000
+و ال isolation ال inspection طبعا بالملاحظة شو
+
+141
+00:09:12,000 --> 00:09:14,500
+التكنيكز اللي أنا بدي أستخدمهم بالملاحظة أنا إيش
+
+142
+00:09:14,500 --> 00:09:17,540
+بدي أشوف ال observation و listening and smelling
+
+143
+00:09:17,540 --> 00:09:20,320
+to the gathering dataبدي أستخدمهم في تجميع
+
+144
+00:09:20,320 --> 00:09:23,440
+معلوماتي والله أنا شايفة بعيني أنه على سبيل المثال
+
+145
+00:09:23,440 --> 00:09:26,940
+ال right hand more swelling than left hand سامع
+
+146
+00:09:26,940 --> 00:09:30,760
+مثلا على سبيل المثال في عناق قرقعة في ال بطن علشان
+
+147
+00:09:30,760 --> 00:09:34,320
+ما أنه في إشي مش مظبوط في الخلال اللي هو العملية
+
+148
+00:09:34,320 --> 00:09:37,360
+الجراحية اللي سويتها ال palpation اللي هو عن طريق
+
+149
+00:09:37,360 --> 00:09:41,710
+ال touch كيف أنا بدي أحس ال patient هل في عنديعلى
+
+150
+00:09:41,710 --> 00:09:44,850
+سبيل المثال في muscle shortening ولا لأ ال
+
+151
+00:09:44,850 --> 00:09:47,790
+percussion اللي هو acting stricken in the object
+
+152
+00:09:47,790 --> 00:09:51,430
+against another to produce sound انه انا على سبيل
+
+153
+00:09:51,430 --> 00:09:56,310
+المثال لو عملت وخبطت على بطن هذا الشخص هل هو في
+
+154
+00:09:56,310 --> 00:09:59,890
+هناك مثلا على سبيل المثال air حواء ولا مش موجود
+
+155
+00:09:59,890 --> 00:10:03,430
+بحسب اللي هو ال escalations اللي هي عبارة عن
+
+156
+00:10:03,430 --> 00:10:06,390
+السماعة انه انا بدي اسمع الدنيا عن طريق
+
+157
+00:10:06,390 --> 00:10:10,250
+الastroscope sound to produce within the body كل
+
+158
+00:10:10,250 --> 00:10:14,770
+هذه الشغلاتسحنها واحدة واحدة الinspection is a
+
+159
+00:10:14,770 --> 00:10:17,210
+declarative and purposeful observation in
+
+160
+00:10:17,210 --> 00:10:20,870
+scientific manners هي عبارة عن حاجات مهمة ودقيقة
+
+161
+00:10:20,870 --> 00:10:24,490
+ممكن أنا أشوفها بعيني use the physical sense طبعا
+
+162
+00:10:24,490 --> 00:10:28,350
+عن طريق ال visual hearing and smell طبعا بالملاحظة
+
+163
+00:10:28,350 --> 00:10:32,030
+أنا ممكن أشوف بعيني أحس بإيدي أيضا أسمع بودني و
+
+164
+00:10:32,030 --> 00:10:37,290
+أشم بأنفيExamination and Equipment used to
+
+165
+00:10:37,290 --> 00:10:40,410
+inspection طبعا شو الأجهزة اللي أنا ممكن أستخدمها
+
+166
+00:10:40,410 --> 00:10:45,230
+العين إلها أجهزة خاصة فيها الأنفل و أجهزة خاصة فيه
+
+167
+00:10:45,230 --> 00:10:48,750
+و كذلك الفم الopto أو الفيوناسكوبيه اللي هي ال
+
+168
+00:10:48,750 --> 00:10:51,590
+examination اللي بعمله لل eyes طبعا هذا بخص
+
+169
+00:10:51,590 --> 00:10:55,950
+أخواتنا في البصريات فبيشتغلوا عليه الوتوسكوب إشي
+
+170
+00:10:55,950 --> 00:10:59,270
+خاص طالما قلتوا حكينا عنه لل air mouth and nose
+
+171
+00:10:59,270 --> 00:11:03,310
+trailsالـ Tongue Fork اللي هي عبارة عن الـ Hearing
+
+172
+00:11:03,310 --> 00:11:07,390
+Nose اللي هي الشوكة الرنانة اللي احنا بنعمل و
+
+173
+00:11:07,390 --> 00:11:11,190
+بنشتغل فيها و احنا فيه ابدائي الـ Nasal Spectrums
+
+174
+00:11:11,190 --> 00:11:14,810
+الفيزيوز and Trements of the Nose و الفسيسكوب اللي
+
+175
+00:11:14,810 --> 00:11:20,730
+هو عبارة عن السماعة اللي موجودة عند الطبلةالـ
+
+176
+00:11:20,730 --> 00:11:24,370
+instruments أيضًا لاستخدامنا أو لابحثنا على اللي
+
+177
+00:11:24,370 --> 00:11:28,770
+هو ال vision أو اللي هو الرؤية اللي هو ال chart
+
+178
+00:11:28,770 --> 00:11:33,130
+هذا اللي بيبقى موجود عند أخصائي البصرية عشان أنه
+
+179
+00:11:33,130 --> 00:11:36,790
+أنا بدي أعمل ال touching بدي أحس بإيدي طبعًا هحكي
+
+180
+00:11:36,790 --> 00:11:40,930
+على ال techniques using ل a sense of touch بالإيد
+
+181
+00:11:40,930 --> 00:11:44,970
+أنا بدي أحس إذا في عندي temperatures هل هي درجة
+
+182
+00:11:44,970 --> 00:11:48,980
+الحرارة للمريضباردة او سخنة، التورم، triggers، ال
+
+183
+00:11:48,980 --> 00:11:52,940
+textures، الملمس تبعها، هل في عندي muscle tone
+
+184
+00:11:52,940 --> 00:11:55,960
+عالية ولا المصل عادية، ال moisture، الرتوبة، ال
+
+185
+00:11:55,960 --> 00:11:59,840
+vibration، ايضا الشيء دائما خده في عين الاعتبار
+
+186
+00:11:59,840 --> 00:12:03,560
+انه انا لازم احس بال palmar aspect of hand وليس
+
+187
+00:12:03,560 --> 00:12:09,570
+الدولزر، بحس بال palmar aspect، تمام؟البركاشينز
+
+188
+00:12:09,570 --> 00:12:18,130
+اللي هو الطريقة الثالثة لاللي هو الفحص البركاشينز
+
+189
+00:12:18,130 --> 00:12:21,970
+طبعا تونز are used for location طبعا زي ما كنا
+
+190
+00:12:21,970 --> 00:12:26,410
+ناخده في المتاج البركاشينز shape of sky البركاشينز
+
+191
+00:12:26,410 --> 00:12:30,450
+تونز ممكن يكون flat ممكن يكون الصوت طبعا دل ممكن
+
+192
+00:12:30,450 --> 00:12:34,510
+يكون في عنده ال resonance اللي هو الصدر لهذا الصوت
+
+193
+00:12:34,510 --> 00:12:38,020
+ال hyper resonance يمكن يكون الصدر عالي جدازي ما
+
+194
+00:12:38,020 --> 00:12:41,220
+الحالات اللى هى التنبني التنبني اللى هى حالات
+
+195
+00:12:41,220 --> 00:12:45,940
+النفاخ طبعا اللى هى عبارة عن ال technique اللى
+
+196
+00:12:45,940 --> 00:12:50,240
+أخير اللى أنا بدي استخدمه لفحص مريض الباطنة act of
+
+197
+00:12:50,240 --> 00:12:53,620
+listening with physical to sound produced within
+
+198
+00:12:53,620 --> 00:12:56,620
+the body اللى أنا بستخدمه لسماع الair على سبيل
+
+199
+00:12:56,620 --> 00:13:00,260
+المثال في ال lungs بستخدمه أيضا لسماع ال heart
+
+200
+00:13:00,260 --> 00:13:04,190
+rate لأسمع أشوف شو ال pumping اللى صارFor
+
+201
+00:13:04,190 --> 00:13:07,090
+Characteristic Assessing للأسئوليشن طبعا
+
+202
+00:13:07,090 --> 00:13:11,350
+لاستخدامها لأربع نقاط أساسية ال pitch النغمة ال
+
+203
+00:13:11,350 --> 00:13:14,530
+loudness الصوت و ال quality of the reading الغرغرة
+
+204
+00:13:14,530 --> 00:13:18,330
+و ال duration طبعا كام فترتها هل هي short ولا
+
+205
+00:13:18,330 --> 00:13:24,180
+medium ولا long طبعا هاي كلهبدي أخد طبعا من ال
+
+206
+00:13:24,180 --> 00:13:27,120
+assessment تبعي أو أهم أهدافي في عندي ال patient
+
+207
+00:13:27,120 --> 00:13:30,260
+history طبعا هيكون في عندي ال chief compliment
+
+208
+00:13:30,260 --> 00:13:34,060
+لإيش هو دخل القسم هل هو دخل القسم على سبيل المثال
+
+209
+00:13:34,060 --> 00:13:38,780
+مثلا بمغس مراري أو دخل القسم في مغس ناتج عن زائدة
+
+210
+00:13:38,780 --> 00:13:41,900
+دودية والتهادل زائدة دودية لازم أشوف شو ال chief
+
+211
+00:13:41,900 --> 00:13:45,660
+compliment تبعته present illness طبعا اللي هو
+
+212
+00:13:45,660 --> 00:13:49,970
+المرض الحالي اللي هو دخلي فيههل هو دخل على سبيل
+
+213
+00:13:49,970 --> 00:13:54,630
+المثال بمغص ب vomiting بدياريا كل هذا الأشي لازم
+
+214
+00:13:54,630 --> 00:13:58,530
+أسجله ال past history أو ما يسمى بالتاريخ المرض
+
+215
+00:13:58,530 --> 00:14:03,310
+القديم هذا المرض المرض القديم زي على سبيل المثال
+
+216
+00:14:03,310 --> 00:14:06,010
+إذا كان بيعاني من diabetic إذا كان بيعاني من
+
+217
+00:14:06,010 --> 00:14:09,530
+hypertension كل الأشي هذا لازم أنا أسجله ال
+
+218
+00:14:09,530 --> 00:14:13,710
+current health status اللي هو طبعا الحالة الصحية
+
+219
+00:14:13,710 --> 00:14:17,770
+الموجودة حاليا هل هو مازال يعاني من هذه الألم ولا
+
+220
+00:14:17,770 --> 00:14:22,890
+خلاصتم تسكينهاظبط الوضع لإذن أنا بحكي في ال
+
+221
+00:14:22,890 --> 00:14:26,310
+assessment تبعي أنه على سبيل المثال شاحب الوجه لو
+
+222
+00:14:26,310 --> 00:14:30,390
+مريض مثلا فيه عنا مرضى ممكن يكون يعانى من كذا قلم
+
+223
+00:14:30,390 --> 00:14:34,590
+لكن مش هينبين عليه إيجانى التران الترما ومافيش
+
+224
+00:14:34,590 --> 00:14:37,430
+عنده مشكلة بدي أشوف في الفيلم ال history إذا عنده
+
+225
+00:14:37,430 --> 00:14:41,370
+مثلا على سبيل المثال أمراض سكري في العيلة في عندهم
+
+226
+00:14:41,370 --> 00:14:44,790
+أمراض مظمنة في عندهم إشي بتورثوه أو لأ ال review
+
+227
+00:14:44,790 --> 00:14:48,490
+لل organ system بدي أشوف كل ال organ system و
+
+228
+00:14:48,490 --> 00:14:52,200
+الأعضاءالـ patient illness بدي أحكي على ال
+
+229
+00:14:52,200 --> 00:14:57,460
+location بدي أحكي على ال quality جدّي كمية الألم و
+
+230
+00:14:57,460 --> 00:15:00,860
+ال severity تبع الألم ال timing هل هو أنه بيجي
+
+231
+00:15:00,860 --> 00:15:04,900
+بروح الألم ولا مستمر ولا كمرة في اليوم بيجيها
+
+232
+00:15:04,900 --> 00:15:09,870
+المغص لهذه السنةsitting and watch to develop انه
+
+233
+00:15:09,870 --> 00:15:14,550
+طبعا جدي اللى هو بتطور القلم عندها شو العوامل اللى
+
+234
+00:15:14,550 --> 00:15:18,450
+بتزيد القلم على سبيل المثال هى اجتنى بمغس ملارى
+
+235
+00:15:18,450 --> 00:15:22,150
+دخلت قسم الباطنة معناه الكلام اذا حسيت أنه انا
+
+236
+00:15:22,150 --> 00:15:26,010
+فعلا هى الست اجتنى اليوم وحالتها كانت هيه جدا
+
+237
+00:15:26,010 --> 00:15:30,630
+معناه تبنسألها اذا هى أكلت اكل بسم او مااكلتش عشان
+
+238
+00:15:30,630 --> 00:15:31,590
+يزيد المغس
+
+239
+00:15:38,740 --> 00:15:41,820
+most important disease chronologically disease زي
+
+240
+00:15:41,820 --> 00:15:45,260
+على سبيل المثال ال diabetes و ال hypertension ال
+
+241
+00:15:45,260 --> 00:15:48,580
+operations بدأ اشوف هل عملت عملية جدد كده او هذا
+
+242
+00:15:48,580 --> 00:15:52,840
+الشخص اللى جاى عندي اعمل car accident ولا لأ
+
+243
+00:15:52,840 --> 00:15:56,600
+allergic هل عندك الحساسية من بعض الأدوية اللى احنا
+
+244
+00:15:56,600 --> 00:16:01,260
+مثلا هنعطيها اياها على سبيل المثال في عندها اخدت
+
+245
+00:16:01,260 --> 00:16:04,420
+بعض اللقاحات طبعا هل اتحسست منهم او لأ ال
+
+246
+00:16:04,420 --> 00:16:07,650
+transfusionsتعملت إنه نقل مثلا على سبيل المثال إذا
+
+247
+00:16:07,650 --> 00:16:10,550
+أنا بدي أعملها نقل لدم أو نقل لإشي هل في عندها
+
+248
+00:16:10,550 --> 00:16:14,330
+مشكلة أو لأ استقرينج test طبعا اللي هو ال
+
+249
+00:16:14,330 --> 00:16:16,630
+comprehensive test أخدناه في system measurement
+
+250
+00:16:16,630 --> 00:16:21,350
+اللي هو عبارة عن إشي التقريم الشامل والكامل في
+
+251
+00:16:21,350 --> 00:16:25,070
+البرنامج current health status أو الحالة الصحية
+
+252
+00:16:25,070 --> 00:16:29,210
+الحالية social circumstances هل هو على سبيل المثال
+
+253
+00:16:29,210 --> 00:16:33,790
+متزوج أعزب مطلق هذا لازم يهمني لإنه بدنا نشوف إذا
+
+254
+00:16:33,790 --> 00:16:37,680
+كان على سبيل المثالفي عنده مشاكل في البيت أو لأ؟
+
+255
+00:16:37,680 --> 00:16:40,820
+وأيضا ال occupations اللي هى عبارة عن الوظيفة انه
+
+256
+00:16:40,820 --> 00:16:44,300
+هل كان مثلا موظف ومازال على رأس عمله ولا كان موظف
+
+257
+00:16:44,300 --> 00:16:47,460
+واتقعد؟ حد بيفرج معايا كمان في التعامل ال
+
+258
+00:16:47,460 --> 00:16:50,120
+environmental hazard هل هو في عنده مخاطر البيئة
+
+259
+00:16:50,120 --> 00:16:53,100
+اللى هو فيها في ال school، في ال workplace؟ هل انه
+
+260
+00:16:53,100 --> 00:16:57,760
+صح يظلوا ولا لأ؟ اتبعت اللى هم الأكل طبعا واللى هم
+
+261
+00:16:57,760 --> 00:17:02,860
+عملية تنظيم وcontrol of feeding الكحول and illicit
+
+262
+00:17:02,860 --> 00:17:07,380
+طبعا ال drugsبعض اللي هو هل هو ممكن يكون مدمنين
+
+263
+00:17:07,380 --> 00:17:10,020
+لكحول زي ما هذا الاشي مش موجود عندنا طبعا موجود
+
+264
+00:17:10,020 --> 00:17:14,280
+برا اتباعك هو هل هو مستخدم او هو هل هو مدخن او لا
+
+265
+00:17:14,280 --> 00:17:17,640
+ال current medications اللي هي الأدوية الحالية
+
+266
+00:17:17,640 --> 00:17:20,980
+اللي بياخدها أدوية للسكري أدوية للضغط أدوية لأي
+
+267
+00:17:20,980 --> 00:17:24,660
+أمراض chronic أخرى exercise and leisure activities
+
+268
+00:17:24,660 --> 00:17:28,320
+هيكيك بيقضي نهاره هل هو بيلعب رياضة ولا بيلعبش
+
+269
+00:17:28,320 --> 00:17:32,900
+رياضة sexual history طبعا و ال sleep patterns مهم
+
+270
+00:17:32,900 --> 00:17:37,310
+جداهistory طبعا بدي أشوف ال parents ال banks ال
+
+271
+00:17:37,310 --> 00:17:40,870
+bars هل الأباء موجودين مش موجودين؟ الأطفال في
+
+272
+00:17:40,870 --> 00:17:43,950
+عندهم أطفال ولا ماعندوش؟ أعمارهم و ال health
+
+273
+00:17:43,950 --> 00:17:47,040
+status بتاعتهم؟بدي أشوف في ال family history هل في
+
+274
+00:17:47,040 --> 00:17:49,460
+ديابتس ولا لأ زي ما حكينا في hypertension,
+
+275
+00:17:49,940 --> 00:17:53,280
+infection disease, malignancy, coagulation
+
+276
+00:17:53,280 --> 00:17:56,160
+disorders بعض الحالات اللي هي ال hematology طبعا
+
+277
+00:17:56,160 --> 00:17:59,580
+اللي موجودة عندنا بعض أمراض الدم و ال psychiatric
+
+278
+00:17:59,580 --> 00:18:02,400
+disease على سبيل المثال و ال symptoms of those
+
+279
+00:18:02,400 --> 00:18:05,020
+patients و بدنا نشوف طبعا كل
+
+280
+00:18:10,330 --> 00:18:14,350
+general status and gender and race بدي اشوف الحالة
+
+281
+00:18:14,350 --> 00:18:17,950
+بشكل عام ال body built ال postural ال usual weight
+
+282
+00:18:17,950 --> 00:18:20,770
+ال weight change هل انه صار فيه تغير بسبب المرض
+
+283
+00:18:20,770 --> 00:18:24,170
+مثلا على الوزن او لأ according organs على سبيل
+
+284
+00:18:24,170 --> 00:18:28,030
+المثال بدنا نشوف ال skin و ال head و ال air و لأنه
+
+285
+00:18:28,030 --> 00:18:31,990
+احنا في قسم الباطنة اللي هو قسم الأم طبعا و بعده
+
+286
+00:18:31,990 --> 00:18:34,390
+زي ما حكينا بتتوزع الحالات
+
+287
+00:18:36,950 --> 00:18:40,270
+ال appearance بعض الحالات زى ما حكيتلكم بكون عندها
+
+288
+00:18:40,270 --> 00:18:45,390
+بلاوي كتيرة ولكن بتجينى بمظهر قوي وكويس وكأنه مافي
+
+289
+00:18:45,390 --> 00:18:49,030
+عندهم إشي لكن بعض الحالات ممكن تكون تشتكى من ألم
+
+290
+00:18:49,030 --> 00:18:53,210
+بسيط ولكن وضعها يرتقلهمالـ Appearance طبعا
+
+291
+00:18:53,210 --> 00:18:56,170
+الهياجين بدي أشوف الـ grooming هل هو إنه قادر على
+
+292
+00:18:56,170 --> 00:19:00,110
+سبيل المثال ينظف حاله من حاله ولا بده مساعدة Signs
+
+293
+00:19:00,110 --> 00:19:04,010
+of illness، أعراض المرض هل واضح عليه ولا لأ ال
+
+294
+00:19:04,010 --> 00:19:06,850
+affected و ال mood و ال attitude طبعا هذه الحالات
+
+295
+00:19:06,850 --> 00:19:10,770
+الأشياء اللي هي psychological موجودة عنده ال reach
+
+296
+00:19:10,770 --> 00:19:15,290
+and social expression ال cognitive process طبعا
+
+297
+00:19:15,290 --> 00:19:19,890
+اللي هي الأمور الإدراكيةزي ال speech content ال
+
+298
+00:19:19,890 --> 00:19:23,010
+pattern ال orientation و ال appropriated verbal
+
+299
+00:19:23,010 --> 00:19:27,090
+response كل الأمور اللي موجودة في ال cognitive هل
+
+300
+00:19:27,090 --> 00:19:31,810
+انها سليمة او ممتازة different signs طبعا ال vital
+
+301
+00:19:31,810 --> 00:19:34,650
+signs اللي موجودين احنا عارفين ال vital signs هي
+
+302
+00:19:34,650 --> 00:19:39,570
+عبارة عن العلمات الحيوية اللي بتكون موجود ال high
+
+303
+00:19:39,570 --> 00:19:42,450
+and weight كمان هحكي عليهم ال vital signs اللي
+
+304
+00:19:42,450 --> 00:19:44,790
+انتوا بتشوفوا التمريدة بييجوا بياخدوهم هو عبارة عن
+
+305
+00:19:45,030 --> 00:19:48,590
+خمسة vital signs ال heart rate و ال temperature و
+
+306
+00:19:48,590 --> 00:19:53,110
+الأمور الأخرى هتدرمي لل normal أو abnormal هل هي
+
+307
+00:19:53,110 --> 00:19:56,390
+طبيعية اليوم كانت في أثناء المرور الصباحي و لا لأ
+
+308
+00:19:56,390 --> 00:20:00,450
+ال height and weight decrement طبعا شكل ال height
+
+309
+00:20:00,450 --> 00:20:02,930
+and weight decrement بعد اللي هو ال patient under
+
+310
+00:20:02,930 --> 00:20:07,450
+normal or under weight لازم أحس أنه متمام و لا لأ
+
+311
+00:20:07,450 --> 00:20:11,030
+بدي أعمل أيضا assessment ل ال head and neck ال
+
+312
+00:20:11,030 --> 00:20:14,050
+head بتشوف ال skin و ال face و ال skull و ال scalp
+
+313
+00:20:14,050 --> 00:20:17,450
+أيضاو ال nose و ال senses و ال mouth و ال pharynx
+
+314
+00:20:17,450 --> 00:20:21,750
+و ال cranial nerve كل هذه الأمور أنا بقيمها لإنه
+
+315
+00:20:21,750 --> 00:20:25,270
+بدي أشوف المشكلة من وين إجتني ال neck بدي أشوف فيه
+
+316
+00:20:25,270 --> 00:20:27,990
+عندي ال skin و ال lymph nodes و ال muscle هل في
+
+317
+00:20:27,990 --> 00:20:34,010
+muscle shortening هل في muscle contractures ولا لأ
+
+318
+00:20:34,010 --> 00:20:37,530
+ال thyroid و التراكيا و ال cortoid طبعا arteries
+
+319
+00:20:37,530 --> 00:20:43,340
+and neck veins بدي أشوف فيهم مشاكلأشوف ال skull و
+
+320
+00:20:43,340 --> 00:20:46,780
+ال face إيش طبعا بدي أشوف فيهم inspected لل size
+
+321
+00:20:46,780 --> 00:20:49,300
+and shape و ال symmetry بدي أشوف هل ال right نفس
+
+322
+00:20:49,300 --> 00:20:53,600
+ال left ولا فيها مشكلةالـ Face بدي أشوف هل هو ال
+
+323
+00:20:53,600 --> 00:20:57,120
+exam لل colors هل هو ماشاء الله عليه مورد المريض
+
+324
+00:20:57,120 --> 00:21:01,660
+تبعي و بنكو و الأمور تمام تمام و لا pale و شاحب
+
+325
+00:21:01,660 --> 00:21:04,380
+السيمتري هل ال right نفس ال left و لا في عندنا
+
+326
+00:21:04,380 --> 00:21:08,020
+مشكلة ال distribution لل facial hair طبعا و ال
+
+327
+00:21:08,020 --> 00:21:11,920
+assessment لل facial nerve and facial muscle بدي
+
+328
+00:21:11,920 --> 00:21:17,330
+أشوف و أقيم كمان بشكل عام الوجهتراكيا طبعا not
+
+329
+00:21:17,330 --> 00:21:20,350
+locations بدي أشوف ليه تراكيا في وضعها و لا مش
+
+330
+00:21:20,350 --> 00:21:25,250
+وضعها ال midline in suprasternal notch طبعا بتكون
+
+331
+00:21:25,250 --> 00:21:30,170
+في المنتصف هل فيها مشكلة لتراكيا ولا لأ طبعا ال
+
+332
+00:21:30,170 --> 00:21:33,750
+thyroid لازم أشوف إذا فيها مشكلة أو لأ normal not
+
+333
+00:21:33,750 --> 00:21:36,790
+elevation و ال elevation of size و ال symmetry
+
+334
+00:21:36,790 --> 00:21:39,870
+تبعها هل فيها tenderness أو لأ ال lymph nodes زي
+
+335
+00:21:39,870 --> 00:21:42,390
+ما انتوا مش تعرفوه جهاز lymphatic system هو عبارة
+
+336
+00:21:42,390 --> 00:21:46,670
+عن جهاز مهم جدا انا كمان لازم أقيمهوأشوفه فيه
+
+337
+00:21:46,670 --> 00:21:49,990
+أمراض الباطنة generally not palpation its
+
+338
+00:21:49,990 --> 00:21:53,470
+palpation should be small mobile small not tender
+
+339
+00:21:53,470 --> 00:21:56,930
+طبعا أنا بحس بعض الأحيان اللي هي أسامي الميتال
+
+340
+00:21:56,930 --> 00:21:59,610
+الوز ممكن تلحسها هي بال palpation لكن بالعادة
+
+341
+00:21:59,610 --> 00:22:03,610
+مابنحس ولكن بعض الأجزاء البسيطة منه أو المكوناة
+
+342
+00:22:03,610 --> 00:22:05,590
+اللي هي ال lymphatic system ممكن أنا أحسها
+
+343
+00:22:05,590 --> 00:22:08,650
+abnormal and enlarged indicated معناته infection
+
+344
+00:22:08,650 --> 00:22:13,210
+وال autoimmune and metastases of cancerعلى سبيل
+
+345
+00:22:13,210 --> 00:22:16,270
+المثال لما بيجي بيحس اللواز لأي طفل صغير إذا كانت
+
+346
+00:22:16,270 --> 00:22:20,650
+كبيرة ومضخمة بنقول هذا بداية influenza أو انه هو
+
+347
+00:22:20,650 --> 00:22:25,330
+لوازه ميزة ايضا ال eye و ال ears لما انا بدي أجي
+
+348
+00:22:25,330 --> 00:22:28,830
+أقيمهم inspection لل External و ال Structural و
+
+349
+00:22:28,830 --> 00:22:33,610
+بدي أشوف ال bulbs and ears اللي هي العدسة و
+
+350
+00:22:33,610 --> 00:22:37,630
+القرنية و كل المكونات اللي موجودة عندى في ال eyes
+
+351
+00:22:37,630 --> 00:22:41,920
+بدي أشوف هل في حمار فيش حمار هل متسعةولا على سبيل
+
+352
+00:22:41,920 --> 00:22:44,760
+المثال فيها مشكلة ال internal structure اللي
+
+353
+00:22:44,760 --> 00:22:49,280
+موجودة و الرؤية هل هي مناسبة ولا مش مناسبة ايضا في
+
+354
+00:22:49,280 --> 00:22:52,640
+ال assessment لائل air بدي اشوف المريض تبعي في
+
+355
+00:22:52,640 --> 00:22:57,560
+الأذن الخارجية هل هو سامعني مريضي او مش سامعنيطبعا
+
+356
+00:22:57,560 --> 00:23:01,060
+و ال location bilaterally air should be smooth
+
+357
+00:23:01,060 --> 00:23:05,000
+gently palpation و check لل hearing و أيضا بنحس و
+
+358
+00:23:05,000 --> 00:23:09,800
+بنشوف هل هو قادر ان يتواصل معنا و لا بس سامعنا و
+
+359
+00:23:09,800 --> 00:23:11,040
+مش قادر يرد على
+
+360
+00:23:20,710 --> 00:23:25,690
+هنا ال Vagoma طبعا هي عبارة عن وجود ماء او نسميها
+
+361
+00:23:25,690 --> 00:23:29,350
+الماء البيضا اللي موجودة في العين ال healthy air
+
+362
+00:23:29,350 --> 00:23:34,270
+اللي هي أذن صليمة و هنشوف ال otitis media التهابة
+
+363
+00:23:34,270 --> 00:23:39,510
+في الأذن الوصفة كيف طبعا بتكون مؤلمة و زي ما
+
+364
+00:23:39,510 --> 00:23:43,250
+بتعرفه بتأثر على ال equilibrium و ان هو ال balance
+
+365
+00:23:43,250 --> 00:23:47,170
+اللي موجود عند المجتمع ال chronic otitis media
+
+366
+00:23:47,170 --> 00:23:55,300
+طبعا هذهطبعا اللي هي التهابات الأذن الوسطى بدي
+
+367
+00:23:55,300 --> 00:23:58,880
+أشوف ال noise هل في مشاكل أو لأ بدي أشوف هل ال
+
+368
+00:23:58,880 --> 00:24:02,280
+right فتحة ال right نفس فتحة ال left أو لأ بدي
+
+369
+00:24:02,280 --> 00:24:05,540
+أشوف ال button في ال open button away هل إنه جادر
+
+370
+00:24:05,540 --> 00:24:08,840
+ياخد نفسه مباشرة من غير أي وسائط ولا لازم يكون في
+
+371
+00:24:08,840 --> 00:24:13,280
+عندى اللي هو وسائط أخرى زي التنفس الصناعي على سبيل
+
+372
+00:24:13,280 --> 00:24:16,410
+المثالال senses اللي هي عبارة عن الجيوب الأنفية
+
+373
+00:24:16,410 --> 00:24:18,710
+وكلكوا بتعرفوا أن الجيوب الأنفية هي عبارة عن أربع
+
+374
+00:24:18,710 --> 00:24:21,730
+أزواج موجودة عندنا طبعا هذه الجيوب الأنفية
+
+375
+00:24:21,730 --> 00:24:24,490
+infection of the senses and gentle palpation of
+
+376
+00:24:24,490 --> 00:24:28,790
+maxillary بدي أشوف طبعا بإحساسي إنهام في ال
+
+377
+00:24:28,790 --> 00:24:32,390
+maxilla bone زي ما بتعرفوا في اللي هو ال head bone
+
+378
+00:24:32,390 --> 00:24:35,150
+اللي موجودة عندنا normally the senses are not
+
+379
+00:24:35,150 --> 00:24:39,030
+being formedإذا كان هو اللي غطب إيدي على أعلى اللي
+
+380
+00:24:39,030 --> 00:24:43,170
+هو الأنف ماحس المريض بوجع معناته إحنا كالسليم لكن
+
+381
+00:24:43,170 --> 00:24:47,350
+إذا حس و اتألم بيكون في عنده مشكلة في جيوب الأنفية
+
+382
+00:24:47,350 --> 00:24:51,430
+الهيمت هم طبعا إذا كان في عنده مشكلة في جيوب
+
+383
+00:24:51,430 --> 00:24:56,070
+الأنفية هنا طبعا ال ال bodies اللي هو انحراف و
+
+384
+00:24:56,070 --> 00:25:01,710
+عوجاج في اللي هو الأنفالـ mouth and pharynx اللي
+
+385
+00:25:01,710 --> 00:25:05,670
+هو الفم وقلب العمل لازم انا اشوف طبعا هذا باعبار
+
+386
+00:25:05,670 --> 00:25:07,810
+عن الفم هو عبارة عن ال entrance لل digestive
+
+387
+00:25:07,810 --> 00:25:12,210
+system مدخل الجهاز الحظمي لازم اشوف هل هو سليم ولا
+
+388
+00:25:12,210 --> 00:25:15,170
+مش سليم ال lips و ال tongue و ال teeth و كل هذه
+
+389
+00:25:15,170 --> 00:25:18,920
+الأمور لازم انا اشوفها ال equipment neededطبعا بدي
+
+390
+00:25:18,920 --> 00:25:22,580
+اشوف اذا في عندى tongue depressors في عندى اللى هو
+
+391
+00:25:22,580 --> 00:25:26,660
+ال pink light و ال gas و ال sponge and gloves طبعا
+
+392
+00:25:26,660 --> 00:25:31,060
+ليش لإن هذى الشغلات لازم عشان اقيام اللى هو فم
+
+393
+00:25:31,060 --> 00:25:36,560
+المريض شايفين فى tonsilites التهاب لللواز زى ما هو
+
+394
+00:25:36,560 --> 00:25:40,040
+شايفينه وزى ما شايفينه واضح فى الصورة اللى واز
+
+395
+00:25:40,040 --> 00:25:45,910
+كبيرالـ Hairy Tongue طبعا بعض اللي هو اللسان فيها
+
+396
+00:25:45,910 --> 00:25:48,750
+geographical tongue و فيها hairy tongue طبعا هي
+
+397
+00:25:48,750 --> 00:25:52,440
+على أشكالهاالـ integrimental system أو الـ
+
+398
+00:25:52,440 --> 00:25:55,900
+integrimental structure اللي هو بيشمل ال skin و ال
+
+399
+00:25:55,900 --> 00:25:59,320
+nails هنحكي عليه و ال hair و ال scalp كل هذه
+
+400
+00:25:59,320 --> 00:26:03,100
+الأمور انا هقيمها ايضا من احنا مثلا أولا بنحكي ال
+
+401
+00:26:03,100 --> 00:26:06,320
+integrimental system ابتيا لل history of rashes
+
+402
+00:26:06,320 --> 00:26:10,900
+and lesions طبعا الاشي اللي بتعلق بالجند و الأضافر
+
+403
+00:26:10,900 --> 00:26:16,200
+و الشعر كل هذا الاشي لازم انا اقيمه طبعا في ال
+
+404
+00:26:16,200 --> 00:26:19,580
+integrimental system ال skin بدي اشوف ال color
+
+405
+00:26:19,580 --> 00:26:24,630
+تبعههل هو طبيعي و بنكو كويس ولا في عنابل و شحوب
+
+406
+00:26:24,630 --> 00:26:28,670
+وفي مشاكل نتجة عن ال cardiovascular system
+
+407
+00:26:31,400 --> 00:26:33,960
+في ال assessment area تبع فيه إذا كان في عندنا
+
+408
+00:26:33,960 --> 00:26:37,920
+redness وإذا كان في عندنا blushing, cyanosis ويلش
+
+409
+00:26:37,920 --> 00:26:41,700
+معناته في جلدس اللي هو اليارقان وvetigars اللي هو
+
+410
+00:26:41,700 --> 00:26:46,060
+الباشر area أو اللي هو عديم اللون بنسميه أو انه
+
+411
+00:26:46,060 --> 00:26:49,040
+autoimmune disease بيكون المرض فيه tanned or
+
+412
+00:26:49,040 --> 00:26:52,460
+browned sun exposures اللي هو حروق الدرجة الأولى
+
+413
+00:26:52,460 --> 00:26:55,320
+إذا احنا روحنا على البحر واتعرضنا لأشهر شمس عالية
+
+414
+00:26:55,320 --> 00:27:01,270
+بيكون في عندنا tanned أو browned skinSensory motor
+
+415
+00:27:01,270 --> 00:27:03,910
+and function بدي أحكي على ال motor على ال balance
+
+416
+00:27:03,910 --> 00:27:07,270
+of gaze هل في أنا عندي مشكلة في ال coordination؟
+
+417
+00:27:07,270 --> 00:27:11,170
+هل في عندي مشكلة في ال sensory؟ ال six طبعا بدي
+
+418
+00:27:11,170 --> 00:27:15,310
+أفحصها لقبل من ال reflex ال biceps و ال triceps و
+
+419
+00:27:15,310 --> 00:27:17,290
+ال patellar و ال achilles tendon
+
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/-6a8GO1_yig_raw.srt b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/-6a8GO1_yig_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..ed3ff0e86db7487711ff08c16481bbf6c7e3c977
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/-6a8GO1_yig_raw.srt
@@ -0,0 +1,1216 @@
+1
+00:00:20,890 --> 00:00:24,150
+طيب بسم الله الرحمن الرحيم اليوم يعني عندنا موضوع
+
+2
+00:00:24,150 --> 00:00:27,570
+اللي هو ال spherical aberrations و ال chromatic
+
+3
+00:00:27,570 --> 00:00:31,610
+aberrations بالنسبة لل spherical aberrations أو ال
+
+4
+00:00:31,610 --> 00:00:34,470
+aberrations بصورة عامة قولنا هي أي زيغ عن ال
+
+5
+00:00:34,470 --> 00:00:37,810
+stigma imaging بس ال spherical aberration إلها
+
+6
+00:00:37,810 --> 00:00:43,190
+أهمية خاصة لأنه كتير كانت تكون يعني أو بيقبلها
+
+7
+00:00:43,190 --> 00:00:46,840
+المريضبعد عمليات الـ Refractive Surgery زي الـ
+
+8
+00:00:46,840 --> 00:00:49,560
+LASIK و الـ PRK و ما إلى ذلك الـ Spherical
+
+9
+00:00:49,560 --> 00:00:53,980
+Aberration سببها .. سببها ان الـ optical system
+
+10
+00:00:53,980 --> 00:00:58,760
+بيعملش Refraction بنفس القوة لكل الرزق طبعا لو
+
+11
+00:00:58,760 --> 00:01:04,460
+احنا جينا نحكي عن القرانية ك optical system قرانية
+
+12
+00:01:04,460 --> 00:01:07,940
+العين ك optical system تعتبر more steep centrally
+
+13
+00:01:07,940 --> 00:01:10,340
+more steep
+
+14
+00:01:13,120 --> 00:01:17,820
+و peripherally بتكون more flat هذا بالنسبة للكونية
+
+15
+00:01:17,820 --> 00:01:22,440
+في الطبيعي بدون أي تدخل يعني refractive surgery من
+
+16
+00:01:22,440 --> 00:01:27,680
+قبل الإنسان إذا القرانية بتكون more flat
+
+17
+00:01:27,680 --> 00:01:31,600
+peripherally و more steep centrally و هذه القضية
+
+18
+00:01:31,600 --> 00:01:37,240
+إلها حكمة إنه لو جينا تصورنا إن القرانية spherical
+
+19
+00:01:37,240 --> 00:01:39,980
+surface تماما هنلاقي
+
+20
+00:01:41,870 --> 00:01:46,850
+الـ Central Rays البرا أكسيال ريز بيصير لها focus
+
+21
+00:01:46,850 --> 00:01:51,350
+على ال retina بينما
+
+22
+00:01:51,350 --> 00:01:55,170
+ال peripheral rays لأن زاوية سقوطها أكبر تمام
+
+23
+00:01:55,170 --> 00:01:59,490
+هتكون انكسارها أكتر و من التالي هيصير focus أمام
+
+24
+00:01:59,490 --> 00:02:02,690
+ال retina يعني هذه العين بالنسبة لل peripheral
+
+25
+00:02:02,690 --> 00:02:07,190
+rays تعتبر myopic بالنسبة لل peripheral rays تعتبر
+
+26
+00:02:07,190 --> 00:02:11,400
+myopicو بالنسبة للـ Central Rays تعتبر Immetropic
+
+27
+00:02:11,400 --> 00:02:16,400
+وعشان هيك من حكمة ان القرانية ربنا عز وجل خلجها
+
+28
+00:02:16,400 --> 00:02:21,000
+Centrally more steep و Peripherally more flat ان
+
+29
+00:02:21,000 --> 00:02:25,560
+الضعف البسيط more flat يعني قوتها الإنكسارية أقل
+
+30
+00:02:25,560 --> 00:02:28,760
+شوية فبالتالي بتأخر ال focus بتاعها بدل ما يكون
+
+31
+00:02:28,760 --> 00:02:32,040
+أمام ال retina بيكون ال peripheral ال peripheral
+
+32
+00:02:32,040 --> 00:02:35,900
+rays على ال retina و في نفس الوقت ال central rays
+
+33
+00:02:35,900 --> 00:02:40,060
+على ال retinaفبالتالي مابيصيرش عنده spherical
+
+34
+00:02:40,060 --> 00:02:43,540
+aberration في الوضع العادي طيب ايش علاقة ال
+
+35
+00:02:43,540 --> 00:02:46,880
+refractive surgery في هذه القضية؟ اذا اول شغلة
+
+36
+00:02:46,880 --> 00:02:52,760
+بنقول القرنية اللي هي ك optical system مالهاش نفس
+
+37
+00:02:52,760 --> 00:02:56,600
+ال refractive power في كل مناطقة generally
+
+38
+00:02:56,600 --> 00:03:01,530
+speaking ال central corneamore steep than the
+
+39
+00:03:01,530 --> 00:03:03,910
+peripheral cornea او بعبارة اخرى ال peripheral
+
+40
+00:03:03,910 --> 00:03:08,090
+cornea is more flat than the central cornea عشان
+
+41
+00:03:08,090 --> 00:03:11,690
+مايحدثش عند ال spherical aberration لو تخلينا هذا
+
+42
+00:03:11,690 --> 00:03:14,670
+الاشي مش موجود و انه القرنية عبارة عن spherical
+
+43
+00:03:14,670 --> 00:03:19,690
+surface بمعنىإن ال radius of curvature لكل نقاط
+
+44
+00:03:19,690 --> 00:03:24,350
+القرنية هو نفس الشيء نفس القوة تمام وبالتالي حيصير
+
+45
+00:03:24,350 --> 00:03:29,890
+عندي multiple focal أو multiple foci في لل
+
+46
+00:03:29,890 --> 00:03:32,830
+peripheral rays و لل central rays يعني ال central
+
+47
+00:03:32,830 --> 00:03:36,110
+rays إذا كانت على الرتina ال peripheral rays هيكون
+
+48
+00:03:36,110 --> 00:03:40,010
+more anterior focus وبالتالي بالنسبة لل peripheral
+
+49
+00:03:40,010 --> 00:03:48,440
+raysالعين تعتبر myopic لأنه قدام الشبكية طبعا ممكن
+
+50
+00:03:48,440 --> 00:03:53,800
+إنسان يقول طيب مش مشكلة لو كانت القرنية sphere
+
+51
+00:03:53,800 --> 00:03:57,540
+pure sphere نقول لأ مشكلة و بالذات هذه المشكلة
+
+52
+00:03:57,540 --> 00:04:01,780
+بتظهر في المساء ليش هذه المشكلة بتظهر في المساء؟
+
+53
+00:04:01,780 --> 00:04:05,740
+لأن لو كان في عندي أناالـ Corneospherical Service
+
+54
+00:04:05,740 --> 00:04:10,720
+تماما في عند الـ Iris بتعمل Blocking للبريفيرال
+
+55
+00:04:10,720 --> 00:04:15,820
+ريز يعني البريفيرال ريز ال Iris بتعمل لهم Blocking
+
+56
+00:04:15,820 --> 00:04:20,740
+و اللي بيدخل العين فقط اللي هو حزمة الأشعة ال
+
+57
+00:04:20,740 --> 00:04:25,300
+Central وبالتالي مافي مشكلة المشكلة بتظهربالقرب من
+
+58
+00:04:25,300 --> 00:04:29,360
+المساء لما أشعة الشمس تخف و الـ pupil يصير dilated
+
+59
+00:04:29,360 --> 00:04:32,100
+وبالتالي يصير الـcentral ray مع الـperipheral ray
+
+60
+00:04:32,100 --> 00:04:35,720
+يعني يوصل إلى الشبكية ويصير عندي multiple فوكاي
+
+61
+00:04:35,720 --> 00:04:39,000
+وبالتالي بيصير عندي بتظهر ظاهرة الاش ال spherical
+
+62
+00:04:39,000 --> 00:04:43,220
+aberration السبب أنه ال regions تعني الكورنيا
+
+63
+00:04:43,220 --> 00:04:48,220
+كoptical system مش متكافئة في قوتها الإنكسارية
+
+64
+00:04:48,220 --> 00:04:52,400
+تمام؟ نجم نحكي كالقاتل إيش علاقة ال refractive
+
+65
+00:04:52,400 --> 00:04:57,260
+surgery؟إيش علاقة ال refractive surgery في اللي هي
+
+66
+00:04:57,260 --> 00:05:02,980
+قضية spherical aberration الوضع الطبيعي ال وضع
+
+67
+00:05:02,980 --> 00:05:11,000
+الطبيعي ال cornea is prolate cornea is prolate في
+
+68
+00:05:11,000 --> 00:05:16,360
+الوضع الطبيعي ال وضع الطبيعي prolate يعني
+
+69
+00:05:16,360 --> 00:05:25,310
+centrally more steep more steepperipherally more
+
+70
+00:05:25,310 --> 00:05:32,650
+flat تمام
+
+71
+00:05:32,650 --> 00:05:35,910
+في
+
+72
+00:05:35,910 --> 00:05:41,490
+عكس هذا الوضع أنه يكون عندي oblate cornea العكس
+
+73
+00:05:41,490 --> 00:05:45,710
+بالضبط يعني centrally more flat peripherally more
+
+74
+00:05:45,710 --> 00:05:49,030
+steep يا ترى أي الوضعين هيسبب ال spherical
+
+75
+00:05:49,030 --> 00:05:53,670
+aberrationالوضع التاني .. الوضع التاني هيزيد سوق
+
+76
+00:05:53,670 --> 00:05:56,650
+بالنسبة للوضوع الـ spherical aberration أما الوضع
+
+77
+00:05:56,650 --> 00:05:58,790
+الأول اللي هو الوضع الطبيعي لما يكون أنديه
+
+78
+00:05:58,790 --> 00:06:02,090
+centrally more steep و peripherally more flat ال
+
+79
+00:06:02,090 --> 00:06:05,130
+peripheral ليه؟ هيتأخر ال focus بتاعها و يسير على
+
+80
+00:06:05,130 --> 00:06:07,830
+ال retina و مافيش أنديه spherical aberration طب
+
+81
+00:06:07,830 --> 00:06:11,690
+هذا الوضع وين أنا ب .. بأصادفه؟ بعد عمليات ال
+
+82
+00:06:11,690 --> 00:06:15,290
+refractive surgery بتاعة ال myopia بعد عمليات ال
+
+83
+00:06:15,290 --> 00:06:18,230
+refractive surgery بتاعة ال myopia ال myopia عند
+
+84
+00:06:18,230 --> 00:06:23,800
+ستيف كورنيابتيجي عملية ال refractive surgery تعمل
+
+85
+00:06:23,800 --> 00:06:28,320
+flattening لل central part of the cornea أصبح هنا
+
+86
+00:06:28,320 --> 00:06:34,820
+عندي more flat عشان نالج الميوبيا وهنا عندي more
+
+87
+00:06:34,820 --> 00:06:40,900
+steep هذه بيسموها oblate cornea تمام؟
+
+88
+00:06:40,900 --> 00:06:46,640
+بينما هذه بيسموها brulateKerny يعني more steep
+
+89
+00:06:46,640 --> 00:06:50,180
+centrally و more flat peripherally تمام هذه oblate
+
+90
+00:06:50,180 --> 00:06:54,480
+kerny طيب ماشي okay نقول هذا المريض اللي عمل
+
+91
+00:06:54,480 --> 00:06:58,420
+refractive surgery سواء عمل radial keratotomy
+
+92
+00:06:58,420 --> 00:07:06,640
+عمليات التشطيب اللي زمان انتهت الآن عمليات
+
+93
+00:07:06,640 --> 00:07:12,360
+تشطيب القرنية سموها radial keratotomy بيعملوا
+
+94
+00:07:12,690 --> 00:07:16,690
+تشطيبات في القرانية بحيث الـ intraocular pressure
+
+95
+00:07:16,690 --> 00:07:20,090
+بيدفع الكورنيا لما تصير thin في المناطق high و
+
+96
+00:07:20,090 --> 00:07:24,710
+بيصير شكلها ايش؟ بيصير شكلها more .. هاي .. هاي
+
+97
+00:07:24,710 --> 00:07:29,110
+المقطع في ال .. في التشطيبات هاي فبتصير القرانية
+
+98
+00:07:29,110 --> 00:07:34,510
+ايش؟ more flat centrally و more steep peripherally
+
+99
+00:07:34,510 --> 00:07:39,530
+radial keratotomy أو PRKاللي هو الليزك السطحي أو
+
+100
+00:07:39,530 --> 00:07:44,610
+الليزك اللي هو بنرفع فلاب و بنعدل تضاريس القرانية
+
+101
+00:07:44,610 --> 00:07:49,190
+و بنرجح هذا الفلاب فبغض اللغة عن أي نوع من العملية
+
+102
+00:07:49,190 --> 00:07:53,270
+هذه حيصير عندي أنا oblate cornea الoblate cornea
+
+103
+00:07:53,270 --> 00:07:57,490
+في النهار المريض مبسوط على نفسه ليش؟ لأن ال pupil
+
+104
+00:07:59,150 --> 00:08:04,170
+يعني Myotic او ال .. ال .. ال .. Lipubule يعني
+
+105
+00:08:04,170 --> 00:08:08,590
+حجمه صغير نوعا ما بالتالي ال peripheral rays مافيش
+
+106
+00:08:08,590 --> 00:08:12,090
+خوف منها و ال central ray بناء على الوضع الجديد
+
+107
+00:08:12,090 --> 00:08:16,650
+هيصير عندها بدل ما كانت قبل تتثبت على أمام الشبكية
+
+108
+00:08:16,650 --> 00:08:19,810
+الآن هيصير ال focus بتاع الشبكية هو النظر 6 ع 6 و
+
+109
+00:08:19,810 --> 00:08:24,570
+مبسوط من نفسه مشكلة هذا المريض ال myopic patient
+
+110
+00:08:24,570 --> 00:08:29,590
+اللي عمل عملية Lasik تمام تيجي في المساءفي المساء
+
+111
+00:08:29,590 --> 00:08:33,670
+في المساء اللي بيبقى من إيش بيصير فيه بيلاتيشن
+
+112
+00:08:33,670 --> 00:08:38,130
+لأنه قلة الضوء تمام وبالتالي بيصير ال peripheral
+
+113
+00:08:38,130 --> 00:08:42,770
+race تدخل و بيصير ال focus بتاعها إيش؟أمام الشبكية
+
+114
+00:08:42,770 --> 00:08:45,810
+طبعا كمية ال peripheral rays أكتر من كمية ال
+
+115
+00:08:45,810 --> 00:08:50,410
+central rays فبالتالي و كأن ال focus غالبيته أمام
+
+116
+00:08:50,410 --> 00:08:54,450
+وهذا بيسموها night myopia لأ night myopia لأنها
+
+117
+00:08:54,450 --> 00:08:59,800
+بتصير إيش في بداية الليل تمام night myopiaيعني
+
+118
+00:08:59,800 --> 00:09:03,280
+بيكون هذا المريض في النهار مبسوط جدا و النظر 6 ع 6
+
+119
+00:09:03,280 --> 00:09:08,400
+بينما لما الجو يبدأ العتمة تنزل أو المغرب ييجي
+
+120
+00:09:08,400 --> 00:09:11,720
+بيصير عندي أنا قضية ال night myopia بسبب ال
+
+121
+00:09:11,720 --> 00:09:15,360
+spherical aberration بسبب ال spherical aberration
+
+122
+00:09:15,360 --> 00:09:18,460
+اللي بيلعب الدور الرئيسي في موضوع ال spherical
+
+123
+00:09:18,460 --> 00:09:21,360
+aberration ال pupilary diameter كل ما كان ال pupil
+
+124
+00:09:21,360 --> 00:09:27,080
+أوسع كل ما كانت المشكلة يعني أكبر كل ما كانت
+
+125
+00:09:27,080 --> 00:09:30,900
+المشكلة أكبرطبعا للتنويه الان عملية الـ LASIK
+
+126
+00:09:30,900 --> 00:09:35,580
+الحديثة تمام بتاخد في الاعتبار قضية المحافظة أو
+
+127
+00:09:35,580 --> 00:09:39,420
+محاولة المحافظة على الشيب الأساسي للقرن يعني بمعنى
+
+128
+00:09:39,420 --> 00:09:43,720
+أخر بدنا نعدل الميوبيا و نتخلص من الميوبيا بس بدنا
+
+129
+00:09:43,720 --> 00:09:49,900
+نتضل عندنا إيش اللي هو الشكل تمام اللي هو ال
+
+130
+00:09:49,900 --> 00:09:56,130
+asperity of the cornea ال asperityبدا تبقى عندي
+
+131
+00:09:56,130 --> 00:09:59,530
+تقريبا محافظة على البروليت فورم تمام وفي يعني
+
+132
+00:09:59,530 --> 00:10:03,830
+برامج و softwares لعمل هذه القضية ان اتخلص من ال
+
+133
+00:10:03,830 --> 00:10:07,730
+refractive error و في نفس الوقت احاول يكون عندي
+
+134
+00:10:07,730 --> 00:10:11,310
+مايظلش عندي قضية ال spherical aberration و يظل شكل
+
+135
+00:10:11,310 --> 00:10:15,090
+القرنية زي الشكل الطبيعي المعتاد عليه وهذا القضية
+
+136
+00:10:15,090 --> 00:10:18,710
+في الأجهزة الحديثة المتوفرة تمام طيب الآن العلماء
+
+137
+00:10:18,710 --> 00:10:23,340
+حاولوا يدرسوايعني قداش مزعجة هذه الـ spherical
+
+138
+00:10:23,340 --> 00:10:26,500
+aberration أو هل في علاقة بتربطها بين الـ
+
+139
+00:10:26,500 --> 00:10:34,740
+pupillary diameter الـ pupillary diameter ويعني
+
+140
+00:10:34,740 --> 00:10:38,860
+ال spherical aberration فوجدوا نعم انه في علاقة ان
+
+141
+00:10:38,860 --> 00:10:45,120
+ال spherical aberration تتناسب ترضيا تتناسب
+
+142
+00:10:45,120 --> 00:10:48,280
+ترضيا مع الأس الرابع ال fourth power
+
+143
+00:10:52,710 --> 00:10:58,670
+للـ pupillary diameter نضرب مثال على ذلك نقول
+
+144
+00:10:58,670 --> 00:11:03,490
+كالقاتل انسان
+
+145
+00:11:03,490 --> 00:11:09,370
+اندوسبيريكال aberration بعد عملية الاسك مقدارها
+
+146
+00:11:09,370 --> 00:11:16,530
+تقريبا ربع ديوبترربيع ديوبتر بعد ما كان عنده مثلا
+
+147
+00:11:16,530 --> 00:11:20,090
+minus خمسة أو minus ستة ما مش هالقضية بيقدر يشوف
+
+148
+00:11:20,090 --> 00:11:24,850
+ستة ع ستة واموره كويسة تمام البيوبيلري ديامتر عنده
+
+149
+00:11:24,850 --> 00:11:29,230
+في النهار تلاتة ميلي متر وكمية الـ spherical
+
+150
+00:11:29,230 --> 00:11:32,510
+aberration وبيوبيلري ديامتر تلاتة ميلي متر مقدارها
+
+151
+00:11:32,510 --> 00:11:34,050
+ايه؟ minus ربيع
+
+152
+00:11:39,160 --> 00:11:42,260
+في الليل عنده ال Pupillary Diameter بيصير 6 ملي
+
+153
+00:11:42,260 --> 00:11:46,400
+يعني كم مرة اضعف ال Pupillary Diameter مرتين كان
+
+154
+00:11:46,400 --> 00:11:51,440
+تلاتة و صارت ستة بنقول اضعف مرتين ال spherical
+
+155
+00:11:51,440 --> 00:11:57,480
+aberration اضعفت من مرتين قص أربعة يعني ست عشر مرة
+
+156
+00:11:57,480 --> 00:12:03,200
+يعني الربيع عدد اللي تضربيه في الست عشر ايش بصف
+
+157
+00:12:03,200 --> 00:12:10,290
+عندي اربعة ديوب ترميوبيا يعني كأنه ماملشمظبوط احنا
+
+158
+00:12:10,290 --> 00:12:14,170
+هنا ضربنا المثال لتقريب المفهوم اذا العلاقة اللى
+
+159
+00:12:14,170 --> 00:12:18,250
+بتربط البيوبيلا
+
+160
+00:12:18,250 --> 00:12:22,850
+لديامتر في ال spherical aberration تمام ان ال
+
+161
+00:12:22,850 --> 00:12:27,920
+spherical aberration تتناسبمع ال fourth power للـ
+
+162
+00:12:27,920 --> 00:12:30,780
+change في الـ pupillary diameter دوابنا مثال على
+
+163
+00:12:30,780 --> 00:12:33,900
+ذلك انه لو كان عندي انا في النهار spherical
+
+164
+00:12:33,900 --> 00:12:36,480
+aberration مقدارها ربع الديوبتر يعني ال focus
+
+165
+00:12:36,480 --> 00:12:42,520
+بتاعها قدام ال retina و بدي minus ربع عشان اخليها
+
+166
+00:12:42,520 --> 00:12:46,560
+ال retina تمام؟ اذا هذه ال spherical aberration
+
+167
+00:12:46,560 --> 00:12:52,940
+قيمة تقريبا بتعطيني ما مقدارهربع ديوبتر of myopia
+
+168
+00:12:52,940 --> 00:12:55,800
+يعني ال focus بتاع ال peripheralism جدّم عن ال
+
+169
+00:12:55,800 --> 00:12:59,600
+retina بمقدار يمكن ارجعها على ال retina بربع
+
+170
+00:12:59,600 --> 00:13:04,520
+ديوبتر minus lens طيب هذا و لبيوبيلاري ديومتر
+
+171
+00:13:04,520 --> 00:13:09,260
+جدّاش؟ تلاتة ملي متر طب الآن البيوبيلاري ديومتر
+
+172
+00:13:09,260 --> 00:13:12,280
+اتضاعف صار مرتين جدّاش بتضاعف ال spherical
+
+173
+00:13:12,280 --> 00:13:17,220
+aberration برضه مرتين لأ مقدار التضاعففي الـ
+
+174
+00:13:17,220 --> 00:13:22,260
+pupillary diameter أُص أربعة أُص أربعة طيب لو كان
+
+175
+00:13:22,260 --> 00:13:25,080
+أنا عندي الـ pupillary diameter كان تلاتة ملي صار
+
+176
+00:13:25,080 --> 00:13:28,940
+أربعة ملي و نص إذا أنا زاد مرة و نص فبحكي أنا مرة
+
+177
+00:13:28,940 --> 00:13:33,940
+و نص أُص أربعة و بطلع عندي كام مرة زادت ال
+
+178
+00:13:33,940 --> 00:13:37,580
+spherical aberration كام مرة زادت ال spherical
+
+179
+00:13:37,580 --> 00:13:41,940
+aberration و للأهمية القصوى أن كتير ناس يعني أنا
+
+180
+00:13:41,940 --> 00:13:46,910
+بالنهاية لما كمريد بدي أعمل عملية Lasikما بعمله
+
+181
+00:13:46,910 --> 00:13:50,890
+عشان أشوف في النهار لحالي يعني بدي بالنهار و
+
+182
+00:13:50,890 --> 00:13:54,330
+بالليل يعني من حد ما أستيقظ لغاية ما أنام أنه يكون
+
+183
+00:13:54,330 --> 00:13:57,590
+ال vision عندي كويس و مقبول و مرضي تمام أما ما بدي
+
+184
+00:13:57,590 --> 00:14:00,910
+أنا في النهار أكون ستة ع ستة و لما أفحص في الليل
+
+185
+00:14:00,910 --> 00:14:04,590
+أو في الليل إنسان على بعد كذا متر مني مثلا أربع
+
+186
+00:14:04,590 --> 00:14:08,290
+خمسة متر مش شايفه أو مش شايف تفاصيل وجههم فبالتالي
+
+187
+00:14:08,290 --> 00:14:12,090
+هذه شيء كمثال هذه شيء مزعج جدا أنه في الليل بترجع
+
+188
+00:14:12,090 --> 00:14:16,380
+المشكلةكما كانت .. كما كانت .. الآن في بعض الحلول
+
+189
+00:14:16,380 --> 00:14:20,600
+ان ممكن انا استخدم قطرة تعمل meiosis او اتضايق
+
+190
+00:14:20,600 --> 00:14:23,420
+البقبو زي قطرة ال bilocarbine بس هل هذا حل اني اضل
+
+191
+00:14:23,420 --> 00:14:27,060
+استخدمها طول .. طول حياتي؟ هذه لأ مش حالة وفي قضية
+
+192
+00:14:27,060 --> 00:14:29,340
+تانية في ال bilocarbine اللي هو بيعملها تضايق
+
+193
+00:14:29,340 --> 00:14:33,280
+البقبو ال bilocarbine لازم يستخدم بحضر شديد جدا
+
+194
+00:14:33,280 --> 00:14:36,980
+عند المرضى اللي اصلا myopic كانواأو ال myubic اللي
+
+195
+00:14:36,980 --> 00:14:40,440
+لسه ماعملوش ليش لأنه ممكن من أثاره الجانبية في بعض
+
+196
+00:14:40,440 --> 00:14:43,160
+الحلات يعمل retinal detachment الفصال في الشبكية
+
+197
+00:14:43,160 --> 00:14:48,660
+تمام او يعمل يعني مزع او تير في ال peripheral
+
+198
+00:14:48,660 --> 00:14:53,200
+retina فبالتالي ضروري للانتباه له لكن من فضل الله
+
+199
+00:14:53,200 --> 00:14:56,440
+ان الأجهزة الحديثة اللي انت تاخد في اعتبارها ان
+
+200
+00:14:56,440 --> 00:15:00,450
+انا ماببنتعامل مع قرانية المرضى اني بدي اعمل ليزك
+
+201
+00:15:00,450 --> 00:15:03,910
+و خلاص لأ بدي اعمل ليزك و بدي احافظ على shape of
+
+202
+00:15:03,910 --> 00:15:06,650
+the cornea بدي احافظ على shape of the cornea و في
+
+203
+00:15:06,650 --> 00:15:10,550
+software و برامج تحسب هذا القضية طبعا و في علم
+
+204
+00:15:10,550 --> 00:15:14,270
+يعني للمحافظ على ال aspericity بتاعة ال cornea ان
+
+205
+00:15:14,270 --> 00:15:18,030
+نخليها بروليات و ماتتحولش لا إيش لقبلات كورنيا
+
+206
+00:15:18,030 --> 00:15:22,730
+وبالتالي بتتم التخلص من هذه القضية اذا هذا بالنسبة
+
+207
+00:15:22,730 --> 00:15:25,470
+لأ ال spherical aberration اللي هي بتسبب لي نايت
+
+208
+00:15:25,470 --> 00:15:28,990
+مايوبياعند الناس اللي عندهم spherical aberration
+
+209
+00:15:28,990 --> 00:15:34,210
+الان نجلع ل chromatic aberration طبعا ال mind
+
+210
+00:15:34,210 --> 00:15:36,810
+myopia قبل ما نحكي عن ال chromatic aberration نقول
+
+211
+00:15:36,810 --> 00:15:40,750
+ال mind myopia هي يعني المريض بييجي بيوصف انه ال
+
+212
+00:15:40,750 --> 00:15:44,070
+vision عنده fluctuating بمعنى متردد يعني انا في
+
+213
+00:15:44,070 --> 00:15:47,070
+النهار كويس في الليل سيئ تاني يوم النهار كويس تالت
+
+214
+00:15:47,070 --> 00:15:54,010
+يوم وفي الليل يعني يعني بتردد عندي القضية بتاعة
+
+215
+00:15:54,010 --> 00:15:58,210
+اللي هي ال visionfluctuating vision طبعا نجي لـ
+
+216
+00:15:58,210 --> 00:16:04,350
+chromatic aberration ال aberration نتيجة اختلاف ال
+
+217
+00:16:04,350 --> 00:16:10,150
+focus هذه ال spherical aberration لان معروف انه ال
+
+218
+00:16:10,150 --> 00:16:13,630
+white light بتكون من ألوان الطيف او من اللي هو ال
+
+219
+00:16:13,630 --> 00:16:18,130
+spectrum بتاع الطيف طبعا معروف انه كل ما كانت طول
+
+220
+00:16:18,130 --> 00:16:22,250
+الموج أقصر كل ما كان ال refractive index لل medium
+
+221
+00:16:22,250 --> 00:16:29,290
+أعلى بمعنى أخرالـ Cornea والـ Aqueous هذه Medium
+
+222
+00:16:29,290 --> 00:16:32,290
+والـ Aqueous Medium والـ Crystalline Lens Medium
+
+223
+00:16:32,290 --> 00:16:36,370
+والـ Vitreous Medium وهذه الـ Retina اللي هي ورقة
+
+224
+00:16:36,370 --> 00:16:41,010
+الاستقبال في علم الـ Geometric Optics طبعا الان ال
+
+225
+00:16:41,010 --> 00:16:50,940
+blue light وال yellow light وال red lightطبعا ال
+
+226
+00:16:50,940 --> 00:16:53,260
+blue اللي هو short wavelength و ال yellow اللي هو
+
+227
+00:16:53,260 --> 00:16:55,940
+ال intermediate wavelength و ال red اللي هو ال
+
+228
+00:16:55,940 --> 00:17:01,300
+long wavelength اللي هو الممثلين عن اللي هو التلت
+
+229
+00:17:01,300 --> 00:17:05,400
+أنواع من ال wavelength of visible light الآن
+
+230
+00:17:05,400 --> 00:17:09,160
+القرنية اللي هي refractive index لل blue light و
+
+231
+00:17:09,160 --> 00:17:11,960
+لل yellow و لل orange و لل red و ل .. إلى آخرى
+
+232
+00:17:11,960 --> 00:17:16,300
+تمام أعلى شيء refractive index هيكون لل blue في كل
+
+233
+00:17:16,300 --> 00:17:24,450
+الأوساط هاي و أدنى شيء هيكونللرد بمعنى اخر لو
+
+234
+00:17:24,450 --> 00:17:27,430
+تصورنا ان ال yellow light ال focus بتاعه جاي على
+
+235
+00:17:27,430 --> 00:17:31,770
+ال retina ال blue light هيكون أمام ال retina لو ال
+
+236
+00:17:31,770 --> 00:17:36,900
+refractive index أعلى فبالتالي الانكسار أكترو ال
+
+237
+00:17:36,900 --> 00:17:40,440
+red هيكون يعني إذا هنا عندنا blue و هنا عندنا
+
+238
+00:17:40,440 --> 00:17:44,100
+yellow و هنا عندنا red حاجة تسمى ال chromatic
+
+239
+00:17:44,100 --> 00:17:47,100
+aberration ال chromatic aberration بتنتج عن ال
+
+240
+00:17:47,100 --> 00:17:50,540
+dispersion تاع الأطياف المختلفة و ال dispersion
+
+241
+00:17:50,540 --> 00:17:53,980
+بسبب ان ال refractive indices للأطوال الموجية
+
+242
+00:17:53,980 --> 00:17:57,800
+المختلفة مختلفة يعني ممكن اعتبار نفس العين امة
+
+243
+00:17:57,800 --> 00:18:02,980
+rope بالنسبة لل yellow light تماموميوب بالنسبة للـ
+
+244
+00:18:02,980 --> 00:18:07,660
+blue light وهيبرمتروب بالنسبة للـ red light أحيانا
+
+245
+00:18:07,660 --> 00:18:10,680
+الإنسان بلاحظش ال difference بس بعض الناس بتلاحظ
+
+246
+00:18:10,680 --> 00:18:13,520
+ال difference وبعض الناس اللي بنعطيها correction
+
+247
+00:18:13,520 --> 00:18:17,100
+glasses أو contact lenses تمام وبيصير عنده media
+
+248
+00:18:17,100 --> 00:18:21,460
+أكتر تمام ال dispersion بيصير أكتر وبالتالي بيصير
+
+249
+00:18:21,460 --> 00:18:25,550
+الفرقبين الأطياف الموجية المختلفة أعظم وبالتالي
+
+250
+00:18:25,550 --> 00:18:31,230
+بيصير عندي انا مشكلة في انه بشوف هلات لونية حول
+
+251
+00:18:31,230 --> 00:18:34,390
+المصادر اللي بتطلع عليها او ال objects اللي بتطلع
+
+252
+00:18:34,390 --> 00:18:36,910
+عليها وبالتالي هذا يسمى ايه ايش chromatic
+
+253
+00:18:36,910 --> 00:18:41,490
+aberration حاولوا جيسوا الفرج في الطبيعة بين ال
+
+254
+00:18:41,490 --> 00:18:47,890
+red focus و ال blue focus تمامفوجدوا ان ال red
+
+255
+00:18:47,890 --> 00:18:51,730
+focus و ال blue focus تقريبا نص ديوبتر عشان angle
+
+256
+00:18:51,730 --> 00:18:55,850
+focus للتاني يعني انا بدأ استعمل plus نص لل red
+
+257
+00:18:55,850 --> 00:19:00,030
+عشان ييجي هنا او بستعمل minus نص لل blue عشان ييجي
+
+258
+00:19:00,030 --> 00:19:05,490
+هنا او بستعملplus ربع للرد عشان ايجي ع الشبكية و
+
+259
+00:19:05,490 --> 00:19:08,910
+اشوفه واضح و minus ربع لل blue عشان ايجي ع الشبكية
+
+260
+00:19:08,910 --> 00:19:12,950
+و اشوفه واضح لعين يعني اللي هو under examination
+
+261
+00:19:12,950 --> 00:19:17,390
+فبالتالي الفارق او ال difference نص ضيوبة تمام
+
+262
+00:19:17,390 --> 00:19:21,850
+فبالتالي في عندي انا هذا يسمى ايش ال chromatic
+
+263
+00:19:21,850 --> 00:19:25,050
+aberration بعض الناس بالنسبة له ال chromatic
+
+264
+00:19:25,050 --> 00:19:28,950
+aberration مش كتير مزعجة بس ناس تانية بتصير عندي
+
+265
+00:19:28,950 --> 00:19:34,340
+انا في مشكلة فيالـ Optical System اللي بوصفله يا
+
+266
+00:19:34,340 --> 00:19:39,000
+لأنه هيسبب له معاناة انه يعني في عنده هلات لونية
+
+267
+00:19:39,000 --> 00:19:42,260
+حوالي مصادر الضوء و ال objects اللي بتطلع عليها ما
+
+268
+00:19:42,260 --> 00:19:45,860
+الحل في هذه القضية .. ما الحل في هذه القضية لما
+
+269
+00:19:45,860 --> 00:19:49,620
+حكينا عن ال spherical aberration وجدوا حل انه نظام
+
+270
+00:19:49,620 --> 00:19:52,740
+خاص لعملية ال refractive surgery بتحافظ على الشكل
+
+271
+00:19:52,740 --> 00:19:58,660
+التالكههنا وجدوا حلول لبعض الأجهزة المتقدمة زي
+
+272
+00:19:58,660 --> 00:20:03,590
+المايكرسكوبات تمام الجراحية وما شابه تمامبعض
+
+273
+00:20:03,590 --> 00:20:08,250
+الأجهزة البصرية المتقدمة بتعمل color compensation
+
+274
+00:20:08,250 --> 00:20:12,130
+أو تقليل من ال chromatic aberration
+
+275
+00:20:34,680 --> 00:20:37,940
+Spectrum واحد .. واحد .. تمام؟ يعني أنا مابديش أحل
+
+276
+00:20:37,940 --> 00:20:40,320
+مثلا ال blue و يظهر عند ال red أو أحل ال red و
+
+277
+00:20:40,320 --> 00:20:43,400
+يظهر عند ال blue و مابينه .. و كله بيكون focus في
+
+278
+00:20:43,400 --> 00:20:47,040
+نفس المكان طب أنا كيف ده أتحكم في القضية إذا كان
+
+279
+00:20:47,040 --> 00:20:50,400
+refractive index للأطوال الموجية المختلفة مختلفة
+
+280
+00:20:50,400 --> 00:20:54,920
+.. تمام؟ فيعني اخترعوا أو أوجدوا طالما أنا مش قادر
+
+281
+00:20:54,920 --> 00:20:59,540
+أحل المشكلة بشكل جذريفي .. في هذه المسائل اللي هي
+
+282
+00:20:59,540 --> 00:21:03,040
+قضية العدسات و العدسات اللاصقة .. عدسات النظارات و
+
+283
+00:21:03,040 --> 00:21:06,160
+العدسات اللاصقة و ال IOL اللي هي intraocular
+
+284
+00:21:06,160 --> 00:21:09,760
+lenses أجالما فيها أنا بخلص المريض من الأشياء
+
+285
+00:21:09,760 --> 00:21:13,160
+الأكثر إزعاجا .. الأكثر إزعاجا فصاروا يعملوا
+
+286
+00:21:13,160 --> 00:21:16,520
+tinting أو يضيفوا chrome of war صبغة معينة اللي ..
+
+287
+00:21:17,180 --> 00:21:24,120
+تمتص او يعني تزيل احدى اللي هو للأطياف اللي انا
+
+288
+00:21:24,120 --> 00:21:27,440
+مابديش اياها احدى الأطياف اللي انا مابديش اياها
+
+289
+00:21:27,440 --> 00:21:30,760
+يعني زي مثلا ال IOL اللي بتنزرع في حالة ال
+
+290
+00:21:30,760 --> 00:21:36,300
+cataract تمام ممكن يكون فيها UV filter هذا عشان
+
+291
+00:21:36,300 --> 00:21:42,940
+قضية الدرر تمام UV filter و blue blocking filterمن
+
+292
+00:21:42,940 --> 00:21:46,540
+اسمه blue blocking يعني أنا بتخلص من اللي هو short
+
+293
+00:21:46,540 --> 00:21:51,280
+wavelength تمام وبالتالي بيبقى لعندي الأطياف
+
+294
+00:21:51,280 --> 00:21:55,620
+التانية يعني تمام بقاعدة ما لا يدركه كله لا يدركه
+
+295
+00:21:55,620 --> 00:21:59,840
+جله وبالتالي بيصير عندي انا الوضع افضل تمام
+
+296
+00:21:59,840 --> 00:22:04,400
+فاستخدموا قضية انه يكونفيه filters معينة او
+
+297
+00:22:04,400 --> 00:22:07,920
+tinting معين بحيث انه يخلصني من اللي هو ال
+
+298
+00:22:07,920 --> 00:22:12,800
+chromatic aberration الاكثر ازعاجا طبعا هذا هيكون
+
+299
+00:22:12,800 --> 00:22:16,520
+على حساب انه الأطياف اللي داخلة عبر ال optical
+
+300
+00:22:16,520 --> 00:22:20,380
+system هذا المضاف له الصبغة او اللي فيه tinting
+
+301
+00:22:20,380 --> 00:22:23,640
+بيكون على حساب يعني كمية الإضاءة و ال brightness
+
+302
+00:22:23,640 --> 00:22:29,030
+هتكونمئة بالمئة اقل من لو كان مش موجود اقل لو من
+
+303
+00:22:29,030 --> 00:22:35,030
+ماكانش ايش موجود و هيك يعني بيخففوا من قضية ايش ال
+
+304
+00:22:35,030 --> 00:22:38,730
+chromatic aberration يعطيكوا العافية
+
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/0weJBp8bWkY_raw.json b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/0weJBp8bWkY_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..6ae5264b560951ec0c3246b04767806577662fc1
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/0weJBp8bWkY_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 4950, "start": 21.4, "end": 49.5, "text": "رحمان الله الرحيم علم البصريات الهندسية علم البصريات الهندسية بدرس رحلة الضوء بين تلت أشياء جسم أو object optical system أو نظام بصري", "tokens": [2288, 35571, 7649, 21984, 34892, 5016, 32640, 11203, 2304, 29739, 9381, 16572, 9307, 2423, 3224, 41260, 3794, 10632, 11203, 2304, 29739, 9381, 16572, 9307, 2423, 3224, 41260, 3794, 10632, 47525, 2288, 3794, 12602, 5016, 37977, 6024, 114, 2407, 38207, 49374, 6055, 1211, 2655, 5551, 8592, 1829, 16606, 10874, 38251, 34051, 2657, 20674, 1185, 34051, 8717, 19913, 10943, 4724, 9381, 16572], "avg_logprob": -0.10329149541307668, "compression_ratio": 1.5845070422535212, "no_speech_prob": 1.1920928955078125e-07, "words": [{"start": 21.4, "end": 21.66, "word": "رحمان", "probability": 0.5548502604166666}, {"start": 21.66, "end": 21.66, "word": " الله", "probability": 0.7998046875}, {"start": 21.66, "end": 22.14, "word": " الرحيم", "probability": 0.8527018229166666}, {"start": 22.14, "end": 23.82, "word": " علم", "probability": 0.8876953125}, {"start": 23.82, "end": 24.42, "word": " البصريات", "probability": 0.990966796875}, {"start": 24.42, "end": 25.08, "word": " الهندسية", "probability": 0.99169921875}, {"start": 25.08, "end": 25.88, "word": " علم", "probability": 0.873779296875}, {"start": 25.88, "end": 26.38, "word": " البصريات", "probability": 0.9952392578125}, {"start": 26.38, "end": 27.1, "word": " الهندسية", "probability": 0.99384765625}, {"start": 27.1, "end": 28.1, "word": " بدرس", "probability": 0.8440755208333334}, {"start": 28.1, "end": 28.6, "word": " رحلة", "probability": 0.9920247395833334}, {"start": 28.6, "end": 29.2, "word": " الضوء", "probability": 0.947998046875}, {"start": 29.2, "end": 31.0, "word": " بين", "probability": 0.89208984375}, {"start": 31.0, "end": 31.32, "word": " تلت", "probability": 0.8434244791666666}, {"start": 31.32, "end": 31.82, "word": " أشياء", "probability": 0.9832763671875}, {"start": 31.82, "end": 39.96, 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تصوير هذا أبسط جهاز تصوير الآن نرجع للرحلة اللي قلناها", "tokens": [2407, 8978, 11296, 11933, 11242, 16606, 3660, 29910, 9307, 10632, 11331, 49975, 45164, 16490, 31845, 2655, 3660, 11331, 49975, 45164, 8978, 1357, 116, 40294, 25720, 33251, 3794, 38688, 37495, 22653, 5551, 9566, 23557, 5172, 11296, 3714, 11242, 1829, 28671, 6156, 3555, 6027, 2655, 6027, 1829, 4724, 28543, 2288, 41850, 5551, 4117, 2407, 11703, 1211, 5296, 11296, 20328, 13063, 3660, 4032, 5551, 15040, 5016, 19913, 11296, 4032, 39896, 4117, 41850, 4724, 995, 14851, 5172, 25708, 9154, 11933, 1829, 8592, 9154, 13672, 1829, 31439, 10874, 3224, 31377, 16712, 9381, 2407, 13546, 13672, 1829, 24525, 2304, 3224, 2423, 3435, 31439, 11933, 15730, 23758, 46740, 5551, 3555, 3794, 9566, 10874, 3224, 31377, 6055, 9381, 2407, 13546, 23758, 5551, 3555, 3794, 9566, 10874, 3224, 31377, 6055, 9381, 2407, 13546, 6024, 48506, 8717, 47341, 3615, 24976, 2288, 5016, 37977, 13672, 1829, 12174, 1211, 8315, 11296], "avg_logprob": 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{"start": 1629.97, "end": 1630.31, "word": " عدد", "probability": 0.9939778645833334}, {"start": 1630.31, "end": 1630.59, "word": " كبير", "probability": 0.9962565104166666}, {"start": 1630.59, "end": 1631.29, "word": " أكيد،", "probability": 0.8558349609375}, {"start": 1631.29, "end": 1631.55, "word": " طيب", "probability": 0.9765625}, {"start": 1631.55, "end": 1631.89, "word": " لما", "probability": 0.870849609375}, {"start": 1631.89, "end": 1632.21, "word": " بيكون", "probability": 0.9318033854166666}, {"start": 1632.21, "end": 1632.57, "word": " عندي", "probability": 0.60845947265625}], "temperature": 1.0}, {"id": 59, "seek": 166071, "start": 1633.11, "end": 1660.71, "text": "أكتر من light ray ماشيين في نفس الاتجاه سواء متوازين أو متطاربين هذه تسمى حزمة ضوئية تمام؟ bundle of light حزمة ضوئية أو pencil of light لما رسمنا تجربة ال pen hole تمام؟ قلنا من النقطة ايه؟ بتصدر حزمة ضوئية شرط هذه الحزمة الضوئية", "tokens": [10721, 4117, 2655, 2288, 9154, 1442, 18592, 3714, 33599, 1829, 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عدد العدسات أكتر وهذا هنيجيله في وقته بيكون", "tokens": [2407, 11242, 2407, 5016, 31767, 13063, 3660, 34051, 6225, 40448, 4032, 11242, 2407, 5016, 11296, 3714, 43500, 3555, 9566, 20666, 20674, 1185, 11933, 15730, 2423, 20674, 1185, 4724, 3794, 1829, 9566, 10874, 28259, 30767, 1829, 2423, 5447, 5458, 46811, 10943, 39894, 30544, 20328, 13063, 47395, 4032, 4032, 11242, 2407, 5016, 11296, 4724, 40294, 2655, 10874, 28259, 20193, 6055, 14851, 9778, 40448, 8978, 21542, 25528, 3660, 18863, 42213, 10632, 11933, 15730, 25961, 30767, 1829, 18863, 3215, 3794, 9307, 8608, 995, 34268, 11296, 11933, 1829, 8592, 4724, 1829, 30544, 2423, 2407, 11242, 2407, 5016, 5551, 5172, 11242, 1211, 4032, 28820, 19446, 25961, 6225, 3215, 3215, 18863, 3215, 3794, 9307, 5551, 4117, 2655, 2288, 37037, 15730, 8032, 22653, 7435, 26895, 3224, 8978, 4032, 38149, 3224, 4724, 1829, 30544], "avg_logprob": -0.10199652659514594, "compression_ratio": 1.8451882845188285, "no_speech_prob": 1.3887882232666016e-05, "words": [{"start": 2300.45, "end": 2300.95, "word": "وضوح", "probability": 0.9447021484375}, {"start": 2300.95, "end": 2301.65, "word": " الصورة", "probability": 0.974609375}, {"start": 2301.65, "end": 2302.65, "word": " أو", "probability": 0.70751953125}, {"start": 2302.65, "end": 2302.97, "word": " عدم", "probability": 0.960693359375}, {"start": 2302.97, "end": 2303.43, "word": " وضوحها", "probability": 0.98681640625}, {"start": 2303.43, "end": 2303.91, "word": " مرتبط", "probability": 0.9859619140625}, {"start": 2303.91, "end": 2304.07, "word": " بال", "probability": 0.98876953125}, {"start": 2304.07, "end": 2304.39, "word": " optical", "probability": 0.3349609375}, {"start": 2304.39, "end": 2304.95, "word": " system", "probability": 0.9697265625}, {"start": 2304.95, "end": 2305.45, "word": " إذا", "probability": 0.93017578125}, {"start": 2305.45, "end": 2305.59, "word": " ال", "probability": 0.9775390625}, {"start": 2305.59, "end": 2305.89, "word": " optical", "probability": 0.91064453125}, {"start": 2305.89, "end": 2306.39, "word": " system", "probability": 0.9765625}, {"start": 2306.39, "end": 2306.89, "word": " بسيط", "probability": 0.9921875}, {"start": 2306.89, "end": 2307.25, "word": " جدا", "probability": 0.9853515625}, {"start": 2307.25, "end": 2307.49, "word": " زي", "probability": 0.848876953125}, {"start": 2307.49, "end": 2307.59, "word": " ال", "probability": 0.92236328125}, {"start": 2307.59, "end": 2307.77, "word": " pin", "probability": 0.71435546875}, {"start": 2307.77, "end": 2308.09, "word": " hole", "probability": 0.475830078125}, {"start": 2308.09, "end": 2308.87, "word": " تمام", "probability": 0.952392578125}, {"start": 2308.87, "end": 2309.63, "word": " بتكون", "probability": 0.6380615234375}, {"start": 2309.63, "end": 2310.11, "word": " صورته", "probability": 0.98291015625}, {"start": 2310.11, "end": 2310.79, "word": " و", "probability": 0.994140625}, {"start": 2310.79, "end": 2311.39, "word": " وضوحها", "probability": 0.8818359375}, {"start": 2311.39, "end": 2311.77, "word": " باهت", "probability": 0.799072265625}, {"start": 2311.77, "end": 2312.09, "word": " جدا", "probability": 0.997802734375}, {"start": 2312.09, "end": 2312.31, "word": " لا", "probability": 0.56884765625}, {"start": 2312.31, "end": 2312.85, "word": " تستخدم", "probability": 0.970947265625}, {"start": 2312.85, "end": 2312.97, "word": " في", "probability": 0.96630859375}, {"start": 2312.97, "end": 2313.47, "word": " الحياة", "probability": 0.9943033854166666}, {"start": 2313.47, "end": 2314.31, "word": " العملية", "probability": 0.9181315104166666}, {"start": 2314.31, "end": 2314.85, "word": " إذا", "probability": 0.967041015625}, {"start": 2314.85, "end": 2315.13, "word": " كان", "probability": 0.98583984375}, {"start": 2315.13, "end": 2315.73, "word": " زي", "probability": 0.98486328125}, {"start": 2315.73, "end": 2316.41, "word": " العدسات", "probability": 0.98681640625}, {"start": 2316.41, "end": 2317.05, "word": " ساعتها", "probability": 0.9794921875}, {"start": 2317.05, "end": 2317.37, "word": " إيش", "probability": 0.80859375}, {"start": 2317.37, "end": 2318.15, "word": " بيكون", "probability": 0.8605143229166666}, {"start": 2318.15, "end": 2318.91, "word": " الوضوح", "probability": 0.956640625}, {"start": 2318.91, "end": 2319.49, "word": " أفضل", "probability": 0.9930419921875}, {"start": 2319.49, "end": 2320.05, "word": " وكل", "probability": 0.840087890625}, {"start": 2320.05, "end": 2320.39, "word": " ما", "probability": 0.958984375}, {"start": 2320.39, "end": 2320.87, "word": " كان", "probability": 0.98193359375}, {"start": 2320.87, "end": 2321.15, "word": " عدد", "probability": 0.9920247395833334}, {"start": 2321.15, "end": 2321.65, "word": " العدسات", "probability": 0.9942626953125}, {"start": 2321.65, "end": 2322.05, "word": " أكتر", "probability": 0.97900390625}, {"start": 2322.05, "end": 2322.27, "word": " وهذا", "probability": 0.838134765625}, {"start": 2322.27, "end": 2322.75, "word": " 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37495, 22653, 16490, 1211, 9381, 8315, 9673, 5016, 46958, 25720, 4032, 37495, 9566, 1829, 4117, 14407, 18863, 31845, 10632], "avg_logprob": -0.10792151440021604, "compression_ratio": 1.5947368421052632, "no_speech_prob": 2.6166439056396484e-05, "words": [{"start": 2324.06, "end": 2324.64, "word": "ال", "probability": 0.7333984375}, {"start": 2324.64, "end": 2325.1, "word": " quality", "probability": 0.5224609375}, {"start": 2325.1, "end": 2325.46, "word": " بتاعة", "probability": 0.83984375}, {"start": 2325.46, "end": 2325.6, "word": " ال", "probability": 0.9658203125}, {"start": 2325.6, "end": 2325.86, "word": " image", "probability": 0.93798828125}, {"start": 2325.86, "end": 2326.14, "word": " أو", "probability": 0.58203125}, {"start": 2326.14, "end": 2326.74, "word": " جودة", "probability": 0.9952799479166666}, {"start": 2326.74, "end": 2327.18, "word": " الصورة", "probability": 0.9903971354166666}, {"start": 2327.18, "end": 2327.66, "word": " بتكون", "probability": 0.98046875}, {"start": 2327.66, "end": 2328.38, "word": " أعلى", "probability": 0.8728841145833334}, {"start": 2328.38, "end": 2328.78, "word": " و", "probability": 0.6455078125}, {"start": 2328.78, "end": 2329.34, "word": " أفضل", "probability": 0.965576171875}, {"start": 2329.34, "end": 2329.92, "word": " طبعا", "probability": 0.9134521484375}, {"start": 2329.92, "end": 2330.48, "word": " المرايا", "probability": 0.8798828125}, {"start": 2330.48, "end": 2331.08, "word": " تشتغل", "probability": 0.9123046875}, {"start": 2331.08, "end": 2331.54, "word": " بنفس", "probability": 0.988525390625}, {"start": 2331.54, "end": 2332.06, "word": " فكرة", "probability": 0.982421875}, {"start": 2332.06, "end": 2332.64, "word": " العدسات", "probability": 0.98193359375}, {"start": 2332.64, "end": 2332.8, "word": " مع", "probability": 0.974609375}, {"start": 2332.8, "end": 2333.52, "word": " اختلافات", "probability": 0.96279296875}, {"start": 2333.52, "end": 2335.18, "word": " بسيطة", "probability": 0.9919921875}, {"start": 2335.18, "end": 2335.44, "word": " و", "probability": 0.55810546875}, {"start": 2335.44, "end": 2336.94, "word": " هيك", "probability": 0.892822265625}, {"start": 2336.94, "end": 2337.24, "word": " احنا", "probability": 0.9407552083333334}, {"start": 2337.24, "end": 2337.56, "word": " يعني", "probability": 0.748779296875}, {"start": 2337.56, "end": 2338.06, "word": " بنكون", "probability": 0.96435546875}, {"start": 2338.06, "end": 2338.74, "word": " يعني", "probability": 0.83837890625}, {"start": 2338.74, "end": 2339.18, "word": " خلصنا", "probability": 0.9771728515625}, {"start": 2339.18, "end": 2339.84, "word": " المحاضرة", "probability": 0.9871826171875}, {"start": 2339.84, "end": 2340.22, "word": " و", "probability": 0.96630859375}, {"start": 2340.22, "end": 2340.6, "word": " يعطيكوا", "probability": 0.765234375}, {"start": 2340.6, "end": 2341.0, "word": " العافية", "probability": 0.86474609375}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 2341.3014375, "duration_after_vad": 2209.5412499999925}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/2i7O6I8KxYE_postprocess.srt b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/2i7O6I8KxYE_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..49769ea5de90c9c1ee4354e2c0abad7992fa0fa1
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/2i7O6I8KxYE_postprocess.srt
@@ -0,0 +1,1424 @@
+1
+00:00:20,650 --> 00:00:25,670
+بسم الله الرحمن الرحيم المرة الماضية بدينا يعني
+
+2
+00:00:25,670 --> 00:00:29,550
+نعرف في علم الـ geometrical optics أو البصريات
+
+3
+00:00:29,550 --> 00:00:34,590
+الهندسية وحكينا إن هي رحلة الضوء ابتداء من أو
+
+4
+00:00:34,590 --> 00:00:37,630
+انطلاقا من ال object باتجاه ال optical system
+
+5
+00:00:37,630 --> 00:00:43,110
+وانتهاءا بيعني تكوين ال image أو الصورة كل علم
+
+6
+00:00:43,110 --> 00:00:49,160
+بلزمه يعني أشياءمتفق عليها او متعرف عليها او تتخذ
+
+7
+00:00:49,160 --> 00:00:53,500
+كنقاط مرجعية اليوم هنحكي عن اول نقطة مرجعية بتخص
+
+8
+00:00:53,500 --> 00:00:58,540
+هذا العلم و هنشوف هذه النقطة المرجعية ايش بتفيدنا
+
+9
+00:00:58,540 --> 00:01:03,940
+في علم ال geometrical optics هنحكي عن حاجة اسمها
+
+10
+00:01:03,940 --> 00:01:07,780
+ال optical axis ال optical axis طبعا
+
+11
+00:01:09,860 --> 00:01:16,820
+ال optical axis بنقول أنه most optical systems are
+
+12
+00:01:16,820 --> 00:01:20,860
+rotationally symmetric about their long axis يعني
+
+13
+00:01:20,860 --> 00:01:28,480
+لو عندى optical system معين تمام إيه له محور؟و
+
+14
+00:01:28,480 --> 00:01:33,020
+حبيت انا الفه شوية partial rotation نعمل فيه
+
+15
+00:01:33,020 --> 00:01:37,620
+بنلاقي ان شكله ماتغيرش طبعا شكله ماتغيرش يعني بيظل
+
+16
+00:01:37,620 --> 00:01:43,320
+عنده يعني بيحتفظ بنفس ال shape بتاعه غالبية ال
+
+17
+00:01:43,320 --> 00:01:49,290
+optical systemsالها long axis about which يعني ال
+
+18
+00:01:49,290 --> 00:01:53,270
+partial rotation بيغيرش إشي في الموضوع هذا ال long
+
+19
+00:01:53,270 --> 00:01:59,190
+axis أصبح يعرف بال optical axis من الآن فصاعدا إذا
+
+20
+00:01:59,190 --> 00:02:03,340
+بدنا نرسم أي optical system هنرسم معاهال optical
+
+21
+00:02:03,340 --> 00:02:08,120
+axis لأن هذا ال optical axis يعتبر أساسي جدا في
+
+22
+00:02:08,120 --> 00:02:12,280
+علم ال geometrical optics و هنستفيد منه في شغلات
+
+23
+00:02:12,280 --> 00:02:17,880
+كتيرة يعني بتفيدنا و هنعرفها ان شاء الله في يعني
+
+24
+00:02:17,880 --> 00:02:23,200
+خلال المحاضرة هاي طبعا عين الإنسان تعتبر optical
+
+25
+00:02:23,200 --> 00:02:28,620
+system متفق عليه ولا في حد بيعترض على هيك ليش
+
+26
+00:02:28,620 --> 00:02:29,420
+optical system
+
+27
+00:02:32,010 --> 00:02:35,750
+لأنها تستطيع تكون صورة يعني أنا الإنسان لما بيشوف
+
+28
+00:02:35,750 --> 00:02:40,850
+بعينه بيكون انطبعت صورة و ورقة التلقي مش ورقة ال
+
+29
+00:02:40,850 --> 00:02:44,710
+a4 هي الشبكية بتاعة عينه طالما شاف الإشي شايف
+
+30
+00:02:44,710 --> 00:02:47,470
+الجلم شايف الإنسان شايف السيارة إذا العين optical
+
+31
+00:02:47,470 --> 00:02:52,160
+system بدون جدالالعين لو عملنا فيها partial
+
+32
+00:02:52,160 --> 00:02:56,040
+rotation بيكون فيها عنده اختلاف يعني مش .. مش مية
+
+33
+00:02:56,040 --> 00:02:59,560
+بالمية بتكون rotationally symmetric حوالين ال axis
+
+34
+00:02:59,560 --> 00:03:05,140
+اللي احنا بنحكي عنه ولكن تعتبر تقريبا symmetric
+
+35
+00:03:05,140 --> 00:03:10,200
+فيعتبر فيه اللي هيش optical axis optical axis ينظر
+
+36
+00:03:10,200 --> 00:03:13,080
+اليها الرغم انها مش مائة بالمائة rotationally
+
+37
+00:03:13,080 --> 00:03:17,120
+symmetric تمام فإذا ال optical axis هذا ضروري انه
+
+38
+00:03:17,120 --> 00:03:21,890
+يتم إدراجهيعني في رسمات المسائل الخاصة بالـ
+
+39
+00:03:21,890 --> 00:03:26,590
+Geometrical Optics طب إيش فائدة الـ Optical Axis
+
+40
+00:03:26,590 --> 00:03:32,450
+هذا؟ هنحكي عنه في المحاضرة هاي وفي محاضرات أخرى
+
+41
+00:03:32,450 --> 00:03:40,090
+بالنسبة للتلت أشياء الرئيسية في عندي object الخاصة
+
+42
+00:03:40,090 --> 00:03:44,910
+بالرحلة و optical system وعندي image اليوم بدنا
+
+43
+00:03:44,910 --> 00:03:47,750
+نحكي عن ال object characteristics
+
+44
+00:03:51,020 --> 00:03:55,160
+صفات ال object تمام و بنحكي عن ال image
+
+45
+00:03:55,160 --> 00:04:01,040
+characteristics صفات
+
+46
+00:04:01,040 --> 00:04:08,860
+ال image ال object بنركز على حاجتين ال location و
+
+47
+00:04:08,860 --> 00:04:09,640
+ال luminosity
+
+48
+00:04:17,160 --> 00:04:20,960
+الإضاءية بتاعة ال object ال location بالنسبة لإيش
+
+49
+00:04:20,960 --> 00:04:28,100
+بالنسبة لل optical system يعني لما بنقول إنسان يقف
+
+50
+00:04:28,100 --> 00:04:34,200
+أمام كاميرا عشان تلتقط إله صورة هذا ال object وهذه
+
+51
+00:04:34,200 --> 00:04:38,000
+المسافة إحدى الصفات بتاعته يعني ممكن يقف على بعد
+
+52
+00:04:38,000 --> 00:04:43,180
+عشر سانت عبعد اتنين متر على بعد مائة متر أو أي
+
+53
+00:04:43,180 --> 00:04:48,350
+مسافة هذا يعني بختلفالصورة الناتجة بتختلف باختلاف
+
+54
+00:04:48,350 --> 00:04:52,930
+موقع ال object باختلاف موقع ال object اذا اول حاجة
+
+55
+00:04:52,930 --> 00:04:56,550
+بدي انا اوصف فيها ال object اللي بدأت من عنده
+
+56
+00:04:56,550 --> 00:05:01,190
+الرحلة موقعه موقعه تمام احدد موقعه تنسوش ان احنا
+
+57
+00:05:01,190 --> 00:05:08,470
+بندرس geometric optics يعني بصريات فراغية موقعه في
+
+58
+00:05:08,470 --> 00:05:12,210
+الفراغ بالنسبة لل optical system هذا احد الصفات
+
+59
+00:05:12,210 --> 00:05:16,020
+اللي بتميز فيها ال objectالصفة التانية ال
+
+60
+00:05:16,020 --> 00:05:22,000
+luminosity هل هو luminous object يعني مضيق بذاته
+
+61
+00:05:22,000 --> 00:05:25,800
+وضربنا أمثل المرة اللي فاتت زي الشمس زي مصباح
+
+62
+00:05:25,800 --> 00:05:30,020
+الكهرباء زي لهب الشمعة إلى آخره أو illuminated
+
+63
+00:05:30,020 --> 00:05:36,060
+بمعنى
+
+64
+00:05:36,060 --> 00:05:41,040
+آخر إذا كان مش مضيق عشان أقدر أشوفه لازم يكون مضاء
+
+65
+00:05:41,040 --> 00:05:47,480
+وهل بس فقط مضاء بتكفيلازم يكون أيضا عاكس لازم يكون
+
+66
+00:05:47,480 --> 00:05:52,500
+عادل illuminated and reflective وحكينا إذا كان مش
+
+67
+00:05:52,500 --> 00:05:56,980
+مضاء مش هينشاف إذا هو مش مضيء بذاته ومش مضاء يعني
+
+68
+00:05:56,980 --> 00:06:02,660
+إنسان يجلس في غرفة معتمة جدا تمام مافيش إضاءة تسقط
+
+69
+00:06:02,660 --> 00:06:06,080
+على جسمه ممكن احنا ندخل الغرفة هاي ومانلاحظوش
+
+70
+00:06:06,080 --> 00:06:10,960
+ومانلاحظوش تمام فبالتالي لازم يكون illuminated إذا
+
+71
+00:06:10,960 --> 00:06:16,300
+مش هو luminous طيب بعض الأشياءمضاءة بس أحيانا
+
+72
+00:06:16,300 --> 00:06:21,780
+بيخيلنا أنها مش موجودة ليش؟ لأنها مش عاكسة أو كمية
+
+73
+00:06:21,780 --> 00:06:25,080
+الأشعة اللي بتعكسها قليلة جدا وقلنا مثل على ذلك
+
+74
+00:06:25,080 --> 00:06:28,660
+المرة اللي فاتت اللي هي واجهات المحلات اللي هي
+
+75
+00:06:28,660 --> 00:06:34,000
+الزجاجية لما تكون نظيفة جدا وما بتعكسش كمية كافية
+
+76
+00:06:34,000 --> 00:06:38,100
+من الإشعاع ممكن يتخيلنا أن لوح الزجاج هذا مش موجود
+
+77
+00:06:38,100 --> 00:06:42,360
+يعني أحيانا تمام فبالتالي هذه صفات ال object إذا
+
+78
+00:06:42,360 --> 00:06:46,300
+ال locationو ال luminosity نيجي لصفات ال image
+
+79
+00:06:46,300 --> 00:06:50,600
+اللي هيكون ليها ال object مع ال optical system ال
+
+80
+00:06:50,600 --> 00:06:55,540
+image تميز أو ندرس فيها أربع صفات ال magnification
+
+81
+00:06:55,540 --> 00:07:01,580
+و
+
+82
+00:07:01,580 --> 00:07:05,540
+ال location و
+
+83
+00:07:05,540 --> 00:07:09,660
+ال quality و ال brightness
+
+84
+00:07:14,660 --> 00:07:19,960
+إيش يعني magnification التكبير التكبير و ال
+
+85
+00:07:19,960 --> 00:07:24,040
+location موقع ال image يعني وين اتكونت في الفراغ
+
+86
+00:07:24,040 --> 00:07:27,020
+ال image أنا حطيت ورقة تلقي وين اتلقيت ال image
+
+87
+00:07:27,020 --> 00:07:31,020
+عباعد سانتي عباعد متر عباعد نص متر خمسة وسبعين
+
+88
+00:07:31,020 --> 00:07:35,060
+سانتي يعني وين انا استطعت اني اتلقى ال image ال
+
+89
+00:07:35,060 --> 00:07:42,880
+quality الجودة إيش المقصود بالجودة هنا مش الضوء ما
+
+90
+00:07:42,880 --> 00:07:46,580
+هو إيش المقصود بالوضوحالكلام صحيح بس إيش المقصود
+
+91
+00:07:46,580 --> 00:07:53,080
+جديش ال image بتشبه ال object جديش التفاصيل واضحة
+
+92
+00:07:53,080 --> 00:07:58,200
+اللي موجودة في ال object و نقلت إلى ال image يعني
+
+93
+00:07:58,200 --> 00:08:04,480
+لو ما نقولنا جهاز تصوير تمام وعندي object واتكونت
+
+94
+00:08:04,480 --> 00:08:11,600
+image هذه ال image بتشبه 80% ال object جهاز تصوير
+
+95
+00:08:11,600 --> 00:08:18,470
+تاني نفس ال object صورناهأصبحت تشبه 95%، مين ال
+
+96
+00:08:18,470 --> 00:08:22,530
+quality بتاعتها أعلى؟ التانية، المثال التاني، إذا
+
+97
+00:08:22,530 --> 00:08:27,830
+كل ما كانت ال image أشبه بال object كل ما كان ال
+
+98
+00:08:27,830 --> 00:08:32,550
+quality أعلى وكل ما كانت أقل شبها بال object
+
+99
+00:08:32,550 --> 00:08:34,710
+معناته ال quality أقل
+
+100
+00:08:36,580 --> 00:08:42,980
+مثال من حياتنا العادية لما بدأت تظهر اللي هو
+
+101
+00:08:42,980 --> 00:08:47,540
+الهواتف الخلوية و تضاف إلىها الكاميرات كانت
+
+102
+00:08:47,540 --> 00:08:52,640
+الكاميرا جودة الصورة اللي بتنقلها أقل بكتير من
+
+103
+00:08:52,640 --> 00:08:56,100
+الآن الكاميرات المرفقة مع الجوالات اللي بتعطي يعني
+
+104
+00:08:56,100 --> 00:09:00,620
+high quality image السؤال اللي بطرح نفسه هل يوجد
+
+105
+00:09:00,620 --> 00:09:10,450
+.. هل يوجد optical systemيستطيع إنتاج image صورة
+
+106
+00:09:10,450 --> 00:09:19,010
+تشبه مائة بالمائة ال object إيش رأيكم؟ هل في
+
+107
+00:09:19,010 --> 00:09:26,230
+optical system جهاز تصوير بيستطيع إنتاج image تشبه
+
+108
+00:09:26,230 --> 00:09:28,970
+مائة بالمائة ال object عارفين إيش يعني تشبه مائة
+
+109
+00:09:28,970 --> 00:09:34,340
+بالمائة ال object؟ يعني إذا التنين حطوا جنب بعضمش
+
+110
+00:09:34,340 --> 00:09:40,460
+لازم نفرج بين مين ال image و مين ال object حقيقة
+
+111
+00:09:40,460 --> 00:09:48,100
+لأ لسه لسه تماملسه لا يوجد جهاز يستطيع انه ينقل
+
+112
+00:09:48,100 --> 00:09:52,540
+تفاصيل ال object مائة بالمائة وكلمة مائة بالمائة
+
+113
+00:09:52,540 --> 00:09:56,420
+يعني مش تسعة و تسعين point تسعة تسعة بنسبة مائة
+
+114
+00:09:56,420 --> 00:10:00,380
+بالمائة اذا ال quality بتحكي عن جودة الصورة
+
+115
+00:10:00,380 --> 00:10:05,880
+والمقصود فيها يعني جداش الصورة بتشبه الجسم اللي هي
+
+116
+00:10:05,880 --> 00:10:08,980
+صورتهاللي هي صورة ال brightness اللي هي كمية
+
+117
+00:10:08,980 --> 00:10:14,980
+الإضاءة اللي نقلت يعني في الصورة يعني مقارنة مع
+
+118
+00:10:14,980 --> 00:10:20,810
+إضاءة ال objectبالنسبة لـ Quality و لـ Brightness
+
+119
+00:10:20,810 --> 00:10:24,330
+أيه علاقة ما بالـ Physical Optics؟ أيه علاقة ما
+
+120
+00:10:24,330 --> 00:10:28,050
+بالـ Physical Optics؟ و أيه علاقة ما بأشياء هنحكي
+
+121
+00:10:28,050 --> 00:10:34,570
+عنها يعني في المحاضرات القادمة؟ بدنا الآن نحكي عن
+
+122
+00:10:34,570 --> 00:10:45,250
+الـ Magnification بدنا نحكي عن ال Magnification ال
+
+123
+00:10:45,250 --> 00:10:46,010
+Magnification
+
+124
+00:10:53,570 --> 00:10:57,990
+ترجمته لغة التكبير بس في علم الـ Geometrical
+
+125
+00:10:57,990 --> 00:11:01,850
+Optics يحتمل التكبير و يحتمل التصغير يحتمل
+
+126
+00:11:01,850 --> 00:11:10,770
+المعنيين التكبير أو التصغير تمام؟ في أنواع تلاتة
+
+127
+00:11:10,770 --> 00:11:15,250
+من ال magnification هندرسهم أول حاجة ل Transverse
+
+128
+00:11:15,250 --> 00:11:16,070
+Magnification
+
+129
+00:11:25,550 --> 00:11:34,850
+تاني حاجة ال angular magnification تالت
+
+130
+00:11:34,850 --> 00:11:39,630
+حاجة ال axial magnification
+
+131
+00:11:39,630 --> 00:11:45,450
+فنيجي
+
+132
+00:11:45,450 --> 00:11:48,910
+احنا نحكي اليوم عنالـ Transverse Magnification
+
+133
+00:11:48,910 --> 00:11:53,730
+يترى إيش هو وإيش علاقة الـ Optical Axis في الموضوع
+
+134
+00:11:53,730 --> 00:11:57,630
+هذا .. إيش علاقة الـ Optical Axis في الموضوع هذا
+
+135
+00:11:57,630 --> 00:12:06,350
+الـ Transverse Magnification هو نسبة ارتفاع الصورة
+
+136
+00:12:06,350 --> 00:12:10,410
+مقارنة مع ارتفاع الـ object إذا it .. it is the
+
+137
+00:12:10,410 --> 00:12:14,010
+ratio اللي هو الـ Transverse Magnification it is
+
+138
+00:12:14,010 --> 00:12:22,570
+the ratioof image height to
+
+139
+00:12:22,570 --> 00:12:27,950
+the object height
+
+140
+00:12:27,950 --> 00:12:32,650
+وبنجيبها بمعادلة بسيطة Transphase Magnification
+
+141
+00:12:32,650 --> 00:12:37,830
+تساوي ال image height على
+
+142
+00:12:37,830 --> 00:12:38,890
+ال object height
+
+143
+00:12:44,820 --> 00:12:50,440
+الان بيجي دور ال optical axis عشان منه هيتم القياس
+
+144
+00:12:50,440 --> 00:12:55,320
+اول فائدة لل optical axis منه هيقاس الارتفاع تاع
+
+145
+00:12:55,320 --> 00:12:59,180
+ال object و تاع ال image يعني انا لما برسم optical
+
+146
+00:12:59,180 --> 00:13:04,100
+system و بقول هي ال object هجيس ارتفاعه انطلاقا من
+
+147
+00:13:04,100 --> 00:13:07,840
+وين؟ من ال optical axis هيرسم بدايته عند ال
+
+148
+00:13:07,840 --> 00:13:12,820
+optical axis تمام؟نهايته اللي هي طرف السهم يعني
+
+149
+00:13:12,820 --> 00:13:18,540
+لما بنقول ارتفاع ال object مثلا عشرة صنطي يعني هو
+
+150
+00:13:18,540 --> 00:13:23,520
+قيمته أعلى من ال optical axis بعشرة صنطي ارتفاع ال
+
+151
+00:13:23,520 --> 00:13:27,640
+image سواء ال image عدلة أو مجلوبة تمام أيضا يقاس
+
+152
+00:13:27,640 --> 00:13:32,740
+من وين من ال optical axis مثلا خمسة صنطي مثلا تمام
+
+153
+00:13:34,100 --> 00:13:38,160
+لما بنقول جداش ال transfer magnification في المثل
+
+154
+00:13:38,160 --> 00:13:46,100
+اللي أنا رسمته بنطبق المعادلة مباشرة تمام لأ
+
+155
+00:13:46,100 --> 00:13:49,440
+مش عشرة على خمسة image height هي ال image height
+
+156
+00:13:49,440 --> 00:13:59,180
+هي خمسة صنطي على عشرة صنطي تمام مايساوي النص
+
+157
+00:14:00,640 --> 00:14:04,720
+ممتاز طبعا يرمز لل magnification بالرمز ال
+
+158
+00:14:04,720 --> 00:14:10,720
+multiplication sign تمام يعني كأنه الجسم تكبرت
+
+159
+00:14:10,720 --> 00:14:15,280
+الصورة نص مرة يعني كأنها صغرت للنص تمام كأنها صغرت
+
+160
+00:14:15,280 --> 00:14:19,740
+للنص هذا كلام ممتاز ولكن في نقطة حابوا يضيفوها
+
+161
+00:14:19,740 --> 00:14:25,680
+العلماء برضه بمساعدة ال optical axis هذا ال
+
+162
+00:14:25,680 --> 00:14:30,710
+magnificationما بيأشر ليش هل الصورة عدلة و لا
+
+163
+00:14:30,710 --> 00:14:34,410
+مجلوبة فجالوا عشان نعرف الصورة عدلة و لا مجلوبة
+
+164
+00:14:34,410 --> 00:14:40,570
+بدنا يكون شيء متعرف عنا عرف انه كل جسم او صورة فوق
+
+165
+00:14:40,570 --> 00:14:46,920
+ال optical axis بياخد إشارة plusكل صورة أو جسم تحت
+
+166
+00:14:46,920 --> 00:14:50,860
+الـ optical axis بياخد إشارة minus إذا إحنا هذه
+
+167
+00:14:50,860 --> 00:14:54,580
+المعادلة بيناعود و نعدّلها ليش؟ لأن هنا في الرسمة
+
+168
+00:14:54,580 --> 00:14:59,600
+ال object فوق ال optical axis طوله plus عشرة سنتين
+
+169
+00:14:59,600 --> 00:15:07,200
+و ال image minus ليش؟ لأنها تمتد أو جاية تحت ال
+
+170
+00:15:07,200 --> 00:15:13,090
+optical axis إذا minus5 cm فبيكون عندي ضرب minus
+
+171
+00:15:13,090 --> 00:15:18,470
+نص لما بقول ضرب minus نص معناته هو صغر للنص الصورة
+
+172
+00:15:18,470 --> 00:15:22,470
+مقارنة مع ال object و ال minus هذه تعني أن الصورة
+
+173
+00:15:22,470 --> 00:15:27,710
+مجلوبة الصورة مجلوبة بدون حل مسائل لو قولنا ضرب
+
+174
+00:15:27,710 --> 00:15:35,670
+plus 2 معناته ال image عدلة مش مجلوبة كيف يعرف
+
+175
+00:15:35,670 --> 00:15:40,340
+نعمل إشارة ال plusومرتين بقى في ال object يعني هي
+
+176
+00:15:40,340 --> 00:15:43,360
+أعلى منه مرتين ارتفاعها يساوي ارتفاع ال object
+
+177
+00:15:43,360 --> 00:15:47,140
+مرتين نضرب مثال على ذلك ونجيب اللي هو ال transfers
+
+178
+00:15:47,140 --> 00:15:53,320
+magnification بنقول optical system واقف قدامه
+
+179
+00:15:53,320 --> 00:16:02,460
+object ارتفاعه واحد متر الصورة ارتفاعها مثلا أربعة
+
+180
+00:16:02,460 --> 00:16:10,010
+متر كيف ال transfers magnification بده يحسب؟بنقول
+
+181
+00:16:10,010 --> 00:16:15,410
+الصورة فوق الـ optical axis is a plus أربعة متر
+
+182
+00:16:15,410 --> 00:16:22,670
+على plus واحد متر ويساوي ضرب plus أربعة ايش يعني
+
+183
+00:16:22,670 --> 00:16:27,550
+ضرب plus أربعة يعني الصورة عدلة أول شي بنعلق على
+
+184
+00:16:27,550 --> 00:16:31,690
+الإشارةالصورة عدلة يعني مش مجلوبة يعني فوق الـ
+
+185
+00:16:31,690 --> 00:16:36,330
+optical axis و أربع أضعاف ال optical axis تمام و
+
+186
+00:16:36,330 --> 00:16:40,870
+أربع أضعاف ال optical axis مثال آخر عشان ننتقل
+
+187
+00:16:40,870 --> 00:16:48,290
+لنقطة اللي بعدها الجسم
+
+188
+00:16:48,290 --> 00:16:52,770
+طوله عشرة صنطي الصورة طولها خمستاشر صنطي ال
+
+189
+00:16:52,770 --> 00:16:55,270
+transfer of magnification يساوي image head
+
+190
+00:17:08,600 --> 00:17:13,220
+الجسم تم تكبيره minus مرة و نص، minus يعني مجلوبة
+
+191
+00:17:13,220 --> 00:17:18,950
+و مرة و نص يعني ال image ارتفاعهاأكتر مرة و نص من
+
+192
+00:17:18,950 --> 00:17:21,910
+ارتفاع ال object ارتفاع ال object و ارتفاع ال
+
+193
+00:17:21,910 --> 00:17:25,290
+image يقاس بمساعدة ايش ال optical axis يعني أنا
+
+194
+00:17:25,290 --> 00:17:30,210
+ببدأ منه القياس ببدأ منه القياس في نقطة ضروري جدا
+
+195
+00:17:30,210 --> 00:17:33,750
+احنا في ال transfers magnification ناخد بالنا منها
+
+196
+00:17:33,750 --> 00:17:38,930
+لو ال object لو ال object ميل او ال image ميلة
+
+197
+00:17:38,930 --> 00:17:43,570
+يعني احنا بنجيس ارتفاعه كيف يعني نفرض ان ال object
+
+198
+00:17:43,570 --> 00:17:51,310
+اللي عنده مثلا نخلةobject ولا مش object ممكن
+
+199
+00:17:51,310 --> 00:17:56,010
+يتكوّن لها صورة ممكن يتكوّن لها صورة تمام بدنا
+
+200
+00:17:56,010 --> 00:18:01,090
+نفرض جدلا انه اتكوّنت صورة ميلة على سبيل المثال مش
+
+201
+00:18:01,090 --> 00:18:06,690
+مشكلة ميلة يعني كيف يقاس الارتفاع الارتفاع يقاس
+
+202
+00:18:06,690 --> 00:18:10,850
+باسقاط عمود هذا هو الارتفاع مش هذا هو الارتفاع
+
+203
+00:18:10,850 --> 00:18:17,430
+يعني يقاس الارتفاع باسقاط
+
+204
+00:18:17,430 --> 00:18:25,630
+عمودعلى الـ optical axis هو مرجعيتي في معرفة
+
+205
+00:18:25,630 --> 00:18:29,390
+ارتفاع ال object وهو مرجعيتي في معرفة ارتفاع ال
+
+206
+00:18:29,390 --> 00:18:34,030
+image هو مرجعيتي في معرفة الصورة هل هي مجلوبة ولا
+
+207
+00:18:34,030 --> 00:18:39,070
+لا كل ما هو أسفل منه يعتبر minus وكل ما هو فوق منه
+
+208
+00:18:39,500 --> 00:18:43,780
+يعتبر plus لو كان ال object واقف بشكل عمودي بجيس
+
+209
+00:18:43,780 --> 00:18:47,640
+طول ال object لو ال object واقف بشكل مائل بدي أسقط
+
+210
+00:18:47,640 --> 00:18:51,900
+عمودي ويعتبر هذا العمود تمام هذا العمود هو ال ايش
+
+211
+00:18:51,900 --> 00:18:56,620
+الارتفاع بتاع ال object وهذا ينطبق أيضا على ال
+
+212
+00:18:56,620 --> 00:19:00,520
+image هذا ينطبق أيضا على ال image واضحة النقطة هي
+
+213
+00:19:00,520 --> 00:19:05,650
+يا بناتطيب احنا نجي لان للنقطة اللي بعدها الأجسام
+
+214
+00:19:05,650 --> 00:19:10,270
+في حياتنا غالبيتها العظمة ثلاثية الأبعاد وممكن
+
+215
+00:19:10,270 --> 00:19:14,530
+تكون زي ورقة الدفتر ايش ثنائية الأبعاد هل ال
+
+216
+00:19:14,530 --> 00:19:18,690
+transfer magnification السؤال بينطبق على بعد واحد
+
+217
+00:19:18,690 --> 00:19:26,210
+و لا على بعدين و لا على تلت أبعاد ايش رأيكم يعني
+
+218
+00:19:26,210 --> 00:19:30,620
+العدسةأو الـ optical system هتيجي للطول تقوله اه
+
+219
+00:19:30,620 --> 00:19:33,640
+انا بعملك تكبير والعرض تقوله الله انا يعني مش ..
