Anatomy: lumbar plexus uye awo

Mumiviri yedu hapana okushamisira - Mother Nature akatora nokuuchengeta zvakanaka. Kunyange zvazvo, sezvambotaurwa nevamwe, muviri yakadai okuwedzera, aiva muduku kukosha, uye zvinokwanisika kuti tirarame hupenyu huzere pasina izvozvo. Asi mubvunzo ikozvino haazi pamusoro kuti, uye pamusoro kukosha basa reDare lumbar plexus, kana plexus lumbalis. It pfungwa nesumbu tsinga harinzwi chiuno uye ezasi migumo.

anogumbura pezvakaitwa munzvimbo iyi vari achiperekedzwa neuralgia, anofukidza rezasi hafu muviri. Kazhinji panguva pane kurwadziwa. Kuti kunyatsonzwisisa sei pezvakaitwa pathological vanofanira kujairana anatomi redhipatimendi ichi.

tsananguro

Lumbar plexus muunganidzwa pakubhadhara anoverengeka tsinga. In kwayo inotungamirwa chikamu musana tsinga zvitatu zvokutanga. Neimwe pano rinogonawo vanoumba mapazi 12 thoracal uye 4 bazi musana etsinga. Large tsandanyama fibers ndidzo nzvimbo lumbar plexus iri. Anatomy kunosanganisira kuwana mapazi etsinga pamberi transverse dzinotsanagura ari lumbar vertebrae.

tsinga ava basa zvimwe zvikamu innervation kuti tsandanyama fibers, kusanganisira paganda peritoneum. Mukuwedzera, vari chokuita ganda penyika kwokunze nhengo dzokubereka nadzo, kuti medial pemvura tibia, ivo anteromedial chinoumba yehudyu. Total muchikamu chino kune marudzi anoverengeka tsinga harinzwi:

• iliohypogastric;
• ilioinguinal;
• femoral-kurara;
• lateral;
• obturator;
• Femoral.

Chimbofunga zvishoma pamusoro zvavari uye kupi nhema. Conventionally, zvose manzwiro unogona kukamurwa mapoka maviri akaenzana.

tsinga nhatu dzokutanga

Iliohypogastric tsinga yacho lumbar plexus vari yakaumbwa pamberi rumbabvu 12 uye mumwe mapazi tsinga lumbar. Kubva Ivo nepakati psoas tsandanyama, uye apinda neVadzidzi pamberi penyika quadratus lumborum, ari pedyo neitsvo. Uyezve tsinga anomhanyira kubva kumusoro kusvikira pasi, nokuchengeta mirayiridzo yaro kudzokera kumberi. On panzira iliac penyika azara transverse abdominal tsandanyama uye nhema pakati payo uye dzomunyika oblique abdominal tsandanyama fibers. Chimwe nzira kare pakati maviri oblique netsandanyama.

In zvakadzama inguinal mhete iliohypogastric tsinga uyewo chinopinda dzomunyika oblique tsandanyama uye mudzira paupamhi bwendefa kwokunze oblique tsandanyama. Zvadaro, mapazi kupinda cutaneous zvinoshandiswa abdominal rusvingo pamusoro pubic symphysis. Basa rayo rinosanganisira innervation akawanda tsandanyama ari mudumbu. Also akaedzwa tsinga paganda iri hudyu, buttock, Anterior abdominal rusvingo pamusoro pubis.

Mumwe davi, rwakatanga kubva pamberi etsinga mudzi, asi zviri zvishoma kuvatumwa yapfuura, inonzi ilioinguinal tsinga, mune lumbar plexus. Anatomy varume vake nevakadzi zvakasiyana. A simba pabonde tsinga inopfuura nomunyika inguinal Canal nokuparurwa kupinda duku cutaneous mapazi vose hukawanika yehudyu pedyo scrotal masero etsinga. Last mhosva innervation pakati paganda yemukomana uye scrotum muchidimbu. Vakadzi vane chete kuguma nechepakati tsinga Rinobatanidzwa ganda pamusoro pubis uye labia miromo.

Femoral-pabonde azara dzakawanda psoas uye kunyange rakakamurwa pamatavi maviri - dzezvepabonde uye rokurudyi. Flooring, zvimwe akadana sezvo mbeu etsinga rinotungamirirwa pasi uye, sezvo spermatic tambo inopfuura nomunyika inguinal mugero. In hono, inobatanidzwa tsandanyama, riri basa rokurera mazai, paganda scrotum, uyewo dzine goko uye pemvura ganda verhnemedialnoy hudyu nharaunda. Vakadzi lumbar plexus hwakarongwa zvakasiyana - etsinga vaviri ine kumativi shwashwa pamusoro dumbu pamusoro inguinal Canal uye ipapo akatumira ganda pose labia majora.

