Matenda a Nthenda ndi Kubwerera Kumbuyo
Mitsempha yambiri yomwe imatumiza uthenga kuchokera ku ubongo umatulutsira uthengawo kudzera mu msana wamkati, womwe uli mkati mwa chitetezo cha vertebrae , pakati pa mazenera (foramina) omwe amalola kuti mizu ya mitsempha ifike. Mitsempha imeneyo imapitiriza kupanga dongosolo la mitsempha ya phokoso.
Nthawi zina mizu ya mitsempha imatha kupanikizidwa ndi kukula kochokera ku vertebrae, kapena kutuluka kwa vertebra imodzi kumbali inayo kumachepetsa kutsegula (foramen) kumene mitsempha imathamanga.
Izi zikachitika, mizu ya mitsempha yavulala mu zomwe zimatchedwa radiculopathy . Zotsatira zake zimasiyana, malingana ndi malo a mitsempha.
Anatomy ya Spinal Column
Ngakhale kuti pali kusiyana pakati pa anthu, mbali zambiri, tonse tiri ndi vesi 7 m'khosi mwathu, wotchedwa cervical vertebrae. Pansi pazi ndizomwe zimagwiritsidwa ntchito ndi nthiti, ndiyeno zisanu zowonjezereka. Lumbar vertebra yomaliza imaphatikizidwa ndi sacrum, fupa lalikulu lomwe limathandiza kupanga mapangidwe a pakhosi.
Mitsemphayi imadulidwa mpaka nambala ndi kalata, kuwerengera kuchokera pamwamba pa msana mpaka pansi. Mwachitsanzo, C5 imatanthauza mtundu wachisanu wa vertebra wam'mimba kuchokera pamwamba pa msana. T8 amatanthawuza 8th thotic vertebra pansi kuchokera ku C7 (wotsirizira ya pervicra vertebra).
Kawirikawiri, mizu ya mitsempha imatchulidwa ndi fupa pamwamba pawo. Mwachitsanzo, mizu ya mitsempha yomwe imachoka pakati pa 4th ndi 5th Lumbar vertebrae idzakhala yotchedwa L4.
Mitsempha ya chiberekero ndi yosiyana, komabe: ngakhale kuti pali mitundu 7 yokha yamtundu wachiberekero, pali mitsempha 8 ya mitsempha ya chiberekero, yoyamba yomwe ilipo pamwamba pa mimba yoyamba ya versabra. Kotero mu khosi, mitsempha imatchulidwa pambuyo pa ma vertebrae pansi pawo. Pofuna kumveka bwino, nthawi zambiri ndi bwino kufotokozera mizu ya mitsempha mwa kufotokoza ma vertebrae, mwachitsanzo (C7-T1), koma madokotala ambiri samachita izi tsiku ndi tsiku.
Mtambo wa msana wokha umatsikira ku L1 mwa akuluakulu, kumene umathera mumtundu wotchedwa conus medullaris. Mitsempha imapitirizabe kugwedezeka kuchokera pansi pano, komabe, ikuyandama mu sac ya cerebrospinal fluid. Mitsempha imeneyi imatchedwa cauda equina, Chilatini kuti "mchira wa kavalo," yomwe mitsempha yotayirira imakhala yofanana mpaka itachoka ku foramina pakati pa maluwa otchedwa lumbar vertebrae.
Zizindikiro za Radiculopathy
Mzu uliwonse wa mitsempha umene umachokera mumthambo wa msana umanyamula mauthenga ochokera ku ubongo kuti apange minofu inayake kusuntha, ndipo amalandira mauthenga ochokera kumadera ena a khungu. Chifukwa cha izi, n'zotheka kudziwa kuti pamakhala chiwonetsero cha radiculopathy, chifukwa cha zizindikiro zomwe zakhalapo. Kuwonjezera pamenepo, radiculopathies nthawi zonse zimakhala zopweteka, pomwe mavuto ambiri a mitsempha sali.