+
+220
+00:19:33,640 --> 00:19:38,520
+مش شغلي هذا اذا بينطبق على كل ال dimensions بتاع
+
+221
+00:19:38,520 --> 00:19:42,200
+ال object اذا ال object ثلاث الأبعاد و بيتم تصويره
+
+222
+00:19:42,200 --> 00:19:47,620
+تمام هذا بينطبق على كل الأبعاد وبالتالي لما بنقول
+
+223
+00:19:47,620 --> 00:19:54,290
+احنا object بشكل مستطيلobject ما ورق الدفتر كده
+
+224
+00:19:54,290 --> 00:20:02,450
+اشي طولها الطول عشرة صنطة و العرض ستة صنطة تمام في
+
+225
+00:20:02,450 --> 00:20:08,990
+المسألة تم تصويرها تم تصوير هذا ال object بتكبير
+
+226
+00:20:08,990 --> 00:20:13,510
+magnification transfers magnification ضرب plus
+
+227
+00:20:13,510 --> 00:20:20,230
+اتنين معناته الطول اتضاعف مرتين و العرض اتضاعف
+
+228
+00:20:20,230 --> 00:20:28,580
+مرتين السؤالما هو التغير او ما هو مساحة الصورة
+
+229
+00:20:28,580 --> 00:20:37,580
+مقارنة مع مساحة الجسم اول اشي بدأ اقول ضرب اتنين
+
+230
+00:20:37,580 --> 00:20:41,900
+الطول اش صار العشرة صار عشرين صنطي هي الصورة
+
+231
+00:20:41,900 --> 00:20:48,480
+والستة في اتنين اتناشر صنطي تمام ياديش مساحة ال
+
+232
+00:20:48,480 --> 00:20:59,140
+objectطول في العرض يعني ايش؟ 60 cm مربع بينما 240
+
+233
+00:20:59,140 --> 00:21:05,480
+cm مربع لما بدنا نقارن مساحة ال image مع مساحة ال
+
+234
+00:21:05,480 --> 00:21:12,340
+object جداش التضاعف اربع مرات 240 على 60 يعني اربع
+
+235
+00:21:12,340 --> 00:21:17,560
+مراتكل ضلع في ال object اتضاعف مرتين بس المساحة
+
+236
+00:21:17,560 --> 00:21:22,320
+اتضاعفت أربع مرات فبالتالي .. بالتالي بدنا ننتبه
+
+237
+00:21:22,320 --> 00:21:29,500
+جدا لقضية انه ال transfer magnification بينطبق على
+
+238
+00:21:29,500 --> 00:21:34,640
+كل أبعاد الجسم على كل أبعاد الجسم المعروف الأجسام
+
+239
+00:21:34,640 --> 00:21:39,260
+اللي في حياتنا غالبيتها العظمة بتكون إيش ثلاثية
+
+240
+00:21:39,260 --> 00:21:43,440
+الأبعاد لما بنقول مثال مثال
+
+241
+00:21:45,990 --> 00:21:54,710
+مكعب تم تصويره ب transfer magnification مقداره
+
+242
+00:21:54,710 --> 00:22:01,210
+طبعا المكعب ضلعه عشرة صنطي ب transfer
+
+243
+00:22:01,210 --> 00:22:06,310
+magnification مقداره ضرب تلاتة ما هو التغير في
+
+244
+00:22:06,310 --> 00:22:11,350
+الحجم بين
+
+245
+00:22:11,350 --> 00:22:19,400
+الصورة وبين ال objectالمكعب حجمه إيش يساوي؟
+
+246
+00:22:19,400 --> 00:22:26,360
+عشرة أس تلاتة يعني كدهش؟ ألف سنتيمتر مكعب تمام
+
+247
+00:22:26,360 --> 00:22:32,460
+الصورة تلاتين في تلاتين في تلاتين ليش قلت تلاتين
+
+248
+00:22:32,460 --> 00:22:36,240
+في تلاتين في تلاتين؟ لأنه كل ضلع من أضلاع المكعب
+
+249
+00:22:36,240 --> 00:22:41,080
+طوله و عرضه و ارتفاعه إيش صار فيه؟ اضاعف تلات مرات
+
+250
+00:22:41,080 --> 00:22:49,890
+إذا بيكون عنده27000 cm مكعب تمام جداش التضاعف
+
+251
+00:22:49,890 --> 00:22:58,020
+الحجم27 ألف على ألف 27 مرة 27 مرة القصد من ال
+
+252
+00:22:58,020 --> 00:23:02,800
+transfer magnification انه ينطبق على كل اللي هي
+
+253
+00:23:02,800 --> 00:23:11,480
+مقاييس على كل مقاييس ال object يعني ما بيكون على
+
+254
+00:23:11,480 --> 00:23:16,300
+dimension واحد دون المقاسات التانية على الطول وعلى
+
+255
+00:23:16,300 --> 00:23:20,040
+العرض وعلى الارتفاع ان وجد تمام؟ وعلى الارتفاع
+
+256
+00:23:23,140 --> 00:23:27,840
+أنا حابب نعطي بعض المسائل البسيطة في ال transfer
+
+257
+00:23:27,840 --> 00:23:40,280
+magnification ال
+
+258
+00:23:40,280 --> 00:23:45,440
+transfer magnification ضرب minus 2 طول ال image ال
+
+259
+00:23:45,440 --> 00:23:46,260
+image هيت
+
+260
+00:23:48,780 --> 00:23:55,380
+يساوي خمسة صنطي ما هو طول ال object ما هو طول ال
+
+261
+00:23:55,380 --> 00:24:03,420
+object ما هو طول الجسم تمام أول حاجة حسب الرسمة
+
+262
+00:24:03,420 --> 00:24:07,580
+بنقول ال transfer magnification يساوي image height
+
+263
+00:24:07,580 --> 00:24:11,960
+على
+
+264
+00:24:11,960 --> 00:24:14,660
+ال object height هذا المعادلة
+
+265
+00:24:17,610 --> 00:24:21,610
+الان ال transfer magnification جداش مقداره minus
+
+266
+00:24:21,610 --> 00:24:30,550
+اتنين الصورة جداش ارتفاعها خمسة لأ الرقم
+
+267
+00:24:30,550 --> 00:24:34,390
+صح سالب خمسة بدناش ننسى الإشارة بدناش ننسى الإشارة
+
+268
+00:24:34,390 --> 00:24:38,050
+سالب خمسة صنطي وبيضل عندى انا ال object hit
+
+269
+00:24:38,050 --> 00:24:42,590
+المعادلة
+
+270
+00:24:42,590 --> 00:24:50,150
+تصبح ال object hit تساويناقص خمسة صنطة على ناقص
+
+271
+00:24:50,150 --> 00:24:56,650
+اتنين ويساوي موجب اتنين و نص صنطة ايش يعني موجب
+
+272
+00:24:56,650 --> 00:25:01,090
+اتنين و نص ايش يعني كلمة موجب يعني ال object فوق
+
+273
+00:25:01,090 --> 00:25:06,590
+وهو اتنين و نص صنطة يعني هو نص ال image لأن ال
+
+274
+00:25:06,590 --> 00:25:10,170
+image ضرفه لأن ال image ضرفه واضح طيب
+
+275
+00:25:17,550 --> 00:25:21,470
+مثال آخر لتثبيت لهذا بس قبل المثال بنقول نحط هيك
+
+276
+00:25:21,470 --> 00:25:28,510
+مربع في الملزمة أو في الدفتر لا ننسى الإشارة
+
+277
+00:25:28,510 --> 00:25:34,430
+الإشارة المقصود فيها كل جسم أو صورة فوق ال optical
+
+278
+00:25:34,430 --> 00:25:38,370
+axis بتاخد plus sign تحت ال optical axis بتاخد
+
+279
+00:25:38,370 --> 00:25:43,750
+minus sign ماننساش الإشارة دايما، تمام؟ بنقول أن
+
+280
+00:25:43,750 --> 00:25:49,990
+optical systemوعنا object طوله خمسة و عشرين صنطة
+
+281
+00:25:49,990 --> 00:25:58,370
+تم التكبير لل image ضرب
+
+282
+00:25:58,370 --> 00:26:02,590
+اتنين
+
+283
+00:26:02,590 --> 00:26:06,750
+من عشرة ايش يعني ضرب اتنين من عشرة بمعنى اخر
+
+284
+00:26:06,750 --> 00:26:12,950
+الصورة عدلة و خمس اتنين من عشرة هي خمس خمس ال
+
+285
+00:26:12,950 --> 00:26:18,830
+objectما هو ارتفاع الصورة ما هو ارتفاع الصورة ال
+
+286
+00:26:18,830 --> 00:26:23,190
+image hit برضه بنرجع للمعادلة ال transfers
+
+287
+00:26:23,190 --> 00:26:28,290
+magnification يساوي image hit هنكتبها بالاختصار
+
+288
+00:26:28,290 --> 00:26:32,690
+على object hit طيب عندي transfers magnification
+
+289
+00:26:32,690 --> 00:26:41,730
+يداش اتنين من عشرة يساوي image hit على خمسة وعشرين
+
+290
+00:26:43,440 --> 00:26:51,280
+5 cm تمام؟ اذا ال image height تساوي 2 من 10 طارب
+
+291
+00:26:51,280 --> 00:26:58,460
+25 cm ويساوي 5 cm واضح؟
+
+292
+00:27:02,610 --> 00:27:06,210
+كل ما حلّينا مسائل اكتر طبعا هذه المسائل هي مسائل
+
+293
+00:27:06,210 --> 00:27:10,270
+تعتبر بداية للغاية وبسيطة للغاية الهدف منها
+
+294
+00:27:10,270 --> 00:27:14,650
+التعويض على ان انا ممكن يكون عندي المجهول ال image
+
+295
+00:27:14,650 --> 00:27:18,270
+هات اجيبها ممكن يكون ال transfers magnification هو
+
+296
+00:27:18,270 --> 00:27:21,710
+اللي مجهول اجيبه او ممكن التنتين معروفات بس ال
+
+297
+00:27:21,710 --> 00:27:25,030
+object بده اجيب ارتفاعه وهذا بشكل رياضي مباشر
+
+298
+00:27:25,030 --> 00:27:29,730
+مافيش مشكلة اهم نقطة في الموضوعما ننساش الإشارة
+
+299
+00:27:29,730 --> 00:27:33,190
+تمام ممكن إنسان يقول طب لو نسيت الإشارة ما هي من
+
+300
+00:27:33,190 --> 00:27:37,130
+الرسمة بينها ماشي الأن في عندي optical systems
+
+301
+00:27:37,130 --> 00:27:41,830
+مكونة من عدة عدسات تمام ممكن يكون عشر عدسات ست
+
+302
+00:27:41,830 --> 00:27:47,310
+عدسات تمان عدسات تمام وممكن انابنسيان الإشارة high
+
+303
+00:27:47,310 --> 00:27:50,670
+الإشارة هنا بالنسبة لي بتعني إنه عدل أو مجلوب
+
+304
+00:27:50,670 --> 00:27:53,910
+الإشارة ال plus معناته عدل الإشارة ال minus بتعني
+
+305
+00:27:53,910 --> 00:27:59,010
+إنه مجلوب بدنا يعني نسبج وهذا هنصله في المحاضرات
+
+306
+00:27:59,010 --> 00:28:03,470
+التالية بنقول صورة العدسة الأولى هي object للعدسة
+
+307
+00:28:03,470 --> 00:28:06,110
+التانية الصورة نفسها اللي بتكونها العدسة الأولى هي
+
+308
+00:28:06,110 --> 00:28:10,090
+object للعدسة التانية وصورة العدسة التانية object
+
+309
+00:28:10,090 --> 00:28:13,590
+للعدسة التالتة وها كذا ان شاء الله ألف عدسة الآن
+
+310
+00:28:13,590 --> 00:28:18,440
+لو أنا نسيت الإشارةوكانت عند الصورة عدلة واعتبرتها
+
+311
+00:28:18,440 --> 00:28:21,740
+مجلوبة او مجلوبة واعتبرتها عدلة كل ما يتله خطأ
+
+312
+00:28:21,740 --> 00:28:26,860
+انهارت المسألة كلها انهارت المسألة كلها فضروري جدا
+
+313
+00:28:26,860 --> 00:28:30,040
+وهذا بنحب نظل نذاكر فيه انه ما ننساش الإشارة
+
+314
+00:28:30,040 --> 00:28:35,060
+بالنسبة لموضوع ما فوق ال optical axis وما تحت ال
+
+315
+00:28:35,060 --> 00:28:40,430
+optical axis بالنسبة لال angular magnification
+
+316
+00:28:40,430 --> 00:28:44,510
+هنحكي عنه كلمة بسيطة اليوم و بعدين هنكمله المرة
+
+317
+00:28:44,510 --> 00:28:47,530
+الجاية ان شاء الله تعالى ال angular magnification
+
+318
+00:28:47,530 --> 00:28:55,970
+اذا أحبنا احنا نقول بالنسبة لعين الإنسان لو
+
+319
+00:28:55,970 --> 00:29:03,710
+ضربنا مثل نقول إنسان كان واقف جنبنا تمام ازميل او
+
+320
+00:29:03,710 --> 00:29:09,380
+أستاذ او ما شبهطوله بالنسبة لنا مقدر مثلا نقول متر
+
+321
+00:29:09,380 --> 00:29:15,020
+وسبعين صنطي و بدى يمشي مبتعد عننا كل ما ماشي أبعد
+
+322
+00:29:15,020 --> 00:29:22,400
+بيكون طوله أصغر لغاية ما يتحول لإشي دقيق جدا بعدين
+
+323
+00:29:22,400 --> 00:29:26,800
+بعد مسافة معينة ممكن إيش يختفي أيضا الطائرة اللى
+
+324
+00:29:26,800 --> 00:29:30,420
+حجمها ضخم جدا لما بتكون طائرة في السماء و بعيدة
+
+325
+00:29:30,420 --> 00:29:36,380
+عننا مسافة كبيرة تمامبيكون يعني حجمها صغير مقارنة
+
+326
+00:29:36,380 --> 00:29:42,940
+مع حجمها الحقيقي أشعة الشمس ممكن أنا بقطعة نقدية
+
+327
+00:29:42,940 --> 00:29:48,080
+صغيرة تمام أجربها من عيني أغطي أشعة الشمس إذا غطت
+
+328
+00:29:48,080 --> 00:29:54,030
+أشعة الشمسمعناته هي يعني حجمها أكبر من حجم الشمس
+
+329
+00:29:54,030 --> 00:29:57,090
+لأ هي حجمها مش أكبر من حجم الشمس لأن حجم الأرض
+
+330
+00:29:57,090 --> 00:30:02,070
+أصلا مش أكبر من حجم الشمس ولكن العلة في الأمثلة
+
+331
+00:30:02,070 --> 00:30:07,530
+اللي ضربناها انه ارتفاع ال angular magnification
+
+332
+00:30:07,530 --> 00:30:13,150
+أو الارتفاع الزاوي هو قداش الجسم بيعمل زاوية مع
+
+333
+00:30:13,150 --> 00:30:16,130
+العين قداش الجسم بيعمل زاوية مع العين لو تخيلنا في
+
+334
+00:30:16,130 --> 00:30:23,440
+جسم هناوهذا الجسم نفسه نجلناه على بعد أبعد وهو
+
+335
+00:30:23,440 --> 00:30:27,800
+جريب بيعمل زاوية مع الأين أكبر من الزاوية اللي
+
+336
+00:30:27,800 --> 00:30:34,080
+بيعملها هو إيشأبعد هذه الفكرة المبسطة بتمهد
+
+337
+00:30:34,080 --> 00:30:38,400
+للموضوع التاني اللي هو ال angular magnification بس
+
+338
+00:30:38,400 --> 00:30:41,380
+في ال angular magnification احنا هارف التجربة هنا
+
+339
+00:30:41,380 --> 00:30:47,000
+او في المثال هنا الجسم مضطر يبعد او يجرب يبعد عشان
+
+340
+00:30:47,000 --> 00:30:50,900
+زاويته مع العين تجل أو يجرب عشان زاويته مع العين
+
+341
+00:30:50,900 --> 00:30:56,130
+تكبرالمثل اللي عكس انه مش بعيد عنه لما بقترب الشخص
+
+342
+00:30:56,130 --> 00:31:00,450
+بيبدأ طوله يكبر بيبدأ طوله يكبر الآن في ال angular
+
+343
+00:31:00,450 --> 00:31:05,030
+magnification الجسم هيظل ثابت ايش اللي هيتغير هحط
+
+344
+00:31:05,030 --> 00:31:09,090
+optical system بين الجسم وبين العين واشوف هذا ال
+
+345
+00:31:09,090 --> 00:31:14,020
+optical system جداش كبر ليهزاوية رؤية الجسم زاوية
+
+346
+00:31:14,020 --> 00:31:18,560
+رؤية الجسم احنا لما بنمسك عدسات plus او magnifier
+
+347
+00:31:18,560 --> 00:31:21,800
+عدسات plus عالية و بنطلع منها على الأجسام بنلاحظ
+
+348
+00:31:21,800 --> 00:31:26,400
+ان الأجسام كبرت طيب او صار الهتة كبير او لما بنمسك
+
+349
+00:31:26,400 --> 00:31:30,480
+ال magnifier ال hand held magnifier بنحس ان
+
+350
+00:31:30,480 --> 00:31:33,500
+الأجسام اللي تحته كبيرة هل هي فعلا كبرت حقيقة
+
+351
+00:31:33,500 --> 00:31:39,990
+الجسم مابتغير تمامزاوية رؤية العين لهذا الجسم هي
+
+352
+00:31:39,990 --> 00:31:43,090
+اللي كبرت يعني اللي عمله ال optical system اللي
+
+353
+00:31:43,090 --> 00:31:47,490
+عمله ال optical system انه كبر الزاوية اللي انا
+
+354
+00:31:47,490 --> 00:31:51,170
+بشوف من خلال هذا الجسم وهذا هو المقصود بال angular
+
+355
+00:31:51,170 --> 00:31:54,250
+magnification و هنعرف المرة القادمة ان شاء الله
+
+356
+00:31:54,250 --> 00:31:59,470
+كيف طريقة حسابه حد يسأل سؤال يعطيكوا العافية
+
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/2i7O6I8KxYE_raw.json b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/2i7O6I8KxYE_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..44ff5e44031e4c817575853062dcf4fe5f440228
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/2i7O6I8KxYE_raw.json
@@ -0,0 +1 @@
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{"start": 1880.88, "end": 1880.98, "word": " على", "probability": 0.78125}, {"start": 1880.98, "end": 1881.36, "word": " الأجسام", "probability": 0.97509765625}, {"start": 1881.36, "end": 1881.8, "word": " بنلاحظ", "probability": 0.9539794921875}, {"start": 1881.8, "end": 1881.92, "word": " ان", "probability": 0.54443359375}, {"start": 1881.92, "end": 1882.46, "word": " الأجسام", "probability": 0.96728515625}, {"start": 1882.46, "end": 1883.0, "word": " كبرت", "probability": 0.9365234375}, {"start": 1883.0, "end": 1884.2, "word": " طيب", "probability": 0.8304036458333334}, {"start": 1884.2, "end": 1884.46, "word": " او", "probability": 0.821044921875}, {"start": 1884.46, "end": 1884.64, "word": " صار", "probability": 0.967041015625}, {"start": 1884.64, "end": 1884.96, "word": " الهتة", "probability": 0.731201171875}, {"start": 1884.96, "end": 1885.34, "word": " كبير", "probability": 0.8411458333333334}, {"start": 1885.34, "end": 1885.8, "word": " او", "probability": 0.95556640625}, {"start": 1885.8, "end": 1885.96, "word": " لما", "probability": 0.97998046875}, {"start": 1885.96, "end": 1886.4, "word": " بنمسك", "probability": 0.978759765625}, {"start": 1886.4, "end": 1886.5, "word": " ال", "probability": 0.90771484375}, {"start": 1886.5, "end": 1887.16, "word": " magnifier", "probability": 0.859619140625}, {"start": 1887.16, "end": 1887.44, "word": " ال", "probability": 0.73974609375}, {"start": 1887.44, "end": 1888.7, "word": " hand", "probability": 0.5849609375}, {"start": 1888.7, "end": 1888.98, "word": " held", "probability": 0.50439453125}, {"start": 1888.98, "end": 1889.6, "word": " magnifier", "probability": 0.95849609375}, {"start": 1889.6, "end": 1890.28, "word": " بنحس", "probability": 0.9347330729166666}, {"start": 1890.28, "end": 1890.48, "word": " ان", "probability": 0.83203125}, {"start": 1890.48, "end": 1891.06, "word": " الأجسام", "probability": 0.981689453125}, {"start": 1891.06, "end": 1891.2, "word": " اللي", "probability": 0.7919921875}, {"start": 1891.2, "end": 1891.52, "word": " تحته", "probability": 0.9890950520833334}, {"start": 1891.52, "end": 1891.88, "word": " كبيرة", "probability": 0.9879557291666666}, {"start": 1891.88, "end": 1892.1, "word": " هل", "probability": 0.94580078125}, {"start": 1892.1, "end": 1892.24, "word": " هي", "probability": 0.94580078125}, {"start": 1892.24, "end": 1892.58, "word": " فعلا", "probability": 0.9270833333333334}, {"start": 1892.58, "end": 1893.0, "word": " كبرت", "probability": 0.9033203125}, {"start": 1893.0, "end": 1893.5, "word": " حقيقة", "probability": 0.9052734375}, {"start": 1893.5, "end": 1894.36, "word": " الجسم", "probability": 0.60552978515625}, {"start": 1894.36, "end": 1895.04, "word": " مابتغير", "probability": 0.82822265625}, {"start": 1895.04, "end": 1895.5, "word": " تمام", "probability": 0.970703125}], "temperature": 1.0}, {"id": 75, "seek": 191947, "start": 1897.11, "end": 1919.47, "text": "زاوية رؤية العين لهذا الجسم هي اللي كبرت يعني اللي عمله ال optical system اللي عمله ال optical system انه كبر الزاوية اللي انا بشوف من خلال هذا الجسم وهذا هو المقصود بال angular magnification و هنعرف المرة القادمة ان شاء الله كيف طريقة حسابه حد يسأل سؤال يعطيكوا العافية", "tokens": [11622, 995, 2407, 10632, 12602, 33604, 10632, 18863, 9957, 46740, 15730, 25724, 38251, 39896, 13672, 1829, 9122, 26890, 2655, 37495, 22653, 13672, 1829, 6225, 42213, 3224, 2423, 20674, 1185, 13672, 1829, 6225, 42213, 3224, 2423, 20674, 1185, 16472, 3224, 9122, 26890, 6024, 110, 995, 2407, 10632, 13672, 1829, 1975, 8315, 4724, 8592, 38688, 9154, 16490, 1211, 6027, 23758, 25724, 38251, 37037, 15730, 31439, 9673, 4587, 9381, 23328, 20666, 24413, 4944, 3774, 4032, 8032, 1863, 3615, 28480, 9673, 25720, 25062, 18513, 46007, 16472, 13412, 16606, 21984, 9122, 33911, 23032, 16572, 28671, 11331, 3794, 16758, 3224, 11331, 3215, 7251, 3794, 10721, 1211, 8608, 33604, 6027, 37495, 9566, 1829, 4117, 14407, 18863, 31845, 10632], "avg_logprob": -0.09089006909302302, "compression_ratio": 1.8541666666666667, "no_speech_prob": 5.960464477539062e-07, "words": [{"start": 1897.1100000000001, "end": 1897.8700000000001, "word": "زاوية", "probability": 0.94921875}, {"start": 1897.8700000000001, "end": 1898.63, "word": " رؤية", "probability": 0.990234375}, {"start": 1898.63, "end": 1899.03, "word": " العين", "probability": 0.9794921875}, {"start": 1899.03, "end": 1899.39, "word": " لهذا", "probability": 0.912353515625}, {"start": 1899.39, "end": 1899.73, "word": " الجسم", "probability": 0.979248046875}, {"start": 1899.73, "end": 1899.99, "word": " هي", "probability": 0.87939453125}, {"start": 1899.99, "end": 1900.17, "word": " اللي", "probability": 0.760986328125}, {"start": 1900.17, "end": 1900.55, "word": " كبرت", "probability": 0.9679361979166666}, {"start": 1900.55, "end": 1900.77, "word": " يعني", "probability": 0.77734375}, {"start": 1900.77, "end": 1901.07, "word": " اللي", "probability": 0.959228515625}, {"start": 1901.07, "end": 1901.41, "word": " عمله", "probability": 0.9449869791666666}, {"start": 1901.41, "end": 1901.49, "word": " ال", "probability": 0.9765625}, {"start": 1901.49, "end": 1901.79, "word": " optical", "probability": 0.6806640625}, {"start": 1901.79, "end": 1902.45, "word": " system", "probability": 0.9736328125}, {"start": 1902.45, "end": 1903.09, "word": " اللي", "probability": 0.918701171875}, {"start": 1903.09, "end": 1903.37, "word": " عمله", "probability": 0.9920247395833334}, {"start": 1903.37, "end": 1903.47, "word": " ال", "probability": 0.982421875}, {"start": 1903.47, "end": 1903.77, "word": " optical", "probability": 0.97607421875}, {"start": 1903.77, "end": 1904.31, "word": " system", "probability": 0.98095703125}, {"start": 1904.31, "end": 1904.69, "word": " انه", "probability": 0.736328125}, {"start": 1904.69, "end": 1905.07, "word": " كبر", "probability": 0.973876953125}, {"start": 1905.07, "end": 1905.77, "word": " الزاوية", "probability": 0.982421875}, {"start": 1905.77, "end": 1906.95, "word": " اللي", "probability": 0.948486328125}, {"start": 1906.95, "end": 1907.49, "word": " انا", "probability": 0.740966796875}, {"start": 1907.49, "end": 1907.97, "word": " بشوف", "probability": 0.9886067708333334}, {"start": 1907.97, "end": 1908.31, "word": " من", "probability": 0.9970703125}, {"start": 1908.31, "end": 1908.61, "word": " خلال", "probability": 0.994140625}, {"start": 1908.61, "end": 1908.89, "word": " هذا", "probability": 0.8935546875}, {"start": 1908.89, "end": 1909.35, "word": " الجسم", "probability": 0.9833984375}, {"start": 1909.35, "end": 1909.91, "word": " وهذا", "probability": 0.81103515625}, {"start": 1909.91, "end": 1910.05, "word": " هو", "probability": 0.99169921875}, {"start": 1910.05, "end": 1910.59, "word": " المقصود", "probability": 0.995361328125}, {"start": 1910.59, "end": 1910.79, "word": " بال", "probability": 0.92724609375}, {"start": 1910.79, "end": 1911.17, "word": " angular", "probability": 0.4423828125}, {"start": 1911.17, "end": 1912.03, "word": " magnification", "probability": 0.9677734375}, {"start": 1912.03, "end": 1912.21, "word": " و", "probability": 0.65087890625}, {"start": 1912.21, "end": 1912.93, "word": " هنعرف", "probability": 0.73052978515625}, {"start": 1912.93, "end": 1913.27, "word": " المرة", "probability": 0.939208984375}, {"start": 1913.27, "end": 1913.73, "word": " القادمة", "probability": 0.9847005208333334}, {"start": 1913.73, "end": 1913.89, "word": " ان", "probability": 0.77587890625}, {"start": 1913.89, "end": 1914.07, "word": " شاء", "probability": 0.98876953125}, {"start": 1914.07, "end": 1914.25, "word": " الله", "probability": 0.95703125}, {"start": 1914.25, "end": 1914.97, "word": " كيف", "probability": 0.9833984375}, {"start": 1914.97, "end": 1915.57, "word": " طريقة", "probability": 0.98095703125}, {"start": 1915.57, "end": 1916.41, "word": " حسابه", "probability": 0.9853515625}, {"start": 1916.41, "end": 1916.75, "word": " حد", "probability": 0.92431640625}, {"start": 1916.75, "end": 1917.05, "word": " يسأل", "probability": 0.9560546875}, {"start": 1917.05, "end": 1917.51, "word": " سؤال", "probability": 0.9962565104166666}, {"start": 1917.51, "end": 1919.07, "word": " يعطيكوا", "probability": 0.86767578125}, {"start": 1919.07, "end": 1919.47, "word": " العافية", "probability": 0.9697265625}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1920.406375, "duration_after_vad": 1796.864374999996}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/O4j6n1zdCBo.srt b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/O4j6n1zdCBo.srt
new file mode 100644
index 0000000000000000000000000000000000000000..ec24b0932809e13c659eb65d24d3dfc4fc79e4ee
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/O4j6n1zdCBo.srt
@@ -0,0 +1,1425 @@
+1
+00:00:20,650 --> 00:00:23,710
+بسم الله الرحمن الرحيم وصلنا عند أول قانون من
+
+2
+00:00:23,710 --> 00:00:27,190
+قوانين الـ geometrical optics اللي هو قانون
+
+3
+00:00:27,190 --> 00:00:32,230
+السريان المستقيم اللي بنص على أنه light propagates
+
+4
+00:00:32,230 --> 00:00:37,400
+in straight line paths called light rays يعني
+
+5
+00:00:37,400 --> 00:00:40,820
+يصير الضوء في مسارات مستقيمة تسمى الإشعاعات
+
+6
+00:00:40,820 --> 00:00:43,860
+الضوئية هذا بالنسبة للـ geometrical optics يعني
+
+7
+00:00:43,860 --> 00:00:48,340
+صحيح ما فيه أي كلام بس في موضوع الـ physical
+
+8
+00:00:48,340 --> 00:00:54,320
+optics هيكون فيه يعني خلل بسيط أن الضوء بما أنه
+
+9
+00:00:54,320 --> 00:01:00,070
+عبارة عن waves يعني قضية السريان المستقيم هذه مش
+
+10
+00:01:00,070 --> 00:01:04,190
+شرط أن تكون صحيحة 100% لأنه لما بيصادف الضوء
+
+11
+00:01:04,190 --> 00:01:08,090
+فتحة في جدار بيصير له diffraction والـ
+
+12
+00:01:08,090 --> 00:01:11,530
+diffraction هو حيود الضوء عن مساره المستقيم يعني
+
+13
+00:01:11,530 --> 00:01:15,550
+الـ divergence بتاع الـ light بعد هذا، فلو الضوء يعني
+
+14
+00:01:15,550 --> 00:01:20,750
+بيصير في مسارات مستقيمة يعني غير قابلة للتغير
+
+15
+00:01:20,750 --> 00:01:25,270
+كمفروض، الـ diffraction هذا ما يصيرش. طيب الآن الـ
+
+16
+00:01:25,270 --> 00:01:29,250
+geometrical optics كعلم لما بيعتمد على قانون
+
+17
+00:01:29,250 --> 00:01:33,970
+السريان المستقيم بيسهل الأمور كثيراً ويمكن حل
+
+18
+00:01:33,970 --> 00:01:40,760
+مسائل كثيرة بهذه القضية. أما في الحالات المعينة اللي
+
+19
+00:01:40,760 --> 00:01:45,700
+بيكون فيها الـ diffraction significant ساعتها علم
+
+20
+00:01:45,700 --> 00:01:48,620
+الـ geometrical optics بيقدرش يعطيني تصور كامل عن
+
+21
+00:01:48,620 --> 00:01:52,280
+الصورة و صفاتها اللي احنا حكينا عنها زي الـ
+
+22
+00:01:52,280 --> 00:01:54,460
+magnification والـ location والـ quality والـ
+
+23
+00:01:54,460 --> 00:01:58,440
+brightness فبالتالي ساعتها بيكون الـ diffraction
+
+24
+00:01:58,440 --> 00:02:02,160
+له أثره. في غالب الأحيان الـ diffraction قليل يمكن
+
+25
+00:02:02,160 --> 00:02:05,720
+إهماله وبالتالي هذا القانون صحيح بالنسبة لعلم الـ
+
+26
+00:02:05,720 --> 00:02:10,880
+geometrical optics.الضوء بيسير في مسارات مستقيمة تسمى
+
+27
+00:02:10,880 --> 00:02:13,520
+الإشعاعات الضوئية.
+
+28
+00:02:15,340 --> 00:02:19,780
+فبالتالي هذه القضية بتكون واضحة. الآن نجي نلاقي
+
+29
+00:02:19,780 --> 00:02:23,660
+موضوع اسمه الـ optical interfaces بيقول لنا احنا كل
+
+30
+00:02:23,660 --> 00:02:28,020
+مادة بتمرر الضوء هي عبارة عن optical medium. عبارة
+
+31
+00:02:28,020 --> 00:02:32,420
+عن optical medium سواء ماء سواء هواء سواء زجاج
+
+32
+00:02:32,420 --> 00:02:35,700
+سواء... يعني كل مادة أو الـ biological tissues زي
+
+33
+00:02:35,700 --> 00:02:38,620
+القرنية زي الـ crystalline lens زي الـ vitreous إلى
+
+34
+00:02:38,620 --> 00:02:43,110
+آخره. هذه تعتبر media، optical media يعني material
+
+35
+00:02:43,110 --> 00:02:47,330
+بيمر فيها الضوء ويمكن أن يسرى فيها الضوء. السطوح
+
+36
+00:02:47,330 --> 00:02:52,950
+الفاصلة بين مادتين بصريتين متجاورتين between two
+
+37
+00:02:52,950 --> 00:02:57,410
+optical media، سطح الفاصل يسمى optical interface
+
+38
+00:02:57,410 --> 00:03:05,060
+optical interface يعني سطح فاصل بين المادة سين
+
+39
+00:03:05,060 --> 00:03:09,620
+والمادة صاد، والاثنين مواد يعني optical media يعني
+
+40
+00:03:09,620 --> 00:03:15,260
+بيمر فيها الضوء. لما بيصل الضوء قادماً من سين ووصل
+
+41
+00:03:15,260 --> 00:03:23,540
+للسطح الفاصل بين سين وصاد بيحدث ثلاث أشياء، ثلاث
+
+42
+00:03:23,540 --> 00:03:30,880
+أشياء. أول شيء جزء منه بيصير له reflection، جزء
+
+43
+00:03:30,880 --> 00:03:33,200
+آخر بيصير له refraction.
+
+44
+00:03:35,310 --> 00:03:40,230
+جزء بيصير له absorption. absorption طبعاً
+
+45
+00:03:40,230 --> 00:03:47,750
+absorption يعني جزء بينعكس وجزء بيمتص وجزء بينتقل.
+
+46
+00:03:47,750 --> 00:03:53,850
+تتخيل المثال التالي: إنسان
+
+47
+00:03:53,850 --> 00:04:02,810
+جالس داخل سيارة، إنسان واقف خارج السيارة. ضوء سقط
+
+48
+00:04:02,810 --> 00:04:11,210
+على هذا الإنسان اللي جوه ثم انعكس باتجاه الخارج. كيف
+
+49
+00:04:11,210 --> 00:04:15,910
+أعرف أن الضوء مر عبر هذا الزجاج اللي هنا؟ شايف اللي
+
+50
+00:04:15,910 --> 00:04:20,610
+برا تمام، اللي هنا شايف اللي برا. إذًا الضوء جزء منه
+
+51
+00:04:20,610 --> 00:04:25,590
+مر. طب كيف أعرف أنه جزء انعكس؟ هذا الإنسان لو جرب من
+
+52
+00:04:25,590 --> 00:04:29,590
+السيارة ممكن يشوف صورة نفسه، صورة نفسه أحياناً كثيراً
+
+53
+00:04:29,590 --> 00:04:33,570
+من مرة، جوه السيارة بيكون صورتنا موجودة واحنا
+
+54
+00:04:33,570 --> 00:04:37,590
+برا، وشايفين الصورة تمام. فجزء ايه انعكس. لو ما انعكسش
+
+55
+00:04:37,590 --> 00:04:41,110
+هذا الجزء، ما نشوفش صورة، صح؟ تمام. لو حط إيده على
+
+56
+00:04:41,110 --> 00:04:45,670
+الزجاج، تمام. أحياناً بيحس الزجاج اما دافئ أو حتى ساخن
+
+57
+00:04:45,670 --> 00:04:48,850
+أحياناً. فبالتالي جزء من هذه الطاقة الضوئية الحراري
+
+58
+00:04:48,850 --> 00:04:54,920
+تحولت إلى ايش؟ إلى حرارة. فبالتالي لما بيصل الضوء لسطح فاصل
+
+59
+00:04:54,920 --> 00:05:00,060
+بين two optical media بيحدث ثلاث ظواهر، مش شرط أن
+
+60
+00:05:00,060 --> 00:05:04,120
+هذه الظواهر تحدث بنفس الدرجة. يعني لازم يكون مثلاً
+
+61
+00:05:04,120 --> 00:05:09,100
+ثلث reflected وثلث refracted وثلث absorbed. لأ مش
+
+62
+00:05:09,100 --> 00:05:11,800
+هيك القضية. يعني ممكن اللي reflected على سبيل
+
+63
+00:05:11,800 --> 00:05:16,490
+المثال يكون مثلاً 1% أو 2% مثلاً، واللي
+
+64
+00:05:16,490 --> 00:05:19,190
+بيصير له absorption مثلاً 50% على سبيل
+
+65
+00:05:19,190 --> 00:05:22,870
+المثال، والباقي مثلاً بيعدي، اللي هو الجزء الأكبر
+
+66
+00:05:22,870 --> 00:05:25,910
+بيعدي، بيصير له ايش؟ transmission أو refraction يعني
+
+67
+00:05:25,910 --> 00:05:32,030
+مش شرط أن تكون القسمة بين الثلاث ظواهر بالتساوي، مش
+
+68
+00:05:32,030 --> 00:05:37,790
+شرط أن تكون بالتساوي. طيب
+
+69
+00:05:37,790 --> 00:05:41,590
+نجيء
+
+70
+00:05:41,590 --> 00:05:42,490
+احنا بنقول كده
+
+71
+00:05:45,260 --> 00:05:50,140
+ايش اللي بتحكم في أن جزء يصير له... أو ايش اللي
+
+72
+00:05:50,140 --> 00:05:54,720
+بتحكم في الكمية اللي بيصير لها reflection والكمية
+
+73
+00:05:54,720 --> 00:05:59,260
+اللي بيصير لها reflection؟ عوامل كثيرة، من أهمها
+
+74
+00:05:59,260 --> 00:06:07,600
+زاوية السقوط. زاوية السقوط وعامل ثاني هيمر عليكم
+
+75
+00:06:07,600 --> 00:06:12,900
+في الـ physical optics، الـ plane of
+
+76
+00:06:12,900 --> 00:06:14,380
+polarization of light.
+
+77
+00:06:19,470 --> 00:06:24,550
+هذه العوامل تتحكم في كمية الانعكاس وكمية الانكسار.
+
+78
+00:06:24,550 --> 00:06:29,250
+تمام. فبالتالي
+
+79
+00:06:29,250 --> 00:06:37,130
+هذه العوامل تتحكم في الكمية. الآن يجيء السطوح
+
+80
+00:06:37,130 --> 00:06:44,130
+الفاصلة بين المواد، مش شرط كلها تكون smooth، أحياناً
+
+81
+00:06:44,130 --> 00:06:48,990
+بيكون في عندي smooth optical interface أو rough
+
+82
+00:06:48,990 --> 00:06:54,830
+surface. يعني سطح أملس فاصل بين مادتين وأحياناً
+
+83
+00:06:54,830 --> 00:07:00,730
+بيكون عندي rough optical interface بين المادة سين
+
+84
+00:07:00,730 --> 00:07:06,110
+وسطح صاد. طبعاً حيث
+
+85
+00:07:06,110 --> 00:07:11,390
+أن السطح ممكن تكون smooth وممكن تكون عندي rough.
+
+86
+00:07:11,390 --> 00:07:16,210
+لو سقط الضوء على smooth optical interface هتحدث
+
+87
+00:07:16,210 --> 00:07:21,040
+ثلاث ظواهر. لو سقط على rough optical interface فوقها
+
+88
+00:07:21,040 --> 00:07:24,700
+تحصل نفس الثلاث ظواهر، بس النتيجة مش واحدة، النتيجة
+
+89
+00:07:24,700 --> 00:07:29,460
+مش واحدة. قبل ما نحكي ايش اللي هيحصل في الحالتين
+
+90
+00:07:29,460 --> 00:07:34,520
+بينا نقول أنه من أهم الـ optical media اللي هنتعامل
+
+91
+00:07:34,520 --> 00:07:38,140
+معها اللي هو الاشياء اللي بيخص العين. يا ترى كم
+
+92
+00:07:38,140 --> 00:07:42,800
+optical interface موجود
+
+93
+00:07:42,800 --> 00:07:49,970
+في موضوع العين؟ لو رسمنا العين بشكل مكبر شوية فيها
+
+94
+00:07:49,970 --> 00:07:54,170
+إنها العديد من الـ optical interface. قلنا الـ
+
+95
+00:07:54,170 --> 00:07:57,650
+optical interface هو الحد اللي بيفصل بين مادة و
+
+96
+00:07:57,650 --> 00:08:01,090
+مادة ثانية بتختلف عنها في refractive index أو في
+
+97
+00:08:01,090 --> 00:08:04,470
+معامل الانكسار. فيها إن هي طبقة رقيقة بتكسو العين
+
+98
+00:08:04,470 --> 00:08:10,530
+بيسموها tear film، طبقة الدمع. tear film. تتوقع أن
+
+99
+00:08:10,530 --> 00:08:15,580
+أنا بدي ييجي من الهواء، أول حاجة هيقابله طبقة الـ
+
+100
+00:08:15,580 --> 00:08:20,340
+tear film، الـ refractive index بتاعها تقريباً 1.33.
+
+101
+00:08:20,340 --> 00:08:24,620
+وتاعي ايش؟ 1. إذًا السطح الأمامي للـ tear film
+
+102
+00:08:24,620 --> 00:08:32,220
+هو optical interface رقم 1. الضوء عدى عبر الـ
+
+103
+00:08:32,220 --> 00:08:37,300
+tear film، وصل للسطح الأمامي للقرنية. القرنية الـ
+
+104
+00:08:37,300 --> 00:08:43,990
+refractive index بتاعها 1.376، يختلف عن الـ 1.33
+
+105
+00:08:43,990 --> 00:08:49,930
+سائل
+
+106
+00:08:49,930 --> 00:08:58,910
+المائي، الـ aqueous 1.33. سائل المائي، الـ aqueous 1.33
+
+107
+00:08:58,910 --> 00:09:01,110
+سائل المائي، الـ aqueous 1.33. سائل المائي، الـ aqueous
+
+108
+00:09:01,110 --> 00:09:03,010
+1.33. سائل المائي، الـ aqueous 1.33. سائل المائي، الـ
+
+109
+00:09:03,010 --> 00:09:09,230
+aqueous 1.33. سائل المائي، الـ aqueous 1.33. سائل
+
+110
+00:09:09,230 --> 00:09:10,290
+المائي، الـ aqueous 1.33. سائل المائي، الـ aqueous 1.33
+
+111
+00:09:10,290 --> 00:09:10,750
+المائي، الـ aqueous 1.33. سائل المائي، الـ aqueous 1.33
+
+112
+00:09:10,750 --> 00:09:14,320
+سائل المائي. هينتقل من الأكوياس للعدسة. العدسة تقريباً
+
+113
+00:09:14,320 --> 00:09:20,700
+1.4 من 1.4 أَكْثَرَ أَقَلّ، تمام حسب يعني مناطق معينة من
+
+114
+00:09:20,700 --> 00:09:25,280
+العدسة. إذًا هينتقل، إذًا السطح الأمامي للعدسة عنده
+
+115
+00:09:25,280 --> 00:09:31,720
+رابع optical interface. وصل الضوء للسطح الخلفي
+
+116
+00:09:31,720 --> 00:09:35,820
+للعدسة، هينتقل للـ vitreous. الـ vitreous 1.33. إذًا
+
+117
+00:09:35,820 --> 00:09:39,100
+هينتقل بين مادتين مختلفتين في الـ refractive index.
+
+118
+00:09:39,520 --> 00:09:43,780
+إذًا عندي خمسة optical interface في العين، خمسة
+
+119
+00:09:43,780 --> 00:09:48,140
+optical interface في العين. في كل مرة يعني كل ما
+
+120
+00:09:48,140 --> 00:09:54,480
+ينتقل من وسط لوسط هيحدث الثلاث ظواهر، بمعنى آخر
+
+121
+00:09:54,480 --> 00:10:01,740
+بمعنى آخر هيعكس جزء منه من الأسطح المختلفة. تمام.
+
+122
+00:10:01,740 --> 00:10:06,400
+الأربع أسهم اللي أنا رسمتهم، الأربع أسهم اللي أنا
+
+123
+00:10:06,400 --> 00:10:12,350
+رسمتهم بيعكسوا جزء من الضوء الداخل وبيعتِمُونَهُ. سواق
+
+124
+00:10:12,350 --> 00:10:19,890
+هذا السواق بيسموه بوركنجي إيميج، Purkinje images.
+
+125
+00:10:22,480 --> 00:10:26,360
+أول واحدة اللي هي من السطح الأمامي للقرنية. أحياناً
+
+126
+00:10:26,360 --> 00:10:29,320
+لما احنا بنطلع في عين بني آدم بنلاقي صورتنا احنا
+
+127
+00:10:29,320 --> 00:10:33,220
+موجودة، احنا بنعتبر عينها كعينها مرايا بالنسبة لنا
+
+128
+00:10:33,220 --> 00:10:36,680
+بنشوف صورة حالنا في العين. هذه الـ first Purkinje
+
+129
+00:10:36,680 --> 00:10:41,980
+image، واللي بتستخدم في فحوصات كثيرة منها تصوير
+
+130
+00:10:41,980 --> 00:10:46,320
+القرنية. منها تصوير القرنية. هذه الـ Purkinje image
+
+131
+00:10:46,320 --> 00:10:49,920
+اللي هي الجزء اللي انعكس من السطح الأمامي للقرنية
+
+132
+00:10:49,920 --> 00:10:54,850
+من السطح الخلفي للقرنية، من السطح الأمامي للـ lens، من
+
+133
+00:10:54,850 --> 00:10:58,650
+السطح الخلفي للـ lens. هدول الأربع Purkinje images
+
+134
+00:10:58,650 --> 00:11:02,470
+بتكونوا نتيجة انعكاس جزء من الأشعة اللي دخلت
+
+135
+00:11:02,470 --> 00:11:08,390
+انعكاسها يعني من الأسطح المختلفة. ايش السبب؟ السبب
+
+136
+00:11:08,390 --> 00:11:13,910
+أنه كقاعدة كل ما بيغادر الضوء medium وبنتقل لـ medium
+
+137
+00:11:13,910 --> 00:11:18,030
+الثانية اللي بعدها على السطح الفاصل بين الـ two
+
+138
+00:11:18,030 --> 00:11:23,660
+media بيحدث ثلاث ظواهر، جزء بينعكس، قليل طبعاً، وجزء
+
+139
+00:11:23,660 --> 00:11:27,280
+بيمر وجزء بيصير له ايش؟ absorption. فبالتالي هذه
+
+140
+00:11:27,280 --> 00:11:31,020
+القضية يعني تفسير ليش احنا لما نطلع أحياناً في عين
+
+141
+00:11:31,020 --> 00:11:34,960
+بني آدم بنشوف صورة حالنا في هذه، في هذه
+
+142
+00:11:34,960 --> 00:11:39,800
+الظاهرة. طيب، نجيء. احنا بنقول الثلاث ظواهر اللي
+
+143
+00:11:39,800 --> 00:11:44,580
+بتحدث لما ينتقل الضوء من مادة لمادة ثانية بتختلف
+
+144
+00:11:44,580 --> 00:11:50,820
+عنها في refractive index. الثلاث ظواهر، يا ترى لو السطح
+
+145
+00:11:50,820 --> 00:11:55,940
+الفاصل بين المادتين أملس، كيف هيكون؟ لو السطح خشن
+
+146
+00:11:55,940 --> 00:12:00,820
+أو مش أملس، كيف هيكون؟ الضوء هيسير بشكل حزمة ضوئية
+
+147
+00:12:00,820 --> 00:12:06,940
+هينعكس جزء منه، وهيمر جزء منه. احنا ما بنحكيش عن
+
+148
+00:12:06,940 --> 00:12:10,120
+الجزء اللي بيمتص، لأن هذا اتحول لطاقة من شكل آخر
+
+149
+00:12:10,120 --> 00:12:15,280
+غير... يعني بطل ضوء، بطل ضوء، أصبح طاقة حرارية. إذًا
+
+150
+00:12:15,280 --> 00:12:19,700
+السقوط بيكون على سطح أملس، الانعكاس بيكون منتظم
+
+151
+00:12:19,700 --> 00:12:27,340
+والمرور منتظم. سقوط الضوء على سطح أملس فاصل بين two
+
+152
+00:12:27,340 --> 00:12:32,740
+media بيعطيني specular... specular reflection
+
+153
+00:12:32,740 --> 00:12:39,230
+انعكاس منتظم، وspecular transmission، مرور أو انكسار
+
+154
+00:12:39,230 --> 00:12:45,650
+منتظم، مرور منتظم، transmission منتظم. طالما منتظم، إذًا
+
+155
+00:12:45,650 --> 00:12:50,710
+بيحكمه قانون، القانون
+
+156
+00:12:50,710 --> 00:12:55,430
+هذا هيعرف فيما بعد بقليل باسم قانون الانعكاس اللي
+
+157
+00:12:55,430 --> 00:13:01,920
+هو law of reflection. بينما لما بيسقط الضوء على سطح
+
+158
+00:13:01,920 --> 00:13:08,620
+غير منتظم، سطح خشن غير منتظم، هتسقط حزمة الأشعة، تمام؟
+
+159
+00:13:08,620 --> 00:13:14,540
+هتحدث ثلاث ظواهر، مرور وانعكاس وامتصاص. الامتصاص
+
+160
+00:13:14,540 --> 00:13:18,800
+هتتحول لنوع أو شكل آخر من أشكال الطاقة، بينما
+
+161
+00:13:18,800 --> 00:13:25,680
+الانعكاس هيكون عشوائي تماماً، والمرور برضه عشوائي.
+
+162
+00:13:25,680 --> 00:13:30,840
+ليش؟ لأن السطح مش منتظم، وطالما عشوائي ما فيه قانون
+
+163
+00:13:31,110 --> 00:13:34,630
+بيحكمه، ما فيه قانون بيحكمه. بيسموه diffuse reflection
+
+164
+00:13:34,630 --> 00:13:39,650
+و
+
+165
+00:13:39,650 --> 00:13:48,050
+diffuse transmission. diffuse
+
+166
+00:13:48,050 --> 00:13:52,130
+reflection وdiffuse transmission. الآن في حالة
+
+167
+00:13:52,130 --> 00:13:57,830
+خاصة ممكنة من ناحية النظرية بس مش من ناحية العملية
+
+168
+00:13:57,830 --> 00:14:02,540
+نشهد الحالة الخاصة. بنقول لما عندنا سطح غير منتظم
+
+169
+00:14:02,540 --> 00:14:06,140
+وحزمة
+
+170
+00:14:06,140 --> 00:14:10,120
+الضوء، الـ pencil of light، المكون من مئات الآلاف
+
+171
+00:14:10,120 --> 00:14:16,460
+من الأشعة، اختصرناه، جديدنا بوسيلة ما نختصره لـ single
+
+172
+00:14:16,460 --> 00:14:21,240
+ray. طبعاً ما فيه مصدر يعطيني single ray، single ray
+
+173
+00:14:21,240 --> 00:14:27,950
+واحد، تمام؟ لو صورنا هذا، ممكن، هذا الـ single ray
+
+174
+00:14:27,950 --> 00:14:32,830
+أسقطناه على سطح غير منتظم فاصل بين مادتين مختلفتين
+
+175
+00:14:32,830 --> 00:14:37,690
+في الـ refractive index وتخيلنا هذا الـ single ray
+
+176
+00
+
+223
+00:18:28,410 --> 00:18:32,070
+surface normal معناها عمود السطح أو العمود المقام
+
+224
+00:18:32,070 --> 00:18:37,730
+على السطح، تمام؟
+
+225
+00:18:37,730 --> 00:18:41,650
+إذن هنا زي ما نقول عين باللغة العربية، إلها كذا
+
+226
+00:18:41,650 --> 00:18:47,480
+معنى، عين الإنسان أو عين الماء أو العين اللي هو
+
+227
+00:18:47,480 --> 00:18:50,840
+الجاسوس إلى آخره، تمام. فبالتالي بتحمل هنا surface
+
+228
+00:18:50,840 --> 00:18:56,700
+normal معناته عمود السطح. طيب الزاوية الموجودة بين
+
+229
+00:18:56,700 --> 00:18:59,600
+الـ surface normal والـ incident ray هذه زاوية
+
+230
+00:18:59,600 --> 00:19:08,960
+السقوط اللي هو θI، angle of incidence، angle of
+
+231
+00:19:08,960 --> 00:19:15,120
+incidence، زاوية السقوط. ما حدش
+
+232
+00:19:15,950 --> 00:19:21,210
+يعتقد أن هذه اللي أنا مقشر عليها باللون الأحمر أن
+
+233
+00:19:21,210 --> 00:19:24,170
+هي زاوية السقوط. هذه ليست زاوية السقوط. زاوية
+
+234
+00:19:24,170 --> 00:19:27,730
+السقوط هي الزاوية المحصورة بين الشعاع الساقط
+
+235
+00:19:27,730 --> 00:19:33,210
+والعمود المقام. واضح؟ طيب، والزاوية المحصورة بين
+
+236
+00:19:33,210 --> 00:19:38,370
+الشعاع المنعكس والعمود أيضا هي زاوية الانعكاس،
+
+237
+00:19:38,370 --> 00:19:41,250
+θR، angle of reflection.
+
+238
+00:19:46,060 --> 00:19:51,240
+لما برسم الرسم، هاي بيتضح عندي قانون الانعكاس. قانون
+
+239
+00:19:51,240 --> 00:19:57,000
+الانعكاس عبارة عن جملتين، لثالث لهم. الجملة الأولى
+
+240
+00:19:57,000 --> 00:20:03,820
+من نص القانون: incident ray، شعاع
+
+241
+00:20:03,820 --> 00:20:12,380
+الساقط، فاصلة، reflected ray، شعاع المنعكس، and
+
+242
+00:20:12,380 --> 00:20:13,740
+surface normal،
+
+243
+00:20:18,420 --> 00:20:27,100
+are all in one plane، كلها
+
+244
+00:20:27,100 --> 00:20:33,300
+تقع في مستوى فراغي واحد. أكمل
+
+245
+00:20:33,300 --> 00:20:39,590
+القانون: θI تساوي θR. يعني زاوية السقوط تساوي زاوية
+
+246
+00:20:39,590 --> 00:20:44,190
+الانعكاس. زاوية السقوط إذا 30 درجة، لازم زاوية
+
+247
+00:20:44,190 --> 00:20:47,590
+الانعكاس تكون 30 درجة. إذا زاوية السقوط
+
+248
+00:20:47,590 --> 00:20:53,510
+15 درجة، تساوي زاوية الانعكاس 15 درجة.
+
+249
+00:20:53,510 --> 00:21:00,910
+إذا زاوية السقوط 50 درجة، زاوية الانعكاس 50
+
+250
+00:21:00,910 --> 00:21:05,970
+درجة، وهكذا. يعني زاوية السقوط... طبعا هدف الانعكاس
+
+251
+00:21:05,970 --> 00:21:09,370
+المنظم مش في الانعكاس اللي هو العشوائي، تمام.
+
+252
+00:21:09,370 --> 00:21:15,390
+فبالتالي هذه القضية بتكون واضحة بالنظر برضه.
+
+253
+00:21:15,390 --> 00:21:21,100
+ليست زاوية الانعكاس هي الزاوية المحصورة بين الشعاع
+
+254
+00:21:21,100 --> 00:21:24,860
+المنعكس والـ optical interface. لأ، مش هذا. زاوية
+
+255
+00:21:24,860 --> 00:21:28,320
+السقوط هيها، وزاوية الانعكاس هيها. يعني الـ surface
+
+256
+00:21:28,320 --> 00:21:32,760
+normal هو اللي بيحدد زاوية السقوط وزاوية الانعكاس.
+
+257
+00:21:32,760 --> 00:21:38,360
+نجي للجملة الأولى من القانون. يعني لو إحنا سلطنا ضوء
+
+258
+00:21:38,360 --> 00:21:41,940
+ليزر، أتخيل أن سطح المكتب هو السطح الفاصل بين
+
+259
+00:21:41,940 --> 00:21:46,160
+المادتين سين وسين، و سلطنا ضوء الليزر، وجزء منه
+
+260
+00:21:46,160 --> 00:21:53,560
+انعكس. الضوء إذا جاء بالشكل هذا، مش هيروح ينعكس هيك،
+
+261
+00:21:53,560 --> 00:21:57,840
+ولا هيروح ينعكس باتجاهه هذا. لا، في نفس المستوى
+
+262
+00:21:57,840 --> 00:22:01,340
+الفراغي اللي هو موجود فيه. المستوى الفراغي اللي
+
+263
+00:22:01,340 --> 00:22:04,800
+بيشمل الشعاع الساقط والـ surface normal هو اللي
+
+264
+00:22:04,800 --> 00:22:09,060
+هيشمل نفسه الشعاع المنعكس. هدول الثلاثه يكونوا في
+
+265
+00:22:09,060 --> 00:22:12,960
+نفس المستوى الفراغي، لأن الضوء لن يغير طريقه عن هذا
+
+266
+00:22:12,960 --> 00:22:17,020
+المستوى. سقط باتجاه، سيبقى في نفس الاتجاه، لن يذهب
+
+267
+00:22:17,020 --> 00:22:23,140
+يمينا ولا يسارا، تمام. فبالتالي هذه القضية اللي هي
+
+268
+00:22:23,140 --> 00:22:27,320
+النص الأول أو الجملة الأولى من قانون الانعكاسي:
+
+269
+00:22:27,320 --> 00:22:29,900
+الـ incident ray والـ reflected ray والـ surface
+
+270
+00:22:29,900 --> 00:22:36,340
+normal are all in one plane. θI تساوي θR، قولا واحدا.
+
+271
+00:22:36,340 --> 00:22:40,220
+طيب، في عندنا حاجة خاصة من سقوط منظم، وبدنا
+
+272
+00:22:40,220 --> 00:22:47,460
+نستنتج مع بعض. يعني مين هينعكس؟ الشعاع اللي منعكس، و
+
+273
+00:22:47,460 --> 00:22:51,600
+ليه؟ الحاجة الخاصة عندي: سطح منتظم بين سين وسين،
+
+274
+00:22:51,600 --> 00:22:56,600
+وعندي أشعة سقطت بشكل عمودي. يترى هتنعكس؟ الجزء اللي
+
+275
+00:22:56,600 --> 00:22:59,440
+هينعكس منها، هينعكس كيف؟ وليه؟
+
+276
+00:23:02,250 --> 00:23:06,930
+قدرش زاوية السقوط؟ صفر. إذا زاوية الانعكاس، إيش؟
+
+277
+00:23:06,930 --> 00:23:11,090
+زاوية الانعكاس صفر؟ يعني الشعاع المنعكس ينقبل على
+
+278
+00:23:11,090 --> 00:23:15,310
+الـ surface normal. يعني بما أن زاوية السقوط θI
+
+279
+00:23:15,310 --> 00:23:20,790
+تساوي الصفر، معناته θR تساوي صفر. يعني من حين
+
+280
+00:23:20,790 --> 00:23:26,880
+سقط فوقها، عاد الجزء اللي انعكس، انعكس على طول الخط اللي
+
+281
+00:23:26,880 --> 00:23:31,880
+إيجى منه الضوء. سقط سقوط عمودي، بعضه مرة، مش موضوعنا،
+
+282
+00:23:31,880 --> 00:23:35,460
+وبعضه انعكس. اللي انعكس، بما أن زاوية السقوط تساوي
+
+283
+00:23:35,460 --> 00:23:40,240
+صفر. ليش تساوي صفر؟ لأنه شعاع الساقط جاذب من الـ
+
+284
+00:23:40,240 --> 00:23:42,720
+surface normal لغاية ما انطبق عليه. يعني زاوية
+
+285
+00:23:42,720 --> 00:23:48,070
+السقوط تساوي صفر. بما أن زاوية السقوط تساوي صفر، وهذا
+
+286
+00:23:48,070 --> 00:23:51,430
+انعكاس منتظم. أنا بعرف أنه من نص القانون الانعكاس
+
+287
+00:23:51,430 --> 00:23:57,030
+θI تساوي θR. بما أن هي صفر، معناته هذه أيضا صفر.
+
+288
+00:23:57,030 --> 00:24:01,710
+وبالتالي زاوية الانعكاس صفر. يعني الشعاع الساقط
+
+289
+00:24:01,710 --> 00:24:05,810
+المنعكس، عفوا، بده يكون منطبق. يعني هذه زاوية صفر.
+
+290
+00:24:05,810 --> 00:24:09,690
+عشان تساوي صفر، بده يرجع على نفس الخط اللي إيجى منه.
+
+291
+00:24:09,690 --> 00:24:12,570
+إذا انعكس انعكاس بهذا
+
+292
+00:24:19,570 --> 00:24:23,030
+زي ما حكينا إحنا، هذا قانون الانعكاس، وزي ما حكينا
+
+293
+00:24:23,030 --> 00:24:29,090
+أنه
+
+294
+00:24:29,090 --> 00:24:32,630
+الثلاث ظواهر
+
+295
+00:24:32,630 --> 00:24:37,150
+اللي بتحدث، عشان يقيسوها العلماء، فوجدوا أنها بترتبط
+
+296
+00:24:37,150 --> 00:24:41,170
+جدا شي انعكس، جدا شي more، بزاوية السقوط اللي هي θ
+
+297
+00:24:41,170 --> 00:24:46,970
+I، والـ plane of polarization، Polarization of light.
+
+298
+00:24:46,970 --> 00:24:49,450
+وهذا ناخذه في الـ Geometrical... عفوا، في الـ
+
+299
+00:24:49,450 --> 00:24:53,130
+Physical Optics، Layer of Polarization of Light.
+
+300
+00:24:53,130 --> 00:25:00,110
+طبعا فيه حسابات معينة، ولكن السقوط العمودي، السقوط
+
+301
+00:25:00,110 --> 00:25:07,130
+العمودي ممكن نحسبه بطريقة بسيطة بإيجاد معامل
+
+302
+00:25:07,130 --> 00:25:12,940
+الانعكاس. معامل الانعكاس لهذه المادة نسميها nI، يعني
+
+303
+00:25:12,940 --> 00:25:15,460
+الـ Refractive Index بتاعها، بتاع المادة اللي منها
+
+304
+00:25:15,460 --> 00:25:18,960
+الـ incidence بيحدث. I incidence، هذه المادة اللي جاي
+
+305
+00:25:18,960 --> 00:25:22,380
+ساقط منها الضوء، فهنرمز لـ refractive index بتاعها
+
+306
+00:25:22,380 --> 00:25:26,170
+بـ nR، وهذه المادة اللي رايح عليها الضوء هي المادة
+
+307
+00:25:26,170 --> 00:25:29,850
+رقم 2، اللي هي المادة الثانية، تمام. فإذا رمزنا بالـ
+
+308
+00:25:29,850 --> 00:25:32,370
+refractive index للمادة الأولى اللي جاي منها الضوء
+
+309
+00:25:32,370 --> 00:25:36,490
+وسقط منها الضوء، بـ nI، ورمزنا للمادة الثانية
+
+310
+00:25:36,490 --> 00:25:40,170
+refractive index تاعها، أعطينا رمز n2. n تعود للـ
+
+311
+00:25:40,170 --> 00:25:45,510
+refractive index، و 2 يعني هي المادة رقم 2. لو في
+
+312
+00:25:45,510 --> 00:25:49,850
+حالة السقوط العمودي، تمام. إذا كان الامتصاص قليل جدا،
+
+313
+00:25:49,850 --> 00:25:54,490
+ممكن أحسب كمية الضوء اللي مرت، كمية الضوء اللي
+
+314
+00:25:54,490 --> 00:25:58,210
+انعكس، تمام. اللي مرت، كمية الضوء اللي انعكس، بإيجاد
+
+315
+00:25:58,210 --> 00:26:05,570
+معامل الانعكاس بالمعادلة البسيطة جدا: n2 ناقص nI
+
+316
+00:26:05,570 --> 00:26:12,910
+على n2 زائد nI، الكل تربيع. يعني هذا بقدر أجيب معامل
+
+317
+00:26:12,910 --> 00:26:16,750
+الانعكاس، وبالتالي أقدر أعرف كده نسبة اللي مرت وكده
+
+318
+00:26:16,750 --> 00:26:21,970
+نسبة اللي انعكس، بشرط أن يكون اللي صار له
+
+319
+00:26:21,970 --> 00:26:26,390
+absorption كميته قليل، كميته قليل. هذا بالنسبة
+
+320
+00:26:26,390 --> 00:26:34,250
+لموضوع الانعكاس. هذا بالنسبة لموضوع الانعكاس، واضح
+
+321
+00:26:34,250 --> 00:26:34,590
+الأمر.
+
+322
+00:26:45,650 --> 00:26:50,030
+نجي للموضوع التالي، اللي هو Specular Transmission.
+
+323
+00:26:50,030 --> 00:26:54,950
+Specular Transmission
+
+324
+00:26:54,950 --> 00:27:00,970
+Law
+
+325
+00:27:00,970 --> 00:27:07,310
+of Refraction، قانون الانكسار،
+
+326
+00:27:07,310 --> 00:27:14,590
+واللي يسمى باسم Snell's Law. Snell's Law، تكريما لهذا
+
+327
+00:27:14,590 --> 00:27:19,720
+العالم. طيب، نجي
+
+328
+00:27:19,720 --> 00:27:25,120
+الآن للجزء اللي مر، للجزء اللي مر، يعني انتقل للـ
+
+329
+00:27:25,120 --> 00:27:29,180
+media الثانية، في
+
+330
+00:27:29,180 --> 00:27:34,840
+حالة المرور المنتظم، الأشعة كلها هتختصر لشعاع واحد.
+
+331
+00:27:34,840 --> 00:27:43,480
+للتوضيح بنقول أن المادة scene والمادة صورة، تمام، أو
+
+332
+00:27:43,480 --> 00:27:54,440
+خلينا نقول مادة السقوط، الـ Incident Media، والـ
+
+333
+00:27:54,440 --> 00:28:02,480
+Media لـ Transmission، Transmission Media. يعني
+
+334
+00:28:02,480 --> 00:28:07,200
+الـ Refractive Index هنا هنرمز له بـ nI، و Refractive
+
+335
+00:28:07,200 --> 00:28:13,160
+Index هنا هنرمز له بـ nT. طبعا يفضل نستخدم كلمة
+
+336
+00:28:13,160 --> 00:28:18,650
+Transmission أفضل من refraction. ليش؟ لو أنا استخدمت
+
+337
+00:28:18,650 --> 00:28:23,950
+refraction وأخذت الحرف الأول منها، هقول θr،
+
+338
+00:28:23,950 --> 00:28:28,830
+angle of refraction. ممكن اللغة تبنى بين θr،
+
+339
+00:28:28,830 --> 00:28:33,090
+الـ angle of reflection اللي مرت قبل شوية.
+
+340
+00:28:33,090 --> 00:28:38,780
+reflection انعكاس، و refraction انكسار، في تداخل فقط
+
+341
+00:28:38,780 --> 00:28:41,360
+للـ Reflection. طبعا الـ Refraction هو نفسه الـ
+
+342
+00:28:41,360 --> 00:28:44,780
+Transmission، فأخذ أول حرف
+
+343
+00:28:44,780 --> 00:28:49,260
+من كلمة Transmission، وأرمز له بـ nT. يعني n بتاع الـ
+
+344
+00:28:49,260 --> 00:28:52,640
+Transmission، يعني المادة اللي مر فيها الضوء، اللي
+
+345
+00:28:52,640 --> 00:28:58,660
+انتقل إليها الضوء. فبنقول هذا الشعاع كان مصيره أنه يمر
+
+346
+00:28:58,660 --> 00:29:07,930
+نفترض مر بالطريقة... نفترض أن nT أكبر من nI. يعني هنا أعلى
+
+347
+00:29:07,930 --> 00:29:12,510
+في الـ refractive index. نفترض الـ nT مثلا 1.4، و
+
+348
+00:29:12,510 --> 00:29:17,470
+هنا المادة 1، نفترض هو مثلا
+
+349
+00:29:17,470 --> 00:29:23,610
+مادة زجاجية مثلا، تمام. اللي هيحصل، اللي هيحصل تغير
+
+350
+00:29:23,610 --> 00:29:32,610
+في سرعة الضوء، أولا. اتنين،
+
+351
+00:29:33,810 --> 00:29:39,930
+غالبا تغير في الاتجاه، طبعا ما عدا في حالة السقوط
+
+352
+00:29:39,930 --> 00:29:46,650
+العمودي. ما عدا في حالة السقوط العمودي، لأن في
+
+353
+00:29:46,650 --> 00:29:52,270
+السقوط العمودي، سيبقى ماره، إذا ما، ولا يغير اتجاهه،
+
+354
+00:29:52,270 --> 00:29:59,190
+بس ستتغير سرعته، ستتغير سرعته، تمام. يا ترى أيش القانون
+
+355
+00:29:59,190 --> 00:30:02,490
+اللي يحكم هذا الـ incident ray،
+
+356
+00:30:05,990 --> 00:30:13,110
+وهذا لـ transmitted ray. يا
+
+357
+00:30:13,110 --> 00:30:18,570
+ترى ما القانون الذي يحكم العلاقة بين هذا الشعاع و
+
+358
+00:30:18,570 --> 00:30:22,230
+هذا الشعاع؟ يعني بين الشعاع الساقط والشعاع المنكسر،
+
+359
+00:30:22,230 --> 00:30:28,650
+أو الشعاع المار. القانون اللي بيحكمهم هو قانون
+
+360
+00:30:28,650 --> 00:30:33,330
+الانكسار، أو Snell's law. قانون الانكسار، أو Snell's
+
+361
+00:30:33,330 --> 00:30:36,930
+law. عشان نعرف قانون الانكسار، أو Snell's law برضه،
+
+362
+00:30:36,930 --> 00:30:41,330
+بدنا نرسم الـ surface normal عشان نحدد زاوية السقوط،
+
+363
+00:30:41,330 --> 00:30:46,090
+وزاوية المرور أو الانكسار. زي surface normal،
+
+364
+00:30:46,090 --> 00:30:52,190
+الزاوية هذه المحصورة بين شعاع السطح والعمود
+
+365
+00:30:52,190 --> 00:30:57,550
+المقام على السطح هي θI. دائما زوايا تُنسب للـ
+
+366
+00:30:57,550 --> 00:31:01,690
+surface normal، مش للسطح الفاصل. يعني ما بقولش أن في
+
+367
+00:31:01,690 --> 00:31:05,330
+تقاينة هي هذه، لأ، في تقاينة الشعاع الساقط والـ
+
+368
+00:31:05,330 --> 00:31:10,150
+surface normal، طبعا. طيب، وزاوية الانكسار أو الـ
+
+369
+00:31:10,150 --> 00:31:13,430
+angle of transmission، أيضا المحصورة بين الشعاع والـ
+
+370
+00:31:13,430 --> 00:31:20,190
+surface normal، هي θT. ما
+
+371
+00:31:20,190 --> 00:31:22,310
+هو نص قانون الانكسار:
+
+372
+00:31:26,370 --> 00:31:31,010
+برضه من جملتين، بس الجملة الأولى بتشبه الجملة
+
+373
+00:31:31,010 --> 00:31:34,830
+الأولى في قانون الانعكاس، بس الاختلاف في الجملة
+
+374
+00:31:34,830 --> 00:31:40,730
+الثانية. بنقول incident ray، صحيح،
+
+375
+00:31:40,730 --> 00:31:47,870
+بدل من نقول reflected، بنقول transmitted ray، and
+
+376
+00:31:47,870 --> 00:31:50,410
+surface normal، ثلاثة، كلها تقع
+
+377
+00:31:55,410 --> 00:32:05,070
+All are in the same plane. الجملة
+
+378
+00:32:05,070 --> 00:32:11,070
+الثانية هنا تقول θI تساوي θR، زاوية السقوط تساوي
+
+379
+00:32:11,070 --> 00:32:23,030
+زاوية الانعكاس. هنا لأ، nI sin θI يساوي nT sin θT.
+
+380
+00:32:24,710 --> 00:32:30,730
+يعني الـ refractive index بتاع المادة هاي مضروبا في
+
+381
+00:32:30,730 --> 00:32:34,330
+جيب الزاوية هاد، يساوي الـ refractive index بتاع
+
+382
+00:32:34,330 --> 00:32:38,390
+المادة الثانية مضروبا في جيب الزاوية بتاعة
+
+383
+00:32:38,390 --> 00:32:43,770
+الانكسار. مرة ثانية: الـ Refractive Index n تاع مادة
+
+384
+00:32:43,770 --> 00:32:47,670
+السقوط مضروبا في جيب زاوية السقوط، يساوي الـ
+
+385
+00:32:47,670 --> 00:32:50,010
+Refractive Index تاع المادة اللي راح لها الضوء
+
+386
+00:32:50,010 --> 00:32:55,150
+مضروبا في جيب زاوية الانكسار. في جيب زاوية الانكسار.
+
+387
+00:32:55,150 --> 00:33:02,950
+فبالتالي هذا اللي هو هنا، قلنا θI تساوي θR، سهل جدا.
+
+388
+00:33:02,950 --> 00:33:07,750
+هنا لأننا نضرب الـ Refractive Index بتاع مادة السقوط
+
+389
+00:33:07,750 --> 00:33:11,270
+اللي سقطت منها الضوء، في جيب زاوية السقوط، هنلاقي
+
+390
+00:33:11,270 --> 00:33:15,710
+بيساوي الـ Refractive Index بتاع المادة اللي
+
+391
+00:33:15,710 --> 00:33:21,030
+راح لها الضوء مضروبا في جيب زاوية الانكسار، تمام.
