Mawu ogwirizanitsa amagwira ntchito zambiri mupoti la zotsatira za maphunziro azachipatala ndi kafukufuku. Ochita kafukufuku amalankhula za ntchito yogwirizana komanso momwe imakhudzira matenda, monga nyamakazi , kapena mankhwala a nyamakazi. Kodi ntchito yowumikizana ndi chiyani?
Zogwirizana ndi Ntchito Yogwirizana
Mgwirizanowu umatanthauzidwa ngati malo omwe mafupa awiri kapena angapo amabwera palimodzi pofuna kuyenda kapena kukhazikika.
Kusiyanitsa kwa minofu kudutsa mgwirizano kumayambitsa kusuntha. Ntchito yodziwika bwino imatanthauzidwa ngati mphamvu yogwirizana kuti isunthe kuyenda kwake konse, kulemera ndi kugwira ntchito.
Madokotala ndi othandizira opaleshoni amaphunzitsidwa ku anatomy ndi physiology kuti adziwe momwe mgwirizano weniweni uyenera kuyang'ana ndi kuchita. Iwo amadziwa momwe thupi limagwirira ntchito, minofu, mitsempha, mitsempha, mitsempha, ndi magazi omwe amagawana nawo. Zonsezi zingasonyezedwe muzithunzi ndi dissecting cadavers. Koma kupyola apo, amayenera kudziwa momwe ntchito yowonjezera imagwirira ntchito. Izi zimaphatikizapo kutali komwe ziyenera kusinthasintha, kuwonjezera kapena kusinthasintha. Kukhoza kulemera kapena kukana kukakamizidwa kutsutsana ndi zochita za mgwirizano ndi mbali zina za mgwirizano.
Kuwona Ntchito Yogwirizana
Mukapita kwa dokotala ndikudandaula za mafupa, minofu kapena ophatikizana, adzayesa kufufuza minofu yomwe imaphatikizapo kuyesa ntchito yogwirizana.
Ntchito yowonjezereka ingakhudzidwe ndi kuvulala kapena kutupa, kotero iye adzayang'ana kufiira, kuvulaza, ndi momwe zikufananirana ndi mgwirizano womwe sukhoza kuvulazidwa. Kodi ali ofanana kukula ndi mawonekedwe?
Dokotala atha kuti wodwala asunthire mgwirizano kudzera mu kayendetsedwe ka kayendetsedwe kake-kusintha, kutambasula, kuzungulira.
Adzagwiritsanso ntchito mgwirizano kuti awusunthire. Pazochitika zonsezi, amayang'ana zoletsa pazomwe akuyenda komanso ngati pali ululu uliwonse panthawiyi. Amagwirana manja pamagulu kuti azimva za crepitus (kuseka) akuwonetsa kuwonongeka kwa mgwirizano. Adzachita mayesero ena enieni omwe akuganiza kuti akuvulala. Amayang'ana momwe wodwalayo angatetezere kayendetsedwe kake.
Chitsanzo cha Ntchito Yophatikiza Yoyesayesa Ayesa
Njira zosiyanasiyana zoyendetsera mapepala zimaphatikizapo kutengako, kutambasula dzanja kutsika pansi, kumbali ndi pamwamba pa mutu mu arc, ndi kupima kuyesedwa ndi mikono kutsogolo ndikukwera pamwamba pa mutu, mwachibadwa kuyambira 0 mpaka 180 madigiri. Kutengeka ndi kusinthana kwa mkati ndiyeno kutengako ndi kuzungulira kunja kumayesedwa ndi mkono umodzi poyamba kufika kumbuyo kuchokera pansi ndiyeno kuchokera pamwamba. Mayesero ena akuphatikizapo mayesero a Neer's and Hawkin's test for impingement ndi mayesero a Empty Can and Gerbers Liftoff kwa kuvulala kwa katemera.
Chitsanzo cha Kafukufuku Wothandizira Wophatikiza
Kwa bondo, dokotalayo amayang'ana wodwalayo kuyenda ndikuwona ngati pali chiwindi, chomwe chingawonetse kuti ntchito yowonjezera ili yovuta. Dokotala adzayang'ana wodwala ataimirira kuti aone ngati miyendo yoweramitsidwa kapena kugogoda ( varus vs. valgus deformity ) yomwe imasonyeza ntchito yovuta ya bondo.
Momwe wodwalayo amachokera pa mpando ndipo ngati angathe kukwera masitepe amasonyezanso ntchito yogwirizana. Wodwala amatsika, ndipo adokotala amamuguguda, zomwe ziyenera kuwonjezera madigiri a zero ndikutha kusintha mpaka madigiri 140 ndi ntchito yogwirizana. Dokotala nayenso amaweramitsa bondo.
Kuyesedwa kwina kwa ntchito yogwiritsira ntchito mawondo kumaphatikizapo kuyesa kwa McMurray ndi Appley Grind Test kwa meniscus kuvulaza kwapakati, kuyesedwa kwapakati pazowonongeka ndi mgwirizano wapakati, kuyesedwa kwa Lachman kwapadera, kupima kwapansi ndi mayeso a chondromalacia.
Zotsatira:
Musculo-Skeletal Examination, University of California, San Diego, October 2015.
Buku la Merck, Consumer Version, 2015.