The bazi femoral chechipiri ichi kuvhara zvakajairika rakatarira pasi uye anoenda parutivi kwokunze iliac tsinga pakarepo nechepazasi inguinal shwashwa. Below rayo tsinga rinokamukana kupinda mapazi chidya ganda pemvura.

Wechipiri tsinga matatu

Below dziri zvose tsinga vatatu mapazi akakura matatu. Ichi lateral, femoral uye obturator tsinga. Chokutanga Pamazita iri parutivi inguinal shwashwa. Inogona kuva panyika kana mukati kuti sartorius tsandanyama, apo pasi connective tishu mumuhara. The tsinga ndiye anokonzera aikanganiswa rutivi hukawanika ose magaro zvishoma mamwe trochanteric hudyu mapfupa uye pedyo lateral pechiso femur.

Ramba parse chaiwo sei lumbar plexus aumbwa, zvakakodzera kuenda obturator etsinga. Anoenda pasi achitevedza psoas tsandanyama, kuwedzera chaizvo, pamupendero wayo uye munzvimbo pelvic nzvimbo. Kubatana kweropa hurongwa rosvika pamwe nemidziyo kusvika femoral munharaunda obturator canal, kutangira intermedia adductors. The tsinga Rinobatanidzwa neboka adductors, ibvi uye hudyu majoini. Uyewo tsinga innervates chiso pakati chikamu yehudyu pedyo ibvi.

Of femoral bazi dzose lumbar plexus ndiyo pakukura. It rinobva pamuganhu wechishanu vertebra muchiuno muzita iwoyu tsandanyama fibers. Achienda lateral unopinza tsandanyama, etsinga riri pazasi pakati mamwe mapoka maviri tsandanyama: yacho lumbar uye iliac, kuenda pasi rokupedzisira nevamwe.

Kuuya pasi inguinal shwashwa, lumbar plexus tsinga akakamurwa mapazi dzakawanda dzinoitwa ganda uye tsandanyama ari pamberi hudyu, ibvi uye hudyu majoini.

chikamu rose

Lumbar tsinga harinzwi inhengo nehurongwa rinonzi "lumbar-sacral plexus." Mapazi lumbar, sacral, uye coccygeal madhipatimendi, kurukana umwe kuumbika zviviri zvepuraimari plexus: lumbar uye sacral. Sezvo rokutanga izwi zvino pachena, inogona kune imwe tsananguro.

In achiumba sacral plexus (plexus sacralis) unotora pamberi bazi, izvo anomhanya kubva wechina uye wechishanu lumbar uye vokutanga bazi rechitatu sacral musana tsinga harinzwi yacho. Hazvibetseri lumbar plexus iri muna chiuno zvakananga connective zvinyama mumuhara piriformis. Rinomiririrwa muchimiro gobvu bwendefa mativi chimiro, iro chakaderedzwa mutengo izvo rakatarira kurutivi Subpiriforme mutswe.

Mujinga Triangle riri pamusoro pelvic mawindo. Panguva imwe chete dzimwe plexus iri pamberi sacrum, uye mumwe - pamberi piriformis. Kumativi ose rakakomberedzwa nzenza connective tishu. Sezvaiitwa lumbar nharaunda, panewo kupa chine harinzwi tsinga kuti ingava pfupi uye refu.

Short sacral tsinga

Short bazi tsinga vanomirira zvinotevera:

• gluteal (okumusoro);
• pabonde;
• zvemukati obturator;
• peya-zvakaumbwa;
• tsinga sikweya pechidya tsandanyama.

Gluteal tsinga lumbosacral plexus vari rakakamurwa okumusoro. Origin steamed pamwe gluteal tsinga haazotaurwizve pelvic mhango kuburikidza nadgrushevidnoe yokutanga. The tsinga Rinobatanidzwa navaduku uye svikiro gluteal tsandanyama uye fibers chokuita kuti fascia Lata. Lower tsinga pamwe tsinga kusiya pelvic Subpiriforme kuburikidza mugomba uye zvakabatana kuti gluteus Maximus tsandanyama. Asi kunze kuti chokuita Kamudzira ari muhudyu rwakashodoka.