+
+392
+00:33:21,030 --> 00:33:24,550
+فإحنا قلنا علم الـ Geometric Optics قائم على
+
+393
+00:33:24,550 --> 00:33:30,510
+المقاربات. يعني لو في شيء يُسهل عملية الحساب، تمام،
+
+394
+00:33:31,300 --> 00:33:35,120
+
+445
+00:37:47,100 --> 00:37:50,620
+شوية تمام؟ هذه بس شغلة بسيطة عشان تظلّ يعني في
+
+446
+00:37:50,620 --> 00:37:53,620
+الذاكرة بقى، دخل مادة كثيفة يعني أعلى في ال
+
+447
+00:37:53,620 --> 00:37:57,000
+refractive index، الدّوق هينكسر باتجاه أبوه.. مين
+
+448
+00:37:57,000 --> 00:38:00,300
+أبوه؟ الـ service normal، وهيبقى ما فيش حد بيمشي في
+
+449
+00:38:00,300 --> 00:38:06,040
+السوق بنفس سرعته، برا السوق تمام؟ لو تصوّرنا العكس
+
+450
+00:38:06,040 --> 00:38:10,480
+الدّوق بدي يصدر من السوق، من المادة الكثيفة ويطلع
+
+451
+00:38:10,480 --> 00:38:15,890
+لبرا باتجاه الهواء مثلاً، ومادة أقل كثافة، بيبتعد ومش
+
+452
+00:38:15,890 --> 00:38:20,830
+بس بيبتعد وبيسرق وبيسرق، واضح المثال هذا؟ يعطيكم
+
+453
+00:38:20,830 --> 00:38:21,450
+ألف عافية
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/RCAbqCq5XRw_postprocess.srt b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/RCAbqCq5XRw_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..330f40b0c2150e52b17800bdab4c4836ec5addbb
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/RCAbqCq5XRw_postprocess.srt
@@ -0,0 +1,1444 @@
+1
+00:00:20,670 --> 00:00:23,470
+بسم الله الرحمن الرحيم اليوم موضوعنا في ال
+
+2
+00:00:23,470 --> 00:00:27,090
+geometric optics عن ال thick lenses و اذا يعني
+
+3
+00:00:27,090 --> 00:00:31,750
+بنلاحجها بال focal lengths بالنسبة ل ال thin lens
+
+4
+00:00:31,750 --> 00:00:38,590
+حكينا انه احنا فيه عندنا ال powerبتاعة الـ thin
+
+5
+00:00:38,590 --> 00:00:42,990
+lens تساوي ال power بتاعة ال front surface زاد ال
+
+6
+00:00:42,990 --> 00:00:46,310
+power بتاعة ال back surface وقولنا ال power بتاعة
+
+7
+00:00:46,310 --> 00:00:49,850
+ال transfer of light through the lens بنهملها
+
+8
+00:00:49,850 --> 00:00:56,950
+لأنها too small و هتعقد الموضوع فبالتالي تهمل
+
+9
+00:00:56,950 --> 00:01:01,460
+وتعتبر فقطالـ Power بتاعة الـ Thin Lens هي الـ P
+
+10
+00:01:01,460 --> 00:01:05,520
+Front زائد الـ P بتاعة الـ Back Service اليوم في
+
+11
+00:01:05,520 --> 00:01:09,520
+موضوع الـ Thick Lenses القمر بيختلف لأنه من اسمها
+
+12
+00:01:09,520 --> 00:01:14,340
+Thick Lens إذا في سمك محترم لهذه العدسة وبالتالي
+
+13
+00:01:14,340 --> 00:01:22,470
+بدنا نشوفأو حنشوف أنه في كمية من ال versions بتاع
+
+14
+00:01:22,470 --> 00:01:25,130
+ال light أو بيصير change لل versions بتاع ال light
+
+15
+00:01:25,130 --> 00:01:32,010
+عبر الصمك بتاع ال lens فبالتالي ال power هتقسم ال
+
+16
+00:01:32,010 --> 00:01:34,870
+power بتاعة ال lens لل power بتاعة ال front
+
+17
+00:01:34,870 --> 00:01:38,230
+service زاد ال power بتاعة ال back service زاد ال
+
+18
+00:01:38,230 --> 00:01:42,000
+power بتاعة ال transferالـ power بتاعة لترانسفير
+
+19
+00:01:42,000 --> 00:01:45,540
+ومعروف ان ال versions of light بتغير و بتغير
+
+20
+00:01:45,540 --> 00:01:49,280
+المسافة و هو يساوي مقلوب المسافة و هنا عندي
+
+21
+00:01:49,280 --> 00:01:54,520
+المسافة معتبرة فبالتالي بيكون عندي ال change يعني
+
+22
+00:01:54,520 --> 00:01:59,320
+لا يمكن تجاهله بنسأل نفسنا سؤال عندنا thin lens
+
+23
+00:01:59,320 --> 00:02:00,780
+مثلا
+
+24
+00:02:04,180 --> 00:02:08,420
+الـ Power بتاعة ال front service plus عشرة بتاعة
+
+25
+00:02:08,420 --> 00:02:11,260
+ال back service نفرض plus خمسة بنقول ال power
+
+26
+00:02:11,260 --> 00:02:15,440
+بتاعة ال thin lens تساوي plus عشرة زائد plus خمسة
+
+27
+00:02:15,440 --> 00:02:19,520
+ويساوي plus خمستاشر دي ال total power بتاعتها صافي
+
+28
+00:02:19,520 --> 00:02:25,500
+ال power بتاعتها تمام؟ بينما اندي thick lens ثمكها
+
+29
+00:02:25,500 --> 00:02:31,230
+واحد صنطي مثلا تمام؟ ال power بتاعة ال frontوالـ
+
+30
+00:02:31,230 --> 00:02:34,590
+power بتاعة ال back تشبه المثل في الـ thin lens بس
+
+31
+00:02:34,590 --> 00:02:38,310
+لنشوف إيش ال effective power بتاعتها يعني جداش بصف
+
+32
+00:02:38,310 --> 00:02:44,110
+من قوتها كلها عشان نحسب ال power الكلية بتاعتها أو
+
+33
+00:02:44,110 --> 00:02:46,470
+ال effective power بتاعتها بدنا نحسب ال power
+
+34
+00:02:46,470 --> 00:02:51,530
+change of transfer يعني جداش بتصرف من قوتها داخلها
+
+35
+00:02:51,530 --> 00:02:54,590
+في معادلة بسيطة لهذه القضية ال power بتاعة ال
+
+36
+00:02:54,590 --> 00:02:59,860
+transferالـ power بتاعة ال transfer تساوي طبعا هنا
+
+37
+00:02:59,860 --> 00:03:06,780
+بنفرض اللي هو ال refractive index N 1.5 للإجزاز
+
+38
+00:03:06,780 --> 00:03:10,480
+تمام ال power بتاعة ال transfer تساوي معادلتها
+
+39
+00:03:10,480 --> 00:03:18,020
+ناقص T على NL في ال P بتاعة ال front في ال B بتاعة
+
+40
+00:03:18,020 --> 00:03:21,940
+ال back surface ال T هنا ترمز لل thickness ال T
+
+41
+00:03:21,940 --> 00:03:27,460
+ترمزللـ thickness بتاعة ال lens بال متر طبعا بال
+
+42
+00:03:27,460 --> 00:03:31,940
+متر والان قال ال refractive index بتاع ال lens
+
+43
+00:03:31,940 --> 00:03:37,640
+refractive index of lens نشوف المثل اللي عندنا
+
+44
+00:03:37,640 --> 00:03:42,120
+بنقول كالقاتي ال power exchange on transfer في
+
+45
+00:03:42,120 --> 00:03:47,800
+المثال اللي عندنا يسوى ناقص واحد صنط يعني واحد من
+
+46
+00:03:47,800 --> 00:03:52,940
+مية متر على refractive index واحد و نص فيه
+
+47
+00:03:55,510 --> 00:04:02,470
+الـ Back بالـ B Front عشرة والـ B Back خمسة طبعا
+
+48
+00:04:02,470 --> 00:04:05,770
+هنا لما ابدأ أشيل النقطة أو أشيل الفاصلة العشرية
+
+49
+00:04:05,770 --> 00:04:14,950
+بتصير عند هنا واحد من عشر طبعا ناقص ناقص تمام عشرة
+
+50
+00:04:14,950 --> 00:04:23,830
+في واحد من عشرة يساوي إيش واحد في خمسة على خمستاش
+
+51
+00:04:23,830 --> 00:04:29,240
+تمامو يساوي ناقص خمسة على خمستاش و يساوي ناقص تلت
+
+52
+00:04:29,240 --> 00:04:35,980
+ديوبتر اذا بيصرف تلت ديوبتر على ال power change on
+
+53
+00:04:35,980 --> 00:04:39,600
+transfer ال power ال effective power اللي بيصفيلي
+
+54
+00:04:39,600 --> 00:04:42,720
+من ال thick lens اللي هي power بتاعة ال front اللي
+
+55
+00:04:42,720 --> 00:04:51,490
+هي عشرة زائد خمسة ناقص تلت ديوبتر و يساوي اربعتاشو
+
+56
+00:04:51,490 --> 00:04:58,410
+تلتين دا يبتر plus 14 و تلتين دا يبتر إذا مين أقوى
+
+57
+00:04:58,410 --> 00:05:04,610
+ال thin lens إذا تساوت ال thin lens و ال thick
+
+58
+00:05:04,610 --> 00:05:09,470
+lens في قوة السطح الأمامي و في قوة السطح الخلفي
+
+59
+00:05:09,470 --> 00:05:19,500
+فالفعيلية في كسر الضوء تكون لصالحالـ Thin Lens لأن
+
+60
+00:05:19,500 --> 00:05:23,180
+هنا الـ Effective Power صفت عندي 14.6 من 10 أو 14
+
+61
+00:05:23,180 --> 00:05:28,960
+.6 من 100 ديوبتر بينما هنا تقريبا 15 ديوبتر يعني
+
+62
+00:05:28,960 --> 00:05:33,560
+الـ Thin Lens بتكون more powerfulفي الـ Refraction
+
+63
+00:05:33,560 --> 00:05:37,780
+بتاع الـ Light تمام السبب انه بيستهلك جزء من قوة
+
+64
+00:05:37,780 --> 00:05:42,400
+العدسة على ال power change on a transfer نيجي نضرب
+
+65
+00:05:42,400 --> 00:05:49,120
+مثال تاني حتى المسألة تصير اوضة بنقول هنا what is
+
+66
+00:05:49,120 --> 00:05:54,020
+the effective power لعدسة سمكها واحد و نص سانت و
+
+67
+00:05:54,020 --> 00:05:59,440
+ال refractive index واحد و أربعة من عشرة هذه ال
+
+68
+00:05:59,440 --> 00:06:05,690
+thicknessإذا علمنا إنه plus تمانية السطح الأمامي و
+
+69
+00:06:05,690 --> 00:06:12,050
+plus مثلا ستة السطح الخلفي بنقول ال power بتاعة ال
+
+70
+00:06:12,050 --> 00:06:21,510
+transfer تساوي ناقص T على NL في PF في P ال back و
+
+71
+00:06:21,510 --> 00:06:27,450
+يساوي ناقص واحد و نص سانت يعني خمستاش من ألف متر
+
+72
+00:06:27,450 --> 00:06:32,110
+على واحد و أربعة من عشرةفى ال B بتاعة ال front
+
+73
+00:06:32,110 --> 00:06:38,130
+تمانية فى ال B بتاعة ال back ستة تمام هنا بنشيل
+
+74
+00:06:38,130 --> 00:06:43,550
+الفاصلة العشرية بيصير عندى خمستاش من مية فى تمانية
+
+75
+00:06:43,550 --> 00:06:48,970
+فى ستة على أربعة عشر هنا على اتنين فيها الأربعة
+
+76
+00:06:48,970 --> 00:06:54,850
+وعلى اتنين فيها السبعة تمام حد يعملنا يوم على
+
+77
+00:06:54,850 --> 00:06:55,630
+الحسبة
+
+78
+00:07:04,630 --> 00:07:11,850
+6×4×24 ماينوس نص ماينوس نص ده يبطر هذا ليس قوة
+
+79
+00:07:11,850 --> 00:07:14,850
+العدسة هذا قوة ال power على ال transfer يعني اللي
+
+80
+00:07:14,850 --> 00:07:18,190
+هيستهلك في ال transfer ال power بتاعة ال lens
+
+81
+00:07:18,190 --> 00:07:20,750
+بتاعة هذه ال thick lens تساوي ال power بتاعة ال
+
+82
+00:07:20,750 --> 00:07:24,010
+front زاد ال power بتاعة ال back زاد ال power
+
+83
+00:07:24,010 --> 00:07:31,830
+بتاعة ال transfer ويساوي تمانيةزائد ستة ناقص نص
+
+84
+00:07:31,830 --> 00:07:38,110
+يعني يساوي plus 13.5 لو انها عدسة thin كان plus 14
+
+85
+00:07:38,110 --> 00:07:45,220
+كان plus 14 تمام نضرب مثال تالت بنقول عدسةthick
+
+86
+00:07:45,220 --> 00:07:51,700
+lens ثمكها 2 cm وrefractive index 1.3 من عشرة ال
+
+87
+00:07:51,700 --> 00:07:54,900
+power بتاعة ال front plus 10 وتاعة ال back مثلا
+
+88
+00:07:54,900 --> 00:07:59,760
+plus 8 بدنا ال effective power بتاعتها بنقول ال
+
+89
+00:07:59,760 --> 00:08:04,420
+power بتاعة ال transfer تساوي ناقص T على NL في ال
+
+90
+00:08:04,420 --> 00:08:06,900
+power بتاعة ال front في ال power بتاعة ال back
+
+91
+00:08:06,900 --> 00:08:12,850
+ويساوي ناقص 2 من 100 متر علىواحد و تلاتة من عشرة
+
+92
+00:08:12,850 --> 00:08:15,690
+في عشرة في تمانية
+
+93
+00:08:22,320 --> 00:08:27,700
+النتيجة النهائية سالب واحد فاصل اتنين ديوبتر طيب
+
+94
+00:08:27,700 --> 00:08:33,680
+الآن بنقول ال power الكلية تساوي plus عشرة زائد
+
+95
+00:08:33,680 --> 00:08:39,760
+تمانية ناقص واحد فاصل اتنين ويساوي ستاش و تمانية
+
+96
+00:08:39,760 --> 00:08:44,400
+plus ستاش و تمانية يعني أفرجت بأكتر من one ديوبتر
+
+97
+00:08:44,400 --> 00:08:48,440
+في حال لو ما كانت هي thin lens هتكون plus تمانتاش
+
+98
+00:08:48,880 --> 00:08:51,200
+ليه ال power بتاعة ال front زاد ال power بتاعة ال
+
+99
+00:08:51,200 --> 00:08:55,340
+back وبالتالي صار عندي فارق كبير صار فارق كبير
+
+100
+00:08:55,340 --> 00:09:01,800
+فعشان هي thick lens بتاعي بتصير
+
+101
+00:09:01,800 --> 00:09:05,600
+less effective في ال refraction لان في very
+
+102
+00:09:05,600 --> 00:09:08,280
+interesting question اللي علاقة بال physiology
+
+103
+00:09:08,280 --> 00:09:12,430
+حسيبه open questionهسيبه open question لأنه مش
+
+104
+00:09:12,430 --> 00:09:15,810
+موضوع في الـ Geometric Optics بس حبيت أترحولي عن
+
+105
+00:09:15,810 --> 00:09:21,430
+نوع ده في كتاب ال physiology مطروح الآن هي ال lens
+
+106
+00:09:21,430 --> 00:09:26,830
+أو ال crystalline lens عند الإنسان في ال non
+
+107
+00:09:26,830 --> 00:09:30,530
+accommodating state طالع على distant target مافيش
+
+108
+00:09:30,530 --> 00:09:35,450
+أي مشكلة الآن لما بيصير موضوع ال accommodation
+
+109
+00:09:35,450 --> 00:09:41,830
+بتصير ال lens more curved مظبوططب ال accommodation
+
+110
+00:09:41,830 --> 00:09:45,850
+ايش الهدف منه انه يكون عندى ال near object clear
+
+111
+00:09:45,850 --> 00:09:51,270
+بمعنى اخر كيف بدى يصير ال near object clear العدسة
+
+112
+00:09:51,270 --> 00:09:53,830
+المستخدمة او ال crystalline lens لازم تزيد ال
+
+113
+00:09:53,830 --> 00:09:58,250
+power بتاعتها طيب احنا في عندى حاجة paradoxical
+
+114
+00:09:58,250 --> 00:10:02,890
+يعني حاجة متناقضة لما يصير عندى accommodating
+
+115
+00:10:02,890 --> 00:10:06,430
+crystalline lens هاي ال iris تمام بتصير more thick
+
+116
+00:10:06,430 --> 00:10:13,430
+فمفروض ان يصير قوتها ايش اضعفمفروض يصير قوتها أضعف
+
+117
+00:10:13,430 --> 00:10:23,010
+السؤال بترح نفسه يعني كيف تصبح العدسة داخل العين
+
+118
+00:10:23,010 --> 00:10:34,460
+أسمك و مع ذلك يعني تزيد القوةأو هل هي بتزداد القوة
+
+119
+00:10:34,460 --> 00:10:38,240
+أو هل بيحدث اشي معين تاني اخر هذا السؤال هيظل open
+
+120
+00:10:38,240 --> 00:10:42,840
+question للي بيحب يعني يعني يتعمق في هذا الموضوع
+
+121
+00:10:42,840 --> 00:10:45,440
+هذه شغلة مناقضة للاشي اللي احنا بندرسه في الـ
+
+122
+00:10:45,440 --> 00:10:48,220
+Geometric Optics معروف في الـ Geometric Optics ال
+
+123
+00:10:48,220 --> 00:10:53,470
+lens كل ما كانت أسمكيعني يستهلك من قوتها على نقل
+
+124
+00:10:53,470 --> 00:10:57,710
+الضوء أو ترحيل الضوء من السطح الأمامي للسطح الخلفي
+
+125
+00:10:57,710 --> 00:11:00,470
+طب هذا اللي بيحدث حقيقة أثناء ال accommodation
+
+126
+00:11:00,470 --> 00:11:04,030
+احنا ال accommodation بالبلد بالبلدي البسيط جدا
+
+127
+00:11:04,030 --> 00:11:08,150
+بيصير عشان تصير العدسة more powerful عشان نقدر
+
+128
+00:11:08,150 --> 00:11:12,290
+نعمل focusing لل targets طب ال accommodation عبارة
+
+129
+00:11:12,290 --> 00:11:16,320
+عن إيه؟Contraction of the ciliary muscle الزنيول
+
+130
+00:11:16,320 --> 00:11:20,380
+بتبطل فيها tension فبالتالي بتصير more curved او
+
+131
+00:11:20,380 --> 00:11:24,320
+more يعني spherical shape فبالتالي انحنائها بيزيد
+
+132
+00:11:24,320 --> 00:11:26,880
+بتصير ال thickness بتاعتها ال anteroposterior
+
+133
+00:11:26,880 --> 00:11:30,780
+diameter بتاعها بيصير أكبر أصبحت more thick lens
+
+134
+00:11:30,780 --> 00:11:34,480
+فالمفروض قوتها تجل ايش اللي بيحصل أثناء عملية ال
+
+135
+00:11:34,480 --> 00:11:38,360
+accommodation هذا بنخليه open equation عشان نكمل
+
+136
+00:11:38,360 --> 00:11:43,350
+في الأمثلة بتاعتناطيب نيجي نضرب كمان مثال حتى يعني
+
+137
+00:11:43,350 --> 00:11:49,570
+ما ننساش القاعدة و تظلها يعني أنها يعني واضحة و
+
+138
+00:11:49,570 --> 00:11:55,030
+نقول أن what is the difference between the thin
+
+139
+00:11:55,030 --> 00:12:01,190
+lens plus عشرة و نقول plus أربعة و thick lensبرضه
+
+140
+00:12:01,190 --> 00:12:06,370
+plus 10 و plus 4 هنا ال thickness نقول واحد و نص
+
+141
+00:12:06,370 --> 00:12:12,530
+سانتي و ال refractive index ايضا واحد و نص للجزاز
+
+142
+00:12:12,530 --> 00:12:18,680
+نقول هنا تقريبا plus 14 ال powerجمع السطح الأمامي
+
+143
+00:12:18,680 --> 00:12:22,200
+مع السطح الخالفي هنا بنجيب ال power on transfer
+
+144
+00:12:22,200 --> 00:12:27,460
+power on transfer ناقص T على NL في ال power بتاعة
+
+145
+00:12:27,460 --> 00:12:30,580
+ال front في ال power بتاعة ال back service ويساوي
+
+146
+00:12:30,580 --> 00:12:36,320
+ناقص thickness بالمتر خمستاشر من الف متر على واحد
+
+147
+00:12:36,320 --> 00:12:40,580
+و نص في ال power بتاعة ال front عشرة في ال power
+
+148
+00:12:40,580 --> 00:12:42,040
+بتاعة ال back هنا
+
+149
+00:12:46,300 --> 00:12:51,060
+-4 من 10 ديوبتر تمام ماينس أربعة من عشرة ديوبتر
+
+150
+00:12:51,060 --> 00:12:57,080
+إذا ال power ال total عشرة زائد أربعة ماينس أربعة
+
+151
+00:12:57,080 --> 00:13:03,200
+من عشرة ويساوي plus تلتاشر وستة من عشرة ديوبتر إذا
+
+152
+00:13:03,200 --> 00:13:07,500
+الفرق بينهم أربعة من عشرة ديوبترأربعة من عشرة
+
+153
+00:13:07,500 --> 00:13:12,360
+ديوبتر إذا الـ thin lens أقوى باربع من عشرة ديوبتر
+
+154
+00:13:12,360 --> 00:13:16,860
+في مقارنة مع ال fake lens لو هنا تصورنا هنا non
+
+155
+00:13:16,860 --> 00:13:22,380
+accommodating lensوهنا accommodating lens هيصيق
+
+156
+00:13:22,380 --> 00:13:24,720
+صفة ان ال accommodating lens المفروض تكون less
+
+157
+00:13:24,720 --> 00:13:28,760
+powerful than بس في شغلات تانية بتحصل بتؤدي لهذه
+
+158
+00:13:28,760 --> 00:13:33,500
+القضية في شغلات تانية بتحصل بتؤدي لهذه القضية هذا
+
+159
+00:13:33,500 --> 00:13:36,900
+موضوعنا الأول بالنسبة لل thick lenses اذا بقاجيش
+
+160
+00:13:36,900 --> 00:13:40,480
+احكي انا ان ال thick lens ال power بتاعتها simply
+
+161
+00:13:40,480 --> 00:13:43,820
+تساوي ال power بتاعة ال front زي ال power بتاعة ال
+
+162
+00:13:43,820 --> 00:13:46,900
+back لازم ادرج من ضمنها ال power بتاعة ال transfer
+
+163
+00:13:46,900 --> 00:13:48,900
+ال power بتاعة ال transfer
+
+164
+00:13:53,060 --> 00:13:57,300
+بنجي لموضوع التاني الـFocal Length فيه أنه لكل
+
+165
+00:13:57,300 --> 00:14:00,440
+عدسة فيه الـAnterior Focal Length و الـPosterior
+
+166
+00:14:00,440 --> 00:14:04,180
+Focal Length الـAnterior Focal Length و
+
+167
+00:14:04,180 --> 00:14:11,260
+الـPosterior Focal Length اللي هو الـAFL و الـPFL
+
+168
+00:14:11,260 --> 00:14:16,420
+طبعا يقاس الـAnterior Focal Length من المسافة من
+
+169
+00:14:16,420 --> 00:14:19,520
+الـAnterior Principal Point
+
+170
+00:14:23,680 --> 00:14:30,740
+لغاية الـ anterior focal point يعني
+
+171
+00:14:30,740 --> 00:14:37,140
+من هنا للـ FA هذه الـ anterior focal length ويقاس
+
+172
+00:14:37,140 --> 00:14:44,520
+ال posterior focal length من
+
+173
+00:14:44,520 --> 00:14:48,340
+ال posterior principal point
+
+174
+00:14:52,450 --> 00:14:57,090
+لأ ال posterior focal point يعني من ال posterior
+
+175
+00:14:57,090 --> 00:15:04,370
+principal point من ال anterior principal point
+
+176
+00:15:04,370 --> 00:15:13,230
+طبعا هذه تسمى ال PFL و هذه تسمى ال AFL كيف حسابيا
+
+177
+00:15:13,230 --> 00:15:19,590
+اجيب كيف حسابيا اجيب ال anterior focal length و ال
+
+178
+00:15:19,590 --> 00:15:25,160
+posterior focal lengthقبل أن نقول حسابيا هل الشرط
+
+179
+00:15:25,160 --> 00:15:31,560
+أن يكون ال AFL تساوي ال BFL؟ مش شرط .. مش شرط
+
+180
+00:15:31,560 --> 00:15:35,200
+أحياناً بيكونوا متساويين و أحياناً بيكونوا غير
+
+181
+00:15:35,200 --> 00:15:40,100
+متساويين من المعادلة هنفهم ليش أحياناً بيكونوا
+
+182
+00:15:40,100 --> 00:15:43,840
+متساويين و أحياناً مش متساويين ال anterior focal
+
+183
+00:15:43,840 --> 00:15:52,470
+length بجيبه بالمعادلة N على ال powerتمام؟ و الـ
+
+184
+00:15:52,470 --> 00:15:57,830
+posterior focal length أن شرطة على ال power إذا
+
+185
+00:15:57,830 --> 00:16:02,450
+كان أن و أن شرطة متساويين ساعتها ال anterior focal
+
+186
+00:16:02,450 --> 00:16:04,770
+length و ال posterior focal length بيكونوا
+
+187
+00:16:04,770 --> 00:16:09,190
+متساويين يعني إذا عندي هنا هوا و هنا هوا أصبح هنا
+
+188
+00:16:09,190 --> 00:16:12,810
+ال refractive index واحد و واحد فهيصف هنا واحد على
+
+189
+00:16:12,810 --> 00:16:15,970
+ال power و هنا واحد على ال power هيكونوا متساويين
+
+190
+00:16:15,970 --> 00:16:21,760
+طيب الآن في optical systems بيكونش على الجانبيننفس
+
+191
+00:16:21,760 --> 00:16:27,120
+الشيء مثال عين البني آدم ال cornea هنا هيكون عندي
+
+192
+00:16:27,120 --> 00:16:34,500
+هوى و هنا عندي ايش اكويس تمام اكويس فبالتالي انا
+
+193
+00:16:34,500 --> 00:16:39,000
+عندي هنا ال focal length هنا غير ال focal length
+
+194
+00:16:39,000 --> 00:16:45,260
+هنا تمام فبالتالي ضروري جدايعني نعرف هذه القضية
+
+195
+00:16:45,260 --> 00:16:49,400
+إذا هذه المعادلة اللي أنا بجيب فيها الـ anterior
+
+196
+00:16:49,400 --> 00:16:53,320
+focal length و ال posterior focal length وعشان هيك
+
+197
+00:16:53,320 --> 00:16:57,540
+اختصارا لما بتكون العدسة موجودة في uniform medium
+
+198
+00:16:57,540 --> 00:17:00,440
+و في homogeneous medium يعني ما وراها هو نفس ما
+
+199
+00:17:00,440 --> 00:17:04,660
+أمامها بيكونوا المسافتين متساويات و يكفي أن أحسب
+
+200
+00:17:05,020 --> 00:17:09,060
+مسافة واحدة بتنعرف التانية تلقائيًا أما لما يكون
+
+201
+00:17:09,060 --> 00:17:12,500
+عندي الوسط غير متجانس يعني ما أمام العدسة غير ما
+
+202
+00:17:12,500 --> 00:17:17,160
+ورا العدسة لازم أستعمل القاعدتين هدولة ال anterior
+
+203
+00:17:17,160 --> 00:17:19,620
+focal length and على ال power وال posterior focal
+
+204
+00:17:19,620 --> 00:17:24,460
+length and شرط على ال power طبعًا بل نقطة في قضية
+
+205
+00:17:24,460 --> 00:17:29,420
+هذه المسافات بتأخذ الإشارات المناسبة لأن ال
+
+206
+00:17:29,420 --> 00:17:32,580
+anterior focal length على شمال العدسة بياخد إشارة
+
+207
+00:17:32,580 --> 00:17:36,600
+سالبةوالـ posterior focal length على يمينها بياخد
+
+208
+00:17:36,600 --> 00:17:45,060
+إيش إشارة موجبة، تمام؟ طيب، لأن في نقطة مهمة بس
+
+209
+00:17:45,060 --> 00:17:48,700
+قبل ما نقولها بنضرب بعض الأمثلة، بنقول إن plus
+
+210
+00:17:48,700 --> 00:17:54,220
+lens plus عشرة lens موجودة في الهواء ال AFL و ال
+
+211
+00:17:54,220 --> 00:18:00,210
+PFL جداش تساوي موجودة في الهواءو 1 على ال power و
+
+212
+00:18:00,210 --> 00:18:04,210
+يساوي 1 على 10 ديوبتر و يساوي 1 من 10 متر و يساوي
+
+213
+00:18:04,210 --> 00:18:10,940
+10 صنط-10 cm للـ anterior focal length و 10 cm
+
+214
+00:18:10,940 --> 00:18:19,240
+للمسافة على اليمين نفس المثال بس بنقول هنا في عندي
+
+215
+00:18:19,240 --> 00:18:23,800
+ماء 1.3 من 10 ال refractive index و هنا هواء 1 من
+
+216
+00:18:23,800 --> 00:18:26,420
+10 ال refractive index و هنا plus 10 ال anterior
+
+217
+00:18:26,420 --> 00:18:32,030
+focal length minus 10 cmالـ Posterior Focal Length
+
+218
+00:18:32,030 --> 00:18:36,210
+يساوي Uncharted على الـ Power و يساوي 1 و 3 من 10
+
+219
+00:18:36,210 --> 00:18:44,090
+على 10 و يساوي 13 من 100 متر و يساوي 13 cm بالـ
+
+220
+00:18:44,090 --> 00:18:48,370
+Plus إذا أصبح الـ Posterior Focal Length و الـ
+
+221
+00:18:48,370 --> 00:18:51,970
+Anterior Focal Length مش متساويين السبب الوسط مش
+
+222
+00:18:51,970 --> 00:18:55,550
+متجانس يعني ما أمام العدسة حاجة و ما خلف العدسة
+
+223
+00:18:55,550 --> 00:19:00,010
+حاجة تانية ممكن نحسب هذا لقرانية العين مثلاقرانية
+
+224
+00:19:00,010 --> 00:19:04,610
+العين الـ Aquos 1 3 من 10 والهواء 1 والقوة
+
+225
+00:19:04,610 --> 00:19:09,170
+القرانية جداش لفرض 60 ديوبتر رفلي يعني هي مش 60
+
+226
+00:19:09,170 --> 00:19:15,050
+بالظبط بس احنا بنقول تقريبا plus 60 ديوبتر لو
+
+227
+00:19:15,050 --> 00:19:17,890
+أجينا نحسب هذه العدسة تمام ال anterior focal
+
+228
+00:19:17,890 --> 00:19:22,410
+length جداش وال posterior focal length جداش بنقول
+
+229
+00:19:22,410 --> 00:19:26,940
+ال anterior focal lengthهنعطيله إشارة minus واحد
+
+230
+00:19:26,940 --> 00:19:35,920
+على ستين ديوبتر ويساوي minus جداش واحد
+
+231
+00:19:35,920 --> 00:19:43,640
+على ستين ست عشر من الف متر مظبوط ست عشر من الف متر
+
+232
+00:19:43,640 --> 00:19:48,080
+ويساوي واحد وستة من عشرة صنط يساوي ست عشر ملي
+
+233
+00:19:48,080 --> 00:19:52,850
+تقريبا تمام16 ملي أمام العين الـ anterior focal
+
+234
+00:19:52,850 --> 00:19:56,470
+ليه FA تاعة العين تاعة القرانية عفوا تاعة القرانية
+
+235
+00:19:56,470 --> 00:20:02,330
+16 ملي متر على الشمال تمام مايلوس 16 ملي تمام طيب
+
+236
+00:20:02,330 --> 00:20:07,430
+ال posterior focal length للقرانية نقول واحد و
+
+237
+00:20:07,430 --> 00:20:15,510
+تلاتة من عشرة على ستين ويساوي واحد وعشرين من الف
+
+238
+00:20:15,510 --> 00:20:22,560
+متر ويساوي اتنين وواحد من عشرة صنطي ويساوي21 ملي
+
+239
+00:20:22,560 --> 00:20:27,860
+متر 21 ملي
+
+240
+00:20:27,860 --> 00:20:29,480
+متر 21 ملي متر 21 ملي متر 21 ملي متر 21 ملي متر 21
+
+241
+00:20:29,480 --> 00:20:33,760
+ملي متر 21 ملي متر 21 ملي متر 21 ملي متر 21 ملي
+
+242
+00:20:33,760 --> 00:20:33,860
+متر 21 ملي متر 21 ملي متر 21 ملي متر 21 ملي متر 21
+
+243
+00:20:33,860 --> 00:20:34,460
+ملي متر 21 ملي متر 21 ملي متر 21 ملي متر 21 ملي
+
+244
+00:20:34,460 --> 00:20:35,080
+متر 21 ملي متر 21 ملي متر 21 ملي متر 21 ملي متر 21
+
+245
+00:20:35,080 --> 00:20:37,160
+ملي متر 21 ملي متر 21 ملي متر 21 ملي متر 21 ملي
+
+246
+00:20:37,160 --> 00:20:41,440
+متر 21 ملي متر 21 ملي متر 21 ملي متر 21 ملي متر 21
+
+247
+00:20:41,440 --> 00:20:42,720
+ملي متر 21 ملي متر 21 ملي متر 21 ملي متر 21 ملي
+
+248
+00:20:42,720 --> 00:20:44,560
+ملي متر 21 ملي متر 21 ملي متحكيناها المرة الماضية
+
+249
+00:20:44,560 --> 00:20:48,100
+بس بدنا نأكد عليها و نشوف هذه المعلومة إيش
+
+250
+00:20:48,100 --> 00:20:52,040
+تطبيقاتها عمليا .. إيش تطبيقاتها عمليا نقول لو
+
+251
+00:20:52,040 --> 00:21:01,020
+عندي optical system و الوسط متجانس معناته
+
+252
+00:21:01,020 --> 00:21:08,340
+AFL و PFL نفس المسافة هاي عندي أنا وسط كمان و هاي
+
+253
+00:21:10,110 --> 00:21:14,890
+هنا الـ AFL من الـ anterior principal point إلى
+
+254
+00:21:14,890 --> 00:21:18,830
+الـ anterior focal point وهنا الـ posterior focal
+
+255
+00:21:18,830 --> 00:21:23,310
+length من الـ posterior principal point إلى الـ
+
+256
+00:21:23,310 --> 00:21:28,310
+posterior focal point تمام؟ طيب، احنا بنقول كل
+
+257
+00:21:28,310 --> 00:21:32,190
+system فيه 3 pairs of cardinal points two
+
+258
+00:21:32,190 --> 00:21:35,750
+principal و two nodal و two focal هاي two
+
+259
+00:21:35,750 --> 00:21:39,820
+principalوهي two focal بيبقى لدي الـ two nodal إذا
+
+260
+00:21:39,820 --> 00:21:45,720
+الوسط متجانس إيش يعني متجانس؟ يعني هنا و هنا نفس
+
+261
+00:21:45,720 --> 00:21:50,860
+الشيء تمام ساعتها ال nodal points و ال principal
+
+262
+00:21:50,860 --> 00:21:53,500
+points بيمتبقوا على بعض هي anterior principal
+
+263
+00:21:53,500 --> 00:21:56,820
+point وهي نفسها عليها ممتبقة ال anterior nodal
+
+264
+00:21:56,820 --> 00:22:01,960
+point طيب هنا ال posterior principal point و ال
+
+265
+00:22:01,960 --> 00:22:06,730
+posterior nodal point ممتبقين على بعضهم البعضإيش
+
+266
+00:22:06,730 --> 00:22:10,070
+يعني ممطابقين على بعضهم البعض يعني المسافة بينهم
+
+267
+00:22:10,070 --> 00:22:18,710
+صفر طيب okay فيه قاعدة المسافة بين ال anterior
+
+268
+00:22:18,710 --> 00:22:24,130
+principal point و ال anterior nodal point المسافة
+
+269
+00:22:24,130 --> 00:22:33,270
+بين الاتنين دائما دائما تساوي المسافة بينالـ
+
+270
+00:22:33,270 --> 00:22:36,790
+posterior principal point و ال posterior nodal
+
+271
+00:22:36,790 --> 00:22:40,490
+point يعني إذا المسافة بين ال anterior principal
+
+272
+00:22:40,490 --> 00:22:44,250
+point و ال anterior nodal point صفر معناته بين ال
+
+273
+00:22:44,250 --> 00:22:47,150
+posterior principal point و ال posterior nodal
+
+274
+00:22:47,150 --> 00:22:51,550
+point أيضا صفر طب ممكن ماينطبقوش على بعض اه إذا
+
+275
+00:22:51,550 --> 00:22:56,580
+كان الوسط مش متجانس و هنحكي كيف تمامإذا كان
+
+276
+00:22:56,580 --> 00:22:59,060
+المسافة بين الـ anterior principal point و الـ
+
+277
+00:22:59,060 --> 00:23:02,840
+anterior nodal point واحد صنطي لازم تكون بين الـ
+
+278
+00:23:02,840 --> 00:23:05,260
+posterior principal point و الـ posterior nodal
+
+279
+00:23:05,260 --> 00:23:10,120
+point ايضا واحد صنطي إذا المسافة بين النقطتين دولة
+
+280
+00:23:10,120 --> 00:23:14,080
+عشرة متر لازم تكون بينها دولة عشرة متر يعني القصد
+
+281
+00:23:14,080 --> 00:23:18,980
+أن المسافة دائما بين الـ principal point و الـ
+
+282
+00:23:18,980 --> 00:23:22,200
+nodal point المشابهة إليها يعني الموصوفة بنفس
+
+283
+00:23:22,200 --> 00:23:26,250
+الوصف anterior و anteriorتساوي المسافة بين
+
+284
+00:23:26,250 --> 00:23:30,910
+النقطتين التانيات كيف تحسب المسافة بين ال
+
+285
+00:23:30,910 --> 00:23:38,270
+principal points و ال nodal points كيف نحسب
+
+286
+00:23:38,270 --> 00:23:45,410
+المسافة بين ال principal points و ال nodal points
+
+287
+00:23:45,410 --> 00:23:47,510
+المسافة تساوي distance
+
+288
+00:23:51,930 --> 00:23:57,930
+AFL زائد BFL مع
+
+289
+00:23:57,930 --> 00:24:05,570
+عدم نسيان الإشارة طيب
+
+290
+00:24:05,570 --> 00:24:12,790
+مثال عندي وسط متجانس يعني هو مثلا و هو و ال power
+
+291
+00:24:12,790 --> 00:24:21,320
+plus خمسة ال AFL تساويواحد على ال power في ال
+
+292
+00:24:21,320 --> 00:24:25,640
+minus طبعا لأنها مسافة سالبة ويساوي minus خمس متر
+
+293
+00:24:25,640 --> 00:24:31,040
+ويساوي minus عشرين صنطة تمام؟ وبما أن المصد متجانس
+
+294
+00:24:31,040 --> 00:24:35,100
+إذا ال posterior focal length إيش ماله؟ plus عشرين
+
+295
+00:24:35,100 --> 00:24:39,380
+صنطةلو سألنا لهذا الـ optical system جداش المسافة
+
+296
+00:24:39,380 --> 00:24:43,160
+بين الـ nodal points و ال principal points بنقول
+
+297
+00:24:43,160 --> 00:24:48,640
+المسافة تساوي plus عشرين minus عشرين و يساوي صفر
+
+298
+00:24:48,640 --> 00:24:52,580
+إيش يعني يساوي صفر؟ منطبقات على بعضهم البعض
+
+299
+00:24:52,580 --> 00:24:59,300
+منطبقات على بعضهم البعض تمام؟ طيب هذا الكلام بسيط
+
+300
+00:24:59,300 --> 00:25:03,960
+الآن بدنا نخلي الوسط غير متجانس بنقول عندنا
+
+301
+00:25:03,960 --> 00:25:10,470
+optical systemعنا optical system مكوّن من عدسة
+
+302
+00:25:10,470 --> 00:25:19,090
+أمامها ماء مثلا العدسة
+
+303
+00:25:19,090 --> 00:25:24,210
+plus 5 أمامها ماء الماء واحد و تلاتة من عشرة و
+
+304
+00:25:24,210 --> 00:25:30,750
+وراها هوا على سبيل المثال واحد ال AFL جديشواحد و
+
+305
+00:25:30,750 --> 00:25:35,570
+تلاتة من عشرة على خمسة طبعا بال minus لأنه minus
+
+306
+00:25:35,570 --> 00:25:41,370
+ستة و عشرين من مية متر و يساوي minus ستة و عشرين
+
+307
+00:25:41,370 --> 00:25:46,110
+صنطي تمام بينما ال posterior focal length يساوي
+
+308
+00:25:46,110 --> 00:25:50,330
+واحد طبعا بال plus مسافة plus على خمسة و يساوي
+
+309
+00:25:50,330 --> 00:25:56,250
+plus عشرين صنطي المسافة بين ال principal points و
+
+310
+00:25:56,250 --> 00:26:01,510
+ال nodal pointsاللي هي ال distance تساوي ال AFL
+
+311
+00:26:01,510 --> 00:26:10,630
+زائد ال PFL و يساوي minus 26 cm زائد 20 cm و يساوي
+
+312
+00:26:10,630 --> 00:26:17,210
+minus 6 cm يعني هاي ال anterior principal point
+
+313
+00:26:17,210 --> 00:26:22,790
+المسافة بينها و بين ال anterior nodal point 6 cm
+
+314
+00:26:22,790 --> 00:26:28,680
+للشمال هاي ال anterior nodal point 6 cm للشمالوالـ
+
+315
+00:26:28,680 --> 00:26:32,860
+posterior principal point تبعد عن الـ posterior
+
+316
+00:26:32,860 --> 00:26:36,360
+nodal point برضه 6 cm يعني كل من الـ anterior
+
+317
+00:26:36,360 --> 00:26:39,380
+nodal point و الـ posterior nodal point نزاحة
+
+318
+00:26:39,380 --> 00:26:45,640
+لليسار 6 cm اللي بيزاح الـ nodal points بالنسبة
+
+319
+00:26:45,640 --> 00:26:49,420
+للـ principal points تمام؟ وحسب الإشارة الإزاحة
+
+320
+00:26:49,420 --> 00:26:55,240
+للشمال is a minus والإزاحة لليمين is a plus بعبارة
+
+321
+00:26:55,240 --> 00:27:00,110
+أخرىأنتوا ملاحظين الـ nodal points أزيحت باتجاه
+
+322
+00:27:00,110 --> 00:27:04,490
+المادة الأكثر مثال
+
+323
+00:27:04,490 --> 00:27:13,210
+تاني عين الإنسان بدنا نحسب بدنا نحسب وين
+
+324
+00:27:13,210 --> 00:27:16,410
+ال nodal points بتاع عين الإنسان بدنا نتخيل عين
+
+325
+00:27:16,410 --> 00:27:21,330
+الإنسانقوة العين كلها احنا اختارنا القرانية مش
+
+326
+00:27:21,330 --> 00:27:25,450
+ستين العين كلها ستين قرانية تلاتة وأربعين تقريبا
+
+327
+00:27:25,450 --> 00:27:29,230
+او اتنين واربعين ونص زي هي كان احنا بس ضربنا مثال
+
+328
+00:27:29,230 --> 00:27:33,370
+من وجهة نظر geometrical optics فقط تمام بدنا نفرض
+
+329
+00:27:33,370 --> 00:27:38,890
+عين الإنسان كلها plus ستين ديوبتر تمام و ال
+
+330
+00:27:38,890 --> 00:27:42,850
+aqueous و ما داخل العين كله واحد و تلاتة من عشرة
+
+331
+00:27:42,850 --> 00:27:47,840
+تمام و الهوى طبعا واحدبدنا نحسب الـ anterior focal
+
+332
+00:27:47,840 --> 00:27:51,300
+length و الـ posterior focal length و بدنا نشوف
+
+333
+00:27:51,300 --> 00:27:54,360
+المسافة بين الـ principal points و ال nodal points
+
+334
+00:27:54,360 --> 00:27:57,620
+لهذا الـ optical system بنقول الـ anterior focal
+
+335
+00:27:57,620 --> 00:28:01,480
+length يساوي هنعطيله إشارة minus لإنه على الشمال
+
+336
+00:28:01,480 --> 00:28:08,620
+هيكون تمام؟ واحد على ستين وجدشت للمعنى minus ست
+
+337
+00:28:08,620 --> 00:28:16,160
+عشر من الف متر اه minus ست عشر ملي متريعني سنتي و
+
+338
+00:28:16,160 --> 00:28:20,500
+ستة من عشر طيب الآن ال posterior focal length
+
+339
+00:28:20,500 --> 00:28:27,400
+يساوي plus واحد و تلاتة من عشر على ستين ويساوي
+
+340
+00:28:27,400 --> 00:28:33,160
+جداش plus ستة و عشرين من الف يعني ستة و عشرين
+
+341
+00:28:33,160 --> 00:28:38,460
+millimeter واحد و عشرين أسف واحد و عشرين
+
+342
+00:28:38,460 --> 00:28:44,290
+millimeter المسافة بين النقطة ال pointsوالـ
+
+343
+00:28:44,290 --> 00:28:52,810
+principal points تساوي AFL زائد PFL ويساوي الـ AFL
+
+344
+00:28:52,810 --> 00:29:00,970
+minus 16 ميلي زائد 21 ميلي متر ويساوي plus 5 ميلي
+
+345
+00:29:00,970 --> 00:29:06,010
+متر يعني الـ nodal points مزاحة بالنسبة للـ
+
+346
+00:29:06,010 --> 00:29:10,530
+principal points مسافة 5 ميلي متر لليمين لحنية
+
+347
+00:29:10,530 --> 00:29:15,380
+المادة الأكثرنحيط المادة الأكثر واضح الكلام في
+
+348
+00:29:15,380 --> 00:29:20,780
+حالة وجود وسط متجانس طبعا في كل الأحوال المسافة
+
+349
+00:29:20,780 --> 00:29:25,160
+بين ال anterior principal point و ال anterior
+
+350
+00:29:25,160 --> 00:29:28,300
+nodal point عفوا ال anterior principal point و ال
+
+351
+00:29:28,300 --> 00:29:32,940
+anterior nodal point هي مسافة ال anterior
+
+352
+00:29:32,940 --> 00:29:38,970
+principal point و هنا عندالـ posterior principal
+
+353
+00:29:38,970 --> 00:29:41,930
+point و هنا الـ anterior nodal point و الـ
+
+354
+00:29:41,930 --> 00:29:45,030
+posterior nodal point الـ nodal points تزاح بس
+
+355
+00:29:45,030 --> 00:29:47,410
+دايما المسافة بين الـ anterior و الـ anterior
+
+356
+00:29:47,410 --> 00:29:49,730
+تساوي المسافة بين الـ posterior و الـ posterior
+
+357
+00:29:49,730 --> 00:29:53,930
+إذا هاي خمسة ملي معناته هذه خمسة ملي هاي اتنين ملي
+
+358
+00:29:53,930 --> 00:29:57,330
+يعني هاي اتنين ملي صفر يعني منطبقين على بعض معناته
+
+359
+00:29:57,330 --> 00:30:02,430
+برضه بتكون صفر منطبقين على بعض تمام و تحسب
+
+360
+00:30:02,430 --> 00:30:06,450
+بالمعادلةالمسافة بين ال principal points و ال
+
+361
+00:30:06,450 --> 00:30:14,850
+nodal points AFL زائد PFL تمام؟ يعطيكوا العافية
+
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/RRbs9AmXWQs_raw.json b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/RRbs9AmXWQs_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..fa388080409f6d2c28572917133e53853c526bbf
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/RRbs9AmXWQs_raw.json
@@ -0,0 +1 @@
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equation", "probability": 0.849609375}], "temperature": 1.0}, {"id": 27, "seek": 72107, "start": 691.87, "end": 721.07, "text": "و هذه تسمى thin lens equation ما الفرق نفس الكتابة بس هنا لما بقول lens makers equation أنا بتعامل مع single refracting surface single بينما هنا أنا بتعامل بقول thin lens يعني في لسطح أمامي و في لسطح خلفي هذه بتعامل مع thin lens إلها front surface و back surface", "tokens": [2407, 29538, 6055, 38251, 7578, 5862, 6765, 5367, 19446, 27188, 2288, 4587, 8717, 36178, 33251, 2655, 16758, 3660, 4724, 3794, 34105, 5296, 15042, 4724, 39648, 6765, 19323, 5367, 41850, 39894, 3615, 10943, 1211, 20449, 2167, 45353, 278, 3753, 2167, 49374, 15042, 34105, 41850, 39894, 3615, 10943, 1211, 4724, 39648, 5862, 6765, 37495, 22653, 8978, 5296, 3794, 9566, 5016, 5551, 2304, 10943, 1829, 4032, 8978, 5296, 3794, 9566, 5016, 16490, 46538, 1829, 29538, 39894, 3615, 10943, 1211, 20449, 5862, 6765, 11933, 1211, 11296, 1868, 3753, 4032, 646, 3753], "avg_logprob": -0.1647727321833372, 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"end": 1850.09, "word": " عشرين", "probability": 0.9178059895833334}, {"start": 1850.09, "end": 1850.89, "word": " ديوبتر", "probability": 0.98447265625}, {"start": 1850.89, "end": 1851.75, "word": " زائد", "probability": 0.9482421875}, {"start": 1851.75, "end": 1851.91, "word": " ال", "probability": 0.85498046875}, {"start": 1851.91, "end": 1852.23, "word": " power", "probability": 0.85107421875}, {"start": 1852.23, "end": 1852.97, "word": " يساوي", "probability": 0.966064453125}, {"start": 1852.97, "end": 1853.33, "word": " plus", "probability": 0.95361328125}, {"start": 1853.33, "end": 1853.81, "word": " عشرة", "probability": 0.9793294270833334}, {"start": 1853.81, "end": 1855.31, "word": " ديوبتر", "probability": 0.98408203125}, {"start": 1855.31, "end": 1855.67, "word": " ال", "probability": 0.8916015625}, {"start": 1855.67, "end": 1855.91, "word": " minus", "probability": 0.92138671875}, {"start": 1855.91, "end": 1856.31, "word": " عشرين", "probability": 0.9366861979166666}, {"start": 1856.31, "end": 1856.47, "word": " لما", "probability": 0.854736328125}, {"start": 1856.47, "end": 1857.01, "word": " تنتقل", "probability": 0.989501953125}, {"start": 1857.01, "end": 1857.17, "word": " عن", "probability": 0.8583984375}, {"start": 1857.17, "end": 1857.43, "word": " ناحية", "probability": 0.6881510416666666}, {"start": 1857.43, "end": 1857.95, "word": " التانية", "probability": 0.93896484375}, {"start": 1857.95, "end": 1858.87, "word": " اذا", "probability": 0.654541015625}, {"start": 1858.87, "end": 1859.37, "word": " بتصير", "probability": 0.9021809895833334}, {"start": 1859.37, "end": 1859.73, "word": " ايش", "probability": 0.6529134114583334}, {"start": 1859.73, "end": 1860.07, "word": " ال", "probability": 0.88818359375}, {"start": 1860.07, "end": 1860.41, "word": " power", "probability": 0.90771484375}, {"start": 1860.41, "end": 1861.97, "word": " plus", "probability": 0.90625}, {"start": 1861.97, "end": 1862.59, "word": " تلاتين", "probability": 0.9515380859375}, {"start": 1862.59, "end": 1863.19, "word": " ديوبتر", "probability": 0.9841796875}], "temperature": 1.0}, {"id": 70, "seek": 188722, "start": 1869.48, "end": 1887.22, "text": "الان بيظل عندى ايش ل transfer magnification ل transfer magnification لأ موجود عفوا بس لو حبينا نجيبه بال U على V minus 20 ع plus 10 هيتأكد ايش ضال عندى انا ال object distance", "tokens": [6027, 7649, 4724, 1829, 19913, 1211, 43242, 7578, 1975, 1829, 8592, 5296, 5003, 4944, 3774, 5296, 5003, 4944, 3774, 5296, 10721, 3714, 29245, 23328, 6225, 5172, 14407, 4724, 3794, 45164, 11331, 21292, 8315, 8717, 7435, 1829, 3555, 3224, 20666, 624, 15844, 691, 3175, 945, 6225, 1804, 1266, 8032, 36081, 10721, 4117, 3215, 1975, 1829, 8592, 48812, 6027, 43242, 7578, 1975, 8315, 2423, 2657, 4560], "avg_logprob": -0.2800480769230769, "compression_ratio": 1.4352941176470588, "no_speech_prob": 2.384185791015625e-07, "words": [{"start": 1869.48, "end": 1870.24, "word": "الان", "probability": 0.34149169921875}, {"start": 1870.24, "end": 1870.6, "word": " بيظل", "probability": 0.58135986328125}, {"start": 1870.6, "end": 1870.94, "word": " عندى", "probability": 0.730712890625}, {"start": 1870.94, "end": 1872.38, "word": " ايش", "probability": 0.7550455729166666}, {"start": 1872.38, "end": 1872.64, "word": " ل", "probability": 0.319091796875}, {"start": 1872.64, "end": 1873.02, "word": " transfer", "probability": 0.465087890625}, {"start": 1873.02, "end": 1874.02, "word": " magnification", "probability": 0.8701171875}, {"start": 1874.02, "end": 1874.44, "word": " ل", "probability": 0.767578125}, {"start": 1874.44, "end": 1874.82, "word": " transfer", "probability": 0.84375}, {"start": 1874.82, "end": 1875.82, "word": " magnification", "probability": 0.968994140625}, {"start": 1875.82, "end": 1877.82, "word": " لأ", "probability": 0.6114501953125}, {"start": 1877.82, "end": 1878.32, "word": " موجود", "probability": 0.9319661458333334}, {"start": 1878.32, "end": 1878.72, "word": " عفوا", "probability": 0.90771484375}, {"start": 1878.72, "end": 1879.18, "word": " بس", "probability": 0.9111328125}, {"start": 1879.18, "end": 1879.32, "word": " لو", "probability": 0.98876953125}, {"start": 1879.32, "end": 1879.7, "word": " حبينا", "probability": 0.8821614583333334}, {"start": 1879.7, "end": 1880.1, "word": " نجيبه", "probability": 0.9908203125}, {"start": 1880.1, "end": 1880.28, "word": " بال", "probability": 0.91015625}, {"start": 1880.28, "end": 1880.46, "word": " U", "probability": 0.445556640625}, {"start": 1880.46, "end": 1880.68, "word": " على", "probability": 0.60546875}, {"start": 1880.68, "end": 1880.92, "word": " V", "probability": 0.93603515625}, {"start": 1880.92, "end": 1881.38, "word": " minus", "probability": 0.1434326171875}, {"start": 1881.38, "end": 1881.88, "word": " 20", "probability": 0.669921875}, {"start": 1881.88, "end": 1882.04, "word": " ع", "probability": 0.61669921875}, {"start": 1882.04, "end": 1882.3, "word": " plus", "probability": 0.8515625}, {"start": 1882.3, "end": 1882.72, "word": " 10", "probability": 0.93896484375}, {"start": 1882.72, "end": 1885.04, "word": " هيتأكد", "probability": 0.90283203125}, {"start": 1885.04, "end": 1885.28, "word": " ايش", "probability": 0.888671875}, {"start": 1885.28, "end": 1885.5, "word": " ضال", "probability": 0.439208984375}, {"start": 1885.5, "end": 1885.82, "word": " عندى", "probability": 0.863525390625}, {"start": 1885.82, "end": 1886.06, "word": " انا", "probability": 0.907470703125}, {"start": 1886.06, "end": 1886.3, "word": " ال", "probability": 0.9140625}, {"start": 1886.3, "end": 1886.62, "word": " object", "probability": 0.96435546875}, {"start": 1886.62, "end": 1887.22, "word": " distance", "probability": 0.94873046875}], "temperature": 1.0}, {"id": 71, "seek": 190226, "start": 1889.58, "end": 1902.26, "text": "أحنا استنتجناها استنتاج صحيح بس كان ممكن نجيبها برضه من اليوم مافيش مشكلة مافي مشكلة هيك خلصت المسألة هيك خلصت المسألة حد يسأل سؤال يعطيكوا العافية", "tokens": [10721, 5016, 8315, 44713, 29399, 7435, 8315, 11296, 44713, 29399, 26108, 20328, 5016, 1829, 5016, 4724, 3794, 25961, 3714, 43020, 8717, 7435, 1829, 3555, 11296, 4724, 43042, 3224, 9154, 45595, 20498, 19446, 41185, 8592, 37893, 28820, 3660, 19446, 41185, 37893, 28820, 3660, 39896, 4117, 16490, 1211, 9381, 2655, 9673, 3794, 10721, 37977, 39896, 4117, 16490, 1211, 9381, 2655, 9673, 3794, 10721, 37977, 11331, 3215, 7251, 3794, 10721, 1211, 8608, 33604, 6027, 7251, 3615, 9566, 1829, 4117, 14407, 18863, 31845, 10632], "avg_logprob": -0.0948591806270458, "compression_ratio": 1.881118881118881, "no_speech_prob": 5.960464477539063e-08, "words": [{"start": 1889.58, "end": 1889.8, "word": "أحنا", "probability": 0.7232259114583334}, {"start": 1889.8, "end": 1890.42, "word": " استنتجناها", "probability": 0.97275390625}, {"start": 1890.42, "end": 1890.96, "word": " استنتاج", "probability": 0.7947591145833334}, {"start": 1890.96, "end": 1891.42, "word": " صحيح", "probability": 0.9710693359375}, {"start": 1891.42, "end": 1891.72, "word": " بس", "probability": 0.899169921875}, {"start": 1891.72, "end": 1891.92, "word": " كان", "probability": 0.9775390625}, {"start": 1891.92, "end": 1892.14, "word": " ممكن", "probability": 0.97412109375}, {"start": 1892.14, "end": 1892.54, "word": " نجيبها", "probability": 0.95537109375}, {"start": 1892.54, "end": 1892.94, "word": " برضه", "probability": 0.9544270833333334}, {"start": 1892.94, "end": 1893.24, "word": " من", "probability": 0.9921875}, {"start": 1893.24, "end": 1893.5, "word": " اليوم", "probability": 0.85498046875}, {"start": 1893.5, "end": 1893.84, "word": " مافيش", "probability": 0.9309895833333334}, {"start": 1893.84, "end": 1894.44, "word": " مشكلة", "probability": 0.9856770833333334}, {"start": 1894.44, "end": 1894.9, "word": " مافي", "probability": 0.763671875}, {"start": 1894.9, "end": 1895.18, "word": " مشكلة", "probability": 0.9847005208333334}, {"start": 1895.18, "end": 1895.36, "word": " هيك", "probability": 0.875244140625}, {"start": 1895.36, "end": 1895.84, "word": " خلصت", "probability": 0.9666748046875}, {"start": 1895.84, "end": 1896.28, "word": " المسألة", "probability": 0.974365234375}, {"start": 1896.28, "end": 1896.56, "word": " هيك", "probability": 0.8896484375}, {"start": 1896.56, "end": 1897.16, "word": " خلصت", "probability": 0.9970703125}, {"start": 1897.16, "end": 1898.3, "word": " المسألة", "probability": 0.967041015625}, {"start": 1898.3, "end": 1900.0, "word": " حد", "probability": 0.88671875}, {"start": 1900.0, "end": 1900.28, "word": " يسأل", "probability": 0.9893798828125}, {"start": 1900.28, "end": 1900.68, "word": " سؤال", "probability": 0.9957682291666666}, {"start": 1900.68, "end": 1901.96, "word": " يعطيكوا", "probability": 0.7987467447916666}, {"start": 1901.96, "end": 1902.26, "word": " العافية", "probability": 0.9239908854166666}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1902.248375, "duration_after_vad": 1796.5149999999958}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/RRbs9AmXWQs_raw.srt b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/RRbs9AmXWQs_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..958d9e61287e42d23599cca64cc5e8c441f6198d
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/RRbs9AmXWQs_raw.srt
@@ -0,0 +1,1376 @@
+1
+00:00:20,700 --> 00:00:24,560
+بسم الله الرحمن الرحيم المرة الماضية حكينا عن ال
+
+2
+00:00:24,560 --> 00:00:27,380
+divergence وحكينا أنه فينا divergent light بياخد
+
+3
+00:00:27,380 --> 00:00:30,660
+negative sign وconvergent light بياخد positive
+
+4
+00:00:30,660 --> 00:00:36,320
+sign وparallel light بياخد zero وقعدنا
+
+5
+00:00:36,320 --> 00:00:40,340
+صيابة ال lens makers equation بطريقة اللي هو ال
+
+6
+00:00:40,340 --> 00:00:45,480
+divergence اللي U زائد P تساوي V اليوم هنحكي على
+
+7
+00:00:45,480 --> 00:00:49,020
+transfers magnification using single refracting
+
+8
+00:00:49,020 --> 00:00:52,920
+surfaceSingle Refracting Surface طبعاً Spherical
+
+9
+00:00:52,920 --> 00:00:58,180
+Surface فيه لها نصف قطر فيه لها نصف قطر اللي هو R
+
+10
+00:00:58,180 --> 00:01:08,580
+نفرض عندي object وعندي image ال object distance
+
+11
+00:01:08,580 --> 00:01:12,080
+كانت تقاس من سطح ال reflecting surface لل object
+
+12
+00:01:12,080 --> 00:01:17,810
+هذه ال object distance و ال image distanceمن الـ
+
+13
+00:01:17,810 --> 00:01:23,590
+Image لـ Refracting Serbs حقيقةممكن الإنسان يجيس
+
+14
+00:01:23,590 --> 00:01:27,150
+ال object و ال image distances عشان يجيب .. إذا
+
+15
+00:01:27,150 --> 00:01:29,390
+جيبت ال image distance و ال object distance معناته
+
+16
+00:01:29,390 --> 00:01:33,750
+بقدر أجيب ل transfers magnification إذا أنا بدي
+
+17
+00:01:33,750 --> 00:01:38,010
+أستعمل ممكن أستعمل ال nodal point و ال nodal point
+
+18
+00:01:38,010 --> 00:01:40,770
+في ال spherical refracting surface هي مركز الكرة
+
+19
+00:01:40,770 --> 00:01:47,030
+مركز الكرة و الأشعة اللي بتعدي في مركز الكرة عادة
+
+20
+00:01:47,030 --> 00:01:50,430
+بتكون سقوطها عمودي فبالتالي مابتغيرش اتجاهها يعني
+
+21
+00:01:50,430 --> 00:01:55,140
+من النقطة Aلأي شرطة هذا الشعاع بيسموه الـ chief
+
+22
+00:01:55,140 --> 00:01:59,900
+ray أو الـ central ray بسقط سقوط عمودي ليش لأنه
+
+23
+00:01:59,900 --> 00:02:05,300
+امتداده بيمر في مركز الكورة فإذا أنا بدأ أجيس من
+
+24
+00:02:05,300 --> 00:02:08,940
+مركز الكورة ك nodal point تمام بتصير ال object
+
+25
+00:02:08,940 --> 00:02:14,100
+distance المفروض أضيف لها بدل ما هي هيك أضيف لها
+
+26
+00:02:14,100 --> 00:02:20,080
+نصف القطر يعني بتصير O زائد R تمام وال image
+
+27
+00:02:20,080 --> 00:02:24,750
+distanceبتكون I ناقص R لأنه هتصير إذا بدي أجيس من
+
+28
+00:02:24,750 --> 00:02:28,090
+هنا هتصير هذه المسافة ال image distance هتصير I
+
+29
+00:02:28,090 --> 00:02:32,670
+ناقص R احنا قلنا ل transfer magnification يساوي
+
+30
+00:02:32,670 --> 00:02:38,390
+image distance على object distance يعني إذا أنا
+
+31
+00:02:38,390 --> 00:02:43,630
+بدي أعتمد المسافات هيبدي أقول I ناقص R على O زائد
+
+32
+00:02:43,630 --> 00:02:49,440
+Rتمام؟ طيب في عندي ضال نقطة واحدة انه هذا بدي احطه
+
+33
+00:02:49,440 --> 00:02:54,220
+كله في جوس بحط minus ليش minus؟ لأن هذا ع اليسار
+
+34
+00:02:54,220 --> 00:02:57,880
+جاي فبالتالي هذه minus distance هذه minus distance
+
+35
+00:02:57,880 --> 00:03:01,760
+بينما هذه ايش plus distance اذا بدي افك الجوس
+
+36
+00:03:01,760 --> 00:03:09,280
+هيكون عندي I ناقص R علىناقص O ناقص R عادة الناقص
+
+37
+00:03:09,280 --> 00:03:12,300
+هاي بتنشال لإنه معروف ال object distance اللي على
+
+38
+00:03:12,300 --> 00:03:16,120
+الشمال هتنحط لها ال minus مباشرة هتتحط لها ال
+
+39
+00:03:16,120 --> 00:03:21,140
+minus مباشرة يعني هذه القضية ليه O ناقص R لنتخيل
+
+40
+00:03:21,140 --> 00:03:28,530
+إنها في أقواص محتوطة إيشناقص O زائد R ناقص O زائد
+
+41
+00:03:28,530 --> 00:03:34,110
+R واضح اذا transfers magnification يساوي I ناقص R
+
+42
+00:03:34,110 --> 00:03:38,950
+على O ناقص R مانستغربش ليش O ناقص R الآن إجراء
+
+43
+00:03:38,950 --> 00:03:44,110
+عمليات حسابية بسيطة على هذا الكسر بيؤدي لإن ال
+
+44
+00:03:44,110 --> 00:03:48,110
+transfers magnification هنصل لطبعا هذه الحسابات
+
+45
+00:03:48,110 --> 00:03:52,060
+الرياضية مش داخلة معنابس هتوصلنا إلى ان ال
+
+46
+00:03:52,060 --> 00:03:58,960
+transfer magnification يساوي U على V نضرب أنفلة
+
+47
+00:03:58,960 --> 00:04:04,620
+بنقول بدنا ل transfer magnification لما يكون في
+
+48
+00:04:04,620 --> 00:04:10,960
+عندي عدسة تمام و عندي object تمام و عندي image ال
+
+49
+00:04:10,960 --> 00:04:16,220
+object على بعد نص متر و ال image على بعد ربع متر
+
+50
+00:04:16,940 --> 00:04:21,420
+بدي اجيب ال transfer magnification بطريقتين image
+
+51
+00:04:21,420 --> 00:04:28,360
+distance ربع متر المسافات مظبوط على minus نص متر
+
+52
+00:04:28,360 --> 00:04:34,180
+ويساوي ضرب minus نص ايش يعني ضرب minus نص صورة
+
+53
+00:04:34,180 --> 00:04:40,900
+مقلوبة واش بدي اجيبها بطريقة ال U على V بنقول ال U
+
+54
+00:04:40,900 --> 00:04:48,990
+تساوي ناقص N على O ويساوي ناقص واحد على Oنص متر و
+
+55
+00:04:48,990 --> 00:04:55,490
+يساوي ناقص اتنين ديوبتر تمام ال V تساوي ان شرط على
+
+56
+00:04:55,490 --> 00:05:04,590
+I و يساوي واحد على ربع متر و يساوي plus اربعة
+
+57
+00:05:04,590 --> 00:05:09,570
+ديوبترهي ال U وهي ال V Transfers Magnification
+
+58
+00:05:09,570 --> 00:05:15,410
+يساوي U على V ويساوي ناقص اتنين ديوبتر على ناقص
+
+59
+00:05:15,410 --> 00:05:23,830
+على زائد اربعة ديوبتر ويساوي ضرب minus ماهي اختلفت
+
+60
+00:05:23,830 --> 00:05:28,550
+نفس الشيء اذا الان بقدر اجيب ل Transfers
+
+61
+00:05:28,550 --> 00:05:33,650
+Magnification ب 3 معادلات اول
+
+62
+00:05:33,650 --> 00:05:39,180
+معادلةالـ Image Distance الـ Transfers
+
+63
+00:05:39,180 --> 00:05:41,780
+Magnification يساوي Image Distance على Object
+
+64
+00:05:41,780 --> 00:05:45,460
+Distance تاني معادلة Transfers Magnification Image
+
+65
+00:05:45,460 --> 00:05:49,520
+Head على .. ليه أول واحدة أخدناها؟ على Object Head
+
+66
+00:05:49,520 --> 00:05:54,400
+تالت معادلة Transfers Magnification يساوي U على V
+
+67
+00:05:54,400 --> 00:05:57,800
+تمام؟ إذا أنا عندي سهولة في التعامل يعني أي مقطع
+
+68
+00:05:57,800 --> 00:06:01,360
+من المعطيات عندي متوفر بستخدمه أي مقطع من المعطيات
+
+69
+00:06:01,360 --> 00:06:04,160
+بستخدمه تمام؟
+
+70
+00:06:21,370 --> 00:06:26,050
+طيب نيجي لالموضوع اللي هو بتاعي اليوم thin lens
+
+71
+00:06:26,050 --> 00:06:30,270
+equation قبل ما ندخل في الموضوع بدنا نحكي انه ال
+
+72
+00:06:30,270 --> 00:06:34,770
+lens makers equation تم التوصل إليها بناء على ال
+
+73
+00:06:34,770 --> 00:06:35,750
+approximations
+
+74
+00:06:37,980 --> 00:06:45,360
+الـ Approximations طيب الآن انطلق
+
+75
+00:06:45,360 --> 00:06:52,520
+الضوء من النقطة A انتشر بشكل Divergent دخل ال
+
+76
+00:06:52,520 --> 00:06:59,100
+optical system غادر ال optical system Convergent
+
+77
+00:06:59,100 --> 00:07:08,050
+تمام اتكونت ال image اللي هي Aاحنا متفقين جدا انه
+
+78
+00:07:08,050 --> 00:07:15,490
+ال virgence بتاع ال light بيتغير بتغير المسافة
+
+79
+00:07:15,490 --> 00:07:19,770
+يعني كل ما بيقطع مسافة اكتر بيجيل ال virgence و ال
+
+80
+00:07:19,770 --> 00:07:24,970
+virgence هو مقلوب المسافة طيب حقيقة من عند ال
+
+81
+00:07:24,970 --> 00:07:31,690
+object لعند ال image في تلت مسافات يعني يمكن تمييز
+
+82
+00:07:31,690 --> 00:07:37,550
+تلت مسافات عن بعضها البعضالمسافة من ال object لسطح
+
+83
+00:07:37,550 --> 00:07:42,290
+العدسة والمسافة اللي بيقطعها الضوء داخل العدسة
+
+84
+00:07:42,290 --> 00:07:45,670
+والمسافة التالتة اللي هي من بعد العدسة لغاية ال
+
+85
+00:07:45,670 --> 00:07:52,410
+image هذه العدسة رفيعة كتير thin lens تمام بس أنا
+
+86
+00:07:52,410 --> 00:07:56,210
+رسمها هيك عشان أوضح أن في عندي سمك و لو جزء من
+
+87
+00:07:56,210 --> 00:08:00,270
+الملي تمام و لو جزء من الملي الضوء لما بيقطع هذه
+
+88
+00:08:00,270 --> 00:08:05,410
+المسافة البسيطةبتغير ال virgence بتاعه ولا لا؟
+
+89
+00:08:05,410 --> 00:08:10,450
+بتغير ليش؟ لأنها مسافة وقلنا طالما اتغيرت المسافة
+
+90
+00:08:10,450 --> 00:08:16,230
+بتغير ال virgence لأن في معادلة بتربطهم تغير أحد
+
+91
+00:08:16,230 --> 00:08:22,790
+المتغيرين بقدر تغير المتغير التاني فبالتالي بينظر
+
+92
+00:08:22,790 --> 00:08:28,450
+العلماء إلى أن قوة العدسة ال power تنفق
+
+93
+00:08:28,450 --> 00:08:35,300
+في تلت أوجهتنفق في تلات أوجه الوجه الأول على السطح
+
+94
+00:08:35,300 --> 00:08:39,960
+الأمامي للعدسة هذه وظيفته هذا جزء من قوة العدسة
+
+95
+00:08:39,960 --> 00:08:43,260
+ينفق على السطح الأمامي وظيفته لغاء ال divergence
+
+96
+00:08:43,260 --> 00:08:51,060
+لغاء التشتت والجزء التالت هذا الجزء الأول والجزء
+
+97
+00:08:51,060 --> 00:08:56,380
+التالت وظيفته التجميع إذا طبعا تبقى معها قوة معين
+
+98
+00:08:56,380 --> 00:09:03,110
+والجزء التاني هوبسموه ال virgins change on
+
+99
+00:09:03,110 --> 00:09:08,270
+transfer virgins change تغير ال virgins تغير ال
+
+100
+00:09:08,270 --> 00:09:12,310
+light on transfer يعني جزء من قوة العدسة بيروح
+
+101
+00:09:12,310 --> 00:09:16,450
+أثناء انتقال الضوء تمام ومروره من خلال العدسة
+
+102
+00:09:16,450 --> 00:09:20,190
+virgins change on transfer transfer يعني ترحيل
+
+103
+00:09:20,190 --> 00:09:24,150
+الضوء من السطح الأمامي للسطح الخلفي يعني إذا بدي
+
+104
+00:09:24,150 --> 00:09:29,450
+أكتب ال lens makers equation بدي أقولN على O أو
+
+105
+00:09:29,450 --> 00:09:36,090
+ناقص N على O زائد P يساوي ان شرط على I P هذه بدأت
+
+106
+00:09:36,090 --> 00:09:42,330
+تكتب بتفاصيلها زائد P front زائد P transfer زائد P
+
+107
+00:09:42,330 --> 00:09:47,050
+back يساوي ان شرط على I إيش هدولة التلاتة هدولة
+
+108
+00:09:47,050 --> 00:09:52,070
+تفاصيل قوة العدسة نفرض مثلا إن العدسة قوتها plus
+
+109
+00:09:52,070 --> 00:09:57,490
+10أنفقت مثلا plus 6 عشان إلغاء ال divergence اللي
+
+110
+00:09:57,490 --> 00:10:02,810
+هو إجت ضوء ب divergence minus 6 دين minus 6 تمام و
+
+111
+00:10:02,810 --> 00:10:08,650
+نفرض 1 من 100 ديوبتر من العشرة أنفق على transfer و
+
+112
+00:10:08,650 --> 00:10:12,670
+الباقي اللي هو أربعة إلا اللي هو تلاتة و تسعة و
+
+113
+00:10:12,670 --> 00:10:17,810
+تسعين من 100 ديوبتر على تجميع الضوء أنفق تمام طبعا
+
+114
+00:10:17,810 --> 00:10:19,530
+هذا
+
+115
+00:10:20,950 --> 00:10:24,730
+الأشياء المفصلة الآن العلماء قالوا احنا كل ال lens
+
+116
+00:10:24,730 --> 00:10:28,950
+makers equation تمام بنية على approximation واذا
+
+117
+00:10:28,950 --> 00:10:33,930
+احنا بدنا نحسبالـvergence exchange on transfer
+
+118
+00:10:33,930 --> 00:10:38,410
+هندخل في تعقيدات كتيرة كميته بسيطة جدا لدرجة انه
+
+119
+00:10:38,410 --> 00:10:44,710
+إيش يمكن تهمل بمعنى آخر قوة أي عدسة ممكن ننظرها
+
+120
+00:10:44,710 --> 00:10:47,550
+على إنها قوة السطح الأمامي وقوة السطح الخالفي
+
+121
+00:10:47,550 --> 00:10:51,890
+وخلصنا طيب واللي يستهلك من قوتها على transfer كمية
+
+122
+00:10:51,890 --> 00:10:56,610
+ضئيلة يمكن إيش أهملها فتصبح الـLensmakers equation
+
+123
+00:10:56,610 --> 00:11:04,130
+ناقص N على O زائد P front زائدببك يساوي on شرطة
+
+124
+00:11:04,130 --> 00:11:09,930
+على I وإن هذه تهمة لقيمتها القليلة جدا طبعا في
+
+125
+00:11:09,930 --> 00:11:13,550
+حالة الـ Thin Lenses ضروري نتأكد إن هذه Thin Lens
+
+126
+00:11:13,550 --> 00:11:16,690
+لأنه إذا هي Thick Lens هذه إلها وضع تاني هنيجي في
+
+127
+00:11:16,690 --> 00:11:23,290
+درس خاص في هذا الموضوع هذه القضية إذا بدأ اختصرها
+
+128
+00:11:23,290 --> 00:11:28,670
+ناقص N على O زائد P يساوي on شرطة على I إيش الفرق
+
+129
+00:11:28,670 --> 00:11:33,210
+بين هاي هذه الـ Lensmakers equationو هذه تسمى thin
+
+130
+00:11:33,210 --> 00:11:39,630
+lens equation ما الفرق نفس الكتابة بس هنا لما بقول
+
+131
+00:11:39,630 --> 00:11:43,210
+lens makers equation أنا بتعامل مع single
+
+132
+00:11:43,210 --> 00:11:47,590
+refracting surface single بينما هنا أنا بتعامل
+
+133
+00:11:47,590 --> 00:11:51,490
+بقول thin lens يعني في لسطح أمامي و في لسطح خلفي
+
+134
+00:11:51,490 --> 00:11:59,750
+هذه بتعامل مع thin lens إلها front surface و back
+
+135
+00:11:59,750 --> 00:12:01,070
+surface
+
+136
+00:12:02,820 --> 00:12:07,640
+و يهمل الـvergence change on a transfer واضح إذا
+
+137
+00:12:07,640 --> 00:12:11,040
+هذه الـthin lens equation أيضا الـthin lens
+
+138
+00:12:11,040 --> 00:12:16,120
+equation قائمة على ال approximation لأنه أنا أهملت
+
+139
+00:12:16,120 --> 00:12:20,480
+إشي من مقابل التسهيل أهملت شيء معين اللي هو
+
+140
+00:12:20,480 --> 00:12:23,680
+الـchange تاع الvergence تاع ال light عند انتقاله
+
+141
+00:12:23,680 --> 00:12:28,640
+المسافة هذه البسيطة لأنه قليل التغير فبالتاليتعتبر
+
+142
+00:12:28,640 --> 00:12:32,180
+يمكن إهماله عساس انبسط الأمور إذا الـ Thin Lens
+
+143
+00:12:32,180 --> 00:12:37,220
+Equation تختلف عن الـ Lens Maker Equation في انه
+
+144
+00:12:37,220 --> 00:12:41,040
+بتتعامل أو بتحكي عن العدسات ذات السطحين العدسات
+
+145
+00:12:41,040 --> 00:12:44,300
+المعتادة تمام بينما هذه بتتعامل مع Single
+
+146
+00:12:44,300 --> 00:12:46,820
+Refracting Surface بس هي مبنية على ال
+
+147
+00:12:46,820 --> 00:12:49,760
+approximation وهي مبنية برضه على ال approximation
+
+148
+00:12:49,760 --> 00:12:52,640
+ناخد مسائل لتوضح القضية هاي
+
+149
+00:13:02,730 --> 00:13:13,250
+عندي فن لينز وبنتصور هنا هوا وهنا ماء مثلا ده ماء
+
+150
+00:13:13,250 --> 00:13:17,410
+بنقول
+
+151
+00:13:17,410 --> 00:13:26,030
+object على بعد نص متر العدسة قوتها plus 5 ديوبتر
+
+152
+00:13:26,980 --> 00:13:30,240
+الماء واحد و تلاتة من عشرة ال refractive index
+
+153
+00:13:30,240 --> 00:13:34,460
+تمام بدنا نعرف وين الصورة و إيش هو ال transfers
+
+154
+00:13:34,460 --> 00:13:37,740
+magnification طبعا الماء خلّيني اكتب هنا واحد و
+
+155
+00:13:37,740 --> 00:13:40,880
+تلاتة من عشرة عشان نبعد عن ال V و ال U نقول U
+
+156
+00:13:40,880 --> 00:13:45,720
+تساوي ناقص N على O يساوي ناقص واحد على نص متر و
+
+157
+00:13:45,720 --> 00:13:50,780
+يساوي ناقص اتنين ديوبتر هيناقص اتنين ديوبتر ال V
+
+158
+00:13:50,780 --> 00:13:59,270
+قداش plus تلاتة plus تلاتةالان V تساوي on شرطة على
+
+159
+00:13:59,270 --> 00:14:06,350
+I إذا I تساوي on شرطة على V و يساوي واحد و تلاتة
+
+160
+00:14:06,350 --> 00:14:22,230
+من عشرة على plus تلاتة كده ايش بيطلع يا بنات تلاتة
+
+161
+00:14:22,230 --> 00:14:25,370
+و أربعين من مية متر
+
+162
+00:14:26,410 --> 00:14:30,790
+يعني تلاتة وأربعين صنطين إذا الصورة هتتكون في
+
+163
+00:14:30,790 --> 00:14:35,170
+الماء اللي هو على الجهة هاي على بعد تلاتة وأربعين
+
+164
+00:14:35,170 --> 00:14:43,030
+صنطين تمام الآن أنا عندي طريقتين طريقتين لإيجاد ال
+
+165
+00:14:43,030 --> 00:14:46,910
+transfer magnification إما مسافة على مسافة أو U
+
+166
+00:14:46,910 --> 00:14:53,830
+على V transfer magnification يساوي U على V ويساوي
+
+167
+00:14:54,580 --> 00:14:59,800
+نقص اتنين ديوبتر على زائد تلاتة ديوبتر هو يساوي
+
+168
+00:14:59,800 --> 00:15:03,200
+ضرب
+
+169
+00:15:03,200 --> 00:15:09,500
+ماينوس طولتين تمام ضرب ماينوس طولتين فزي هيك
+
+170
+00:15:09,500 --> 00:15:12,440
+المسائل ايش ابتنحن ناخد مسألة تانية
+
+171
+00:15:22,890 --> 00:15:29,390
+بنقول thin lens in air عدسة في الهواء ونقول object
+
+172
+00:15:29,390 --> 00:15:37,970
+على بعد ربع متر و العدسة plus تمانية تمام بدنا ال
+
+173
+00:15:37,970 --> 00:15:42,750
+transfers magnification وبدنا ال image distance
+
+174
+00:15:42,750 --> 00:15:47,770
+تمام نقول ال U تساوي ناقص N على O يساوي ناقص واحد
+
+175
+00:15:47,770 --> 00:15:54,620
+علىربع متر يساوي ناقص أربعة ديوبتر ناقص أربعة
+
+176
+00:15:54,620 --> 00:15:58,960
+ديوبتر ممكن ناس يقول أنا صعب علي أستنتج ال V على
+
+177
+00:15:58,960 --> 00:16:04,260
+السريع يقول U زائد P تساوي V ناقص أربعة ديوبتر
+
+178
+00:16:04,260 --> 00:16:11,000
+زائد تمانية ديوبتر تساوي V إذا V إيش تساوي plus
+
+179
+00:16:11,000 --> 00:16:15,460
+أربعة ديوبتر plus أربعة ديوبتر
+
+180
+00:16:17,350 --> 00:16:21,690
+I تساوي أن شرط على V كيف عرفنا لأن V تساوي أن شرط
+
+181
+00:16:21,690 --> 00:16:28,350
+على I V تساوي أن شرط على I إذا بنبدل مع بعض I
+
+182
+00:16:28,350 --> 00:16:32,770
+تساوي أن شرط على V و يساوي أن شرط واحد طالما إحنا
+
+183
+00:16:32,770 --> 00:16:36,370
+في الهواء إذا ما ذكرش في الهواء الهواء واحد الهواء
+
+184
+00:16:36,370 --> 00:16:40,470
+refractive index تاوي إيش واحد فعلى V ليه plus
+
+185
+00:16:40,470 --> 00:16:43,810
+أربعة ديوبتر ليه متر و ناقص واحد واحد على أربعة
+
+186
+00:16:43,810 --> 00:16:49,760
+ربعوالمتر اصلاقس واحد بتصير متر plus ربع متر اذا
+
+187
+00:16:49,760 --> 00:16:54,100
+الصورة على بعد ربع متر جداش ال transfers
+
+188
+00:16:54,100 --> 00:16:59,720
+magnification بدون ما اعرف واحد minus واحد لان
+
+189
+00:16:59,720 --> 00:17:04,920
+minus على plus زي u على v minus او مسافات plus على
+
+190
+00:17:04,920 --> 00:17:08,800
+minus طبعا المسافة minus تمام برضه minus واحد
+
+191
+00:17:08,800 --> 00:17:14,410
+الصورة ارتفاعها جد ارتفاع ال object ومقلوبةناخد
+
+192
+00:17:14,410 --> 00:17:19,030
+كمان مسألة عساس برضه بالمسائل الأمور بتصير أسهل ان
+
+193
+00:17:19,030 --> 00:17:29,570
+شاء الله نقول كالقاتل عندي عدسة اللي هطوأ مجهول
+
+194
+00:17:29,570 --> 00:17:40,490
+واجفنا أمامها object تمام و هذا
+
+195
+00:17:40,490 --> 00:17:47,110
+ال object على بعدبرضه مجهول فلنحاول نشوف مجهولين
+
+196
+00:17:47,110 --> 00:17:54,370
+تمام ال image كانت على بعد نص متر ل Transphase
+
+197
+00:17:54,370 --> 00:18:00,490
+Magnification Transphase Magnification ضرب minus
+
+198
+00:18:00,490 --> 00:18:07,150
+نص تمام المطلوب بدي ال power بتاعة ال lens هذا
+
+199
+00:18:07,150 --> 00:18:12,840
+واحد و بدي ال object distanceتمام بدي ال power
+
+200
+00:18:12,840 --> 00:18:17,580
+بتاعة ال lens و بدي ال object distance تمام في
+
+201
+00:18:17,580 --> 00:18:22,820
+طريقة سهلة جدا لهذه المسائل milletransfer
+
+202
+00:18:22,820 --> 00:18:26,760
+magnification ايش يعني ضرب minus نص يعني الصورة نص
+
+203
+00:18:26,760 --> 00:18:33,260
+ال object معناته مسافتها نص مسافة ال object هنا يد
+
+204
+00:18:33,260 --> 00:18:38,780
+هنا يد مش احنا نقول لاالـ Transfers Magnification
+
+205
+00:18:38,780 --> 00:18:43,100
+هو Image Distance على Object Distance امتى هذا
+
+206
+00:18:43,100 --> 00:18:49,560
+بيكون يساوي نص؟
+
+207
+00:18:49,560 --> 00:18:52,840
+إذا واحد Object Distance يساوي اتنين Image
+
+208
+00:18:52,840 --> 00:18:58,640
+Distance2 في I distance يساوي 1 إيش يعني object
+
+209
+00:18:58,640 --> 00:19:02,860
+distance واحدة بتساوي تنتين image distance معناته
+
+210
+00:19:02,860 --> 00:19:06,820
+ال object distance ضعف ال A إذا كان هذه نص متر
+
+211
+00:19:06,820 --> 00:19:11,560
+معناته هذه إيش واحد متر تمام؟ الآن ببدأ حل عادي
+
+212
+00:19:11,560 --> 00:19:17,640
+إيش ال U تساوي؟ناقص N على O يساوي ماينوس واحد على
+
+213
+00:19:17,640 --> 00:19:21,620
+واحد متر ويساوي ماينوس واحد دا يبتر هاي ماينوس
+
+214
+00:19:21,620 --> 00:19:28,100
+واحد دا يبتر ال V جداش أنشرطة على I يساوي أنشرطة
+
+215
+00:19:28,100 --> 00:19:33,220
+اللي هي واحد على نص متر ويساوي plus اتنين دا يبتر
+
+216
+00:19:36,050 --> 00:19:41,410
+بقى اللي عندي المجهول منين ال power U زائد P يساوي
+
+217
+00:19:41,410 --> 00:19:46,370
+V بعود مباشرة ناقص واحد ده يبتر زائد ال power
+
+218
+00:19:46,370 --> 00:19:50,790
+يساوي plus 2 ده يبتر هذه لما أنجلها على ناحية
+
+219
+00:19:50,790 --> 00:19:56,490
+التانية تصير plus plus واحد و plus اتنين اذا ال
+
+220
+00:19:56,490 --> 00:20:00,970
+power ايه اشملها plus تلاتة ده يبتر في صعوبة في
+
+221
+00:20:00,970 --> 00:20:06,700
+المسائل هذه اعتقد الواحد يعنيمافيش صعوبة ناخد كمان
+
+222
+00:20:06,700 --> 00:20:23,640
+مثال بنقول
+
+223
+00:20:23,640 --> 00:20:31,040
+كالقاتل object ع مسافة معينة و العدسة plus 7
+
+224
+00:20:31,040 --> 00:20:39,480
+ديوبتر تمامالـ Image اتكونت ع بُعد 25 سنطة بدي وين
+
+225
+00:20:39,480 --> 00:20:43,240
+كان ال object و ايش ال transfers و ال
+
+226
+00:20:43,240 --> 00:20:47,780
+magnification المعلوم
+
+227
+00:20:47,780 --> 00:20:51,860
+الوحيد عندي مين اللي هو ال image distance بالاضافة
+
+228
+00:20:51,860 --> 00:20:58,260
+لل power ال V تساوي انشرطة على I و يساوي واحد على
+
+229
+00:20:58,260 --> 00:20:59,880
+لأ
+
+230
+00:21:02,940 --> 00:21:06,380
+تنسوش يا بنات قضية الـ cent ننساها في هذه القضية
+
+231
+00:21:06,380 --> 00:21:10,560
+القياسات كلها مترية فبالتالي الـ 25 cent هي ربع
+
+232
+00:21:10,560 --> 00:21:19,840
+متر ربع متر 1 على ربع متر plus 4 ديوبتر امتى بيكون
+
+233
+00:21:19,840 --> 00:21:26,940
+عندى تبقى 4 ديوبتر من السبعة المحتار هي U زائد P
+
+234
+00:21:26,940 --> 00:21:32,610
+يساوي V V اللى هي plus 4 ديوبترو ال power plus 7
+
+235
+00:21:32,610 --> 00:21:37,150
+ديوبتر و ال U هي المجهولة لو نقل plus 7 هنا يصير
+
+236
+00:21:37,150 --> 00:21:42,010
+minus 7 و plus 4 minus 3 ديوبتر اللي هي ال U minus
+
+237
+00:21:42,010 --> 00:21:48,270
+3 ديوبتر لسه انا ماجيبتش لا ال object distance ولا
+
+238
+00:21:48,270 --> 00:21:50,790
+ال image distance بس طلع معايا ال variance of
+
+239
+00:21:50,790 --> 00:21:56,350
+light اللي هو ال U ال reduced variance Uتساوي N
+
+240
+00:21:56,350 --> 00:22:00,490
+على O ليش ما قلتش ناقص N على O عشان ال object
+
+241
+00:22:00,490 --> 00:22:08,050
+مجهول ال U ناقص تلاتة ده يبتر يساوي واحد على O اذا
+
+242
+00:22:08,050 --> 00:22:13,670
+O تساوي واحد على ناقص تلاتة ده يبتر ده يبتر اللي
+
+243
+00:22:13,670 --> 00:22:23,650
+هو عياش ويساوي موجب على ناقص ناقص تلتمتر طلع من
+
+244
+00:22:23,650 --> 00:22:28,490
+المقام صار ناقص تلت متر ناقص هذه الناقص مش معناها
+
+245
+00:22:28,490 --> 00:22:34,250
+مجلوب هذه مسافة هذه مسافة تعني على الشمال تلت متر
+
+246
+00:22:34,250 --> 00:22:38,310
+يعني تلاتة او تلاتين صنطي الان بقدر اجيب ل
+
+247
+00:22:38,310 --> 00:22:41,710
+transfers magnification اما image distance على
+
+248
+00:22:41,710 --> 00:22:47,430
+object distance او U على V او U على V وبالتالي هذه
+
+249
+00:22:47,430 --> 00:22:54,310
+القضية بتكون عندي ايش سهلة U على V اللي هوU على V
+
+250
+00:22:54,310 --> 00:22:59,130
+يساوي ناقص تلاتة ديوبتر على plus أربعة ديوبتر
+
+251
+00:22:59,130 --> 00:23:04,610
+ويساوي ضرب ناقص تلت أربعة أو خمسة وسبعين من مية
+
+252
+00:23:04,610 --> 00:23:07,890
+طبعا الديوبتر مع الديوبتر إيش بتروح إيش معناته
+
+253
+00:23:07,890 --> 00:23:12,590
+الصورة مجلوبة و تلت أربعة ارتفاع ال object ممكن
+
+254
+00:23:12,590 --> 00:23:16,810
+ييجي في المسألة أن ال object ارتفاعه عشرة صنطي ما
+
+255
+00:23:16,810 --> 00:23:22,110
+ارتفاع الصورةخمسة سبعة و نص صندوق اللي هي تلت أربع
+
+256
+00:23:22,110 --> 00:23:27,510
+العشرة تلت أربع العشرة واضح يا بنات طيب نكمل ناخد
+
+257
+00:23:27,510 --> 00:23:31,530
+مسألة تانية ضروري نحل مسائل كتير لأنه يعني هذه
+
+258
+00:23:31,530 --> 00:23:37,430
+بتمكن العملية الحسابية و العملية التفكيرية بالنسبة
+
+259
+00:23:37,430 --> 00:23:45,810
+لهذه المسائل نقول كالقاتل او خلينا نعمل مسألة على
+
+260
+00:23:46,510 --> 00:23:50,310
+الـ Single Refracting Surface Glass Rod Spherical
+
+261
+00:23:50,310 --> 00:23:55,030
+Refracting Surface تمام واحد و أربعة من عشرة
+
+262
+00:23:55,030 --> 00:24:01,350
+object طبعا نصف القطر نقول واحد من عشرة متر object
+
+263
+00:24:01,350 --> 00:24:05,750
+على بعد ربع
+
+264
+00:24:05,750 --> 00:24:12,010
+متر بدي ال image اللي بتتكون في داخل ال glass وينو
+
+265
+00:24:12,010 --> 00:24:14,650
+لـ Transfers Magnification لـ Transfers
+
+266
+00:24:14,650 --> 00:24:24,990
+Magnification نقول U تساوي ناقص N على O يعني
+
+267
+00:24:24,990 --> 00:24:27,570
+احنا ممكن نحلها بطريقة الـ Lensmakers equation
+
+268
+00:24:27,570 --> 00:24:32,890
+ناقص N على O زائد انشرطة ناقص N على R يساوي انشرطة
+
+269
+00:24:32,890 --> 00:24:42,450
+على I ناقص واحد على ربع مترزائد واحد واربعة من
+
+270
+00:24:42,450 --> 00:24:47,290
+عشرة ناقص واحد على واحد من عشرة متر يساوي واحد
+
+271
+00:24:47,290 --> 00:24:52,310
+واربعة من عشرة على I I هي الوحيدة المجهولة واحد
+
+272
+00:24:52,310 --> 00:24:56,070
+على ربع اربعة طبعا ناقص اربعة متر او ناقص واحد
+
+273
+00:24:56,070 --> 00:25:01,470
+يعني ده يبتر زائد واحد واربعة من عشرة ناقص واحد
+
+274
+00:25:01,470 --> 00:25:04,890
+اربعة من عشرة اربعة من عشرة على واحد من عشرة برضه
+
+275
+00:25:04,890 --> 00:25:11,940
+اربعة متر ده يبتر صحيساوي واحد واربعة من عشرة على
+
+276
+00:25:11,940 --> 00:25:19,400
+I تمام ناقص اربعة وزاد اربعة صفر يساوي واحد واربعة
+
+277
+00:25:19,400 --> 00:25:25,860
+من عشرة على I اذا I تساوي واحد واربعة من عشرة على
+
+278
+00:25:25,860 --> 00:25:29,260
+ويساوي اذا الأشعة
+
+279
+00:25:31,730 --> 00:25:35,170
+Parallel أشعة Parallel الصورة في ال plus optical
+
+280
+00:25:35,170 --> 00:25:40,530
+infinity تمام في ال plus optical infinity تمام طيب
+
+281
+00:25:40,530 --> 00:25:50,810
+ناخد
+
+282
+00:25:50,810 --> 00:25:55,430
+نفس المثال بس بدنا نغير موقع ال object نقول single
+
+283
+00:25:55,430 --> 00:25:59,870
+refracting surface القطر أو نصف القطر واحد من عشرة
+
+284
+00:25:59,870 --> 00:26:05,270
+مترالـ Refractive Index 1 و 4 من 10 للهواء واحد ال
+
+285
+00:26:05,270 --> 00:26:10,130
+object على بعد نص متر نحل بطريقة الـ Lensmakers
+
+286
+00:26:10,130 --> 00:26:14,850
+equation ناقص N على O زائد انشرطة ناقص N على R
+
+287
+00:26:14,850 --> 00:26:21,350
+يساوي انشرطة على I ناقص 1 على نص متر زائد 1 و 4 من
+
+288
+00:26:21,350 --> 00:26:28,290
+10 ناقص 1 على 1 من 10 متر يساوي 1 و 4 من 10 على I
+
+289
+00:26:30,030 --> 00:26:35,850
+هنا ناقص اتنين ديوبتر زائد اربع ديوبتر يساوي واحد
+
+290
+00:26:35,850 --> 00:26:39,930
+واربع من عشرة على I هنا بيضل عندى plus اتنين
+
+291
+00:26:39,930 --> 00:26:45,410
+ديوبتر يساوي واحد واربع من عشرة على I اذا I تساوي
+
+292
+00:26:45,410 --> 00:26:50,730
+واحد واربع من عشرة على اتنين plus اتنين ديوبتر
+
+293
+00:26:50,730 --> 00:26:54,950
+اللى هى متر او ناقص واحد ويساوي جديش سبعة من عشرة
+
+294
+00:26:54,950 --> 00:27:04,110
+متريعني سبعين صنطي على بعد سبعين صنطي تمام بقدر
+
+295
+00:27:04,110 --> 00:27:06,810
+اجيب transfers magnification image distance على
+
+296
+00:27:06,810 --> 00:27:10,810
+object distance image distance على object distance
+
+297
+00:27:10,810 --> 00:27:15,750
+بنقول transfers magnification يساوي image distance
+
+298
+00:27:15,750 --> 00:27:23,530
+سبعين صنطي على minus خمسين صنطي قياسات هذا ممكن
+
+299
+00:27:23,530 --> 00:27:25,410
+بالمتر سبعة من عشرة متر
+
+300
+00:27:28,250 --> 00:27:34,510
+على نص متر المتر مع المتر بيروح اذا واحد واربعة من
+
+301
+00:27:34,510 --> 00:27:38,190
+عشرة بالمينوس طبعا بالمينوس ايش يعني واحد واربعة
+
+302
+00:27:38,190 --> 00:27:42,390
+من عشرة بالمينوس يعني المينوس هنا يعني مجلوبة
+
+303
+00:27:42,390 --> 00:27:45,870
+because it transfers magnification ومرة واربعة من
+
+304
+00:27:45,870 --> 00:27:51,650
+عشرةجد ارتفاع يعني اذا ال object ارتفاعه عشرة صنطي
+
+305
+00:27:51,650 --> 00:27:55,470
+هذه هيكون ارتفاعها ايش اربع اتاشر صنطي بس مجلوبة
+
+306
+00:27:55,470 --> 00:28:06,250
+بالنسبة لل object تمام ناخد كمان امثلة بكافية
+
+307
+00:28:06,250 --> 00:28:10,370
+نقول
+
+308
+00:28:10,370 --> 00:28:15,990
+image تكونت على بعد عشرة صنطي
+
+309
+00:28:21,280 --> 00:28:26,440
+تمام و ال
+
+310
+00:28:26,440 --> 00:28:31,980
+object مجهول و ال power مجهولة ل transfer
+
+311
+00:28:31,980 --> 00:28:37,960
+magnification ل transfer magnification ضرب
+
+312
+00:28:37,960 --> 00:28:46,020
+minus 2 ايش يعني ضرب minus 2 يعني الصورة ارتفاعها
+
+313
+00:28:46,020 --> 00:28:50,740
+جد ارتفاع ال object مرتينبمعنى آخر Transfers
+
+314
+00:28:50,740 --> 00:28:55,760
+Magnification يساوي Image Distance على Object
+
+315
+00:28:55,760 --> 00:29:03,640
+Distance Transfers Magnification مرتين على واحد
+
+316
+00:29:03,640 --> 00:29:08,000
+Image Distance
+
+317
+00:29:08,000 --> 00:29:13,780
+على Object Distance واحد
+
+318
+00:29:13,780 --> 00:29:17,500
+Image Distance يساوي اتنين Object Distanceيعني
+
+319
+00:29:17,500 --> 00:29:21,420
+مسافة ال image مرتين جت مسافة ال object طب مسافة
+
+320
+00:29:21,420 --> 00:29:27,220
+ال image عشرة صنطة اذا مسافة ال object جديش خمسة
+
+321
+00:29:27,220 --> 00:29:31,360
+صنطة نعيد احنا بنقول Transphase Magnification يسوى
+
+322
+00:29:31,360 --> 00:29:33,720
+image distance على object distance هنا على واحد
+
+323
+00:29:33,720 --> 00:29:43,810
+طبعادرب تبادل 1 image distance يساوي 2 object
+
+324
+00:29:43,810 --> 00:29:48,050
+distance يعني مسافة ال image مرتين جد مسافة ال
+
+325
+00:29:48,050 --> 00:29:52,170
+object مسافة ال image عشرة صنطة جد مسافة ال object
+
+326
+00:29:52,170 --> 00:29:56,890
+خمسة صنطة مرتين واضح؟ الآن واضحة عند الأمور تماما
+
+327
+00:29:56,890 --> 00:30:01,230
+الآن بدي أجي للمطلوب الأول اللي هو ال power
+
+328
+00:30:06,060 --> 00:30:10,960
+بنقول ال U جداش تساوي ناقص N على O يساوي ناقص واحد
+
+329
+00:30:10,960 --> 00:30:14,320
+على خمسة
+
+330
+00:30:14,320 --> 00:30:21,720
+إيش متر ويساوي ناقص عشرين ديوبتر ناقص عشرين ديوبتر
+
+331
+00:30:21,720 --> 00:30:28,240
+واحد على خمسة من مية عشرين طبعا ناقص عشرين ديوبتر
+
+332
+00:30:28,240 --> 00:30:35,470
+و ال V انشرطة على I ويساوي واحد علىواحد من عشرة
+
+333
+00:30:35,470 --> 00:30:45,230
+متر ويساوي plus عشرة ديوبتر plus عشرة ديوبتر تمام
+
+334
+00:30:45,230 --> 00:30:52,230
+U زائد P يساوي V minus عشرين ديوبتر زائد ال power
+
+335
+00:30:52,230 --> 00:30:57,170
+يساوي plus عشرة ديوبتر ال minus عشرين لما تنتقل عن
+
+336
+00:30:57,170 --> 00:31:02,590
+ناحية التانية اذا بتصير ايش ال power plus تلاتين
+
+337
+00:31:02,590 --> 00:31:03,190
+ديوبتر
+
+338
+00:31:09,480 --> 00:31:14,440
+الان بيظل عندى ايش ل transfer magnification ل
+
+339
+00:31:14,440 --> 00:31:19,700
+transfer magnification لأ موجود عفوا بس لو حبينا
+
+340
+00:31:19,700 --> 00:31:25,280
+نجيبه بال U على V minus 20 ع plus 10 هيتأكد ايش
+
+341
+00:31:25,280 --> 00:31:30,420
+ضال عندى انا ال object distanceأحنا استنتجناها
+
+342
+00:31:30,420 --> 00:31:33,500
+استنتاج صحيح بس كان ممكن نجيبها برضه من اليوم
+
+343
+00:31:33,500 --> 00:31:37,160
+مافيش مشكلة مافي مشكلة هيك خلصت المسألة هيك خلصت
+
+344
+00:31:37,160 --> 00:31:42,260
+المسألة حد يسأل سؤال يعطيكوا العافية
+
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/aPI0V8u9Lmc_postprocess.srt b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/aPI0V8u9Lmc_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..383f5167561528f859379e23b129edbd8e043f45
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/aPI0V8u9Lmc_postprocess.srt
@@ -0,0 +1,1912 @@
+1
+00:00:20,940 --> 00:00:26,620
+بسم الله الرحمن الرحيم اليوم موضوعنا نستكمل ما
+
+2
+00:00:26,620 --> 00:00:30,940
+بدأناه من نسبة لموضوع ال Prisms وحكينا أن ال Prism
+
+3
+00:00:30,940 --> 00:00:37,230
+ال cross section بتاعه فيه ألو apexو فيه الو بيز و
+
+4
+00:00:37,230 --> 00:00:40,270
+كل ما كانت ال apex angle أكبر كل ما كانت قوة
+
+5
+00:00:40,270 --> 00:00:46,430
+البريزم على يعني أقوى أو أكتر قوة و قولنا إنه
+
+6
+00:00:46,430 --> 00:00:50,130
+مافيش refractive power للبريزم تمام يعني ما بيغير
+
+7
+00:00:50,130 --> 00:00:54,350
+ال image characteristics تمام و قولنا إنه فينا
+
+8
+00:00:54,350 --> 00:01:00,350
+special case من البريزم اللي هي ال plane parallel
+
+9
+00:01:00,350 --> 00:01:05,740
+plateالـ Plane Parallel Plate إذا يعني سقط عليه
+
+10
+00:01:05,740 --> 00:01:10,400
+الضوء بشكل Oblique أو مائل الضوء هذا هيصيرله
+
+11
+00:01:10,400 --> 00:01:14,320
+انكسار داخل الـ Plane Parallel Plate ومن ثم انكسار
+
+12
+00:01:14,320 --> 00:01:18,680
+مرة أخرى بيصيرله إزاحة وليس deviation وليس
+
+13
+00:01:18,680 --> 00:01:22,880
+deviation عن مساره يعني إذا كان مائل على المحور
+
+14
+00:01:22,880 --> 00:01:26,660
+الأفقي بزاوية مثلا θيتا و هو خارج من الـ Plane
+
+15
+00:01:26,660 --> 00:01:29,940
+Parallel Plate برضه بيظل مائل بزاوية ثيتا يعني ما
+
+16
+00:01:29,940 --> 00:01:34,790
+اتغير ميلانهأو مساره الفراري بس صارله إزاحة فقط
+
+17
+00:01:34,790 --> 00:01:38,490
+لأن ال plane parallel plate لو سقط عليه الضوء بشكل
+
+18
+00:01:38,490 --> 00:01:43,150
+عمودي هيمر عمودياً هيبطأ في منطقة ال plane
+
+19
+00:01:43,150 --> 00:01:47,710
+parallel plate ثم هيكمل مساره بشكل عمودي يعني مافي
+
+20
+00:01:47,710 --> 00:01:51,190
+لا displacement ولا deviation يعني لا displacement
+
+21
+00:01:51,190 --> 00:01:52,550
+ولا deviation
+
+22
+00:01:54,710 --> 00:02:02,270
+بتكون هنا ال plane برا لل plate قوته zero يمكن
+
+23
+00:02:02,270 --> 00:02:09,270
+اعتباره لان اي prism مهما صغر او كبربيعمل net
+
+24
+00:02:09,270 --> 00:02:14,410
+deviation لـ light ray اللي بتدخل فيه بمعنى أخر
+
+25
+00:02:14,410 --> 00:02:17,910
+تنحرف الضوء أو بنحرف الضوء اللي داخل ال Librisim
+
+26
+00:02:17,910 --> 00:02:22,430
+بعد خروجه من ال Librisim بيكون انحرف عن نصره بكمية
+
+27
+00:02:22,430 --> 00:02:27,990
+معينة موافقة لكمية Librisim وهذه الكمية تسمى ال
+
+28
+00:02:27,990 --> 00:02:31,210
+angle of deviation قبل ما نحكي عن ال angle of
+
+29
+00:02:31,210 --> 00:02:36,230
+deviationفي مجال العيون والبصريات فيما تستخدم اللي
+
+30
+00:02:36,230 --> 00:02:40,610
+هو البريزمات البريزمات بتستخدم في أشياء عديدة فيها
+
+31
+00:02:40,610 --> 00:02:43,250
+أن ال low power بريزم يعني ال apex تاعتها بتكون أو
+
+32
+00:02:43,250 --> 00:02:48,050
+ال apex angle بتكون صغيرة ممكن تستخدمبنعملها
+
+33
+00:02:48,050 --> 00:02:54,210
+incorporation in spectacle يعني بتضاف لل glasses
+
+34
+00:02:54,210 --> 00:02:58,490
+تمام لأهداف معينة مثلا إذا كان عندي زاوية حوال
+
+35
+00:02:58,490 --> 00:03:02,950
+صغيرة ممكن يتم تعديلها بواسطة هذا ال prism المرفق
+
+36
+00:03:02,950 --> 00:03:06,970
+مع ال glasses تمام في ال contact lenses أحيانا نفس
+
+37
+00:03:06,970 --> 00:03:11,290
+القضية ممكن نعملها incorporation هي المسئولة ال
+
+38
+00:03:11,290 --> 00:03:14,750
+low power prisms هي المسئولة عن ال doubling image
+
+39
+00:03:14,750 --> 00:03:19,560
+في جهاز الكيراتوميتريعني فصل الصورة لصورتين في
+
+40
+00:03:19,560 --> 00:03:23,900
+جهاز الكيروتومتري و ال high power prisms الى
+
+41
+00:03:23,900 --> 00:03:28,420
+استخدامات كتيرة زي في قياس الحولزي في عملية الـ
+
+42
+00:03:28,420 --> 00:03:32,020
+Application Tonometry يعني قياس ضغط العين زي في ال
+
+43
+00:03:32,020 --> 00:03:35,700
+treatment of retinal periphery with laser يعني
+
+44
+00:03:35,700 --> 00:03:38,900
+application of laser energy to the extreme
+
+45
+00:03:38,900 --> 00:03:43,440
+periphery of the retina ممكن احتاج لhigh power
+
+46
+00:03:43,440 --> 00:03:47,620
+iparism فبالتالي هذه تعتبر يعني بعض الاستخدامات
+
+47
+00:03:49,030 --> 00:03:52,930
+للبريزم لما بنحكي عن ال angle of deviation اللي
+
+48
+00:03:52,930 --> 00:03:56,230
+بنحكي عن ال angle of deviation ال deviation ممكن
+
+49
+00:03:56,230 --> 00:04:02,930
+يصير على سطح واحد و ممكن يصير على السطحين بالنسبة
+
+50
+00:04:02,930 --> 00:04:08,190
+للبريزم مثال على deviation يحدث على سطح واحد إذا
+
+51
+00:04:08,190 --> 00:04:13,190
+الدوق سقط سقوط عمودي على السطح الأول هذا السطح
+
+52
+00:04:13,190 --> 00:04:18,570
+الأول للبريزم هي ال apex وهي ال baseالسقوط العمودي
+
+53
+00:04:18,570 --> 00:04:24,450
+لا يصح به تغير في الاتجاه يعني الجزء اللي بيمر من
+
+54
+00:04:24,450 --> 00:04:28,950
+الإشعاع أو من الأشعة الضوئية هيكمل طريقه بدون أي
+
+55
+00:04:28,950 --> 00:04:33,230
+deviation كل ال deviation بيتم
+
+56
+00:04:34,710 --> 00:04:37,990
+على السطح التاني يعني الضوء بدل ما يكون مساره
+
+57
+00:04:37,990 --> 00:04:42,630
+مستقيم الـ prism عند السطح التاني بيحرف الضوء عن
+
+58
+00:04:42,630 --> 00:04:46,310
+مساره هذه ال angle of deviation على السطح
+
+59
+00:04:51,090 --> 00:04:54,770
+على السطح رقم 2 هي الـ Total Angle of Deviation
+
+60
+00:04:54,770 --> 00:04:59,070
+لأن على السطح الأول كمية الـ Deviation هي 0 مسار
+
+61
+00:04:59,070 --> 00:05:03,110
+Deviation للضوء فبالتالي الـ Angle of Deviation
+
+62
+00:05:03,110 --> 00:05:07,090
+إذا افترضنا هنا مثلا 30 ديجرين حرف عن مساره معناته
+
+63
+00:05:07,090 --> 00:05:11,870
+الـ Total Angle of Deviation يعني 30 ديجرين طيب
+
+64
+00:05:11,870 --> 00:05:16,050
+هذا إذا كان الـ Deviation تم على سطح واحد أحيانا
+
+65
+00:05:16,050 --> 00:05:20,210
+بيتم الـ Deviation على سطحين
+
+66
+00:05:22,190 --> 00:05:26,650
+بمعنى اخر هاي
+
+67
+00:05:26,650 --> 00:05:33,510
+الشعاع سين وصل لسطح الفاصل بين البرزم انكسر اجه
+
+68
+00:05:33,510 --> 00:05:37,410
+لسطح الفاصل التاني بين البرزم و الهواء انكسر مرة
+
+69
+00:05:37,410 --> 00:05:44,970
+تانية الان المسار الأساسي للضوء قبل ما يوصل لبرزم
+
+70
+00:05:44,970 --> 00:05:49,600
+كان بالاتجاه اللي انا رسمتهيعني أول مرة صار له
+
+71
+00:05:49,600 --> 00:05:54,580
+deviation بمقدار هذه الزاوية نفرض إنها A تمام و
+
+72
+00:05:54,580 --> 00:06:00,840
+مرة تانية صار له deviation بمقدار
+
+73
+00:06:00,840 --> 00:06:05,040
+هذه الزاوية اللي هي B ال total angle of deviation
+
+74
+00:06:05,040 --> 00:06:10,780
+ال total angle of deviation إيش تساوي A زائد B
+
+75
+00:06:10,780 --> 00:06:19,570
+تساوي A زائد BA زائد B تمام فبالتالي هو الحرف نفرض
+
+76
+00:06:19,570 --> 00:06:22,790
+هنا عشرين degree وهنا مثلا خمسة و عشرين degree
+
+77
+00:06:22,790 --> 00:06:27,350
+معناته ال total angle of deviation خمسة و أربعين
+
+78
+00:06:27,350 --> 00:06:32,350
+degree خمسة و أربعين degree بقدر أعرف ال total
+
+79
+00:06:32,350 --> 00:06:36,110
+angle of deviation أن هذا الشعاع اللي خرج من ال
+
+80
+00:06:36,110 --> 00:06:39,830
+prism و الشعاع اللي دخل ال .. أشوف الزاوية بينهم
+
+81
+00:06:39,830 --> 00:06:44,570
+ننسم الرسم I مكبرة شوية عشان توضح الأمور
+
+82
+00:06:52,550 --> 00:06:58,530
+هي A وهي
+
+83
+00:06:58,530 --> 00:07:07,450
+B طبعا هذا الشعع ال incident ريه
+
+84
+00:07:07,450 --> 00:07:13,750
+وهذا ال exiting ريه يعني الشعع اللي سقط و الشعع
+
+85
+00:07:13,750 --> 00:07:19,980
+اللي خرج من ال prison تمامطيب الآن بنمدهم حتى
+
+86
+00:07:19,980 --> 00:07:25,900
+يلتقوا هذه الزاوية هي ال total angle of deviation
+
+87
+00:07:25,900 --> 00:07:30,760
+بمعنى أخر ننسى ال prism وكأن الدوق كان ماشي
+
+88
+00:07:30,760 --> 00:07:35,920
+بالطريقة هاي أو بالاتجاه هذا و بعدين فجأة غير
+
+89
+00:07:35,920 --> 00:07:40,060
+مصاره مرة واحدة صار بالاتجاه هذا هاي ال total
+
+90
+00:07:40,060 --> 00:07:44,320
+angle of deviation هذه فيته لازم تساوي a زائد b
+
+91
+00:07:45,820 --> 00:07:52,440
+تمام بي تساوي هنا هكتب بي ليش لأنه بالتقابل مظبوط
+
+92
+00:07:52,440 --> 00:07:58,320
+و هاد الزاوية تكمل الزاوية هاي في المثلث اذا ثيتا
+
+93
+00:07:58,320 --> 00:08:05,300
+تساوي a زائد b واضح اذا ال total angle of
+
+94
+00:08:05,300 --> 00:08:10,640
+deviation هي مجموعة ال deviation على سطحي ال prism
+
+95
+00:08:12,530 --> 00:08:15,610
+طب ممكن ال deviation يكون على سطح واحد ممكن ساعة
+
+96
+00:08:15,610 --> 00:08:19,890
+تبقى نقول ال deviation على السطح الأول صفر زائد
+
+97
+00:08:19,890 --> 00:08:23,350
+تلاتين ويساوي ال total angle of deviation مجموعة
+
+98
+00:08:23,350 --> 00:08:28,100
+ال deviation على السطحينبغض النظر السطحين صار
+
+99
+00:08:28,100 --> 00:08:31,440
+عندهم deviation ولا ماصارش deviation تمام اذا ال
+
+100
+00:08:31,440 --> 00:08:35,260
+total angle of deviation مجموعة ال deviation
+
+101
+00:08:35,260 --> 00:08:39,540
+مجموعة ال deviation على سطحي ال prism يعني جديش
+
+102
+00:08:39,540 --> 00:08:44,520
+انحرف الضوء عن مصاره جديش زاوية انحرف عن مصاره هذا
+
+103
+00:08:44,520 --> 00:08:48,700
+بالنسبة لل total angle of deviation بنجي لمفهوم
+
+104
+00:08:48,700 --> 00:08:55,250
+اخر اللي هو ال minimum angle of deviationبس هذا في
+
+105
+00:08:55,250 --> 00:08:59,950
+نقطة لازم نعدي عليها دائما و أبدا ال deviation على
+
+106
+00:08:59,950 --> 00:09:04,970
+السطحي ال Prism ممكن يكون في نفس الاتجاه أو في
+
+107
+00:09:04,970 --> 00:09:10,350
+اتجاهات متضادة يعني مثال على ذلك هذا ال deviation
+
+108
+00:09:10,350 --> 00:09:15,410
+يعتبر بنفس الاتجاه بمعنى أخر هذا الشعاع لما دخل ال
+
+109
+00:09:15,410 --> 00:09:21,440
+Prism انكسر باتجاه اليمينالى اليمين و بعد هيك مرة
+
+110
+00:09:21,440 --> 00:09:27,320
+تانية انكسر كمان مرة لياش لليمين اذا ال deviation
+
+111
+00:09:27,320 --> 00:09:31,920
+بنفس الاتجاه تمام هنا المثال هذا الضوء جاي من فوق
+
+112
+00:09:31,920 --> 00:09:37,460
+انكسر هذا انكسار in opposite direction هنا in the
+
+113
+00:09:37,460 --> 00:09:44,960
+same direction هنا
+
+114
+00:09:44,960 --> 00:09:46,460
+in opposite direction
+
+115
+00:09:52,190 --> 00:09:57,250
+الضوء انكسر إلى يساره نازل انكسر لليسار و بعدين
+
+116
+00:09:57,250 --> 00:09:59,930
+انكسر لليمين is in opposite direction
+
+117
+00:10:04,480 --> 00:10:10,220
+ال بريزم بيحرف الأشعة باتجاه ال base بغض النظر
+
+118
+00:10:10,220 --> 00:10:14,020
+الدوق جاي من فوق أو جاي من تحت أو جاي دوبري دائما
+
+119
+00:10:14,020 --> 00:10:19,220
+بالنهاية الحصيلة أن الدوق أو ال بريزم بيحرف الأشعة
+
+120
+00:10:19,220 --> 00:10:23,620
+باتجاه ال base طيب بدأ أضرب مثال على ذلك عشان برضه
+
+121
+00:10:23,620 --> 00:10:28,600
+ما تختلط الأمور هنا هاي أنا عندي انكساء دوق جاي
+
+122
+00:10:28,600 --> 00:10:35,200
+بالشكل هذاهل انحرفت الأشعة هاي باتجاه ال base؟ لأ،
+
+123
+00:10:35,200 --> 00:10:40,740
+باتجاه ال base الإبرة بالنسبة، الإبرة نسبية، بمعنى
+
+124
+00:10:40,740 --> 00:10:45,100
+آخر، هذا الضوء جاب لدخوله ال Prism هاي اتجاهه،
+
+125
+00:10:45,100 --> 00:10:49,840
+مظبوط؟ الآن اتجاهه أصبح أقرب لل base، يعني هذا عند
+
+126
+00:10:49,840 --> 00:10:55,900
+خروجه أقرب مما لو دل ماشي في طريقهإذن المسألة يعني
+
+127
+00:10:55,900 --> 00:10:59,420
+مش بس مطلقة لأ نسبية أيضا يعني هنا الشعاع اللي خرج
+
+128
+00:10:59,420 --> 00:11:03,440
+من ال البرزم و كأنه البرزم جرب الشعاع باتجاه ال
+
+129
+00:11:03,440 --> 00:11:07,960
+base باتجاه ال base واضح فبالتالي يعني مش شرط ان
+
+130
+00:11:07,960 --> 00:11:13,680
+يكون واضح لنا هذه القضية لأ هي دايما ال deviation
+
+131
+00:11:13,680 --> 00:11:19,560
+اللي بيحدثه البرزم بيحدثه باتجاه ال base باتجاه ال
+
+132
+00:11:19,560 --> 00:11:25,920
+base تمامإذا الأمر الآن واضح ننتقل للنقطة التالية
+
+133
+00:11:25,920 --> 00:11:30,560
+ال
+
+134
+00:11:30,560 --> 00:11:35,020
+minimum angle of deviation قبل ما نحكي عن ال
+
+135
+00:11:35,020 --> 00:11:39,940
+minimum angle of deviation بنقول شيء بسيط أو مفهوم
+
+136
+00:11:39,940 --> 00:11:44,440
+بسيط أن ال prison بحسب وضعيته بالنسبة للضوء ال
+
+137
+00:11:44,440 --> 00:11:50,200
+total angle of deviation بتختلف بمعنى آخر high
+
+138
+00:11:50,200 --> 00:11:55,960
+prisonالضغط إذا إجاله من هنا هى مرة هى تجربة أو
+
+139
+00:11:55,960 --> 00:11:59,040
+إجاله بالزاوية high بالزاوية السقوط high أو إجاله
+
+140
+00:11:59,040 --> 00:12:02,280
+بالزاوية السقوط high أو إجاله بالزاوية السقوط high
+
+141
+00:12:02,280 --> 00:12:06,220
+بالنهاية سواء واحد تجربة الأولى أو التانية أو
+
+142
+00:12:06,220 --> 00:12:10,460
+التالتة أو الرابعة بالنهاية كله هيصفي أقرب لل base
+
+143
+00:12:10,460 --> 00:12:17,300
+and خروجه ولكن لما بنحسب للأربع تجارب لما بنحسب ال
+
+144
+00:12:17,300 --> 00:12:19,160
+total angle of deviation
+
+145
+00:12:23,270 --> 00:12:29,070
+بنجي تختلف بين تجربة والتانية بمعنى أخر ال Prism
+
+146
+00:12:29,070 --> 00:12:35,130
+ليس له total angle of deviation ثابتة ليس له total
+
+147
+00:12:35,130 --> 00:12:39,250
+angle of deviation ثابتة طيب ليش؟ لأنه ممكن الضوء
+
+148
+00:12:39,250 --> 00:12:42,990
+يجيله بزاوية سقوط مختلفة في كل مرة إذا اختلفت
+
+149
+00:12:42,990 --> 00:12:46,990
+زاوية السقوط تمام بالنهاية total angle of
+
+150
+00:12:46,990 --> 00:12:51,130
+deviation ممكن تختلف أجل علماء سألوا أنفسهم السؤال
+
+151
+00:12:52,200 --> 00:12:58,400
+أيش الوضعية؟ أيش الوضعية اللي بتحقق ما يسمى بالـ
+
+152
+00:12:58,400 --> 00:13:02,420
+Minimum Angle of Deviation يعني أيش الوضعية للـ
+
+153
+00:13:02,420 --> 00:13:06,600
+Prism وزايد سقوط معينة بتحدث لأقل الـ Deviation
+
+154
+00:13:06,600 --> 00:13:11,900
+ممكن وجد العلماء بالتجربة أن الـ Minimum Angle of
+
+155
+00:13:11,900 --> 00:13:21,540
+Deviation بحصل عليها حينما when deviation is equal
+
+156
+00:13:22,860 --> 00:13:28,940
+on both surfaces حينما يتساوى ال deviation على
+
+157
+00:13:28,940 --> 00:13:33,720
+السطحين ساعتها ال total angle of deviation تساوي
+
+158
+00:13:33,720 --> 00:13:38,240
+مجموعهم صحيح ولكن مش فيش لهذا ال prism أقل من هيك
+
+159
+00:13:38,240 --> 00:13:41,040
+مثال
+
+160
+00:13:42,590 --> 00:13:47,550
+إذا قلنا على السطح الأول مثلا عشرين وعلى السطح
+
+161
+00:13:47,550 --> 00:13:51,170
+التاني عشرين إذا ال total angle of deviation
+
+162
+00:13:51,170 --> 00:13:55,630
+أربعين ديجري مظبوط هذا البرزم بيعطيش أقل من أربعين
+
+163
+00:13:55,630 --> 00:14:00,090
+ديجري ممكن يعطي أكبر ماشي بس ال minimum angle of
+
+164
+00:14:00,090 --> 00:14:04,660
+deviationأربعين كيف عرفت أنها أربعين لأنه تساوى ال
+
+165
+00:14:04,660 --> 00:14:09,220
+deviation على السطحين طيب ال Prism تاني ال minimum
+
+166
+00:14:09,220 --> 00:14:13,040
+angle of deviation مثلا خمستاش وخمستاش يساوي
+
+167
+00:14:13,040 --> 00:14:18,510
+تلاتين degree هذا ال Prism لم نحصل منهعلى total
+
+168
+00:14:18,510 --> 00:14:22,430
+angle of deviation أقل من تلاتين اذا التلاتين هي
+
+169
+00:14:22,430 --> 00:14:26,690
+ال minimum تمام انت بحصل على ال minimum angle of
+
+170
+00:14:26,690 --> 00:14:31,550
+deviation لأي بريزم لما يسقط الضوء بزاوية سقوط
+
+171
+00:14:31,550 --> 00:14:35,730
+معينة بحيث ان ال deviation على السطح الأوليساوي
+
+172
+00:14:35,730 --> 00:14:39,170
+الـ deviation على السطح التاني إذا وصلنا لهذه
+
+173
+00:14:39,170 --> 00:14:43,370
+النقطة معناته هذه أقل total angle of deviation و
+
+174
+00:14:43,370 --> 00:14:46,830
+بسميها minimum angle of deviation فهذه القضية
+
+175
+00:14:46,830 --> 00:14:50,870
+ضرورة تكون بالنسبة لنا واضحة أي سقوط بزاوية أخرى
+
+176
+00:14:50,870 --> 00:14:54,570
+هيعطيني total angle أكبر من ال minimum angle أي
+
+177
+00:14:54,570 --> 00:15:00,190
+سقوط بزاوية سقوط أخرى لا تحقق deviation متساوي على
+
+178
+00:15:00,190 --> 00:15:04,450
+السطحين هتلاقي المجموع أكبر من ال minimum angle of
+
+179
+00:15:04,450 --> 00:15:10,780
+deviationطبعا يعني في المثال هتقولنا عشرين وعشرين
+
+180
+00:15:10,780 --> 00:15:15,940
+لو مثلا هنا قولنا خمسة وعشرين واتنين وعشرين مش
+
+181
+00:15:15,940 --> 00:15:20,600
+متساوي ماشي ال total angle of deviation هنا كده؟
+
+182
+00:15:20,600 --> 00:15:25,620
+سبعة واربعين لأ هناجي أقل هناجي زاوية السقوط
+
+183
+00:15:25,620 --> 00:15:29,900
+تعطيني total angle of deviation أقل من الرقم هذا
+
+184
+00:15:29,900 --> 00:15:36,490
+امتى لما هان تساوي هايلما I تساوي I مثلا 22 و22
+
+185
+00:15:36,490 --> 00:15:40,930
+و20 و20 و18 و18 حسب Librisم حسب زاوية السقوط
+
+186
+00:15:40,930 --> 00:15:44,270
+فبالتالي عندما يتساوى ال deviation على السطح الأول
+
+187
+00:15:44,270 --> 00:15:47,730
+مع ال deviation على السطح التاني فلنعلم علم اليقين
+
+188
+00:15:47,730 --> 00:15:51,770
+أن أنا وصلت لل minimum angle of deviation ولا يوجد
+
+189
+00:15:51,770 --> 00:15:55,410
+أقل منها لا يوجد أيش أقل منها وهذا المقصود بال
+
+190
+00:15:55,410 --> 00:16:01,330
+minimum angle of deviation طيب نيجي لقياس قوة
+
+191
+00:16:01,330 --> 00:16:09,610
+Librisمقياس قوة لبريزم قوة
+
+192
+00:16:09,610 --> 00:16:17,370
+العدسات تقاس بإيش؟ بالديوبترا الان قوة لبريزم تقاس
+
+193
+00:16:17,370 --> 00:16:21,990
+ب لبريزم ديوبترا بدنا
+
+194
+00:16:21,990 --> 00:16:26,970
+ننبه لنقطة هنا مانفعش أقول لبريزم وأسكتوبنفعش اقول
+
+195
+00:16:26,970 --> 00:16:29,970
+ديوبتر واسكت ديوبتر يعني هيصير الإنسان اللي
+
+196
+00:16:29,970 --> 00:16:36,250
+بيسمعني بيحسب ان انا بحكي عن العدسات تمام لأ كلمة
+
+197
+00:16:36,250 --> 00:16:40,190
+هذه كلمة غير قابلة للاختصار يعني هي prison diopter
+
+198
+00:16:40,190 --> 00:16:45,590
+واختصارها PD او برمزه لعب الرمز اللي هو المثلث
+
+199
+00:16:45,590 --> 00:16:50,810
+تمامأيش المقصود بالـ Prism Diopter؟ لو جيبنا Prism
+
+200
+00:16:50,810 --> 00:16:55,310
+ونقول هذا الـ Prism قوة واحد Prism Diopter ايش
+
+201
+00:16:55,310 --> 00:17:01,590
+ابتعنى؟ ابتعنى لو الضوء مر عبر هذا الـ Prism تمام
+
+202
+00:17:01,590 --> 00:17:06,790
+نفرض و نسقط على السطح الأول عمودي بس مش شرط بس
+
+203
+00:17:06,790 --> 00:17:11,870
+نفرض جبل عشان نقول الـ Deviation و جينا احنا نجيس
+
+204
+00:17:11,870 --> 00:17:18,230
+الـ Deviation على بعد 100 صنطمن الـ Prism هنلاقي
+
+205
+00:17:18,230 --> 00:17:21,970
+الأشعة انحرفت عن مسارها هاي مسارها الأصلي هذا
+
+206
+00:17:21,970 --> 00:17:26,830
+المسار الأصلي تمام هنلاقيها انحرفت واحد صنطي
+
+207
+00:17:26,830 --> 00:17:31,830
+ساعتها بقول هذا ال Prism قوته واحد ال Prism ده
+
+208
+00:17:31,830 --> 00:17:37,030
+يبتر بس ما تقاسش جنب ال Prism تقاس عبقر مائة صنطي
+
+209
+00:17:37,030 --> 00:17:40,410
+من ال Prism إذا لاجيت الأشعة انحرفت واحد صنطي
+
+210
+00:17:40,410 --> 00:17:44,130
+معناه تقوت هذا ال Prism واحد ال Prism ده يبتر طيب
+
+211
+00:17:44,130 --> 00:17:51,230
+نعطي أنفلةهذا البرزم حرف الأشعة على بُقة خمسة
+
+212
+00:17:51,230 --> 00:17:59,810
+وعشرين صنطة مسافة تلاتة صنطة كده قوته؟ على خمسة
+
+213
+00:17:59,810 --> 00:18:04,570
+وعشرين صنطة انحرفت تلاتة صنطة اذا على مية صنطة
+
+214
+00:18:04,570 --> 00:18:11,510
+انحرفت X X تساوي تلاتة في مية على خمسة وعشرين هنا
+
+215
+00:18:11,510 --> 00:18:16,480
+واحد وهنا أربع يساوي اتناشر برزم دا يبتدىأسئلة زيك
+
+216
+00:18:16,480 --> 00:18:23,420
+ممكن تيجي لازم مية بالضبط هي المسافة مية كام صنط
+
+217
+00:18:23,420 --> 00:18:33,200
+انحرفت بعيدا بعيدا عن البريزم بمسافة ميت صنط كام
+
+218
+00:18:33,200 --> 00:18:38,660
+جدر هذا البريزم يحرف ليه الأشعة تمام كام جدر يحرف
+
+219
+00:18:38,660 --> 00:18:43,960
+ليه الأشعة تمام فبالتالي نضرب مثال آخر بنقول على
+
+220
+00:18:43,960 --> 00:18:44,260
+بعد
+
+221
+00:18:48,040 --> 00:18:55,140
+على بُعد مثلا مائة متر حرفة
+
+222
+00:18:55,140 --> 00:19:03,520
+الأشعة خمسين صنطة جداش قوة البريزم الآن نقول مائة
+
+223
+00:19:03,520 --> 00:19:13,280
+متر نحوّلها لصنطة مائة متر يعني عشر ألف صنطةحرفة
+
+224
+00:19:13,280 --> 00:19:22,300
+الأشعة خمسين صنطة على بعد مائة صنطة X إذا X تساوي
+
+225
+00:19:22,300 --> 00:19:28,780
+مية في خمسين على عشرة ألف هاي تلت أصفر ما تلت خمسة
+
+226
+00:19:28,780 --> 00:19:32,540
+على عشرة إذا بيحرف بيكون لو على بعد مائة صنطة حرف
+
+227
+00:19:32,540 --> 00:19:38,910
+الأشعة عشرين صنطةإذا عشرين بريزم ديوبتر قوته عشرين
+
+228
+00:19:38,910 --> 00:19:43,110
+بريزم ديوبتر قوته تمام فبالتالي هذا البريزم ديوبتر
+
+229
+00:19:43,110 --> 00:19:49,070
+الآن احنا جثنا لما حددنا قوة البريزم بالبريزم
+
+230
+00:19:49,070 --> 00:19:52,470
+ديوبتر كام سانت انحرفت الأشياء عن مسارها الأصلي
+
+231
+00:19:52,470 --> 00:19:57,070
+طبعا هذا يقاس على بقد مائة سانت من البريزم في نفس
+
+232
+00:19:57,070 --> 00:20:02,170
+الوقت بنقدر نقول ان الأشياء انحرفت زاوية مقدرها
+
+233
+00:20:02,170 --> 00:20:08,320
+إيش ثيتازاوية مقدارها فيتا طبعا هنا على بعد 100
+
+234
+00:20:08,320 --> 00:20:12,580
+صنطي عدد الصنطيات اللي هي يساوي عدد البرزمات إذا
+
+235
+00:20:12,580 --> 00:20:16,300
+عندي 3 صنطي بيصير 3 برزم ديوب تر قوته إذا عندي 10
+
+236
+00:20:16,300 --> 00:20:20,200
+صنطي معناته 10 برزم ديوب تر طبعا مقاس على بعد 100
+
+237
+00:20:20,200 --> 00:20:24,300
+صنطي يعني هذه المسافة بقدر أرمزها بالرمز برزم لأن
+
+238
+00:20:24,300 --> 00:20:29,000
+عدد الصنطيات يساوي عدد البرزم ديوب تر الهدا أنا
+
+239
+00:20:29,000 --> 00:20:32,820
+عندي الآن مثلث قائم الزاوية تمام هذه الزاوية
+
+240
+00:20:32,820 --> 00:20:43,470
+القائمةو تان ثيتا يساوي المقابل عدد البريزمات على
+
+241
+00:20:43,470 --> 00:20:54,730
+مية تمام؟ إذا البريزم يساوي تان ثيتا في مية تمام؟
+
+242
+00:21:02,810 --> 00:21:11,230
+بدي انا اصل لثيتا نفسها بدي اجسم على مية اذا
+
+243
+00:21:11,230 --> 00:21:17,130
+tan ثيتا هيرجعنا لأ tan ثيتا يساوي لprism على مية
+
+244
+00:21:17,130 --> 00:21:28,100
+ثيتا نفسها ايش تساوي shift tan لprism على ميةيعني
+
+245
+00:21:28,100 --> 00:21:32,240
+بقدر أعرف أزاوية لانحراف الأشياء أجيسها بال degree
+
+246
+00:21:32,240 --> 00:21:37,240
+إذا بديش أعبر بال Prism دا يبطى إذا بديش أعبر بال
+
+247
+00:21:37,240 --> 00:21:44,860
+Prism دا يبطى طبعا roughly بشكل يعني مش دقيق بقى
+
+248
+00:21:44,860 --> 00:21:49,180
+بالمئة ولكن تقريبا كل one degree تقريبا تساوي
+
+249
+00:21:49,180 --> 00:21:54,780
+اتنين Prism دا يبطىكل one degree تقريبا تساوي
+
+250
+00:21:54,780 --> 00:21:59,740
+اتنين Prism ديوبتر يعني اذا قلنا عشرة degree
+
+251
+00:21:59,740 --> 00:22:04,000
+معناته انا بتكلم تقريبا عن عشرين Prism ديوبتر و
+
+252
+00:22:04,000 --> 00:22:12,660
+هكذا و هكذا طيب
+
+253
+00:22:12,660 --> 00:22:18,800
+الآن في حاجة اسمها ال calibration of Prism ال
+
+254
+00:22:18,800 --> 00:22:20,620
+calibration of Prism
+
+255
+00:22:24,730 --> 00:22:33,150
+هنا لعين من ال calibration هي
+
+256
+00:22:33,150 --> 00:22:39,590
+عندي حاجة اسمها Prentice Position ال
+
+257
+00:22:39,590 --> 00:22:47,450
+Prentice Position بيكون ال Prism مصنع بحيث انه
+
+258
+00:22:47,450 --> 00:22:52,380
+يكونأحد الأسطح مايتمش عليه ال deviation بيكون سقوط
+
+259
+00:22:52,380 --> 00:22:57,300
+الضوء عمودي على هذا السطح تمام عمودي على هذا السطح
+
+260
+00:22:57,300 --> 00:23:00,820
+حد بيسموه ال apprentice position تمام و ال
+
+261
+00:23:00,820 --> 00:23:05,260
+deviation بيكون على السطح التالي كله تمام و في
+
+262
+00:23:05,260 --> 00:23:09,980
+بريزمات تصنع بحيث تعطيني لما أمسكها بالشكل الصحيح
+
+263
+00:23:09,980 --> 00:23:14,340
+تعطيني ال minimum angle of deviationبمعنى آخر
+
+264
+00:23:14,340 --> 00:23:20,420
+الانحراف بدو يتم على السطح الأمامي وعالسطح الخلفي
+
+265
+00:23:20,420 --> 00:23:24,580
+لل Prism بشكل متساوي بشكل متساوي فهيعطيني ال
+
+266
+00:23:24,580 --> 00:23:28,780
+minimum angle of deviation اللغة الأولة غالبا
+
+267
+00:23:28,780 --> 00:23:34,280
+glass Prism مصنعة من الذجاج وهنا plastic Prism
+
+268
+00:23:36,810 --> 00:23:41,810
+يعني الـ Plastic Prisms غالبا تصنع بحيث أنه لازم
+
+269
+00:23:41,810 --> 00:23:45,610
+أمسكها في وضعية تعطيني ال minimum angle of
+
+270
+00:23:45,610 --> 00:23:49,630
+deviation لو أمسكتها خطأ بصير عندي القياس خطأ احنا
+
+271
+00:23:49,630 --> 00:23:54,270
+قلنا البريزمات ممكن تستخدم في قياس الحول طب لو أنا
+
+272
+00:23:54,270 --> 00:23:59,260
+بدأ أجيس الحولوأمسك ال Prism بشكل خاطئ هيديني قياس
+
+273
+00:23:59,260 --> 00:24:03,400
+خاطئ وإذا أخذ قرار مثلا إجراء عملية جراحية للحول
+
+274
+00:24:03,400 --> 00:24:08,060
+فهيكون هذا بناء على قياس خاطئ تمام و الخطأ ممكن
+
+275
+00:24:08,060 --> 00:24:12,620
+يكون كبير تمام طيب غالبا ال Prismات غالبا في العصر
+
+276
+00:24:12,620 --> 00:24:17,460
+الحالي يعني تصنع من ال plastic و بتكون calibrated
+
+277
+00:24:17,460 --> 00:24:21,830
+عشان تستعملبحيث تعطيني ال minimum angle of
+
+278
+00:24:21,830 --> 00:24:25,830
+deviation طب انا كيف امسك البريزم عشان يعطيني ال
+
+279
+00:24:25,830 --> 00:24:30,390
+minimum angle of deviation طبعا ال minimum angle
+
+280
+00:24:30,390 --> 00:24:34,990
+of deviation هاي
+
+281
+00:24:34,990 --> 00:24:39,790
+ال frontal plane تمام هاي ال frontal plane البريزم
+
+282
+00:24:39,790 --> 00:24:45,050
+بدي يكون موازي ل ال frontal plane نقسم رسم توضيحي
+
+283
+00:24:45,050 --> 00:24:50,780
+بنقول انسانعنده Exotropia يعني حوال وحشي مثلا تمام
+
+284
+00:24:50,780 --> 00:24:54,620
+او بدي امسك لبرزم لبرزم بدي يكون parallel ل ال
+
+285
+00:24:54,620 --> 00:25:00,320
+face parallel ل ال face تمام parallel يعني لو
+
+286
+00:25:00,320 --> 00:25:03,000
+تصورنا ايه دي هي البرزم بدي يكون parallel ل ال
+
+287
+00:25:03,000 --> 00:25:06,920
+face تمام مابدوش يكون tilted جزء منه لجدام وجزء
+
+288
+00:25:06,920 --> 00:25:10,560
+منه لورا ومابدوش يكون tilted بالشكل هذا تمام بدي
+
+289
+00:25:10,560 --> 00:25:14,400
+يكون parallel ل ال face طيب ل glass prism لازم
+
+290
+00:25:14,400 --> 00:25:20,250
+تنمسكبالـ Apprentice position نفس المثال بيقول
+
+291
+00:25:20,250 --> 00:25:25,150
+كالقاتي هاي عندى exotropia right exotropia بده
+
+292
+00:25:25,150 --> 00:25:30,640
+ينمسك لجلاص برزيم بحيث يكوناتجاه ال visual axis
+
+293
+00:25:30,640 --> 00:25:36,740
+عمودي تمام و ال deviation بيكون يعني على سطح واحد
+
+294
+00:25:36,740 --> 00:25:41,100
+يعني ب .. بال .. يعني بدأ احرك ال prism بحيث انه
+
+295
+00:25:41,100 --> 00:25:45,460
+وين العين رايحة وين العين فيها حوالي بدأ احرك ال
+
+296
+00:25:45,460 --> 00:25:49,120
+prism بحيث يكون ال visual axis او ال line of sight
+
+297
+00:25:49,120 --> 00:25:53,120
+جاي perpendicular لالاتجاه اللي انا ماسك فيه ال
+
+298
+00:25:53,120 --> 00:25:56,320
+prism عشان يعطيني ال apprentice positionطبعاً
+
+299
+00:25:56,320 --> 00:25:59,380
+الغالبية العظمى من ال بريزمات اللى بنستخدمها في
+
+300
+00:25:59,380 --> 00:26:02,820
+قياس الحوار هي plastic prisms و بتنمسك في ال
+
+301
+00:26:02,820 --> 00:26:06,740
+frontal plane وهذا بيسهل يعني القياس بشغل بشكل
+
+302
+00:26:06,740 --> 00:26:10,560
+كبير طبعا نضرب مثال على ذلك بنقول كالقاتل لو انسان
+
+303
+00:26:10,560 --> 00:26:16,980
+عنده حوال مقدار اربعين بريزم مثلا و المفروض ينمسك
+
+304
+00:26:18,150 --> 00:26:21,270
+البلاستيك بريزم بحيث يعطيني ال minimum angle of
+
+305
+00:26:21,270 --> 00:26:25,550
+deviation وما انمسكش بالشكل هذا انمسك على أساس انه
+
+306
+00:26:25,550 --> 00:26:28,570
+glass بريزم ممكن يعطيني خطأ في القياس مثلا يعطيني
+
+307
+00:26:28,570 --> 00:26:32,350
+قياس 32 بريزم اذا التمانية بريزم هذه اللي ما
+
+308
+00:26:32,350 --> 00:26:37,440
+انجستش راحت في خطأ القياسو هذه كمية كبيرة .. هذه
+
+309
+00:26:37,440 --> 00:26:42,400
+كمية كبيرة فبالتالي طبعا هذه هتأثر على نتائج
+
+310
+00:26:42,400 --> 00:26:46,200
+الجراحة إذا كان أجريت أو احتاج هذا المريض انه نجري
+
+311
+00:26:46,200 --> 00:26:50,940
+له جراحة إذا ضروري ينمسك لبريزم أمام عين المريض
+
+312
+00:26:50,940 --> 00:26:54,840
+بوضعية ال calibration اللي هو اتصنع عشان ينمسك
+
+313
+00:26:54,840 --> 00:26:58,300
+فيها تمام فبالتالي هذه القضية ضروري تكون بالنسبة
+
+314
+00:26:58,300 --> 00:27:03,240
+لنا واضحة طيب نجي للمقطة التالية بالنسبة للبريزمات
+
+315
+00:27:11,970 --> 00:27:16,010
+Displacement of images by prisms احنا عارفين ان
+
+316
+00:27:16,010 --> 00:27:18,770
+البرزم لا يكون image لانه مش refractive او مش
+
+317
+00:27:18,770 --> 00:27:24,110
+optical system تمام اذا هاي عندي انا العدسات اللي
+
+318
+00:27:24,110 --> 00:27:30,290
+احنا يعني رحلنا معها رحلة طويلة نقول كالقاتل هاي
+
+319
+00:27:30,290 --> 00:27:34,910
+انا عندي object ونفرض ان ال image بدأ تتكون على
+
+320
+00:27:34,910 --> 00:27:40,310
+المسافة هذهرحت انا حطيت في طريق الأشعة اللى رايحة
+
+321
+00:27:40,310 --> 00:27:46,170
+تتجمع عشان تكون ال image رحت انا حطيت برزم base
+
+322
+00:27:46,170 --> 00:27:51,610
+down فحلاجى انه ال image هتتكون على نفس المسافة بس
+
+323
+00:27:51,610 --> 00:27:57,870
+هتكون انزحت وزيحتللأسفل باتجاه ال base أو أقرب لل
+
+324
+00:27:57,870 --> 00:28:01,470
+base أقرب مش على ال optical axis تعالى العدسة لأ
+
+325
+00:28:01,470 --> 00:28:06,090
+أقرب يعني أقرب باتجاه ال base يعني more down more
+
+326
+00:28:06,090 --> 00:28:10,930
+down تمام فبالتالي هذه الصورة ال real image اللي
+
+327
+00:28:10,930 --> 00:28:16,590
+أنا تلقيتها تمام دائما باتجاه ال base دائما باتجاه
+
+328
+00:28:16,590 --> 00:28:23,170
+ال base لو ضربنا مثال تاني نفس المثالبدل ما الصورة
+
+329
+00:28:23,170 --> 00:28:27,590
+تتكون هنا روحت انا حطيت برزم base up هلاجي الصورة
+
+330
+00:28:27,590 --> 00:28:36,910
+ايش اتجمعت تمام البرزم ماغير ماغير بُعدها عن ال
+
+331
+00:28:36,910 --> 00:28:39,890
+distance ال image distance عن ال optical system
+
+332
+00:28:39,890 --> 00:28:43,270
+ماتغير يعني ال image distance و ال magnification
+
+333
+00:28:43,270 --> 00:28:46,590
+مابلعبش دور في ال characteristics بتاعة ال image
+
+334
+00:28:46,590 --> 00:28:51,350
+وانما حرفها باتجاه ال base بتاعته تمام طيب الآن
+
+335
+00:28:53,160 --> 00:28:58,240
+كقاعدة ضرورية جدا يعني .. يعني نستوعبها ان ال real
+
+336
+00:28:58,240 --> 00:29:06,180
+image ال real image دائما بتحرف باتجاه ال base إذا
+
+337
+00:29:06,180 --> 00:29:08,920
+حكينا ال real image دائما تحرف باتجاه ال base
+
+338
+00:29:08,920 --> 00:29:12,420
+معناته في حاجة اسمها virtual image تمام؟ لو أنا
+
+339
+00:29:12,420 --> 00:29:16,000
+استبدلت ورقة التلقى بعيني
+
+340
+00:29:20,400 --> 00:29:26,700
+هذه الأشعة تبدو للعين جاية من أعلى فتظهر الصورة
+
+341
+00:29:26,700 --> 00:29:33,160
+كأنها موجودة في الأعلى فدائما و أبدا لما أبدأ أطلع
+
+342
+00:29:33,160 --> 00:29:36,340
+الصورة من خلال الـ Prism من خلال الـ Prism سأشوف
+
+343
+00:29:36,340 --> 00:29:39,040
+الصورة جاية من فوق إذا كان الـ Prism Based Down
+
+344
+00:29:39,040 --> 00:29:44,560
+يعني باتجاه الـ Apex تمام؟ بينما و لو هنا أبدأ
+
+345
+00:29:44,560 --> 00:29:49,980
+أستبدل ورقة التلقي بعيني سأشوف كأنها جايةمن ناحية
+
+346
+00:29:49,980 --> 00:29:52,600
+الـ Apex تاعت الـ Prism هذه الـ virtual image اللي
+
+347
+00:29:52,600 --> 00:29:56,320
+احنا بنشوفه لما بنمسك ال Prism و بنطلع من خلاله
+
+348
+00:29:56,320 --> 00:30:01,520
+هنشوف دائما الصورة محروفة باتجاه ال Apex هذه ال
+
+349
+00:30:01,520 --> 00:30:04,180
+virtual image بينما الصورة الحقيقية اللي أنا
+
+350
+00:30:04,180 --> 00:30:09,910
+بتلقها على ال screenهذه دائما لأن الأشعة بيحرفها
+
+351
+00:30:09,910 --> 00:30:14,170
+ال بريزم حقيقة باتجاه ال base بس لو أنا بتطلع على
+
+352
+00:30:14,170 --> 00:30:17,970
+هذه الأشعة اللي جاية عشان تكون صورة هيبينلي كانها
+
+353
+00:30:17,970 --> 00:30:23,830
+جاية من ناحية ال apex إذا real image دائما في ال
+
+354
+00:30:23,830 --> 00:30:27,170
+بريزم real image لو ننطلقها على ال screen towards
+
+355
+00:30:27,170 --> 00:30:31,830
+the base بينما
+
+356
+00:30:31,830 --> 00:30:37,540
+ال virtual imageاللي انا بدأ اشوفها بعيني دائما
+
+357
+00:30:37,540 --> 00:30:42,540
+هشوفها toward the apex وهذه
+
+358
+00:30:42,540 --> 00:30:48,720
+القضية ممكن احنا نتأكد
+
+359
+00:30:48,720 --> 00:30:54,720
+منها بشكل معملي فبالتالي وهذا السر في انه احنا
+
+360
+00:30:54,720 --> 00:30:58,760
+اتعلمنا من زمان في المدارس ان البريزم دائما بحرف
+
+361
+00:30:58,760 --> 00:31:03,250
+الصورة باتجاه ال apexباتجاه ال Apex تاعته و حقيقة
+
+362
+00:31:03,250 --> 00:31:07,510
+بيحرفها أو بيحرف الأشعة باتجاه ال base بس أنا بشوف
+
+363
+00:31:07,510 --> 00:31:12,930
+virtual image متجهها باتجاه ال Apex باتجاه ال Apex
+
+364
+00:31:12,930 --> 00:31:22,890
+طبعا ال image اللي بتكونها العدسات طيب
+
+365
+00:31:25,370 --> 00:31:34,390
+نجي لموضوع مهم جدا اللي هو Prismatic Effect
+
+366
+00:31:34,390 --> 00:31:44,670
+of Lenses ولا
+
+367
+00:31:44,670 --> 00:31:46,870
+يتبع من Librentis Rule
+
+368
+00:31:54,870 --> 00:32:01,510
+كل عدسة سواء
+
+369
+00:32:01,510 --> 00:32:10,190
+plus أو minus تسلك
+
+370
+00:32:10,190 --> 00:32:15,290
+أو تتصرف كأنها برزم في كل نقاطها ما عدا الـ
+
+371
+00:32:15,290 --> 00:32:21,050
+optical axisيعني هذه عدسة plus 5 okay هي optical
+
+372
+00:32:21,050 --> 00:32:25,570
+system قوته plus 5 ديوبتر عند كل نقطة من نقاطها
+
+373
+00:32:25,570 --> 00:32:31,510
+إلها تأثير كإنها prism يعني بالإضافة لكونها عدسة
+
+374
+00:32:31,510 --> 00:32:37,370
+بالإضافة لكونها عدسة بتشتغل كمنشور أيضا تمام في كل
+
+375
+00:32:37,370 --> 00:32:40,430
+نقاطها ماعدا النقاط اللي على ال إيش اللي على ال
+
+376
+00:32:40,430 --> 00:32:47,300
+optical axis لأن تأثيرها المنشوري صفروينظر للعدسة
+
+377
+00:32:47,300 --> 00:32:57,020
+الـ plus كأنها two prisms base to base وينظر
+
+378
+00:32:57,020 --> 00:33:03,400
+للعدسة الـ minus على أنها two prisms apex to apex
+
+379
+00:33:03,400 --> 00:33:11,700
+واضح الأمر هذا يعني كل عدسة تعتبر عدسة مع منشور في
+
+380
+00:33:11,700 --> 00:33:15,840
+كل نقاطهايعني كل نقطة من النقاط لو جولنا النقطة
+
+381
+00:33:15,840 --> 00:33:21,260
+سين والنقطة صد والنقطة عين هاي تلت نقاط ابعد عن ال
+
+382
+00:33:21,260 --> 00:33:28,300
+optical axis ونقول النقطة لم مثلا هاي أربع نقاط
+
+383
+00:33:28,300 --> 00:33:32,860
+النقطة لم على ال optical axis النقطة عين أبعد شوية
+
+384
+00:33:32,860 --> 00:33:38,800
+النقطة صد أبعد وأبعد النقطة سين الأكثر بعد عن ال
+
+385
+00:33:38,800 --> 00:33:43,970
+optical axisالنقطة سين وعند النقطة ساد وعند النقطة
+
+386
+00:33:43,970 --> 00:33:48,270
+عين فيه تأثير منشور للعدسة وكأن الضوء بيمر مش بس
+
+387
+00:33:48,270 --> 00:33:53,450
+من عدسة من منشور تمام له قوة معينةبس عند النقطة
+
+388
+00:33:53,450 --> 00:33:56,950
+لام لأ مافيش تأثير منشوري لأن النقطة لام تقع على
+
+389
+00:33:56,950 --> 00:34:01,890
+ال optical axis السؤال هل التأثير المنشوري للعدسة
+
+390
+00:34:01,890 --> 00:34:05,290
+عند النقطة عيني يساوي عند النقطة الصادر يساوي عند
+
+391
+00:34:05,290 --> 00:34:09,490
+النقطة الصين لأ في اختلاف في اختلاف هذا الاختلاف
+
+392
+00:34:09,490 --> 00:34:13,650
+هنستنتجه و يصف في معنى حاجة بيسميها Leprentice
+
+393
+00:34:13,650 --> 00:34:18,850
+rule كالقاتي بندخلسم رسمة بسيطة بتوضح هذه القضية
+
+394
+00:34:25,530 --> 00:34:32,810
+هذه عدسة وهذه
+
+395
+00:34:32,810 --> 00:34:42,230
+ال FP بتاعة العدسة نقول الشعاع الموازي تمام الشعاع
+
+396
+00:34:42,230 --> 00:34:52,920
+الموازي بيمر في ال FP بعد مروره تمامأنا بدأ أحسب
+
+397
+00:34:52,920 --> 00:34:57,740
+التأثير المنشوري عند النقطة C التي تبعد مسافة H عن
+
+398
+00:34:57,740 --> 00:35:01,560
+الـ Optical Axis أو الـ Center بتاع العدسة تمام
+
+399
+00:35:01,560 --> 00:35:12,920
+المطلوب المطلوب ما هو التأثير المنشوري الـ
+
+400
+00:35:12,920 --> 00:35:21,520
+Prismatic Effect للعدسة عند النقطةسين التي تبعد
+
+401
+00:35:21,520 --> 00:35:30,680
+مسافة H عن البريزم ديوبتر بمعنى آخر عند النقطة هاي
+
+402
+00:35:30,680 --> 00:35:35,540
+كام بريزم ديوبتر قوة المنشور أو تأثير العدسة
+
+403
+00:35:35,540 --> 00:35:40,020
+كمنشور يعني هي بتقدر تشتغلي كمنشور قوته جديش كام
+
+404
+00:35:40,020 --> 00:35:43,960
+بريزم ديوبتر عند النقطة سين بنرجع لتعريف البريزم
+
+405
+00:35:43,960 --> 00:35:52,060
+ديوبتر هوعلى بعد متر كم صنطي انحرفت مظبوط يعني هاي
+
+406
+00:35:52,060 --> 00:35:57,460
+الشعاع قبل دخوله وهي الشعاع بعد خروجه من العدسة
+
+407
+00:35:57,460 --> 00:36:04,960
+وهي مسافة مائة صنطي يعني هذه المسافة مائة صنطي وهي
+
+408
+00:36:04,960 --> 00:36:10,460
+عدد الصنطيات خلينا نكمل المثلثةسأرمزها بالرمز
+
+409
+00:36:10,460 --> 00:36:14,300
+بريزم ديوبتر لإيش لأن عدد الصنطيات عبارة من 100 هو
+
+410
+00:36:14,300 --> 00:36:19,100
+عدد ال بريزمات الديوبتر اللي صار معايا هذه أيش
+
+411
+00:36:19,100 --> 00:36:25,700
+المسافة هذه
+
+412
+00:36:25,700 --> 00:36:37,100
+ال posterior focal length كيف بنجيبه واحد على ال
+
+413
+00:36:37,100 --> 00:36:46,110
+powerتمام طيب واحد على plus خمسة مثلا يساوي اتنين
+
+414
+00:36:46,110 --> 00:36:51,190
+من عشرة متر تمام بس أنا بديش بالمتر بدي تطلع
+
+415
+00:36:51,190 --> 00:36:59,050
+الإجابة معايا بالصانتي بجسم مية على ال power مظبوط
+
+416
+00:36:59,050 --> 00:37:02,750
+كلام صحيح مية بس هي واحد على ال power إذا بدي
+
+417
+00:37:02,750 --> 00:37:08,790
+أطلعها بالمتر ومية على ال power بالصانتي تماممية
+
+418
+00:37:08,790 --> 00:37:15,830
+على ال power ال power نرمزها بالرمز D يعني هذه
+
+419
+00:37:15,830 --> 00:37:19,830
+المسافة بقدر أصلها تساوي اللي هو ال posterior
+
+420
+00:37:19,830 --> 00:37:23,910
+focal length مية على D ال D اللي هي ال diopter تقى
+
+421
+00:37:23,910 --> 00:37:36,910
+ال lens طيب واضح؟ بتقول هذا المثلث وهذا
+
+422
+00:37:36,910 --> 00:37:44,930
+المثلثعفوا هرسم بلون تاني حتى تتضح الأمور و هذا
+
+423
+00:37:44,930 --> 00:37:52,170
+المثلث بدنا
+
+424
+00:37:52,170 --> 00:38:01,450
+نشتغل عليهم بدنا نقول كالقاتل الزاوية هنا لثيتا
+
+425
+00:38:01,450 --> 00:38:10,490
+تساوي ثيتا شرطة مظبوط بالتبادل بالتبادلتمام بما
+
+426
+00:38:10,490 --> 00:38:15,390
+انه
+
+427
+00:38:15,390 --> 00:38:18,530
+فيتا
+
+428
+00:38:18,530 --> 00:38:27,490
+تساوي فيتا شرطة اذا tan فيتا يساوي tan فيتا شرطة
+
+429
+00:38:27,490 --> 00:38:38,010
+ايش tan فيتا H على مية على D صح تساوي
+
+430
+00:38:38,940 --> 00:38:49,400
+10 θ شرطة المقابل لبرزم على المية طيب مقام لمقام
+
+431
+00:38:49,400 --> 00:38:57,540
+اذا H في D يساوي على مية طبعا يساوي لبرزم على مية
+
+432
+00:38:57,540 --> 00:39:03,260
+لما يكون المقامات نفس الشي بشيلهم اذا البرزماتيك
+
+433
+00:39:03,260 --> 00:39:08,930
+effect عند النقطة C يساوي H في Dالـ Prismatic
+
+434
+00:39:08,930 --> 00:39:13,450
+Effect يساوي H في D بمعنى هذه النقطة عشان أعرف
+
+435
+00:39:13,450 --> 00:39:17,130
+تأثيرها المنشورة بدأ أعرف بعضها عن الـ Optical
+
+436
+00:39:17,130 --> 00:39:21,070
+Center و هذا البعد بالصينطي أضربه في قوة العدسة
+
+437
+00:39:21,070 --> 00:39:28,420
+نفرض البعد 2 صانطيوقمت العدسة مثلا بلص 6 ديوبتر
+
+438
+00:39:28,420 --> 00:39:32,740
+بقول البريزماتيك effect عند النقطة sin يساوي h جد
+
+439
+00:39:32,740 --> 00:39:39,220
+إيش؟ 2 صنطي في دي 6 ويساوي 12 بريزم ديوبتر 12
+
+440
+00:39:39,220 --> 00:39:45,260
+بريزم ديوبتر، تمام؟ ولكن بقى النقطة واحدة دائما
+
+441
+00:39:45,260 --> 00:39:50,660
+البريزم لازم أحدد اتجاهه واتجاه البريزم يسمى
+
+442
+00:39:50,660 --> 00:39:56,050
+باتجاه ال base بتاعة البريزمهذا البريزم ال base
+
+443
+00:39:56,050 --> 00:40:02,590
+بتاعته اين؟ down اذا اتناشر بريزم base down يعني
+
+444
+00:40:02,590 --> 00:40:10,250
+لما يمر الضوء من النقطة C من العدسة كأنه مر من
+
+445
+00:40:10,250 --> 00:40:15,830
+خلال اتناشر بريزم ديوتر بريزم قوت و اتناشر بريزم
+
+446
+00:40:15,830 --> 00:40:21,980
+ديوتر و ال base بتاعته downواضح كأنه مر بالظبط
+
+447
+00:40:21,980 --> 00:40:27,260
+بالظبط يعني مرور الضوء من عنده من خلال المقتصين
+
+448
+00:40:27,260 --> 00:40:32,960
+وانكساره بالظبط يساوي مروره من ال Prism هذا ال
+
+449
+00:40:32,960 --> 00:40:36,560
+Prism قوته اتناشر Prism ديوتر و ال base بتاعته اين
+
+450
+00:40:36,560 --> 00:40:43,090
+down و ال base بتاعته down طيب كل هذا الكلامشئ
+
+451
+00:40:43,090 --> 00:40:47,130
+ممتاز هذه المعادلة الأخيرة اللي وصلنا لها اسمها
+
+452
+00:40:47,130 --> 00:40:52,390
+البرنتس برول و هنستخدمها كتير كتير في ال
+
+453
+00:40:52,390 --> 00:40:55,870
+concentration بتاع ال glasses عشان نحصل على
+
+454
+00:40:55,870 --> 00:41:01,290
+prismatic effect احنا اليوم أنهينا المحاضرة ولكن
+
+455
+00:41:01,290 --> 00:41:04,950
+بدي اعطي مثال بسيط انسان عنده كمية حوال بسيطة جدا
+
+456
+00:41:04,950 --> 00:41:11,820
+خفيفة جدامش مستهلة إجراء عملية و عنده refractive
+
+457
+00:41:11,820 --> 00:41:16,640
+error و أنا قررت بدأ ألبسه نضارة هذه النضارة انا
+
+458
+00:41:16,640 --> 00:41:19,260
+ممكن احدث فيها decentralization يعني ال center
+
+459
+00:41:19,260 --> 00:41:20,580
+بتاعي مايكونش في النص
+
+460
+00:41:23,780 --> 00:41:27,500
+عشان أحدث الـ Prismatic Effect الإنسان إذا اتطلع
+
+461
+00:41:27,500 --> 00:41:31,040
+من منتصف النضارة يعني هيتطلع من ال optical center
+
+462
+00:41:31,040 --> 00:41:35,680
+مظبوط؟ مافيش تأثير منشوري أنا بدي إيه يتطلع من
+
+463
+00:41:35,680 --> 00:41:38,760
+النقطة سين أو من النقطة ساب عشان هذا التأثير
+
+464
+00:41:38,760 --> 00:41:43,280
+المنشور يلغي الحوال البسيط اللي موجود عنده تمام؟
+
+465
+00:41:43,280 --> 00:41:50,970
+فبتنجس النضارة أخدته DispensingDispensing او اعداد
+
+466
+00:41:50,970 --> 00:41:56,010
+النضارات بتيجي القطعة الأساسية الشابلونة بيسموها و
+
+467
+00:41:56,010 --> 00:42:00,710
+هي ال center لما انا بدي اجس النضارة بحيث انه
+
+468
+00:42:00,710 --> 00:42:04,210
+المركز ييجي في النص مش هحدف تأثير منشوري بينما
+
+469
+00:42:04,210 --> 00:42:07,250
+مثلا انا بدي مركز النضارة على سبيل المثال انا هذا
+
+470
+00:42:07,250 --> 00:42:10,630
+الكلام مبسط جدا بس عشان اوضح فكرة قضية ال
+
+471
+00:42:10,630 --> 00:42:14,250
+decentration تمام؟ بدي انا ال center ييجي لتحت
+
+472
+00:42:14,250 --> 00:42:14,870
+مثلا
+
+473
+00:42:17,910 --> 00:42:21,510
+لما بجس النضارة بالشكل هذا أصبح ال center لتحت
+
+474
+00:42:21,510 --> 00:42:27,610
+أصبح ال pupil ع جبال النقطة C تمام أصبح ال pupil ع
+
+475
+00:42:27,610 --> 00:42:32,090
+جبال النقطة C بيصير هو يتطلع من نضارة أو من عدسة
+
+476
+00:42:32,090 --> 00:42:36,410
+قوتها كذا ديوتر وفي نفس الوقت هي بتشتغله كمنشور
+
+477
+00:42:36,410 --> 00:42:40,590
+هذا المنشور هو مطلوب لتعديل زاوية الحوالي البسيطة
+
+478
+00:42:40,590 --> 00:42:42,610
+واضح يعطيكوا العافية
+
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/at9niaFB2yM_postprocess.srt b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/at9niaFB2yM_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..d16f5e8ea7c4135c6cc8f7d42543696f234fa4aa
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/at9niaFB2yM_postprocess.srt
@@ -0,0 +1,1140 @@
+1
+00:00:21,020 --> 00:00:24,340
+طيب بسم الله الرحمن الرحيم اليوم في ال geometrical
+
+2
+00:00:24,340 --> 00:00:30,480
+optics وصلنا لموضوع بسيط بس مهم جدا اللي هو ال
+
+3
+00:00:30,480 --> 00:00:34,940
+principle planes هنحكي عنهم و هنحكي عن modeling an
+
+4
+00:00:34,940 --> 00:00:40,400
+unknown optical system بالنسبة لل principle planes
+
+5
+00:00:40,400 --> 00:00:45,550
+عشان نوضح فكرتهمبدنا نعطي مثال بس قبل المثال هدبنا
+
+6
+00:00:45,550 --> 00:00:49,830
+نقول احنا اللي حتى الآن مرنا ب reference points و
+
+7
+00:00:49,830 --> 00:00:55,610
+planes عديدة قولنا مثلا أن ال optical axis اعتبرنا
+
+8
+00:00:55,610 --> 00:00:59,290
+reference يعني كل إيش فوق ال optical axis يعتبر
+
+9
+00:00:59,290 --> 00:01:04,630
+ارتفاعه positivebelow the optical axis اعتبرنا
+
+10
+00:01:04,630 --> 00:01:09,090
+ارتفاعه negative ايضا بالنسبالى المسافات اللى على
+
+11
+00:01:09,090 --> 00:01:12,510
+يمين ال optical system اعتبرناها مسافة positive و
+
+12
+00:01:12,510 --> 00:01:15,250
+اللى على الشمال ال optical system اعتبرناها مسافة
+
+13
+00:01:15,250 --> 00:01:19,790
+negative ايضا استخدمنا reference points زى ال
+
+14
+00:01:19,790 --> 00:01:22,590
+nodal points قلنا فيها ان ال anterior nodal point
+
+15
+00:01:22,590 --> 00:01:24,070
+و ال posterior nodal point
+
+16
+00:01:28,370 --> 00:01:31,810
+و استخدمناهم في عدة استخدامات و حكينا ان الشعاع
+
+17
+00:01:31,810 --> 00:01:35,010
+اللى بدخل بالـ anterior nodal point لازم يخرج من
+
+18
+00:01:35,010 --> 00:01:38,630
+ال posterior nodal point و بيكون عامل زاوية مع ال
+
+19
+00:01:38,630 --> 00:01:43,050
+optical axis زاوية الشعاع اللى دخل في ال optical
+
+20
+00:01:43,050 --> 00:01:46,390
+system هي نفس الزاوية يعني اذا كنا هي زاوية Alpha
+
+21
+00:01:46,390 --> 00:01:50,260
+هنا هتكون هنازاوية Alpha وإذا النقطتين منطبقين على
+
+22
+00:01:50,260 --> 00:01:53,740
+بعض بيكون الشعاع اللي بيدخل في ال node ال point لا
+
+23
+00:01:53,740 --> 00:01:58,400
+يغير طريقه إطلاقا ولا حتى يعني يحدث معاه إزاحة
+
+24
+00:01:58,400 --> 00:02:02,680
+وأيضا حكينا عن reference points أخرى زي ال focal
+
+25
+00:02:02,680 --> 00:02:11,490
+pointsوعنا FP وقلنا استفدنا منهم استفادة كبيرة بأن
+
+26
+00:02:11,490 --> 00:02:15,170
+الشعاع الموازي لل optical axis لما بينكسر بيعدي في
+
+27
+00:02:15,170 --> 00:02:19,830
+ال FP الشعاع المنطلق من ال FA لما بينكسر بيكون
+
+28
+00:02:19,830 --> 00:02:24,510
+موازي لل optical axis وكذا يعني فيها ال reference
+
+29
+00:02:24,510 --> 00:02:28,070
+points كتيرة تستخدم في علم ال geometrical optics
+
+30
+00:02:28,070 --> 00:02:32,370
+حكينا أنهفي محاضرات سابقة أنه في عندنا ال
+
+31
+00:02:32,370 --> 00:02:36,410
+principal points بس ما حكينا يعني في إيش بنستفيد
+
+32
+00:02:36,410 --> 00:02:41,650
+منهم هنيجي احنا نعطي مثال يوضح فكرة ال principal
+
+33
+00:02:41,650 --> 00:02:45,730
+planes و ال principal points و إيش الاستفادة من
+
+34
+00:02:45,730 --> 00:02:51,750
+هذه القضية لو تخيلنا أن شخص بدي يروح من طرف حي
+
+35
+00:02:51,750 --> 00:02:54,990
+لطرف آخر وهي البيوت في هذا الحي
+
+36
+00:03:11,680 --> 00:03:16,700
+هذا الشخص واقف في موعد مع صديق له عند الطرف الآخر
+
+37
+00:03:16,700 --> 00:03:21,120
+من الحيط وقلنا هو بده يروح راح ماشي بالطريقة هاي
+
+38
+00:03:21,120 --> 00:03:25,160
+ثم هيك ثم هيك ثم هيك ثم هيك ثم هيك ثم هيك ثم هيك
+
+39
+00:03:25,160 --> 00:03:26,540
+ثم هيك ثم هيك ثم هيك ثم هيك ثم هيك ثم هيك ثم هيك
+
+40
+00:03:26,540 --> 00:03:28,580
+ثم هيك ثم هيك ثم هيك ثم هيك ثم هيك ثم هيك ثم هيك
+
+41
+00:03:28,580 --> 00:03:29,000
+ثم هيك ثم هيك ثم هيك ثم هيك ثم هيك ثم هيك ثم هيك
+
+42
+00:03:29,000 --> 00:03:29,220
+ثم هيك ثم هيك ثم هيك ثم هيك ثم هيك ثم هيك ثم هيك
+
+43
+00:03:29,220 --> 00:03:35,120
+ثم هيك ثم هيكيعطينا خارطة أبسط ممكن يقول ببساطة
+
+44
+00:03:35,120 --> 00:03:39,620
+شديدة جدا نقدر نتخيل أن هذا مثلا راح للمسافة هاي و
+
+45
+00:03:39,620 --> 00:03:43,700
+بعدين اذا غير اتجاهه مرة واحدة بس هنا هي تغير
+
+46
+00:03:43,700 --> 00:03:48,680
+اتجاه هي اتنين هي تلاتة هي أربعة هي خمسة هي ستة هي
+
+47
+00:03:48,680 --> 00:03:52,760
+سبعة هي تمان مرات غير اتجاهه ال principle planes
+
+48
+00:03:52,760 --> 00:03:57,760
+هي virtual planes planes تخيّلية بتقول كل ال
+
+49
+00:03:57,760 --> 00:04:00,780
+reflection اللي تم على أسطح العدسات المتتالية
+
+50
+00:04:01,580 --> 00:04:04,500
+بنتخيل أنه مش موجود أنه في عندي anterior principal
+
+51
+00:04:04,500 --> 00:04:07,020
+plane و posterior principal plane عندهم تم
+
+52
+00:04:07,020 --> 00:04:12,220
+الإنكسار بمعنى آخر، الآن هذا المثال نيجي نقول عنا
+
+53
+00:04:12,220 --> 00:04:18,320
+optical system مكوّن من عدة عدسات، تمام؟ والصورة
+
+54
+00:04:18,320 --> 00:04:23,130
+نفرض اتكونت في المكان هذابالاخر بالنهاية بدل ما
+
+55
+00:04:23,130 --> 00:04:26,030
+اقول ان الأشعة اللي جاية من ال object انكسرت على
+
+56
+00:04:26,030 --> 00:04:29,690
+السطح الأمامي و بعدين انكسرت على السطح الخالفي و
+
+57
+00:04:29,690 --> 00:04:32,950
+بعدين انكسرت مرة تانية هاي اول انكسار و هاي التاني
+
+58
+00:04:32,950 --> 00:04:35,350
+و هاي التالت و هاي الرابع و هاي الخامس و هاي
+
+59
+00:04:35,350 --> 00:04:39,510
+السادس و هاي السابع و هاي التامل هذا كله بدي أشيله
+
+60
+00:04:39,510 --> 00:04:44,360
+و اقول عندي في two planes تخيلياتوكأن هدول ال two
+
+61
+00:04:44,360 --> 00:04:47,780
+planes تخيلا بيضموا عدسة واحدة كبيرة هيك مش موجودة
+
+62
+00:04:47,780 --> 00:04:51,820
+في خيالنا موجودة عند سطحها الأمامي تم انكسار وعند
+
+63
+00:04:51,820 --> 00:04:55,500
+سطحها الخالفي تم انكسار هدول الانكسارين عند السطح
+
+64
+00:04:55,500 --> 00:05:00,420
+الأمامي والسطح الخالفي للعدسة التخيلية بيسد عن كل
+
+65
+00:05:00,420 --> 00:05:05,440
+هذه القضية بيقول اتكونت الصورة هنا وخلصنا اذا فكرة
+
+66
+00:05:05,440 --> 00:05:10,860
+ال principle planes هيVirtual planes مستويات
+
+67
+00:05:10,860 --> 00:05:15,920
+تخيلية وضعها العلماء عشان يقولوا لبدل ما أشغل نفسي
+
+68
+00:05:15,920 --> 00:05:18,760
+في الإنكسارات الكتيرة للأسطح يعني بعض الكاميرات
+
+69
+00:05:18,760 --> 00:05:22,580
+مثلا الصحفية ممكن فيها سبع عدسات تمان عدسات عشر
+
+70
+00:05:22,580 --> 00:05:26,440
+عدسات اتناشر عدسة اتناشر عدسة يعني اربع وعشرين سطح
+
+71
+00:05:26,950 --> 00:05:31,910
+يعني الانكسار تم 24 مرة لكل شعاع لكل شعاع انا
+
+72
+00:05:31,910 --> 00:05:35,670
+بلزمني كحد ادنى شعاعين عشان التقائهم بعد ما يخرجوا
+
+73
+00:05:35,670 --> 00:05:40,810
+من العدسة رقم 12 ويكونوا ال final image تمام بدي
+
+74
+00:05:40,810 --> 00:05:46,490
+ادرس شعاعين في 24 انكسار يعني 48 مرة بدي فبدل ما
+
+75
+00:05:46,490 --> 00:05:51,090
+ادرس ال 48 مرة بقول كل هذه العدسات الموجودة بي سد
+
+76
+00:05:51,090 --> 00:05:55,540
+عنهامستويين تخيّلين وكأني أنا بتخيل أن هذا ال
+
+77
+00:05:55,540 --> 00:05:59,020
+optical system المكون من 12 عدسة شيلناها و حطينا
+
+78
+00:05:59,020 --> 00:06:04,580
+عدسة تخيّلية مكانه قوتها نفس قوته يعني بالنهاية
+
+79
+00:06:04,580 --> 00:06:08,480
+هتعطي صورة في نفس المكان وبنفس الصفات و بقول عند
+
+80
+00:06:08,480 --> 00:06:12,610
+السطح الأمامي لهذا العدسة التخيّلية تماماللي هو
+
+81
+00:06:12,610 --> 00:06:15,930
+بيسميه الـ anterior principal plane تم انكسار
+
+82
+00:06:15,930 --> 00:06:19,290
+وبعدين عند السطح الخلفي مافي اقل من اتنين مافي اقل
+
+83
+00:06:19,290 --> 00:06:22,230
+من اتنين يعني العدسة او العدسات اللي احنا بنعرفها
+
+84
+00:06:22,230 --> 00:06:26,190
+مافي اقل من سطحين تمام يعني احنا مابنستعمل في
+
+85
+00:06:26,190 --> 00:06:30,510
+الحياة العملية اللي هي single refracting service
+
+86
+00:06:30,510 --> 00:06:33,950
+فهذه فكرة ال principal planes هذه فكرة ال
+
+87
+00:06:33,950 --> 00:06:38,070
+principal planes طبعا هم ال virtual planes بي
+
+88
+00:06:39,080 --> 00:06:44,360
+استخدمهم عشان اتخيل او يعني اقول انه كل ال
+
+89
+00:06:44,360 --> 00:06:48,160
+refraction اللي حصل في العدسات المتتالية بيكافئه
+
+90
+00:06:48,160 --> 00:06:52,600
+refraction حدث عند ال anterior principal plane وعن
+
+91
+00:06:52,600 --> 00:06:55,800
+ال posterior principal plane هنعرف فائدة هذا
+
+92
+00:06:55,800 --> 00:06:59,880
+الكلام في الموضوع التاني بس قبل ما نبدأ فيه بدنا
+
+93
+00:06:59,880 --> 00:07:06,210
+نخلص الكلام على ال principal plane اصبح عندي انافي
+
+94
+00:07:06,210 --> 00:07:10,890
+تلت شغلات نقول عندنا principal planes هاي optical
+
+95
+00:07:10,890 --> 00:07:15,550
+system مثلا وعندي principal planes anterior
+
+96
+00:07:15,550 --> 00:07:19,830
+principal plane مثلا و posterior principal plane
+
+97
+00:07:19,830 --> 00:07:26,830
+تقاطع ال principal plane مع ال optical axis بيحدد
+
+98
+00:07:26,830 --> 00:07:30,830
+ال anterior principal point و ال posterior
+
+99
+00:07:30,830 --> 00:07:37,190
+principal point أصبح عنديthree pairs of cardinal
+
+100
+00:07:37,190 --> 00:07:44,790
+points في عندي two nodal points وعندي
+
+101
+00:07:44,790 --> 00:07:50,970
+two principal points و
+
+102
+00:07:50,970 --> 00:07:57,770
+two focal points يعني
+
+103
+00:07:57,770 --> 00:08:01,700
+أي optical systemأي optical system انا اختصارا
+
+104
+00:08:01,700 --> 00:08:06,280
+رسمت عدسة العدسة optical system اه العدستين برضه
+
+105
+00:08:06,280 --> 00:08:10,020
+optical system الميت عدسة برضه optical system اي
+
+106
+00:08:10,020 --> 00:08:13,400
+optical system بغض النظر عن عدد العدسات اللي فيه
+
+107
+00:08:13,400 --> 00:08:17,560
+فيه له تلت أزواج من ال reference points اللي
+
+108
+00:08:17,560 --> 00:08:21,960
+باستخدمهم عشان افهم كيف خصائص الصورة اللي بتتكون
+
+109
+00:08:21,960 --> 00:08:27,340
+بواسطة هذا ال optical systemكل optical system فيه
+
+110
+00:08:27,340 --> 00:08:32,400
+له FA و FB anterior focus و posterior focal point
+
+111
+00:08:32,400 --> 00:08:36,700
+تمام؟ وإله two principal points وإله two nodal
+
+112
+00:08:36,700 --> 00:08:39,520
+points ممكن ينطبقوا على بعض وممكن الأربع يكونوا
+
+113
+00:08:39,520 --> 00:08:43,560
+منطبقين على بعض هذا مافي مشكلة بس أنا تقنيا لازم
+
+114
+00:08:43,560 --> 00:08:48,480
+أتعامل مع كل نقطة علىطيب هدولة ال two nodal points
+
+115
+00:08:48,480 --> 00:08:50,900
+و ال two principal points و ال two focal points
+
+116
+00:08:50,900 --> 00:08:55,580
+اللي هم خصائص اللي هم خصائص هنلخصها في الجمل
+
+117
+00:08:55,580 --> 00:09:04,060
+التالية بيقول كالقاتل في عندنا two pairs are
+
+118
+00:09:04,060 --> 00:09:06,440
+conjugate points conjugate
+
+119
+00:09:11,740 --> 00:09:15,620
+بمعنى متناظرة أو صور بعضها البعض أو إذا الأشعة
+
+120
+00:09:15,620 --> 00:09:20,080
+دخلت في point هتدخل في ال point المقابل إليها مين
+
+121
+00:09:20,080 --> 00:09:26,180
+هما ال two nodal points are
+
+122
+00:09:26,180 --> 00:09:32,860
+conjugate و ال two principal points هدولة
+
+123
+00:09:32,860 --> 00:09:35,840
+conjugate points بمعنى الشعاع اللي بدخل في ال
+
+124
+00:09:35,840 --> 00:09:40,240
+anterior nodal point لازم يخرج من ال posterior
+
+125
+00:09:40,240 --> 00:09:45,260
+nodal pointالشعاع اللي بدخل في ال anterior
+
+126
+00:09:45,260 --> 00:09:48,340
+principal point لازم يخرج من ال posterior
+
+127
+00:09:48,340 --> 00:09:53,400
+principal point بينما ال focal points ال two focal
+
+128
+00:09:53,400 --> 00:09:59,880
+points are not conjugated بدليل الشعاع اللي بتطلع
+
+129
+00:09:59,880 --> 00:10:05,540
+من ال F A بتخرج موازية بتروحش على ال FB مظبوط
+
+130
+00:10:05,540 --> 00:10:10,870
+والأشعة المتوازية تلتقي وين؟فى ال F & P يعني
+
+131
+00:10:10,870 --> 00:10:15,690
+ماقدرش أقول F & A و F & P are conjugate او مراية
+
+132
+00:10:15,690 --> 00:10:19,350
+لبعض من البعض او متناظر يعني الشعاع اللى بدخل فى F
+
+133
+00:10:19,350 --> 00:10:23,210
+& A لازم يخلص يوصل ل F & P لأ بالعكس الشعاع اللى
+
+134
+00:10:23,210 --> 00:10:26,350
+بدخل فى F & A بيطلع موازي يعني بيكون صورة فى ال
+
+135
+00:10:26,350 --> 00:10:29,990
+infinity تمام اذا ال two focal points are not
+
+136
+00:10:29,990 --> 00:10:36,190
+conjugate هذه
+
+137
+00:10:36,190 --> 00:10:43,850
+أولشيء بالنسبة للـ three pairs of reference points
+
+138
+00:10:43,850 --> 00:10:54,170
+تاني شيء two
+
+139
+00:10:54,170 --> 00:10:59,350
+pairs are associated with planes
+
+140
+00:11:05,060 --> 00:11:08,660
+يعني إلها مستويات فراغية اللي هي الـ two focal
+
+141
+00:11:08,660 --> 00:11:13,720
+points نقول فيه anterior focal plane و posterior
+
+142
+00:11:13,720 --> 00:11:21,200
+focal plane و ال two principal points بعضهم
+
+143
+00:11:21,200 --> 00:11:24,760
+نقول anterior principal plane و posterior
+
+144
+00:11:24,760 --> 00:11:31,120
+principal plane تمام؟ هنا anterior focal plane
+
+145
+00:11:32,190 --> 00:11:37,270
+وPosterior Focal Plane لهم مستويات فرارية بينما لا
+
+146
+00:11:37,270 --> 00:11:41,090
+يوجد شيء اسمه
+
+147
+00:11:41,090 --> 00:11:45,370
+نودة لبلاين مافيش حاجة اسمها نودة لبلاين تمام اذا
+
+148
+00:11:45,370 --> 00:11:50,230
+النودة لبلاين مش موجود تمام هذه ال three pairs
+
+149
+00:11:50,230 --> 00:11:54,350
+التلت أزواج من ال reference points
+
+150
+00:11:56,020 --> 00:12:00,040
+ولبعض له planes بتساعدنا كتير في فهم ال optical
+
+151
+00:12:00,040 --> 00:12:05,420
+systems وحاليا هنحكي على modeling an unknown
+
+152
+00:12:05,420 --> 00:12:07,720
+optical system
+
+153
+00:12:27,120 --> 00:12:30,200
+نجي لموضوع ال modeling of an unknown optical
+
+154
+00:12:30,200 --> 00:12:34,840
+system عندي optical system كاميرا معينة أو جهاز
+
+155
+00:12:34,840 --> 00:12:44,280
+تصوير معين وهذا الجهاز مكون من عدسات كثيرة على
+
+156
+00:12:44,280 --> 00:12:49,080
+سبيل المثال بشكل
+
+157
+00:12:49,080 --> 00:12:53,160
+التالي الآن إنسان أعطاني هذا الجهاز وقال لي لو
+
+158
+00:12:53,160 --> 00:12:59,620
+سمحت بدي أعرفإيش خصائص الجهاز هذا؟بمعنى آخر خصائص
+
+159
+00:12:59,620 --> 00:13:04,180
+الجهاز هذا يعني هذا الجهاز لو وقفنا أمامه object
+
+160
+00:13:04,180 --> 00:13:08,300
+إيش صفات الصورة اللي بيعملها هو أصلا معمول كجهاز
+
+161
+00:13:08,300 --> 00:13:12,360
+ينتج image ينتج image وعشانك سميناه optical system
+
+162
+00:13:12,360 --> 00:13:16,520
+بس المشكلة أننا اليوم أننا مش عارفين قوة العدسات
+
+163
+00:13:16,520 --> 00:13:21,020
+ولا المسافات بين هذه العدسات فبالتالي الحل بطريق
+
+164
+00:13:21,020 --> 00:13:24,140
+المعادلات الرياضية و ال convergence calculations
+
+165
+00:13:24,140 --> 00:13:29,880
+مش هيفيدنا هذا كاميرا مثلا موجودةفي الغلاف
+
+166
+00:13:29,880 --> 00:13:34,080
+البلاستيك بتاعها أو جهاز معين تليسكوب أو ما شابه
+
+167
+00:13:34,080 --> 00:13:38,400
+وانسان أعطانيه بصفتي أنا إلي علاقة في البصريات
+
+168
+00:13:38,400 --> 00:13:41,860
+وقاللي يا ترى إيش .. إيش صفات هذا ال optical
+
+169
+00:13:41,860 --> 00:13:45,280
+system يعني لو نحط قدامه object إيش الصورة اللي
+
+170
+00:13:45,280 --> 00:13:49,700
+بيعطينيها جدش تكبيرها جدش بعدها عن العدسة الأخيرة
+
+171
+00:13:49,700 --> 00:13:54,500
+إلى آخر يعني هذا الموضوع بيسمى كيف أنا أتعامل مع
+
+172
+00:13:54,500 --> 00:13:58,220
+optical system مش معروف بالنسبة ليطالما أنا
+
+173
+00:13:58,220 --> 00:14:02,720
+الأرقام مش معروفة إليه بدي أضطر أشتغل عملي مع هذا
+
+174
+00:14:02,720 --> 00:14:07,400
+اللي هو ال optical system و أتعامل معاه بشيء يسمى
+
+175
+00:14:07,400 --> 00:14:11,480
+هذا بدي أعتبره .. نفرض هذه الكاميرا بدي أعتبره أنا
+
+176
+00:14:11,480 --> 00:14:15,940
+عندي هنا هذا صندوق أسود black box
+
+177
+00:14:18,820 --> 00:14:22,900
+يعني بمعنى أخر ال black box لا يفتح إلا في ساعة
+
+178
+00:14:22,900 --> 00:14:26,500
+الضرورة القصوى يعني لما الطائرة بتسقط و يكون فيها
+
+179
+00:14:26,500 --> 00:14:30,040
+الصندوق الأسود تمام بتضطروا يفتحوه عشان يشوفوا
+
+180
+00:14:30,040 --> 00:14:35,020
+التسجيلات و آخر ما تم قبل عملية سقوط الطائرة الآن
+
+181
+00:14:35,020 --> 00:14:39,340
+أنا بديش أنا أفك في جهاز و ماعرفش أرجعه تاني بس
+
+182
+00:14:39,340 --> 00:14:46,000
+بدي أعرف صفاته من التجربة العملية بدون أن ..يعني
+
+183
+00:14:46,000 --> 00:14:52,460
+أعمل أي شيء يعني يتلف هذا الجهاز بدي أضطر أستخدم
+
+184
+00:14:52,460 --> 00:15:04,140
+اللي هو الـ three pairs of reference points هذا
+
+185
+00:15:04,140 --> 00:15:08,300
+الجهاز طالما أنه optical system إذا فيه إله
+
+186
+00:15:08,300 --> 00:15:12,750
+optical axisهذا الـ optical axis بدي أتخيل أنا
+
+187
+00:15:12,750 --> 00:15:18,130
+عندي جسم موجود على بعد معين و بدي أستخدم ال laser
+
+188
+00:15:18,130 --> 00:15:24,130
+pointer عشان أنا بدي .. بدي شعاع يكون من النقطة A
+
+189
+00:15:24,130 --> 00:15:27,670
+فقط مابديش أدرس كل النقاط لأنه إذا درست نقطة أخدت
+
+190
+00:15:27,670 --> 00:15:32,390
+معلومة عن كل الجهاز إذا أنا بدي النقطة A و بدي أنا
+
+191
+00:15:32,390 --> 00:15:36,790
+أستخدم laser pointer ينطلق منه أشعة ال laser تمام
+
+192
+00:15:36,790 --> 00:15:45,190
+بحيث إيش؟يعني أستخدمها في التجربة الآن بدي أبدأ
+
+193
+00:15:45,190 --> 00:15:52,450
+أميل ال laser pointer تمام مرة هيك مرة التانية هيك
+
+194
+00:15:52,450 --> 00:15:56,430
+المرة التالتة هيك إلى آخره نفرض عند ميلان معين
+
+195
+00:15:56,430 --> 00:16:03,170
+لأشعة ال laser عند
+
+196
+00:16:03,170 --> 00:16:05,070
+ميلان معين لأشعة ال laser
+
+197
+00:16:10,140 --> 00:16:14,520
+يعني ال laser pointer بيكون فوهة ال laser هنا تمام
+
+198
+00:16:14,520 --> 00:16:18,360
+عند ميلان معين لاحظت أن الأشعة اللي طلعت من ال
+
+199
+00:16:18,360 --> 00:16:22,960
+system parallel لل optical axis ساعتها بقول ..
+
+200
+00:16:22,960 --> 00:16:30,980
+ساعتها بقول أن هذا الشعاع مر في FA اعتمادا على
+
+201
+00:16:30,980 --> 00:16:37,420
+معلومة سبق أنه .. عرفنا أن اللي بيمر في FAبيخرج
+
+202
+00:16:37,420 --> 00:16:41,440
+موازي هذا الكلام مش بس لعدسة واحدة ولكل ال optical
+
+203
+00:16:41,440 --> 00:16:46,320
+system لكل ال optical system إذا عند ميلان معين
+
+204
+00:16:46,320 --> 00:16:53,280
+إذا بحط هذه النقطة هي FA تمام طيب الأشعة حقيقة
+
+205
+00:16:53,280 --> 00:16:57,380
+تاعة ال laser دخلت انكسرت على السطح الأمامي و
+
+206
+00:16:57,380 --> 00:16:59,900
+الخالفي و الأمامي و الخالفي و الأمامي و الخالفي
+
+207
+00:16:59,900 --> 00:17:06,110
+إلى آخرين هذا الانكسرات كلهابتعني ماذا؟ بأمد هذا
+
+208
+00:17:06,110 --> 00:17:12,750
+الخط بشكل مستقيم وبأمد هذا الخط بشكل مستقيم عند
+
+209
+00:17:12,750 --> 00:17:18,550
+إلتقائهم بأنشئ عمود هذا العمود هو الـ anterior
+
+210
+00:17:18,550 --> 00:17:20,410
+principal plane
+
+211
+00:17:27,380 --> 00:17:31,060
+أحنا قلنا الـ principal plane الانكسار عنده بيسد
+
+212
+00:17:31,060 --> 00:17:34,800
+عن كل الانكسارات و احنا بنقول كأن مشفاعتها الليزر
+
+213
+00:17:34,800 --> 00:17:39,140
+وصل للـ anterior principal plane وانكسر انكسر وظل
+
+214
+00:17:39,140 --> 00:17:44,320
+طالع موازي إيش لل optical axis ماشي هذا بيسد عن كل
+
+215
+00:17:44,320 --> 00:17:47,420
+الانكسارات إذا هنا ال anterior principal plane
+
+216
+00:17:47,420 --> 00:17:52,720
+تقاطعوه مع ال optical axis ال anterior principal
+
+217
+00:17:52,720 --> 00:18:00,100
+point واضح طيبهي اول جزء من التجربة اني بضل اميل
+
+218
+00:18:00,100 --> 00:18:04,990
+في شعاع الليزر لغاية ما يطلع عندي إيشالشعاع موازي
+
+219
+00:18:04,990 --> 00:18:08,590
+للـ optical axis بقى أوقف هي الخطوة الأولى تمت بقى
+
+220
+00:18:08,590 --> 00:18:12,510
+أوصل على الرسم تمام لغاية ما أحدد ال anterior
+
+221
+00:18:12,510 --> 00:18:16,370
+principal plane و ال anterior principal point okay
+
+222
+00:18:16,370 --> 00:18:21,610
+تمام طيب الآن أنا المرة هاي بدي أخلي الأشعة موازية
+
+223
+00:18:21,610 --> 00:18:24,950
+هذا الشعاع رقم واحد في التجربة الأولى الأشعة
+
+224
+00:18:24,950 --> 00:18:31,430
+موازية لل optical axis هذه الأشعة هتخرج
+
+225
+00:18:34,760 --> 00:18:39,060
+و تقطع الـ optical axis عند الـ FP تاع الـ system
+
+226
+00:18:39,060 --> 00:18:44,240
+كله مش تاع العدسة الأخيرة بروح أنا بمدت بشكل
+
+227
+00:18:44,240 --> 00:18:49,080
+مستقيم وهنا بمدت بشكل مستقيم لغاية ما اياش يلتقيوا
+
+228
+00:18:49,080 --> 00:18:53,160
+نقطة التقائهم بسقط منها عمود هذا الـ posterior
+
+229
+00:18:53,160 --> 00:18:59,380
+principal plane احنا قلنا عشان ادرسمن النقطة A
+
+230
+00:18:59,380 --> 00:19:04,440
+بكفيني شعاعين واحد موازي هيدخل في ال FB واحد دخل
+
+231
+00:19:04,440 --> 00:19:11,440
+في ال FA هيخرج موازي والتقائهم
+
+232
+00:19:11,440 --> 00:19:15,940
+بيحدد الصورة وهنا نفس القضية بس بدل عدسة ال
+
+233
+00:19:15,940 --> 00:19:20,000
+optical system كامل حددنا ال posterior principal
+
+234
+00:19:20,000 --> 00:19:23,700
+plane تقاطع مع ال optical axis هو ال posterior
+
+235
+00:19:23,700 --> 00:19:36,380
+principal point ممتاز جداممتاز جدا اتحددوا
+
+236
+00:19:36,380 --> 00:19:43,660
+اربع نقاط لل optical system اذا
+
+237
+00:19:43,660 --> 00:19:49,940
+كانت ال media على جانبي ال optical system هي نفس
+
+238
+00:19:49,940 --> 00:19:54,970
+ال mediaيعني وسط متجانس يعني مش قدامه مي و ورا هو
+
+239
+00:19:54,970 --> 00:20:00,250
+مثلا أو العكس ساعتها ال anterior nodal point تنطبق
+
+240
+00:20:00,250 --> 00:20:03,010
+على ال anterior principal point و ال posterior
+
+241
+00:20:03,010 --> 00:20:07,570
+nodal point تنطبق على ال posterior principal point
+
+242
+00:20:07,570 --> 00:20:14,960
+الست نقاط طالما حددتهمطالما حددتهم هلاجي انه كل ال
+
+243
+00:20:14,960 --> 00:20:19,200
+optical system هذا نعرف إلي طيب لو وجهت إشعاع ال
+
+244
+00:20:19,200 --> 00:20:22,060
+laser باتجاه ال anterior nodal point الشعاع اللي
+
+245
+00:20:22,060 --> 00:20:26,420
+هيخرج هيخرج من هنا و يلتقي عند خط التقاء العدستين
+
+246
+00:20:26,420 --> 00:20:32,760
+تمام؟ الشعاعين السابقين هذه هي ال image ساعتها لو
+
+247
+00:20:32,760 --> 00:20:37,400
+حد سألني هذا ال optical system عبارة عن إيه؟ هنقول
+
+248
+00:20:37,400 --> 00:20:42,580
+له عبارة عن optical system plusplus يعني بيقدر
+
+249
+00:20:42,580 --> 00:20:48,180
+يسويلي real image ال focal point بتاعته على بعد
+
+250
+00:20:48,180 --> 00:20:51,780
+كذا منه ال posterior focal point على بعد كذا منه
+
+251
+00:20:51,780 --> 00:20:56,820
+ال principal planes بتاعته بالشكل التالي وبالتالي
+
+252
+00:20:56,820 --> 00:21:00,540
+بالرسم انا بقدر اجيبه تمام ممكن هذا كله في مجموعة
+
+253
+00:21:00,540 --> 00:21:06,640
+يكونه minus optical system اه بحيث انه لما بوجه
+
+254
+00:21:06,640 --> 00:21:11,420
+شعاع ليزرموازي للـ optical axis بتلاقي بالنهاية
+
+255
+00:21:11,420 --> 00:21:17,010
+هيخرج إياشDivergent Divergent امتداده هيدخل في ال
+
+256
+00:21:17,010 --> 00:21:21,350
+F P اللي بتكون في ال minus system جاية على الشمال
+
+257
+00:21:21,350 --> 00:21:25,310
+تمام فالموديلينج of a non optical system انا
+
+258
+00:21:25,310 --> 00:21:29,050
+استعملت فيه الرسم و الرسم فقط واعتمدت على ال three
+
+259
+00:21:29,050 --> 00:21:32,470
+pairs of reference points وبالتالي حددته لا في
+
+260
+00:21:32,470 --> 00:21:36,250
+داعي اني افكفكم ولا في داعي اني اعرف كل عدسة لان
+
+261
+00:21:36,250 --> 00:21:39,310
+واحدة هيشتغل ك system موحد الكاميرا الصحفية
+
+262
+00:21:39,310 --> 00:21:43,950
+بعدساتها مافيش عدسة بتاخد اجازةمافيش عدسة بتقول
+
+263
+00:21:43,950 --> 00:21:47,450
+انا اليوم مش ناوي اعمل يعني refraction للضوء او
+
+264
+00:21:47,450 --> 00:21:52,250
+انكسار للضوء كله هيكون بيشتغل كتيم مع بعض البعض بس
+
+265
+00:21:52,250 --> 00:21:55,830
+بدل ما اخوض في عملية الفكفكة و ال virgin's
+
+266
+00:21:55,830 --> 00:22:00,550
+calculation عند كل سطح تمام و هذا باعتبره كله كام
+
+267
+00:22:00,550 --> 00:22:04,690
+واحد و بقى استعيد عن كل هذا ال optical system ب
+
+268
+00:22:04,690 --> 00:22:08,880
+two principal planesتقاطعهم مع الـ optical axis
+
+269
+00:22:08,880 --> 00:22:11,620
+هيحدد لي ال principal points ال anterior و ال
+
+270
+00:22:11,620 --> 00:22:15,040
+posterior إذا الوسط متجانس يعني ما أمام ال optical
+
+271
+00:22:15,040 --> 00:22:18,100
+system هو نفسه اللي خلفه ساعتها ال nodal points
+
+272
+00:22:18,100 --> 00:22:21,980
+منطبق على ال principal points وبالتالي أنا حددت
+
+273
+00:22:21,980 --> 00:22:26,360
+إحداثيات هذا ال ..الـ optical system و بقدر أعرف
+
+274
+00:22:26,360 --> 00:22:30,420
+هل هو بيكون لي real image ولا إذا كان مجموعه في
+
+275
+00:22:30,420 --> 00:22:35,080
+مجموعه minus minus optical system تمام بيكون لي
+
+276
+00:22:35,080 --> 00:22:38,900
+virtual image وفق اللي هو هذا طبعا بعد ال object
+
+277
+00:22:38,900 --> 00:22:43,730
+بتحدد عنديوين انا ماسك ال laser pointer هل انا
+
+278
+00:22:43,730 --> 00:22:48,170
+مجربه كتير ولا انا جاي يعني ابعيد يعني هل انا مثلا
+
+279
+00:22:48,170 --> 00:22:53,550
+ال laser pointer ماسكه عند ال FA ولا اقرب من ال FA
+
+280
+00:22:53,550 --> 00:22:57,050
+ولا ابعد من ال FA و هكذا فبالتالي بدون الحاجة
+
+281
+00:22:57,050 --> 00:23:01,490
+لحسابات بالتطبيق العملي وبالتجربة العملية باستعمال
+
+282
+00:23:01,490 --> 00:23:05,650
+laser pointerو ال optical system و يعني إيش اللي
+
+283
+00:23:05,650 --> 00:23:10,370
+بيحصل معايا بأرسمه على الورق فبالتالي بيتحدد معايا
+
+284
+00:23:10,370 --> 00:23:14,490
+ال optical system باستخدام هذه ال reference points
+
+285
+00:23:14,490 --> 00:23:19,110
+حد يسأل سؤال يعطيكوا العافية
+
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/dVq5euZGppM.srt b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/dVq5euZGppM.srt
new file mode 100644
index 0000000000000000000000000000000000000000..b9c7ed4516863fadc6ebe8262e7df1cc7b1cccc4
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/dVq5euZGppM.srt
@@ -0,0 +1,1271 @@
+
+1
+00:00:20,790 --> 00:00:25,010
+بسم الله الرحمن الرحيم، نذكر بالمرات الماضية لما
+
+2
+00:00:25,010 --> 00:00:28,690
+استنتجنا الـ Lens makers equation وقلنا ناقص N على
+
+3
+00:00:28,690 --> 00:00:35,890
+O زائد ان شرطة ناقص N على R يساوي ان شرطة على I أو I
+
+4
+00:00:35,890 --> 00:00:41,890
+ونستبدلها بالـ power، اليوم نحكي عن مفاتيح الـ lenses
+
+5
+00:00:41,890 --> 00:00:48,330
+وبدنا نبدأ الحكي بمفهوم الـ Vergence
+
+6
+00:00:51,160 --> 00:01:01,040
+الـ divergence اللي هو الحالة التشتتية للضوء
+
+7
+00:01:01,040 --> 00:01:07,520
+الحالة التشتتية للضوء، الضوء بيكون على حالة من ثلاث
+
+8
+00:01:07,520 --> 00:01:13,360
+حالات، إما divergence يعني
+
+9
+00:01:13,360 --> 00:01:17,620
+الضوء يبتعد عن بعض البعض، هذه حالته التشتتية
+
+10
+00:01:23,230 --> 00:01:26,570
+موازي لبعض، يعني لا هو divergent ولا هو
+
+11
+00:01:26,570 --> 00:01:30,990
+convergent، تمام، وبنقول عنه الـ divergence بتاعه
+
+12
+00:01:30,990 --> 00:01:35,830
+zero، أو حالته التشتتية zero، zero تعني لا متشتت ولا
+
+13
+00:01:35,830 --> 00:01:41,810
+متجمع، تمام، والحالة التشتتية الثالثة convergent
+
+14
+00:01:41,810 --> 00:01:45,950
+طبعًا
+
+15
+00:01:45,950 --> 00:01:51,180
+هنا negative divergence، الضوء بيبتعد عن بعض، فبقى
+
+16
+00:01:51,180 --> 00:01:55,280
+نعطيه الإشارة الـ minus، هنا positive divergence
+
+17
+00:01:55,280 --> 00:02:00,420
+نعطيه الإشارة الـ plus، نعطيه الإشارة الـ plus، تمام
+
+18
+00:02:00,420 --> 00:02:08,160
+طيب، دراسة الحالة التشتتية للضوء هذه، هتمهد الأمر
+
+19
+00:02:08,160 --> 00:02:12,300
+إلى أن نصل لحاجة أسهل من الـ Lensmakers equation
+
+20
+00:02:12,300 --> 00:02:15,580
+لأن الـ Lensmakers equation اللي قامت على الـ
+
+21
+00:02:15,580 --> 00:02:19,620
+approximation، سهلت موضوع حساب موقع الصورة بشكل إيش
+
+22
+00:02:19,620 --> 00:02:24,520
+كبير جدًا، بس قضية الـ Vergence ومفهوم الـ Vergence
+
+23
+00:02:24,520 --> 00:02:29,320
+هيسهل أكثر زي ما هنشوف بعد شوية، إذًا الـ Vergence هو
+
+24
+00:02:29,320 --> 00:02:34,180
+الحالة التشتتية للضوء، هل هو متشتت أم متجمع؟ إذًا
+
+25
+00:02:34,180 --> 00:02:37,660
+متشتت، حالته التشتتية negative، يعني الأشعة الضوئية
+
+26
+00:02:37,660 --> 00:02:44,420
+بتبعد عن بعضها البعض، إذا بتجمع معناته حالته التشتتية
+
+27
+00:02:44,420 --> 00:02:48,570
+positive Vergence، يعني الأشعة الضوئية بتجمع
+
+28
+00:02:48,570 --> 00:02:53,430
+تمام، وإذا كان الـ Vergence zero معناته الضوء موازي
+
+29
+00:02:53,430 --> 00:02:59,030
+لبعضه البعض، ولا يوجد لا تشتيت ولا تجمع، طيب، وين
+
+30
+00:02:59,030 --> 00:03:02,670
+بنجابل هذه الحلقة؟ وين بنجابل هذه الحلقة؟ لو تصورنا
+
+31
+00:03:02,670 --> 00:03:07,810
+object point، نفرض الـ object عبارة عن النقطة A
+
+32
+00:03:07,810 --> 00:03:13,870
+الضوء هيصدر منها في جميع الاتجاهات، من ضمنها بعض
+
+33
+00:03:13,870 --> 00:03:17,830
+الضوء هيروح للـ Optical System، هذا الضوء في هذه
+
+34
+00:03:17,830 --> 00:03:23,690
+الحالة بيكون إيش؟ Divergent، يعني الضوء الصادر من
+
+35
+00:03:23,690 --> 00:03:28,110
+الأجسام Divergent، تمام؟ Divergent، الآن لما العدسة
+
+36
+00:03:28,110 --> 00:03:32,990
+بتجمع الضوء في صورة، هذا Convergent، إذًا هنا عندي
+
+37
+00:03:32,990 --> 00:03:36,490
+Negative Vergence، وهنا عندي Positive Vergence أو
+
+38
+00:03:36,490 --> 00:03:39,290
+Convergent Light، Convergent Light، هنا الحالة
+
+39
+00:03:39,290 --> 00:03:43,620
+التشتتية negative، هنا الحالة التشتتية positive
+
+40
+00:03:43,620 --> 00:03:49,500
+بمعنى أن الضوء قاعد بيتجمع مش بيتفرق، أحيانًا بيكون
+
+41
+00:03:49,500 --> 00:03:55,140
+الضوء divergent جاي من الـ object، والعدسة بتحاول
+
+42
+00:03:55,140 --> 00:04:00,840
+تجمعه، بس ما بتقدرش، بيكون divergence zero، وهذا
+
+43
+00:04:00,840 --> 00:04:04,600
+هنجيله في وقته، وهذا هنجيله في وقته، الآن نيجي نمسك
+
+44
+00:04:05,340 --> 00:04:09,240
+حالة حالة، اللي هي حالة الـ divergence، لما الضوء
+
+45
+00:04:09,240 --> 00:04:23,480
+بيصدر من الأجسام، منقول
+
+46
+00:04:23,480 --> 00:04:28,460
+عندنا نقطة A بيصدر منها الضوء، بيكون divergence
+
+47
+00:04:28,460 --> 00:04:35,470
+روحنا حطينا احنا عدسة قريب من النقطة A، optical
+
+48
+00:04:35,470 --> 00:04:44,610
+system قريب من النقطة A، هذه العدسة هيكون
+
+49
+00:04:44,610 --> 00:04:50,310
+نصيبها كمية من الأشعة، هي الشعاع الطرفي الأعلى وهي
+
+50
+00:04:50,310 --> 00:04:59,310
+الشعاع الطرفي الأسفل، تمام؟ طيب، هذه العدسة أبعدناها
+
+51
+00:05:03,160 --> 00:05:10,360
+هتلاقي أنه كمية الأشعة اللي جمعتها العدسة وهي
+
+52
+00:05:10,360 --> 00:05:14,340
+بعيدة، أقل من كمية الأشعة اللي جمعتها وهي قريبة
+
+53
+00:05:14,340 --> 00:05:20,800
+بمعنى آخر، الشعاعين الطرفيين قريب من الـ object
+
+54
+00:05:20,800 --> 00:05:28,320
+بيكونوا more divergent، و
+
+55
+00:05:28,320 --> 00:05:31,740
+بعيد عن الـ object، less divergent
+
+56
+00:05:35,620 --> 00:05:39,780
+هذا الشعاع الطرفي الأعلى، وهذا الشعاع الطرفي
+
+57
+00:05:39,780 --> 00:05:44,440
+الأسفل، هو المقصود بالأعلى والأسفل أنه أبعد شعاعين
+
+58
+00:05:46,070 --> 00:05:49,330
+الشعاع اللي بعد ذلك، مش هيدخل في الـ Lens، إيش يعني
+
+59
+00:05:49,330 --> 00:05:51,450
+مش هيدخل في الـ Lens؟ مش هيكون الصورة، يعني مش
+
+60
+00:05:51,450 --> 00:05:54,290
+هيشترك في تكوين الصورة، مين الأشعة اللي بتشارك في
+
+61
+00:05:54,290 --> 00:05:57,610
+تكوين الصورة؟ فقط اللي كان نصيبه يدخل في الـ
+
+62
+00:05:57,610 --> 00:06:01,150
+Optical System، إذًا الشعاع اللي .. اللي بعد الشعاع
+
+63
+00:06:01,150 --> 00:06:05,510
+الأعلى هذا، والشعاع اللي أسفل من الشعاع الأسفل، مش
+
+64
+00:06:05,510 --> 00:06:08,590
+هيشتركوا في تكوين الصورة، أنا بحكي على الأشعة اللي
+
+65
+00:06:08,590 --> 00:06:15,380
+هتدخل في الـ Lens، هذا الشعاع رقم 1 و2، وهنا الشعاع
+
+66
+00:06:15,380 --> 00:06:21,400
+رقم ثلاثة ورقم أربعة، أيهم، أي زوج من الأشعة more
+
+67
+00:06:21,400 --> 00:06:26,660
+divergent؟ ثلاثة وأربعة، لأنه ثلاثة وأربعة، لو مشينا
+
+68
+00:06:26,660 --> 00:06:30,980
+معهم مددهم في خطوط مستقيمة، هنلاقي أنهم more
+
+69
+00:06:30,980 --> 00:06:35,140
+divergent بالمقارنة مع واحد واثنين، إذًا لما نكون
+
+70
+00:06:35,140 --> 00:06:39,160
+أقرب للـ object، بتكون الأشعة more divergent
+
+71
+00:06:41,930 --> 00:06:47,210
+close to the object, light
+
+72
+00:06:47,210 --> 00:06:51,410
+is
+
+73
+00:06:51,410 --> 00:07:03,550
+more divergent، هذه قاعدة، far from the object, light
+
+74
+00:07:03,550 --> 00:07:11,140
+is less divergent، أظن هذه واضحة من المثال اللي احنا
+
+75
+00:07:11,140 --> 00:07:18,360
+ضربناه، كل ما بنكون أقرب من الـ object، كل ما كانت
+
+76
+00:07:18,360 --> 00:07:23,020
+الأشعة more divergent، وكل ما كنا أبعد عن الـ object
+
+77
+00:07:23,020 --> 00:07:27,060
+كل ما كانت الأشعة less divergent، الآن بدنا نعكس
+
+78
+00:07:27,060 --> 00:07:32,400
+المسألة، هنخلّي القاعدتين مكتوبات، وهنعكس المسألة
+
+79
+00:07:32,400 --> 00:07:34,280
+الآن الأشعة دخلت
+
+80
+00:07:36,890 --> 00:07:41,170
+في الـ optical system، وده تروح هيجمعها الـ optical
+
+81
+00:07:41,170 --> 00:07:49,190
+system في صورة، هاي الصورة لإيش؟ أي شرط احنا
+
+82
+00:07:49,190 --> 00:07:54,230
+هنا عند النقطة هاي، لسه بعاد عن الـ image، وفي النقطة
+
+83
+00:07:54,230 --> 00:08:00,390
+هاي قريب من الـ image، وين بيكون الأشعة أو الأشعة
+
+84
+00:08:00,390 --> 00:08:05,460
+الضوئية more convergent؟ اه، لأنه أدا التقى مع بعضه
+
+85
+00:08:05,460 --> 00:08:15,380
+أدا التقى مع بعضه، إذًا close to the image, light
+
+86
+00:08:15,380 --> 00:08:23,940
+is more convergent، وبعيد
+
+87
+00:08:23,940 --> 00:08:27,040
+عن الـ image، far from the image, light
+
+88
+00:08:33,050 --> 00:08:41,130
+is less convergent، هدول
+
+89
+00:08:41,130 --> 00:08:46,550
+الأربع قواعد، أو القواعد، بدنا نلخصهم في رسمة واحدة
+
+90
+00:08:46,550 --> 00:08:52,130
+وهذه الرسمة بدنا نكتب عليها بعض المعطيات البسيطة
+
+91
+00:09:01,890 --> 00:09:10,450
+هنا more divergent، less divergent، less
+
+92
+00:09:10,450 --> 00:09:15,630
+convergent، more
+
+93
+00:09:15,630 --> 00:09:22,110
+convergent، هذه الحالة التشتتية للضوء، وكأنه الضوء
+
+94
+00:09:22,110 --> 00:09:27,050
+بيبدأ متشتت كثير، قصة رحلته، رحلة الضوء، القصة تبدأ
+
+95
+00:09:27,050 --> 00:09:34,910
+بتشتت كثير، أقل تشتت، تجمع، أكثر تجمع، التقاء، تتكون
+
+96
+00:09:34,910 --> 00:09:40,370
+الـ image، هذه القصة، القصة تبدأ متشتتًا بشكل كبير
+
+97
+00:09:42,790 --> 00:09:47,550
+،كلما زادت المسافة، كلما قل التشتت بتاعه
+
+98
+00:09:47,550 --> 00:09:52,030
+بعدين بيصادف الـ optical system، الـ optical system
+
+99
+00:09:52,030 --> 00:09:56,730
+بيحول الـ divergence لـ convergence، تمام، بس الـ
+
+100
+00:09:56,730 --> 00:10:00,210
+convergence في بدايته بيكون أقل، بعدين بيزيد، بيزيد
+
+101
+00:10:00,210 --> 00:10:05,410
+لغاية ما يلتقي، وتتكون إيش الـ image، إذًا الـ
+
+102
+00:10:05,410 --> 00:10:11,810
+divergence of light بيتغير
+
+103
+00:10:12,700 --> 00:10:18,980
+بتغير المسافة، بيتغير
+
+104
+00:10:18,980 --> 00:10:25,580
+بتغير المسافة، يعني
+
+105
+00:10:25,580 --> 00:10:29,820
+إيش فرق النقطة هاي، المسافة هاي، أو الموقع هذا عن
+
+106
+00:10:29,820 --> 00:10:34,310
+الموقع هاي؟ هنا more divergent، بزيادة المسافة صار less
+
+107
+00:10:34,310 --> 00:10:38,490
+divergent، طيب إيش فارق الموقع هذا عن الموقع هذا من
+
+108
+00:10:38,490 --> 00:10:41,970
+حيث الفراغ؟ هنا less convergent، هنا more convergent، طب
+
+109
+00:10:41,970 --> 00:10:47,290
+هنا more and more convergent، تمام، إذًا الـ .. الـ ..