Kuburikidza chete buri Subpiriforme pelvic mhango anosiya pudendal etsinga, seri bypasses ari ischium uye anoenda akananga kuna ischiorectal fossa. Pano zviri akaparadzaniswa munzvimbo dzakaderera mapazi rectal uye perineal. Uyezve, wokutanga akasungwa ane kwokunze sphincter pamusoro horo uye nokunobuda netsvina ganda nharaunda. Nepo ekupedzisira ndiwo anokonzera innervation tsandanyama uye paganda perineum uye scrotum ngakuite muviri. Zvishoma zvakasiyana akaronga munhukadzi lumbosacral plexus. Anatomy Paaiita pakuti perineal bazi chokuita labia majora.

Long sacral tsinga

Long bazi zvinosanganisira:

• posterior cutaneous tsinga;
• sciatic tsinga.

Posterior cutaneous tsinga nekuguma anosiya chiuno kubudikidza Subpiriforme buri, pasi pedyo sciatic etsinga. Posterior femoral cutaneous tsinga pedyo yepazasi pamucheto gluteus Maximus rakakamurwa rezasi gluteal uye mapazi tsinga perineal. Rezasi bazi innervates rezasi buttock ganda pemvura.

cutaneous femoral bazi Posterior inopfuura nomunyika paburi intermedia semitendinosus uye biceps femoral tsandanyama. Bazi rawo kutekeshera fascia Lata uye akakamurwa zviduku kubva mukati yehudyu, kusvika popliteal fossa.

Sciatic tsinga nekuguma, chikamu sacral uye lumbar plexus, ndicho chikamu chikuru bazi muviri womunhu uye akakodzera vainyatsotarisirwa. Kuburikidza makomba Subpiriforme tsinga haazotaurwizve chiuno, pamwe nedzimwe tsinga (nechepazasi buttock, pabonde, posterior femoral cutaneous) uye sciatic tsinga, rinotungamirirwa pasi. Nehasha maererano mwoyo madhayamondi kuumbwa kuti shure ibvi, rakakamurwa matavi vaviri tibia uye fibula kwose.

tibial bazi

Zvinonzi akatungamirira vertically pasi kurutivi soleus golenopodkolennogo chiteshi. Mumazana kureba kwayo etsinga rinokamukana kupinda mapazi akawanda. Vamwe vavo vane yakakodzera Misoro matatu nemhuru tsandanyama, mumwe kutungamirirwa refu flexor tsandanyama fibers minwe uye hombe toe. Kune avo vari chokuita pasi uye rinosimudzwa tsandanyama.

Chinonyanya nzwisisa magumo dziri sacral uye lumbar plexus, chokuita Kamudzira iri ibvi muhudyu, interosseous Kamudzira repasi gumbo, neketani, Shin mapfupa. Kudeuka bazi tibial bazi vasanonoka ndiyo medial cutaneous etsinga kuti caviar. It ngaubve bazi iroro uye akatuma pasi ganda nomumativi dzakarukwa caviar cutaneous tsinga, izvo zvinozoita kunobva vanhuwo peroneal etsinga.

Mubayiro kwemapazi pakati zviteshi zviviri ndiyo paumbwe sural etsinga. Akatanga akabata kurutivi neketani uye anofambisa achitevedza lateral kumahombekombe norutsoka. Panguva ino akanga atova akadana lateral dorsal cutaneous tsinga mhosva innervation ganda munzvimbo idzi.

Total peroneal bazi

It anoenda zvishoma kure pamitsipa fibula panzvimbo yacho popliteal fossa. Kuramba pamwe lumbar plexus uye awo, zvinokosha kuziva kuti panguva iyi yokupedzisira rakakamurwa mapazi maviri:

• nhema;
• zvakadzama.

Pamusoro tsinga pasi. Ndiye anokonzera innervation pamusoro pfupi uye refu peroneal tsandanyama. Paakabva gwara ichi, tsinga inoenda rwemberi kurutivi rutsoka, apo inokamura kupinda medial uye zvenguva shure ganda kuvhara.

The medial tsinga rinopiwa anenge ganda seri rutsoka pedyo kwayo divi unopinza, uye seri ganda 2 3 minwe. For cutaneous innervation rwemberi divi hukawanika 3, 4 uye 5 rinoenderana zvenguva minwe cutaneous tsinga nemagumo.