+
+110
+00:10:47,290 --> 00:10:51,490
+الـ .. الـ divergence بيتغير بتغير المسافة، كل ما زادت
+
+111
+00:10:51,490 --> 00:10:58,350
+المسافة بيقل أو بيزيد، تمام، الـ divergence of light
+
+112
+00:10:58,350 --> 00:11:02,150
+يساوي واحد على الـ distance، واحد على المسافة
+
+113
+00:11:06,140 --> 00:11:13,340
+يساوي واحد على المسافة، واضح؟ يعني بنقول ضوء انطلق
+
+114
+00:11:13,340 --> 00:11:22,040
+من النقطة A، وصار في الفراغ مسافة نصف متر، احسب الـ
+
+115
+00:11:22,040 --> 00:11:25,620
+divergence على بُعد نصف متر من الـ object، النقطة A
+
+116
+00:11:25,620 --> 00:11:31,120
+بنقول الـ divergence of light يساوي واحد على الـ
+
+117
+00:11:31,120 --> 00:11:39,550
+distance، على المسافة، ويساوي واحد على نصف متر، ويساوي
+
+118
+00:11:39,550 --> 00:11:46,670
+اثنين، متر⁻¹، ويساوي اثنين ديوبتر، يقاس
+
+119
+00:11:46,670 --> 00:11:51,770
+بالديوبتر، زي ما زي قوة العدسة، تشتت الضوء أو تجمع
+
+120
+00:11:51,770 --> 00:11:57,210
+الضوء، يقاس بالديوبتر، زي ما زي قوة العدسة، تمام؟ زي ما
+
+121
+00:11:57,210 --> 00:12:01,030
+زي قوة العدسة، إذًا الـ divergence هو مقلوب المسافة
+
+122
+00:12:02,350 --> 00:12:06,830
+طيب، بدنا نشوف إن الضوء كل ما بيصير مسافة أكثر، الـ
+
+123
+00:12:06,830 --> 00:12:14,330
+divergence بتاعه بيقل، بدنا نحسب لنفس الضوء على
+
+124
+00:12:14,330 --> 00:12:19,270
+بعد مترين، جداش الـ divergence؟ بنقول واحد على
+
+125
+00:12:19,270 --> 00:12:23,370
+divergence على بُعد مترين بتاع الـ light، واحد على مترين
+
+126
+00:12:23,370 --> 00:12:29,480
+متر، ويساوي نصف ديوبتر، إذًا الـ Vergence قريب من الـ
+
+127
+00:12:29,480 --> 00:12:33,080
+object كان 2 ديوبتر، على بُعد نصف متر، ولما أبعدنا
+
+128
+00:12:33,080 --> 00:12:36,780
+صار نصف ديوبتر، ولو أبعدنا أكثر حيصير ربع ديوبتر،
+
+129
+00:12:36,780 --> 00:12:40,760
+عشر ديوبتر، واحد على عشرة ديوبتر، وهكذا، إذًا كل ما بتزيد
+
+130
+00:12:40,760 --> 00:12:49,760
+المسافة بتقل الـ Vergence، بتقل الـ Vergence، تمام؟
+
+131
+00:12:49,760 --> 00:12:52,820
+الآن
+
+132
+00:12:52,820 --> 00:12:58,420
+في عندي مصطلح جديد، وهذا المصطلح اسمه Reduced
+
+133
+00:12:58,420 --> 00:13:06,440
+Vergence، Reduced Vergence، Reduced
+
+134
+00:13:06,440 --> 00:13:11,920
+Vergence، يعرف على أنه الـ Vergence ضرب
+
+135
+00:13:11,920 --> 00:13:18,860
+الـ refractive index، الـ Vergence ده الـ light ضرب الـ
+
+136
+00:13:18,860 --> 00:13:22,760
+refractive index للمادة اللي بيصير فيها الضوء هذا
+
+137
+00:13:22,760 --> 00:13:29,310
+Reduced Vergence، إيش يعني Reduced؟ المختزل أو المختصر
+
+138
+00:13:29,310 --> 00:13:33,430
+احنا
+
+139
+00:13:33,430 --> 00:13:40,830
+الـ refractive index عمره بيكون أقل من واحد دائمًا
+
+140
+00:13:40,830 --> 00:13:47,050
+غالبا واحد فما فوق، للـ vacuum، في أي مادة ثانية
+
+141
+00:13:47,050 --> 00:13:53,090
+أكثر، لما بندرس الـ Vergence في واحد point كذا، تمام،
+
+142
+00:13:53,090 --> 00:13:57,990
+المفروض تطلع القيمة الكلية أكثر من الـ Vergence نفسه
+
+143
+00:13:57,990 --> 00:14:03,750
+إذًا كقيمة reduced Vergence أكثر من الـ Vergence، طب
+
+144
+00:14:03,750 --> 00:14:11,970
+ليش سُمّي reduced؟ هذا اسم أُطلق بالخطأ، وتجذر مع
+
+145
+00:14:11,970 --> 00:14:17,090
+السنين اللي مضت، لدرجة أنه يعني، جاله، لما بنخليه زي
+
+146
+00:14:17,090 --> 00:14:22,670
+ما هو، يعني لما بنشوف كلمة reduced Vergence، اللي
+
+147
+00:14:22,670 --> 00:14:25,210
+بده يفسرها، لغاية هو، يعني الـ Vergence المختصرة
+
+148
+00:14:25,210 --> 00:14:28,830
+المفروض قيمته أقل من الـ Vergence، بس هو لأنه تعريفه
+
+149
+00:14:28,830 --> 00:14:31,490
+أنه يساوي الـ Vergence، الـ reduced Vergence
+
+150
+00:14:37,140 --> 00:14:41,440
+يساوي الـ Vergence تاع الـ Light في مادة ما، في الـ
+
+151
+00:14:41,440 --> 00:14:43,540
+Refractive Index تاع عادي، المادة اللي بيصير فيها
+
+152
+00:14:43,540 --> 00:14:49,480
+الضوء، قيمته غالبًا أكبر من الـ Vergence، Reduced
+
+153
+00:14:49,480 --> 00:14:55,360
+Vergence، أكبر من الـ Vergence، مصطلح خاطئ وظل متجذر
+
+154
+00:14:55,360 --> 00:15:03,510
+في الكتب، وفي اللي هو، يعني على مدى السنين، فبالتالي
+
+155
+00:15:03,510 --> 00:15:06,770
+تركه العلماء على حاله، بس فهموا أن الـ reduced
+
+156
+00:15:06,770 --> 00:15:11,510
+Vergence قيمته أكبر من الـ Vergence، نضرب مثال على ذلك
+
+157
+00:15:11,510 --> 00:15:18,190
+نقول ضوء انطلق داخل الزجاج، نفرض احنا عندنا مصدر
+
+158
+00:15:18,190 --> 00:15:22,210
+ضوء فيه داخل الزجاج، وده زجاج الـ refractive index
+
+159
+00:15:22,210 --> 00:15:27,370
+هو كذا؟ واحد ونصف، وبنقول احسب الـ Vergence على بُعد
+
+160
+00:15:27,370 --> 00:15:36,790
+متر، الـ Vergence يساوي مقلوب المسافة، ويساوي واحد على
+
+161
+00:15:36,790 --> 00:15:45,650
+واحد متر، ويساوي واحد ديوبتر، تمام، الآن احسب الـ
+
+162
+00:15:45,650 --> 00:15:46,890
+reduced Vergence
+
+163
+00:15:50,750 --> 00:15:55,210
+على المسافة، إيش؟ إن هنا في هذه الحالة للزجاج واحد
+
+164
+00:15:55,210 --> 00:16:00,190
+ونصف × واحد على متر، ما يساوي واحد ونصف ديوبتر، إذًا الـ
+
+165
+00:16:00,190 --> 00:16:05,170
+reduced Vergence أكبر من الـ Vergence، مضبوط؟ مع أنه
+
+166
+00:16:05,170 --> 00:16:14,990
+حسب الاسم المفروض يكون أقل، طيب ماشي، هذا
+
+167
+00:16:14,990 --> 00:16:16,210
+الـ Vergence، تعالوا لوحدي
+
+168
+00:16:19,290 --> 00:16:25,690
+احنا الآن بدنا نضيف كلمة reduced Vergence، بدنا
+
+169
+00:16:25,690 --> 00:16:31,170
+نضيف كلمة object هنا في
+
+170
+00:16:31,170 --> 00:16:35,750
+النص، إيش المقصود بكلمة reduced object Vergence؟
+
+171
+00:16:35,750 --> 00:16:40,190
+يعني الـ reduced Vergence تاع الـ light الصادر من الـ
+
+172
+00:16:40,190 --> 00:16:45,210
+object، هو نفسه reduced Vergence، بس لما بحط كلمة
+
+173
+00:16:45,210 --> 00:16:48,270
+object بعرف أن هذا الـ light الصادر من الـ object
+
+174
+00:16:53,280 --> 00:17:03,280
+تمام، لو حطيت reduced image Vergence، يعني هذا الـ
+
+175
+00:17:03,280 --> 00:17:07,140
+reduced Vergence بتاع الـ light اللي رايح يكون الـ
+
+176
+00:17:07,140 --> 
+
+223
+00:21:55,480 --> 00:21:59,560
+فيهم شغل الأربع اللي ضاعتها من قوة العدسة وكأن
+
+224
+00:21:59,560 --> 00:22:05,600
+العدسة أنفقت من قوتها +2 عشان تلغي التشتت كأن
+
+225
+00:22:05,600 --> 00:22:10,220
+العدسة أنفقت من قوتها الـ +6 ديوبتر، أنفقت الـ
+
+226
+00:22:10,220 --> 00:22:14,800
++2 ليش أنفقتهم؟ لأنه جاء الضوء متشتت، وهيبدأ
+
+227
+00:22:14,800 --> 00:22:19,560
+تجمعه، ما تجمعه، لازم تلغي التشتت بتاعه، تصفره
+
+228
+00:22:20,330 --> 00:22:25,890
+صفرت تشتت +2 و -2 بيصير صفر، أصبح الضوء
+
+229
+00:22:25,890 --> 00:22:31,550
+متوازى، بس لسه باقى معها قوة +4، بتجمع فيهم إيه؟
+
+230
+00:22:31,550 --> 00:22:36,670
+إيش الضوء؟ V تساوي +4 ديوبتر، إيش V تساوي؟ V
+
+231
+00:22:36,670 --> 00:22:44,710
+تساوي n شرطة على I، صح؟ إذا I تساوي n شرطة على V
+
+232
+00:22:44,710 --> 00:22:48,450
+وهي تساوي n شرطة في الهواء، إحنا بنحكي عن الهواء، واحد
+
+233
+00:22:49,520 --> 00:22:55,880
+وهي تساوي 1 على +4 ديوبتر، تمام؟ إيش
+
+234
+00:22:55,880 --> 00:23:01,380
+الديوبتر؟ اللي هو متر<sup>-1</sup>، مظبوط؟ واحد على
+
+235
+00:23:01,380 --> 00:23:06,420
+أربعة، ربع، والمتر<sup>-1</sup> متر، إذا الصورة
+
+236
+00:23:06,420 --> 00:23:12,280
+هتتكون على بعد ربع متر من الـ optical system، واضح؟
+
+237
+00:23:12,280 --> 00:23:17,950
+إذا هي مسافة الـ image، وهي مسافة الـ object الـ
+
+238
+00:23:17,950 --> 00:23:21,930
+transfer magnification إيش يساوي؟ image distance
+
+239
+00:23:21,930 --> 00:23:28,130
+على... وهي تساوي الـ image distance ربع متر، والـ
+
+240
+00:23:28,130 --> 00:23:37,670
+object distance كده؟ -0.5 متر، -0.5 متر
+
+241
+00:23:37,670 --> 00:23:43,910
+-0.5 متر، إذا الـ Transverse Magnification ضرب
+
+242
+00:23:43,910 --> 00:23:50,610
++ على -، - و ربع على نص، -0.5، إيش
+
+243
+00:23:50,610 --> 00:23:57,010
+تعني أن الصورة مقلوبة وارتفاعها نصف ارتفاع الـ
+
+244
+00:23:57,010 --> 00:23:58,890
+object، ناخد مسألة ثانية
+
+245
+00:24:16,800 --> 00:24:26,520
+عدسة +1.25 ديوبتر، object على بعد أربعة
+
+246
+00:24:26,520 --> 00:24:35,220
+متر، بدي الـ image و الـ transfer magnification سريعا
+
+247
+00:24:35,220 --> 00:24:40,700
+U تساوي -n على O، يساوي -1 على 4 متر
+
+248
+00:24:40,700 --> 00:24:46,820
+ويساوي -0.25 ديوبتر، لما بيطلع بيصير متر<sup>-1</sup>
+
+249
+00:24:46,820 --> 00:24:49,880
+<sup>-1</sup> اللي هو الديوبتر، ع السريع بروح بحط
+
+250
+00:24:49,880 --> 00:24:57,680
+-0.25 ديوبتر، الضوء متشتت بمقدار 0.25 ديوبتر
+
+251
+00:24:57,680 --> 00:25:02,000
+قداش هتنفق العدسة على إلغاء الـ 0.25؟ 0.25 مقابله، بس
+
+252
+00:25:02,000 --> 00:25:05,760
++ هيتاخد من الـ +1.25، بدنا 0.25 لسداد
+
+253
+00:25:05,760 --> 00:25:09,880
+الدين، بظل واحد تلقائيا، ما فيش، ده اللي هي الـ U
+
+254
+00:25:09,880 --> 00:25:15,170
+زاد بيه، تمام؟ من الـ +1.25 العدسة بتنفق
+
+255
+00:25:15,170 --> 00:25:20,350
+0.25 عشان تسد الدين، الدين اللي هو تشتت الضوء بمقدار
+
+256
+00:25:20,350 --> 00:25:26,770
+0.25، تمام؟ إذا V تساوي كده؟ +1 ديوبتر، I
+
+257
+00:25:26,770 --> 00:25:31,770
+تساوي n شرطة على V، ويساوي 1 على 1 ديوبتر
+
+258
+00:25:31,770 --> 00:25:36,570
+الديوبتر اللي هو متر<sup>-1</sup>، ويساوي 1 متر
+
+259
+00:25:36,570 --> 00:25:44,450
+إذا الصورة هتتكون على بعد 1 متر من الـ optical
+
+260
+00:25:44,450 --> 00:25:49,670
+system، طيب transference magnification يساوي image
+
+261
+00:25:49,670 --> 00:25:53,830
+distance على object distance، ويساوي image distance
+
+262
+00:25:53,830 --> 00:26:01,170
+1 متر، والـ object distance -4 متر، ويساوي ضرب
+
+263
+00:26:01,170 --> 00:26:07,380
+-0.25، إيش يعني ضرب -0.25؟ مقلوبة وارتفاعها
+
+264
+00:26:07,380 --> 00:26:14,660
+ربع ارتفاع الـ object، ناخد مسألة أخرى
+
+265
+00:26:14,660 --> 00:26:20,360
+الصورة
+
+266
+00:26:20,360 --> 00:26:23,360
+أصبحت مسافتها، الـ location، والـ magnification
+
+267
+00:26:23,360 --> 00:26:30,540
+بنجيبه في أقل من نصف دقيقة، تمام؟ نقول كالقاتل، +
+
+268
+00:26:30,540 --> 00:26:40,900
+7 diopter lens، وعندي object عبارة عن ثلث متر، بدي الـ
+
+269
+00:26:40,900 --> 00:26:48,820
+image، وبدي الـ transfers magnification، بنقول U
+
+270
+00:26:48,820 --> 00:26:55,320
+تساوي -N على O، ويساوي -1 على ثلث متر
+
+271
+00:26:55,320 --> 00:27:00,240
+مقام لمقام، بس، إذا -3 متر<sup>-1</sup>، -1
+
+272
+00:27:00,240 --> 00:27:06,480
+يعني -3 ديوبتر، إذا الـ V قداش؟ +4، أنا جيت
+
+273
+00:27:06,480 --> 00:27:12,600
+مدينة تلاتة ومعاه سبعة، بيديني أربعة، V تساوي n
+
+274
+00:27:12,600 --> 00:27:17,100
+شرطة على I، إذن I، اللي هي المطلوب الأول، تساوي n
+
+275
+00:27:17,100 --> 00:27:21,080
+شرطة على V، بنبدل هاي مكان هاي، ويساوي 1، طالما
+
+276
+00:27:21,080 --> 00:27:25,540
+أنا في الهواء، على +4 ديوبتر، أبدلها بمتر<sup>-1</sup>
+
+277
+00:27:25,540 --> 00:27:31,230
+ومتر<sup>-1</sup>، إذن 0.25 متر، +0.25 متر، يعني على
+
+278
+00:27:31,230 --> 00:27:37,230
+يمين الـ optical system بمقدار 0.25 متر، تمام؟ يا دكتور
+
+279
+00:27:37,230 --> 00:27:42,190
+الـ transfer magnification، transfer magnification
+
+280
+00:27:42,190 --> 00:27:46,470
+يساوي image distance على object distance، ويساوي
+
+281
+00:27:46,470 --> 00:27:53,590
+image distance 0.25 متر على، ممتازين جدا، -ثلث
+
+282
+00:27:53,590 --> 00:28:04,180
+متر، ويساوي 0.25 في -3، ويساوي ضرب -0.75
+
+283
+00:28:04,180 --> 00:28:09,800
+صحيح؟ إيش يعني ضرب -0.75؟ يعني
+
+284
+00:28:09,800 --> 00:28:12,900
+الصورة مقلوبة، الـ - يعني مقلوبة، و 0.75
+
+285
+00:28:12,900 --> 00:28:17,680
+ارتفاع الـ object، يعني إذا الـ object 10 سم، الـ
+
+286
+00:28:17,680 --> 00:28:22,520
+image 7.5 سم، 7.5 سم، واضح؟ ناخد
+
+287
+00:28:22,520 --> 00:28:23,120
+كمان مسألة
+
+288
+00:29:10,680 --> 00:29:14,320
+هي عندكم الصورة، الـ object  عبارة عن 20 سم، الـ image
+
+289
+00:29:14,320 --> 00:29:18,020
+عبارة عن 1 متر، هو الحاجة المطلوبة، الـ power بتاعة الـ
+
+290
+00:29:18,020 --> 00:29:25,780
+lens، ثانية حاجة، الـ transfer magnification، تمام؟ من
+
+291
+00:29:25,780 --> 00:29:34,360
+GPU، -N على O، يساوي -1 على القياسات
+
+292
+00:29:34,360 --> 00:29:40,530
+مترية، 2 من 10 متر، 2 من 10 متر، 1 على 2
+
+293
+00:29:40,530 --> 00:29:48,070
+من 10، 5 ديوبتر، -5 ديوبتر، الـ image، الـ V
+
+294
+00:29:48,070 --> 00:29:52,890
+تساوي n شرطة على I، يساوي 1 على 1 متر
+
+295
+00:29:52,890 --> 00:29:58,090
+ويساوي +1 ديوبتر، ليش هنا أقول +؟ مش عشان
+
+296
+00:29:58,090 --> 00:30:04,600
+هذا اليمين، عشان الأشعة convergent، تمام؟ U + P
+
+297
+00:30:04,600 --> 00:30:11,580
+يساوي V، مين المجهول الوحيد عندنا؟ P، U قداش؟ -5
+
+298
+00:30:11,580 --> 00:30:18,380
+ديوبتر، + P يساوي +1 ديوبتر، إذا P تساوي
+
+299
+00:30:18,380 --> 00:30:24,140
+قداش؟ +6 ديوبتر، +6 ديوبتر، لما هذه بتنتقل
+
+300
+00:30:24,140 --> 00:30:29,620
+بتصير بالـ +5، 1، 6، إذا أوجدنا هي +6 ديوبتر
+
+301
+00:30:32,940 --> 00:30:36,120
+العنصر المطلوب الثاني، image distance على object
+
+302
+00:30:36,120 --> 00:30:40,120
+distance، لو transfers magnification يساوي image
+
+303
+00:30:40,120 --> 00:30:44,580
+distance على object distance، يساوي 1 متر على
+
+304
+00:30:45,940 --> 00:30:50,140
+-0.2 متر، المتر مع المتر بيروح، ضرب
+
+305
+00:30:50,140 --> 00:30:54,600
+-5، إيش يعني ضرب -5؟ يعني الصورة
+
+306
+00:30:54,600 --> 00:31:00,380
+مقلوبة وارتفاعها إيش؟ 5 مرات أو 5 أضعاف ارتفاع
+
+307
+00:31:00,380 --> 00:31:05,380
+الـ object، واضح؟ طيب ناخد كمان مسألة، شايفين كم مسألة
+
+308
+00:31:05,380 --> 00:31:13,080
+حلينا، يعني إذا رحلة الضوء أو صفات الصورة اللي بنقدر
+
+309
+00:31:13,080 --> 00:31:15,860
+نحصل عليها، ليه؟ الـ magnification والـ location، أصبح
+
+310
+00:31:15,860 --> 00:31:20,360
+نعيش... بنقدر نتعامل معاه بشكل سريع للغاية، بدون
+
+311
+00:31:20,360 --> 00:31:26,740
+الحاجة للـ service normal ولا ل... يعني exact ray
+
+312
+00:31:26,740 --> 00:31:33,200
+tracing، تمام؟ طيب ناخد مسألة ثانية، بنقول كالقاتل
+
+313
+00:31:33,200 --> 00:31:40,940
+نصف متر، والعدسة +2، where is the image؟
+
+314
+00:31:47,600 --> 00:31:53,260
+الحل، U تساوي -N على O، يساوي -1 على نصف
+
+315
+00:31:53,260 --> 00:31:59,880
+متر، ويساوي -2 ديوبتر، ع السريع بقول وصلت
+
+316
+00:31:59,880 --> 00:32:05,800
+-2 ديوبتر، العدسة قداش قوتها؟ تمام، الـ V إيش
+
+317
+00:32:05,800 --> 00:32:12,730
+هتكون هنا إيش؟ يعني صفر، الأشعة هتطلع متوازية، الـ
+
+318
+00:32:12,730 --> 00:32:16,090
+image هتتكون في الـ ∞ هنا، على يمين الـ optical
+
+319
+00:32:16,090 --> 00:32:19,950
+system، ∞ بيسموه مسافة ∞، في الـ optical
+
+320
+00:32:19,950 --> 00:32:25,030
+infinity، اللي مش مصدق يروح على الـ infinity ويستنى
+
+321
+00:32:25,030 --> 00:32:29,510
+الصورة هناك، طبعا هي ممكن تتكون الصورة، إن أحط كمان
+
+322
+00:32:29,510 --> 00:32:35,250
+عدسة + وأطلق الصورة، كيف أطلق الصورة؟ الأشعة
+
+323
+00:32:35,250 --> 00:32:38,950
+المتوازية، الـ virgins، الـ V بتاعها صفر، لما تصل هنا لـ
+
+324
+00:32:38,950 --> 00:32:47,290
+U بتاعها صفر، ما بغلبش حالي إن أحسبه، الأشعة المتوازية الـ
+
+325
+00:32:47,290 --> 00:32:51,510
+virgins تقع في ∞، يعني لا هي متشتتة ولا هي متجمعة، و
+
+326
+00:32:51,510 --> 00:32:55,410
+بدون حسابات، بدون ما أقول U تساوي -N على O، أو
+
+327
+00:32:55,410 --> 00:33:00,790
+أقول V تساوي n شرطة على I، معروف إن الـ virgins ∞
+
+328
+00:33:00,790 --> 00:33:04,530
+ناخد كمان مسألة
+
+329
+00:33:16,800 --> 00:33:27,240
+عدسة +10 ديوبتر، الصورة اتكونت على بعد نصف
+
+330
+00:33:27,240 --> 00:33:31,160
+متر، where
+
+331
+00:33:31,160 --> 00:33:37,970
+was the object؟ وما هو الـ transfer magnification؟ أول
+
+332
+00:33:37,970 --> 00:33:42,250
+حاجة، ببدأ بالـ V، V تساوي n شرطة على I، ويساوي
+
+333
+00:33:42,250 --> 00:33:47,690
+1 على نصف متر، ويساوي +2 ديوبتر، +
+
+334
+00:33:47,690 --> 00:33:54,630
+2 ديوبتر، لأن أسأل حالي سؤال بسيط، كيف عرفته؟
+
+335
+00:33:56,730 --> 00:34:00,810
+راح معايا 10، شكل قدرت أشتري بـ 2، معناته كان
+
+336
+00:34:00,810 --> 00:34:07,170
+عليا دين قداش؟ 8، اللي متغلب، U + P يساوي V، V
+
+337
+00:34:07,170 --> 00:34:15,090
+قداش؟ +2، والـ P +10، تساوي U، مظبوط؟ U
+
+338
+00:34:15,090 --> 00:34:23,070
++ P يساوي 10، الـ U بتضلها هنا +2، هذه
+
+339
+00:34:23,070 --> 00:34:28,460
+بتصير -8، ويساوي 10 - 8 ديوبتر، إذا -
+
+340
+00:34:28,460 --> 00:34:33,540
+8 ديوبتر، لسه أنا ما جبتش الـ object، الآن U
+
+341
+00:34:33,540 --> 00:34:40,560
+تساوي -n على O، هو يساوي، طبعا إحنا بنقول لما
+
+342
+00:34:40,560 --> 00:34:44,280
+الـ object يكون مجهول مسافته بالنسبة لنا، بنحط لها
+
+343
+00:34:44,280 --> 00:34:50,880
+إشارة، تمام؟ الـ U قداش؟ -8 ديوبتر، يساوي
+
+344
+00:34:50,880 --> 00:34:57,840
+1 على O، إذن O تساوي 1 على -8 ديوبتر، اللي هو متر<sup>-1</sup>، ويساوي
+
+345
+00:34:57,840 --> 00:35:01,200
+-0.125 متر، يعني -12.5 سم، -12.5 سم
+
+346
+00:35:01,200 --> 00:35:09,620
+ونص، واضح؟ طيب، طبعا هنا المسافة بالـ - يعني ع شمال
+
+347
+00:35:09,620 --> 00:35:14,600
+الـ optical system، ع شمال الـ optical system، طيب
+
+348
+00:35:14,600 --> 00:35:18,460
+okay، لأن الـ transfer magnification يساوي image
+
+349
+00:35:18,460 --> 00:35:23,090
+distance على object distance، الـ image distance نصف
+
+350
+00:35:23,090 --> 00:35:26,350
+متر على object distance، ويساوي قداش؟ -4، أحسنتم
+
+351
+00:35:26,350 --> 00:35:35,230
+أحسنتم، ممتاز جدا، ضرب -4، إيش يعني ضرب
+
+352
+00:35:35,230 --> 00:35:41,130
+-4؟ - يعني الصورة مقلوبة، - يعني
+
+353
+00:35:41,130 --> 00:35:47,330
+الصورة مقلوبة، وأربعة أضعاف ارتفاع الـ object، واضحة
+
+354
+00:35:47,330 --> 00:35:53,960
+المسألة هاه؟ طيب، هذه
+
+355
+00:35:53,960 --> 00:36:00,320
+قضية الـ virgins، من هنا فالسعادة، هيصير غالبا يتحل
+
+356
+00:36:00,320 --> 00:36:05,440
+على هذه المسائل، طبعا هيدخل بعدها في الحل إن عندي
+
+357
+00:36:05,440 --> 00:36:11,020
+optical system مكون من عدستين، فأكثر من عدستين
+
+358
+00:36:11,020 --> 00:36:15,220
+فأكثر، تمام؟ الشيء اللي بنذكره فيه، بنقول إنه ما ننساش
+
+359
+00:36:15,220 --> 00:36:20,120
+الإشارة، ده إطلاقا، الإشارة الآن الها يعني، عرف، ما
+
+360
+00:36:20,120 --> 00:36:26,420
+فوق الـ optical axis +، ما تحت الـ optical axis
+
+361
+00:36:26,420 --> 00:36:29,500
+-، عن يمين الـ optical system +، عن شماله
+
+362
+00:36:29,500 --> 00:36:33,200
+-، ضوء متشتت -، ضوء متجمع +، واضح؟ هذه
+
+363
+00:36:33,200 --> 00:36:41,540
+القواعد، مش لازم إحنا أياش ننساها، حد يسأل سؤال؟
+
+364
+00:36:47,840 --> 00:36:48,660
+يعطيكم العافية
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/dVq5euZGppM_raw.srt b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/dVq5euZGppM_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..b773750358707a7d850f8e9d57e27252c5797607
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/dVq5euZGppM_raw.srt
@@ -0,0 +1,1460 @@
+1
+00:00:20,790 --> 00:00:25,010
+بسم الله الرحمن الرحيم بنذكر بالمرات الماضية لما
+
+2
+00:00:25,010 --> 00:00:28,690
+استنتجنا ال lens makers equation وقلنا ناقص N على
+
+3
+00:00:28,690 --> 00:00:35,890
+O زائد ان شرط ناقص N على R يساوي ان شرط على I أو I
+
+4
+00:00:35,890 --> 00:00:41,890
+ونستبدلها بال power اليوم نحكي عن مفتالم ال lenses
+
+5
+00:00:41,890 --> 00:00:48,330
+وبدنا نبدأ الحكي بمفهوم ال virgins
+
+6
+00:00:51,160 --> 00:01:01,040
+الـ divergence اللي هو الحالة التشتتية للضوء
+
+7
+00:01:01,040 --> 00:01:07,520
+الحالة التشتتية للضوء الضوء بيكون على حالة من تلت
+
+8
+00:01:07,520 --> 00:01:13,360
+حالات إما divergence يعني
+
+9
+00:01:13,360 --> 00:01:17,620
+الضوء يبتعد عن بعض البعض هذه حالته التشتتية
+
+10
+00:01:23,230 --> 00:01:26,570
+موازي لبعض و لبعض يعني لا هو divergent ولا هو
+
+11
+00:01:26,570 --> 00:01:30,990
+convergent تمام و بنقول عنه ال divergence بتاعه
+
+12
+00:01:30,990 --> 00:01:35,830
+zero او حالته التشتتية zero zero تعني لا متشتت ولا
+
+13
+00:01:35,830 --> 00:01:41,810
+متجمع تمام و الحالة التشتتية التالتة convergent
+
+14
+00:01:41,810 --> 00:01:45,950
+طبعا
+
+15
+00:01:45,950 --> 00:01:51,180
+هنا negative divergenceالضوء بيبتعد عن بعض فبقى
+
+16
+00:01:51,180 --> 00:01:55,280
+اعطوله الإشارة ال minus هنا positive divergence
+
+17
+00:01:55,280 --> 00:02:00,420
+اعطوله الإشارة ال plus اعطوله الإشارة ال plus تمام
+
+18
+00:02:00,420 --> 00:02:08,160
+طيب دراسة الحالة التشتتية للضوء هذه هتمتهيبالأمر
+
+19
+00:02:08,160 --> 00:02:12,300
+إلى إنه نصل لحاجة أسهل من الـ Lensmakers equation
+
+20
+00:02:12,300 --> 00:02:15,580
+ما أنه الـ Lensmakers equation اللي قامت على ال
+
+21
+00:02:15,580 --> 00:02:19,620
+approximation سهلت موضوع حساب موقع الصورة بشكل إيش
+
+22
+00:02:19,620 --> 00:02:24,520
+كبير جدا بس قضية ال Virgin's ومفهوم ال Virgin's
+
+23
+00:02:24,520 --> 00:02:29,320
+هيسهل أكتر زي ما هنشوف بعد شوية إذا ال Virgin's هو
+
+24
+00:02:29,320 --> 00:02:34,180
+الحالة التشتتية للضوء هل هو متشتت ولا متجمع؟إذا
+
+25
+00:02:34,180 --> 00:02:37,660
+متشتت حالته التشتتية negative يعني الأشياء الضوئية
+
+26
+00:02:37,660 --> 00:02:44,420
+بتبعد عن بعض البعض إذا بتجمع معناته حالته التشتتة
+
+27
+00:02:44,420 --> 00:02:48,570
+انه جادpositive versions يعني جاهد الضوء بتجمع
+
+28
+00:02:48,570 --> 00:02:53,430
+تمام وإذا كان ال versions zero معناته الضوء موازي
+
+29
+00:02:53,430 --> 00:02:59,030
+لبعض لبعض ولا يوجد لا تشتيت ولا تجمر طيب وين
+
+30
+00:02:59,030 --> 00:03:02,670
+بنجابل هذه الحلقة وين بنجابل هذه الحلقة لو تصورنا
+
+31
+00:03:02,670 --> 00:03:07,810
+object point نفرض ال object عبارة عن النقطة A
+
+32
+00:03:07,810 --> 00:03:13,870
+الضوء هيصدر منها في جميع الاتجاهات من ضمنها بعض
+
+33
+00:03:13,870 --> 00:03:17,830
+الضوء هيروحللـ Optical System هذا الضوء في هذه
+
+34
+00:03:17,830 --> 00:03:23,690
+الحالة بيكون ايش؟ Divergent يعني الضوء الصادر من
+
+35
+00:03:23,690 --> 00:03:28,110
+الأجسام Divergent تمام؟ Divergent الآن لما العدسة
+
+36
+00:03:28,110 --> 00:03:32,990
+بتجمع الضوء في صورة هذا Convergent اذا هنا عندي
+
+37
+00:03:32,990 --> 00:03:36,490
+Negative Vergence وهنا عندي Positive Vergence او
+
+38
+00:03:36,490 --> 00:03:39,290
+Convergent Light Convergent Light هنا الحالة
+
+39
+00:03:39,290 --> 00:03:43,620
+التشتتيةnegative هنا الحالة التشتتية positive
+
+40
+00:03:43,620 --> 00:03:49,500
+بمعنى ان الضوء قاعد بتجمع مش بيتفرق أحيانا بيكون
+
+41
+00:03:49,500 --> 00:03:55,140
+الضوء divergent جاي من ال object و العدسة بتحاول
+
+42
+00:03:55,140 --> 00:04:00,840
+تجمعه بس مابتقدرش بيكون divergence zero وهذا
+
+43
+00:04:00,840 --> 00:04:04,600
+هنجيله في وقته وهذا هنجيله في وقته الآن نيجي نمسك
+
+44
+00:04:05,340 --> 00:04:09,240
+حالة حالة اللي هي حالة ال divergence لما الضوء
+
+45
+00:04:09,240 --> 00:04:23,480
+بيصدر من الأجسام منقول
+
+46
+00:04:23,480 --> 00:04:28,460
+عندنا نقطة ايه بيصدر منها الضوء بيكون divergence
+
+47
+00:04:28,460 --> 00:04:35,470
+روحنا حطينا احنا عدسةقريب من النقطة A optical
+
+48
+00:04:35,470 --> 00:04:44,610
+system قريب من النقطة A هذه العدسة هيكون
+
+49
+00:04:44,610 --> 00:04:50,310
+نصيبها كمية من الأشعة هي الشعاع الطرفي الأعلى وهي
+
+50
+00:04:50,310 --> 00:04:59,310
+الشعاع الطرفي الأسفل تمام؟ طيب هذه العدسة أبعدناها
+
+51
+00:05:03,160 --> 00:05:10,360
+هتلاقي إنه كمية الأشعة اللي جمعتها العدسة و هي
+
+52
+00:05:10,360 --> 00:05:14,340
+بعيدة أقل من كمية الأشعة اللي جمعتها و هي قريبة
+
+53
+00:05:14,340 --> 00:05:20,800
+بمعنى آخر الشعين الطرفيين قريب من ال object
+
+54
+00:05:20,800 --> 00:05:28,320
+بيكونوا more divergent و
+
+55
+00:05:28,320 --> 00:05:31,740
+بعيد عن ال object less divergent
+
+56
+00:05:35,620 --> 00:05:39,780
+هذا الشوائع الطرفي الأعلى وهذا الشوائع الطرفي
+
+57
+00:05:39,780 --> 00:05:44,440
+الأسفل هو المقصود بالأعلى والأسفل أنه أبعد شوائعين
+
+58
+00:05:46,070 --> 00:05:49,330
+الشعاع اللي بعد ذلك مش هيدخل في الـ Lens إيش يعني
+
+59
+00:05:49,330 --> 00:05:51,450
+مش هيدخل في الـ Lens؟ مش هيكون الصورة يعني مش
+
+60
+00:05:51,450 --> 00:05:54,290
+هيشترك في تكوين الصورة مين الأشعة اللي بتشارك في
+
+61
+00:05:54,290 --> 00:05:57,610
+تكوين الصورة؟ فقط اللي كان نصيبة تدخل في الـ
+
+62
+00:05:57,610 --> 00:06:01,150
+Optical System إذا الشعاع اللي .. اللي بعد الشعاع
+
+63
+00:06:01,150 --> 00:06:05,510
+الأعلى هذا و الشعاع اللي أسفل من الشعاع الأسفل مش
+
+64
+00:06:05,510 --> 00:06:08,590
+هيشاركوا في تكوين الصورة أنا بحكي على أشعة اللي
+
+65
+00:06:08,590 --> 00:06:15,380
+هتدخل في الـ Lens هذا الشعاع رقم 1 و 2وهنا الشعاع
+
+66
+00:06:15,380 --> 00:06:21,400
+رقم تلاتة ورقم أربعة أيهم أي زوج من الأشعة more
+
+67
+00:06:21,400 --> 00:06:26,660
+divergent؟ تلاتة وأربعة لأنه تلاتة وأربعة لو مشينا
+
+68
+00:06:26,660 --> 00:06:30,980
+معهم مدنهم في خطوط مستقيمة هنلاقي أنهم more
+
+69
+00:06:30,980 --> 00:06:35,140
+divergent بالمقارنة مع واحد واثنين إذا لما نكون
+
+70
+00:06:35,140 --> 00:06:39,160
+أقرب لل object بتكون الأشعة more divergent
+
+71
+00:06:41,930 --> 00:06:47,210
+close to the object light
+
+72
+00:06:47,210 --> 00:06:51,410
+is
+
+73
+00:06:51,410 --> 00:07:03,550
+more divergent هذه قاعدة far from the object light
+
+74
+00:07:03,550 --> 00:07:11,140
+is less divergentأظن هذه واضحة من المثال اللي احنا
+
+75
+00:07:11,140 --> 00:07:18,360
+ضربنا كل ما بنكون أقرب من ال object كل ما كانت
+
+76
+00:07:18,360 --> 00:07:23,020
+الأشعة more divergent وكل ما كنا أبعد عن ال object
+
+77
+00:07:23,020 --> 00:07:27,060
+كل ما كانت الأشعة less divergent الآن بدنا نعكس
+
+78
+00:07:27,060 --> 00:07:32,400
+المسألة هنخل القاعدتين مكتوبات و هنعكس المسألة
+
+79
+00:07:32,400 --> 00:07:34,280
+الآن الأشعة دخلت
+
+80
+00:07:36,890 --> 00:07:41,170
+في الـ optical system وده تروح هيجمعها ال optical
+
+81
+00:07:41,170 --> 00:07:49,190
+system في صورة هاي الصورة لإيه اي شرط احنا
+
+82
+00:07:49,190 --> 00:07:54,230
+هنا عند النقطة هاي لسه بعاد عن ال image وفي النقطة
+
+83
+00:07:54,230 --> 00:08:00,390
+هاي اجراب من ال image وين بيكون الأشعاع أو الأشعاع
+
+84
+00:08:00,390 --> 00:08:05,460
+الضوئية more convergentأه لأنه أدوا التقى مع بعضه
+
+85
+00:08:05,460 --> 00:08:15,380
+أدوا التقى مع بعضه إذا close to the image light
+
+86
+00:08:15,380 --> 00:08:23,940
+is more convergent وبعيد
+
+87
+00:08:23,940 --> 00:08:27,040
+عن ال image far from the image light
+
+88
+00:08:33,050 --> 00:08:41,130
+is less convergent هدول
+
+89
+00:08:41,130 --> 00:08:46,550
+الأربع قاعدات أو قواعد بدنا نلخصهم في رسمة واحدة
+
+90
+00:08:46,550 --> 00:08:52,130
+وهذه الرسمة بدنا نكتب عليها بعض المعطيات البسيطة
+
+91
+00:09:01,890 --> 00:09:10,450
+هنا more divergent less divergent less
+
+92
+00:09:10,450 --> 00:09:15,630
+convergent more
+
+93
+00:09:15,630 --> 00:09:22,110
+convergent هذه الحالة التشتتية للضوء وكأنه الضوء
+
+94
+00:09:22,110 --> 00:09:27,050
+بيبدأ متشتت كتير قصة رحلته رحلة الضوء القصة تبدأ
+
+95
+00:09:27,050 --> 00:09:34,910
+تشتت كتيرأقل تشتت، تجمع، أكثر تجمع، التقاء، اتكونة
+
+96
+00:09:34,910 --> 00:09:40,370
+الإمش، هذه القصة القصة الدوق صدر متشتتا بشكل كبير
+
+97
+00:09:42,790 --> 00:09:47,550
+روح المسافة كل ما بتزيد المسافة بجل التشتت بتاعه
+
+98
+00:09:47,550 --> 00:09:52,030
+بعدين بيصادف ال optical system ال optical system
+
+99
+00:09:52,030 --> 00:09:56,730
+بيحول ال divergence ل convergence تمام بس ال
+
+100
+00:09:56,730 --> 00:10:00,210
+convergence في بدايته بيكون أقل بعدين بيزيد بيزيد
+
+101
+00:10:00,210 --> 00:10:05,410
+لغاية ما يلتقي و تتكون ايش ال image اذا ال
+
+102
+00:10:05,410 --> 00:10:11,810
+divergence of light يتغير
+
+103
+00:10:12,700 --> 00:10:18,980
+بتغير المسافة يتغير
+
+104
+00:10:18,980 --> 00:10:25,580
+بتغير المسافة يعني
+
+105
+00:10:25,580 --> 00:10:29,820
+ايش فرق النقطة هاي المسافة هاي او الموقع هذا عن
+
+106
+00:10:29,820 --> 00:10:34,310
+الموقع هاي هنا more divergentجبع مسافة صار less
+
+107
+00:10:34,310 --> 00:10:38,490
+divergent طيب إيش فارق الموقع هذا عن الموقع هذا من
+
+108
+00:10:38,490 --> 00:10:41,970
+الفراغ هنا less convergent هنا more convergent طب
+
+109
+00:10:41,970 --> 00:10:47,290
+هنا more and more convergent تمام إذا ال .. ال ..
+
+110
+00:10:47,290 --> 00:10:51,490
+ال .. ال divergence بتغير بتغير المسافة كل ما زادت
+
+111
+00:10:51,490 --> 00:10:58,350
+المسافة بيجل أو بيزيد تمام ال divergence of light
+
+112
+00:10:58,350 --> 00:11:02,150
+يساوي واحد على ال distance واحد على المسافة
+
+113
+00:11:06,140 --> 00:11:13,340
+يساوي واحد على المسافة واضح يعني بنقول ضوء انطلق
+
+114
+00:11:13,340 --> 00:11:22,040
+من النقطة A وصار في الفراغ مسافة نص متر احسب ال
+
+115
+00:11:22,040 --> 00:11:25,620
+divergence على بقد نص متر من ال object النقطة A
+
+116
+00:11:25,620 --> 00:11:31,120
+بنقول ال divergence of light يساوي واحد على ال
+
+117
+00:11:31,120 --> 00:11:39,550
+distanceعالمسافة و يساوي واحد على نص متر و يساوي
+
+118
+00:11:39,550 --> 00:11:46,670
+اتنين متر اص ناقص واحد و يساوي اتنين ديوبتر يقاس
+
+119
+00:11:46,670 --> 00:11:51,770
+بالديوبتر زي و زي قوة العدسة تشتت الضوء او تجمع
+
+120
+00:11:51,770 --> 00:11:57,210
+الضوء يقاس بالديوبتر زي و زي قوة العدسة تمام؟ زي و
+
+121
+00:11:57,210 --> 00:12:01,030
+زي قوة العدسة اذا ال divergence هو مقلوب المسافة
+
+122
+00:12:02,350 --> 00:12:06,830
+طيب بدنا نشوف إن الضوء كل ما بيصير مسافة أكتر ال
+
+123
+00:12:06,830 --> 00:12:14,330
+divergence بتاعه بيقل بدنا نحسب لنفس الضوء على
+
+124
+00:12:14,330 --> 00:12:19,270
+بعد 2 متر جداش ال divergence بنقول واحد ال
+
+125
+00:12:19,270 --> 00:12:23,370
+divergence على بعد 2 متر بتاع ال light واحد على 2
+
+126
+00:12:23,370 --> 00:12:29,480
+متر ويساوي نص ديوبترإذا ال Virgin's قريب من ال
+
+127
+00:12:29,480 --> 00:12:33,080
+object كان 2 ديوبتر على بعد نص متر و لما أبعدنا
+
+128
+00:12:33,080 --> 00:12:36,780
+صار نص ديوبتر و لو أبعدنا أكتر حيصير ربع ديوبتر
+
+129
+00:12:36,780 --> 00:12:40,760
+عشر ديوبتر واحد عمية ديوبتر و هكذا إذا كل ما بتزيد
+
+130
+00:12:40,760 --> 00:12:49,760
+المسافة بتقل ال Virgin's بتقل ال Virgin's تمام؟
+
+131
+00:12:49,760 --> 00:12:52,820
+الآن
+
+132
+00:12:52,820 --> 00:12:58,420
+في عندي مصطلح جديدوهذا المصطلح اسمه Reduced
+
+133
+00:12:58,420 --> 00:13:06,440
+Virgins Reduced Virgins Reduced
+
+134
+00:13:06,440 --> 00:13:11,920
+Virgins يعرف على إن ال Virgins ضرب
+
+135
+00:13:11,920 --> 00:13:18,860
+ال refractive index ال Virgins ده ال light ضرب ال
+
+136
+00:13:18,860 --> 00:13:22,760
+refractive index للمادة اللي بيصير فيها الضوء هذا
+
+137
+00:13:22,760 --> 00:13:29,310
+Reduced Virgins إيش يعني Reducedالمختزل او المختصر
+
+138
+00:13:29,310 --> 00:13:33,430
+احنا
+
+139
+00:13:33,430 --> 00:13:40,830
+ال fact of index عمره بيكون اقل من واحد دائما
+
+140
+00:13:40,830 --> 00:13:47,050
+غالبا واحد فما فوق واحد لل vacuumفي أي مادة تانية
+
+141
+00:13:47,050 --> 00:13:53,090
+اكتر لما بندرس ال virgins في واحد point كذا تمام
+
+142
+00:13:53,090 --> 00:13:57,990
+المفروض تطلع القيمة الكلية اكتر من ال virgins نفسه
+
+143
+00:13:57,990 --> 00:14:03,750
+اذا كقيمة reduced virgins اكتر من ال virgins طب
+
+144
+00:14:03,750 --> 00:14:11,970
+ليش سموه reduced هذا اسم اطلق بالخطأ وتجذر معمئات
+
+145
+00:14:11,970 --> 00:14:17,090
+السنين اللي مضت لدرجة انه يعني جاله لما بنخليه زي
+
+146
+00:14:17,090 --> 00:14:22,670
+ما هو يعني لما بنشوف كلمة reduced versions اللي
+
+147
+00:14:22,670 --> 00:14:25,210
+بده يفسرها لغاهم هو يعني ال versions المختصرة
+
+148
+00:14:25,210 --> 00:14:28,830
+المفروض قيمته أقل من ال versions بس هو لأنه تعريفه
+
+149
+00:14:28,830 --> 00:14:31,490
+أن هو يساوي ال versions ال reduced versions
+
+150
+00:14:37,140 --> 00:14:41,440
+يساوي الـ Vergence تاع الـ Light في مادة ما في الـ
+
+151
+00:14:41,440 --> 00:14:43,540
+Refractive Index تاع عادي المادة اللي بيصير فيها
+
+152
+00:14:43,540 --> 00:14:49,480
+الضوء قيمته غالبا أكبر من الـ Vergence Reduced
+
+153
+00:14:49,480 --> 00:14:55,360
+Vergence أكبر من ال Vergence مصطلح خاطئ وظل متجذر
+
+154
+00:14:55,360 --> 00:15:03,510
+في الكتب و في اللي هو يعني على مدى السنينفبالتالي
+
+155
+00:15:03,510 --> 00:15:06,770
+تركوا العلماء على حاله بس فهموا ان ال reduced
+
+156
+00:15:06,770 --> 00:15:11,510
+virgins قيمته أكبر من ال virgins نضرب مثال على ذلك
+
+157
+00:15:11,510 --> 00:15:18,190
+نقول ضوء انطلط داخل الزجاج نفرض احنا عندنا مصدر
+
+158
+00:15:18,190 --> 00:15:22,210
+ضوء فيه داخل الزجاج وده زجاج ال refractive index
+
+159
+00:15:22,210 --> 00:15:27,370
+هو كده؟ واحد و نصف و بنقول احسب ال virgins على بعد
+
+160
+00:15:27,370 --> 00:15:36,790
+متر ال virginsيساوي مقلوب المسافة ويساوي واحد على
+
+161
+00:15:36,790 --> 00:15:45,650
+واحد متر ويساوي واحد ديوبتر تمام الان احسب ال
+
+162
+00:15:45,650 --> 00:15:46,890
+reduced versions
+
+163
+00:15:50,750 --> 00:15:55,210
+ان عالمسافة إيش ان هنا في هذه الحالة للإجازة واحد
+
+164
+00:15:55,210 --> 00:16:00,190
+و نص على واحد متر مايساوة واحد و نص ديوبتر إذا ال
+
+165
+00:16:00,190 --> 00:16:05,170
+reduced variance أكبر من ال variance مصبوط؟ مع أنه
+
+166
+00:16:05,170 --> 00:16:14,990
+حسب الإسم المفروض يكون أقل طيب ماشي هذا
+
+167
+00:16:14,990 --> 00:16:16,210
+ال variance تعالي لوحدي
+
+168
+00:16:19,290 --> 00:16:25,690
+أحنا الآن بدنا نضيف لكلمة reduced versions بدنا
+
+169
+00:16:25,690 --> 00:16:31,170
+نضيف كلمة object هنا في
+
+170
+00:16:31,170 --> 00:16:35,750
+النص ايش المقصود بكلمة reduced object versions
+
+171
+00:16:35,750 --> 00:16:40,190
+يعني ال reduced versions تاع ال light الصادر من ال
+
+172
+00:16:40,190 --> 00:16:45,210
+object هو نفسه reduced versions بس لما بحط كلمة
+
+173
+00:16:45,210 --> 00:16:48,270
+object بعرف ان هذا ال light الصادر من ال object
+
+174
+00:16:53,280 --> 00:17:03,280
+تمام لو حطيت reduced image versions يعني هذا ال
+
+175
+00:17:03,280 --> 00:17:07,140
+reduced versions بتاع ال light اللي رايح يكون ال
+
+176
+00:17:07,140 --> 00:17:09,520
+image تمام
+
+177
+00:17:11,820 --> 00:17:14,580
+يعني في الحالة الأولى هي الـ reduced versions بتاع
+
+178
+00:17:14,580 --> 00:17:17,820
+الضوء هذا اللي وصادر من ال object وفي الحالة
+
+179
+00:17:17,820 --> 00:17:23,900
+التانية هو ال reduced versions بتاع الضوء اللي
+
+180
+00:17:23,900 --> 00:17:30,320
+رايح يكون ال image يرمز لل reduced object versions
+
+181
+00:17:30,320 --> 00:17:38,510
+بالرمز Uويرمز لل reduced image versions بالرمز V
+
+182
+00:17:38,510 --> 00:17:45,250
+ال reduced versions عبارة عن إيش؟ ال reduced
+
+183
+00:17:45,250 --> 00:17:48,770
+versions عبارة عن إيش؟ إيش يساوي؟ ال reduced
+
+184
+00:17:48,770 --> 00:17:58,110
+versions إيش يساوي؟ ال versions فئة okay بدنا نشوف
+
+185
+00:17:58,110 --> 00:18:01,930
+ال reduced object versions اللي هو ال U إيش يساوي؟
+
+186
+00:18:01,930 --> 00:18:09,310
+N اللي هي الهواءو في واحد على O تمام اذا ايش يساوي
+
+187
+00:18:09,310 --> 00:18:16,290
+N على O تمام okay في نقطة تانية ال reduced image
+
+188
+00:18:16,290 --> 00:18:21,650
+variance اللي هو ال V ايش تساوي ان شرطة عن ناحية
+
+189
+00:18:21,650 --> 00:18:29,350
+التانية تمام في واحد على I اللي هو مقلوب مسافة ال
+
+190
+00:18:29,350 --> 00:18:36,500
+image و يساوي ان شرطة على I تمامواضح؟ طيب بس في
+
+191
+00:18:36,500 --> 00:18:39,680
+نقطة واحدة احنا ماحكيناها اش احنا زمان كنا نقول
+
+192
+00:18:39,680 --> 00:18:43,680
+لابد من مراعاة الإشارة وماننساش الإشارة بنرجع
+
+193
+00:18:43,680 --> 00:18:47,460
+بنذكر اللي فوق ال optical axis ارتفاعه plus اللي
+
+194
+00:18:47,460 --> 00:18:53,040
+تحته minus اللي عيمين ال optical system plus عيمين
+
+195
+00:18:53,040 --> 00:18:57,660
+واللي عشمال ال optical system minus الان المتشتت
+
+196
+00:18:57,660 --> 00:19:02,820
+ال divergence بياخد minus و ال convergentplus طيب
+
+197
+00:19:02,820 --> 00:19:08,920
+إذا مين فيهم بدأ تاخد إيش minus ناقص
+
+198
+00:19:08,920 --> 00:19:14,540
+N على O وهذه بتبقى plus لأن الأشعة متجمعة لأنها
+
+199
+00:19:14,540 --> 00:19:17,240
+convergent مش لينها على اليمين المرة هاي احنا
+
+200
+00:19:17,240 --> 00:19:21,660
+بنتعامل مع divergence وconvergent طيب ناقص N على O
+
+201
+00:19:21,660 --> 00:19:28,340
+بدنا نحكط مكانها U تمام
+
+202
+00:19:28,340 --> 00:19:36,520
+وان شرط على Iبنحط مكانها هاي
+
+203
+00:19:36,520 --> 00:19:40,840
+ال lens makers equation بحسابات ال versions هاي ال
+
+204
+00:19:40,840 --> 00:19:47,860
+lens U زائد P يساوي V واضح
+
+205
+00:19:47,860 --> 00:19:54,720
+المسألة نبدأ نحل مسائل بالشكل التالي هنضرب مسائل
+
+206
+00:19:54,720 --> 00:19:56,600
+بالشكل التالي
+
+207
+00:20:07,790 --> 00:20:21,370
+في حل المسائل أول قاعدة لا ننسى الإشارة object
+
+208
+00:20:21,370 --> 00:20:30,670
+على بعد نص متر من عدسة plus 6 ديوبتر أول حاجة بدنا
+
+209
+00:20:30,670 --> 00:20:33,390
+ال image وين تاني حاجة بدنا ال transfers
+
+210
+00:20:33,390 --> 00:20:34,170
+magnification
+
+211
+00:20:36,730 --> 00:20:42,110
+أول حاجة ببدأ الحل بالترتيب U تساوي ناقص N على O
+
+212
+00:20:42,110 --> 00:20:50,310
+يساوي ناقص واحد على نص متر يساوي ناقص اتنين ديوبتر
+
+213
+00:20:50,310 --> 00:21:01,520
+ناقص اتنين ديوبتر تمام هاي الجزء الأولانا الناقص 2
+
+214
+00:21:01,520 --> 00:21:06,580
+ديوبتر الناقص 2 ديوبتر رسمتها او كتبتها باتجاه ال
+
+215
+00:21:06,580 --> 00:21:10,200
+object وكأنه بقى احكي انه الضوء اللي وصل من ال
+
+216
+00:21:10,200 --> 00:21:15,920
+object لما قطع مسافة نص متر كان تشتته بمقدار minus
+
+217
+00:21:15,920 --> 00:21:24,600
+2 minus 2 زاد ال power بتاعة العدسة كده؟ 6 يساوي V
+
+218
+00:21:24,600 --> 00:21:26,700
+إذا V إيش تساوي؟
+
+219
+00:21:29,820 --> 00:21:37,560
+plus 4 ديوب دار plus 4 ديوب دار الدوق المتشتت زي
+
+220
+00:21:37,560 --> 00:21:45,720
+إنسان عنده دين زي إنسان عنده دين أنا عند دين اتنين
+
+221
+00:21:45,720 --> 00:21:51,800
+شكل و جاي معايا فجيبتي ستة شكل ده اشتري من ال
+
+222
+00:21:51,800 --> 00:21:55,480
+supermarketبسد الاتنين و بيضال معايا أربعة أشتري
+
+223
+00:21:55,480 --> 00:21:59,560
+فيهم شغل الاربعة اللي ضالتها من قوة العدسة و كأن
+
+224
+00:21:59,560 --> 00:22:05,600
+العدسة أنفقت من قوتها plus 2 عشان تلغي التشتت كأن
+
+225
+00:22:05,600 --> 00:22:10,220
+العدسة أنفقت من قوتها ال plus 6 ديوب تانفقت ال
+
+226
+00:22:10,220 --> 00:22:14,800
+plus 2 ليش أنفقتهم؟ لأنه إجا الضوء متشتت و هيبدأ
+
+227
+00:22:14,800 --> 00:22:19,560
+تجمعه جبل ما تجمعه لازم تلغي التشتت بتاعه تصفره
+
+228
+00:22:20,330 --> 00:22:25,890
+سفرت تشتت plus 2 و minus 2 بيصير صفر أصبح الضوء
+
+229
+00:22:25,890 --> 00:22:31,550
+متوازى بس لسه بايل معها طوة plus 4 بتجمع فيهم إيه
+
+230
+00:22:31,550 --> 00:22:36,670
+إيش الضوء V تساوي plus 4 ديوبتر إيش V تساوي V
+
+231
+00:22:36,670 --> 00:22:44,710
+تساوي أن شرطة على I صح إذا I تساوي أن شرطة على V
+
+232
+00:22:44,710 --> 00:22:48,450
+وهي ساوي أن شرطة في الهوى إحنا بنحكي عن الهوى واحد
+
+233
+00:22:49,520 --> 00:22:55,880
+وهي ساوي واحد على plus اربعة ديوبتر تمام؟ ايش
+
+234
+00:22:55,880 --> 00:23:01,380
+الديوبتر؟ اللي هو متر اصلاقس واحد، مظبوط؟ واحد على
+
+235
+00:23:01,380 --> 00:23:06,420
+اربعة ربع والمتر اصلاقس واحد متر، اذا الصورة
+
+236
+00:23:06,420 --> 00:23:12,280
+هتتكون على بعد ربع متر من ال optical system، واضح؟
+
+237
+00:23:12,280 --> 00:23:17,950
+اذا هي مسافة ال imageوهي مسافة ال object ال
+
+238
+00:23:17,950 --> 00:23:21,930
+transfer magnification ايش يساوي image distance
+
+239
+00:23:21,930 --> 00:23:28,130
+على ..وهي ساوي ال image distance ربع متر و ال
+
+240
+00:23:28,130 --> 00:23:37,670
+object distance كده؟ minus نص متر minus نص متر
+
+241
+00:23:37,670 --> 00:23:43,910
+minus نص مترإذا لـ Transverse Magnification ضرب
+
+242
+00:23:43,910 --> 00:23:50,610
+plus على minus minus و ربع على نص نص minus نص إيش
+
+243
+00:23:50,610 --> 00:23:57,010
+تعني أن الصورة مجلوبة و ارتفاعها نص ارتفاع ال
+
+244
+00:23:57,010 --> 00:23:58,890
+object ناخد مسألة تانية
+
+245
+00:24:16,800 --> 00:24:26,520
+عدسة plus واحد وربع ديوبتر object على بعد أربعة
+
+246
+00:24:26,520 --> 00:24:35,220
+متر بدي ال image و ل transfer magnification سريعا
+
+247
+00:24:35,220 --> 00:24:40,700
+u تساوي ناقص n على o يساوي ناقص واحد على أربعة متر
+
+248
+00:24:40,700 --> 00:24:46,820
+ويساوي ناقص ربع ديوبترمتر لما بيطلع بيصير متر
+
+249
+00:24:46,820 --> 00:24:49,880
+اصناقس واحد اللي هو الديوبتر ع السريع بروح بحط
+
+250
+00:24:49,880 --> 00:24:57,680
+minus ربيع ديوبتر الدقجة متشتت بمقدار ربيع ديوبتر
+
+251
+00:24:57,680 --> 00:25:02,000
+جداش هتنفق العدسة على إلغاء الربيع ربيع مقابله بس
+
+252
+00:25:02,000 --> 00:25:05,760
+plus هيتاخد من ال plus واحد و ربيع بدنا ربيع لسداد
+
+253
+00:25:05,760 --> 00:25:09,880
+الدين بظل واحد تلقائيا مافيش ده اكتب اللي هي ال U
+
+254
+00:25:09,880 --> 00:25:15,170
+زاد بيه تمام؟من الـ plus واحد و ربع العدسة بتنفق
+
+255
+00:25:15,170 --> 00:25:20,350
+ربع عشان تسد الدين الدين اللي هو تشتت الضوء بمقدار
+
+256
+00:25:20,350 --> 00:25:26,770
+ربع تمام؟ اذا V تساوي كده؟ plus واحد ديوبتر I
+
+257
+00:25:26,770 --> 00:25:31,770
+تساوي ان شرط على V و يساوي واحد على واحد ديوبتر
+
+258
+00:25:31,770 --> 00:25:36,570
+الديوبتر اللي هو متر اصلاقس واحد ويساوي واحد متر
+
+259
+00:25:36,570 --> 00:25:44,450
+اذا الصورة هتتكون على بواد1 متر من الـ optical
+
+260
+00:25:44,450 --> 00:25:49,670
+system طيب transference magnification يساوي image
+
+261
+00:25:49,670 --> 00:25:53,830
+distance على object distance ويساوي image distance
+
+262
+00:25:53,830 --> 00:26:01,170
+1 متر وال object distance سالب 4 متر ويساوي ضرب
+
+263
+00:26:01,170 --> 00:26:07,380
+minus ربع ايش يعني ضرب minus ربعمقلوبة وارتفاعها
+
+264
+00:26:07,380 --> 00:26:14,660
+ربع ارتفاع ال object ناخد مسألة أخرى
+
+265
+00:26:14,660 --> 00:26:20,360
+الصورة
+
+266
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+distance على object distance يساوي واحد متر على
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+حلنا يعني اذا رحلة الضوء او صفات الصورةاللي بنقدر
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+نحصل عليها ليه ال magnification و ال location أصبح
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+system plus بيسموه مسافة plusه في ال plus optical
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+نص واضح طيب طبعا هنا المسافة بال minus يعني ع شمال
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+ال optical system ع شمال ال optical system طيب
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+okay لإن ال transfer is magnificationيساوي image
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+distance على object distance ال image distance نص
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+متر على object distance ويساوي كدهاش minus أحسنتهم
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+قضية ال versions من هنا فالسعادة هيصير غالبى يتحل
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+على هذه المسائل طبعا هيدخل بعدها في الحل ان عندي
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+فأكثر تمامالاشي اللي بنذكر فيه بنقول انه ما ننساش
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+minus عن يمين ال optical system plus عن شماله
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+minus ضوء متشتت minus ضوء متجمع plus واضح؟ هذه
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+القواعد مش لازم احنا أياش ننساها حد يسأل سؤال
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+
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/f7iOoMV4fHw_raw.json b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/f7iOoMV4fHw_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..8e7e729f7f014bfa5dde748a4f9ee1f4a1692b43
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/f7iOoMV4fHw_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 4285, "start": 21.11, "end": 42.85, "text": "بسم الله الرحمن الرحيم، اليوم هناخد بعض المواضيع في الـ Geometrical Optics زي الـ Gaussian Reduction وNables Law، الـ Beda Principle، الـ Optometer Principle والـ Telecentricity وذا يعني كف الوقت معانا بنبدأ في الـ Focal Systems", "tokens": [3555, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 12399, 45595, 20498, 8032, 1863, 47283, 3215, 45030, 11242, 9673, 2407, 46958, 40228, 8978, 2423, 39184, 2876, 649, 15888, 21455, 1167, 30767, 1829, 2423, 39184, 39148, 4477, 27549, 4032, 45, 455, 75, 279, 7744, 12399, 2423, 39184, 363, 8801, 38372, 781, 12399, 2423, 39184, 21455, 13606, 38372, 781, 16070, 39184, 14889, 45300, 507, 4032, 15730, 37495, 22653, 9122, 5172, 2423, 30543, 2655, 20449, 7649, 995, 44945, 44510, 10721, 8978, 2423, 39184, 479, 36483, 27059], "avg_logprob": -0.3379836164060093, "compression_ratio": 1.445945945945946, "no_speech_prob": 1.1920928955078125e-07, "words": [{"start": 21.11, "end": 21.57, "word": "بسم", "probability": 0.7353515625}, {"start": 21.57, "end": 21.73, "word": " الله", "probability": 0.94287109375}, {"start": 21.73, "end": 22.05, "word": " الرحمن", "probability": 0.9734700520833334}, {"start": 22.05, "end": 23.87, "word": " الرحيم،", "probability": 0.781280517578125}, {"start": 23.87, "end": 24.29, "word": " اليوم", "probability": 0.9638671875}, {"start": 24.29, "end": 24.71, "word": " هناخد", "probability": 0.8856201171875}, {"start": 24.71, "end": 25.03, "word": " بعض", "probability": 0.916259765625}, {"start": 25.03, "end": 25.67, "word": " المواضيع", "probability": 0.982421875}, {"start": 25.67, "end": 27.15, "word": " في", "probability": 0.9462890625}, {"start": 27.15, "end": 27.31, "word": " الـ", "probability": 0.82958984375}, {"start": 27.31, "end": 27.83, "word": " Geometrical", "probability": 0.7237955729166666}, {"start": 27.83, "end": 28.41, "word": " Optics", "probability": 0.906494140625}, {"start": 28.41, "end": 29.49, "word": " 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minus هذه شوية myopia slight myopia", "tokens": [39237, 10943, 22807, 37037, 1829, 43242, 1829, 41850, 18863, 9957, 25124, 2304, 6027, 46811, 10943, 22807, 6024, 48506, 18863, 9957, 2423, 32640, 9957, 8717, 5172, 43042, 36145, 11296, 452, 40216, 46851, 452, 22376, 46811, 10943, 22807, 16070, 148, 48506, 47525, 7578, 5551, 14851, 25957, 1211, 47525, 7578, 5551, 14851, 25957, 1211, 3175, 29538, 13412, 2407, 10632, 452, 22376, 4036, 452, 22376], "avg_logprob": -0.24672380041691563, "compression_ratio": 1.6158940397350994, "no_speech_prob": 0.0, "words": [{"start": 714.01, "end": 714.57, "word": "تمام؟", "probability": 0.507080078125}, {"start": 714.57, "end": 715.01, "word": " وهي", "probability": 0.72412109375}, {"start": 715.01, "end": 715.31, "word": " عندي", "probability": 0.654296875}, {"start": 715.31, "end": 715.45, "word": " أنا", "probability": 0.72265625}, {"start": 715.45, "end": 715.83, "word": " العين", "probability": 0.984375}, {"start": 715.83, "end": 716.63, "word": " 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هيحصل معايا انه different image size حجم الصورة بتاعة ال object اللي بتطلع عليه هذا البني آدم different image size", "tokens": [2407, 29538, 50113, 15040, 8922, 452, 22376, 6024, 48506, 47525, 10721, 5551, 14851, 25957, 1211, 50113, 15040, 3175, 6225, 8592, 25720, 4032, 47525, 10721, 5551, 14851, 25957, 1211, 50113, 15040, 3175, 1975, 2655, 1863, 9957, 5296, 2655, 9381, 5016, 1829, 5016, 2423, 45353, 488, 6713, 46811, 10943, 6024, 48506, 13672, 1829, 39896, 5016, 36520, 20449, 995, 25528, 16472, 3224, 819, 3256, 2744, 11331, 7435, 2304, 31767, 13063, 3660, 39894, 995, 27884, 2423, 2657, 13672, 1829, 39894, 9566, 1211, 3615, 47356, 23758, 29739, 22653, 19753, 40448, 819, 3256, 2744], "avg_logprob": -0.18416433253984774, "compression_ratio": 1.6774193548387097, "no_speech_prob": 1.1920928955078125e-07, "words": [{"start": 745.27, "end": 745.51, "word": "و", "probability": 0.73828125}, {"start": 745.51, "end": 745.75, "word": " هذه", "probability": 0.26904296875}, {"start": 745.75, "end": 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"text": "هل بنقدر بدون ما نعرف هل هي Axial او Refractive ان نطبق Nabs Law؟ طبعاً لأ لأن اذا Refractive مش هينفع هذا بينفع في حالة ال Axial المعيق التاني و اللي هو اكبر بالنسبة لتطبيق Nabs Law قضية الـ Anterior Focal Point بتاعة العين FA بتاعة العين تقريبا تبعد 17 ملي عن الوجه او عن العين", "tokens": [3224, 1211, 44945, 28543, 2288, 47525, 11536, 19446, 8717, 3615, 28480, 8032, 1211, 39896, 20118, 831, 1975, 2407, 16957, 1897, 488, 16472, 8717, 9566, 3555, 4587, 426, 17243, 7744, 22807, 23032, 3555, 3615, 995, 14111, 5296, 10721, 5296, 33456, 1975, 15730, 16957, 1897, 488, 37893, 8032, 9957, 5172, 3615, 23758, 4724, 9957, 5172, 3615, 8978, 11331, 6027, 3660, 2423, 20118, 831, 9673, 3615, 1829, 4587, 16712, 7649, 1829, 4032, 13672, 1829, 31439, 1975, 4117, 26890, 20666, 1863, 35457, 3660, 5296, 2655, 9566, 21292, 4587, 426, 17243, 7744, 12174, 11242, 10632, 2423, 39184, 1107, 10872, 479, 36483, 12387, 39894, 995, 27884, 18863, 9957, 479, 32, 39894, 995, 27884, 18863, 9957, 6055, 4587, 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0.993896484375}, {"start": 2148.83, "end": 2149.65, "word": " وهنا", "probability": 0.784912109375}, {"start": 2149.65, "end": 2150.27, "word": " يستخدم", "probability": 0.9783935546875}, {"start": 2150.27, "end": 2150.95, "word": " في", "probability": 0.830078125}, {"start": 2150.95, "end": 2151.07, "word": " ال", "probability": 0.861328125}, {"start": 2151.07, "end": 2151.21, "word": " low", "probability": 0.71630859375}, {"start": 2151.21, "end": 2151.53, "word": " vision", "probability": 0.84912109375}, {"start": 2151.53, "end": 2151.89, "word": " aids", "probability": 0.9501953125}, {"start": 2151.89, "end": 2152.55, "word": " والشغلات", "probability": 0.85224609375}, {"start": 2152.55, "end": 2152.75, "word": " اللي", "probability": 0.77197265625}, {"start": 2152.75, "end": 2152.93, "word": " زي", "probability": 0.964111328125}, {"start": 2152.93, "end": 2153.15, "word": " هيك", "probability": 0.900146484375}, {"start": 2153.15, "end": 2153.43, "word": " يعني", "probability": 0.6844482421875}, {"start": 2153.43, "end": 2153.59, "word": " في", "probability": 0.83056640625}, {"start": 2153.59, "end": 2154.33, "word": " المساعدات", "probability": 0.98935546875}, {"start": 2154.33, "end": 2155.09, "word": " البصرية", "probability": 0.85302734375}, {"start": 2155.09, "end": 2155.91, "word": " الاستخدامات", "probability": 0.8635660807291666}, {"start": 2155.91, "end": 2156.37, "word": " كتيرة", "probability": 0.7190755208333334}, {"start": 2156.37, "end": 2156.71, "word": " تانية", "probability": 0.7167154947916666}, {"start": 2156.71, "end": 2157.11, "word": " تمام", "probability": 0.846923828125}, {"start": 2157.11, "end": 2158.11, "word": " كيف", "probability": 0.832275390625}, {"start": 2158.11, "end": 2158.41, "word": " احنا", "probability": 0.9375}, {"start": 2158.41, "end": 2158.91, "word": " نبني", "probability": 0.9503580729166666}, {"start": 2158.91, "end": 2160.01, "word": " تليسكوب", "probability": 0.859423828125}, {"start": 2160.01, "end": 2160.23, "word": " او", "probability": 0.908935546875}, {"start": 2160.23, "end": 2160.71, "word": " نصنع", "probability": 0.9674072265625}, {"start": 2160.71, "end": 2161.41, "word": " تليسكوب", "probability": 0.97626953125}, {"start": 2161.41, "end": 2162.19, "word": " او", "probability": 0.971923828125}, {"start": 2162.19, "end": 2163.13, "word": " يعني", "probability": 0.944580078125}, {"start": 2163.13, "end": 2163.35, "word": " اش", "probability": 0.6611328125}, {"start": 2163.35, "end": 2163.65, "word": " معنى", "probability": 0.7906901041666666}, {"start": 2163.65, "end": 2164.17, "word": " المسافة", "probability": 0.9884033203125}, {"start": 2164.17, "end": 2164.49, "word": " هاي", "probability": 0.72216796875}, {"start": 2164.49, "end": 2165.81, "word": " اش", "probability": 0.654052734375}, {"start": 2165.81, "end": 2165.99, "word": " معنى", "probability": 0.98486328125}, {"start": 2165.99, "end": 2166.51, "word": " المسافة", "probability": 0.9935302734375}, {"start": 2166.51, "end": 2166.79, "word": " هاي", "probability": 0.903076171875}], "temperature": 1.0}, {"id": 84, "seek": 219433, "start": 2167.63, "end": 2194.33, "text": "هذه شغلة بسيطة جدا هنعرفها ان شاء الله للمرة القادمة عندما نبدأ نتكلم عن التليسكوبات بالتفصيل ونبدأ نشوف خصائص كل image بتتكون عبر التليسكوب والتكبير كيف أجيبه بمعادلة بسيطة وبالتالي الأمور مش صعبة هتكون و هنعمل جدوة للمقارنة بين اللي هو الـGalilean Telescope وKeplerian Telescope يعطيكوا العافية", "tokens": [3224, 24192, 13412, 17082, 37977, 4724, 3794, 1829, 9566, 3660, 10874, 28259, 8032, 1863, 3615, 28480, 11296, 16472, 13412, 16606, 21984, 5296, 19528, 25720, 25062, 18513, 46007, 43242, 15042, 8717, 44510, 10721, 8717, 2655, 4117, 19528, 18871, 16712, 20292, 3794, 4117, 37746, 9307, 20666, 2655, 5172, 9381, 26895, 4032, 1863, 44510, 10721, 8717, 8592, 38688, 16490, 9381, 16373, 9381, 28242, 3256, 39894, 2655, 30544, 6225, 26890, 16712, 20292, 3794, 4117, 37746, 4032, 6027, 2655, 4117, 3555, 13546, 9122, 33911, 5551, 7435, 1829, 3555, 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2170.19, "word": " ان", "probability": 0.425537109375}, {"start": 2170.19, "end": 2170.37, "word": " شاء", "probability": 0.982666015625}, {"start": 2170.37, "end": 2170.45, "word": " الله", "probability": 0.953125}, {"start": 2170.45, "end": 2170.79, "word": " للمرة", "probability": 0.8003743489583334}, {"start": 2170.79, "end": 2171.39, "word": " القادمة", "probability": 0.99169921875}, {"start": 2171.39, "end": 2171.99, "word": " عندما", "probability": 0.817626953125}, {"start": 2171.99, "end": 2172.27, "word": " نبدأ", "probability": 0.9300130208333334}, {"start": 2172.27, "end": 2172.71, "word": " نتكلم", "probability": 0.9873046875}, {"start": 2172.71, "end": 2172.99, "word": " عن", "probability": 0.994140625}, {"start": 2172.99, "end": 2173.95, "word": " التليسكوبات", "probability": 0.8732096354166666}, {"start": 2173.95, "end": 2174.97, "word": " بالتفصيل", "probability": 0.974609375}, {"start": 2174.97, "end": 2175.91, "word": " ونبدأ", "probability": 0.8868408203125}, {"start": 2175.91, "end": 2176.25, "word": " نشوف", "probability": 0.9853515625}, {"start": 2176.25, "end": 2176.75, "word": " خصائص", "probability": 0.9820556640625}, {"start": 2176.75, "end": 2177.07, "word": " كل", "probability": 0.98046875}, {"start": 2177.07, "end": 2178.35, "word": " image", "probability": 0.73388671875}, {"start": 2178.35, "end": 2179.07, "word": " بتتكون", "probability": 0.8780924479166666}, {"start": 2179.07, "end": 2179.39, "word": " عبر", "probability": 0.988037109375}, {"start": 2179.39, "end": 2180.11, "word": " التليسكوب", "probability": 0.95537109375}, {"start": 2180.11, "end": 2180.79, "word": " والتكبير", "probability": 0.8572998046875}, {"start": 2180.79, "end": 2181.01, "word": " كيف", "probability": 0.95947265625}, {"start": 2181.01, "end": 2181.59, "word": " أجيبه", "probability": 0.94150390625}, {"start": 2181.59, "end": 2182.49, "word": " بمعادلة", "probability": 0.95771484375}, {"start": 2182.49, "end": 2183.43, "word": " بسيطة", "probability": 0.9921875}, {"start": 2183.43, "end": 2185.21, "word": " وبالتالي", "probability": 0.8436686197916666}, {"start": 2185.21, "end": 2185.77, "word": " الأمور", "probability": 0.9807942708333334}, {"start": 2185.77, "end": 2185.95, "word": " مش", "probability": 0.9892578125}, {"start": 2185.95, "end": 2186.27, "word": " صعبة", "probability": 0.9912109375}, {"start": 2186.27, "end": 2186.69, "word": " هتكون", "probability": 0.9334309895833334}, {"start": 2186.69, "end": 2186.85, "word": " و", "probability": 0.8955078125}, {"start": 2186.85, "end": 2187.35, "word": " هنعمل", "probability": 0.8912353515625}, {"start": 2187.35, "end": 2187.73, "word": " جدوة", "probability": 0.8785400390625}, {"start": 2187.73, "end": 2188.55, "word": " للمقارنة", "probability": 0.9581705729166666}, {"start": 2188.55, "end": 2188.85, "word": " بين", "probability": 0.61962890625}, {"start": 2188.85, "end": 2189.39, "word": " اللي", "probability": 0.879150390625}, {"start": 2189.39, "end": 2189.63, "word": " 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\ No newline at end of file
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/f7iOoMV4fHw_raw.srt b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/f7iOoMV4fHw_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..1b8607f530f1f4e2caac88a970546be08c20bc57
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/f7iOoMV4fHw_raw.srt
@@ -0,0 +1,1652 @@
+1
+00:00:21,110 --> 00:00:25,670
+بسم الله الرحمن الرحيم، اليوم هناخد بعض المواضيع
+
+2
+00:00:25,670 --> 00:00:31,290
+في الـ Geometrical Optics زي الـ Gaussian
+
+3
+00:00:31,290 --> 00:00:36,410
+Reduction وNables Law، الـ Beda Principle، الـ
+
+4
+00:00:36,410 --> 00:00:40,070
+Optometer Principle والـ Telecentricity وذا يعني
+
+5
+00:00:40,070 --> 00:00:44,680
+كف الوقت معانا بنبدأ في الـ Focal Systemsنبدأ
+
+6
+00:00:44,680 --> 00:00:47,680
+بالشيء الأول اللي هو ال Gaussian reduction تمام
+
+7
+00:00:47,680 --> 00:00:52,200
+نقول احنا كل optical system له cardinal points
+
+8
+00:00:52,200 --> 00:00:56,340
+يعني بمعنى له two focal points له two principal
+
+9
+00:00:56,340 --> 00:01:00,060
+points له two nodal points الآن ماذا يحدث حينما
+
+10
+00:01:00,060 --> 00:01:04,560
+نضيف optical system إلى optical system آخر بمعنى
+
+11
+00:01:04,560 --> 00:01:11,590
+آخرهذه العدسة لـ Blast Lens لها three pairs of
+
+12
+00:01:11,590 --> 00:01:15,450
+cardinal points لو أضفنا لها عدسة تانية إيش اللي
+
+13
+00:01:15,450 --> 00:01:19,990
+بيحصل عنده؟ بينشأ optical system جديد مكون من
+
+14
+00:01:19,990 --> 00:01:25,210
+عدستين وإله طاقم جديد من ال reference points يعني
+
+15
+00:01:25,210 --> 00:01:28,990
+كل عدسة لوحدها هذه العدسة رقم واحد وهذه العدسة رقم
+
+16
+00:01:28,990 --> 00:01:33,630
+اتنين هي لحالها إلى three pairs of reference
+
+17
+00:01:33,630 --> 00:01:38,450
+pointsاللي هما two nodal points و two principal
+
+18
+00:01:38,450 --> 00:01:42,790
+points و two focal points تمام؟ وهذه العدسة لها
+
+19
+00:01:42,790 --> 00:01:47,990
+نفس الشيء لما بن .. بنحطهم مع بعض في optical
+
+20
+00:01:47,990 --> 00:01:54,250
+system بيصيرش عند 12 لأ بيصير هذا optical system
+
+21
+00:01:54,250 --> 00:01:59,390
+جديدoptical system جديد له طاقم جديد من ال
+
+22
+00:01:59,390 --> 00:02:03,110
+reference points يعني في عندي two nodal points و
+
+23
+00:02:03,110 --> 00:02:08,250
+two focal points و two principal points لل system
+
+24
+00:02:08,250 --> 00:02:14,390
+الجديد كله ككل كوحدة واحدة تمام طيب هذا الطاقم
+
+25
+00:02:14,390 --> 00:02:17,590
+الجديد من ال reference points يعني بنجي مثلا تلاتة
+
+26
+00:02:17,590 --> 00:02:21,090
+من هنا و تلاتة من العدسة التانية بقول هذا الجديد
+
+27
+00:02:21,090 --> 00:02:27,160
+لأالجديد لا علاقة له بكل واحدة على واحدة يعني ال
+
+28
+00:02:27,160 --> 00:02:31,600
+reference points تعين ال system ككل ليس لها علاقة
+
+29
+00:02:31,600 --> 00:02:35,800
+بال reference points على كل عدسة على واحدة تمام
+
+30
+00:02:35,800 --> 00:02:42,400
+هذا بيتعامل معاه ككم واحد ككم واحد تمام ككم واحد
+
+31
+00:02:42,400 --> 00:02:46,020
+من ضمن الأشياء اللي انا ب .. باضيف فيها optical
+
+32
+00:02:46,020 --> 00:02:48,960
+system ل optical system تصحيح ال refractive error
+
+33
+00:02:50,250 --> 00:02:54,090
+العين عبارة عن optical system مظبوط و لما أنا
+
+34
+00:02:54,090 --> 00:02:56,850
+بقادي بصحح ال refractive error أنا بضيف optical
+
+35
+00:02:56,850 --> 00:03:01,410
+system ل optical system already موجود تمام
+
+36
+00:03:01,410 --> 00:03:05,830
+فبالتالي بينشأ عندي optical system جديد له طاقم
+
+37
+00:03:05,830 --> 00:03:09,630
+جديد من ال reference pointstwo focal و two nodal و
+
+38
+00:03:09,630 --> 00:03:12,450
+two principal points هذا الطاقم الجديد من ال
+
+39
+00:03:12,450 --> 00:03:16,770
+reference points ليس مأخوذا من ال reference points
+
+40
+00:03:16,770 --> 00:03:20,450
+بتاع ال two optical systems أخد يعني جزء من هنا و
+
+41
+00:03:20,450 --> 00:03:23,730
+أخد جزء من هنا لأ هذا طاقم من ال reference points
+
+42
+00:03:23,730 --> 00:03:27,090
+جديد تماما و هذا المقصود بالإيش بال Gaussian
+
+43
+00:03:27,090 --> 00:03:33,510
+reduction بالمعنى أخر لو عندي عشر عدسات كل عدسة
+
+44
+00:03:33,510 --> 00:03:37,990
+لحالهالها three pairs of reference points لما بحط
+
+45
+00:03:37,990 --> 00:03:43,050
+العشر عدسات مع بعض بيصير عند العشرة كلهم بيعطوني
+
+46
+00:03:43,050 --> 00:03:47,590
+ال three pairs of لل system ككل لل system ككل طيب
+
+47
+00:03:47,590 --> 00:03:52,290
+هذا بالنسبة لل Gaussian reductionنجي للموضوع أو
+
+48
+00:03:52,290 --> 00:03:55,970
+النقطة التالية اللي هي Nabs Law قبل ما نحكي عن الـ
+
+49
+00:03:55,970 --> 00:04:01,370
+Nabs Law نحكي على مقدمة بسيطة عن الـ Refractive
+
+50
+00:04:01,370 --> 00:04:04,850
+Errors اللي انتوا مريتوا عليها بالتأكيد الـ
+
+51
+00:04:04,850 --> 00:04:09,890
+Refractive Errors في
+
+52
+00:04:09,890 --> 00:04:14,610
+عندي اللي هي الـ Myopia وفي عندي الـ Hypermetropia
+
+53
+00:04:14,610 --> 00:04:17,250
+هحكي عنهم مش هحكي عن الـ Astigmatism
+
+54
+00:04:20,730 --> 00:04:27,310
+الان العلماء بيجسموا ال myopia لنوعين طبعا في
+
+55
+00:04:27,310 --> 00:04:31,110
+تجسيمات كتيرة مثلا تجسيمة حسب ال severity mild و
+
+56
+00:04:31,110 --> 00:04:35,530
+moderate و severe بس احنا هنجسمها حسب ال cause إلى
+
+57
+00:04:35,530 --> 00:04:40,470
+myopia axial myopia و refractive myopia
+
+58
+00:04:44,870 --> 00:04:49,530
+هذا الكلام اللي بنحكيه تمهيد لـ Nabs law و الـ
+
+59
+00:04:49,530 --> 00:04:51,970
+hypermetropia نفس الشي بيسموها لـ axial
+
+60
+00:04:51,970 --> 00:04:58,890
+hypermetropia و
+
+61
+00:04:58,890 --> 00:05:07,490
+لـ refractive hypermetropia إيش
+
+62
+00:05:07,490 --> 00:05:11,850
+المقصود بالـ axial myopia الإنسان الطبيعي اللي
+
+63
+00:05:11,850 --> 00:05:18,470
+عنده قوة العين طبيعيةالصورة وين تجي عنده على
+
+64
+00:05:18,470 --> 00:05:28,750
+الشبكية قوة العين طبيعية ال average تقريبا 58.6
+
+65
+00:05:28,750 --> 00:05:34,270
+ديابتر تقريبا تمام بتاع الكورنيا مع ال lens بتاع
+
+66
+00:05:34,270 --> 00:05:38,230
+ال optical system بتاعها هذا ال power نعتبرها ال
+
+67
+00:05:38,230 --> 00:05:42,430
+power الطبيعية تمام و في هذه الحالة ال parallel
+
+68
+00:05:42,430 --> 00:05:47,580
+rays اللي جاية من distant objectبدا تصير الـ
+
+69
+00:05:47,580 --> 00:05:51,540
+focusing على ال retina لو اتخيلنا ان ال refractive
+
+70
+00:05:51,540 --> 00:05:56,100
+power بتاعة العين ما تغيرت ما تغيرت بس طول العين
+
+71
+00:05:56,100 --> 00:06:00,900
+كان أطول من الطبيعي الطول تاع العين أطول من
+
+72
+00:06:00,900 --> 00:06:05,740
+الطبيعي ساعتها الأشعة وين هتكون هذه بيسموها axial
+
+73
+00:06:05,740 --> 00:06:10,740
+myopia يعني myopia ناتجة عن زيادة في طول العين مش
+
+74
+00:06:12,830 --> 00:06:16,410
+إن الـrefractive power بتاعت العين صارت أقوى من
+
+75
+00:06:16,410 --> 00:06:20,650
+اللازم فجمعت الأشعة في مسافة أقرب هذه axial myopia
+
+76
+00:06:20,650 --> 00:06:29,810
+إذا القوة الإنكسارية للعين طبيعية الطول
+
+77
+00:06:29,810 --> 00:06:38,270
+زائد زيادة عن الطبيعي مثال
+
+78
+00:06:38,270 --> 00:06:47,400
+آخر إنسان طول العين عنده طبيعيولكن قوة العين أقوى
+
+79
+00:06:47,400 --> 00:06:54,740
+من اللازم يعني مثلا قول plus 70 ديوبتر مش 58 و 6
+
+80
+00:06:54,740 --> 00:06:58,840
+ساعتها القوة الزائدة هتجمع ال parallel rays في
+
+81
+00:06:58,840 --> 00:07:02,740
+مسافة أقرب من ال retina هذا بيسموها refractive
+
+82
+00:07:02,740 --> 00:07:08,200
+myopia ناتجة عن ان ال refractive power بتاعة العين
+
+83
+00:07:08,200 --> 00:07:11,420
+أقوى من اللازم تمام؟ إذا هنا في ال refractive
+
+84
+00:07:11,420 --> 00:07:18,070
+myopiaالطول الطبيعي القوة
+
+85
+00:07:18,070 --> 00:07:22,450
+الانكسارية للعين
+
+86
+00:07:22,450 --> 00:07:27,390
+زائدة واضح
+
+87
+00:07:27,390 --> 00:07:31,830
+طيب
+
+88
+00:07:31,830 --> 00:07:36,970
+ال
+
+89
+00:07:36,970 --> 00:07:41,990
+hypermetropia نفرض
+
+90
+00:07:41,990 --> 00:07:47,710
+انهقوة العين طبيعية ولكن
+
+91
+00:07:47,710 --> 00:07:51,850
+العين قصيرة إذا
+
+92
+00:07:51,850 --> 00:07:55,130
+إيش صار عندي Axial hypermetropia Axial
+
+93
+00:07:55,130 --> 00:08:03,910
+hypermetropia هنا القوة طبيعية الطول
+
+94
+00:08:03,910 --> 00:08:11,750
+قليل مقارنة مع الطبيعي طول العين الأمامي و الخلفي
+
+95
+00:08:12,600 --> 00:08:17,400
+قصير هذا تسمى axial hypermetropia refractive
+
+96
+00:08:17,400 --> 00:08:22,100
+hypermetropia ال refractive power بتاعة العين
+
+97
+00:08:22,100 --> 00:08:28,940
+ضعيفة ال refractive power بتاعة العين ضعيفة يعني
+
+98
+00:08:28,940 --> 00:08:32,840
+مثلا نقول خمسين ديوبتر بدل تمانية و خمسين و طول
+
+99
+00:08:32,840 --> 00:08:37,160
+العين طبيعية الخمسين ديوبتر أضعف من أنها تجمع
+
+100
+00:08:37,160 --> 00:08:41,020
+الصورة عند الشبكة يابدا لسه مسافة أطول تمام
+
+101
+00:08:43,680 --> 00:08:49,320
+الطول الطبيعي القوة
+
+102
+00:08:49,320 --> 00:08:58,660
+الإنكسارية أضعف من اللازم مثال
+
+103
+00:08:58,660 --> 00:09:03,640
+على ال refractive hypermetropia أحيانا يكون الطول
+
+104
+00:09:03,640 --> 00:09:08,860
+الطبيعي نجي بنعمل cataract بنشيل العدسة ونقدرش
+
+105
+00:09:08,860 --> 00:09:17,390
+نزرع عدسة تانيةلسبب تقني تمام بصف المريض في حالة
+
+106
+00:09:17,390 --> 00:09:20,270
+بنسميها aphemia aphemia يعني عدم موجود ل
+
+107
+00:09:20,270 --> 00:09:24,650
+crystalline lens شيلناها عشان فيها كترك وماقدرنا
+
+108
+00:09:24,650 --> 00:09:30,270
+نزرع IOL intraocular lens أصبح قوة العين هي قوة
+
+109
+00:09:30,270 --> 00:09:36,670
+القرانية فقطوهذه أضعف من إنها تجمع الأشعة على
+
+110
+00:09:36,670 --> 00:09:40,070
+الشبكات ويصبح عندي refractive hypermetropia يعني
+
+111
+00:09:40,070 --> 00:09:44,430
+كمثال على refractive hypermetropia حالة كمثال
+
+112
+00:09:44,430 --> 00:09:49,290
+لحالة الأفكيا تمام
+
+113
+00:09:49,290 --> 00:09:56,090
+حالة الأفكيا إيش علاقة هذا الكلام بالنابسلو
+
+114
+00:10:03,920 --> 00:10:13,080
+الان هنحكي ايش علاقة هذا الكلام بال نفسله عشان
+
+115
+00:10:13,080 --> 00:10:19,240
+نحكي بدنا نذكر بالمعادلة
+
+116
+00:10:19,240 --> 00:10:25,440
+نقول
+
+117
+00:10:25,440 --> 00:10:32,920
+ناقص N على O زائد P ساوية ان شرطة على I هذه معادلة
+
+118
+00:10:34,250 --> 00:10:37,870
+الـ Lens Maker Equation أو معادلة الـ Thin Lens
+
+119
+00:10:37,870 --> 00:10:41,550
+Equation وقلنا احنا امتى بنحكي عن الـ Thin Lens
+
+120
+00:10:41,550 --> 00:10:47,170
+Equation لما بكون عندي عدسة ذات سطحين مش Single
+
+121
+00:10:47,170 --> 00:10:51,330
+Refracting Surface طيب هذه المعادلة اللي هي الـ
+
+122
+00:10:51,330 --> 00:10:56,290
+Thin Lens Equation بتقوللي ان بعد ال object مرتبط
+
+123
+00:10:57,250 --> 00:11:01,370
+ارتباط وثيق هو أبعد الصورة إذا بتغير موقع ال
+
+124
+00:11:01,370 --> 00:11:05,090
+object لازم يتغير موقع الصورة ومش بالضروري أن يكون
+
+125
+00:11:05,090 --> 00:11:10,290
+بنفس القدر تمام بس الحاجة التانية المهمة جدا أن ال
+
+126
+00:11:10,290 --> 00:11:14,950
+power بتاعة ال lens بتلعب دور في خصائص الصورة
+
+127
+00:11:14,950 --> 00:11:22,550
+مظبوط يعني لو جبنا مثل ال object موقعه ثابت تمام
+
+128
+00:11:24,550 --> 00:11:30,390
+ال power مرة غيرناها تمام؟ معناته في عندي مشكلة
+
+129
+00:11:30,390 --> 00:11:37,170
+ليش؟ إذا تغيرت ال power تمام؟ الصورة هيتغير
+
+130
+00:11:37,170 --> 00:11:42,190
+خصائصها ومن ضمن خصائصها ال magnification طبعا ممكن
+
+131
+00:11:42,190 --> 00:11:45,230
+الإنسان يقول لسه لحتى الآن ماوصلناش للعلاقة بال
+
+132
+00:11:45,230 --> 00:11:48,530
+نفس له إحنا لسه قاعدين نعطي تمهيد عشان نوضح الفكرة
+
+133
+00:11:48,530 --> 00:11:55,010
+طيب نيجي نحكي القاتل هاي عند العين اليمينتمام؟ وهي
+
+134
+00:11:55,010 --> 00:12:02,430
+عندي أنا العين الشمال تمام؟ الآن العين اليمين نفرض
+
+135
+00:12:02,430 --> 00:12:07,030
+إنها myopic axial
+
+136
+00:12:07,030 --> 00:12:13,270
+myopia تمام؟
+
+137
+00:12:13,270 --> 00:12:21,050
+والآن بدى أستعمل بدى أستعمل minus هذه شوية myopia
+
+138
+00:12:21,050 --> 00:12:21,970
+slight myopia
+
+139
+00:12:25,270 --> 00:12:31,610
+و هذه مثلا severe myopia الآن
+
+140
+00:12:31,610 --> 00:12:37,210
+بدأ أستعمل مثلا minus عشرة و بدأ أستعمل مثلا minus
+
+141
+00:12:37,210 --> 00:12:43,390
+اتنين لتصحيح ال refractive error تمام الآن اللي
+
+142
+00:12:43,390 --> 00:12:50,090
+هيحصل معايا انه different image size حجم الصورة
+
+143
+00:12:50,090 --> 00:12:52,890
+بتاعة ال object اللي بتطلع عليه هذا البني آدم
+
+144
+00:12:52,890 --> 00:13:01,440
+different image sizeبسبب ان ال power بتلعب
+
+145
+00:13:01,440 --> 00:13:07,940
+دور في خصائص ال image مظبوط ولا لأ تغيير ال power
+
+146
+00:13:07,940 --> 00:13:14,060
+بأدى لتغيير خصائص ال image واضح هل ال power عندى
+
+147
+00:13:14,060 --> 00:13:19,780
+هنا عندى power تختلف عن ال power هنا حجم الصورة
+
+148
+00:13:19,780 --> 00:13:23,880
+على ال retina هنالا يساوي حجم الصورة على ال retina
+
+149
+00:13:23,880 --> 00:13:27,680
+هنا صورة الشيء اللي بتطلع عليه هذا الإنسان هذه
+
+150
+00:13:27,680 --> 00:13:31,020
+مثلا ال right eye وهذه ال left eye مثلا رسمته فوق
+
+151
+00:13:31,020 --> 00:13:35,640
+بعض لتوضيح الفكرة تمام اذا لما انا بيكون عندي
+
+152
+00:13:35,640 --> 00:13:39,120
+anisometropia بعرفش اذا وصلته في ال refraction انه
+
+153
+00:13:39,120 --> 00:13:42,820
+ممنوع يكون difference في قوة العدسات في ال glasses
+
+154
+00:13:42,820 --> 00:13:46,400
+اكتر مثلا من اتنين و نص ديوبتر او اكتر من تلاتة
+
+155
+00:13:46,400 --> 00:13:50,650
+ديوبتر على اقصى تقدير تمامإذا ما وصلتوا الوش احنا
+
+156
+00:13:50,650 --> 00:13:54,470
+بنشرح هذا الكلام عشان لما توصلوله ال different
+
+157
+00:13:54,470 --> 00:13:58,670
+image size طيب
+
+158
+00:13:58,670 --> 00:14:02,950
+ما المعنى انه يكون ال image size بتاعة الشيء اللي
+
+159
+00:14:02,950 --> 00:14:06,350
+انا بتطلع عليه انا بتطلع الجلام انطبعتله صورة على
+
+160
+00:14:06,350 --> 00:14:11,270
+عيني او على شبكية عيني اليمين وانطبعتله صورة في
+
+161
+00:14:11,270 --> 00:14:15,450
+نفس اللحظة على شبكية عيني الشمال الصورتين مش نفس
+
+162
+00:14:15,450 --> 00:14:19,790
+الحجمهو في العادة أن الصورتين لازم يكونوا نفس
+
+163
+00:14:19,790 --> 00:14:23,770
+الوضوح ونفس الحجم ويرسلوا للدماغ لل visual cortex
+
+164
+00:14:23,770 --> 00:14:27,470
+عشان يتم توحيدهم في صورة احنا بنشوف الشقل واحد
+
+165
+00:14:27,470 --> 00:14:35,710
+واحد طيب الدماغ جداش بيستحمل فرج في حجم الصورتين
+
+166
+00:14:35,710 --> 00:14:37,130
+انهم يفرجوا عن بعض
+
+167
+00:14:39,840 --> 00:14:45,460
+عند ال adults عند ال adults لعند 8% difference في
+
+168
+00:14:45,460 --> 00:14:49,200
+الحجم ممكن يتحملوا الابرين يعني لو في فرج في حجم
+
+169
+00:14:49,200 --> 00:14:53,540
+السورتين لغاية 8% ممكن يدمج السورتين وينتج منهم
+
+170
+00:14:53,540 --> 00:14:59,500
+صورة واحدة تمام عند الأصغار أكتر شوية بعض الكتب
+
+171
+00:14:59,500 --> 00:15:04,320
+بتحكي لعند 12% طب لو كان الفرج هي صورة على الشبكية
+
+172
+00:15:04,320 --> 00:15:07,940
+وهي صورة يعني هي تقريبا صورة ضعف الصورة يعني 100%
+
+173
+00:15:07,940 --> 00:15:15,880
+فرجساعتها هيصير إزدواجية في الرؤية أو ممكن لدماغ
+
+174
+00:15:15,880 --> 00:15:19,040
+يلغي إحدى الصورتين و يصير الإنسان يركز بعين واحدة
+
+175
+00:15:19,040 --> 00:15:27,300
+إجا نابس حط حل للمشكلة إجا نابس حط حل و أصبح هذا
+
+176
+00:15:27,300 --> 00:15:33,980
+الحل يعرف بنابس لو من وين جاب الحل بتاعه؟ بس واضحة
+
+177
+00:15:33,980 --> 00:15:37,700
+الفكرة أنه لما أنا قاعد أعمل correction
+
+178
+00:15:40,320 --> 00:15:46,460
+للإنسان اللي عنده unequal
+
+179
+00:15:46,460 --> 00:15:51,040
+refractive error في ال two eyes يعني هنا في
+
+180
+00:15:51,040 --> 00:15:53,980
+refractive error و هنا في refractive error يعني في
+
+181
+00:15:53,980 --> 00:15:57,180
+فرق في refractive error تمام أو واحدة فيها
+
+182
+00:15:57,180 --> 00:15:59,640
+refractive error والتانية مافيش فيها refractive
+
+183
+00:15:59,640 --> 00:16:04,210
+error فلما أجى أصحح ال refractive errorشيء ممتاز
+
+184
+00:16:04,210 --> 00:16:08,290
+عشان اوضح الصورة بس في عندنا نقطة انه لازم الحجم
+
+185
+00:16:08,290 --> 00:16:13,210
+بتاع ال retinal image size يكون تقريبا equal في
+
+186
+00:16:13,210 --> 00:16:18,130
+العينتين طيب ماشي بدنا نخليه equal في العينتين
+
+187
+00:16:18,130 --> 00:16:25,170
+كيف؟ اجى نابس وضع قانون قال احنا بنقول كالقاتل
+
+188
+00:16:27,140 --> 00:16:30,920
+استفاد من قاعدتين من القواعد اللي مروا عنها نقول
+
+189
+00:16:30,920 --> 00:16:37,380
+الذي يمر في FA يخرج من ال optical system ماله
+
+190
+00:16:37,380 --> 00:16:46,080
+موازي لل optical axis مظبوط الذي الشعاع الذي يمر
+
+191
+00:16:46,080 --> 00:16:54,860
+في ال nodal point لا يغير طريقه يعني ممتاز شيء
+
+192
+00:16:54,860 --> 00:17:03,680
+ممتازمافي مشكلة بغض النظر جال انا بستعمل القاعدتين
+
+193
+00:17:03,680 --> 00:17:12,760
+دولة حتى يكون ال retinal image size موحد بين
+
+194
+00:17:12,760 --> 00:17:17,480
+الأنتين نقول
+
+195
+00:17:17,480 --> 00:17:21,100
+كالقاتل هي عدسة
+
+196
+00:17:23,900 --> 00:17:35,500
+وهي ال optical axis بتاعها وهي العين تمام وهي
+
+197
+00:17:35,500 --> 00:17:40,740
+العين وهي العين اقصد في التلات رسمات هدول سواء
+
+198
+00:17:40,740 --> 00:17:45,400
+العين كانت hyper metropic قصيرة او immetropic او
+
+199
+00:17:45,400 --> 00:17:51,960
+طولة طبيعي او قصير او طويل بغض النظرجال القانون
+
+200
+00:17:51,960 --> 00:17:58,360
+بتاعه إذا وضعنا الـ Correcting Lens اللي
+
+201
+00:17:58,360 --> 00:18:03,620
+هتصحح للـ Reflective Error بحيث الـ Nodal Point
+
+202
+00:18:03,620 --> 00:18:08,120
+بتاعتها الـ Nodal Point أو بالأصحى الـ Posterior
+
+203
+00:18:08,120 --> 00:18:12,380
+Nodal Point لأنه هيخرج منها تنطبق على FA بتاعة
+
+204
+00:18:12,380 --> 00:18:20,700
+العين FA بتاعة العين تمام؟ هاي ال object ماشي؟هذه
+
+205
+00:18:20,700 --> 00:18:26,280
+النقطة ايه صورتها هتكون عرّيت هنا اي شرطة مظبوط من
+
+206
+00:18:26,280 --> 00:18:30,320
+النقطة ايه لو دخل في ال nodal point بتاعة العدسة
+
+207
+00:18:30,320 --> 00:18:35,000
+لو دخل في ال nodal point ركزولي مع العدسة نتعامل
+
+208
+00:18:35,000 --> 00:18:40,500
+مع كل عدسة على حدر نفرض العين عدسة و العدسة عدسة
+
+209
+00:18:40,500 --> 00:18:43,680
+لحالها هي هذه العدسة رقم واحد الشعاع
+
+210
+00:18:46,350 --> 00:18:50,470
+اللي هيدخل في ال node ال point بتاعة العدسة هيغير
+
+211
+00:18:50,470 --> 00:18:56,430
+طريقه لأ مغيرش طريقه و في نفس اللحظة الرسم هنا
+
+212
+00:18:56,430 --> 00:19:01,670
+بدها تكبير شوية في نفس اللحظة هذا الشعاع دخل وين
+
+213
+00:19:01,670 --> 00:19:06,770
+في ال FA بتاعة العين لما بيخرج من ال optical
+
+214
+00:19:06,770 --> 00:19:09,750
+system بتاعة العين بيكون موازي لل optical axis
+
+215
+00:19:09,750 --> 00:19:17,440
+ماشي يعنيسواء العين هيبرمتروب أو سواء طولها طبيعي
+
+216
+00:19:17,440 --> 00:19:22,440
+أو سواء ميوب طبعا سوريه هيبقى اسمها مش موفقة كتير
+
+217
+00:19:22,440 --> 00:19:28,560
+ال retinal image size بيظله ايش نفس ال retinal
+
+218
+00:19:28,560 --> 00:19:36,500
+image size نفسله ببساطة او العالم ناب بيقولنا
+
+219
+00:19:36,500 --> 00:19:45,440
+ببساطة شديدة اذا النضارةبتكون على بعد يساوي ال fa
+
+220
+00:19:45,440 --> 00:19:50,680
+بتاعة العين ساعتها ال written image size بتكون إيش
+
+221
+00:19:50,680 --> 00:19:55,140
+سابتة بمعنى هحصل على written image size للعين
+
+222
+00:19:55,140 --> 00:19:58,800
+اليمين يساوي ال written image size بغض النظر عن
+
+223
+00:19:58,800 --> 00:20:05,220
+طول العين ما هو لو تقول أنها عين ميوب اليمين وعين
+
+224
+00:20:05,220 --> 00:20:10,690
+الشمال ميوب أكتر منها يعني أطول منهابغض النظر عن
+
+225
+00:20:10,690 --> 00:20:16,670
+الطول ال results واحدة شرط عشان يتحقق القانون هذا
+
+226
+00:20:16,670 --> 00:20:21,210
+او قاعدة NAB لازم ال correcting lens تكون ال nodal
+
+227
+00:20:21,210 --> 00:20:26,570
+point بتاعتها منطبق على FA بتاعت العين بس جال انا
+
+228
+00:20:26,570 --> 00:20:36,090
+في عندي شرط تاني ان يكون ال refractive error axial
+
+229
+00:20:36,090 --> 00:20:44,570
+ايش يعني axial؟مش refractive مش refractive يعني
+
+230
+00:20:44,570 --> 00:20:48,040
+هذا مانفعش في حالة ما يكونrefractive power بتاعة
+
+231
+00:20:48,040 --> 00:20:52,140
+العين اضعف من اللازم او اقوى من اللازم قوة العين
+
+232
+00:20:52,140 --> 00:20:56,260
+طبيعية بس طول العين هو اللي مش طبيعي اما اطول من
+
+233
+00:20:56,260 --> 00:21:01,000
+اللازم او اقصر من اللازم بتطبيق nab's law بنحصل
+
+234
+00:21:01,000 --> 00:21:05,660
+على equal retinal image size وبالتالي بنعانيش من
+
+235
+00:21:05,660 --> 00:21:10,340
+قضية الازدواجية وال brain بتاعنا بيقدر يتحمل
+
+236
+00:21:13,400 --> 00:21:16,800
+يعني بيكون الفرق في ال retinal image تقريبا مافيش
+
+237
+00:21:16,800 --> 00:21:20,980
+فرق تقريبا مافيش فرق بناء على القاعدة هاي بشرط انه
+
+238
+00:21:20,980 --> 00:21:25,760
+يكون ال refractive error ماله أكسيا و عادة احنا
+
+239
+00:21:25,760 --> 00:21:30,740
+ممكن الإنسان يكون عنده axial refractive error او
+
+240
+00:21:30,740 --> 00:21:35,660
+refractive cause او اتنين مع بعض احيانا بيكون في
+
+241
+00:21:35,660 --> 00:21:41,330
+نفس الإنسان الاتنين مع بعض طيب الآنأتجوا العلماء
+
+242
+00:21:41,330 --> 00:21:44,910
+لاجوا فيه مشكلتين للتطبيق العملي في الحياة
+
+243
+00:21:44,910 --> 00:21:51,410
+الواقعية لنفسه أول مشكلة غالبا غالبا الإنسان اللي
+
+244
+00:21:51,410 --> 00:21:56,890
+عنده refractive error ممكن يكون عنده axial cause
+
+245
+00:21:56,890 --> 00:22:01,750
+زائد refractive cause يعني إن اللاجي pure axial
+
+246
+00:22:01,750 --> 00:22:07,170
+refractive error موجود بس جليل بس جليل تمام؟ وعادة
+
+247
+00:22:07,170 --> 00:22:11,700
+إحنا لما بنفحص ال refractive errorمش دايما بنجيز
+
+248
+00:22:11,700 --> 00:22:17,000
+طول العين للمريض مش دايما إلا في حالات معينة تمام
+
+249
+00:22:17,000 --> 00:22:21,020
+يعني إحنا بنقول إنسان مثلا أحمد عنده minus 2
+
+250
+00:22:21,020 --> 00:22:25,680
+diopter myopia بنقولش ال minus 2 diopter axial أو
+
+251
+00:22:25,680 --> 00:22:28,100
+refractive فبالتالي
+
+252
+00:22:29,590 --> 00:22:33,030
+هل بنقدر بدون ما نعرف هل هي Axial او Refractive ان
+
+253
+00:22:33,030 --> 00:22:36,050
+نطبق Nabs Law؟ طبعاً لأ لأن اذا Refractive مش
+
+254
+00:22:36,050 --> 00:22:40,350
+هينفع هذا بينفع في حالة ال Axial المعيق التاني و
+
+255
+00:22:40,350 --> 00:22:45,790
+اللي هو اكبر بالنسبة لتطبيق Nabs Law قضية الـ
+
+256
+00:22:45,790 --> 00:22:50,350
+Anterior Focal Point بتاعة العين FA بتاعة العين
+
+257
+00:22:50,350 --> 00:22:56,220
+تقريبا تبعد 17 ملي عن الوجه او عن العينيعني ال
+
+258
+00:22:56,220 --> 00:22:59,920
+back vertex distance بتاعة العدسة المسافة هاي
+
+259
+00:22:59,920 --> 00:23:05,540
+بتكون 17 مليون ال vertex distance المتعرف عليها
+
+260
+00:23:05,540 --> 00:23:11,880
+تقريبا 12 في دول معينة بتكون أنوفهم يعني مرتفعة
+
+261
+00:23:11,880 --> 00:23:16,680
+تشريحيا تمام ممكن توصل ل 15 maximum يعني انا
+
+262
+00:23:16,680 --> 00:23:23,480
+مابقدرش يعني احصل على اكتر من هيك ممكن انه نعمل
+
+263
+00:23:24,100 --> 00:23:28,240
+نضارة يكون ال back vertex distance تقريبا 15 ممكن
+
+264
+00:23:28,240 --> 00:23:33,820
+بس مش متعود انه الانسان يعني يلبس نضارات ب vertex
+
+265
+00:23:33,820 --> 00:23:38,640
+distance كبيرة زي هيك اذا عمليا نابس له رغم فائدته
+
+266
+00:23:38,640 --> 00:23:41,560
+رغم انه مبني على قواعد الـ Geometric Optics وانه
+
+267
+00:23:41,560 --> 00:23:44,900
+صحيح بالنسبة لـ Axial Refractive Error إلى انه
+
+268
+00:23:44,900 --> 00:23:50,680
+تطبيقاته العمليةيعني ما وجدته في موضوع النضارات و
+
+269
+00:23:50,680 --> 00:23:56,860
+موضوع إعداد النضارات ماوجدته سيط أو شهرة عالية رغم
+
+270
+00:23:56,860 --> 00:24:00,020
+أنه صحيح من ناحية علمية بالنسبة للـ Axial
+
+271
+00:24:00,020 --> 00:24:04,220
+Refractive Error رغم ذلك أتوا العلماء استفادوا من
+
+272
+00:24:04,220 --> 00:24:09,560
+نفسه في شغلات تانية في شغلات تانية من ضمن الشغلات
+
+273
+00:24:09,560 --> 00:24:16,770
+اللي استفادوا منها الـ Lens Meterاللي بيجيس لي قوة
+
+274
+00:24:16,770 --> 00:24:22,170
+العدسات الـ Lens Meter الـ Lens Meter بيستعمل مبدأ
+
+275
+00:24:22,170 --> 00:24:27,850
+NABSLOW بالضبط بس عشان أنا بطبق NABSLOW في الـ
+
+276
+00:24:27,850 --> 00:24:32,310
+Lens Meter أصبح NABSLOW اسمه Badal PrinciplePedal
+
+277
+00:24:32,310 --> 00:24:35,870
+principle يعني لو حد سألنا ايش هو ال pedal
+
+278
+00:24:35,870 --> 00:24:41,490
+principle هو نفسه نفسله نفسه بالضبط بس العلماء
+
+279
+00:24:41,490 --> 00:24:45,470
+استعملوا واستفادوا منه في قضية ال lensmeter اللي
+
+280
+00:24:45,470 --> 00:24:52,450
+بيجيس لقوة عدسات للنضارات و مبني او نفس فكرةاللي
+
+281
+00:24:52,450 --> 00:24:56,070
+هو ايش ان ال focal point بتاع ال system بدت تيجي
+
+282
+00:24:56,070 --> 00:24:59,410
+على ال nodal point بتاع العدسة اللي ايش اللي انا
+
+283
+00:24:59,410 --> 00:25:03,830
+بجيس فيها عساس ان ال image size يكون نفس ال image
+
+284
+00:25:03,830 --> 00:25:08,850
+او ال retina ال image size يكون نفس الشيء هل فقط
+
+285
+00:25:08,850 --> 00:25:14,060
+استفادوا منهفي قضية الـ Lensmeter لأ ايضا استفادوا
+
+286
+00:25:14,060 --> 00:25:17,740
+من النافس له في شغله تانية اسمها الـ Optometer
+
+287
+00:25:17,740 --> 00:25:21,980
+Principle Optometer هو جهاز بيعمللي objective
+
+288
+00:25:21,980 --> 00:25:28,620
+refraction زي و زي ال auto refractometer زي ال
+
+289
+00:25:28,620 --> 00:25:32,160
+auto refractometer بيعطي objective refraction ال
+
+290
+00:25:32,160 --> 00:25:36,000
+retinoscope ايضا هو جهاز للحصول على او لعمل
+
+291
+00:25:37,040 --> 00:25:44,580
+Objective is refraction الoptometer مع تعديل بسيط
+
+292
+00:25:44,580 --> 00:25:51,200
+لنابسلو بيتم عمل الoptometer وبيسموه optometer
+
+293
+00:25:51,200 --> 00:25:54,900
+principle
+
+294
+00:25:58,130 --> 00:26:01,950
+فبالتالي استفيد من نفسه في الـ Beta principle و في
+
+295
+00:26:01,950 --> 00:26:04,450
+الـ Optometer principle هما نفسه من نفسه مع
+
+296
+00:26:04,450 --> 00:26:10,810
+تعديلات قفيفة جدا ايضا في صناعة الأجهزة المعقدة زي
+
+297
+00:26:10,810 --> 00:26:16,250
+المايكروسكوبات و التليسكوبات استفادوا من نفسهفي
+
+298
+00:26:16,250 --> 00:26:21,010
+تصنيع هذه الأجهزة وهذا يسمى في الـ Optical
+
+299
+00:26:21,010 --> 00:26:24,770
+Engineering مبدأ الـ Telecentricity الهدف منه
+
+300
+00:26:24,770 --> 00:26:29,250
+تحسين جودة الصورة اللي بتعطينيها الأجهزة هذه اللي
+
+301
+00:26:29,250 --> 00:26:33,050
+هي أجهزة المايكروسكوبات المعقدة زي المايكروسكوبات
+
+302
+00:26:33,050 --> 00:26:37,390
+الجراحية والتليسكوبات الفضائية وما إلى ذلك
+
+303
+00:26:37,390 --> 00:26:43,600
+فبالتالي نابسلو له تطبيقات عملية كتيرة تماممهم
+
+304
+00:26:43,600 --> 00:26:48,200
+يعني صعب تطبيقه بالنسبة للبني آدم في قضية اللي هو
+
+305
+00:26:48,200 --> 00:26:54,340
+إعداد النضارات الخاصة بارتداء الإنسان فهذا كله
+
+306
+00:26:54,340 --> 00:26:59,100
+يعني تابع ل maps law اللي بنص على أنهالـ Retinal
+
+307
+00:26:59,100 --> 00:27:04,240
+Image Size الـ Retinal Image Size بيكون نفس الشيء
+
+308
+00:27:04,240 --> 00:27:07,860
+إذا كان الـ nodal point بتاعة ال correcting lens
+
+309
+00:27:07,860 --> 00:27:11,200
+انطبقت على ال focal ال anterior focal point بتاعة
+
+310
+00:27:11,200 --> 00:27:11,860
+العين
+
+311
+00:27:14,490 --> 00:27:18,290
+وهذه رغم عدم القدرة على الاستفادة منه عمليًا في
+
+312
+00:27:18,290 --> 00:27:22,590
+موضوع النضارات إلا إنه تم الاستفادة منه في كثير من
+
+313
+00:27:22,590 --> 00:27:26,970
+الأجهزة ومن ضمنها الـ Lens Meter و الـ Optometer و
+
+314
+00:27:26,970 --> 00:27:30,270
+اللي هو في صناعة في الـ Optical Engineering في
+
+315
+00:27:30,270 --> 00:27:34,010
+صناعة التليسكوبات و الميكروسكوبات و ما إلى ذلك نجي
+
+316
+00:27:34,010 --> 00:27:42,110
+لـ A Focal System حقيقة احنا قلنا كل Optical
+
+317
+00:27:42,110 --> 00:27:47,530
+Systemله three pairs of cardinal points two focal
+
+318
+00:27:47,530 --> 00:27:51,650
+و two nodal و two principal points و لو أضفنا
+
+319
+00:27:51,650 --> 00:27:55,730
+optical system ل optical system آخر بينشأ عندي
+
+320
+00:27:55,730 --> 00:28:00,990
+منهم اتنين optical system جديد له طاقم جديد من ال
+
+321
+00:28:00,990 --> 00:28:06,750
+reference points الآن هذه تعتبر قاعدة فيها استثناء
+
+322
+00:28:06,750 --> 00:28:14,200
+نضرب مثال بنقول كالقادة احنا عندنا عدسة plus 2و
+
+323
+00:28:14,200 --> 00:28:26,340
+عدسة ماينس خمسة و المسافة الفاصلة بينهم تلاتين
+
+324
+00:28:26,340 --> 00:28:29,180
+صنطي
+
+325
+00:28:33,060 --> 00:28:41,220
+وبنقول بدنا نحدد ال focal point ال posterior focal
+
+326
+00:28:41,220 --> 00:28:48,320
+point لهذا ال system لل system ككل مش لعدسة واحد
+
+327
+00:28:48,320 --> 00:28:52,320
+لل system ككل كيف بتتم تحديد ال posterior focal
+
+328
+00:28:52,320 --> 00:28:58,840
+point احنا بنقول ان الشعاع ال parallel بدخل في FB
+
+329
+00:28:58,840 --> 00:29:07,040
+مظبوطالشعاع الـ Parallel يدخل في FB OK ماشي نرى
+
+330
+00:29:07,040 --> 00:29:10,340
+الأشعة الـ Parallel اللى بدأت تدخل الـ System هذا
+
+331
+00:29:10,340 --> 00:29:15,840
+إيش بده يصير فيها؟ إيش بده يصير فيها؟ طيب بنقول
+
+332
+00:29:15,840 --> 00:29:20,500
+عنا أشعة Parallel وكيف هتخرج من الـ System هذا
+
+333
+00:29:20,500 --> 00:29:24,820
+المفروض لما تخرج من هذا الـ System ككل تروح على FB
+
+334
+00:29:24,820 --> 00:29:27,880
+مش على العدسة هاي بتاع الـ System ككل بتاع الـ
+
+335
+00:29:27,880 --> 00:29:33,510
+System ككل الأشعة الـ Parallel الـ U هنا إيش؟الـ V
+
+336
+00:29:33,510 --> 00:29:40,250
+هنا إيش ال image I تساوي on شرط على V ويساوي واحد
+
+337
+00:29:40,250 --> 00:29:47,730
+على plus اتنين ويساوي plus نص متر خمسين صنطي يعني
+
+338
+00:29:47,730 --> 00:29:53,310
+الأشعة ال parallel هتكون صورة عباد خمسين صنطي يعني
+
+339
+00:29:53,310 --> 00:29:59,470
+من هنا لهنا خمسين صنطي هذه ال real image للأشعة ال
+
+340
+00:29:59,470 --> 00:30:04,030
+parallel مظبوطباتكلمش انا عن ال magnification لان
+
+341
+00:30:04,030 --> 00:30:10,170
+تمام بما ان هذا يعتبر virtual object للعدسة
+
+342
+00:30:10,170 --> 00:30:13,110
+التانية مظبوط صورة العدسة الأولى virtual object
+
+343
+00:30:13,110 --> 00:30:17,170
+جاية عاليمين تمام اذا ال U بال plus مظبوط كداشة
+
+344
+00:30:17,170 --> 00:30:24,410
+بتبعد عن العدسة هاي خمسين نقص تلاتين اذا U تساوي
+
+345
+00:30:24,410 --> 00:30:30,840
+زائد Nsorry زائد N على O يساوي زائد واحد على اتنين
+
+346
+00:30:30,840 --> 00:30:40,520
+من عشرة متر ويساوي زائد خمسة ديوبتر ال V قداش؟ ايش
+
+347
+00:30:40,520 --> 00:30:44,560
+يعني صفر؟
+
+348
+00:30:44,560 --> 00:30:49,820
+أشعة parallel الآن أنا بتتكلم عن ال system ككل
+
+349
+00:30:49,820 --> 00:30:53,840
+الأشعة ال parallel خرجت مالها من ال system
+
+350
+00:30:53,840 --> 00:31:00,500
+parallelاحنا القاعدة بتقول ال parallel لل optical
+
+351
+00:31:00,500 --> 00:31:08,020
+axis بدخل في FB هذا ال system يسمى a focal system
+
+352
+00:31:08,020 --> 00:31:12,880
+a نافية a focal system ليس له focal points لا
+
+353
+00:31:12,880 --> 00:31:17,220
+posterior زي ما ضربنا مثل ولا anterior وحقيقة ليس
+
+354
+00:31:17,220 --> 00:31:25,010
+له cardinal points طيب شيلنا العدسة دي لحالالعدسة
+
+355
+00:31:25,010 --> 00:31:28,710
+لحالها إلها cardinal points two nodal و two
+
+356
+00:31:28,710 --> 00:31:34,350
+principal و two focal العدسة هذه لحالها برضه إلها
+
+357
+00:31:34,350 --> 00:31:38,590
+three pairs of cardinal points طيب لو بعدنا
+
+358
+00:31:38,590 --> 00:31:43,270
+المسافة بينهم أو جربنا المسافة بينهم بيصبح system
+
+359
+00:31:43,270 --> 00:31:47,770
+إله focus و إله three set of cardinal points هدولة
+
+360
+00:31:47,770 --> 00:31:53,350
+العدساتين بالمسافة المعينة هذهالمنظومة هي زي ما
+
+361
+00:31:53,350 --> 00:32:00,030
+انتوا شايفينها a focal system في الوضعية هي لا
+
+362
+00:32:00,030 --> 00:32:03,290
+إرسال ولا استقبال كما يقولون يعني تمام ليس له
+
+363
+00:32:03,290 --> 00:32:10,190
+cardinal points تمام هذه مثال نضرب مثال تاني
+
+364
+00:32:10,190 --> 00:32:17,490
+المثال
+
+365
+00:32:17,490 --> 00:32:19,950
+التاني بنقول مثلا عندي plus 2
+
+366
+00:32:24,770 --> 00:32:31,410
+و plus أربعة و المسافة بينهم خمسة و سبعين سنتيمتر
+
+367
+00:32:31,410 --> 00:32:35,950
+خمسة
+
+368
+00:32:35,950 --> 00:32:37,350
+و سبعين سنتيمتر
+
+369
+00:32:39,840 --> 00:32:42,640
+Posterior focal point لهذا ال system ولا لا احنا
+
+370
+00:32:42,640 --> 00:32:46,380
+جولنا القاعدة بسيطة اللي parallel لل optical axis
+
+371
+00:32:46,380 --> 00:32:50,340
+لازم يدخل في FP هذا لما يكون عدسة و لما يكون
+
+372
+00:32:50,340 --> 00:32:53,640
+system اللي parallel لل optical axis بده يدخل في
+
+373
+00:32:53,640 --> 00:32:59,560
+ال FP بتاعة ال system كله طيب هاي ال parallel اذا
+
+374
+00:32:59,560 --> 00:33:04,740
+ال U ايش؟ Zero بدون حساب ال parallel ال U Zero ال
+
+375
+00:33:04,740 --> 00:33:10,410
+virgins بتاع ال light Zeroإذا V بلس اتنين I تساوي
+
+376
+00:33:10,410 --> 00:33:14,010
+ان شرط على V و يساوي واحد على plus اتنين ديوبتر و
+
+377
+00:33:14,010 --> 00:33:22,030
+يساوي plus نص متر خمسين سانتي بغض النظر الصورة
+
+378
+00:33:22,030 --> 00:33:30,290
+مجلوبة عدلة مش قضية okay طيب خمسين سانتي إذا
+
+379
+00:33:30,290 --> 00:33:36,450
+المسافة من هنا لهنا جداشخمسة و عشرين صنطة هذه صورة
+
+380
+00:33:36,450 --> 00:33:41,430
+العدسة الأولى object للتانية مظبوط U تساوي ناقص N
+
+381
+00:33:41,430 --> 00:33:45,770
+على O يساوي ناقص واحد على ربع متر و يساوي ناقص
+
+382
+00:33:45,770 --> 00:33:50,670
+أربعة ديوبتر ايش
+
+383
+00:33:50,670 --> 00:33:58,870
+هنزيره ايضا هذا ال system a focal system أشعة دخلت
+
+384
+00:33:58,870 --> 00:34:05,280
+منه متوازية وخرجت منه كما دخلت تمامحقيقة المثال
+
+385
+00:34:05,280 --> 00:34:14,300
+الأول المثال الأول هذا
+
+386
+00:34:14,300 --> 00:34:21,640
+Galilean Telescope هذا يسمى Galilean Telescope و
+
+387
+00:34:21,640 --> 00:34:26,360
+هذا المثال التاني يسمى Keplerian Telescope
+
+388
+00:34:30,530 --> 00:34:36,430
+التليسكوبات are a focal systems التليسكوبات اللي
+
+389
+00:34:36,430 --> 00:34:39,930
+احنا بنسمع فيهم وقرأنا عنهم في المدارس بشكل مبسط
+
+390
+00:34:39,930 --> 00:34:45,510
+هم عبارة عن a focal systems يعني systems ملهاش
+
+391
+00:34:45,510 --> 00:34:49,880
+cardinal pointsوالأشعة ال parallel اللى بتدخل فيها
+
+392
+00:34:49,880 --> 00:34:53,560
+هتخرج parallel إلها فائدة كبيرة في موضوع ال
+
+393
+00:34:53,560 --> 00:34:57,380
+magnification إلها فائدة كبيرة واستعمالات كتيرة في
+
+394
+00:34:57,380 --> 00:35:01,180
+موضوع ال magnification طبعا هذا Galilean Telescope
+
+395
+00:35:01,180 --> 00:35:04,760
+وهذا
+
+396
+00:35:04,760 --> 00:35:11,900
+Keplerian Telescope طبعا
+
+397
+00:35:11,900 --> 00:35:13,680
+Galilean Telescope
+
+398
+00:35:16,580 --> 00:35:21,740
+يعني تم تسميته ب Galilean Telescope تكريما للعالم
+
+399
+00:35:21,740 --> 00:35:26,840
+Galileo Galilei ولكن ليس هو مخترع التلسكوب هذا بس
+
+400
+00:35:26,840 --> 00:35:31,860
+تكريما له تم تسميته Galilean Telescope بناء على
+
+401
+00:35:31,860 --> 00:35:36,880
+أبحاثه واختراعاته وإلى آخرى أما ال Keplerian
+
+402
+00:35:36,880 --> 00:35:42,640
+Telescope اللي اخترعه اللي هو Johans Kepler
+
+403
+00:35:42,640 --> 00:35:49,650
+وهذا يستخدمكثيرا في التليسكوبات الفضائية وهنا
+
+404
+00:35:49,650 --> 00:35:53,150
+يستخدم في ال low vision aids والشغلات اللي زي هيك
+
+405
+00:35:53,150 --> 00:35:56,710
+يعني في المساعدات البصرية الاستخدامات كتيرة تانية
+
+406
+00:35:56,710 --> 00:36:03,130
+تمام كيف احنا نبني تليسكوب او نصنع تليسكوب او يعني
+
+407
+00:36:03,130 --> 00:36:08,290
+اش معنى المسافة هاي اش معنى المسافة هايهذه شغلة
+
+408
+00:36:08,290 --> 00:36:11,990
+بسيطة جدا هنعرفها ان شاء الله للمرة القادمة عندما
+
+409
+00:36:11,990 --> 00:36:16,250
+نبدأ نتكلم عن التليسكوبات بالتفصيل ونبدأ نشوف
+
+410
+00:36:16,250 --> 00:36:21,010
+خصائص كل image بتتكون عبر التليسكوب والتكبير كيف
+
+411
+00:36:21,010 --> 00:36:26,690
+أجيبه بمعادلة بسيطة وبالتالي الأمور مش صعبة هتكون
+
+412
+00:36:26,690 --> 00:36:30,330
+و هنعمل جدوة للمقارنة بين اللي هو الـGalilean
+
+413
+00:36:30,330 --> 00:36:34,330
+Telescope وKeplerian Telescope يعطيكوا العافية
+
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/lKjfmgkqWeY_raw.json b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/lKjfmgkqWeY_raw.json
new file mode 100644
index 0000000000000000000000000000000000000000..47c907e8feb505824ea14d1511271beb4b90ad2b
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/lKjfmgkqWeY_raw.json
@@ -0,0 +1 @@
+{"segments": [{"id": 1, "seek": 4487, "start": 20.77, "end": 44.87, "text": "طيب بسم الله الرحمن الرحيم اليوم بنكمل مع المنشير ال prismات و لدينا أول نقطة بنحكي عنها اللي هي vector additions of a prism لو إنسان اتخيلنا عنده نوعين من الحوال حوال أفقي أزوتروبيا أو أكزوتروبيا بسيط و حوال رأسي hyper لل right أو لل left تمام", "tokens": [9566, 1829, 3555, 4724, 38251, 21984, 34892, 5016, 27842, 34892, 5016, 32640, 45595, 20498, 44945, 24793, 1211, 20449, 9673, 1863, 8592, 13546, 2423, 582, 1434, 9307, 4032, 5296, 16254, 8315, 5551, 12610, 8717, 47432, 3660, 44945, 5016, 4117, 1829, 18871, 11296, 13672, 1829, 39896, 8062, 35113, 295, 257, 582, 1434, 45164, 36145, 3794, 7649, 1975, 2655, 9778, 26895, 8315, 43242, 3224, 8717, 45367, 9957, 9154, 21542, 2407, 6027, 11331, 2407, 6027, 5551, 5172, 38436, 5551, 11622, 35473, 2288, 2407, 21292, 995, 34051, 5551, 4117, 11622, 35473, 2288, 2407, 21292, 995, 4724, 3794, 1829, 9566, 4032, 11331, 2407, 6027, 12602, 10721, 3794, 1829, 9848, 24976, 558, 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prism وجداش ال N خمسة prism هذه الستة prism انا بدأ انجله هنا تمام", "tokens": [7435, 3215, 33599, 2423, 3096, 11778, 3224, 8608, 2655, 3660, 582, 1434, 46811, 10943, 8608, 2655, 3660, 582, 1434, 49610, 3215, 33599, 2423, 426, 16490, 2304, 3794, 3660, 582, 1434, 29538, 21136, 2655, 3660, 582, 1434, 1975, 8315, 47525, 10721, 16472, 7435, 43761, 34105, 46811, 10943], "avg_logprob": -0.3803191603498256, "compression_ratio": 1.5294117647058822, "no_speech_prob": 2.384185791015625e-07, "words": [{"start": 343.27, "end": 344.33, "word": "جداش", "probability": 0.44464111328125}, {"start": 344.33, "end": 344.45, "word": " ال", "probability": 0.91162109375}, {"start": 344.45, "end": 344.69, "word": " base", "probability": 0.603515625}, {"start": 344.69, "end": 345.11, "word": " ده", "probability": 0.816162109375}, {"start": 345.11, "end": 346.87, "word": " ستة", "probability": 0.800048828125}, {"start": 346.87, "end": 347.55, "word": " prism", "probability": 0.614013671875}, {"start": 347.55, 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"word": " لان", "probability": 0.6314697265625}, {"start": 758.33, "end": 758.51, "word": " لما", "probability": 0.864990234375}, {"start": 758.51, "end": 758.71, "word": " انا", "probability": 0.830322265625}, {"start": 758.71, "end": 759.03, "word": " بكون", "probability": 0.939453125}, {"start": 759.03, "end": 759.37, "word": " مضطر", "probability": 0.9754638671875}, {"start": 759.37, "end": 759.87, "word": " استعمل", "probability": 0.8818359375}, {"start": 759.87, "end": 760.25, "word": " prism", "probability": 0.58221435546875}, {"start": 760.25, "end": 760.39, "word": " و", "probability": 0.77685546875}, {"start": 760.39, "end": 760.61, "word": " high", "probability": 0.7236328125}, {"start": 760.61, "end": 760.91, "word": " power", "probability": 0.87158203125}, {"start": 760.91, "end": 761.29, "word": " prism", "probability": 0.859619140625}, {"start": 761.29, "end": 761.91, "word": " أحيانا", "probability": 0.8923828125}], "temperature": 1.0}, {"id": 30, "seek": 78558, "start": 762.22, "end": 785.58, "text": "يعني ممكن اشوف حوالين المصادر الضوء اللمبات او المصابيح الضوئية يعني هالات لونية وهذه ممكن تكون مزعجة للمريض يعني مش دائما بيكون يقدر يتحملها المريض اذا من اهم ال aberrations اللي بيعملياها لبرزم ل chromatic aberration وكل ما زادت قوة البرزم بيكون ال aberration كميتها اكتر", "tokens": [40228, 22653, 3714, 43020, 1975, 8592, 38688, 11331, 2407, 6027, 9957, 9673, 9381, 18513, 2288, 6024, 114, 2407, 38207, 13672, 2304, 3555, 9307, 1975, 2407, 9673, 9381, 16758, 1829, 5016, 6024, 114, 2407, 19986, 10632, 37495, 22653, 8032, 6027, 9307, 5296, 11536, 10632, 37037, 24192, 3714, 43020, 6055, 30544, 3714, 11622, 3615, 7435, 3660, 5296, 19528, 16572, 11242, 37495, 22653, 37893, 11778, 16373, 15042, 4724, 1829, 30544, 7251, 28543, 2288, 7251, 2655, 35571, 1211, 11296, 9673, 16572, 11242, 1975, 15730, 9154, 1975, 16095, 2423, 4340, 12154, 13672, 1829, 4724, 1829, 25957, 1211, 25528, 11296, 5296, 26890, 11622, 2304, 5296, 16209, 2399, 4340, 2405, 4032, 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"probability": 0.99169921875}, {"start": 1326.68, "end": 1327.48, "word": " الوظيفة", "probability": 0.980859375}, {"start": 1327.48, "end": 1327.66, "word": " ..", "probability": 0.104736328125}, {"start": 1327.66, "end": 1328.16, "word": " نفس", "probability": 0.96142578125}, {"start": 1328.16, "end": 1329.04, "word": " الوظيفة", "probability": 0.98740234375}, {"start": 1329.04, "end": 1329.48, "word": " اللي", "probability": 0.7978515625}, {"start": 1329.48, "end": 1329.72, "word": " هي", "probability": 0.69921875}, {"start": 1329.72, "end": 1330.58, "word": " بتقديها", "probability": 0.9312744140625}, {"start": 1330.58, "end": 1330.94, "word": " لـ", "probability": 0.4654541015625}, {"start": 1330.94, "end": 1331.2, "word": " Fresnel", "probability": 0.777099609375}, {"start": 1331.2, "end": 1331.6, "word": " برزم", "probability": 0.5858154296875}, {"start": 1331.6, "end": 1332.28, "word": " المعتاد", "probability": 0.9733072916666666}, {"start": 1332.28, "end": 1333.56, "word": " ويلها", "probability": 0.7386881510416666}, {"start": 1333.56, "end": 1334.38, "word": " استعمالات", "probability": 0.9794921875}, {"start": 1334.38, "end": 1335.16, "word": " يعني", "probability": 0.885986328125}, {"start": 1335.16, "end": 1336.56, "word": " متعددة", "probability": 0.978515625}, {"start": 1336.56, "end": 1337.86, "word": " تمام؟", "probability": 0.6509602864583334}, {"start": 1337.86, "end": 1338.2, "word": " الآن", "probability": 0.67822265625}, {"start": 1338.2, "end": 1338.42, "word": " بدنا", "probability": 0.2960205078125}, {"start": 1338.42, "end": 1338.84, "word": " نيجي", "probability": 0.987060546875}, {"start": 1338.84, "end": 1339.82, "word": " يعني", "probability": 0.81201171875}, {"start": 1339.82, "end": 1340.04, "word": " هيك", "probability": 0.939208984375}, {"start": 1340.04, "end": 1340.52, "word": " تقريبا", "probability": 0.98271484375}, {"start": 1340.52, "end": 1340.76, "word": " احنا", "probability": 0.93505859375}, {"start": 1340.76, "end": 1341.22, "word": " حكينا", "probability": 0.942138671875}, {"start": 1341.22, "end": 1341.56, "word": " عن", "probability": 0.98681640625}], "temperature": 1.0}, {"id": 55, "seek": 135486, "start": 1342.4, "end": 1354.86, "text": "يعني معظم الأشياء اللي بدنا نحكي عنها في الprismat بدنا نيجي احنا ناخد تدريب على المحاضرة السابقة وليه مهم جدا في قضية ال lens decentration", "tokens": [40228, 22653, 20449, 19913, 2304, 16247, 8592, 1829, 16606, 13672, 1829, 47525, 8315, 8717, 5016, 4117, 1829, 18871, 11296, 8978, 2423, 1424, 1434, 267, 47525, 8315, 8717, 1829, 7435, 1829, 1975, 5016, 8315, 8717, 47283, 3215, 6055, 3215, 16572, 3555, 15844, 9673, 5016, 46958, 25720, 21136, 16758, 28671, 4032, 20292, 3224, 3714, 16095, 10874, 28259, 8978, 12174, 11242, 10632, 2423, 6765, 8681, 2405], "avg_logprob": -0.2100830131676048, "compression_ratio": 1.4528301886792452, "no_speech_prob": 1.615285873413086e-05, "words": [{"start": 1342.4, "end": 1342.78, "word": "يعني", "probability": 0.541259765625}, {"start": 1342.78, "end": 1343.2, "word": " معظم", "probability": 0.9817708333333334}, {"start": 1343.2, "end": 1343.6, "word": " الأشياء", "probability": 0.9835205078125}, {"start": 1343.6, "end": 1343.68, "word": " اللي", "probability": 0.771484375}, {"start": 1343.68, "end": 1343.86, "word": " بدنا", "probability": 0.905517578125}, {"start": 1343.86, "end": 1344.16, "word": " نحكي", "probability": 0.979736328125}, {"start": 1344.16, "end": 1344.42, "word": " عنها", "probability": 0.98388671875}, {"start": 1344.42, "end": 1344.6, "word": " في", "probability": 0.92138671875}, {"start": 1344.6, "end": 1345.26, "word": " الprismat", "probability": 0.627899169921875}, {"start": 1345.26, "end": 1345.9, "word": " بدنا", "probability": 0.50518798828125}, {"start": 1345.9, "end": 1346.18, "word": " نيجي", "probability": 0.9024658203125}, {"start": 1346.18, "end": 1346.54, "word": " احنا", "probability": 0.8888346354166666}, {"start": 1346.54, "end": 1348.12, "word": " ناخد", "probability": 0.82470703125}, {"start": 1348.12, "end": 1349.06, "word": " تدريب", "probability": 0.988037109375}, {"start": 1349.06, "end": 1350.02, "word": " على", "probability": 0.83056640625}, {"start": 1350.02, "end": 1350.68, "word": " المحاضرة", "probability": 0.988037109375}, {"start": 1350.68, "end": 1351.36, "word": " السابقة", "probability": 0.9884440104166666}, {"start": 1351.36, "end": 1351.78, "word": " وليه", "probability": 0.76953125}, {"start": 1351.78, "end": 1352.02, "word": " مهم", "probability": 0.98779296875}, {"start": 1352.02, "end": 1352.42, "word": " جدا", "probability": 0.771728515625}, {"start": 1352.42, "end": 1352.58, "word": " في", "probability": 0.8486328125}, {"start": 1352.58, "end": 1353.04, "word": " قضية", "probability": 0.9847005208333334}, {"start": 1353.04, "end": 1353.74, "word": " ال", "probability": 0.84521484375}, {"start": 1353.74, "end": 1354.0, "word": " lens", "probability": 0.857421875}, {"start": 1354.0, "end": 1354.86, "word": " decentration", "probability": 0.651611328125}], "temperature": 1.0}, {"id": 56, "seek": 138453, "start": 1356.17, "end": 1384.53, "text": "عشان نحدث الـprismatic effect احنا بدنايا او ان نعرف الـprismatic effect للـdecentred lenses تمام فبالتالي بدنا ناخد مسألة بس المرة هاي هناخد مسألة تشمل العينتين تشمل العينتين ويعني نشوف الأثر النهائي الكلي على ال vertical و ال horizontal بالنسبة ليعني عين المريض او عينين المريض تمام يعطيكوا العافية", "tokens": [3615, 8592, 7649, 8717, 24401, 12984, 2423, 39184, 1424, 34088, 1802, 1975, 5016, 8315, 47525, 8315, 25528, 1975, 2407, 16472, 8717, 3615, 28480, 2423, 39184, 1424, 34088, 1802, 24976, 39184, 1479, 2207, 986, 18059, 46811, 10943, 6156, 3555, 6027, 2655, 6027, 1829, 47525, 8315, 8717, 47283, 3215, 47524, 10721, 37977, 4724, 3794, 9673, 25720, 8032, 47302, 8032, 1863, 47283, 3215, 47524, 10721, 37977, 6055, 8592, 42213, 18863, 9957, 2655, 9957, 6055, 8592, 42213, 18863, 9957, 2655, 9957, 4032, 40228, 22653, 8717, 8592, 38688, 16247, 49115, 28239, 3224, 16373, 1829, 33251, 20292, 15844, 2423, 9429, 4032, 2423, 12750, 20666, 1863, 35457, 3660, 5296, 40228, 22653, 6225, 9957, 9673, 16572, 11242, 1975, 2407, 6225, 9957, 9957, 9673, 16572, 11242, 46811, 10943, 37495, 9566, 1829, 4117, 14407, 18863, 31845, 10632], "avg_logprob": -0.1870117182843387, "compression_ratio": 1.9215686274509804, "no_speech_prob": 9.918212890625e-05, "words": [{"start": 1356.17, "end": 1356.61, "word": "عشان", "probability": 0.95947265625}, {"start": 1356.61, "end": 1357.05, "word": " نحدث", "probability": 0.9664713541666666}, {"start": 1357.05, "end": 1357.47, "word": " الـprismatic", "probability": 0.603118896484375}, {"start": 1357.47, "end": 1357.95, "word": " effect", "probability": 0.93359375}, {"start": 1357.95, "end": 1358.25, "word": " احنا", "probability": 0.8697916666666666}, {"start": 1358.25, "end": 1358.83, "word": " بدنايا", "probability": 0.6813151041666666}, {"start": 1358.83, "end": 1359.63, "word": " او", "probability": 0.7646484375}, {"start": 1359.63, "end": 1359.81, "word": " ان", "probability": 0.82275390625}, {"start": 1359.81, "end": 1360.19, "word": " نعرف", "probability": 0.8292643229166666}, {"start": 1360.19, "end": 1360.69, "word": " الـprismatic", "probability": 0.843994140625}, {"start": 1360.69, "end": 1361.33, "word": " effect", "probability": 0.9638671875}, {"start": 1361.33, "end": 1363.09, "word": " للـdecentred", "probability": 0.48671875}, {"start": 1363.09, "end": 1363.85, "word": " lenses", "probability": 0.79345703125}, {"start": 1363.85, "end": 1364.51, "word": " تمام", "probability": 0.833740234375}, {"start": 1364.51, "end": 1365.13, "word": " فبالتالي", "probability": 0.9557291666666666}, {"start": 1365.13, "end": 1365.41, "word": " بدنا", "probability": 0.6534423828125}, {"start": 1365.41, "end": 1365.73, "word": " ناخد", "probability": 0.9931640625}, {"start": 1365.73, "end": 1366.21, "word": " مسألة", "probability": 0.94921875}, {"start": 1366.21, "end": 1366.47, "word": " بس", "probability": 0.961669921875}, {"start": 1366.47, "end": 1366.83, "word": " المرة", "probability": 0.964599609375}, {"start": 1366.83, "end": 1367.05, "word": " هاي", "probability": 0.663330078125}, {"start": 1367.05, "end": 1367.45, "word": " هناخد", "probability": 0.958251953125}, {"start": 1367.45, "end": 1368.01, "word": " مسألة", "probability": 0.9783528645833334}, {"start": 1368.01, "end": 1368.79, "word": " تشمل", "probability": 0.9728190104166666}, {"start": 1368.79, "end": 1369.49, "word": " العينتين", "probability": 0.8138427734375}, {"start": 1369.49, "end": 1370.43, "word": " تشمل", "probability": 0.8173014322916666}, {"start": 1370.43, "end": 1371.13, "word": " العينتين", "probability": 0.974853515625}, {"start": 1371.13, "end": 1373.67, "word": " ويعني", "probability": 0.8235677083333334}, {"start": 1373.67, "end": 1374.21, "word": " نشوف", "probability": 0.93994140625}, {"start": 1374.21, "end": 1374.61, "word": " الأثر", "probability": 0.777587890625}, {"start": 1374.61, "end": 1375.15, "word": " النهائي", "probability": 0.97607421875}, {"start": 1375.15, "end": 1375.57, "word": " الكلي", "probability": 0.6502685546875}, {"start": 1375.57, "end": 1376.31, "word": " على", "probability": 0.830078125}, {"start": 1376.31, "end": 1376.69, "word": " ال", "probability": 0.9931640625}, {"start": 1376.69, "end": 1377.09, "word": " vertical", "probability": 0.79296875}, {"start": 1377.09, "end": 1377.31, "word": " و", "probability": 0.84228515625}, {"start": 1377.31, "end": 1377.35, "word": " ال", "probability": 0.78955078125}, {"start": 1377.35, "end": 1377.77, "word": " horizontal", "probability": 0.7373046875}, {"start": 1377.77, "end": 1378.49, "word": " بالنسبة", "probability": 0.990966796875}, {"start": 1378.49, "end": 1379.53, "word": " ليعني", "probability": 0.74755859375}, {"start": 1379.53, "end": 1379.99, "word": " عين", "probability": 0.958740234375}, {"start": 1379.99, "end": 1382.13, "word": " المريض", "probability": 0.8937174479166666}, {"start": 1382.13, "end": 1382.33, "word": " او", "probability": 0.8427734375}, {"start": 1382.33, "end": 1382.75, "word": " عينين", "probability": 0.9365234375}, {"start": 1382.75, "end": 1383.27, "word": " المريض", "probability": 0.9952799479166666}, {"start": 1383.27, "end": 1383.67, "word": " تمام", "probability": 0.93359375}, {"start": 1383.67, "end": 1384.15, "word": " يعطيكوا", "probability": 0.8060546875}, {"start": 1384.15, "end": 1384.53, "word": " العافية", "probability": 0.8829752604166666}], "temperature": 1.0}], "language": "ar", "language_probability": 1.0, "duration": 1384.6755625, "duration_after_vad": 1314.335}
\ No newline at end of file
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/lKjfmgkqWeY_raw.srt b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/lKjfmgkqWeY_raw.srt
new file mode 100644
index 0000000000000000000000000000000000000000..eca686bbfd9adee21cbc453afdbd0abecf3acb93
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/lKjfmgkqWeY_raw.srt
@@ -0,0 +1,1084 @@
+1
+00:00:20,770 --> 00:00:25,710
+طيب بسم الله الرحمن الرحيم اليوم بنكمل مع المنشير
+
+2
+00:00:25,710 --> 00:00:29,770
+ال prismات و لدينا أول نقطة بنحكي عنها اللي هي
+
+3
+00:00:29,770 --> 00:00:35,130
+vector additions of a prism لو إنسان اتخيلنا عنده
+
+4
+00:00:35,130 --> 00:00:39,030
+نوعين من الحوال حوال أفقي أزوتروبيا أو أكزوتروبيا
+
+5
+00:00:39,030 --> 00:00:45,970
+بسيط و حوال رأسي hyper لل right أو لل left تمامو
+
+6
+00:00:45,970 --> 00:00:50,930
+حابب انا استعمل بريزمين واحد horizontal و واحد
+
+7
+00:00:50,930 --> 00:00:56,610
+vertical عشان نعمل neutralization او الغاء لزاوية
+
+8
+00:00:56,610 --> 00:01:02,670
+الحوال السؤال بيطرح نفسه هل ممكن استبدل ال
+
+9
+00:01:02,670 --> 00:01:06,030
+vertical بريزم و ال horizontal بريزم ب oblique
+
+10
+00:01:06,030 --> 00:01:11,090
+بريزم مكافئ بمعنى
+
+11
+00:01:11,090 --> 00:01:22,240
+اخر لو انا عندىهذا الإنسان يعني بدي مثلا base out
+
+12
+00:01:22,240 --> 00:01:30,220
+بريزم عشان أعالج ال isotropia اللي عنده و بدي base
+
+13
+00:01:30,220 --> 00:01:36,280
+up بريزم عشان أعالج الhypotropia اللي عنده تمام
+
+14
+00:01:36,280 --> 00:01:40,700
+نفرض عندي بدي انا تمانية بريزم base out و ستة
+
+15
+00:01:40,700 --> 00:01:46,160
+بريزم base upهل ممكن انا استبدلهم برزم مكافئ
+
+16
+00:01:46,160 --> 00:01:53,060
+الجواب نعم تجمع البرزمات أو القوة المكافئة بطريقة
+
+17
+00:01:53,060 --> 00:01:56,860
+جمع القوة المتجهة طبعا احنا قلنا اتجاه البرزم هو
+
+18
+00:01:56,860 --> 00:02:00,920
+اتجاه ال base بتاعته لو حبينا نعطي البرزم ال
+
+19
+00:02:00,920 --> 00:02:06,720
+horizontal برزم اتجاه نقول اتجاه ال base out تمام
+
+20
+00:02:06,720 --> 00:02:13,310
+و البرزم التاني ال vertical upده افرض ان عندي
+
+21
+00:02:13,310 --> 00:02:18,910
+بريزم مكافئ تمام حرسمه بالشكل المتقطع هذا البريزم
+
+22
+00:02:18,910 --> 00:02:23,490
+مكافئ قوة البرزمين ال horizontal و ال vertical و
+
+23
+00:02:23,490 --> 00:02:27,210
+بيقدي العمل بتاعهم بيقدي العمل بتاعهم ال base
+
+24
+00:02:27,210 --> 00:02:35,110
+بتاعته هتكون out and up out and up لإن واحد out و
+
+25
+00:02:35,110 --> 00:02:38,370
+واحد up هذه ال base هتكون بالشكل هذا
+
+26
+00:02:40,850 --> 00:02:47,250
+بدي اعرف .. بدي اعرف كيف اجيب قوة البرزم المكافئ و
+
+27
+00:02:47,250 --> 00:02:52,450
+اجدش الزاوية بينه و بين المحور الأفقي او بينه و
+
+28
+00:02:52,450 --> 00:02:56,950
+بين المحور العمودي بنقول البرزم هذا اللي هو ستة
+
+29
+00:02:56,950 --> 00:03:02,210
+برزم و هي تمانية برزم بدي ارسمه على الناحية
+
+30
+00:03:02,210 --> 00:03:06,960
+التانية عشان يصير عندي مثلثطائم الزاوية أستعمل
+
+31
+00:03:06,960 --> 00:03:12,100
+نظرية قديمة استخدمناها في المدارس ليه نظرية فيثا
+
+32
+00:03:12,100 --> 00:03:18,900
+وورث تمام اللي بتقول البرزم المكافئ يساوي الجزر
+
+33
+00:03:18,900 --> 00:03:26,620
+التربيعي لمربع البرزمين
+
+34
+00:03:26,620 --> 00:03:28,620
+64
+
+35
+00:03:32,990 --> 00:03:36,230
+تمانية تربية عربعة و ستين زائد ستة و تلاتين يساوي
+
+36
+00:03:36,230 --> 00:03:41,690
+جذر المية ويساوي عشرة Prism إذا ال Prism المكافئ
+
+37
+00:03:41,690 --> 00:03:50,210
+بيساوي عشرة Prism عشرة Prism عشرة Prism بل الآن ما
+
+38
+00:03:50,210 --> 00:03:56,070
+يلانوا على المحور الأفقي مثلا بيقول هذه الزاوية
+
+39
+00:03:56,070 --> 00:04:03,170
+ثيتا بدي أجيبها ثيتا أو تان ثيتاماذا يساوي؟ ستة
+
+40
+00:04:03,170 --> 00:04:09,790
+على تمانية المقابل على المجاور في تنافسة shift M
+
+41
+00:04:09,790 --> 00:04:15,330
+الستة على تمانية وبالأعلى الحسبة بقدر أجيب الاتجاه
+
+42
+00:04:15,330 --> 00:04:20,410
+لا يكفي فقط أجيب الكم
+
+43
+00:04:23,470 --> 00:04:27,450
+لازم احدد اتجاه الـ Base لأن لو قلت مثلا لو طلعت
+
+44
+00:04:27,450 --> 00:04:33,310
+End فيتا مثلا 37 degree على سبيل المثال بنفعش اقول
+
+45
+00:04:33,310 --> 00:04:37,890
+بدي Prism مكافئ قوته عشرة Prism بيبطر يميل على
+
+46
+00:04:37,890 --> 00:04:43,030
+المحور الأفقي عشرة سبعة و تلاتين degree معادل سبعة
+
+47
+00:04:43,030 --> 00:04:47,130
+و تلاتين degree لو كان Base up and out و مائل سبعة
+
+48
+00:04:47,130 --> 00:04:52,270
+و تلاتين degree او لو كان Base down and inبرضه
+
+49
+00:04:52,270 --> 00:04:56,570
+يميل 37 degree ضروري تحديد اتجاه ال base لل prism
+
+50
+00:04:56,570 --> 00:05:00,430
+المكافئ نضرب مثال تاني عشان توضح الأمور
+
+51
+00:05:14,040 --> 00:05:20,400
+لو احنا بدنا مثلا base in برزم لو بدنا base in
+
+52
+00:05:20,400 --> 00:05:28,180
+برزم مقداره 5 برزم او بدنا base down برزم مقداره
+
+53
+00:05:28,180 --> 00:05:33,260
+مثلا 6 برزم ايش البرزم المكافئ بروح برسم الرسم
+
+54
+00:05:33,260 --> 00:05:39,060
+اتجاه البرزم باتجاه ال base بتاعته هنا in و هنا
+
+55
+00:05:39,060 --> 00:05:48,010
+ايش down base downجداش ال base ده ستة prism تمام
+
+56
+00:05:48,010 --> 00:05:55,390
+ستة prism وجداش ال N خمسة prism هذه الستة prism
+
+57
+00:05:55,390 --> 00:05:57,150
+انا بدأ انجله هنا تمام
+
+58
+00:06:03,440 --> 00:06:07,160
+بتكون in and down ال base بتاعته in and down ضروري
+
+59
+00:06:07,160 --> 00:06:12,180
+تحديد الاتجاه واحد in وواحد down لبرزم المكافئة
+
+60
+00:06:12,180 --> 00:06:17,420
+بيكون in and down تمام in and down طيب جداش مقداره
+
+61
+00:06:17,420 --> 00:06:23,360
+مقداره حسب نظرية في ثورث البرزم المكافئة الجذر
+
+62
+00:06:23,360 --> 00:06:29,360
+التربيعي للخمسة تربيع زائد ستة تربيع خمسة و عشرين
+
+63
+00:06:29,360 --> 00:06:35,620
+زائد ستة و تلاتين ايه شو ساويجزر ال 61 جداش بيطلع
+
+64
+00:06:35,620 --> 00:06:43,120
+7.8 من 10 ابريزم طبعا
+
+65
+00:06:43,120 --> 00:06:47,040
+مش هنلاقي 7.8 من 10 ابريزم ممكن نلاقي 7.5 مثلا
+
+66
+00:06:47,040 --> 00:06:51,320
+اقرب شيء او تمانية مثلا تمام مش الفارق الكبير تمام
+
+67
+00:06:51,320 --> 00:06:58,620
+القصد انا احددت طب الاتجاه بدأ احدد فيتا فيتا
+
+68
+00:06:58,620 --> 00:07:08,580
+time فيتا ايش يساوي6 على 5 6 على 5 تمام فى تنافسة
+
+69
+00:07:08,580 --> 00:07:15,280
+ايش تساوي اركتان اللى
+
+70
+00:07:15,280 --> 00:07:21,620
+هو ال 6 على 5 هو يساوي 50 ديجري 50 ديجري حددتها
+
+71
+00:07:21,620 --> 00:07:26,080
+بوسطة القالة الحاسبة بقول لبرزم المكافئة لهدول
+
+72
+00:07:26,080 --> 00:07:31,880
+البرزمين لازم يكون عندي ال base بتاعته ال base
+
+73
+00:07:31,880 --> 00:07:37,840
+بتاعتهin and down هاي in and down بيتركب على
+
+74
+00:07:37,840 --> 00:07:41,640
+النضارة تمام؟ بده يميل على المحور الأفطي بمقدار
+
+75
+00:07:41,640 --> 00:07:46,620
+إياش خمسين degree هيك الجواب متكامل عندي حددت ال
+
+76
+00:07:46,620 --> 00:07:50,540
+amount بتاعته يعني بدل ما أستعمل برزمين قدام بعض
+
+77
+00:07:50,540 --> 00:07:56,800
+بستعمل برزم واحد مكافئ لهم وهكذا بشتغل طبعا لو
+
+78
+00:07:56,800 --> 00:07:59,680
+عندي مثلا down
+
+79
+00:08:00,970 --> 00:08:04,390
+أحد الـ Prismات الـ Base ذات والتاني Up والتاني
+
+80
+00:08:04,390 --> 00:08:11,190
+Out ال Prism المكافئة بيكون Down and Out لو N
+
+81
+00:08:11,190 --> 00:08:16,330
+والتاني Up ال Prism المكافئة بيكون N زائد Up اتجاه
+
+82
+00:08:16,330 --> 00:08:21,050
+ال Base اعتقد مافي مشكلة طالما انا بستعمل نظرية
+
+83
+00:08:21,050 --> 00:08:25,830
+ايش في Fours والاتجاه بواسطة تحديد الزاوية فيه
+
+84
+00:08:25,830 --> 00:08:28,550
+ننتقل للنقطة التانية
+
+85
+00:08:31,770 --> 00:08:37,250
+النقطة التانية الرئيس البريزم الرئيس البريزم عبارة
+
+86
+00:08:37,250 --> 00:08:43,510
+عن two prisms قوتهم واحدة نفرض مثلا عشرة بريزم لكل
+
+87
+00:08:43,510 --> 00:08:49,990
+بريزم هدولة البريزمين محطوطين في housing يعني زي
+
+88
+00:08:49,990 --> 00:08:55,270
+ال box بتاع ال trial frame housing للرئيس البريزم
+
+89
+00:08:55,270 --> 00:09:00,530
+موجودين في جهاز الفوروبترممكن انا استعملهم هدولة
+
+90
+00:09:00,530 --> 00:09:03,850
+ايش انا ممكن اعمل فيهم هدولة ممكن ينعملوا counter
+
+91
+00:09:03,850 --> 00:09:08,190
+rotated يعني يلفوا عكس بعضهم البعض counter rotated
+
+92
+00:09:08,190 --> 00:09:14,890
+تمام بحيث لما ال base بتيجي على ال base و ال apex
+
+93
+00:09:14,890 --> 00:09:20,190
+على ال apex بيكون بيعطون قوتهم الكلية عشرين prism
+
+94
+00:09:20,190 --> 00:09:28,180
+و لما بتيجي العكس تمام انا رسمت مقطع بس فيهملأن
+
+95
+00:09:28,180 --> 00:09:34,540
+قوتهم عكس بعض و قوتهم متساوية يعطيني Zero يعني هذا
+
+96
+00:09:34,540 --> 00:09:39,020
+الجهاز بستخدمه
+
+97
+00:09:39,020 --> 00:09:43,040
+لجياز الفوريا أو الحوالي الخفي الفوريا أو الحوالي
+
+98
+00:09:43,040 --> 00:09:43,480
+الخفي
+
+99
+00:09:46,610 --> 00:09:52,630
+زيرو لعشرين بريزم في معايا مثلا قياس تمام الان لو
+
+100
+00:09:52,630 --> 00:09:55,810
+انا حرفتهم بالنسبة لبعض من البعض يعني مش مش
+
+101
+00:09:55,810 --> 00:10:00,370
+منطبقين على بعض من البعض يعني واحد هيك وواحد هيك
+
+102
+00:10:00,370 --> 00:10:05,310
+ال housing نفسه في مؤشر بيعطيني ال بريزم المكافئ
+
+103
+00:10:05,310 --> 00:10:10,310
+وزاويته يعني بدل ما اجهد يعنيلسه اطبق اثارية فيفا
+
+104
+00:10:10,310 --> 00:10:14,410
+غولف و اجيب ثيتا هو بيعطيني ايها الامور جاهزة تمام
+
+105
+00:10:14,410 --> 00:10:17,810
+لو حركت بريزم باتجاه معين يعني لو الزاوية بينهم
+
+106
+00:10:17,810 --> 00:10:20,670
+مثلا تلاتين degree او اربعين degree او مائة و
+
+107
+00:10:20,670 --> 00:10:24,310
+عشرين degree بغض النظر عن ازاي المؤشر هيعطيني
+
+108
+00:10:24,860 --> 00:10:28,360
+البرزم المكافئ للتانين في الوضعية هذه البرزم
+
+109
+00:10:28,360 --> 00:10:31,840
+المكافئ للتانين في الوضعية هذه وبالتالي بعرف
+
+110
+00:10:31,840 --> 00:10:37,040
+مباشرة البرزم المكافئ واتجاهه يعني الزاوية اللي
+
+111
+00:10:37,040 --> 00:10:41,300
+بيميل فيها على المحور الأفقي فهذه فايدة الرايس
+
+112
+00:10:41,300 --> 00:10:46,360
+لبرزم هذه فايدة الرايس لبرزم وحكينا بالنسبة له لما
+
+113
+00:10:46,360 --> 00:10:50,080
+بيكونوا بيز مع البيز والابكس مع الابكس بيكون
+
+114
+00:10:50,080 --> 00:10:54,200
+مجموعهملما يكون ال base مع ال apex و ال base مع ال
+
+115
+00:10:54,200 --> 00:10:57,700
+apex زيرو هتحققه و القياسات اللي بين هيك القياسات
+
+116
+00:10:57,700 --> 00:11:01,760
+البينية ايضا بحصل عليها لما يكون الزاوية بتختلف
+
+117
+00:11:01,760 --> 00:11:06,100
+بين وضعية و وضعية بين ال two prisms بين ال two
+
+118
+00:11:06,100 --> 00:11:10,220
+prisms فهذا بالنسبة لرئيس ال prism هو استخدم غالبا
+
+119
+00:11:10,220 --> 00:11:14,960
+في قياس الفوريا اللي هي الحوال الخفيالخفي اللي مش
+
+120
+00:11:14,960 --> 00:11:19,340
+ظاهر بس بيظهر بفحوصات معينة تمام موجود ال rice
+
+121
+00:11:19,340 --> 00:11:23,700
+liparism في كتير من أجهزة الفوروبترز الفوروبترز
+
+122
+00:11:23,700 --> 00:11:27,740
+تمام هاد الجهاز عشان نعمل فيه إيش ال subjective
+
+123
+00:11:27,740 --> 00:11:31,840
+refraction ال subjective refraction نيجي احنا
+
+124
+00:11:31,840 --> 00:11:38,120
+بنقولنحكي الآن عن البريزماتيك أبيريشن لبريزماتيك
+
+125
+00:11:38,120 --> 00:11:43,420
+أبيريشن طبعا أي بريزم أي بريزم ممكن يعمل لأبيريشن
+
+126
+00:11:43,420 --> 00:11:48,340
+لفي الضوء اللي بيدخل من خلاله طبعا كل ما زادت
+
+127
+00:11:48,340 --> 00:11:52,320
+القوة بتاعت البريزم هيصير كمية الابيريشن أكتر يعني
+
+128
+00:11:52,320 --> 00:11:57,590
+هذا البريزم هيعطيك more aberrationمقارنة مع ال
+
+129
+00:11:57,590 --> 00:12:01,770
+Prism اللي هو أضعف منه أهم نقطة في ال aberration
+
+130
+00:12:01,770 --> 00:12:04,550
+هي قضية ال chromatic aberration ال chromatic
+
+131
+00:12:04,550 --> 00:12:07,890
+aberration ان الضوء اللي بيدخل ال polychromatic
+
+132
+00:12:07,890 --> 00:12:12,670
+light الضوء الأبيض تمام لما بيدخل من خلال ال Prism
+
+133
+00:12:12,670 --> 00:12:17,790
+إذا قوة ال Prism عالية تمام بيعمله تمام اللي هو
+
+134
+00:12:19,010 --> 00:12:24,450
+color fringes يعني هالات لونية او هالات ضوئية
+
+135
+00:12:24,450 --> 00:12:29,250
+ملونة حوالين المصادر الضوئية وهذا سر اللي هو
+
+136
+00:12:29,250 --> 00:12:32,990
+المعلومة القديمة اللي اتعلمناها في المدارس ان
+
+137
+00:12:32,990 --> 00:12:37,190
+الضوء او المنشور الزجاجي بيحلل الضوء الى ألوان
+
+138
+00:12:37,190 --> 00:12:40,610
+الطيف لان لما انا بكون مضطر استعمل prism و high
+
+139
+00:12:40,610 --> 00:12:44,360
+power prism أحيانايعني ممكن اشوف حوالين المصادر
+
+140
+00:12:44,360 --> 00:12:49,160
+الضوء اللمبات او المصابيح الضوئية يعني هالات لونية
+
+141
+00:12:49,160 --> 00:12:52,280
+وهذه ممكن تكون مزعجة للمريض يعني مش دائما بيكون
+
+142
+00:12:52,280 --> 00:12:56,020
+يقدر يتحملها المريض اذا من اهم ال aberrations اللي
+
+143
+00:12:56,020 --> 00:13:01,340
+بيعملياها لبرزم ل chromatic aberration وكل ما زادت
+
+144
+00:13:01,340 --> 00:13:06,530
+قوة البرزم بيكون ال aberration كميتها اكترأحياناً
+
+145
+00:13:06,530 --> 00:13:10,030
+أنا بضطر ألبس المريض بريسم معين بقوة معينة جدّام
+
+146
+00:13:10,030 --> 00:13:13,410
+عين و لأن التاني بيكون فيش جدّامها بريسم وهذه ممكن
+
+147
+00:13:13,410 --> 00:13:16,330
+تعملي operation تانية أو مشكلة تانية اسمها
+
+148
+00:13:16,330 --> 00:13:21,190
+asymmetrical magnification يعني بالنسبة لإش اللي
+
+149
+00:13:21,190 --> 00:13:25,470
+بيطلع عليه هذه من ضمن أيضا عيوب ال field وممكن
+
+150
+00:13:25,470 --> 00:13:28,850
+تعملي حاجة تالتة اللي بيسموها curvature of field
+
+151
+00:13:28,850 --> 00:13:32,980
+يعني بيحس أنه في الحناءلل field اللي هو او للمنطقة
+
+152
+00:13:32,980 --> 00:13:36,680
+اللي بيتطلع فيها فهذه من ضمن ال aberrations رغم
+
+153
+00:13:36,680 --> 00:13:40,080
+الفوائد الكتيرة اللي ممكن يعني و الاستخدامات
+
+154
+00:13:40,080 --> 00:13:43,220
+الكتيرة اللي عرضناها المرة الماضية بالنسبة لل
+
+155
+00:13:43,220 --> 00:13:47,780
+Prisms الا انها لا تخلو من وجود بعض المشاكل وهذه
+
+156
+00:13:47,780 --> 00:13:50,980
+المشاكل رغم وجودها الا انه بتظل فوائد ال Prism
+
+157
+00:13:50,980 --> 00:13:57,380
+يعني فوائد قيمة جداالان بدنا نيجي لموضوع او النقطة
+
+158
+00:13:57,380 --> 00:14:02,140
+التانية اللي بيسموها الـ Fresnel Prism طبعا ال S
+
+159
+00:14:02,140 --> 00:14:08,920
+silent لا تلفظ هي تكتب Fresnel Prism
+
+160
+00:14:08,920 --> 00:14:16,100
+و ال S هنا لا تلفظ فتلفظ Fresnel Prism لو حبنا
+
+161
+00:14:16,100 --> 00:14:18,640
+نسأل سؤال هيا انا عندي Prism
+
+162
+00:14:21,790 --> 00:14:27,010
+هي ال apex angle عشرين ديجري مثلا وهي عندي أنا
+
+163
+00:14:27,010 --> 00:14:36,170
+سلسلة من البرزمات الصغيرة الملسقة جنبا إلى جنب كل
+
+164
+00:14:36,170 --> 00:14:44,010
+واحد منها ال apex angle بتاعته عشرين ديجري أيهما
+
+165
+00:14:44,010 --> 00:14:52,610
+أقوىنفس القوة لماذا نفس ال apex angle ال prism او
+
+166
+00:14:52,610 --> 00:14:56,770
+المناشير اللي بتتساوى في ال apex angle تتساوى في
+
+167
+00:14:56,770 --> 00:15:01,150
+قوتها في كسر الضوء او في حرف الضوء انها تعمل
+
+168
+00:15:01,150 --> 00:15:04,530
+deviation للضوء عن نصاره تمام لما نقول كسر عشان
+
+169
+00:15:04,530 --> 00:15:08,850
+مايروحش البال لأ قضية اللي هو ال refractive او ال
+
+170
+00:15:08,850 --> 00:15:13,480
+reflection بتاع الضوءقوة البريزم مهما كان حجمه إذا
+
+171
+00:15:13,480 --> 00:15:17,960
+تساوت في الـ apex angle فهي متساوية في قوتها
+
+172
+00:15:17,960 --> 00:15:22,260
+كبريزم بيورترز فبالتالي ضروري نفسنا نعرف القضية
+
+173
+00:15:22,260 --> 00:15:28,360
+هاي الان هذه الـpremilebrism هي عبارة عن side by
+
+174
+00:15:28,360 --> 00:15:34,190
+sidesmall prisms side by side small prisms تمام
+
+175
+00:15:34,190 --> 00:15:39,830
+بتعطي بتعطي ال effect بتاع large prism بتعطي ال
+
+176
+00:15:39,830 --> 00:15:45,810
+effect بتاع large prism يعني انا مثلا لازم عشرة
+
+177
+00:15:45,810 --> 00:15:50,710
+prism احطه based in جادر انا احطه بشكل prism واحد
+
+178
+00:15:50,710 --> 00:15:56,690
+هيكونخميل و تجيل تمام وبالتالي انا باستعيد عنه
+
+179
+00:15:56,690 --> 00:16:00,210
+باستعيد عنه بالـ Fresnel Prism تمام اللى تلصق على
+
+180
+00:16:00,210 --> 00:16:10,890
+سطح النضارة طبعا و بتكون يعني ايش خفيفة الوزن و
+
+181
+00:16:10,890 --> 00:16:16,150
+تقريبا يعني مش مرئية تمام طبعا هى بتشمل كلالنضارة
+
+182
+00:16:16,150 --> 00:16:20,070
+بس او ممكن تشمل جزء منها في بعض الحالات بس انا
+
+183
+00:16:20,070 --> 00:16:23,850
+رسمت يعني مقطع عكس غير لتوضيح الفكرة اللي بيجون
+
+184
+00:16:23,850 --> 00:16:28,810
+فيه ال large prism و اللي بتجون فيه ال small prism
+
+185
+00:16:28,810 --> 00:16:33,610
+نفس الشيء نفس الشيء بس انا باخد advantage او ميزات
+
+186
+00:16:33,610 --> 00:16:38,150
+انه باستعمال friendly prism we can avoid the
+
+187
+00:16:38,150 --> 00:16:43,000
+weight of the prismتجنب الوزن اللي تجير تمام وممكن
+
+188
+00:16:43,000 --> 00:16:48,170
+نتجنب بعض ال aberrationsنخفف منها تمام وبالتالي
+
+189
+00:16:48,170 --> 00:16:53,210
+هذه بقيها ميزة انها خفيفة الحمل تمام وبتجلل البعض
+
+190
+00:16:53,210 --> 00:16:56,050
+ال aberrations هل هي بدون aberrations او بدون
+
+191
+00:16:56,050 --> 00:17:00,210
+مشاكل لأ فيها مشاكل بس من ضمن مميزاتها اول حاجة
+
+192
+00:17:00,210 --> 00:17:05,090
+avoid weight تاني حاجة avoid some aberration تمام
+
+193
+00:17:05,090 --> 00:17:09,530
+وحنحكي عن ميزات لاحقة شوية بسيطة تمام طبعا تصنع
+
+194
+00:17:09,530 --> 00:17:14,040
+تصنع الفرن البرزم من مادةاسمها ال polyvinyl
+
+195
+00:17:14,040 --> 00:17:18,160
+chloride لي عبارة عن مادة بلاستيكية تمام او مادة
+
+196
+00:17:18,160 --> 00:17:25,040
+من اللدائن تمام ويعني بتستعمل بدل ال large prisms
+
+197
+00:17:25,040 --> 00:17:32,580
+في الناس اللي بلزمهم استعمال لبرزمات بشكل يعني
+
+198
+00:17:32,580 --> 00:17:39,280
+أمام النضارة تمام طيب الآن اذا
+
+199
+00:17:39,280 --> 00:17:43,860
+بدنا نحكي بالتفصيلالـ Frame الـ Prism عبارة عن
+
+200
+00:17:43,860 --> 00:17:48,840
+قطعة أو رقاقة من اللدائن أو المواد البلاستيكية
+
+201
+00:17:48,840 --> 00:17:54,020
+الطارية تمام بيسموها أحيانا Press on Prism طبعاً
+
+202
+00:17:54,020 --> 00:17:57,920
+لها سطح أملس والسطح اللي فيه ال Prismات السطح
+
+203
+00:17:57,920 --> 00:18:02,380
+الأملس ممكن ينبل بشوية ميه ويلسق على السطح الخلفي
+
+204
+00:18:02,380 --> 00:18:07,610
+للنضارة طبعاً هل شكلها بيبين بشكل ..تقريباً ما
+
+205
+00:18:07,610 --> 00:18:11,070
+بيبينش إلا إذا الإنسان يعني .. يعني دقيق النظر في
+
+206
+00:18:11,070 --> 00:18:14,750
+النضارة ساعتها بيبين فيه يعني خطوط رفيعة جدا اللي
+
+207
+00:18:14,750 --> 00:18:18,670
+هي الحواف بتاعة ال Prism's الحواف بتاعة ال Prism's
+
+208
+00:18:18,670 --> 00:18:25,610
+طبعاً لها فوائد كتيرة جدا وبالتالي تستعمل هذا تسمى
+
+209
+00:18:25,610 --> 00:18:30,020
+Press on Prism's طيب إيش عيوبها؟أحنا حكينا فائدتين
+
+210
+00:18:30,020 --> 00:18:33,400
+avoid weight avoid some aberration طبعا من ضمن
+
+211
+00:18:33,400 --> 00:18:37,000
+عيوبها ال visual acuity is reduced due to
+
+212
+00:18:37,000 --> 00:18:41,340
+scattering يعني الحفف لما بيدرب الضوء يعني هاي
+
+213
+00:18:41,340 --> 00:18:47,340
+الفرين ال prism أمام العين دي كرسمة ع السرير وهي
+
+214
+00:18:47,340 --> 00:18:49,700
+العين الضوء لما بيجي
+
+215
+00:18:52,670 --> 00:18:56,630
+استضام الضوء بالحفة بتاعة البرزم بيعمل scattering
+
+216
+00:18:56,630 --> 00:19:00,350
+لل light وهذا بيقد شوية ل reduced vision شوية ل
+
+217
+00:19:00,350 --> 00:19:03,370
+reduced vision يعني ممكن يكون نظره 6 ع 6 بالنضارة
+
+218
+00:19:03,370 --> 00:19:09,150
+بدون البرزم بدون فرن البرزم يصير 6 ع 9 او 6 ع 12
+
+219
+00:19:09,150 --> 00:19:13,410
+اذا هذه من ضمن الايوب بتاعها انه reduced vision
+
+220
+00:19:13,410 --> 00:19:16,970
+due to scattering of lightتاني شيء ممكن تعملي
+
+221
+00:19:16,970 --> 00:19:20,850
+chromatic aberration لأن أيضا هي بريزمال و رغم هذه
+
+222
+00:19:20,850 --> 00:19:25,450
+العيوب ال advantage بتاعتها المميزات بتاعتها فوق
+
+223
+00:19:25,450 --> 00:19:30,470
+كثيرا العيوب و لذلك ينصح باستخدامها في حالات كثيرة
+
+224
+00:19:30,470 --> 00:19:34,910
+احنا حكينا عن two advantages ل avoid weight و
+
+225
+00:19:34,910 --> 00:19:39,590
+بتقلل من بعض ال aberrations مش من كلها صحيح هي لها
+
+226
+00:19:39,590 --> 00:19:42,690
+aberration بس هي بتقلل من بعض ال aberrationمن ضمن
+
+227
+00:19:42,690 --> 00:19:46,070
+المميزات هي ease of application يعني لا يوجد اي
+
+228
+00:19:46,070 --> 00:19:50,030
+صعوبة ان السطح الاملس لهذه القطعة او لهذه الرقاقة
+
+229
+00:19:50,030 --> 00:19:54,390
+ان ادهنه بشوية ميه او اقبله بشوية ميه و الصف هذي
+
+230
+00:19:54,390 --> 00:20:01,110
+استعمالها بشكل سهل جدا طب لو انفكت بعود بحط شوية
+
+231
+00:20:01,110 --> 00:20:05,070
+ميه وهذا او ممكن اشيلها وانظفها وكذا وضل استعملها
+
+232
+00:20:05,070 --> 00:20:10,810
+فهي يعني بتلتسق بالسطح الخلفي للنضارةطبعا من بين
+
+233
+00:20:10,810 --> 00:20:15,290
+المميزات التانية انها مش expensive كتير مش غالية
+
+234
+00:20:15,290 --> 00:20:18,910
+كتير وإن كان في بلادنا هذا الكلام يعني مش صحيح
+
+235
+00:20:18,910 --> 00:20:23,150
+انها بتصنع بسعر يعني اعتبر اغلى بكتير من سعر
+
+236
+00:20:23,150 --> 00:20:26,930
+النضارة بس في البلدان اللي تصنع فيها تعتبر مش
+
+237
+00:20:26,930 --> 00:20:31,130
+expensive تمام طيب بما ان في انها مميزات كتيرة
+
+238
+00:20:31,130 --> 00:20:35,260
+تمام ومش غالية كتير بيستعملوهافي الحالات اللي
+
+239
+00:20:35,260 --> 00:20:38,760
+بيكون فيها desquant و changing angle of desquant
+
+240
+00:20:38,760 --> 00:20:43,100
+يعني زرعية الحول مش ثابتة بشكل نهائي اللي احنا
+
+241
+00:20:43,100 --> 00:20:47,460
+مثلا ناخد قرار جراحي او قرار ما شابه ولكن بتتغير
+
+242
+00:20:47,460 --> 00:20:51,730
+هل ممكن في بعض الأمراض يعني بتتغيريعني زاوية
+
+243
+00:20:51,730 --> 00:20:54,890
+الحوال بين فترة والتانية بالظبط لما بيصير أندي
+
+244
+00:20:54,890 --> 00:20:57,930
+يعني ضعف بسيط في .. في عصب من الأعصاب المغذية
+
+245
+00:20:57,930 --> 00:21:00,450
+لعضلات الأيان اللي هو التالت والرابع والسادس
+
+246
+00:21:00,450 --> 00:21:03,610
+أحياناً بيتم الشفاء تلقائيا في كثير من الأحيان
+
+247
+00:21:03,610 --> 00:21:07,690
+فلما بيبدأ الشفاء في العصب يحدث بيبدأ العصب يستعيد
+
+248
+00:21:07,690 --> 00:21:10,650
+وظيفته وبالتالي العضلة اللي هو بيغذيها بتبدأ
+
+249
+00:21:10,650 --> 00:21:14,080
+تستعيد وظيفتهاوبالتالي زاية الحوال بتبدأ تجيل
+
+250
+00:21:14,080 --> 00:21:17,580
+فبالتالي مابن استعجل في أي قرار من هذا النوع طيب
+
+251
+00:21:17,580 --> 00:21:20,980
+الان هو بيشكي من double vision بسبب الحوال تمام
+
+252
+00:21:20,980 --> 00:21:25,220
+فانا بستعمله ال friendly prism وكل شوية بخففله من
+
+253
+00:21:25,220 --> 00:21:29,760
+المقدار بتاعهم كل ما اتحسن الحوال ببدأ أخفف منها
+
+254
+00:21:29,760 --> 00:21:34,440
+لغاية ما أحيانا بيتم رفعة بشكل نهائي وما يعني
+
+255
+00:21:34,440 --> 00:21:38,980
+بيكون خلاص مش محتاج استعملها فهي تستعمل when
+
+256
+00:21:50,740 --> 00:21:55,420
+الان بالنسبة لفرن ال لينزز هي نفس الفرن ال بريزم
+
+257
+00:21:55,420 --> 00:22:00,400
+بس معمولة بدل ما هي بشكل يعني straight هيك بشكل
+
+258
+00:22:00,400 --> 00:22:06,320
+circularto simulate spherical lenses برضه بتقدي
+
+259
+00:22:06,320 --> 00:22:10,940
+نفس الوظيفة .. نفس الوظيفة اللي هي بتقديها لـ
+
+260
+00:22:10,940 --> 00:22:16,560
+Fresnel برزم المعتاد ويلها استعمالات يعني متعددة
+
+261
+00:22:16,560 --> 00:22:21,560
+تمام؟ الآن بدنا نيجي يعني هيك تقريبا احنا حكينا عن
+
+262
+00:22:22,400 --> 00:22:25,260
+يعني معظم الأشياء اللي بدنا نحكي عنها في الprismat
+
+263
+00:22:25,260 --> 00:22:31,360
+بدنا نيجي احنا ناخد تدريب على المحاضرة السابقة
+
+264
+00:22:31,360 --> 00:22:37,050
+وليه مهم جدا في قضية ال lens decentrationعشان نحدث
+
+265
+00:22:37,050 --> 00:22:40,190
+الـprismatic effect احنا بدنايا او ان نعرف
+
+266
+00:22:40,190 --> 00:22:44,510
+الـprismatic effect للـdecentred lenses تمام
+
+267
+00:22:44,510 --> 00:22:48,010
+فبالتالي بدنا ناخد مسألة بس المرة هاي هناخد مسألة
+
+268
+00:22:48,010 --> 00:22:54,610
+تشمل العينتين تشمل العينتين ويعني نشوف الأثر
+
+269
+00:22:54,610 --> 00:22:57,770
+النهائي الكلي على ال vertical و ال horizontal
+
+270
+00:22:57,770 --> 00:23:03,670
+بالنسبة ليعني عين المريض او عينين المريض تمام
+
+271
+00:23:03,670 --> 00:23:04,530
+يعطيكوا العافية
+
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/ncJfQteYm_c_postprocess.srt b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/ncJfQteYm_c_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..f2e5728a9fe9160ddecf951c5d1894c1bd65d594
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/ncJfQteYm_c_postprocess.srt
@@ -0,0 +1,1916 @@
+1
+00:00:21,010 --> 00:00:23,490
+بسم الله الرحمن الرحيم نكمل مع الاسفير و
+
+2
+00:00:23,490 --> 00:00:27,410
+cylindrical lenses و أبسط نوع من الاسفير و
+
+3
+00:00:27,410 --> 00:00:30,370
+cylindrical lenses هي البلانو cylindrical lens
+
+4
+00:00:30,370 --> 00:00:33,470
+البلانو cylindrical lens عبارة عن اسفير و
+
+5
+00:00:33,470 --> 00:00:38,330
+cylindrical lens بس الاسفير فيها قوتها إيش صفر على
+
+6
+00:00:38,330 --> 00:00:42,290
+سبيل المثال في أن بلانو minus 3 أكسيس سين و بلانو
+
+7
+00:00:42,290 --> 00:00:47,910
+مثلا plus 2.5 أكسيس ساد هنا بنقول minus cylinder
+
+8
+00:00:48,730 --> 00:00:54,750
+بدون سفير و plano cylinder plus بدون سفير لو اجينا
+
+9
+00:00:54,750 --> 00:00:59,030
+احنا هذه نتخيل الشكل بتاعها بنقول احنا ال plus
+
+10
+00:00:59,030 --> 00:01:03,550
+cylinder هي عبارة عن جزء من أسطوانة cylindrical
+
+11
+00:01:03,550 --> 00:01:08,810
+lens وهذا الجزء تم اقتطاعه فهيكون الشكل بالشكل
+
+12
+00:01:08,810 --> 00:01:13,070
+التالي لأن
+
+13
+00:01:13,070 --> 00:01:17,410
+هذا السطح هيكون flat والسطح التاني هيكون بشكل ايش
+
+14
+00:01:22,660 --> 00:01:28,060
+بشكل اللي احنا رسمينه plano cylinders لو جبت انا
+
+15
+00:01:28,060 --> 00:01:34,260
+سطوانة و اخدت منها مقطع فتعطيني هذه المقطع هيكون
+
+16
+00:01:34,260 --> 00:01:39,200
+plano cylinder plus cylinder plus cylinder تمام ال
+
+17
+00:01:39,200 --> 00:01:42,400
+minus cylinder ال minus cylinder هيكون شكلها
+
+18
+00:01:42,400 --> 00:01:47,680
+بالشكل التالي برضه
+
+19
+00:01:47,680 --> 00:01:48,520
+سطح هيكون
+
+20
+00:01:53,840 --> 00:01:57,560
+يعني بنحاول نقترب من الرسمة الصحيحة بالشكل هذا هذه
+
+21
+00:01:57,560 --> 00:02:04,220
+minus plano cylinder minus طبعا
+
+22
+00:02:04,220 --> 00:02:09,060
+minus و هنا plano cylinder plus فهذه ال plano
+
+23
+00:02:09,060 --> 00:02:12,040
+cylinder تعتبر أبسط نوع من ال spherical
+
+24
+00:02:12,040 --> 00:02:16,020
+cylindrical lens ممكن توجد في ال plus form أو في
+
+25
+00:02:16,020 --> 00:02:24,670
+ال minus form طبعا بنستخدمهافي حاجات كتيرة طبعا ال
+
+26
+00:02:24,670 --> 00:02:30,970
+trial set موجود في طاقم من ال plus cylinders وطاقم
+
+27
+00:02:30,970 --> 00:02:38,330
+من ال minus cylinders يعني في كل trial set الآن
+
+28
+00:02:38,330 --> 00:02:41,110
+مثال على ال plano cylinder هو ال Maddox road
+
+29
+00:02:42,450 --> 00:02:46,810
+المادوكس رود هو قطعة موجودة في ال trial set و هي
+
+30
+00:02:46,810 --> 00:02:51,410
+عبارة عن plano cylinders plus plano cylinders و ال
+
+31
+00:02:51,410 --> 00:02:58,170
+power بتاعتها high طبعا كل قطعة او كل جزء من هذا
+
+32
+00:02:58,170 --> 00:03:05,450
+اللي بسموه المادوكس رود لو أخدنا يعني قسم واحد منه
+
+33
+00:03:05,450 --> 00:03:10,490
+هذه plus plano cylinderwhy نفس الشي و why نفس الشي
+
+34
+00:03:10,490 --> 00:03:14,390
+و كلها نفس الأشياء طبعا معروف أنه قوة السيلندر
+
+35
+00:03:14,390 --> 00:03:18,530
+بتكون عمودية على اتجاه ال axis ال plano cylinder
+
+36
+00:03:18,530 --> 00:03:23,710
+اللي هو Maddox road مثال على ال plano cylinder و
+
+37
+00:03:23,710 --> 00:03:28,390
+عبارة عن كل مقطع فيه عبارة عن plus high plus plano
+
+38
+00:03:28,390 --> 00:03:33,110
+cylinder الهدف منه استعمال موجود طبعا في ال trial
+
+39
+00:03:33,110 --> 00:03:37,790
+set موجود في ال trial setو يستعمل في بعض الأشياء
+
+40
+00:03:37,790 --> 00:03:43,310
+المعينة في علم الحوار اللي استخدم كتير يعني إيه له
+
+41
+00:03:43,310 --> 00:03:47,750
+أدت استخدامات و أدت فحوصات و إيه له مزايا إن ال
+
+42
+00:03:47,750 --> 00:03:52,800
+point source of light لو مرت عبرالـ Planar
+
+43
+00:03:52,800 --> 00:03:56,900
+Cylinder أو عبر الـ Maddox Road بتحول .. بيحول لل
+
+44
+00:03:56,900 --> 00:04:00,680
+point source of light ل line of light واتجاه ال
+
+45
+00:04:00,680 --> 00:04:02,840
+line عمودي عن اتجاه ال cylinder يعني لو ال
+
+46
+00:04:02,840 --> 00:04:06,580
+cylinder حطيتها في ال trial frame بشكل vertical
+
+47
+00:04:06,580 --> 00:04:11,000
+وضويت أمام المريض يعني نقطة مضيئة حيشوف النقطة
+
+48
+00:04:11,000 --> 00:04:14,960
+بشكل خط horizontal لو كان عند ال .. ال Maddox Road
+
+49
+00:04:16,010 --> 00:04:20,550
+بشكل Horizontal وضوّيت نقطة مضيقة أمام عين المريض
+
+50
+00:04:20,550 --> 00:04:24,970
+اللي لابس المدوكس رود هيشوف Vertical Line و هكذا
+
+51
+00:04:24,970 --> 00:04:28,090
+طبعا ارتجاه ال line اللي بيشوفه اللي هي صورة
+
+52
+00:04:28,090 --> 00:04:34,270
+النقطة هاي عمودي على اتجاه اللي هو ال axis بتاع ال
+
+53
+00:04:34,270 --> 00:04:38,330
+cylinders الموجودة في المدوكس رودهذا المادكس رويد
+
+54
+00:04:38,330 --> 00:04:41,750
+مثال على ال plano cylinders على ال plano cylinders
+
+55
+00:04:41,750 --> 00:04:45,350
+و قلنا ال plano cylinders هي أبسط form من اللي هو
+
+56
+00:04:45,350 --> 00:04:48,810
+ال spherical cylindrical lens ال general form
+
+57
+00:04:48,810 --> 00:04:51,670
+بتاعة ال spherical cylindrical lens انه لازم يكون
+
+58
+00:04:51,670 --> 00:04:55,630
+فيه عندى سفير و لازم يكون فيه عندى إيش سلندر يكون
+
+59
+00:04:55,630 --> 00:05:00,130
+سفير و يكون فيه سلندر بنيجي احنا بنقول كالقاتى هاي
+
+60
+00:05:00,130 --> 00:05:01,390
+عندى أنا plano cylinder
+
+61