Deep tsinga anopinda pamberi hwomukova intermuscular septum tibia uye anoteverwa homonymous tsinga anongovangira pasi. tsinga runoparadzanisa pachiyero rezasi gumbo kuti harinzwi mashoma kuti kubatanidza tibialis Anterior tsandanyama uye refu tsandanyama ari zvigunwe. Inenge iri kumuganhu wokutanga vanoshingaira intertarsal pakakoromoka rearmost tsinga ine mbiri mapazi kuti innervate ganda pose nomunwe 1 uye 2.

pathological ezvinhu

Chimwe ndicho zvirwere akakundwa lumbosacral plexus, iyo chokuita kusunga kana kukanganisa pamusoro sciatic etsinga. Panyaya iyi, chikamu chikuru etsinga iri compressed, kukonzera rutsoka simba marwadzo. Inenge nguva dzose zvokurwara kunoitika chete rumwe rutivi, uye kashoma kumbowanikwa maviri ane mativi chimiro. Hono hafu yevanhu iyo basa unesungano rinorema mumuviri basa, zviri padunhu ngozi nzvimbo.

Mukurapa, maperembudzi kunzi Sciatica, panguva nechirwere anogona semhosva Sciatica , kana Sciatica. zita iri rinobva mushoko rechiGiriki «ishia», zvinoreva "chigaro." The sciatic tsinga muchiLatin anonzi saka - nervus ishiadicus.

symptomatology

Huru chiratidzo unonongedzera kukunda lumbar plexus vane simba kurwadziwa magaro nemakumbo, zvinogona kuitika mune kuratidzwa siyana. Kazhinji, kana kurwadziwa ichi rwakasimba chaizvo zvokuti munhu anorasikirwa kuziva. Mune zvimwe zviitiko, marwadzo inogona kutsva, kubaya kana achicheka zvakasikwa. Zvinogonekawo zviratidzo:

• Akarurama Nzvimbo hazvibviri kuti kuvimba vakuvara gumbo uye pokuva kutarisa kuti hwomutambarakede chinzvimbo.
• Marwadzo anouya kunyanya usiku, kunyanya pashure kushanda kuchitonhora.
• Mune zvimwe zviitiko, zvokurwara iri kutanga kuona necheseri divi yehudyu, uye ipapo anouya gumbo uye netsoka.
• Kana uchidisa kuva imwe chete nzvimbo (nhema, agere), marwadzo kunowandawo, zviri kwakaonekawo panguva refu kufamba.
• Sneezing, vangakosora, achiseka, zvakare, kutsamwisa marwadzo.
• Pamusoro kugamuchira kugadzirira yakakodzera kana pashure kuderera residual marwadzo kurwiswa zvakaitika loin.

Kazhinji pinched nomuzongoza lumbosacral plexus kupinda pasina uye kungaita kuti gait rikavapo uye kukonzera vangadikitira dzemumakumbo. Unogonawo kunzwa tingling kana kutsva manzwiro norutsoka uchingodzikira gumbo. Kazhinji panguva imweyo nokuda chirwere ibvi kunodokuva kusingabviri vanobwembura. The chete zvinogona kutaurwa pamusoro nezvigunwe uye tsoka chisingazivi tenderera.

Diagnostics

Kuona kukuvadza sciatic etsinga kuchabatsira zvakajeka kunotoda mufananidzo, iyo inorondedzera murwere pane mabiko panguva chiremba. Chero nyanzvi Uchaona changing hunhu mudzira hunenge, uye aikanganiswa kurutivi uko murwere anonyunyuta. Dzimwe nguva, kuongorora kwokutanga haibvumiri kuongororwa yakarurama chirwere yakabuda. Muchiitiko chino, dzimwe ongororo anodiwa, pakati zviri:

• Maekisirei;
• computed tomography;
• MRI;
• Ultrasound;
• radioisotope Ongororo yacho nomuzongoza.

Nokuda CT, inova uwane X-ray nzira, kunyange kuchinja kuduku vari nomuzongoza anogona kuonekwa.

Asi mune zvimwe zviitiko, kana kudzidza iri contraindicated, chiremba prescribes MRI of lumbosacral plexus.

mabatiro

Kuti kubvisa zvokurwara akareva rimwe kurapwa mbiri - kuchinja kana kushanda. Asi nguva dzose kutanga nzira yokutanga, iyo inosanganisira zvakawanda zviitiko zvakasiyana. In chenjera Sciatica yakarumbidza mubhedha zororo iri zvakasimba metiresi ine zvishoma kurovedza muviri uye kudya. Unofanira kushandisa ushamwari, kwete Spicy, kwete aisvuta uye kwete grilled, kunyanya emura zvokudya (nyama muriwo soups uye mukaka Porridge).

Drug kurapwa kunosanganisira rokutarisira zvinodhaka, chairayirwa kupinda chiremba. Panongotanga marwadzo anotanga taramuka, zvinoratidza physiotherapy. zviitwa All vanosarudzwa zvichienderana yezvakaita chirwere.