+00:05:05,370 --> 00:05:08,850
+انا عندى plano cylinder لو انا اتخيلت انه هذه ال
+
+62
+00:05:08,850 --> 00:05:14,610
+plano cylinder لينة بحيث مسكتها من أطرافها وعملت
+
+63
+00:05:14,610 --> 00:05:19,230
+فيها انحناء هذه cylinder plano بس مع الانحناء صارت
+
+64
+00:05:19,230 --> 00:05:25,110
+عندى بالشكل التالي أصبح
+
+65
+00:05:25,110 --> 00:05:30,090
+في عندى سطح سفير بدل ما هو flat وفي عندى ال
+
+66
+00:05:30,090 --> 00:05:33,750
+cylinder أصبح في عندى سفيره cylindrical lens أو
+
+67
+00:05:33,750 --> 00:05:44,030
+بيسموهاهذه الـ Sphero cylindrical lens يعني كمثال
+
+68
+00:05:44,030 --> 00:05:48,210
+بسيط على إيش يعني Sphero cylindrical lens هذه الـ
+
+69
+00:05:48,210 --> 00:05:50,930
+Sphero cylindrical lens أو هذا السطح بيسموه تورس
+
+70
+00:05:50,930 --> 00:05:55,390
+أو توريك لينز تورس أو توريك لينز يعني سطح ملتوى
+
+71
+00:05:55,390 --> 00:06:04,470
+توريك لينز التوريك
+
+72
+00:06:04,470 --> 00:06:14,770
+لينزبتشبه كرة القدم الأمريكية كرة
+
+73
+00:06:14,770 --> 00:06:19,790
+القدم الأمريكية لو جينا أخدنا مقطع منها هذا يعتبر
+
+74
+00:06:21,310 --> 00:06:25,670
+في انا الي عندي انحناء بالشكل هذا وفي انحناء
+
+75
+00:06:25,670 --> 00:06:29,790
+بالشكل هذا يعني هنا radius of minimum curvature و
+
+76
+00:06:29,790 --> 00:06:35,490
+هنا radius of maximum curvature
+
+77
+00:06:35,490 --> 00:06:41,050
+فبالتالي عندي انحنائين وبالتالي هذه تعتبر tourique
+
+78
+00:06:41,050 --> 00:06:45,240
+service يعني في meridianأكثر انحناء من meridian
+
+79
+00:06:45,240 --> 00:06:49,540
+تاني أو بالعربي انه ال radius of curvature بتاعته
+
+80
+00:06:49,540 --> 00:06:54,500
+أقصر فبالتالي هو أشد انحناء من ال meridian الآخر
+
+81
+00:06:54,500 --> 00:06:59,120
+من ال meridian الآخر يعني الانحناء هذا طبعا و
+
+82
+00:06:59,120 --> 00:07:01,440
+الانحناء هذا طبعا هذا الانحناء التاني اللي أنا
+
+83
+00:07:01,440 --> 00:07:07,940
+قاعد أعلم عليه هذاعبارة عن منحني أكثر من السطح
+
+84
+00:07:07,940 --> 00:07:11,900
+الأول وبالتالي هذا يعتبر يعني Torque Service أو
+
+85
+00:07:11,900 --> 00:07:16,440
+سفير و cylindrical lens السفير لها قيمة والسلندر
+
+86
+00:07:16,440 --> 00:07:23,060
+لها قيمة ممكن نعتبر السفير و cylindrical lens إنها
+
+87
+00:07:23,060 --> 00:07:30,140
+عبارة عن two plano cylinders أو نعتبرها سفير زائد
+
+88
+00:07:30,140 --> 00:07:34,550
+سلندرفي الحالتين احنا بنكون على صواب يعني الـ
+
+89
+00:07:34,550 --> 00:07:37,890
+Spherical lens ينظر اليها على انها two
+
+90
+00:07:37,890 --> 00:07:45,970
+planocylinders تمام بقوة مختلفة و بمحاور مختلفة
+
+91
+00:07:45,970 --> 00:07:51,570
+محاور مختلفة او سفير مع سلندر على محور معين اذا
+
+92
+00:07:51,570 --> 00:07:55,690
+انا اخترت ال form هاي سفير زائد سلندر بدأ اكتبها
+
+93
+00:07:55,690 --> 00:08:01,000
+بال form ان السفير بدأ تنكتب لحالوبعدين بدنا نحط
+
+94
+00:08:01,000 --> 00:08:07,820
+قيمة السلندر وبدنا نسمي ال axis بتاع السلندر لأن
+
+95
+00:08:07,820 --> 00:08:11,580
+طالما في سلندر لازم يكون في إلها axis لأن السلندر
+
+96
+00:08:11,580 --> 00:08:16,860
+تعمل تسعين درجة بعيدا عن ال axis بتاعه السلندر
+
+97
+00:08:16,860 --> 00:08:22,490
+اللي على تسعينالسيلندر اللي على تسعين قوتها على
+
+98
+00:08:22,490 --> 00:08:26,990
+مية و تمانين قوتها على مية و تمانين ليش هذا الكلام
+
+99
+00:08:26,990 --> 00:08:31,290
+عشان الشيء البسيط جدا اللي بنحاول نتصوره كالقاتي
+
+100
+00:08:31,290 --> 00:08:37,750
+بنقول كالقاتي هاي أنا عندي قرانية وحطيت مثلا
+
+101
+00:08:37,750 --> 00:08:44,190
+سيلندر بلانه سيلندر plus plus
+
+102
+00:08:44,190 --> 00:08:49,310
+على تسعين كيف عرفنا أن قوتها على مية و تمانينأمام
+
+103
+00:08:49,310 --> 00:08:53,670
+الـ Meridian الـ 180 فيه عدسة منحنية تعتبر كإنها
+
+104
+00:08:53,670 --> 00:08:59,710
+سفير لو قلت انا plus 2 سلندر plus 2 plano سلندر
+
+105
+00:08:59,710 --> 00:09:05,090
+أمام الـ 180 فيه سطح منحني قوته plus 2 بينما أمام
+
+106
+00:09:05,090 --> 00:09:10,870
+التسعين سطح flat سطح flat مافي انحناء تمام فعشان
+
+107
+00:09:10,870 --> 00:09:14,510
+هيك بنقول انحناء السلندر عمودي على اتجاه ال axis
+
+108
+00:09:14,510 --> 00:09:21,130
+انحناء السلندرانحناء السيلندر السيلندر منحنية
+
+109
+00:09:21,130 --> 00:09:26,790
+بالشكل هذا وهي ال axis بتاعها هي اتجاه الانحناء
+
+110
+00:09:26,790 --> 00:09:31,630
+وهي اتجاه ال axis فبالتالي الانحناء عمودي على
+
+111
+00:09:31,630 --> 00:09:35,250
+اتجاه ال axis بس منطبق مع المحور العمودي على ال
+
+112
+00:09:35,250 --> 00:09:42,430
+axis فبالتالي السيلندر تعتبر سفير السيلندر تعتبر
+
+113
+00:09:42,430 --> 00:09:46,510
+سفير تسعين درجة من ال axis بتاعه يعني هذه ال plus
+
+114
+00:09:46,510 --> 00:09:52,550
+اتنينالـ Plus 2 سلندر تعتبر كأنه حاطة سفير جدّام
+
+115
+00:09:52,550 --> 00:09:59,980
+الـ 180 Meridian لحالهتعتبر بينما العدسة للسفير
+
+116
+00:09:59,980 --> 00:10:05,380
+هنا نحنقها 180 و هنا نحنقها plus 2 و هنا نحنقها
+
+117
+00:10:05,380 --> 00:10:08,840
+plus 2 و هنا نحنقها plus 2 ففي جميع المحاور
+
+118
+00:10:08,840 --> 00:10:15,200
+ستعطيني plus 2 هنا ستعطيني plus 2 على 180 إذا
+
+119
+00:10:15,200 --> 00:10:20,140
+تخيلنا أنه بلانه سلندر قوتها plus 2 فبالتالي ضروري
+
+120
+00:10:20,140 --> 00:10:24,320
+أحدد ال axis بتاع السلندر ضروري أحدد ال axis بتاع
+
+121
+00:10:24,320 --> 00:10:35,630
+السلندر يعني كقاعدةكقاعدة cylindrical lens acts
+
+122
+00:10:35,630 --> 00:10:47,330
+as a sphere 90 degree from its axis هي
+
+123
+00:10:47,330 --> 00:10:51,890
+تعتبر سفير 90 degree بعيدا عن ال axis طب على ال
+
+124
+00:10:51,890 --> 00:10:55,850
+axis بتاع تعتبر صفر كأنه لا شيء موجود كأنه لا شيء
+
+125
+00:10:55,850 --> 00:11:03,140
+موجود لأنهيعتبر سطح حفلات بالنسبة للمحور المتفق مع
+
+126
+00:11:03,140 --> 00:11:10,300
+ال axis بتاعها طيب لما نيجي نحدد ال axis ال sphere
+
+127
+00:11:10,300 --> 00:11:14,840
+و ال cylinder و ال axis بدنا ننتبه لقضية ان zero
+
+128
+00:11:14,840 --> 00:11:20,340
+degree تساوي 180 degree هي نفس الاشي هي نفس الاشي
+
+129
+00:11:20,340 --> 00:11:26,820
+تمام فبالتالي طبعا عادة يستخدم ال 180 degreeفي
+
+130
+00:11:26,820 --> 00:11:31,140
+الكتابة ولا يستخدم zero degree بس هما اتنين نفس
+
+131
+00:11:31,140 --> 00:11:36,220
+الشيء هما اتنين نفس الشيء اذا ال zero degree هي
+
+132
+00:11:36,220 --> 00:11:45,280
+نفس ال 180 degree الآن ما هي الأشكال الممكنة
+
+133
+00:11:45,280 --> 00:11:49,900
+لكتابة ال spherical cylindrical lens في عندي أشكال
+
+134
+00:11:49,900 --> 00:11:58,170
+عديدة أول شكل أكتب السفير وأكتب السلندرو أكتب ال
+
+135
+00:11:58,170 --> 00:12:08,490
+axis بتاع السلندر هذا أحد الأشكال مثال
+
+136
+00:12:08,490 --> 00:12:19,090
+نقول plus 4 minus 1 axis 90 هاي الشكل الشكل التاني
+
+137
+00:12:19,090 --> 00:12:21,410
+اللي ممكن أكتب عليه بيسموه power cross
+
+138
+00:12:25,230 --> 00:12:28,870
+بنقول كالقادة هذا نفس ال form هاي نفس ال sphere و
+
+139
+00:12:28,870 --> 00:12:34,710
+ال cylinder هي عبارة عن plus أربعة للكل مش سفير
+
+140
+00:12:34,710 --> 00:12:40,730
+بيشمل للكل كل المحاور بس بين اللي بده ينجس بدي أحط
+
+141
+00:12:40,730 --> 00:12:48,070
+minus واحد على تسعين إذا
+
+142
+00:12:48,070 --> 00:12:52,190
+محطوط minus واحد على تسعينمعناته انا بده انا نجس
+
+143
+00:12:52,190 --> 00:12:57,370
+ال 180 بواحد عن كل المحاور اذا كل المحاور بتاخد
+
+144
+00:12:57,370 --> 00:13:01,890
+ايش اربعة ديوبتر مش الاسفير بيشمل كل المحاور تمام
+
+145
+00:13:01,890 --> 00:13:06,690
+و بدنا نجس محور عن كل المحاور بدنا نجسه بمقدار
+
+146
+00:13:06,690 --> 00:13:10,770
+minus واحد هذه الواحد اذا بده تلحق كسلمدر على
+
+147
+00:13:10,770 --> 00:13:15,990
+تسعين اثرها هيكون وين؟ ع مية و تمانين هيصفعنا هنا
+
+148
+00:13:15,990 --> 00:13:18,530
+المجموعة الجبري جديش اذا
+
+149
+00:13:21,190 --> 00:13:25,190
+بقدر اعبر عن الاسفير و السلندر بالاسفير والسلندر و
+
+150
+00:13:25,190 --> 00:13:32,290
+ال axis و بقدر اعبر عنها بال power cross تالت حاجة
+
+151
+00:13:32,290 --> 00:13:38,370
+ال spherical equivalent ال spherical equivalent
+
+152
+00:13:38,370 --> 00:13:45,270
+لهدي اللي هو الاسفير زائد السلندر على اتنين او نص
+
+153
+00:13:45,270 --> 00:13:52,650
+السلندر بيساوي اندي كده؟ plus اربعةزائد ماينس نص
+
+154
+00:13:52,650 --> 00:14:01,710
+ويساوي plus تلاتة و نص ديوبتا plus
+
+155
+00:14:01,710 --> 00:14:06,850
+تلاتة و نص ديوبتا أو
+
+156
+00:14:06,850 --> 00:14:10,950
+بيسموها ال combined cylindrical form combined
+
+157
+00:14:10,950 --> 00:14:13,850
+cylindrical form
+
+158
+00:14:19,700 --> 00:14:23,880
+الـ Combined Cylindrical Form يعني بدي أعبّر عنها
+
+159
+00:14:23,880 --> 00:14:31,060
+بـ Two Cylinders وحدة plus أربعة بدي أتأثر على 180
+
+160
+00:14:31,060 --> 00:14:38,180
+degree عشان أثرها ييجي على 90 واحدة plus تلاتة على
+
+161
+00:14:38,180 --> 00:14:41,720
+90 هذا Combined Cylindrical Form عشان أثرها ييجي
+
+162
+00:14:41,720 --> 00:14:49,010
+على 180مية و تمانين يعني بمعنى اخر الشكل الرابع من
+
+163
+00:14:49,010 --> 00:14:54,650
+أشكال التعبير لو حطينا احنا plus أربعة سلندر على
+
+164
+00:14:54,650 --> 00:14:59,250
+axis مية و تمانين plus أربعة سلندر على axis مية و
+
+165
+00:14:59,250 --> 00:15:05,710
+تمانين أثرها وين هيكون على تسعين و في نفس الوجد
+
+166
+00:15:05,710 --> 00:15:07,590
+حطينا plus تلاتة
+
+167
+00:15:12,600 --> 00:15:17,560
+على 90 أثرها وين هيكون هيأثر على 180 يعني هيحلل
+
+168
+00:15:17,560 --> 00:15:21,540
+هذا ال meridian بده أربع درجات عشان يصير neutral
+
+169
+00:15:21,540 --> 00:15:26,980
+بده plus 4 عشان يصير neutral واضح طب كيف أعطيله
+
+170
+00:15:26,980 --> 00:15:29,540
+لهذا ال meridian ال vertical meridian كيف أخلي
+
+171
+00:15:29,540 --> 00:15:36,040
+plus 4 توصله بنحط سلندر plus 4 ال axis تاعة 180
+
+172
+00:15:36,040 --> 00:15:42,500
+عشان يأثر على 90 يعمله neutralization تماموهنا الـ
+
+173
+00:15:42,500 --> 00:15:45,720
+Meridian هذا في الـ power cross قوةه بيذهب لصة
+
+174
+00:15:45,720 --> 00:15:50,560
+تلاتة عشان تصير normal لو تصورنا هذه القرنية هذه
+
+175
+00:15:50,560 --> 00:15:54,680
+مجسسة أربع بيذهب لصة أربع عشان تصير normal كورنية
+
+176
+00:15:56,050 --> 00:16:00,470
+طبعا على سبيل المثال وهذه بدها plus تلاتة عشان
+
+177
+00:16:00,470 --> 00:16:05,510
+تصير normal cornea طبعا الآن هذه ال plus أربعة
+
+178
+00:16:05,510 --> 00:16:09,530
+عشان تأثر على التسعين عشان اوصلها للتسعين وعشان
+
+179
+00:16:09,530 --> 00:16:13,890
+أثرها فعلا جاي على ال vertical meridian بحط سلندر
+
+180
+00:16:13,890 --> 00:16:17,210
+على مية و تمانين احنا معروف أثر السلندر تسعين
+
+181
+00:16:17,210 --> 00:16:20,790
+degree بعيد عنها بعيد عن ال axis بتاعها فبالتالي
+
+182
+00:16:20,790 --> 00:16:25,850
+لما أحط سلندر على مية و تمانينأثرها بيجي وينها دي
+
+183
+00:16:25,850 --> 00:16:29,570
+ال plus 4 بتجيب تسلح ال plus 4 اللي ناقصها عندي
+
+184
+00:16:29,570 --> 00:16:34,110
+تمام واضح فإذا هذا يسمى combined cylindrical form
+
+185
+00:16:34,110 --> 00:16:37,010
+ال combined cylindrical form يعني أنا بدي أستعمل
+
+186
+00:16:37,010 --> 00:16:41,840
+عدسات سيلندر عشان ب axis معين عشان أصلحالـ defects
+
+187
+00:16:41,840 --> 00:16:45,000
+في الـ power across الـ power across بيحكي لي جداش
+
+188
+00:16:45,000 --> 00:16:48,820
+ناجس لكل meridian من ال meridians بتاعة الكورنية
+
+189
+00:16:48,820 --> 00:16:53,400
+نضرب مثال تاني و هتتضح الأمور إذا أنا بقدر أعبر عن
+
+190
+00:16:53,400 --> 00:17:00,220
+ال spherical lens بأحد أربع أشكالأما بالـ Sphere و
+
+191
+00:17:00,220 --> 00:17:04,160
+الـ Cylinder و الـ Axis أما بالـ Power Cross أما
+
+192
+00:17:04,160 --> 00:17:06,840
+بالـ Spherical Equivalent أو بالـ Combined
+
+193
+00:17:06,840 --> 00:17:10,320
+Cylindrical Form ناخد مثال تاني بس قبل ما ناخد
+
+194
+00:17:10,320 --> 00:17:13,380
+المثال هذه الـ Sphere و الـ Cylindrical و الـ Axis
+
+195
+00:17:13,380 --> 00:17:17,700
+إيه لها شكلين الـ Minus Cylindrical Form و الـ
+
+196
+00:17:17,700 --> 00:17:20,900
+Plus Cylindrical Form الـ Plus Cylindrical Form
+
+197
+00:17:20,900 --> 00:17:26,700
+بنعمله Transposition يعني Plus 3 Plus 1 Axis 180
+
+198
+00:17:28,290 --> 00:17:44,390
+-180 الأن ناخد مثال تاني يوضح المسألة نقول نقول
+
+199
+00:17:44,390 --> 00:17:59,200
+إن مثلا plus 3.5 minus 2.5 أكسي 180اكسيز مية و
+
+200
+00:17:59,200 --> 00:18:02,460
+تمانين بدي احولها لل power across بقول السفير
+
+201
+00:18:02,460 --> 00:18:06,800
+هتأثر على جميع الجهات هي plus تلاتة و نص على كل ال
+
+202
+00:18:06,800 --> 00:18:12,540
+meridian السفير قوتها واحدة لكل ال meridian يعني
+
+203
+00:18:12,540 --> 00:18:17,880
+بتعطي لكل ال meridian بالتساوي طيب في meridian
+
+204
+00:18:17,880 --> 00:18:25,870
+بينقص درجتين و نص عن ال plus تلاتة و نصمن هو نطلع
+
+205
+00:18:25,870 --> 00:18:29,970
+على السيلندر إذا السيلندر 100 ع 180 معناته 90 درجة
+
+206
+00:18:29,970 --> 00:18:34,210
+أثر هذا السيلندر 90 درجة إذا ع 90 إذا هنا بدأ تنجس
+
+207
+00:18:34,210 --> 00:18:39,710
+minus 2.5 أثر السيلندر اللي هتنحط ع 180 هييجي هنا
+
+208
+00:18:39,710 --> 00:18:45,690
+إيش المجموع الجبري هنا plus 1 هاي احنا استنتجنا ال
+
+209
+00:18:45,690 --> 00:18:51,770
+power cross plus 1 واضح؟ هاي ال power cross ببساطة
+
+210
+00:18:51,770 --> 00:18:56,400
+طيب ال spherical equivalentالاسفير زاد نص السيلندر
+
+211
+00:18:56,400 --> 00:19:03,600
+في طريقة تانية مجموعة مع اتنين مجموعة مع اتنين
+
+212
+00:19:03,600 --> 00:19:07,800
+واحد و تلاتة و نص اربعة و نص مع اتنين اتنين و ربع
+
+213
+00:19:07,800 --> 00:19:15,230
+plus اتنين و ربع ده يبطل نشوف هنا واحد و ربعتلاتة
+
+214
+00:19:15,230 --> 00:19:22,830
+و نص واحد و ربع بالمانوس ناقص واحد و ربع نفس
+
+215
+00:19:22,830 --> 00:19:27,950
+الشيء سواء
+
+216
+00:19:27,950 --> 00:19:33,910
+جبتها بالمتوسط تقوة ال meridiansمجموعهم على اتنين
+
+217
+00:19:33,910 --> 00:19:37,930
+او الـ sphere زي نص السيلندر سيظهر نفس الإجابة ده
+
+218
+00:19:37,930 --> 00:19:41,210
+اللي عندي ال combined cylindrical form ال combined
+
+219
+00:19:41,210 --> 00:19:45,170
+cylindrical form بشوف ايش ناجس لكل meridian هذه لو
+
+220
+00:19:45,170 --> 00:19:50,450
+تصورنا انها قرانية وكأنه الجهاز بيقول ليه كأنه
+
+221
+00:19:50,450 --> 00:19:53,970
+الجهاز بيقول ليه هنا انت ناجسك plus واحد ع تسعين
+
+222
+00:19:53,970 --> 00:19:58,770
+عشان تصل ل normal corneal power على سبيل المثالإذا
+
+223
+00:19:58,770 --> 00:20:02,610
+احنا بنشغل معقرنية only مش معين كاملة تمام؟ إذا
+
+224
+00:20:02,610 --> 00:20:05,790
+هنا أنا جسمي plus واحد كيف أحقق ال plus واحد على
+
+225
+00:20:05,790 --> 00:20:11,130
+تسعين؟ سوف أضع سيلندر على مائة و تمانين قوتها plus
+
+226
+00:20:11,130 --> 00:20:16,410
+واحد على مائة و تمانين ستذهب مؤثرة لين؟ على
+
+227
+00:20:16,410 --> 00:20:21,230
+التسعين طيب والمائة و تمانين جدّاش نجسها؟بلاس
+
+228
+00:20:21,230 --> 00:20:24,650
+تلاتة و نص كيف احقق على مية و تمانين لبلاس تلاتة و
+
+229
+00:20:24,650 --> 00:20:28,590
+نص اكسيز السيلندر اللي بيحط بلاس تلاتة و نص اكسيزه
+
+230
+00:20:28,590 --> 00:20:33,770
+بيكون على تسعين تمام اذا بلاس تلاتة و نص على تسعين
+
+231
+00:20:33,770 --> 00:20:38,850
+في فرق بين ال treating cylinder السيلندر المعالجة
+
+232
+00:20:38,850 --> 00:20:42,790
+و ال power across ال power across بيقولي وضعية ال
+
+233
+00:20:42,790 --> 00:20:47,110
+meridian هذا قوته كذا احنا قلنا كالاتي كيف انا
+
+234
+00:20:47,110 --> 00:20:50,270
+استنتج ال corneal refraction قلنا هي قرانية انسان
+
+235
+00:20:52,160 --> 00:20:57,640
+أتيت بالكراتوميتر اللي بيجيس لي قوة القرانية قال
+
+236
+00:20:57,640 --> 00:21:01,480
+لي ال vertical meridian 42 ديوبتر و ال horizontal
+
+237
+00:21:01,480 --> 00:21:07,760
+meridian 40 ديوبتر طيب و قال لي الصحيح المفروض
+
+238
+00:21:07,760 --> 00:21:13,080
+القرانية تكون سفير قوة كل ال meridians 43 ديوبتر
+
+239
+00:21:14,500 --> 00:21:18,020
+بناء عالي انا بستنتش هذا اتنين و اربعين المفروض
+
+240
+00:21:18,020 --> 00:21:21,480
+يكون تلاتة و اربعين جداش ناقصه plus واحد هذا ال
+
+241
+00:21:21,480 --> 00:21:26,180
+vertical meridian بده plus واحد تمام و ال
+
+242
+00:21:26,180 --> 00:21:28,940
+horizontal meridian جداش ناقصه ليس سيرة لأ plus
+
+243
+00:21:28,940 --> 00:21:37,110
+تلاتة تمام اذا هذه وضعية ال meridian نفسهيعني رقم
+
+244
+00:21:37,110 --> 00:21:40,570
+plus واحد دي هي نفس وضعية ال meridian مابيحكيش على
+
+245
+00:21:40,570 --> 00:21:44,530
+تسعين degree منه بس لتريتنج سيلندر إلى حكم آخر
+
+246
+00:21:44,530 --> 00:21:48,870
+عشان أحقق ال plus واحد هاي بدي أحط سيلندر ال axis
+
+247
+00:21:48,870 --> 00:21:55,140
+بتاعها جداش ع مية و تمانين و قوتها plus واحدعشان
+
+248
+00:21:55,140 --> 00:22:00,380
+احقق الـ plus 3 على 180 سلندر الـ axis تاعها على
+
+249
+00:22:00,380 --> 00:22:06,000
+90 ناخد مثال عشان تثبت الأمور بشكل نهائي ونتحرك
+
+250
+00:22:06,000 --> 00:22:07,940
+بعدها للنقطة التالية
+
+251
+00:22:12,090 --> 00:22:15,030
+بس احنا ماعملناش لـ Transposition عشان نقول انه
+
+252
+00:22:15,030 --> 00:22:19,650
+فيه two forms من الـ Spherical Representation هنا
+
+253
+00:22:19,650 --> 00:22:26,390
+بنقول plus واحد plus اتنين و نص Axis تسعين طيب
+
+254
+00:22:26,390 --> 00:22:30,450
+الان بدنا ناخد بداشي نبقى مرتبطين في Axis مية و
+
+255
+00:22:30,450 --> 00:22:36,290
+تمانين و تسعين بدنا نتحرك ل Oblique Stigmatism
+
+256
+00:22:36,290 --> 00:22:39,350
+بنقول مثلا عندي minus أربعة
+
+257
+00:22:42,070 --> 00:22:49,130
+-1.5 axis 20-1
+
+258
+00:22:49,130 --> 00:22:56,530
+axis 20 تمام طيب الآن بدى ال power cross بسيط جدا
+
+259
+00:22:56,530 --> 00:23:02,110
+للغاية الآن طالما في axis 20 معناته ال axis
+
+260
+00:23:02,110 --> 00:23:06,150
+العمودي عليه احنا بنحكي عن regular astigmatism 110
+
+261
+00:23:06,150 --> 00:23:12,610
+اذا في عندي axis 20 degree و axis 110 degreeما
+
+262
+00:23:12,610 --> 00:23:17,270
+اختلف شيء ما اختلف شيء minus 4 على الكل طبعا هنا
+
+263
+00:23:17,270 --> 00:23:23,150
+اكتب 110 degree ايه ال 20 degree و احل بجلم تاني
+
+264
+00:23:23,150 --> 00:23:28,390
+بنقول كالقاتل minus 4 على الكل I minus 4 على الكل
+
+265
+00:23:28,390 --> 00:23:33,190
+لان أسفير هتأثر على كل ال meridians طيب بس في
+
+266
+00:23:33,190 --> 00:23:37,430
+meridian هينجس كمان minus 1 عن ال minus 4 هيصير
+
+267
+00:23:37,430 --> 00:23:42,600
+minus 5السلمدر اللي بتمكسه محطوطة على عشرين اذا
+
+268
+00:23:42,600 --> 00:23:46,420
+انا معنى بانقاس اي meridian المية وعشرة اذا كمان
+
+269
+00:23:46,420 --> 00:23:51,500
+هيجيله minus واحد كده المجموع الجابريت minus خمسة
+
+270
+00:23:51,500 --> 00:23:58,480
+هاي ال power cross هاي ال power cross تمام ال
+
+271
+00:23:58,480 --> 00:24:02,880
+alphabetical equivalent مجموعهم عتنين minus تسعة
+
+272
+00:24:02,880 --> 00:24:11,920
+عتنين-4.5 أو الاسفير زائد نص السيلندر ماينس أربعة
+
+273
+00:24:11,920 --> 00:24:16,500
+و ماينس نص برضه ماينس أربعة و نص تمام ال combined
+
+274
+00:24:16,500 --> 00:24:22,440
+cylindrical power هي ال two cylinders اللازمين
+
+275
+00:24:22,440 --> 00:24:27,730
+لمعالجة ال power crossالـ two cylinders اللازمين
+
+276
+00:24:27,730 --> 00:24:30,990
+لمعالجة الـ power cross انا عندي مشكلة في ال .. في
+
+277
+00:24:30,990 --> 00:24:35,090
+ال axis 110 انه ضعيف او .. او بده او قوي زيادة
+
+278
+00:24:35,090 --> 00:24:39,450
+عليهم بده اضعفه بمقدار خمسة كيف اضعفه بمقدار خمسة
+
+279
+00:24:39,450 --> 00:24:45,990
+بده احط minus خمسة على axis عشرين تمام
+
+280
+00:24:48,740 --> 00:24:55,360
+وال Axis 20 المفروض تضعيفه بمقدار 4 أشيل منه 4
+
+281
+00:24:55,360 --> 00:25:00,700
+أحطله minus 4 كيف بدأ تأثر عليه ال minus 4 Axis
+
+282
+00:25:00,700 --> 00:25:08,120
+110 minus 4 في Axis 110 واضح مافي أي مشكلة مافي أي
+
+283
+00:25:08,120 --> 00:25:13,740
+مشكلة وضل نقطة واحدة ل Transposition minus 5 plus
+
+284
+00:25:13,740 --> 00:25:16,080
+1 Axis 110
+
+285
+00:25:24,500 --> 00:25:29,020
+المهم عدم التوتر أثناء التمييز بين ال power cross
+
+286
+00:25:29,020 --> 00:25:33,660
+و ال combined cylindrical form
+
+287
+00:25:50,320 --> 00:25:55,260
+لـ Transposition لـ Transposition طبعا أخدت فكرة
+
+288
+00:25:55,260 --> 00:25:58,920
+عنه كويسة في المثاقات التانية تمام لـ
+
+289
+00:25:58,920 --> 00:26:03,080
+Transposition هي الـ cylindrical form إذا كانها
+
+290
+00:26:03,080 --> 00:26:06,260
+minus أحوّلها ل plus أو إذا كانها plus أحوّلها ل
+
+291
+00:26:06,260 --> 00:26:10,640
+minus في عندي طريقتين للـ Transposition أول طريقة
+
+292
+00:26:10,640 --> 00:26:19,030
+عندي cylindrical form أحوّلها ل power crossو من ال
+
+293
+00:26:19,030 --> 00:26:26,110
+power cross أستنتج ال other form هذا الطريقة جائزة
+
+294
+00:26:26,110 --> 00:26:33,710
+أو أستعمل الطريقة المعتادة الطريقة المعتادة قبل ما
+
+295
+00:26:33,710 --> 00:26:36,750
+نحكي عن الطريقة المعتادة بنشوف الطريقة الأولى
+
+296
+00:26:36,750 --> 00:26:45,710
+بنقول عندي مثلا plus 8 minus 1 minus 90عشان أعمل
+
+297
+00:26:45,710 --> 00:26:48,670
+Transposition في عندي طريقتين في الطريقة المعتادة
+
+298
+00:26:48,670 --> 00:26:52,650
+ويمكن الغالبية العظمى منكم عارفها أو كلكم عارفينها
+
+299
+00:26:52,650 --> 00:26:57,070
+بس الآن في طريقة أنه أنا في عندي cylindrical form
+
+300
+00:26:57,070 --> 00:27:01,270
+معينة مثلا هنا minus cylinder بدي أحول المعادلة أو
+
+301
+00:27:01,270 --> 00:27:04,850
+ال spherical cylindrical lens ل power across و
+
+302
+00:27:04,850 --> 00:27:07,370
+أستنتج من ال power across ال other form اللي هي ال
+
+303
+00:27:07,370 --> 00:27:11,380
+plus cylinder في المثال اللي مكتوب أمامناكيف نحاول
+
+304
+00:27:11,380 --> 00:27:14,500
+هذا لل power ي cross؟ بطريقة بسيطة جدا، نقول
+
+305
+00:27:14,500 --> 00:27:19,520
+السفير بتأثر على الجميع، هي plus 2 plus 2، في
+
+306
+00:27:19,520 --> 00:27:24,320
+انديق محور لازم ينقص بمقدار 1، السيمندر محطوط على
+
+307
+00:27:24,320 --> 00:27:30,140
+90 هتنقصه على 180، هي minus 1، إذا المجموع الجبري
+
+308
+00:27:30,140 --> 00:27:36,550
+هنا بيضال اندياش، plus 1الان بدي استنتج الـ Format
+
+309
+00:27:36,550 --> 00:27:40,090
+تانية برجع بتطلع الاسفير الاسفير هنا بادية بـ plus
+
+310
+00:27:40,090 --> 00:27:48,850
+2 انا بدي اخد الاسفير هنا plus 1 plus 1 الواحد
+
+311
+00:27:48,850 --> 00:27:54,350
+قلنا فال 2 ناقص الواحد في ال axis بتاع الواحد هاي
+
+312
+00:27:54,350 --> 00:28:01,370
+plus 1 ال 2 ناقص الواحدلأ plus واحد plus اتنين
+
+313
+00:28:01,370 --> 00:28:05,210
+ناقص plus واحد plus واحد في ال axis بتاع الواحد
+
+314
+00:28:05,210 --> 00:28:11,750
+مية و تمانين شايفين هذه ال other form بتاعة ال
+
+315
+00:28:11,750 --> 00:28:16,990
+formula الأولانية نضرب كمان مثال نقول minus سبعة
+
+316
+00:28:16,990 --> 00:28:26,350
+plus اتنين و نص axis عشرين هاي ال axis عشرين عندى
+
+317
+00:28:27,460 --> 00:28:32,940
+وهي ال axis العمودي عليه اللي هو 110 وهي axis 20
+
+318
+00:28:32,940 --> 00:28:41,420
+نقول ال minus 7 هتأثر على كل ال meridians بس
+
+319
+00:28:41,420 --> 00:28:44,460
+أنا في عندي meridian بدي أقويه أحطله plus 2
+
+320
+00:28:44,460 --> 00:28:50,060
+السيلندر محطوط على 20 عشان يتقوي من 110 السيلندر
+
+321
+00:28:50,060 --> 00:28:53,820
+لما أنا بحطها في ال trial frame على 20 هتأثر وين؟
+
+322
+00:28:54,380 --> 00:28:58,720
+إذا هاي عندى plus اتنين و نص واضح؟ طيب المجموع
+
+323
+00:28:58,720 --> 00:29:03,040
+الجبري عندى هنا جداش ضال؟ minus أربعة و نص
+
+324
+00:29:06,360 --> 00:29:11,360
+تمام ماينوس أربعة و نص okay طيب الآن بتطلع على
+
+325
+00:29:11,360 --> 00:29:14,480
+الاسفير ده بدأ استنتج ال format تاني الاسفير بدأت
+
+326
+00:29:14,480 --> 00:29:18,720
+ب ماينوس سبعة المرايحة بدأت وين ماينوس أربعة و نص
+
+327
+00:29:18,720 --> 00:29:22,060
+اذا الواحد هي ال ماينوس أربعة و نص و الاتنين هي
+
+328
+00:29:22,060 --> 00:29:27,500
+الاش اللي هي ال ماينوس سبعة ماينوس أربعة و نص اللي
+
+329
+00:29:27,500 --> 00:29:35,370
+هي الواحد في الاتنين ناقص الواحد-2.5 لأن هأيش ال 2
+
+330
+00:29:35,370 --> 00:29:36,150
+نقص ال 1
+
+331
+00:29:50,660 --> 00:29:55,780
+عشان واضح في صعوبة في هذه الشيء اعتقد لا توجد
+
+332
+00:29:55,780 --> 00:30:00,500
+صعوبة بس الإنسان يتمالك نفسه مايتوترش ومايخربطش
+
+333
+00:30:00,500 --> 00:30:08,120
+بين اللي هو الأشياء اللي هي المحاورة هذه الآن
+
+334
+00:30:08,120 --> 00:30:10,940
+الطريقة المعتادة و اللي هي الأسهل و اللي احنا
+
+335
+00:30:10,940 --> 00:30:16,220
+بنعتمد عليها تمام في ال Transposition السريع بنقول
+
+336
+00:30:17,200 --> 00:30:21,300
+عندي الطريقة المعتادة هي عندي انا مثلا plus 2 و نص
+
+337
+00:30:21,300 --> 00:30:28,740
+minus 1 في axis 40 اول شيء بضيف السيلندر ل الاسفير
+
+338
+00:30:28,740 --> 00:30:34,820
+بإشاراته لما بقول plus 2 و minus 1 بصفه عندي plus
+
+339
+00:30:34,820 --> 00:30:40,400
+1 و نص هي اول خطوة تضاف السيلندر لاسفير تاني خطوة
+
+340
+00:30:40,400 --> 00:30:41,880
+بنجلي بإشارة السيلندر
+
+341
+00:30:44,740 --> 00:30:52,820
+ثالث خطوة نحرك ال axis 90 degree يعني يصف عندي 130
+
+342
+00:30:52,820 --> 00:31:00,440
+degree 130 degree هذا لـ Transposition المباشر لو
+
+343
+00:31:00,440 --> 00:31:03,460
+انا بدي ارجع اشتغل بالطريقة الأولى هشوف هيطلع
+
+344
+00:31:03,460 --> 00:31:07,520
+معايا نفس الشيء و لا لأ هنجرب بنشتغل بالطريقة
+
+345
+00:31:07,520 --> 00:31:12,050
+الأولى بنقول عندي ال plus 2 سفيرعندي أول اشي أحدد
+
+346
+00:31:12,050 --> 00:31:16,570
+ال axis أربعين ديجري و العمودي عليه مية و تلاتين
+
+347
+00:31:16,570 --> 00:31:21,970
+ديجري يعني أربعين ديجري و مية و تلاتين ديجري بنقول
+
+348
+00:31:21,970 --> 00:31:24,550
+ال sphere هتأثر على الجميع اللي هي ال dash plus
+
+349
+00:31:24,550 --> 00:31:32,870
+اتنين و نص في محور لازم ينجس بمقدار واحدكيف عرفنا
+
+350
+00:31:32,870 --> 00:31:36,350
+انه الـ130؟ لأن الـCylinder حطينا عليه على 40 عشان
+
+351
+00:31:36,350 --> 00:31:41,610
+يتأثر على الـ130، اذا هذا بينجز minus 1، تمام؟
+
+352
+00:31:41,610 --> 00:31:46,470
+المجموع الجبريلاء بيبقى لعندي plus 1.5 plus واحد
+
+353
+00:31:46,470 --> 00:31:55,490
+ونص، plus واحد ونص، plus واحد
+
+354
+00:31:55,490 --> 00:31:56,090
+ونص، plus واحد ونص، plus واحد ونص، plus واحد ونص،
+
+355
+00:31:56,090 --> 00:32:00,290
+plus واحد ونص، plus واحد ونص، plus واحد ونص، plus
+
+356
+00:32:00,290 --> 00:32:00,410
+واحد ونص، plus واحد ونص، plus واحد ونص، plus واحد
+
+357
+00:32:00,410 --> 00:32:03,220
+واحد ونص، plus واحد ونص، plus واحد والإتنين ناقص
+
+358
+00:32:03,220 --> 00:32:07,800
+الواحد السليندر في ال axis بتاع الواحد اللي هي
+
+359
+00:32:07,800 --> 00:32:13,460
+هنعتمد يعني بنقول الواحد plus واحد و نص الاتنين
+
+360
+00:32:13,460 --> 00:32:20,220
+ناقص الواحد plus واحد في ال axis بتاع الواحد مية و
+
+361
+00:32:20,220 --> 00:32:24,360
+تلاتين هل طلع المعنى نفس النتيجة نفس النتيجة
+
+362
+00:32:24,360 --> 00:32:28,880
+بالضبط نفس النتيجة بالضبطإذا في ال transposition
+
+363
+00:32:28,880 --> 00:32:42,860
+في عندي طريقتين و بقدر أستعملهم الآن
+
+364
+00:32:42,860 --> 00:32:46,000
+ده اللي عندي أنا موضوع مهم قضية ال combination of
+
+365
+00:32:46,000 --> 00:32:50,520
+cylinders متى أنا بلجأ لcombination of cylinders
+
+366
+00:32:50,520 --> 00:32:55,780
+أحيانا بيجي إنسان عنده نضارة لابس نضارة و عنده
+
+367
+00:32:55,780 --> 00:33:00,190
+high refractive errorعشان ال high refractive error
+
+368
+00:33:00,190 --> 00:33:04,050
+بتطلب ان ال vertex distance تكون accurate ال
+
+369
+00:33:04,050 --> 00:33:07,010
+vertex distance اللي هي المسافة بين السطح الخلفي
+
+370
+00:33:07,010 --> 00:33:11,630
+للنضارة والعينعادة لما احنا بنستعمل فروبتر او
+
+371
+00:33:11,630 --> 00:33:14,350
+trial frame ممكن ما تكونش ال vertex distance
+
+372
+00:33:14,350 --> 00:33:17,670
+مساوية لل vertex distance بتاعة نضارته اللي هو
+
+373
+00:33:17,670 --> 00:33:22,550
+يعني متعود يلبسها والتغيير في النضارة بتاعته اللي
+
+374
+00:33:22,550 --> 00:33:25,530
+فيها high refractive error بدي تغييرات بسيطة نص
+
+375
+00:33:25,530 --> 00:33:29,790
+درجة درجة تلت اربع درجة فبالتالي بعمل حاجة اسمها
+
+376
+00:33:29,790 --> 00:33:33,080
+over refractionover refraction يعني بخليه لابس
+
+377
+00:33:33,080 --> 00:33:37,100
+نضارته وبعمل refraction subjective refraction فوق
+
+378
+00:33:37,100 --> 00:33:44,840
+النضارة نفرض النضارة عندي هنا مثلا plus 3 minus 2
+
+379
+00:33:44,840 --> 00:33:50,780
+.5 axis مثلا 90 واحتجت انا في ال over refraction
+
+380
+00:33:50,780 --> 00:33:54,960
+بدي اضيف فوق هاي مثلا minus ربع
+
+381
+00:34:01,190 --> 00:34:12,890
+-1.5-90 هذا بيضاف لهاي عشان يعطي vision أفضل طبعا
+
+382
+00:34:12,890 --> 00:34:15,450
+هاي اللدارته الأصلية و هو لابسة عملتله over
+
+383
+00:34:15,450 --> 00:34:19,430
+refraction بواسطة الفوروبتر تمام فطلع معايا أنه
+
+384
+00:34:19,430 --> 00:34:26,450
+لما بحط هدولة زيادة تمام بيعطيني vision أفضلإذا
+
+385
+00:34:26,450 --> 00:34:30,030
+أصبح لازم نعمل combination للـ sphero cylindrical
+
+386
+00:34:30,030 --> 00:34:34,390
+lenses كيف أنا بعمل combination للـ sphero
+
+387
+00:34:34,390 --> 00:34:38,550
+cylindrical lenses حقيقة في عندي تلت حالات لا ربي
+
+388
+00:34:38,550 --> 00:34:43,370
+عليها الحالة الأولى اللي أنا قعدت أمامها لما بيكون
+
+389
+00:34:43,370 --> 00:34:49,700
+ال axis متفق مع ال axisلما بيكون ال axis متفق مع
+
+390
+00:34:49,700 --> 00:34:54,560
+ال axis النتيجة النهائية اللى بضعها في وصفة
+
+391
+00:34:54,560 --> 00:34:58,340
+النضارة بتكون المجموع الجبري للاسفير مع الاسفير
+
+392
+00:34:58,340 --> 00:35:01,840
+والسيلندر مع السيلندر وال axis بيبقى زى ما هو
+
+393
+00:35:01,840 --> 00:35:05,720
+ماحدش يجمع ال axis ماحد يجمع ال axis لا يجمع ال
+
+394
+00:35:05,720 --> 00:35:09,900
+axis تمام ماجوش 90 90 يعني 180 لأ هيك اختلف اختلت
+
+395
+00:35:09,900 --> 00:35:14,080
+الأمور تمامايعني هذه النتيجة النهائية حيصف في عيني
+
+396
+00:35:14,080 --> 00:35:19,460
+plus 2 و 75 طبعا الإشارات تتخذ بالاعتبار وهنا
+
+397
+00:35:19,460 --> 00:35:25,800
+minus 3 على axis 90 إذا في حالة أن ال axis اتفق مع
+
+398
+00:35:25,800 --> 00:35:32,340
+ال axis جمع جبري مباشر مع مراعاة الإشارات وال axis
+
+399
+00:35:32,340 --> 00:35:35,200
+نفسه لا يجمع بيبقى على نفس ال axis هذا أول
+
+400
+00:35:35,200 --> 00:35:49,640
+scenario تاني scenarioنفرض نفس ال form اللي فوق بس
+
+401
+00:35:49,640 --> 00:35:58,550
+ايش .. ايش الاختلاف ال two axisالسيلندر الأصلي أو
+
+402
+00:35:58,550 --> 00:36:01,750
+الـ Spherocylinder الأصلي اللي هو لبسه في النضارة
+
+403
+00:36:01,750 --> 00:36:05,410
+و اللي أنا بده أضيفله هي ال axis بتاعهم متعامد على
+
+404
+00:36:05,410 --> 00:36:10,050
+بعض البعض في الحالة هاي قبل ما أجمع بده أعمل خطوة
+
+405
+00:36:10,050 --> 00:36:14,690
+إضافية Transposition بده أعمل Transposition أعمل
+
+406
+00:36:14,690 --> 00:36:20,390
+Transposition للأولانية أو للتانية سيانةلأن سواء
+
+407
+00:36:20,390 --> 00:36:23,230
+اعملت Transposition لهذه سيصبح ال Axis تاعة بعد ال
+
+408
+00:36:23,230 --> 00:36:27,450
+Transposition 180 أو اعملت Transposition للتانية
+
+409
+00:36:27,450 --> 00:36:32,310
+سيصبح ال Axis تاعة 90 انجرب نعمل Transposition
+
+410
+00:36:32,310 --> 00:36:39,030
+للعدسة التانية تمام بنقول minus 3 اربع نجمع
+
+411
+00:36:39,030 --> 00:36:44,730
+السيلندر مع الاسفير بنجلب الإشارة تاعة السيلندر و
+
+412
+00:36:44,730 --> 00:36:51,610
+بنجلب ال Axis 90 درجةكان مائة و تمانين صار تسعين
+
+413
+00:36:51,610 --> 00:36:55,770
+الان طالما انا عملت transposition طالما انا عملت
+
+414
+00:36:55,770 --> 00:37:00,790
+transposition هاي خلص بدل اللي عملت لها
+
+415
+00:37:00,790 --> 00:37:04,550
+transposition اصبح عندي two cylinders بدي اجمعهم
+
+416
+00:37:04,550 --> 00:37:10,170
+جامع مباشر ليش لأن هم نفس الاش ال axis نفس ال axis
+
+417
+00:37:10,170 --> 00:37:14,330
+بيصير عندي plus تلاتة و minus خمسة و سبعين صار
+
+418
+00:37:14,330 --> 00:37:19,960
+عندي اتنين و ربع و هنا عندي بيصفي minus اتنينو ال
+
+419
+00:37:19,960 --> 00:37:29,200
+axis تسعين و ال axis تسعين طيب ايش السيناريو لو
+
+420
+00:37:29,200 --> 00:37:36,600
+انا عملت Transposition للأولانية لحظة
+
+421
+00:37:36,600 --> 00:37:39,460
+شوية خلينا احنا ناخد السيناريو التاني احنا بنقول
+
+422
+00:37:39,460 --> 00:37:43,360
+كالاتي هذه عملناها Transposition بدنا نرجعها minus
+
+423
+00:37:43,360 --> 00:37:52,310
+ربع تمام و minus نص axis مية و تمانينأنا بدي أخلي
+
+424
+00:37:52,310 --> 00:37:58,590
+هذه زي ما هي minus ربع و minus نص axis 180 و مين
+
+425
+00:37:58,590 --> 00:38:03,470
+اللي بدي أحوله ال sphere و ال cylinder الأولى ال
+
+426
+00:38:03,470 --> 00:38:07,550
+sphere و ال cylinder الأولى بتصير plus نص plus
+
+427
+00:38:07,550 --> 00:38:14,710
+اتنين و نص axis 180 ممكن أجمعهم أه و بيكون الإجابة
+
+428
+00:38:14,710 --> 00:38:21,330
+صحيحة تمامهنا plus ربع plus نص و minus ربع plus
+
+429
+00:38:21,330 --> 00:38:27,690
+ربع plus اتنين و نص و minus نص plus اتنين على axis
+
+430
+00:38:27,690 --> 00:38:35,090
+مية و تمانين تمام هاي النتيجة و هاي النتيجة ال
+
+431
+00:38:35,090 --> 00:38:40,800
+Transposition لبعضهم البعضهذه النتيجة وهذه النتيجة
+
+432
+00:38:40,800 --> 00:38:42,820
+Transposition لبعضهم البعض
+
+433
+00:38:58,640 --> 00:39:01,920
+إذن لما بيكون ال axis موحد لل two spherical
+
+434
+00:39:01,920 --> 00:39:06,320
+cylindrical lens بجمع جبري مباشر بس ال axis لا
+
+435
+00:39:06,320 --> 00:39:10,020
+يجمع طب لو ال axis بتاع one cylinder عمودي على ال
+
+436
+00:39:10,020 --> 00:39:13,280
+axis بتاع التانية لازم أعمل transposition لواحدة
+
+437
+00:39:13,280 --> 00:39:19,160
+منهم لواحدة منهم الان بيبقى لاندي آخر scenario ان
+
+438
+00:39:19,160 --> 00:39:23,180
+يكون ال axis بتاع one cylinder و ال axis بتاع ال
+
+439
+00:39:23,180 --> 00:39:27,900
+other cylinder ما بينهم مش 90 degree و مش منطبيقي
+
+440
+00:39:30,730 --> 00:39:39,090
+لو أنا عندى الصيناريو التالى مثلا بنقول plus تلاتة
+
+441
+00:39:39,090 --> 00:39:47,790
+minus واحد اكس عشرين و minus اتنين minus واحد اكس
+
+442
+00:39:47,790 --> 00:39:55,900
+سبعين مالعمل عشان اعرفالـ Spherical lens المكافئة
+
+443
+00:39:55,900 --> 00:39:59,420
+لهم لأنه مش ماجول ألابسه two Spherical أمام بعضهم
+
+444
+00:39:59,420 --> 00:40:03,720
+البعض تمام فين دي طريقة من طريقتين لمعرفة القوة
+
+445
+00:40:03,720 --> 00:40:08,360
+طبعا هذه و ده معادلات معقدة ولكن في طريقتين سهلات
+
+446
+00:40:08,360 --> 00:40:15,190
+جدا الطريقة الأولى بحط في ال trial frameبحط ال
+
+447
+00:40:15,190 --> 00:40:18,930
+lens الأولى بال axis بتاعها و بحط ال lens التانية
+
+448
+00:40:18,930 --> 00:40:22,750
+بال axis بتاعها تمام و بحمل ال trial frame بدون ما
+
+449
+00:40:22,750 --> 00:40:25,810
+احرك ال axis و بجيس النتيجة النهائية على ال
+
+450
+00:40:25,810 --> 00:40:29,850
+lensmeter هيعطيني سفيره سيلندري كال lens المكافئة
+
+451
+00:40:29,850 --> 00:40:34,230
+بس ضروري جدا ما تتحركش ال axis عشان يعطيني القراءة
+
+452
+00:40:34,230 --> 00:40:39,310
+الصحيحةبطريقة القياس المباشر من الـ lensmeter مع
+
+453
+00:40:39,310 --> 00:40:42,990
+الأخذ بالحسبان مايتمش تحريك ال axis لأنه إذا اتحرك
+
+454
+00:40:42,990 --> 00:40:46,970
+ال axis تاع السلندر أصبح في عندي خطأ في القياس
+
+455
+00:40:46,970 --> 00:40:51,010
+فبالتالي بحط التنتين فوق بعض و بروح أنا باخدهم
+
+456
+00:40:51,010 --> 00:40:53,890
+طبعا بحطهم في ال trial frame عشان أحدد ال axis
+
+457
+00:40:53,890 --> 00:40:58,940
+مظبوطالطريقة التانية الآن بفضل تقدم تكنولوجيا
+
+458
+00:40:58,940 --> 00:41:04,320
+المعلومات انه في software برامج على الانترنت زي ال
+
+459
+00:41:04,320 --> 00:41:09,260
+opticampus club تمامبندخل معلومات السيلندر
+
+460
+00:41:09,260 --> 00:41:13,900
+الأولانية و معلومات السيلندر التانية و بنحكي يعني
+
+461
+00:41:13,900 --> 00:41:18,340
+بناعت ال software order calculate وبالتالي بتطلع
+
+462
+00:41:18,340 --> 00:41:23,580
+السيلندر المكافئة بشكل مباشر و بدون أي غلبة أو
+
+463
+00:41:23,580 --> 00:41:29,080
+الحاجة لدخول في عمليات رياضية معقدة فهذه الثلاث
+
+464
+00:41:29,080 --> 00:41:29,780
+سيناريوهات
+
+465
+00:41:33,800 --> 00:41:37,020
+اللي متوقع إما يكون ال two axis بتاع ال cylinders
+
+466
+00:41:37,020 --> 00:41:41,020
+متطابق جامعة جامبري مباشرة بدون جامعة ال axis أو
+
+467
+00:41:41,020 --> 00:41:44,060
+متعامد واحدة بدأت تنصر ل Transposition للتانية
+
+468
+00:41:44,060 --> 00:41:48,380
+عشان يتطابق ثم نجمعهم جامعة جامبري إذا كان في
+
+469
+00:41:48,380 --> 00:41:51,920
+oblique axis between the two cylinders معناته إما
+
+470
+00:41:51,920 --> 00:41:56,120
+بقىعلى باستعمال ال lensmeter مع مراعاة عدم تحريك
+
+471
+00:41:56,120 --> 00:41:59,360
+ال axis يعني لتكون accurate في القياس أو ان ادخل
+
+472
+00:41:59,360 --> 00:42:02,580
+المعطلات هذه على ال software في software كتيرة
+
+473
+00:42:02,580 --> 00:42:07,440
+بتحسبلي اللي هو combining cylinders تحت عنوان
+
+474
+00:42:07,440 --> 00:42:17,880
+combining cylinders at oblique .. oblique axis
+
+475
+00:42:19,720 --> 00:42:25,260
+بطلع عندي برامج كتيرة تمام و ممكن يعني مباشر ادخل
+
+476
+00:42:25,260 --> 00:42:27,900
+الموقعات هذه و اعطي order لل software انه
+
+477
+00:42:27,900 --> 00:42:31,700
+calculate و بالتالي يعطيني الجواب النهائي انه في
+
+478
+00:42:31,700 --> 00:42:37,100
+spherical lens مكافئة للتنتين تمام فبهذا الكلام
+
+479
+00:42:37,100 --> 00:42:40,100
+احنا بننهي محاضرة اليوم و يعطيكوا العافية
+
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/tBPt3Loqvw4_postprocess.srt b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/tBPt3Loqvw4_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..1d58117a8e3007b324e66e8a20535580990b1e50
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/tBPt3Loqvw4_postprocess.srt
@@ -0,0 +1,2144 @@
+1
+00:00:20,770 --> 00:00:24,070
+بسم الله الرحمن الرحيم اليوم الموضوع عن ال mirrors
+
+2
+00:00:24,070 --> 00:00:27,570
+ال mirrors تعتبر optical systems زيها زي العدسات
+
+3
+00:00:27,570 --> 00:00:30,770
+بتشترك مع العدسات في حاجات كتيرة و من ضمن ال
+
+4
+00:00:30,770 --> 00:00:34,150
+versions calculations إلا أنه في بعض الأشياء
+
+5
+00:00:34,150 --> 00:00:38,570
+المميزة المميزة ل ال mirrors في بعض الأشياء
+
+6
+00:00:38,570 --> 00:00:41,730
+المميزة لل mirrors هنحكي عن بعض الأشياء هذه و نشوف
+
+7
+00:00:41,730 --> 00:00:46,660
+بإيش بتتميز عن العدساتطبعاً لما احنا بنحكي عن ال
+
+8
+00:00:46,660 --> 00:00:49,940
+mirror اول حاجة بنحكي عن ال reflecting power
+
+9
+00:00:49,940 --> 00:00:53,560
+مابنحكيش عن ال refracting power في العدسة بتعملي
+
+10
+00:00:53,560 --> 00:00:59,200
+refraction اما ال mirror هتعملي reflecting لو قلنا
+
+11
+00:00:59,200 --> 00:01:06,240
+احنا عشان نقارن بينهم عندي عدسة convex plus وعدسة
+
+12
+00:01:06,240 --> 00:01:14,650
+concave minus هذه concave lensوهذه convex lens
+
+13
+00:01:14,650 --> 00:01:21,110
+المرايا عندي تلت أنواع تمام عندي ال .. اللي هي ال
+
+14
+00:01:21,110 --> 00:01:25,050
+convex mirror طبعا
+
+15
+00:01:25,050 --> 00:01:29,190
+السطح هذا اللي أنا بحط عليه يعني شرطات هذا السطح
+
+16
+00:01:29,190 --> 00:01:32,010
+اللي هو الخلفي للمرأة وهو السطح العاكس اللي هو
+
+17
+00:01:32,010 --> 00:01:39,650
+السطح الأمامي هذه convex mirror minus وهنا concave
+
+18
+00:01:39,650 --> 00:01:40,270
+mirror
+
+19
+00:01:42,700 --> 00:01:46,100
+plus و هنا plain mirror اللي بستعملها كتير في
+
+20
+00:01:46,100 --> 00:01:51,120
+حياتنا اللي هي لا هي plus ولا هي minus تمام قوتها
+
+21
+00:01:51,120 --> 00:01:59,440
+أيهاش zero طبعا لما بنقول concave او minus mirror
+
+22
+00:01:59,440 --> 00:02:05,200
+convex اسف convex او minus mirror يعني الأشعة اللي
+
+23
+00:02:05,200 --> 00:02:11,860
+بتوصلها is a parallel بتصير divergentوإذا كانها
+
+24
+00:02:11,860 --> 00:02:17,440
+divergent بتصير more divergent إذا كانها divergent
+
+25
+00:02:17,440 --> 00:02:23,680
+ريه بتصير more divergent يعني ال convex mirror
+
+26
+00:02:23,680 --> 00:02:29,720
+adds بتضيفلي negative divergence
+
+27
+00:02:29,720 --> 00:02:36,680
+to light بمعنى آخر لو افترضنا جدلا ان ال U اللي هي
+
+28
+00:02:36,680 --> 00:02:41,450
+divergence to light عند سطح المرقام minus 2وقوة ال
+
+29
+00:02:41,450 --> 00:02:46,690
+convex mirror minus 2 ديوبتر بيصير عندي ال V minus
+
+30
+00:02:46,690 --> 00:02:55,130
+4 اذا بتشتغل ال convex mirror كأنها بالضبط بنفس
+
+31
+00:02:55,130 --> 00:03:00,990
+الدور اللي بتكون في ال concave lens ال minus
+
+32
+00:03:00,990 --> 00:03:04,450
+mirror او ال convex mirror adds
+
+33
+00:03:09,620 --> 00:03:14,300
+الكونكيف ميرور الكونكيف ميرور
+
+34
+00:03:31,090 --> 00:03:34,790
+يعني لو في عندي أشياء عبارة عن الـ Concave Mirror
+
+35
+00:03:34,790 --> 00:03:39,770
+بتجمعها و بتكونلي صورة حقيقية ال V هتكون عندي plus
+
+36
+00:03:39,770 --> 00:03:46,510
+ال V هتكون عندي بال plus تمام ال plain mirror adds
+
+37
+00:03:46,510 --> 00:03:51,930
+no variance to light adds no variance to light
+
+38
+00:03:51,930 --> 00:03:55,610
+المعنى
+
+39
+00:03:55,610 --> 00:04:04,170
+الضوء قدم من ال object minus 2هيرجع برضه إيش بـ-2
+
+40
+00:04:04,170 --> 00:04:08,830
+بيوبتر لأن قوة الـ plane mirror صفر لما بنقول U
+
+41
+00:04:08,830 --> 00:04:14,970
+زائد P يساوي V U زائد P تساوي V الـU ال version
+
+42
+00:04:14,970 --> 00:04:17,970
+بتاع الـLight بتاع ال object قولنا ماينوس اتنين
+
+43
+00:04:17,970 --> 00:04:22,970
+زائد Zero يساوي V إذا الـV اللي هي ال version بتاع
+
+44
+00:04:22,970 --> 00:04:27,530
+ال image إيش يساوي ماينوس اتنين إذا إيش غيرت بس
+
+45
+00:04:27,530 --> 00:04:33,280
+عكسة اتجاه الضوءعكست اتجاه الضوء فقط بدون مضيف اي
+
+46
+00:04:33,280 --> 00:04:36,500
+versions لل light لا positive اللي اتجمه ولا
+
+47
+00:04:36,500 --> 00:04:40,620
+negative اللي اتفرقه طبعا هو وصل متفرق بمقدار
+
+48
+00:04:40,620 --> 00:04:45,460
+اتنين وهيرجع متفرق ايضا بمقدار اتنين مع يعني minus
+
+49
+00:04:45,460 --> 00:04:49,840
+اتنين وصوله و minus اتنين صدوره من او انعكسه من
+
+50
+00:04:49,840 --> 00:04:54,240
+المرأة هذا بالنسبة لتأثير ال various mirrors على
+
+51
+00:04:54,240 --> 00:05:00,970
+ال versions of light زي ما العدسات لهاfocal length
+
+52
+00:05:00,970 --> 00:05:07,010
+ال mirrors لها أيضا focal length بس
+
+53
+00:05:07,010 --> 00:05:12,010
+في خصوصية لل focal length بتاع ال mirror هناخد
+
+54
+00:05:12,010 --> 00:05:20,190
+كمثال ال concave mirror concave mirror هاي
+
+55
+00:05:20,190 --> 00:05:25,480
+ال optical axisوهي ال focal length اللي هو من سطح
+
+56
+00:05:25,480 --> 00:05:32,080
+المرأة لغاية ال focus بتاع المرأة تمام طيب بنقول
+
+57
+00:05:32,080 --> 00:05:39,640
+ال focal length لو إجت أشعة عبارة لل .. لل concave
+
+58
+00:05:39,640 --> 00:05:43,260
+mirror بتجمعها
+
+59
+00:05:44,150 --> 00:05:47,790
+فى ال focus بتاعها وبتتكوّن الصورة عندى فى ال
+
+60
+00:05:47,790 --> 00:05:51,810
+focus بتاع المرأة بالظبط زى ما بتيجى أشياء
+
+61
+00:05:51,810 --> 00:05:57,990
+Parallel ل ال convex lens وبتجمعها هنا قولنا
+
+62
+00:05:57,990 --> 00:06:04,070
+بتجمعها فى ال fp ال focus الخلفى بتاع المرأة بتاع
+
+63
+00:06:04,070 --> 00:06:08,090
+العدسة تمام كيف أعرف المسافة هذه ال focal length
+
+64
+00:06:08,090 --> 00:06:08,670
+بتاع ال mirror
+
+65
+00:06:14,070 --> 00:06:17,930
+نرمزه بالرمز F يساوي واحد على ال power بتاعة ال
+
+66
+00:06:17,930 --> 00:06:22,130
+mirror أو ال power بتاعة ال mirror تساوي واحد على
+
+67
+00:06:22,130 --> 00:06:26,390
+ال focal length بتاع المرأة لو قلنا ال focal
+
+68
+00:06:26,390 --> 00:06:31,710
+length بتاع هذه المرأة اللي أنا رسمها مثلا نص متر
+
+69
+00:06:31,710 --> 00:06:36,650
+على سبيل المثالما قوة هذه الـ concave mirror الـ
+
+70
+00:06:36,650 --> 00:06:41,750
+power بتاعة ال mirror تساوي واحد على نص متر ويساوي
+
+71
+00:06:41,750 --> 00:06:46,630
+plus اتنين بيوبتر ليش حطيت plus اتنين لأن هذه مرأة
+
+72
+00:06:46,630 --> 00:06:50,990
+concave و ال concave عبارة عن positive mirror
+
+73
+00:06:50,990 --> 00:06:56,750
+positive mirror لو قلنا negative mirror convex
+
+74
+00:06:56,750 --> 00:07:00,030
+mirror ال focal length بتاعها
+
+75
+00:07:02,730 --> 00:07:10,570
+الـ focal length بتاعها ربع
+
+76
+00:07:10,570 --> 00:07:15,590
+متر جداش ال power بتاعتها ال power تساوي واحد على
+
+77
+00:07:15,590 --> 00:07:22,410
+ال focal length واحد على ربع متر ويساوي minus اربع
+
+78
+00:07:22,410 --> 00:07:27,550
+ديوبتر واحد ع ربع متر اربع طب علشان اعطيت اشارة
+
+79
+00:07:27,550 --> 00:07:34,070
+minusلأ هي عشانها convex عشانها ايش بتشتت الضوء
+
+80
+00:07:34,070 --> 00:07:41,630
+يعني ال parallel light تعمله divergent light واضح؟
+
+81
+00:07:41,630 --> 00:07:45,030
+اذا بقدر اعرف ال power بتاعة ال mirror من ال focal
+
+82
+00:07:45,030 --> 00:07:51,330
+length وبقدر اعرف ال focal length من ال power هذه
+
+83
+00:07:51,330 --> 00:07:57,010
+بالنسبة ل ال focal length of the mirror حقيقة
+
+84
+00:07:59,000 --> 00:08:03,120
+المراية مش بس بقدر أعرفها بواسطة ال focal length
+
+85
+00:08:03,120 --> 00:08:06,800
+وايضا بقدر أعرفها بواسطة ال radius of curvature
+
+86
+00:08:06,800 --> 00:08:15,900
+يعني لو قلنا عنا mirror بنقدر
+
+87
+00:08:15,900 --> 00:08:20,920
+نحصل على ال power بتاعتها بتقسيم واحد على ال focal
+
+88
+00:08:20,920 --> 00:08:25,180
+length وهذا إشي قبل شوية شرحنا تمام؟ الآن في عندي
+
+89
+00:08:25,180 --> 00:08:29,540
+حاجة اسمها radius of curvature هاي ال centerبتاع
+
+90
+00:08:29,540 --> 00:08:35,340
+الكرة اللي جزء منها ال mirror تمام هاي ال center
+
+91
+00:08:35,340 --> 00:08:41,100
+بتاع الكرة اللي المرقاة جزء منها اللي المرقاة جزء
+
+92
+00:08:41,100 --> 00:08:46,780
+منها من ال center لل periphery هذا بيسموه R radius
+
+93
+00:08:46,780 --> 00:08:51,320
+of curvature أو نصف قطر المرقاة تمام طيب وجدوا
+
+94
+00:08:51,320 --> 00:08:58,620
+العلماء ان نصف القطر يساوي 2Fنصف القطر يساوي 2F
+
+95
+00:08:58,620 --> 00:09:03,380
+يعني ال focus بتاع المرأة بيجي فى نص المسافة من
+
+96
+00:09:03,380 --> 00:09:12,240
+مركز الكرة للمرأة طبعا طالما عندي انا R تساوي 2F
+
+97
+00:09:12,240 --> 00:09:21,300
+تمام بدي اصل انا اعيش لمعادلة هنا عندي F تساوي
+
+98
+00:09:21,300 --> 00:09:24,140
+واحد
+
+99
+00:09:25,010 --> 00:09:26,710
+على ال power بتاعة ال mirror
+
+100
+00:09:34,000 --> 00:09:41,540
+هنا ال focus يساوي R على 2 R على 2 الان انا بدي
+
+101
+00:09:41,540 --> 00:09:44,380
+اجيب ال power بتاعة ال mirror بدي استخدم المعادلة
+
+102
+00:09:44,380 --> 00:09:49,580
+high و المعادلة high عشان اصل لمعادلة جديدة بتربط
+
+103
+00:09:49,580 --> 00:09:52,620
+ال power بتاعة ال mirror في نصف القطر تربط ال
+
+104
+00:09:52,620 --> 00:09:55,680
+power بتاعة ال mirror في نصف القطر تمام بيقول ال
+
+105
+00:09:55,680 --> 00:10:01,320
+power بتاعة ال mirror تساوي 1 على F وتساوي 1
+
+106
+00:10:04,070 --> 00:10:10,570
+R على اتنين ويساوي اتنين على R اذا ال power بتاعة
+
+107
+00:10:10,570 --> 00:10:16,090
+ال mirror اما تساوي واحد على F او تساوي اتنين على
+
+108
+00:10:16,090 --> 00:10:21,130
+R او تساوي اتنين على R بنشوف كالاقاتي المثال اللي
+
+109
+00:10:21,130 --> 00:10:26,850
+عندنا بنقول نص في القطر نص متر تمام؟
+
+110
+00:10:28,290 --> 00:10:35,630
+الـ Focus نصه ربع متر الـ Power تساوي واحد على F
+
+111
+00:10:35,630 --> 00:10:41,290
+ويساوي واحد على ربع متر ويساوي plus أربعة ديوبتر
+
+112
+00:10:41,290 --> 00:10:47,610
+أو الـ Power تساوي اتنين على R تساوي اتنين على نص
+
+113
+00:10:47,610 --> 00:10:54,750
+متر ويساوي plus أربعة ديوبتر بغض اللظر استخدمت أي
+
+114
+00:10:54,750 --> 00:11:05,260
+منالقانونين الإجابة سهلة ومباشرة اذا تساوي R على 2
+
+115
+00:11:05,260 --> 00:11:12,980
+او 1 على F طيب في نقطة باللغة بالنسبة للمرايا
+
+116
+00:11:12,980 --> 00:11:17,220
+بتتميز فيها عن العدسات لا مكان لل refractive index
+
+117
+00:11:17,220 --> 00:11:22,610
+عند الحديث عن المرايا ليش؟لأن ال refractive index
+
+118
+00:11:22,610 --> 00:11:28,410
+له علاقة بانكسار الضوء عند تنقله بين مادة optical
+
+119
+00:11:28,410 --> 00:11:32,670
+medium ومادة تانية بينما في المرايا، الضوء لما
+
+120
+00:11:32,670 --> 00:11:36,670
+بيصطدم في المرايا، بينعكس لنفس المادة اللي إيجا
+
+121
+00:11:36,670 --> 00:11:42,370
+منها، الضوء جايمن هذه المنطقة مثلا هوا و هيرجع في
+
+122
+00:11:42,370 --> 00:11:46,290
+نفس الهوا فrefractive index لا دورة له في شغل
+
+123
+00:11:46,290 --> 00:11:50,350
+المرايا لا دورة لrefractive index اللي نرمزله
+
+124
+00:11:50,350 --> 00:11:53,430
+بالرمز N في عمل المرايا
+
+125
+00:11:56,480 --> 00:12:00,980
+الجهة التي أرسلت الضوء هي الجهة التي تستقبل الضوء
+
+126
+00:12:00,980 --> 00:12:05,000
+يعني الضوء هينعكس ويرجع من المكان اللي إجا منه
+
+127
+00:12:05,000 --> 00:12:10,120
+يعني إذا إجا من الشمال لليمين وهو المعتاد عندنا
+
+128
+00:12:10,120 --> 00:12:16,800
+مثلا هي عندي convex mirror وضوء إجا من object ع
+
+129
+00:12:16,800 --> 00:12:23,020
+الشمال هينعكس باتجاه وين؟ الشمال أيضا يعني من ال
+
+130
+00:12:23,020 --> 00:12:27,720
+left to rightقبل ما يصطدم في المرأة رجع من ال
+
+131
+00:12:27,720 --> 00:12:32,440
+right to left بعد اصطدامه بالمرأة يعني هو اتجاهه
+
+132
+00:12:32,440 --> 00:12:37,320
+من الشمال لليمين وهو ذاهب إلى المرأة بعد ما اصطدم
+
+133
+00:12:37,320 --> 00:12:42,220
+من المرأة وانعكس من اليمين راح باتجاه الشمال
+
+134
+00:12:42,220 --> 00:12:49,000
+الحاصل من هذا الكلام انه ظل في نفس الوسط ما تغير
+
+135
+00:12:49,000 --> 00:12:54,560
+عليه الوسط، تمام؟ يعني إذا كان فرضا هنا هواهو جاي
+
+136
+00:12:54,560 --> 00:12:57,660
+من الهواء اصطدم في المرايا ورجع لنفس المنطقة من
+
+137
+00:12:57,660 --> 00:13:01,100
+الهواء فبالتالي هذه مافي داعي للحديث عن الـ
+
+138
+00:13:01,100 --> 00:13:03,260
+Refractive Index احنا بنحكي عن الـ Refractive
+
+139
+00:13:03,260 --> 00:13:06,680
+Index لما ينتقل من وسط لوسط اخر يختلف عنه في الـ
+
+140
+00:13:06,680 --> 00:13:09,700
+Refractive Index طب هنا الهواء واحد و لما نجعله
+
+141
+00:13:09,700 --> 00:13:11,880
+برضه الهواء الـ Refractive Index تهوه واحد يعني
+
+142
+00:13:11,880 --> 00:13:15,740
+ماتغير ايش على الدوق اللهم تغير الاتجاه فقط تغير
+
+143
+00:13:15,740 --> 00:13:20,240
+الاتجاه فقط فبالتالي هذه القضية تميز
+
+144
+00:13:21,960 --> 00:13:25,600
+المرايه عن العدسات في العدسات لازم نحكي عن
+
+145
+00:13:25,600 --> 00:13:30,120
+refractive index ويدخل في معادلاتنا ناقص N على O
+
+146
+00:13:32,120 --> 00:13:34,740
+refractive index بتاع المادة اللي جاي منها الضوء
+
+147
+00:13:34,740 --> 00:13:39,000
+وفي آخر المعادلة بنقول Uncharted على I Refractive
+
+148
+00:13:39,000 --> 00:13:42,060
+Index بتاع وسط المرايا هيكون فيه image تمام
+
+149
+00:13:42,060 --> 00:13:46,520
+فبالتالي هذه القضية بالنسبة للمرايا سقطت سقطت
+
+150
+00:13:46,520 --> 00:13:50,480
+بالنسبة للمرايا أيضا من الأشياء اللي بتتميز فيها
+
+151
+00:13:50,480 --> 00:13:54,420
+اللي بتتميز فيها المرايا عن العدسات reversal of
+
+152
+00:13:54,420 --> 00:14:01,340
+image spacereversal of image space انعكاس الوسط
+
+153
+00:14:01,340 --> 00:14:05,240
+اللي هتتكون فيه الصورة reversal of image space
+
+154
+00:14:05,240 --> 00:14:11,900
+نضرب مثال على ذلك نقول كالاتي عندي plus 5 ديوبتر
+
+155
+00:14:11,900 --> 00:14:18,420
+لينزو object على بعد 1 متر وين الصورة U تساوي ناقص
+
+156
+00:14:18,420 --> 00:14:22,200
+N على O يساوي ناقص 1 على 1 متر ويساوي ناقص 1
+
+157
+00:14:22,200 --> 00:14:27,820
+ديوبتر ال V plus 4 I تساوي on short على V ويساوي 1
+
+158
+00:14:27,820 --> 00:14:34,040
+ع plus 4 ديوبتر ويساوي plus ربع متر plus ربع متر
+
+159
+00:14:34,040 --> 00:14:39,060
+الصورة اتكبرت وين ع يمين ال optical system نفس
+
+160
+00:14:39,060 --> 00:14:45,040
+المسألة بالضبط بالضبطبس بدأ أستخدم positive mirror
+
+161
+00:14:45,040 --> 00:14:48,680
+بدل positive lens هذه positive lens وهذه positive
+
+162
+00:14:48,680 --> 00:14:52,800
+mirror قل ورقة خمسة دا يبتر plus خمسة دا يبتر
+
+163
+00:14:52,800 --> 00:14:58,280
+object على بُعد متر ال Virgin's calculations نفسها
+
+164
+00:14:58,280 --> 00:15:03,760
+نفسها تمام نقول كالقاتي U تساوي ناقص واحد دا يبتر
+
+165
+00:15:03,760 --> 00:15:09,080
+بالظبط زي هاي بالضبط مافي اي اختلاف طيب ال V ايش
+
+166
+00:15:09,080 --> 00:15:15,520
+تساويبلاس أربعة دا يبطر لأن U زائد P تساوي V هند
+
+167
+00:15:15,520 --> 00:15:20,360
+الـ U minus واحد وزائد خمسة يساوي V إذا ال V بلاس
+
+168
+00:15:20,360 --> 00:15:25,460
+أربعة دا يبطر I تساوي انشارطة على V و ساوي ربع متر
+
+169
+00:15:25,460 --> 00:15:31,220
+بس المرة هاي الربع متر مش هنا على اليسار لأن هادي
+
+170
+00:15:31,220 --> 00:15:37,550
+سطح عاكسبمررش الضوء فبالتالي ال image هتتكون عبعد
+
+171
+00:15:37,550 --> 00:15:41,790
+ربع متر من سطح المرأة ايش الاختلاف بين هنا وهنا
+
+172
+00:15:41,790 --> 00:15:46,610
+هذه الصورة حقيقية لان ال V plusالـ V هي الـ U
+
+173
+00:15:46,610 --> 00:15:50,950
+وقلنا minus 1 و V plus 4 إذا صورة حقيقية يمكن
+
+174
+00:15:50,950 --> 00:15:55,030
+تلقيها على الـ Screen وبعدها ربع متر عن المرأة وهي
+
+175
+00:15:55,030 --> 00:15:58,610
+نفس الشيء صورة حقيقية وبعدها ربع متر بس ال image
+
+176
+00:15:58,610 --> 00:16:01,470
+space هنا على يمين ال optical system ال image
+
+177
+00:16:01,470 --> 00:16:04,830
+space هنا على شمال ال optical system إذا في
+
+178
+00:16:04,830 --> 00:16:07,830
+reversal of image space هذا بيميز المرايا عن
+
+179
+00:16:07,830 --> 00:16:13,880
+العدسات نفس القضيةنجي الآن نضرر مثال على الـ minus
+
+180
+00:16:13,880 --> 00:16:22,500
+lens و ال minus mirror واضحة النقطة هاي reversal
+
+181
+00:16:22,500 --> 00:16:28,420
+of image space مقارنة مع العدساتهنوضحها اكتر في
+
+182
+00:16:28,420 --> 00:16:31,820
+مثال الـ minus mirror و الـ minus lens هي عندي انا
+
+183
+00:16:31,820 --> 00:16:37,900
+minus lens minus تلاتة diopter lens مثلا و object
+
+184
+00:16:37,900 --> 00:16:43,920
+على بعد واحد متر ال U تساوي minus واحد ال V ايش
+
+185
+00:16:43,920 --> 00:16:52,510
+تساوي minus اربع تمامالـ U طبعا ماينس واحد ماينس N
+
+186
+00:16:52,510 --> 00:16:55,710
+على O ناقص واحد على واحد متر بيطلع ناقص واحد ده
+
+187
+00:16:55,710 --> 00:17:00,530
+يبطى ال I تساوي Uncharted على V ويساوي واحد على
+
+188
+00:17:00,530 --> 00:17:04,050
+ماينس أربعة ده يبطى ويساوي ماينس ربع متر وين
+
+189
+00:17:04,050 --> 00:17:09,490
+الصورة على الشمال على الشمال أشعة متشتتة الصورة
+
+190
+00:17:09,490 --> 00:17:16,310
+هتتكون على الشمال عبعد ربع متر ال convex mirror او
+
+191
+00:17:16,310 --> 00:17:22,720
+ال minus mirrorالـ object ع شمالها ع بُعد متر الـ
+
+192
+00:17:22,720 --> 00:17:29,040
+U minus واحد نفس الشيء و المرايا minus تلاتة إذا
+
+193
+00:17:29,040 --> 00:17:34,060
+الـ V minus أربع يعني إن عكست الأشعة متشتتة بـ
+
+194
+00:17:34,060 --> 00:17:39,200
+minus أربع تمتد لشمال مش هتلتقي هتتكون صورة
+
+195
+00:17:39,200 --> 00:17:45,600
+تخيّلية ع بُعد ربع متر من المرايا ع اليمينواضح هنا
+
+196
+00:17:45,600 --> 00:17:49,880
+الصورة virtual مظبوط وعشمالي ال optical system
+
+197
+00:17:49,880 --> 00:17:54,140
+بربع متر هنا الصورة أيضا virtual وعيمين ال optical
+
+198
+00:17:54,140 --> 00:17:58,440
+برضه بربع متر الجياسات واحدة تمام بس ال image
+
+199
+00:17:58,440 --> 00:18:02,980
+space معكوس ال image space معكوس ناخد كمان مثال
+
+200
+00:18:02,980 --> 00:18:08,960
+لتوضيح الفكرة عشان
+
+201
+00:18:08,960 --> 00:18:12,060
+الإنسان ما يتخربطش
+
+202
+00:18:14,160 --> 00:18:19,300
+إذا الـ V بالـ Plus الأشعة المعكوسة دايما الأشعة
+
+203
+00:18:19,300 --> 00:18:22,560
+بتعكس إذا إجت من الشمال وفي الـ Geometric Optics
+
+204
+00:18:22,560 --> 00:18:26,440
+دايما تيجي من الشمال إذا الـ V بالـ Plus معناته
+
+205
+00:18:26,440 --> 00:18:31,240
+الأشعة متجمعة هتكوين لي صورة على الشمال إذا الـ V
+
+206
+00:18:31,240 --> 00:18:38,200
+بالـ Minus الأشعة متفرقة و المتفرق بالتقيش هيكوين
+
+207
+00:18:38,200 --> 00:18:42,340
+لي virtual image على أياش؟ على اليمين عكس العدسات
+
+208
+00:18:42,340 --> 00:18:47,520
+تماماالعدسات الأشعة المتفرقة دايما ال object في
+
+209
+00:18:47,520 --> 00:18:52,740
+الشمال الأشعة المتفرقة هتكون ليه virtual image على
+
+210
+00:18:52,740 --> 00:18:56,960
+وين؟ على الشمال والأشعة المتجمعة هتكون ليه real
+
+211
+00:18:56,960 --> 00:19:02,950
+image على اليمينواضح ان هذه على اليمين أشعة متجمعة
+
+212
+00:19:02,950 --> 00:19:07,290
+هنا الأشعة متجمعة صورة حقيقية على الشمال هنا
+
+213
+00:19:07,290 --> 00:19:10,590
+virtual image على الشمال هنا virtual image على
+
+214
+00:19:10,590 --> 00:19:14,190
+اليمين بالظبط المرايا بتشتغل بالنسبة لل image
+
+215
+00:19:14,190 --> 00:19:24,790
+space عكس العدسة عكس العدسة تمام وهذا
+
+216
+00:19:24,790 --> 00:19:28,930
+يسمى reversal of image space و بتتميز فيه
+
+217
+00:19:32,370 --> 00:19:37,590
+بتتميز فيه اللي هو المرايا عن العدسات ناخد بعض ال
+
+218
+00:19:37,590 --> 00:19:42,130
+versions calculations ناخد بعض ال versions
+
+219
+00:19:42,130 --> 00:19:50,330
+calculations بنقول mirror concave mirror ال R
+
+220
+00:19:50,330 --> 00:19:59,810
+تساوي اتنين من عشرة متر object distance بنقول واحد
+
+221
+00:19:59,810 --> 00:20:07,120
+متربدنا ال image وبدنا ال transfers magnification
+
+222
+00:20:07,120 --> 00:20:14,740
+دورسم ال concave mirror plus mirror ال R قداش؟ 2
+
+223
+00:20:14,740 --> 00:20:21,240
+من عشرة متر وال object عبواد واحد متر اول شي بدنا
+
+224
+00:20:21,240 --> 00:20:24,120
+ال power بتاعة ال mirror power بتاعة ال mirror
+
+225
+00:20:24,120 --> 00:20:32,270
+تسوى 2 على Rو يساوي 2 على 2 من 10 متر و يساوي 10
+
+226
+00:20:32,270 --> 00:20:42,530
+ديوبتر plus 10 ديوبتر plus 10 ديوبتر تمام الآن ال
+
+227
+00:20:42,530 --> 00:20:48,430
+object على بُعد متر ال U قداش ناقص N على O ناقص 1
+
+228
+00:20:48,430 --> 00:20:55,130
+على 1 متر و يساوي ناقص 1 ديوبتر ناقص 1 ديوبتر قداش
+
+229
+00:20:55,130 --> 00:20:59,540
+ال Vبلاس تسعة دا يبتر ال V بلاس تسعة دا يبتر
+
+230
+00:20:59,540 --> 00:21:02,600
+بكتوبها على نفس الناحية لأن الضوء إجا من الشمال
+
+231
+00:21:02,600 --> 00:21:07,920
+لليمين هيناكس طبعا بلاس تسعة هيناكس إيش يتجمع وام
+
+232
+00:21:07,920 --> 00:21:12,200
+الصورة هتكون I تساوي on شرط على V ويساوي واحد ع
+
+233
+00:21:12,200 --> 00:21:20,400
+بلاس تسعة دا يبتر ويساوي تقريبا 11 من 100 متر طبعا
+
+234
+00:21:20,400 --> 00:21:24,370
+11 من 100 من الرسم باعرف إنها على الشمالعالشمال
+
+235
+00:21:24,370 --> 00:21:31,750
+تمام أشياء هتجمعت هتكون لي صورة حقيقية على الشمال
+
+236
+00:21:31,750 --> 00:21:36,450
+بعيدة عن سطح المرقاب بمقدار 11 صنطي ال transfer of
+
+237
+00:21:36,450 --> 00:21:42,210
+magnification U
+
+238
+00:21:42,210 --> 00:21:43,190
+على V
+
+239
+00:21:46,550 --> 00:21:52,910
+-1 على plus 9 ويسوي x minus 9 ايش يعني ضرب minus 9
+
+240
+00:21:52,910 --> 00:21:57,950
+يعني الصورة مجلوبة وتسع ال object تسع ال object
+
+241
+00:21:57,950 --> 00:22:01,530
+واضح تسع ال object
+
+242
+00:22:17,220 --> 00:22:20,680
+أذا لـ Transfers Magnification بجيبه بالـ U على V
+
+243
+00:22:20,680 --> 00:22:23,000
+ممكن أجيبه بالـ Image Distance على Object
+
+244
+00:22:23,000 --> 00:22:27,720
+Distance؟ أه نعم، الآن بنشهدني قضية، من وين بدأ
+
+245
+00:22:27,720 --> 00:22:32,020
+أجيس الـ Image Distance و الـ Object Distance؟ الـ
+
+246
+00:22:32,020 --> 00:22:36,560
+Image Distance و الـ Object Distance، تمام؟ عندي
+
+247
+00:22:36,560 --> 00:22:42,900
+وسيلتين، إما أجيسهم من سطح المرأة، بمعنى آخر، هذه
+
+248
+00:22:42,900 --> 00:22:49,510
+الـ Image تبعد 11 cm عن سطح المرأة،11 سانتي عن سطح
+
+249
+00:22:49,510 --> 00:22:57,870
+المرأة و ال object بيبقى واحد متر تمام 100 تمام
+
+250
+00:22:57,870 --> 00:23:05,450
+100 طيب 100 سانتي 11 على 100 تقريبا تسوى minus
+
+251
+00:23:05,450 --> 00:23:10,370
+تسوى لأنها مجلوبة تمام minus تسوى لأنها مجلوبة
+
+252
+00:23:10,370 --> 00:23:14,890
+تمام طيب هذه وسيرة للقياس إذا من سطح المرأة إحدى
+
+253
+00:23:14,890 --> 00:23:21,410
+الوسائلوسيلة تانية أجيزهم من ال center of
+
+254
+00:23:21,410 --> 00:23:27,650
+curvature من ال center of curvature إذا كان هذه
+
+255
+00:23:27,650 --> 00:23:33,990
+المسافة حداشر صنطة هذه المسافة كم؟ تسعة صنطة لأن
+
+256
+00:23:33,990 --> 00:23:41,810
+نصف القطر عشرين صنطة شيلت منه أحداشر تسعة طيب ومن
+
+257
+00:23:41,810 --> 00:23:42,970
+هنا إلى هنا كم؟
+
+258
+00:23:46,730 --> 00:23:54,430
+تمنين صنطي صح تمنين صنطي بدي اجسم تسعة صنطي على
+
+259
+00:23:54,430 --> 00:24:01,450
+تمانين صنطي كده ايش بيطلع احد
+
+260
+00:24:01,450 --> 00:24:05,430
+عاش من المية يعني تسعة تسعة يعني تسعة يعني عندي
+
+261
+00:24:05,430 --> 00:24:10,150
+تلت وسائل او وسيلتي ل transfer magnification تمام
+
+262
+00:24:10,150 --> 00:24:14,650
+وبالوسيلة التالتة اللي هي image height على object
+
+263
+00:24:14,650 --> 00:24:18,560
+heightبس عندنا في الوسيلة التانية اذا بستخدم ال
+
+264
+00:24:18,560 --> 00:24:22,820
+distance ال object distance و ال image distance
+
+265
+00:24:22,820 --> 00:24:26,100
+معاه طريقتين لقياس ال image distance و ال object
+
+266
+00:24:26,100 --> 00:24:29,680
+distance بجيس ال 10 tail من ال center of curvature
+
+267
+00:24:29,680 --> 00:24:35,320
+او من ال من ال من سطح المرأة او من ال center of
+
+268
+00:24:35,320 --> 00:24:41,480
+curvatureمن سطح المرآة التمتين ينسبوا لسطح المرآة
+
+269
+00:24:41,480 --> 00:24:45,080
+ال image تنسب لسطح المرآة مسافتها و ال object ينسب
+
+270
+00:24:45,080 --> 00:24:50,540
+لسطح المرآة او التمتين بدي انسبهم ل ال center of
+
+271
+00:24:50,540 --> 00:24:54,740
+curvature of the mirror من هنا لل center و من ال
+
+272
+00:24:54,740 --> 00:24:57,780
+object لل center و في النهاية هيطلع نفس القياسات
+
+273
+00:24:57,780 --> 00:25:02,410
+او اذا بدي انا اخد ال issue مباشرعلى V U على V
+
+274
+00:25:02,410 --> 00:25:06,550
+فعندي وسائل يعني نفس القضية ما ننساش أنه في عندي
+
+275
+00:25:06,550 --> 00:25:10,810
+reversal of image space يعني لو هذه plus lens بنفس
+
+276
+00:25:10,810 --> 00:25:15,670
+القوة الصورة هتكون حقيقية 11 صنطي بس على اليمين بس
+
+277
+00:25:15,670 --> 00:25:21,810
+على اليمين واضح فهذه بالنسبة لقضية اللي هو المثال
+
+278
+00:25:21,810 --> 00:25:28,090
+هذا ناخد كمان مثال لتثبيت الأمور على ال convex أو
+
+279
+00:25:28,090 --> 00:25:33,180
+خلينا ناخد بس مبدأيا علىخلّيني أخد على ال convex و
+
+280
+00:25:33,180 --> 00:25:40,660
+بعدها على ال plane mirror نقول convex mirror
+
+281
+00:25:40,660 --> 00:25:50,140
+نقول هنا object على بُعد عشرين صنطة وال R عندي هنا
+
+282
+00:25:50,140 --> 00:25:56,200
+اتنين من عشرة متر بدنا ال image و ل transfer
+
+283
+00:25:56,200 --> 00:26:00,940
+magnification ال image و ل transfer magnification
+
+284
+00:26:03,370 --> 00:26:08,110
+image with transphase magnification اول شي بنجيب
+
+285
+00:26:08,110 --> 00:26:17,290
+ال power بتاعة ال mirror بنقول R R 2 من 10 متر طيب
+
+286
+00:26:17,290 --> 00:26:21,770
+ال power تساوي 2 على R و يساوي 2 على 2 من 10 متر و
+
+287
+00:26:21,770 --> 00:26:26,790
+يساوي minus 10 ديوبتر قوتها minus 10 ديوبتر لأنها
+
+288
+00:26:26,790 --> 00:26:32,920
+convex mirror تمامالـ U عندنا هنا جداش U تساوي
+
+289
+00:26:32,920 --> 00:26:38,300
+ناقص N على O ويساوي ناقص
+
+290
+00:26:38,300 --> 00:26:47,120
+واحد على اتنين من عشرة متر ويساوي ناقص خمسة ديوبتر
+
+291
+00:26:47,120 --> 00:26:54,920
+ناقص خمسة ديوبتر جداش ال V-15 ديوبتر يعني الأشعة
+
+292
+00:26:54,920 --> 00:27:00,160
+إجت متشتتة بخمسة وطلعت متشتتة بإيش ارتدت متشتتة
+
+293
+00:27:00,160 --> 00:27:04,120
+بإيش بخمستة عشر يعني زادت divergence طبعا وطالما
+
+294
+00:27:04,120 --> 00:27:09,120
+الأشعة للعكسة الـdivergent تمام مش هتلتقي في صورة
+
+295
+00:27:09,120 --> 00:27:14,100
+حقيقية بس على امتداداتها هتتكون صورة إيش تخيّلية
+
+296
+00:27:14,100 --> 00:27:20,060
+تمام بدنا نحدد احنا موقعها I تساوي on شرط على V
+
+297
+00:27:20,060 --> 00:27:26,060
+ويساويواحد عالى خمستاش دا يبتر أو ماينس خمستاش دا
+
+298
+00:27:26,060 --> 00:27:29,100
+يبتر تمام ويساوي
+
+299
+00:27:30,610 --> 00:27:37,690
+-6 من 100 متر الـ minus الـ minus في العدسات يعني
+
+300
+00:27:37,690 --> 00:27:41,510
+على الشمال في المرايب يعني المسافة على اليمين مش
+
+301
+00:27:41,510 --> 00:27:45,610
+في reversal of image space يعني 6 cm العدسة اللي
+
+302
+00:27:45,610 --> 00:27:50,850
+هي ال image هتتكون على بعد 6 cm من سطح المرأة على
+
+303
+00:27:50,850 --> 00:27:54,270
+اليمين على اليمين واضح؟ لـ Transverse
+
+304
+00:27:54,270 --> 00:28:01,340
+Magnification U على Vو يساوي minus 5 ع minus 15 و
+
+305
+00:28:01,340 --> 00:28:06,260
+يساوي ضرب plus plus
+
+306
+00:28:06,260 --> 00:28:12,520
+إيش تلت إيش يعني ضرب plus تلت ال virtual image لأ
+
+307
+00:28:12,520 --> 00:28:19,460
+عدلة عدلة و تلت ال object و تلت ال object واضح؟
+
+308
+00:28:19,460 --> 00:28:30,710
+إذا بالنسبة ل ال virtual imageمصغق وواجف عدل وطولت
+
+309
+00:28:30,710 --> 00:28:34,550
+ال object طيب
+
+310
+00:28:34,550 --> 00:28:48,110
+الان بدنا ناخد مثال على ال plane mirror هاي
+
+311
+00:28:48,110 --> 00:28:53,730
+object نفرض انه شخص واقف على بعد واحد متر من ال
+
+312
+00:28:53,730 --> 00:29:00,350
+plane mirror قوتها ايه؟زيرو بدنا ال image وين
+
+313
+00:29:00,350 --> 00:29:05,510
+بتتكون و ال transfer magnification جداش ال image
+
+314
+00:29:05,510 --> 00:29:08,290
+وين بتتكون و ال transfer magnification جداش يمكن
+
+315
+00:29:08,290 --> 00:29:12,570
+نقول U تساوي ناقص N على O تساوي ناقص واحد على واحد
+
+316
+00:29:12,570 --> 00:29:17,210
+متر و يساوي ناقص واحد ديوبتر ناقص واحد ديوبتر ال V
+
+317
+00:29:17,210 --> 00:29:24,010
+جداشبرضه ناقص واحد ديوبتر ناقص واحد ديوبتر ليش لأن
+
+318
+00:29:24,010 --> 00:29:29,090
+U زائد P يساوي V ال U قداش minus واحد و ال power
+
+319
+00:29:29,090 --> 00:29:35,310
+Zero يساوي V اذا V ايش تساوي minus واحد I تساوي on
+
+320
+00:29:35,310 --> 00:29:40,530
+شرط على V و يساوي واحد على minus واحد ديوبتر و
+
+321
+00:29:40,530 --> 00:29:44,610
+يساوي minus واحد متر احنا قلنا في العدسات ال minus
+
+322
+00:29:44,610 --> 00:29:49,940
+واحد متر للشمال فإن أنا في المراياعاليمين minus
+
+323
+00:29:49,940 --> 00:29:54,420
+واحد متر okay هذا
+
+324
+00:29:54,420 --> 00:29:58,800
+سر اللي كنا ناخده في المدرسة بعد الصورة عن المرأة
+
+325
+00:29:58,800 --> 00:30:03,380
+يساوي بعد الجسم عن المرأة في المرايا المستوية بعد
+
+326
+00:30:03,380 --> 00:30:11,580
+الصورة عن المرأة واحد متر يساوي بعد ال object عن
+
+327
+00:30:11,580 --> 00:30:16,370
+المرأة واحد متر تمامطيب و ال magnification
+
+328
+00:30:16,370 --> 00:30:22,670
+Transphase magnification U على V و يساوي minus
+
+329
+00:30:22,670 --> 00:30:26,550
+واحد على minus واحد و يساوي X plus واحد يعني
+
+330
+00:30:26,550 --> 00:30:30,830
+الصورة في المرايا المستوية عدلة و نفس الطول و نفس
+
+331
+00:30:30,830 --> 00:30:36,410
+الارتفاع حد تاخدهم بالمسافات هتيجي نفس القضية
+
+332
+00:30:39,150 --> 00:30:42,990
+طب لو جرب ال object او bad هتبقى صورته على نفس
+
+333
+00:30:42,990 --> 00:30:46,070
+البوابة طبعا الصورة virtual كيف يعرفنا انها
+
+334
+00:30:46,070 --> 00:30:51,750
+virtual؟ يعني لا يمكن بحال من ال .. مش عشان
+
+335
+00:30:51,750 --> 00:30:55,690
+اليومين عشان ال V بال minus يعني اجت الأشعة ب
+
+336
+00:30:55,690 --> 00:30:59,250
+minus واحد divergent ورجعت ب minus واحد divergent
+
+337
+00:30:59,250 --> 00:31:02,350
+هذه الأشعة اللي انعكست طالما انها divergent
+
+338
+00:31:02,350 --> 00:31:07,800
+ماتلتقيشهتتكيّب عن صورة تخيّلية يعني عمره حد عمل
+
+339
+00:31:07,800 --> 00:31:11,860
+التقاط على الـscreen لصورته في المرايا مستحيل
+
+340
+00:31:11,860 --> 00:31:16,740
+مستحيل هذه صورة virtual صورة virtual تمام فبالتالي
+
+341
+00:31:16,740 --> 00:31:23,120
+هذه القضية ضرورية احنا تكون واضحة
+
+342
+00:31:23,120 --> 00:31:25,480
+بالنسبة لنا ممكن الانسان يقول طب كيف بنشوفها مدى
+
+343
+00:31:25,480 --> 00:31:28,840
+انها virtual؟ مع هذه الصورة ال virtual اللي جاي
+
+344
+00:31:28,840 --> 00:31:34,340
+منها الأشعةمتفرقة في optical system جاهز ان يجمعها
+
+345
+00:31:34,340 --> 00:31:38,000
+مظبوط ولا لا اللي هو العين اللي هو العين ما ننساش
+
+346
+00:31:38,000 --> 00:31:42,220
+هذه القضية تمام اما طلقها على screen لا يمكن طلقها
+
+347
+00:31:42,220 --> 00:31:48,220
+على screen ابدا لأن هي صورة تخيّلية طيب ناخد كمان
+
+348
+00:31:48,220 --> 00:31:51,960
+مثال عشان نثبت المعلومة اللي جابلي شوية نقول جسم
+
+349
+00:31:51,960 --> 00:31:59,750
+على بعد شخص على بعد هو object على بعد ربع مترمن
+
+350
+00:31:59,750 --> 00:32:05,630
+plane mirror يعني قوتها0 جدّاش ال U و جدّاش ال V
+
+351
+00:32:05,630 --> 00:32:11,010
+ال U تساوي ناقص N على O يساوي ناقص واحد على ربع
+
+352
+00:32:11,010 --> 00:32:15,590
+متر يساوي ناقص أربعة ديوبتر بما أن ال U ناقص أربعة
+
+353
+00:32:15,590 --> 00:32:20,530
+ديوبتر ال V إيش تساوي ناقص أربعة لأنه U زائد P
+
+354
+00:32:20,530 --> 00:32:25,290
+تساوي V I تساوي Uncharted على V ويساوي واحد على
+
+355
+00:32:25,290 --> 00:32:32,150
+ماينس أربعة ديوبتر مايساوي ماينس ربع متربنقول
+
+356
+00:32:32,150 --> 00:32:35,790
+كالاتي الـ minus ربع متر لو احنا نتعامل مع أدسات
+
+357
+00:32:35,790 --> 00:32:39,070
+ده بتطلع على الشمال بس مع مرايا في reversal of ..
+
+358
+00:32:39,070 --> 00:32:43,130
+اذا هي على اليمين وابع متر اذا بعد الصورة
+
+359
+00:32:45,550 --> 00:32:48,730
+بعد الصورة عن المرأة يساوي بعد الجسم عن المرأة
+
+360
+00:32:48,730 --> 00:32:52,970
+Transfers Magnification جدّاش U على V plus واحد
+
+361
+00:32:52,970 --> 00:32:56,150
+بتطلع المسافة على المسافة بتطلع plus واحد يعني
+
+362
+00:32:56,150 --> 00:33:00,090
+الصورة virtual و إدنا و نفس ال object و هذا سر
+
+363
+00:33:00,090 --> 00:33:04,670
+تعليمنا في المدارس أنه بعد الصورة عن المرأة يساوي
+
+364
+00:33:04,670 --> 00:33:09,390
+بعد الجسم عن المرأة بغض النظر عن هذه القضية الآن
+
+365
+00:33:09,390 --> 00:33:16,400
+بدنا كالقاتل فينا حاجة اسمهاهذا يعني ك practice
+
+366
+00:33:16,400 --> 00:33:22,360
+للحياة العملية عادة
+
+367
+00:33:22,360 --> 00:33:29,180
+.. عادة المرايا بتنعمل بشكل في تأثير الأثاث أو ما
+
+368
+00:33:29,180 --> 00:33:33,480
+شابه تمام بتنعمل لأن الجزء الأسفل مابنعملش كمراية
+
+369
+00:33:33,480 --> 00:33:37,320
+الجزء الأعلى و الجزء الأسفل ممكن يكون أدراج أو شيء
+
+370
+00:33:37,320 --> 00:33:40,780
+يعني مفيد للاستخدام تمام؟ إيش السبب في هذا؟ أو إيش
+
+371
+00:33:40,780 --> 00:33:47,030
+السر في هذا؟ هذه الصورةشخص بده يشوف نفسه تمام؟
+
+372
+00:33:47,030 --> 00:33:52,250
+بتنعمل لمراية بحيث انه من أعلى جزء في الصورة لأسفل
+
+373
+00:33:52,250 --> 00:33:55,930
+جزء هذا بيسموه ال angular height فاكرين ال angular
+
+374
+00:33:55,930 --> 00:33:59,350
+magnification؟ ال angular height الارتفاع الزاوي
+
+375
+00:33:59,350 --> 00:34:03,950
+هو اللي يعني بيكفي يعني هذا الجزء لو انعمل كمراية
+
+376
+00:34:03,950 --> 00:34:10,550
+بيسموه unused mirror مالاش فايدةلا تشارك في
+
+377
+00:34:10,550 --> 00:34:14,150
+استقبال الصورة بواسطة عين الـ Observer، تمام؟
+
+378
+00:34:14,150 --> 00:34:17,630
+فعشان هيك هذا الجزء التحتاني، تمام؟ مابيكفيش، فبس
+
+379
+00:34:17,630 --> 00:34:21,010
+من عملش هذا الجزء الأسفل بالشكل هذا لأنه هيغطي على
+
+380
+00:34:21,010 --> 00:34:24,410
+جزء .. هيصير الإنسان مش شايف الجزء الأسفل مثلا
+
+381
+00:34:24,410 --> 00:34:28,390
+منه، تمام؟ أه، فيعني بعض المرافق العامة زي الفنادق
+
+382
+00:34:28,390 --> 00:34:31,030
+أو إشي لو واحد احتاج تطلع في المرايا أو كذا،
+
+383
+00:34:31,030 --> 00:34:34,070
+المرايا بتكون عندهم أماء فوق المجاسي ده، مابشوفش
+
+384
+00:34:34,070 --> 00:34:39,350
+كل طولهبس بيشوفوا هى بتكون مخصصة لرؤية ايش الوجه
+
+385
+00:34:39,350 --> 00:34:44,030
+فقط فهذا بيسموه unused .. unused mirror .. unused
+
+386
+00:34:44,030 --> 00:34:49,650
+mirror تمام فبالتالي هذه من بعض الأشياء اللى هو في
+
+387
+00:34:49,650 --> 00:34:55,310
+التطبيقات العملية طيب هنا احنا ضال بس نقطة واحدة
+
+388
+00:34:55,310 --> 00:34:59,050
+نحكي عنها بالنسبة لل mirrors احنا أقولك بالنسبة
+
+389
+00:34:59,050 --> 00:35:09,470
+للعدسات فى عندي FAفا و فى عندى فب فى ال mirror
+
+390
+00:35:09,470 --> 00:35:13,330
+اتنين جايين على بعض منطبقين على بعض يعنى فا و فب
+
+391
+00:35:13,330 --> 00:35:21,870
+فى العدسة فى العدسة ال concave بيكونوا فا و فب في
+
+392
+00:35:21,870 --> 00:35:26,650
+نفس الموقع و فى العدسة ال convex نفس القضية جذد
+
+393
+00:35:26,650 --> 00:35:31,800
+المرايا ال convex اسففا و فا في نفس القضية يعني
+
+394
+00:35:31,800 --> 00:35:36,000
+منطبقين يعني هدولة كنقات منطبقين على بعضهم إياش
+
+395
+00:35:36,000 --> 00:35:42,040
+بالبعض تمام وهذا بيلزم في ال para axial ray
+
+396
+00:35:42,040 --> 00:35:46,940
+tracing through mirrors يعني زي ما قلنا بالظبط في
+
+397
+00:35:46,940 --> 00:35:53,880
+العدسات في العدسات بقول الموازي بدخل في فا نصبوع
+
+398
+00:35:53,880 --> 00:36:01,710
+واللي دخل في فا بيخرج مالهعفوا واللي دخل في FA
+
+399
+00:36:01,710 --> 00:36:07,170
+بيخرج ماله موازي تمام واللي بيمر في ال central
+
+400
+00:36:07,170 --> 00:36:13,650
+point أو ال nodal point لا يغير اتجاهه الآن بنشوف
+
+401
+00:36:13,650 --> 00:36:17,450
+ال para axial ray tracing through concave mirror و
+
+402
+00:36:17,450 --> 00:36:24,400
+through convex mirror لحد تلان كل الأمور واضحةشيء
+
+403
+00:36:24,400 --> 00:36:29,400
+مقارنة للعدسات تقريبًا فيه تشابه كبير الـ Virgin's
+
+404
+00:36:29,400 --> 00:36:33,080
+calculations لا خلاف منها بنفس النتاج نفس طريقة
+
+405
+00:36:33,080 --> 00:36:36,360
+استنتاج الـ Transfers Magnification الاختلاف
+
+406
+00:36:36,360 --> 00:36:40,000
+الوحيد الـ Image Space إذا كان العدسة بدأت يعطيلي
+
+407
+00:36:40,000 --> 00:36:43,000
+على اليمين هتلاقي المرايا المكافئة اللي هتعطيه على
+
+408
+00:36:43,000 --> 00:36:46,160
+الشمال إذا كان العدسة هتعطيه على الشمال هتلاقي
+
+409
+00:36:46,160 --> 00:36:50,380
+المرايا المكافئة اللي هتعطيه على اليمين طيب احنا
+
+410
+00:36:50,380 --> 00:37:02,060
+بنقولبنذكر فيه تلت رسمات نقول هنا هي FA وهي FP لو
+
+411
+00:37:02,060 --> 00:37:08,220
+كان الجسم عندى براة الـ FA الموازي هيخش في FP
+
+412
+00:37:08,220 --> 00:37:15,480
+تمام؟ واللي دخل في FA هيخرج موازي التقاهم بحدد
+
+413
+00:37:15,480 --> 00:37:19,180
+مكان الصورة اللي بيمر في الـ nodal point لا يغير
+
+414
+00:37:19,180 --> 00:37:27,370
+طريقةنفس القضية بالضبط بالنسبة ل ال concave mirror
+
+415
+00:37:27,370 --> 00:37:35,810
+بس عندي أنا بدل fa و fb عندي f واحدة تمام بيقول
+
+416
+00:37:35,810 --> 00:37:41,990
+هاي موقع ال object الموازي هينعكس اللي مر في f
+
+417
+00:37:41,990 --> 00:37:50,250
+تمام و اللي مر في f هينعكس أيش موازي okay
+
+418
+00:37:52,720 --> 00:37:59,640
+بدل عن دي احنا قلنا اللي هو ال center of curvature
+
+419
+00:37:59,640 --> 00:38:04,800
+هدي R تمام اتنين F اللي بمر في ال center of
+
+420
+00:38:04,800 --> 00:38:08,940
+curvature هيسقط
+
+421
+00:38:08,940 --> 00:38:13,600
+سقوط عمودي يرتد زي ما هو التقاعه لازم يلتقوا
+
+422
+00:38:13,600 --> 00:38:19,320
+التلاتة في نقطة هاي شعاع هاي اتنين هاي تلاتة هاي
+
+423
+00:38:19,320 --> 00:38:25,490
+ال image واضح real imageفاكرين السقوط العمودي على
+
+424
+00:38:25,490 --> 00:38:29,170
+سطح اللي بنعكس بنعكس على نفس اتجاهه هذا بيسموه
+
+425
+00:38:29,170 --> 00:38:35,710
+Central Ray Central Ray اللي بيمر في مركز الكرة
+
+426
+00:38:35,710 --> 00:38:39,930
+اللي مرايا جزء منها بالظبط زي ما هذا بيسميه اللي
+
+427
+00:38:39,930 --> 00:38:42,990
+بيمر في ال node ال point بيسميه Central Ray أو
+
+428
+00:38:42,990 --> 00:38:48,430
+Chief Ray بيغيرش طريقه هنا برضه لما بنعكس بيبقى
+
+429
+00:38:48,430 --> 00:38:52,900
+على نفس الطريق اللي إيجا منهاطبعاً إذا الـ high
+
+430
+00:38:52,900 --> 00:38:58,770
+-end تلتتلات أشعة و اتكوّنت عندي real image زي ما
+
+431
+00:38:58,770 --> 00:39:01,690
+هناك اتكوّنت real image بس الاختلاف الواحد ان ال
+
+432
+00:39:01,690 --> 00:39:04,290
+real image هنا اتكوّنت على اليمين هنا ال real
+
+433
+00:39:04,290 --> 00:39:08,530
+image اتكوّنت على الشمال هنا انا مضطر اقول FA و FP
+
+434
+00:39:08,530 --> 00:39:14,250
+هنا في F اللي بيكون موازي لل optical axis بنعكس
+
+435
+00:39:14,250 --> 00:39:19,530
+بمر في F أثناء انعكاسه طيب اللي هو و هو رايح مر في
+
+436
+00:39:19,530 --> 00:39:24,060
+F بنعكس موازي لل optical axisوالـ Central ray بغير
+
+437
+00:39:24,060 --> 00:39:28,000
+اشتريكه التلاتة لازم يلتقيوا في نفس ال .. نفس ال
+
+438
+00:39:28,000 --> 00:39:34,240
+.. المكان و الصورة بتكون real و inverted نجي
+
+439
+00:39:34,240 --> 00:39:38,080
+للسيناريو التاني برضه لسه احنا مع العدسة و المرايا
+
+440
+00:39:38,080 --> 00:39:46,580
+ال plus نقول لما يكون داخل ال FA هاي FA و هاي FP
+
+441
+00:39:46,580 --> 00:39:55,730
+نقول ال object لما يكون داخل ال FAبنقول الشعاع
+
+442
+00:39:55,730 --> 00:40:01,310
+الموازي للـ optical axis بيدخل في FB بعد خروجه نفس
+
+443
+00:40:01,310 --> 00:40:05,390
+الشيء مافي اي تغيير والشعاع اللي بيمر في ال nodal
+
+444
+00:40:05,390 --> 00:40:15,850
+point لا يغير طريقه والشعاع اللي امتداده بيخش
+
+445
+00:40:15,850 --> 00:40:22,510
+في FA بيخرج مالههذه الأشياء همالها divergence على
+
+446
+00:40:22,510 --> 00:40:27,850
+امتداداتها هتكون الصورة هتكون الصورة مالها virtual
+
+447
+00:40:27,850 --> 00:40:34,210
+erect و magnified ده هذا مبدأ عمل ال magnifier ان
+
+448
+00:40:34,210 --> 00:40:40,430
+نحط الجسم داخل ال FA نفس القضية بالضبط في اللي هو
+
+449
+00:40:40,430 --> 00:40:43,890
+ال concave mirror لو عندي انا concave mirror
+
+450
+00:40:48,020 --> 00:40:57,380
+وهاي F وهاي R وعندي ال object ال object موجود داخل
+
+451
+00:40:57,380 --> 00:41:02,300
+F بنقول الموازي
+
+452
+00:41:02,300 --> 00:41:07,840
+بنعكس جمهور في ال focal point مظبوط هذا الشعار رقم
+
+453
+00:41:07,840 --> 00:41:15,120
+واحد والامتداد بيخش في ال focal point الامتداد
+
+454
+00:41:15,120 --> 00:41:21,580
+بيخش في ال focal point بنعكس موازيواللي امتداده
+
+455
+00:41:21,580 --> 00:41:27,720
+بدخل
+
+456
+00:41:27,720 --> 00:41:32,800
+في الـR بنعكس مطرح مكانه يعني هذا الشعقه هيروح
+
+457
+00:41:32,800 --> 00:41:37,280
+وينعكس مكانه وهذا الشعقه هينعكس موازي وهذا ينعكس
+
+458
+00:41:37,280 --> 00:41:42,160
+بس يمر في الـF ماله الأشعة التلاتة ديفرجنت على
+
+459
+00:41:42,160 --> 00:41:51,650
+امتداداتها هتتكون virtualErect وMagnified image بس
+
+460
+00:41:51,650 --> 00:41:55,410
+ال image is based على اليمين مش زي هنا مش زي هنا
+
+461
+00:41:55,410 --> 00:42:00,730
+علي شمال نفس الفكرة بالضبط ربما أوضح الرسمة هنا
+
+462
+00:42:00,730 --> 00:42:07,670
+بألوان أخرى أفضل عشان مايصيرش عنا يعني اختلاط بين
+
+463
+00:42:07,670 --> 00:42:15,900
+اللي هو الأشعة عندى تلت أشعة high Fوهي ضعف المسافة
+
+464
+00:42:15,900 --> 00:42:19,440
+اللي هي radius of curvature هي C وهي هنا ال focal
+
+465
+00:42:19,440 --> 00:42:25,900
+point بتاعة ال mirror وهي ال object أنا عنده موجود
+
+466
+00:42:25,900 --> 00:42:32,760
+داخل F بتاعة ال mirror الموازي بيمر عبر ال focal
+
+467
+00:42:32,760 --> 00:42:37,020
+point بعد خروجه ماشي طيب نمسك جلم تاني و لون تاني
+
+468
+00:42:37,020 --> 00:42:43,160
+ونقول الامتداد اللي بيخش في ال Fبينعكس ممازي هي
+
+469
+00:42:43,160 --> 00:42:48,440
+الشعر رقم اتنين تمام الشعر رقم تلاتة هي الجلم
+
+470
+00:42:48,440 --> 00:42:56,140
+الأسود اللي امتداده بمر ب Cهيثبت سقوط عمودي و اللي
+
+471
+00:42:56,140 --> 00:42:58,780
+بيثبت سقوط عمودي على سطح المرقام احنا ما قلنا
+
+472
+00:42:58,780 --> 00:43:03,620
+الدائرة او الكرة من مركزها لمحيطها اي خط يعتبر
+
+473
+00:43:03,620 --> 00:43:07,940
+عمودي السقوط العمودي بيعلي الارتداد في نفس الاتجاه
+
+474
+00:43:07,940 --> 00:43:12,620
+يعني هو سقط و هيرتد في نفس الاتجاه هاي عندي شعار
+
+475
+00:43:12,620 --> 00:43:17,340
+رقم واحد اتنين تلاتة ايش مالهم؟ divergence الأهم
+
+476
+00:43:17,340 --> 00:43:21,480
+مش هيكونوا صورة حقيقية هيكونوا صورة virtual تمام
+
+477
+00:43:21,480 --> 00:43:22,860
+كل واحد همده بلونه
+
+478
+00:43:36,200 --> 00:43:42,980
+أتكون عندى بالنهاية صورة Virtual Erect Magnified
+
+479
+00:43:42,980 --> 00:43:49,560
+بنفس الطريقة بتاعة ال lens لما يكون عندى اللى هو
+
+480
+00:43:49,560 --> 00:43:52,740
+ال positive lens لما يكون عند الجسم داخل ال FAA
+
+481
+00:43:52,740 --> 00:43:57,800
+طيب السيناريا
+
+482
+00:43:57,800 --> 00:44:03,630
+التالتة ان يكون عندىعلى الفوق اللي هيعطيني virtual
+
+483
+00:44:03,630 --> 00:44:08,230
+erect magnified أكبر تكبير ممكن وهنا نفس القضية
+
+484
+00:44:08,230 --> 00:44:13,330
+هنا نفس القضية طيب
+
+485
+00:44:13,330 --> 00:44:18,630
+الان
+
+486
+00:44:18,630 --> 00:44:22,530
+بقى ال para axial ray tracing through convex
+
+487
+00:44:22,530 --> 00:44:27,310
+mirrorThrow a convex mirror نفس الشيء سنرى أنه
+
+488
+00:44:27,310 --> 00:44:31,670
+دائما سيناريو واحد ينتج عندي دائما سيناريو واحد
+
+489
+00:44:31,670 --> 00:44:39,390
+ينتج عندي بغض النظر عن موقع الجسم تمام
+
+490
+00:44:39,390 --> 00:44:44,230
+عندي هي F وهي
+
+491
+00:44:44,230 --> 00:44:53,400
+Cوطبعا ال R تساوي 2F بغض النظر عن موقع الجسم دائما
+
+492
+00:44:53,400 --> 00:45:00,160
+و أبدا يعني لو قلنا هاي عندي أنا جسم الموازي لل
+
+493
+00:45:00,160 --> 00:45:06,960
+optical axis هيناكس امتداده هيكون خاش في ايه؟ في
+
+494
+00:45:06,960 --> 00:45:12,320
+ال F طيب و اللي متجه اتجاهه
+
+495
+00:45:15,790 --> 00:45:21,590
+على لو مدينا تجاهه بيمر في ال F هينعكس ماله موازي
+
+496
+00:45:21,590 --> 00:45:27,310
+تمام و ال central ray اللي هو موجه باتجاه ال
+
+497
+00:45:27,310 --> 00:45:33,790
+center of curvature بينعكس
+
+498
+00:45:33,790 --> 00:45:36,910
+على نفس الجهة اللي إيجا منها هو إيجا انعكس على نفس
+
+499
+00:45:36,910 --> 00:45:43,440
+الخط هدولة التلت أشعة نالهم الأزرقوالأسود والأحمر
+
+500
+00:45:43,440 --> 00:45:49,760
+divergent فبالتالي التقائهم هذا إنعكس موازي هامده
+
+501
+00:45:49,760 --> 00:45:54,500
+موازي وهنا
+
+502
+00:45:54,500 --> 00:45:59,120
+طبعا الميالان مش صحيح هيلتقوا في نقطة واحدة
+
+503
+00:45:59,120 --> 00:46:05,680
+هيلتقوا إيش في نقطة واحدة هتكون دائما و أبداالـ
+
+504
+00:46:05,680 --> 00:46:11,760
+Image اللي بتتكون بواسطة الـ Convex Mirror Virtual
+
+505
+00:46:11,760 --> 00:46:19,880
+وErect و Minified بالضبط
+
+506
+00:46:19,880 --> 00:46:26,660
+زي قضية الـ Minus Lens الـ Minus Lens نفس القضية
+
+507
+00:46:26,660 --> 00:46:35,290
+قلنا FA ورا مظبوط؟ FA ورا وFP للأمامwhile object
+
+508
+00:46:35,290 --> 00:46:38,930
+الموازي
+
+509
+00:46:38,930 --> 00:46:47,570
+هيتشتت امتداده يدخل في FB وامتداده يدخل في FA
+
+510
+00:47:00,500 --> 00:47:06,600
+بيخرج ماله موازي واللي بينير في ال nodal point لا
+
+511
+00:47:06,600 --> 00:47:11,980
+يغير طريقه هذه الأشعة اللي ابتدت ألوان divergence
+
+512
+00:47:11,980 --> 00:47:18,210
+هتلتقيهتلتقي لما ندها للخلف هي الأزرق ممدود للخلف
+
+513
+00:47:18,210 --> 00:47:23,770
+والأحمر والأسود على نفس الطول دائما الصورة virtual
+
+514
+00:47:23,770 --> 00:47:28,330
+erect minified virtual erect minified بس إيش اختلف
+
+515
+00:47:28,330 --> 00:47:32,390
+ال image space هنا على اليمين هناك وين على الشمال
+
+516
+00:47:32,390 --> 00:47:36,270
+إذا ال para axial retracing بتده أخد في الحسبان ال
+
+517
+00:47:36,270 --> 00:47:39,820
+virtual imageوانت او ال image بالصورة عامة سواء
+
+518
+00:47:39,820 --> 00:47:42,960
+virtual او هذا دايما فيه reversal of image space
+
+519
+00:47:42,960 --> 00:47:46,580
+هذا واحد تاني حاجة انه عندي في ال lens فيه اتنين
+
+520
+00:47:46,580 --> 00:47:52,350
+اف فيه اف a و اف pتمام؟ و FA في الـPlus Lens بتكون
+
+521
+00:47:52,350 --> 00:47:56,190
+لجدّام و FB لوراء و في الـMinus Lens العكس بينما
+
+522
+00:47:56,190 --> 00:48:00,190
+عندى في ال mirrors بغض النظر Convex Mirror و لا
+
+523
+00:48:00,190 --> 00:48:04,050
+Concave Mirror عندى F واحدة اللي هي انهم انطبقوا
+
+524
+00:48:04,050 --> 00:48:08,390
+التنين على بعض بس نفس القواعد مع التعديلات اللي هي
+
+525
+00:48:08,390 --> 00:48:11,750
+البسيطة اللي ذكرناها وبالتالي هذا القرأ Axial Ray
+
+526
+00:48:11,750 --> 00:48:16,370
+Tracing دائما ال Convex Mirror دائما ال Convex
+
+527
+00:48:16,370 --> 00:48:19,570
+Mirror للـReal Objectللـ real object ضروري يكون
+
+528
+00:48:19,570 --> 00:48:23,190
+real object لأن الـ real object divergence تقوم
+
+529
+00:48:23,190 --> 00:48:27,670
+بتوصل منه وهي بتزيد ال divergence فبالتالي مش ممكن
+
+530
+00:48:27,670 --> 00:48:31,750
+تتكون صورة حقيقية لل real object دائما ال convex
+
+531
+00:48:31,750 --> 00:48:35,510
+mirror وهنا نفس الشيء ال minus lens أو ال concave
+
+532
+00:48:35,510 --> 00:48:39,630
+lens لل real object مستحيل تتكون real image دائما
+
+533
+00:48:39,630 --> 00:48:44,190
+virtual erect unified image بس بتختلف بين الإمرأة
+
+534
+00:48:44,190 --> 00:48:48,360
+والعادسة انه في reversal of imageis based في
+
+535
+00:48:48,360 --> 00:48:54,320
+reversal of image is based حد يسأل سؤال يعطي كله
+
+536
+00:48:54,320 --> 00:48:54,660
+عافية
+
diff --git a/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/wWhZUY1-uaQ_postprocess.srt b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/wWhZUY1-uaQ_postprocess.srt
new file mode 100644
index 0000000000000000000000000000000000000000..4410bc64566cb235ecc3567f34b579c4f3da096c
--- /dev/null
+++ b/PL9fwy3NUQKwb_KOrEPbVXCHcPMZKR0uEY/wWhZUY1-uaQ_postprocess.srt
@@ -0,0 +1,2096 @@
+1
+00:00:21,010 --> 00:00:25,270
+بسم الله الرحمن الرحيم اليوم هنحكي ان شاء الله على
+
+2
+00:00:25,270 --> 00:00:29,410
+موضوع اللي هو ال optical aberrations ونشوف ايش
+
+3
+00:00:29,410 --> 00:00:33,130
+هلاقت هذه ال optical aberrations في موضوع ال
+
+4
+00:00:33,130 --> 00:00:41,870
+geometric optics طبعا اي deviation لل image و اي
+
+5
+00:00:41,870 --> 00:00:45,510
+انحراف لل image و اي بعد لل image عن قضية ال
+
+6
+00:00:45,510 --> 00:00:51,380
+stigmatic imaging يسمى aberration يعني اي صورةلا
+
+7
+00:00:51,380 --> 00:00:56,960
+تشبه ال object بنسبة 100% تسمى aberrated image
+
+8
+00:00:56,960 --> 00:01:02,340
+يعني فيها زواغان أو فيها زيغ أو فيها انحراف عن
+
+9
+00:01:02,340 --> 00:01:05,620
+إنها تشبه ال object بنسبة 100% إذا ال aberration
+
+10
+00:01:05,620 --> 00:01:09,380
+هو أي deviation from stigmatic imaging طبعا ال
+
+11
+00:01:09,380 --> 00:01:13,520
+aberrations أنواع كتيرة وتقسيمات كتيرة بس في يعني
+
+12
+00:01:13,520 --> 00:01:18,490
+تقسيمة عامة لل aberration ال aberration تقسمالى
+
+13
+00:01:18,490 --> 00:01:23,150
+chromatic aberration و monochromatic aberration في
+
+14
+00:01:23,150 --> 00:01:26,010
+ال chromatic aberration الضوء الأبيض بعد ما يعدي
+
+15
+00:01:26,010 --> 00:01:30,110
+من ال optical system بيصير عندي شعور بألوان أخرى
+
+16
+00:01:30,110 --> 00:01:34,550
+يعني أو يعني بتبدأ عندي ألوان الطيف تظهر من هذا
+
+17
+00:01:34,550 --> 00:01:38,970
+الضوء الأبيض فبيحدث color fringes أو هلات لونية
+
+18
+00:01:38,970 --> 00:01:43,350
+حوالين مصدر الضوء إذا أنا بتطلع على هذا المصدر من
+
+19
+00:01:43,350 --> 00:01:46,350
+خلال optical system هذا يسمى chromatic aberration
+
+20
+00:01:47,150 --> 00:01:51,250
+الـ monochromatic aberration الضوء بيبقى محتفظ
+
+21
+00:01:51,250 --> 00:01:59,230
+بنفس اللي هو انه يكون ضوء أبيض ولكن الصورة بتكون
+
+22
+00:01:59,230 --> 00:02:04,470
+aberrated يعني على نحو معين إذن في عندي ال
+
+23
+00:02:04,470 --> 00:02:11,010
+aberrations تقسم ل
+
+24
+00:02:11,010 --> 00:02:15,290
+achromatic و
+
+25
+00:02:15,290 --> 00:02:16,230
+monochromatic
+
+26
+00:02:20,600 --> 00:02:25,160
+الـ Monochromatic aberrations بدورها بتقسم لـ
+
+27
+00:02:25,160 --> 00:02:30,140
+Defocus يعني ال focus بتاع ال image مش صحيح إما
+
+28
+00:02:30,140 --> 00:02:35,740
+أمام الرتينة أو خلف الرتينة تمام و Regular
+
+29
+00:02:35,740 --> 00:02:42,060
+Astigmatism وهذا هيكون الموضوع الأساسي لنا اليوم
+
+30
+00:02:42,060 --> 00:02:46,360
+قضية ال Regular Astigmatism الـ Defocus يُقسم
+
+31
+00:02:46,360 --> 00:02:48,780
+بدوره لـ Hypermetropia
+
+32
+00:02:54,050 --> 00:03:00,350
+و Myopia بمعنى آخر ال patient ال optical system
+
+33
+00:03:00,350 --> 00:03:07,510
+بتاعه العين بتاعته بتعمل focus أمام ال retina أمام
+
+34
+00:03:07,510 --> 00:03:10,670
+ال retina طب على ال retina بيكون ال light بعد ما
+
+35
+00:03:10,670 --> 00:03:15,330
+صار له convergence و اتجمع أمام ال retina بيصيرله
+
+36
+00:03:15,330 --> 00:03:19,090
+مرة تانية divergence يعني بيبقى مش focused على ال
+
+37
+00:03:19,090 --> 00:03:23,240
+retina وبالتالي هذا يسمى defocusالـ Hypermetropic
+
+38
+00:03:23,240 --> 00:03:27,180
+Eye كـ Optical System من وجهة نظر Geometric Optics
+
+39
+00:03:27,180 --> 00:03:31,480
+بتكون صورة ورا الشبكية يعني هي مش هتخترق العين و
+
+40
+00:03:31,480 --> 00:03:35,360
+تتجمع ورا الشبكية هي هتقف عند النقطة هاي لسه
+
+41
+00:03:35,360 --> 00:03:39,300
+ماعملتش focus هنا عملت focus و خلصت و بعد ما صارت
+
+42
+00:03:39,300 --> 00:03:44,150
+focusedرجعت ضوء اتشبتت بعد ما صارت focus رجعت ضوء
+
+43
+00:03:44,150 --> 00:03:48,350
+اتشبتت عن بعض لبعض يعني وصل لل Retina دي focused
+
+44
+00:03:48,350 --> 00:03:52,810
+وهنا لما وصل لل Retina برضه دي focused لسه مش لاحق
+
+45
+00:03:52,810 --> 00:03:57,410
+يتجمع فيه focus إذا الدي focus هنا وهنا هيعمل نوع
+
+46
+00:03:57,410 --> 00:04:00,750
+من ال aberration الصورة مش هتكون بتشبه ال object
+
+47
+00:04:00,750 --> 00:04:04,370
+بنسبة 100% إذا الدي focus هو نوع من أنواع ال
+
+48
+00:04:04,370 --> 00:04:08,840
+monochromaticالـ Defocus نوعين إما hypermetropic
+
+49
+00:04:08,840 --> 00:04:12,920
+أو myopic defocus وبالتالي في الحالتين ال optical
+
+50
+00:04:12,920 --> 00:04:18,000
+system بيعطيش perfect point image لل object point
+
+51
+00:04:18,000 --> 00:04:22,400
+point image لل object point بالنسبة لل regular
+
+52
+00:04:22,400 --> 00:04:27,000
+astigmatism هنتكلم عنه بعد شوية بس في حاجة أخرى في
+
+53
+00:04:27,000 --> 00:04:32,580
+التقسيمةفي aberrations بيسموهم higher order
+
+54
+00:04:32,580 --> 00:04:36,140
+aberrations higher order aberrations او high order
+
+55
+00:04:36,140 --> 00:04:42,000
+aberration هذه
+
+56
+00:04:42,000 --> 00:04:53,940
+زمان كان يسموها irregular astigmatism زمان
+
+57
+00:04:53,940 --> 00:04:57,080
+ما كان في طريقة لقياس ال high order aberrations
+
+58
+00:04:57,080 --> 00:04:58,320
+تمام
+
+59
+00:05:00,270 --> 00:05:03,410
+وكانوا يسموها irregular astigmatism الآن في العصر
+
+60
+00:05:03,410 --> 00:05:07,870
+الحالي في وسائل لقياس ال high order aberrations من
+
+61
+00:05:07,870 --> 00:05:10,310
+ضمن الوسائل ال high اللي هي ال wave front
+
+62
+00:05:10,310 --> 00:05:14,850
+aberometry
+
+63
+00:05:14,850 --> 00:05:17,870
+قياس
+
+64
+00:05:17,870 --> 00:05:24,250
+ال aberrations في موجة الضوءمن مصدرها تمام هذه ال
+
+65
+00:05:24,250 --> 00:05:27,750
+aberrations تقاس وفي إلى أشكال معينة لل point
+
+66
+00:05:27,750 --> 00:05:32,870
+source of light يعني ال point source of light ممكن
+
+67
+00:05:32,870 --> 00:05:39,350
+تعطيني شكل ورقة ثلاثية تمام يعني كأنه بشع منها من
+
+68
+00:05:39,350 --> 00:05:42,350
+أطرافها في ال image يعني هذه ال point source of
+
+69
+00:05:42,350 --> 00:05:44,350
+light وهذه ال image بتاعتها هذا بتسمى ال
+
+70
+00:05:44,350 --> 00:05:49,480
+aberration ال tree foilتمام؟ او ممكن تعطيني صورة و
+
+71
+00:05:49,480 --> 00:05:57,620
+حواليها هالة مستديرة spherical aberration او
+
+72
+00:05:57,620 --> 00:06:01,520
+ممكن تعطيني صورة نقطة بسئلها زي المذنبك بيسموها
+
+73
+00:06:01,520 --> 00:06:06,420
+كمه و في أشكال كتيرةفي أشكال كتيرة للـ higher
+
+74
+00:06:06,420 --> 00:06:09,940
+order aberration طبعا الـ high order aberration أو
+
+75
+00:06:09,940 --> 00:06:13,740
+اللي زمان كنا نسميه irregular astigmatism لا يمكن
+
+76
+00:06:13,740 --> 00:06:17,420
+علاجه بوسائل اللي هو ال correction العادية زي اللي
+
+77
+00:06:17,420 --> 00:06:24,340
+هو إيش النضارة وإنما بعض يعني عمليات ال refractive
+
+78
+00:06:24,340 --> 00:06:29,800
+surgery المتقدمة يعني بعض أنواع الليزك ممكن يعالج
+
+79
+00:06:29,800 --> 00:06:33,530
+هذه ال higher order aberrationإذا مش موضوعنا اليوم
+
+80
+00:06:33,530 --> 00:06:36,050
+اللي هو ال irregular astigmatism بس هذا ال
+
+81
+00:06:36,050 --> 00:06:39,390
+irregular astigmatism أرض أيضا زيغ عن ال stigma
+
+82
+00:06:39,390 --> 00:06:45,270
+imaging زيغ عن ال stigma imaging نجي نحكي عن ما
+
+83
+00:06:45,270 --> 00:06:48,810
+يسمى ب regular astigmatism اللي هو نوع من ال
+
+84
+00:06:48,810 --> 00:06:52,790
+monochromatic aberration نوع من ال monochromatic
+
+85
+00:06:52,790 --> 00:07:00,490
+aberration regular astigmatism تمام
+
+86
+00:07:01,220 --> 00:07:05,380
+لحد الآن .. لحد الآن كل ال optical systems اللي
+
+87
+00:07:05,380 --> 00:07:10,880
+اتعاملنا معها هي عبارة عن spherical systems يعني
+
+88
+00:07:10,880 --> 00:07:15,360
+سواء plus spherical lens أو minus spherical lens
+
+89
+00:07:15,360 --> 00:07:20,140
+بس مش كل lens بنجابلها في شغلنا هي عبارة عن sphere
+
+90
+00:07:20,140 --> 00:07:23,960
+only أحياناً بتكون toric lens أو spherical و
+
+91
+00:07:23,960 --> 00:07:26,660
+cylindrical lens يعني بمعنى آخر
+
+92
+00:07:35,980 --> 00:07:42,980
+معناته meridian و meridian و meridian و meridian و
+
+93
+00:07:42,980 --> 00:07:48,920
+meridian و meridian و هكذا تمام نفرض أنا عنده
+
+94
+00:07:48,920 --> 00:07:55,440
+قرانية الإنسان القرانيةعبارة عن spherical lens مش
+
+95
+00:07:55,440 --> 00:08:01,760
+سفير قرنية ليست سفير تمام؟ spherical lens تمام؟
+
+96
+00:08:01,760 --> 00:08:08,080
+قليلة من الناس اللي بيكون عند القرنيةيعني عبارة عن
+
+97
+00:08:08,080 --> 00:08:12,920
+سفير فقط طيب بمعنى سفير و cylindrical lens يعني
+
+98
+00:08:12,920 --> 00:08:16,800
+قوة meridian بتختلف عن قوة meridian أخر بتختلف عن
+
+99
+00:08:16,800 --> 00:08:20,880
+قوة meridian تالت و هكذا تمام بمعنى أخر طيب ليش
+
+100
+00:08:20,880 --> 00:08:25,600
+احنا أطلقنا كلمة regular astigmatism لأنه وجدوا في
+
+101
+00:08:25,600 --> 00:08:29,220
+قضية ال regular astigmatism ال optical system و
+
+102
+00:08:29,220 --> 00:08:33,680
+احنا ضربنا مثال على الكورنيا بيكون له meridian هو
+
+103
+00:08:33,680 --> 00:08:39,350
+الأقوىو Meridian عمودي عليه هو الأضعف وفي تدرج في
+
+104
+00:08:39,350 --> 00:08:42,410
+القوة لباقي ال Meridian انطلاقا من الأضعف للأقوى
+
+105
+00:08:42,410 --> 00:08:46,670
+أو من الأقوى للأضعف نضرب مثال على ذلك ونقول هنا 44
+
+106
+00:08:46,670 --> 00:08:50,490
+ديوبتر ال Meridian اللي هو 180 درجة ال Meridian
+
+107
+00:08:50,490 --> 00:08:56,710
+الأفقي 44 ديوبتر قوته و ال Meridian العمودي مثلا
+
+108
+00:08:56,710 --> 00:09:02,350
+42 ديوبتر هو الأضعف هنلاقي هنا مثلاتلاتة و اربعين
+
+109
+00:09:02,350 --> 00:09:10,330
+و نص تلاتة و اربعين اتنين و اربعين و نص ديوبتر
+
+110
+00:09:10,330 --> 00:09:14,590
+يعني في تدرج يعني الميليدين اقوى اضعف منه شويه
+
+111
+00:09:14,590 --> 00:09:17,730
+اضعف اضعف اضعف هذا يسمى regular astigmatism
+
+112
+00:09:22,560 --> 00:09:26,300
+الأضعف و ال meridian الأقوى و ندرسهم و دول هيمثلوا
+
+113
+00:09:26,300 --> 00:09:29,760
+باقي ال meridians باقي ال meridians و هنقول كيف
+
+114
+00:09:29,760 --> 00:09:34,320
+بعد فترة بسيطة اذا في العدسات اللي فيها regular
+
+115
+00:09:34,320 --> 00:09:38,820
+astigmatism سواء قرانية الإنسان او في العدسات
+
+116
+00:09:38,820 --> 00:09:43,940
+التورك اللي هي ال spherical lens تمام بنقول
+
+117
+00:09:43,940 --> 00:09:49,040
+كالقاتي انه بيكون عندي meridian أقوى و meridian
+
+118
+00:09:49,040 --> 00:09:54,210
+أضعف و الزاوية بينهم ايش تسعين درجةو بيكون التدرج
+
+119
+00:09:54,210 --> 00:09:57,350
+يعني بلاقيش مثلا اربعة و اربعين اتنين و اربعين
+
+120
+00:09:57,350 --> 00:10:03,360
+تلاتة و اربعينلأ فيش عشوائية في الانتقال من ال
+
+121
+00:10:03,360 --> 00:10:05,660
+meridian الأقوى بيبدأ يتحرك باتجاه ال meridian
+
+122
+00:10:05,660 --> 00:10:11,700
+الأضعف هيكون ال diopter بيجل طبعا لو عندى point
+
+123
+00:10:11,700 --> 00:10:15,480
+source of light هينتشر الضوء منها في جميع
+
+124
+00:10:15,480 --> 00:10:19,120
+الاتجاهات نفرض ال point source هي سن الجلم اللى
+
+125
+00:10:19,120 --> 00:10:22,940
+أنا ماسكه بإيدي وبيبدأ تتجه باتجاه الصبورة هنلاقي
+
+126
+00:10:22,940 --> 00:10:26,820
+pencil of light دخل عبر ال meridian الأفقيو pencil
+
+127
+00:10:26,820 --> 00:10:29,980
+of light عبر ال meridian المائل و pencil of light
+
+128
+00:10:29,980 --> 00:10:34,540
+يعني كل meridian هياخد نصيبه من الإشعاعات الضوئية
+
+129
+00:10:34,540 --> 00:10:42,260
+ولكن .. ولكن بما أن قوة ال meridians تختلف إذا هذا
+
+130
+00:10:42,260 --> 00:10:46,780
+ال meridian هيكسر الأشعة أو يجمعها في منطقة أقرب
+
+131
+00:10:46,780 --> 00:10:52,590
+لأنه أقوىبينما هذا هيكون ال focus بتاعه أبعد شويه
+
+132
+00:10:52,590 --> 00:10:55,550
+وهذا هيكون ال focus بتاعه أبعد شويه ومين ال focus
+
+133
+00:10:55,550 --> 00:10:59,670
+بتاعه هيكون الأبعد اللي هو ال meridian الأضعف ال
+
+134
+00:10:59,670 --> 00:11:03,950
+meridian الأضعف لأن قدرته على جمع الأشعة أقل نضرب
+
+135
+00:11:03,950 --> 00:11:08,050
+مثال على ذلك هذا ال meridian اللي هو الأفقي اللي
+
+136
+00:11:08,050 --> 00:11:13,570
+هو أربع و أربعين بيبتر تمام نفرض أن قوة القرانية
+
+137
+00:11:13,570 --> 00:11:22,800
+قوة القرانية تمامبنقضه بمثال يوضح الفكرة نقول
+
+138
+00:11:22,800 --> 00:11:29,300
+كالقاتل أنه spherical cylindrical
+
+139
+00:11:29,300 --> 00:11:33,780
+lens ال
+
+140
+00:11:33,780 --> 00:11:41,000
+meridian الأقوى المحور الأفقي هو لحاله كأنه عدسة
+
+141
+00:11:41,000 --> 00:11:48,350
+لحاله منفصلة طبعا قوته مثلا plus 6 ديوبتربيمثل
+
+142
+00:11:48,350 --> 00:11:52,450
+عدسة plus 6 دا يوتر تمام و ال meridian الأضعف اللي
+
+143
+00:11:52,450 --> 00:11:59,750
+هو العمودي همثله بعدسة عمودية قوته plus 2 تمام و
+
+144
+00:11:59,750 --> 00:12:04,330
+object على بعد متر
+
+145
+00:12:05,510 --> 00:12:08,470
+يا ترى هذا وين حيانا ال focus و هذا حيانا ال وين
+
+146
+00:12:08,470 --> 00:12:13,090
+focus نتعامل مع كل عدسة على حده هاي أنا عنده ال
+
+147
+00:12:13,090 --> 00:12:16,930
+meridian الأفقي و أنا رسمتها متعمدا يعنى عشان أقول
+
+148
+00:12:16,930 --> 00:12:21,830
+هذا ال meridian الأفقي تمام؟ بنقول البعد واحد متر
+
+149
+00:12:21,830 --> 00:12:27,160
+و هنا عندي plus ستةالـ U ايش تساوي U تساوي ناقص N
+
+150
+00:12:27,160 --> 00:12:31,500
+على O ساوي ناقص واحد على واحد متر و ساوي ناقص واحد
+
+151
+00:12:31,500 --> 00:12:35,780
+ديوبتر ناقص واحد ديوبتر حتضل ال VND plus خمسة
+
+152
+00:12:35,780 --> 00:12:40,570
+ديوبتر ال image بتاعة هذا ال meridian لحالهبمعنى
+
+153
+00:12:40,570 --> 00:12:43,330
+ال image بتاعة الأشعة اللى دخلت في هذا ال meridian
+
+154
+00:12:43,330 --> 00:12:46,790
+اللى كان نصيبها انها تخترق هذا ال meridian قادمة
+
+155
+00:12:46,790 --> 00:12:50,290
+من ال point source of light هتكون على بعد جداش ال
+
+156
+00:12:50,290 --> 00:12:54,090
+focus بتاعها عن شرط على V plus واحد ع بلس خمسة
+
+157
+00:12:54,090 --> 00:12:58,550
+ديوبتر ويساوي عشرين صنطي خمس متر على بعد عشرين
+
+158
+00:12:58,550 --> 00:13:04,650
+صنطي تمام طيب نفس المسألة نفس المسألة بس بدنا
+
+159
+00:13:04,650 --> 00:13:07,410
+نعيدها بالنسبة ليها لل vertical meridian اللى هو
+
+160
+00:13:07,410 --> 00:13:11,890
+الأضعفعلى واحد متر الـU جديش minus واحد بدهاش
+
+161
+00:13:11,890 --> 00:13:16,990
+إعادة حساب طيب جديش ضال من هذا ال meridian قوة
+
+162
+00:13:16,990 --> 00:13:23,950
+plus واحد I إيش تساوي عن شرطه على V مايساوي واحد ع
+
+163
+00:13:23,950 --> 00:13:28,590
+plus واحد دا يبتر ويساوي plus واحد متر بمعنى آخر
+
+164
+00:13:28,590 --> 00:13:34,610
+بمعنى آخر ال toric lens أو ال stigma lens أو ال
+
+165
+00:13:34,610 --> 00:13:38,290
+spherical lens تمام؟
+
+166
+00:13:39,350 --> 00:13:44,970
+بتعملش focus لكل الأشعة في منطقة واحدة وإنما بعضها
+
+167
+00:13:44,970 --> 00:13:48,990
+بيكون ال focus بتاعه في منطقة معينة البعض التاني
+
+168
+00:13:48,990 --> 00:13:53,050
+أبعد منه البعض التالت أبعد منه حتى نشمل كل ال
+
+169
+00:13:53,050 --> 00:13:58,670
+meridians يعني هذه ال spherical lens طبعا هي عبارة
+
+170
+00:13:58,670 --> 00:14:03,850
+عن lens أخدناالمحور الأقوى منها واخدنا المحور
+
+171
+00:14:03,850 --> 00:14:07,090
+الأضعف منها ليش أخدنا الأقوى و الأضعف؟ عشان نشوف
+
+172
+00:14:07,090 --> 00:14:11,430
+أقرب مكان ممكن تتثبت فيه الأشعة و تقيد تكون الصورة
+
+173
+00:14:11,430 --> 00:14:15,570
+وأبعد مكان يعني وكأنه ال point source of light
+
+174
+00:14:15,570 --> 00:14:22,310
+صورتها منتشرة في الفراغبتبدأ من المكان الفلاني و
+
+175
+00:14:22,310 --> 00:14:25,670
+بتنتهي عند المكان الفلاني بمعنى اخر المثال بتاعنا
+
+176
+00:14:25,670 --> 00:14:29,530
+بيقول اقرب focus هو تاع اقوى meridian على بعد 20
+
+177
+00:14:29,530 --> 00:14:35,110
+سانتي و ابعد focus على بعد متر من العدسة يعني لو
+
+178
+00:14:35,110 --> 00:14:42,850
+ال object على بعد متر هتبدأ الصورة معالمها تظهر من
+
+179
+00:14:42,850 --> 00:14:49,700
+عشرين سانتي و هتمتد معالمها لغاية واحد مترهنوضّح
+
+180
+00:14:49,700 --> 00:14:56,980
+حد بكلام لسه أكثر وضوحا إذا الصورة
+
+181
+00:14:56,980 --> 00:15:00,660
+هتنتشر فراغيا بواسط الـ Spherocylindrical أو الـ
+
+182
+00:15:00,660 --> 00:15:05,640
+Astigmatic Lens بين ال focus اللي بيعملليه أقوى
+
+183
+00:15:05,640 --> 00:15:11,120
+Meridian و ال focus اللي بيعملليه أضعف Meridianلو
+
+184
+00:15:11,120 --> 00:15:16,460
+هذه العدسة سفير لو هذه العدسة سفير كان هتعمل focus
+
+185
+00:15:16,460 --> 00:15:20,580
+في منطقة واحدة وخلصنا كان كل الأشعة لو جلنا هنا
+
+186
+00:15:20,580 --> 00:15:25,180
+plus 6 و هنا plus 6 و هنا plus 6 و هنا plus 6 كل
+
+187
+00:15:25,180 --> 00:15:29,020
+ال millions plus 6 اذا هذه spherical lens تمام كان
+
+188
+00:15:29,020 --> 00:15:30,520
+كل الصورة اتكونت
+
+189
+00:15:33,190 --> 00:15:38,370
+على بقعة عشرين سانتي وخلصنا تمام بس مصير الأشعة
+
+190
+00:15:38,370 --> 00:15:41,730
+اللي دخلت من ال horizontal meridian غير مصير
+
+191
+00:15:41,730 --> 00:15:44,750
+الأشعة اللي دخلت من ال oblique meridian غير مصير
+
+192
+00:15:44,750 --> 00:15:48,230
+الأشعة اللي دخلت من ال vertical meridian ليش؟ لأن
+
+193
+00:15:48,230 --> 00:15:52,270
+هذه ال meridians في تدرج في القوة إلها من الأقوى
+
+194
+00:15:52,270 --> 00:15:57,050
+أضعف شوية أضعف شوية الأضعف فبالتالي طالما أضعف كل
+
+195
+00:15:57,050 --> 00:16:00,860
+meridian بيشتغل كأنه عدسة مستقلةفالصورة هتنتشر
+
+196
+00:16:00,860 --> 00:16:05,660
+فراغيا اجوا العلماء جالوا بدنا ندرس طبيعة صورة
+
+197
+00:16:05,660 --> 00:16:10,620
+أبسط جسم اللي بتكوينه هي spherical cylindrical
+
+198
+00:16:10,620 --> 00:16:14,520
+optical system يعني نجيب أبسط جسم هو ال point
+
+199
+00:16:14,520 --> 00:16:18,640
+source of light مافيش أصغر من هيك و بدنا نحط أمامه
+
+200
+00:16:18,640 --> 00:16:22,640
+spherical cylindrical lensتمام؟ و بيبناه هذه الـ
+
+201
+00:16:22,640 --> 00:16:27,700
+Spherical lens نتلقى .. نتلقى الصورة في الفرار و
+
+202
+00:16:27,700 --> 00:16:34,060
+نشوف ايش طبيعة الصورة وجد العلماء لما بنستعمل
+
+203
+00:16:34,060 --> 00:16:39,970
+Spherical lensو point source of light هذه ال point
+
+204
+00:16:39,970 --> 00:16:42,530
+source of light هينتشر منها الضوء في جميع
+
+205
+00:16:42,530 --> 00:16:45,710
+الاتجاهات اشي هيخش عبر ال vertical meridian اشي
+
+206
+00:16:45,710 --> 00:16:48,630
+هيخش عبر ال horizontal meridian اشي عبر ال oblique
+
+207
+00:16:48,630 --> 00:16:55,710
+meridians وجدوا انه بتكون عندي تشكيلة فراغية هذه
+
+208
+00:16:55,710 --> 00:17:04,570
+التشكيلة الفراغية تسمى conoid of stern of stern هي
+
+209
+00:17:04,570 --> 00:17:11,150
+عبارة عن two focal linesواحد أفقي و واحد عمودي إذا
+
+210
+00:17:11,150 --> 00:17:15,130
+كان عندي ال vertical و ال horizontal meridian
+
+211
+00:17:15,130 --> 00:17:25,570
+للعدسة هما الأقوى و الأضعف تمام و لو
+
+212
+00:17:25,570 --> 00:17:32,110
+حطيت ورقة التلقي هنا هتلقى خط عموديلو بعدت ورقة
+
+213
+00:17:32,110 --> 00:17:36,790
+التلقي هنا هتلاقى دائرة بيضاوية او مش دائرة شكل
+
+214
+00:17:36,790 --> 00:17:40,730
+بيضاوي هيك vertical لو بعدت شوية هيبدأ الشكل
+
+215
+00:17:40,730 --> 00:17:45,810
+يستدير عند نقطة معينة هيكون شكله دائرة بعدين هيبدأ
+
+216
+00:17:45,810 --> 00:17:50,090
+يصير بيضاوي بس عمودي على البيضاوي الأول تمام؟
+
+217
+00:17:50,090 --> 00:17:54,070
+وبعدين يعني يصير أطول بعدين هيصير focal line
+
+218
+00:17:54,070 --> 00:17:58,930
+horizontal تمام؟ هذه التشكيلة الفرهية بمعنى آخرأنا
+
+219
+00:17:58,930 --> 00:18:04,230
+ممكن لو بالعين المجردة ما ألاحظش هذا الكلام بس بدي
+
+220
+00:18:04,230 --> 00:18:06,870
+أنا أخلي ال point of source of light ثابتة في
+
+221
+00:18:06,870 --> 00:18:09,850
+مكانها و ال sphere و cylindrical length ثابتة في
+
+222
+00:18:09,850 --> 00:18:15,190
+مكانها و أجيب لوحة التلقي و أبدأ أتلقى الصورة هنا
+
+223
+00:18:15,190 --> 00:18:20,530
+هتلقى vertical line هنا vertical ellipse vertical
+
+224
+00:18:20,530 --> 00:18:26,430
+ellipse بس بدأ يستدير تمام وصلنا لدائرةhorizontal
+
+225
+00:18:26,430 --> 00:18:32,490
+ellipse ممطوط أكتر بعدين horizontal line أو focal
+
+226
+00:18:32,490 --> 00:18:38,660
+lineيعني هذه تعتبر صورة للأشعة وهذه صورة للأشعة
+
+227
+00:18:38,660 --> 00:18:41,260
+وهذه صورة للأشعة يعني بقدر أتلقها في هذا ال space
+
+228
+00:18:41,260 --> 00:18:46,020
+وهذا ال space هذا المكان الفراغي يسمى Kinoid of
+
+229
+00:18:46,020 --> 00:18:51,260
+Stern Kinoid of Stern تحديد حدود ال Kinoid of
+
+230
+00:18:51,260 --> 00:18:55,200
+Stern بسيط جدا جدا يعني وين بيبدأ وين ال first
+
+231
+00:18:55,200 --> 00:18:59,720
+focal line وين ال second focal line بسيط جدا احنا
+
+232
+00:18:59,720 --> 00:19:05,300
+قبل شوية عملنا في تجرباتإن لو عندي ال vertical
+
+233
+00:19:05,300 --> 00:19:09,280
+meridian نفرض إنه هو الأقوى plus 7 تمام؟ وال
+
+234
+00:19:09,280 --> 00:19:14,260
+horizontal meridian هو الأضعف plus 4 وعندي object
+
+235
+00:19:14,260 --> 00:19:19,540
+على بعد أو point source of light على بعد نص متر
+
+236
+00:19:19,540 --> 00:19:25,000
+وقلنا بدنا نحدد ال first focal line هي point
+
+237
+00:19:25,000 --> 00:19:25,840
+source of light
+
+238
+00:19:28,910 --> 00:19:31,950
+الـ first focal line اللي هو الأقرب والـ second
+
+239
+00:19:31,950 --> 00:19:36,210
+focal line وهذه بتكون حدود conoid of stern نقول
+
+240
+00:19:36,210 --> 00:19:39,290
+انه اتعامل مع كل meridian على حده زمان كنا نقول
+
+241
+00:19:39,290 --> 00:19:43,350
+اتعامل مع كل عدسة على حده لأن مع كل meridian ببدأ
+
+242
+00:19:43,350 --> 00:19:47,370
+بال meridian الأقوى لأن صورته هتكون أقرب يعني ال
+
+243
+00:19:47,370 --> 00:19:51,330
+first focal line مرتبط اللي هو الأقرب للعدسة مرتبط
+
+244
+00:19:51,330 --> 00:19:54,310
+بال meridian الأقوى في هذه الحالة ال meridian
+
+245
+00:19:54,310 --> 00:19:59,100
+الأقوى هو ال vertical تمام؟ طيب ال verticalهيعطيني
+
+246
+00:19:59,100 --> 00:20:04,040
+horizontal focal line تمام؟ بس بدى اعرف بعضه عن
+
+247
+00:20:04,040 --> 00:20:08,620
+العدسة جداش بنقول هاي ال object نص متر ال U جداش
+
+248
+00:20:08,620 --> 00:20:14,070
+ماينس اتنين ده يبطهوالـ Meridian قدش قوته plus 7
+
+249
+00:20:14,070 --> 00:20:18,870
+النص متر تعطيني minus 2 لأن U تساوي ناقص N على U
+
+250
+00:20:18,870 --> 00:20:23,950
+ناقص 1 على نص متر ويساوي ناقص 2 ديوبتر ناقص 2
+
+251
+00:20:23,950 --> 00:20:28,890
+ديوبتر معناته عندي ال V plus 5 I إيش تساوي أن شرطة
+
+252
+00:20:28,890 --> 00:20:35,410
+على V 1 على plus 5 ويساوي 20 سنة 5 متر إذا الفرد
+
+253
+00:20:35,410 --> 00:20:41,370
+فوق الله يبعد 20 سنة عنالعدسة ال second focal line
+
+254
+00:20:41,370 --> 00:20:46,250
+بعيد المسألة لل
+
+255
+00:20:46,250 --> 00:20:51,110
+horizontal اللي هو الأضعف قوته plus 4 ال U minus 2
+
+256
+00:20:51,110 --> 00:20:55,970
+نفس مسافة ال objectبداش إعادة حساب اليوم ما اتغيرت
+
+257
+00:20:55,970 --> 00:20:59,310
+بس من من اتغير قوة ال meridian هنا ال meridian كان
+
+258
+00:20:59,310 --> 00:21:05,690
+سبعة بعتبر عدسة سبعة هنا اذا ال V قداش plus 2 اذا
+
+259
+00:21:05,690 --> 00:21:10,830
+ال I قداش هنا minus 2 و plus 4 بيبقى plus 2 ان شرط
+
+260
+00:21:10,830 --> 00:21:16,090
+على V يسوى واحد على plus 2 ده يبتر ويسوى خمسين
+
+261
+00:21:16,090 --> 00:21:24,460
+صنطق نص متر اذا من العدسةاللي هي هنا و انا لان
+
+262
+00:21:24,460 --> 00:21:30,060
+نرسم هنا خمسين صنطي اذا ال second focal line اللي
+
+263
+00:21:30,060 --> 00:21:34,500
+هيكون vertical طبعا ال meridian بيعطي focal line
+
+264
+00:21:34,500 --> 00:21:38,680
+عمودي على اتجاهه عمودي على اتجاهه نرجع للعدسة
+
+265
+00:21:38,680 --> 00:21:43,360
+المتكاملة اللي بيصفره cylindrical lens هذه هتعطيني
+
+266
+00:21:43,360 --> 00:21:49,880
+كنويد أوفستر يمتد من عشرين صنطي ابتدا من عشرين
+
+267
+00:21:49,880 --> 00:21:55,190
+صنطي ويمتهي عندخمسين صنطي، اذا الامتداد وقداش
+
+268
+00:21:55,190 --> 00:22:00,510
+الفراغة تلاتين صنطي، تلاتين صنطي، اذا الامتداد و
+
+269
+00:22:00,510 --> 00:22:07,190
+الفراغة تلاتين صنطي، لو طلبنا جداش، جداشامتداد الـ
+
+270
+00:22:07,190 --> 00:22:10,750
+Conoid of Stern من عشرين لخمسين يعني تلاتين كله
+
+271
+00:22:10,750 --> 00:22:14,890
+يُنسب للـ Optical System للـ Spherical Lens إذاً
+
+272
+00:22:14,890 --> 00:22:17,870
+في الـ Spherical Lens اللي زادت عن الـ Spherical
+
+273
+00:22:17,870 --> 00:22:21,150
+Lens اللي قلنا فترة طويلة بنتعامل معها أنه أنا
+
+274
+00:22:21,150 --> 00:22:26,690
+بتعامل مع كل Meridian على حده طيب، بلزم أتعامل مع
+
+275
+00:22:26,690 --> 00:22:32,710
+الـ Meridians البينية؟ لألأ لأن صورها هتطلع في
+
+276
+00:22:32,710 --> 00:22:37,470
+المناطق ما بين حدود الـ Conoid of Stern ما بين
+
+277
+00:22:37,470 --> 00:22:42,330
+حدود الـ Conoid of Stern طبعا نرجع للـ Conoid of
+
+278
+00:22:42,330 --> 00:22:47,950
+Stern نرجع للـ Conoid of Stern تحديد حدوده بسيطة
+
+279
+00:22:47,950 --> 00:22:51,970
+جدا انه باخد أقوى Meridian و بعدين باخد أضعف
+
+280
+00:22:51,970 --> 00:22:55,790
+Meridian بحدد ال first focal line و second focal
+
+281
+00:22:55,790 --> 00:23:02,210
+line و تشكيلة Conoid of Sternبتكون جاية بينهم في
+
+282
+00:23:02,210 --> 00:23:09,030
+شكل لما بأبدأ بالتلقى حصل شكل circular و هذا الشكل
+
+283
+00:23:09,030 --> 00:23:15,530
+هيكون مقارنة مع باقي الأشكال هو الأوضح أو
+
+284
+00:23:15,530 --> 00:23:19,210
+الأقل
+
+285
+00:23:19,210 --> 00:23:24,270
+غباشا الأكثر
+
+286
+00:23:24,270 --> 00:23:29,390
+وضوحا أو الأقل غباشاوشكله دائري يعني أكثر شيء
+
+287
+00:23:29,390 --> 00:23:35,350
+بيشبه النقطة تمام فهذا الشكل بيسموه circle of
+
+288
+00:23:35,350 --> 00:23:41,850
+least confusion يا
+
+289
+00:23:41,850 --> 00:23:46,150
+ترى وين موقع ال circle of least confusion هل هي
+
+290
+00:23:46,150 --> 00:23:51,570
+أقرب لل first focal line ولا أقرب لل second focal
+
+291
+00:23:51,570 --> 00:23:57,970
+line ولا جاية في نص المسافة بينهمحقيقة ليست
+
+292
+00:23:57,970 --> 00:24:01,290
+بالضرورة انها تكون جاية في نص المسافة بينهم طب كيف
+
+293
+00:24:01,290 --> 00:24:07,070
+احدد موقعها العلماء قالوا اذا انا بدأ اعرف موقع ال
+
+294
+00:24:07,070 --> 00:24:10,690
+circle of least confusion بدأ اعرف كيف اتكونت ال
+
+295
+00:24:10,690 --> 00:24:15,870
+circle of least confusion تمام هذه sphere و
+
+296
+00:24:15,870 --> 00:24:19,830
+cylindrical lens يعني فيها سفير و فيها سلندر
+
+297
+00:24:24,610 --> 00:24:28,810
+في حاجة اسمها الـ dioptric mean ايش المقصود بالـ
+
+298
+00:24:28,810 --> 00:24:33,330
+dioptric mean الـ
+
+299
+00:24:33,330 --> 00:24:38,130
+mean معناه المتوسط الحسابي و لما بنقول متوسط
+
+300
+00:24:38,130 --> 00:24:44,710
+الحسابي بالنسبة لقوة العدسات بنقصد في متوسط قوة ال
+
+301
+00:24:44,710 --> 00:24:50,950
+meridians متوسط قوة ال meridiansمثال عند سفيره
+
+302
+00:24:50,950 --> 00:24:54,010
+cylindrical lens stigmaic lens فيها regular
+
+303
+00:24:54,010 --> 00:25:01,550
+أستيجماتيزم انا هكتب كمثال هاي انا عندي أربع و
+
+304
+00:25:01,550 --> 00:25:06,730
+أربعين ديوبتر هاي تلاتة و أربعين و نص تلاتة و
+
+305
+00:25:06,730 --> 00:25:13,270
+أربعين تمام و اتنين و أربعين و نص ديوبتر تمام
+
+306
+00:25:13,270 --> 00:25:16,610
+خلّيني أضيف لنا ميريديا هنا نقول تلاتة و أربعين و
+
+307
+00:25:16,610 --> 00:25:24,640
+نصو هنا تلاتة و أربعين و هنا
+
+308
+00:25:24,640 --> 00:25:27,560
+اتنين و أربعين و نص و هنا اتنين و أربعين ديوبتر
+
+309
+00:25:27,560 --> 00:25:34,860
+ايش الديوبتر كمين لهذه القرانية بنجمع قوة ال
+
+310
+00:25:34,860 --> 00:25:40,640
+meridian كلها و بنجسمها على عددهابنجمع قوة ال
+
+311
+00:25:40,640 --> 00:25:44,500
+meridian كلها يعني أربعة وأربعين زائد تلاتة
+
+312
+00:25:44,500 --> 00:25:48,740
+وأربعين ونص زائد تلاتة وأربعين حد يبدأ يحسب معايا
+
+313
+00:25:48,740 --> 00:25:53,440
+بالقلة الحاسبة وزائد اتنين وأربعين ونص زائد اتنين
+
+314
+00:25:53,440 --> 00:25:57,660
+وأربعين يساوي عددها جداش واحد اتنين تلاتة أربعة
+
+315
+00:25:57,660 --> 00:25:59,900
+خمسة بنجسم على خمسة
+
+316
+00:26:11,470 --> 00:26:17,390
+تلاتة وأربعين تلاتة وأربعين ديوبتر اذا متوسط قوة
+
+317
+00:26:17,390 --> 00:26:20,690
+ال meridians كلها اللي هي ال dioptric main كمان
+
+318
+00:26:20,690 --> 00:26:25,070
+تلاتة وأربعين ديوبتر في وسيلة أبسط من هيك اجمع
+
+319
+00:26:25,070 --> 00:26:28,850
+اقوى meridian مع اضعف meridian وجسميه مع اتنين
+
+320
+00:26:28,850 --> 00:26:32,710
+اقوى meridian اتنين وأربعين زائد اربع واربعين
+
+321
+00:26:32,710 --> 00:26:36,910
+اتنين واربعين زائد اربع واربعين على اتنين ايش
+
+322
+00:26:36,910 --> 00:26:50,950
+يساوي86 على 2 يساوي 43 ديوبتر في وسيلة تالتة لما
+
+323
+00:26:50,950 --> 00:26:55,070
+بكون انا ماخد مش قوة ال meridian ماخد ال form
+
+324
+00:26:55,070 --> 00:27:00,590
+النهائية لل lens ال form النهائية لل lens باخد
+
+325
+00:27:00,590 --> 00:27:05,690
+السفير زائد نص السلندر هدف ديوبتر اكمين هو نفسه ال
+
+326
+00:27:05,690 --> 00:27:06,990
+spherical equivalent
+
+327
+00:27:09,600 --> 00:27:14,100
+بالظبط هو ال spherical equivalent ال dioptric main
+
+328
+00:27:14,100 --> 00:27:17,700
+هو ال spherical equivalent هو ال spherical
+
+329
+00:27:17,700 --> 00:27:24,100
+equivalent لو عندي عدسة انا اللي حكيناها مثلا plus
+
+330
+00:27:24,100 --> 00:27:31,900
+2 minus 1 axis C مش مهم ال axis لو بنقول جديش ال
+
+331
+00:27:31,900 --> 00:27:34,920
+spherical equivalent اللي معادلة ال spherical
+
+332
+00:27:34,920 --> 00:27:40,300
+equivalent يساوي ال سفيرزائد نص السيلندر أو
+
+333
+00:27:40,300 --> 00:27:44,780
+السيلندر على اتنين تمام جديش الاسفير plus اتنين و
+
+334
+00:27:44,780 --> 00:27:49,840
+نص السيلندر minus نص إذا تخضيها بإشارتها إذا ال
+
+335
+00:27:49,840 --> 00:27:56,240
+spherical equivalent جديش plus واحد و نص واضح طيب
+
+336
+00:27:56,240 --> 00:28:00,960
+بنقول كالقاتل العلماء وجدوا أن ال circle of least
+
+337
+00:28:00,960 --> 00:28:08,200
+confusion تتكون عند الديوبتريكمين تعالى اللنسةكيف
+
+338
+00:28:08,200 --> 00:28:16,260
+نحدد موقعها بسيط جدا بسيط
+
+339
+00:28:16,260 --> 00:28:21,280
+جدا ايش يعني ال circle of least confusion بتتكون
+
+340
+00:28:21,280 --> 00:28:25,140
+عند ال diopteric mean عند ال diopteric mean بتاع
+
+341
+00:28:25,140 --> 00:28:29,360
+ال lens كامهم بيحكولنا انه لما بنشيل هذه ال
+
+342
+00:28:29,360 --> 00:28:33,760
+spherical lens و بنستعيد عنها ب spherical lens
+
+343
+00:28:33,760 --> 00:28:39,610
+مكافئة spherical equivalent تمامهذا الـ spherical
+
+344
+00:28:39,610 --> 00:28:43,630
+equivalent اللي الـ sphere lens هتكوّن لصورة في
+
+345
+00:28:43,630 --> 00:28:48,510
+منطقة ال circle of least confusion هنضرب مثال عشان
+
+346
+00:28:48,510 --> 00:28:52,630
+تتضح الأمور طيب بنقول المثال اللي حكيناه قبل شوية
+
+347
+00:28:52,630 --> 00:29:01,830
+plus 7 و plus 4 تمام plus 7 و plus 4 لما حسبنا
+
+348
+00:29:01,830 --> 00:29:08,110
+قولنا ال object على بعد نص متروالـ Conoid of Stern
+
+349
+00:29:08,110 --> 00:29:14,830
+بيمتد من عشرين صنطة لعند خمسين صنطة يعني امتدوا
+
+350
+00:29:14,830 --> 00:29:19,010
+تلاتين صنطة هذه المسافة من هنا لهنا تلاتين صنطة
+
+351
+00:29:19,010 --> 00:29:24,210
+والموقع الـ Circle of Least Confusion بنقول إيش
+
+352
+00:29:24,210 --> 00:29:28,930
+الديوبتريكمين تاع هذه العدسة سبعة زي أربعة على
+
+353
+00:29:28,930 --> 00:29:34,980
+اتنين سبعة وأربعة11 على 2 خمسة و نص بنروح بنحط
+
+354
+00:29:34,980 --> 00:29:39,520
+بنقول بدناش هذه العدسة بدنا عدسة خمسة و نص object
+
+355
+00:29:39,520 --> 00:29:45,440
+على بعد نص متر وين هتكون وين هتكون ال image
+
+356
+00:29:45,440 --> 00:29:50,640
+بتاعتها نص متر يعني ال U جديش minus اتنين جديش
+
+357
+00:29:50,640 --> 00:29:56,360
+بيبقى لعنديها plus تلاتة و نص I تساوي on شرط على V
+
+358
+00:29:56,360 --> 00:30:01,920
+و يساوي واحد ع plus تلاتة و نص و يساويماديش
+
+359
+00:30:01,920 --> 00:30:08,560
+النتيجة احسبونا بالله على الحاسبة يعني هتطلع اقل
+
+360
+00:30:08,560 --> 00:30:17,240
+من واحد تقسيم تلاتة و نص تمانية
+
+361
+00:30:17,240 --> 00:30:23,490
+و عشرين من مية متر ساوي تمانية و عشرين صنطيإذا
+
+362
+00:30:23,490 --> 00:30:27,650
+هتكون ال circle of least confusion بتبعد تمانية و
+
+363
+00:30:27,650 --> 00:30:32,970
+عشرين صنطي عن العدسة يعني هي أقرب لوين لل first
+
+364
+00:30:32,970 --> 00:30:38,250
+focal line يعني من هنا لهنا تمانية صنطي و من هنا
+
+365
+00:30:38,250 --> 00:30:43,210
+لهنا اتنين و عشرين صنطي واضحة الأمور يعني ال
+
+366
+00:30:43,210 --> 00:30:47,730
+circle of least confusion إذا بدي أجيب موقعها مش
+
+367
+00:30:47,730 --> 00:30:52,370
+لازم انه شرط انها تكون في النصلأ حسب الـ dioptric
+
+368
+00:30:52,370 --> 00:30:55,210
+mean بتاع ال spherical cylindrical lens الـ
+
+369
+00:30:55,210 --> 00:30:58,730
+dioptric mean أو بعبارة أخرى و اللي هتتعاملوا معاه
+
+370
+00:30:58,730 --> 00:31:01,090
+كتير اللي هو ال spherical equivalent ال spherical
+
+371
+00:31:01,090 --> 00:31:05,630
+equivalent لنضرب مثال كامل نحدد فيه ال first focal
+
+372
+00:31:05,630 --> 00:31:09,890
+line و ال second focal line بمعنى أخر نحدد حدود ال
+
+373
+00:31:09,890 --> 00:31:15,550
+conoid of this term و نحدد بعدها اللي هو ال circle
+
+374
+00:31:15,550 --> 00:31:17,670
+of least confusion وين مكانها
+
+375
+00:31:29,980 --> 00:31:33,020
+بنقول كالا قاعدة عندي أنا سفيرو cylindrical lens
+
+376
+00:31:33,020 --> 00:31:41,680
+plus عشرة و plus تمانية من المحور الأقوى المحور
+
+377
+00:31:41,680 --> 00:31:48,920
+العمودي ال plus عشرة وعندي object على بقد عشرين
+
+378
+00:31:48,920 --> 00:31:53,800
+صنطي بدي ال first focal line
+
+379
+00:31:57,470 --> 00:32:00,970
+و ال second focal line يعني امتداد conoid of term
+
+380
+00:32:00,970 --> 00:32:07,030
+في الفراب و ال circle of least confusion ببدأ في
+
+381
+00:32:07,030 --> 00:32:10,610
+أول مطلوب أول مطلوب بدأ أخد ال meridian الأقوى
+
+382
+00:32:10,610 --> 00:32:17,190
+plus عشرة و عندي object عبقر عشرين سانتي ال U
+
+383
+00:32:17,190 --> 00:32:21,330
+هتكون minus خمسة لأن U تساوي ناقص N على O ساوي
+
+384
+00:32:21,330 --> 00:32:25,510
+ناقص واحد على اتنين من عشرة متر تساوي ناقص خمسة
+
+385
+00:32:25,510 --> 00:32:34,680
+إذا V كده؟plus خمسة plus خمسة I تساوي on شرط على V
+
+386
+00:32:34,680 --> 00:32:37,560
+احنا بنحكي عن ال vertical meridian لحاله و بنتعامل
+
+387
+00:32:37,560 --> 00:32:41,540
+معاه كعدسة لحالها ننسى في نفس الوقت ال horizontal
+
+388
+00:32:41,540 --> 00:32:45,580
+meridian لغاية ما نوصل إليه تمام on شرط على V و
+
+389
+00:32:45,580 --> 00:32:50,800
+سوى واحد ع plus خمسة و يساوي اتنين من عشرة متر سبع
+
+390
+00:32:50,800 --> 00:32:56,080
+عشرين صنطة اذا ال first focal lineهيكون على بعد
+
+391
+00:32:56,080 --> 00:33:00,720
+عشرين صنطي هاي أول جزء من المسألة تاني جزء من
+
+392
+00:33:00,720 --> 00:33:03,700
+المسألة ال horizontal meridian اللي هو قوته قداش
+
+393
+00:33:03,700 --> 00:33:07,080
+plus
+
+394
+00:33:07,080 --> 00:33:11,500
+تمانية ال U نفسها ماتغيرش موقع ال object فورا بدون
+
+395
+00:33:11,500 --> 00:33:17,650
+حساب بكتبها minus خمسة قداش ال Vplus تلاتة I تساوي
+
+396
+00:33:17,650 --> 00:33:20,910
+on short على V و يساوي واحد على plus تلاتة ده
+
+397
+00:33:20,910 --> 00:33:24,770
+يبتدى و يساوي تلاتة و تلاتين من مية متر plus تلاتة
+
+398
+00:33:24,770 --> 00:33:29,770
+و تلاتين من مية متر اذا على بعد تلاتة و تلاتين
+
+399
+00:33:29,770 --> 00:33:34,910
+صانت من العدسة اذا باجي للرسمة الكلية للعدسة بقول
+
+400
+00:33:34,910 --> 00:33:42,390
+تمتد من عشرين صانت لغاية تلاتة و تلاتين يعني من
+
+401
+00:33:42,390 --> 00:33:46,700
+هنا لهنا تلاتة و تلاتين صانتومن هنا لأ من العدسة
+
+402
+00:33:46,700 --> 00:33:49,920
+لل face focal line عشرين اذا هذه المسافة كده؟
+
+403
+00:33:49,920 --> 00:33:56,020
+تلتاشر صنطي بقى الأخر مطلوب ايش هو ال circle of
+
+404
+00:33:56,020 --> 00:34:00,000
+least confusion ال circle of least confusion بدي
+
+405
+00:34:00,000 --> 00:34:04,020
+استبدل هدولة ال two meridians او هذه العدسة ككل
+
+406
+00:34:04,020 --> 00:34:06,800
+بال diopteric mean بتاعها بال spherical equivalent
+
+407
+00:34:06,800 --> 00:34:10,670
+بتاعها بدي أشيله و أحط مكانها سفيرعشرة و تمانية
+
+408
+00:34:10,670 --> 00:34:16,330
+تمانتاش على اتنين تسعة يعني بدأ دي ارسم المسألة من
+
+409
+00:34:16,330 --> 00:34:20,250
+جديد اقول في عندي عدسة plus تسعة تكافئ هدول تمام و
+
+410
+00:34:20,250 --> 00:34:24,970
+object على بعد عشرين سانتي هنا minus خمسة مظبوط
+
+411
+00:34:24,970 --> 00:34:31,690
+بيبقى الجداش عند plus أربعة تمام I تساوي on شرطة
+
+412
+00:34:31,690 --> 00:34:35,630
+على V و يسوى واحد ع plus أربعة و يساوي ربع متر
+
+413
+00:34:35,630 --> 00:34:41,460
+يعني خمسة و عشرين سانتيخمسة و عشرين صنطي هي عشرين
+
+414
+00:34:41,460 --> 00:34:45,200
+و كمان خمسة اذا ال circle of least confusion هتكون
+
+415
+00:34:45,200 --> 00:34:49,160
+هنا خمسة صنطي تبعد عن ال first focal line و كده
+
+416
+00:34:49,160 --> 00:34:53,740
+تبعد عن ال second تمانية
+
+417
+00:34:53,740 --> 00:34:57,580
+صنطي هي تلتاشر صنطي تمام اذا هي اقرب لل first
+
+418
+00:34:57,580 --> 00:35:02,940
+focal line اقرب لل first focal line واضحكت هناخد
+
+419
+00:35:02,940 --> 00:35:07,940
+كمان مثال للمزيد من الإيضاح للمزيد من الإيضاح
+
+420
+00:35:14,770 --> 00:35:21,290
+زمان كنا نحكي تعامل مع كل عدسة على حدى، الآن بنحكي
+
+421
+00:35:21,290 --> 00:35:27,260
+لأمع كل Meridian على حده مع كله الكثير من العدسات
+
+422
+00:35:27,260 --> 00:35:30,400
+اللي احنا نوصفها للمرضى عبارة عن Spherocylindrical
+
+423
+00:35:30,400 --> 00:35:33,380
+غالبا يكون فيه Spherical Refractive Error وفيه
+
+424
+00:35:33,380 --> 00:35:37,300
+Cylindrical Refractive Error طيب الان المسألة اللي
+
+425
+00:35:37,300 --> 00:35:42,440
+هعطيها بشكل يشبه الحياة الواقعية بنقول كالاتي بدنا
+
+426
+00:35:42,440 --> 00:35:47,240
+نحسب اللي هو امتداد ال Konoid of Sterm والcircle
+
+427
+00:35:47,240 --> 00:35:52,880
+of least confusion للعدسة التالية plus 4
+
+428
+00:35:56,040 --> 00:36:01,680
+-1-180 ماش فيه prescription زي هيك إذا علمنا إن ال
+
+429
+00:36:01,680 --> 00:36:06,400
+object على بُعد متر إذا علمنا ال object على بُعد
+
+430
+00:36:06,400 --> 00:36:09,580
+أو خلّيني أقول على بُعد ال object distance على
+
+431
+00:36:09,580 --> 00:36:17,640
+بُعد نص متر هذه بتحولها ل meridians هذه بتحولها ل
+
+432
+00:36:17,640 --> 00:36:22,620
+meridians أنا عند أحد ال meridians180 إذا التاني
+
+433
+00:36:22,620 --> 00:36:27,740
+90 هذه ال 180 degree
+
+434
+00:36:27,740 --> 00:36:31,460
+وهذه ال 90 degree عشان أحول هذه ال sphere و
+
+435
+00:36:31,460 --> 00:36:35,040
+cylindrical form ل meridian ال sphere فورا بحطها
+
+436
+00:36:35,040 --> 00:36:40,180
+على ال meridian المكتوب إذا هنا plus 4 واضح؟ إذا
+
+437
+00:36:40,180 --> 00:36:44,980
+ال horizontal meridian هو ال plus 4 طيب كيف أستنتج
+
+438
+00:36:44,980 --> 00:36:51,740
+التاني؟ التاني ينقص عنه بواحدمن اللي ضال ال
+
+439
+00:36:51,740 --> 00:36:54,280
+meridian اللي مش محتوط له إشارة أو مش محتوط له رقم
+
+440
+00:36:54,280 --> 00:37:02,560
+التسعين وكأنهم يقول ال meridian 180 ما هو ال minus
+
+441
+00:37:02,560 --> 00:37:07,550
+واحد لما يحط على 180 تأثيره هيجي اين؟انا لما اقول
+
+442
+00:37:07,550 --> 00:37:11,510
+هذه sphere يعني هذه تشمل كل ال meridians كله plus
+
+443
+00:37:11,510 --> 00:37:15,550
+أربعة ماشي بس عندي بدأ أحط cylinder على مية و
+
+444
+00:37:15,550 --> 00:37:19,890
+تمانين مقدارها minus واحد أثارها هيجيان ع تسعين هي
+
+445
+00:37:19,890 --> 00:37:28,330
+minus واحد إذا هذه هتصفيش إذا هي هي
+
+446
+00:37:28,330 --> 00:37:34,510
+plus تلت ساعة العدسة عندي واضحة ك meridians نعيد؟
+
+447
+00:37:34,510 --> 00:37:39,910
+حد بده نعيد؟تمام طيب الان انا بدي اخد ال meridian
+
+448
+00:37:39,910 --> 00:37:46,230
+الاقوى ال object على بعد كده نص متر وهنا ال
+
+449
+00:37:46,230 --> 00:37:53,230
+meridian الاقوى plus 4 ال U كده مايرس اتنين U تسوى
+
+450
+00:37:53,230 --> 00:37:58,670
+ناقص N على O تسوى ناقص واحد على نص متر تسوى ناقص
+
+451
+00:37:58,670 --> 00:38:03,910
+اتنين ده يبتر اذا ال V plus اتنين
+
+452
+00:38:06,120 --> 00:38:11,420
+مش plus 4 عندى اذا ال V plus 2 I تساوي on شرط على
+
+453
+00:38:11,420 --> 00:38:15,520
+V و ساوي واحد على plus 2 بيبتر و يساوي plus نص متر
+
+454
+00:38:15,520 --> 00:38:21,560
+اذا اول focal line على بعد خمسين سنتين طيب ال
+
+455
+00:38:21,560 --> 00:38:26,140
+second focal line اللي هو تاع ال vertical meridian
+
+456
+00:38:26,140 --> 00:38:31,980
+اللي قوته plus تلاتة ال U قداش تتغيرش ال U ال
+
+457
+00:38:31,980 --> 00:38:37,630
+object ثابتإذا بيبقى ال V عندى كده؟ plus واحد I
+
+458
+00:38:37,630 --> 00:38:42,010
+تساوي واحد متر طالما ال V plus واحد واحد على واحد
+
+459
+00:38:42,010 --> 00:38:45,910
+تساوي واحد متر إذا ال second focal line بيبتد على
+
+460
+00:38:45,910 --> 00:38:54,570
+بعد واحد متر ارجع للرسمة الأساسية ونقول من نص متر
+
+461
+00:38:54,570 --> 00:39:01,490
+خمسين صنطة لعند مية صنطة كده انتي ده ده ال conoid
+
+462
+00:39:01,490 --> 00:39:06,980
+of a starخمسين صنطي خمسين صنطي لأنه ببدأ عند خمسين
+
+463
+00:39:06,980 --> 00:39:10,640
+من العدسة و بنتهي عند مية من العدسة امتداده خمسين
+
+464
+00:39:10,640 --> 00:39:15,220
+صنطي ال circle of least confusion بد ال dioptric
+
+465
+00:39:15,220 --> 00:39:22,960
+مين plus تلاتة و plus أربعة سبعة على اتنين تلاتة و
+
+466
+00:39:22,960 --> 00:39:26,460
+نص طيب لو جيبناها بال spherical equivalent plus
+
+467
+00:39:26,460 --> 00:39:31,960
+أربعة و minus نص plus تلاتة و نصماشي احنا قولنا
+
+468
+00:39:31,960 --> 00:39:35,800
+الـ Sphere زائد لص السيلندر هي plus 3 و نص طبعا
+
+469
+00:39:35,800 --> 00:39:39,240
+بلاش ثلاثة زائد أربعة سبعة على اتنين برضه plus
+
+470
+00:39:39,240 --> 00:39:41,860
+ثلاثة و نص هو الـ dielectric mean هو الـ spherical
+
+471
+00:39:41,860 --> 00:39:45,200
+equivalent طيب هذا الـ spherical equivalent تتخيل
+
+472
+00:39:45,200 --> 00:39:53,240
+ان هو سفير تمام و ال object على بعد نص متر ال U
+
+473
+00:39:53,240 --> 00:39:57,420
+جديش ماعنصر اتنين ال U في جميع الأحوال مش هتتغير
+
+474
+00:39:57,420 --> 00:40:04,350
+ال object ثابتماذا يظهر هنا بلاس واحد و نص اي
+
+475
+00:40:04,350 --> 00:40:09,430
+تساوي ان شرطة على V أسروا واحد على بلاس واحد و نص
+
+476
+00:40:09,430 --> 00:40:14,170
+ديوبتر ويساوي بلاس ستة و ستين من مية متر و ساوي
+
+477
+00:40:14,170 --> 00:40:20,130
+بلاس ستة و ستين صنطي ستة و ستين صنطي يعني بيبعد
+
+478
+00:40:20,130 --> 00:40:23,930
+هذه ال circle of least confusion تبعد ستة عشر صنطي
+
+479
+00:40:23,930 --> 00:40:26,670
+عن ال first focal line وقداش
+
+480
+00:40:28,780 --> 00:40:33,520
+أربعة و تلاتين صمتي عن ال second فوق ال line مش
+
+481
+00:40:33,520 --> 00:40:36,860
+هذه المسافة خمسين راح منها ستة عاشر مضال اربعة و
+
+482
+00:40:36,860 --> 00:40:41,560
+تلاتين تمام واضح الكلام اذا هذا التعامل مع ال
+
+483
+00:40:41,560 --> 00:40:46,360
+spherical cylindrical lens ناخد كمان مثال لتوضيح
+
+484
+00:40:46,360 --> 00:40:48,180
+المسألة بشكل اكبر
+
+485
+00:41:05,020 --> 00:41:13,000
+طيب نقول كالقاعدة في عندي plus سبعة minus اتنين
+
+486
+00:41:13,000 --> 00:41:20,440
+axis تسعين نحوّلها ل meridians قولنا أول حاجة
+
+487
+00:41:20,440 --> 00:41:26,860
+بنرسم ال meridians طلب واحد من ال meridians مذكور
+
+488
+00:41:28,100 --> 00:41:31,460
+تسعين معناته التاني مية و تمانين بروح بحط ل plus
+
+489
+00:41:31,460 --> 00:41:37,940
+سبعة تسعين و كمان ل plus سبعة مية و تمانين minus
+
+490
+00:41:37,940 --> 00:41:44,680
+اتنين لما نحطها على تسعين هتأثر ع وين هذا
+
+491
+00:41:44,680 --> 00:41:47,660
+prescription بس هذا meridian إذا اللي حيصف عنده
+
+492
+00:41:47,660 --> 00:41:55,180
+هنا إيش plus خمسة تمام و object على بُقد object
+
+493
+00:41:55,180 --> 00:41:55,920
+على بُقد
+
+494
+00:41:59,890 --> 00:42:05,510
+عشرين صنطي object على بُعد عشرين صنطي كل meridian
+
+495
+00:42:05,510 --> 00:42:10,310
+برسمه كعدسة لحاله object على بُعد عشرين صنطي
+
+496
+00:42:10,310 --> 00:42:14,410
+المطلوب ال first focal line وال second focal line
+
+497
+00:42:14,410 --> 00:42:18,670
+وال circle of least confusion هاي أقوى meridian ال
+
+498
+00:42:18,670 --> 00:42:25,190
+vertical برسمهobject عبارة عن 20 cm الـ U-5 U
+
+499
+00:42:25,190 --> 00:42:29,370
+تساوي ناقص N على O يساوي ناقص 1 ع 2 من 10 متر
+
+500
+00:42:29,370 --> 00:42:36,430
+ويساوي ناقص 5 ديوبتر وعندي plus 7 plus 2 I تساوي
+
+501
+00:42:36,430 --> 00:42:40,350
+on شرط على V يساوي 1 ع plus 2 ديوبتر ويساوي plus
+
+502
+00:42:40,350 --> 00:42:44,550
+نص متر إذا ال first focal line عبارة عن 50 cm
+
+503
+00:42:44,550 --> 00:42:52,270
+واضح؟ ال second focal lineنفس الرسمة بس باخد ال
+
+504
+00:42:52,270 --> 00:42:58,710
+horizontal مريدا لقوته خمسة تمام ال U ماينس خمسة
+
+505
+00:42:58,710 --> 00:43:06,830
+ما اتغيرت اذا ال V قداش Zero Zero تمام Zero خلينا
+
+506
+00:43:06,830 --> 00:43:11,710
+نحكي Zero تمام ال image في ال infinity second
+
+507
+00:43:11,710 --> 00:43:16,790
+focal line in infinity يعني
+
+508
+00:43:16,790 --> 00:43:21,980
+بيبدأ من عند خمسين صنطةوبيمتد لين إلى ما لا نهاية
+
+509
+00:43:21,980 --> 00:43:26,120
+ال circle of least confusion ال circle of least
+
+510
+00:43:26,120 --> 00:43:30,980
+confusion بدي الديوب تركمين خمسة و سبعة اتناش ع
+
+511
+00:43:30,980 --> 00:43:37,780
+اتنين ستة plus ستة طيب الاسفير و نص السيلندر برضه
+
+512
+00:43:37,780 --> 00:43:41,860
+plus ستة سبعة plus سبعة و minus واحد plus ستة بدي
+
+513
+00:43:41,860 --> 00:43:45,940
+امشي و اقول هاي انا عندي object ع جواد عشرين
+
+514
+00:43:45,940 --> 00:43:52,610
+سانتين اذاو هي plus 6 minus 5 ليه؟ بيبقى لعندي
+
+515
+00:43:52,610 --> 00:43:56,190
+plus 1 إذا ال circle of least confusion ع بُعد متر
+
+516
+00:43:56,190 --> 00:44:01,310
+اكتملت المسألة عندي أول حاجة ال first focal line
+
+517
+00:44:01,310 --> 00:44:06,210
+على بُعد خمسين صنطة ال second focal line في ال
+
+518
+00:44:06,210 --> 00:44:10,970
+infinity ال circle of least confusion ع بُعد متر
+
+519
+00:44:10,970 --> 00:44:14,430
+من العدسة يعني ع بُعد نص متر من ال first focal
+
+520
+00:44:14,430 --> 00:44:20,890
+line واضح؟وبالتالي هذه يعني أمثلة عديدة على قضية
+
+521
+00:44:20,890 --> 00:44:23,250
+الـ Conoid of Sterm وكيف أتعامل مع الـ
+
+522
+00:44:23,250 --> 00:44:27,930
+Spherocylindrical lens اللي بستخدمها لتصحيح ال
+
+523
+00:44:27,930 --> 00:44:32,490
+regular astigmatism .. regular astigmatism حد يسأل
+
+524
+00:44:32,490 --> 00:44:34,850
+سؤال يعطيكوا العافية
+