Mankhwala ambiri a radiculopathies amayamba chifukwa cha kusintha kwachinsinsi m'makina a chigoba. Mphuno ya thoracic imaletsedwa kuti isasunthike kwambiri chifukwa imakhala yozikika ndi nthiti. Pachifukwachi, radicipathies yowonekeratu kwambiri imapezeka mumtundu wa khomo lachiberekero komanso mphalapala.
Cervical Radiculopathies
Mitsempha yomwe imachokera mu khosi la msana pamtambo imachokera ku vertebral foramina kupanga mapangidwe a intermixing otchedwa brachial plexus.
Kuchokera kumeneko, mitsempha imapitirizabe kusungunuka khungu ndi minofu ya mkono. Zolinga zenizeni, mizu yofunika kwambiri m'mitsempha ndi C5, C6, ndi C7. Ndikoyenera kudziŵa kuti pafupifupi 20 peresenti ya radiculopathies yachibelekero ili ndi magawo awiri kapena kuposa.
C5: Deltoid (minofu ya m'mapewa imene imakweza mkono kuchokera mthupi) imakhala ndi mitsempha yochokera ku C5. Kuphatikiza pa zofooka za umphawi, radiculopathy izi zingapangitse kufooka pamapewa ndi kumtunda.
C6: C6 radiculopathy ingayambitse kufooketsa pa biceps ndi kutalika kwa mkono. Kuonjezerapo, pangakhale zovuta zowonongeka muzondandanda ndi zala zapakati, komanso gawo limodzi.
C7: Pafupi theka (46 peresenti) ya radiculopathies yonse ya chibelekero imakhudza mizu imeneyi. Kufooka kwakukulu kuli mu triceps minofu yomwe imawongolera mkono. Pakhoza kukhalanso kutayika pang'ono m'mbali mwa dzanja, monga mphete.
Lumbar Radiculopathies
Mitsempha yomwe imachokera ku neural foramina mu mphalapala ya lumbar imapanga mawonekedwe a lumbar plexus, aastomosis ovuta a mitsempha yambiri. Kuchokera kumeneko, mitsempha iyi imapitirizabe kusungunuka khungu ndi minofu ya mwendo.
L4: Iliopsoas , yomwe imasinthasintha mchiuno, ikhoza kukhala yofooka, monga momwe ma quadriceps angatetezere mwendo paondo. Bondo limodzi ndi gawo la m'munsi mwendo likhoza kukhala losawerengeka.
L5: Kukwanitsa kukweza mfundo ya phazi pansi kungathe kuchepetsedwa, ndipo pamwamba pa phazi likhoza kusweka. Mizu imeneyi imakhudza pafupifupi 40 mpaka 45 peresenti ya radiculopathies ya lumbosacral.
S1: Kukwanitsa kulunjika phazi pansi (ngati kuti mutayima pa tiptoe) ndifooka, ndipo pangakhale phokoso la chala chaching'ono ndi phazi limodzi. Mitsempha imeneyi imakhudza pafupifupi 45 mpaka 50 peresenti ya radiculopathies ya lumbosacral.
Tangopenda kumene kutuluka kwa mitsempha yomwe imachokera mu msana wa msana. Pamene takambirana za zizindikirozi, sitinayambe kufufuza zovuta zosiyanasiyana za matenda a mphuno kapena mankhwala awo. Ngakhale kuti ululu wambiri wammbuyo umachoka paokha, ngati zofooka zikukula, ndizisonyezero kuti mankhwala oopsa angapitirire.
Zotsatira:
Otsatira AR, Sander HW, Clinical Approach to Peripheral Neuropathy: Kufufuza kwa Anatomic ndi Kuyeza Kufufuza. Kupitiliza; Vesi 18, No 1, February 2012
Blumenfeld H, Neuroanatomy kupyolera m'zipatala. Sunderland: Sinauer Associates Publishers 2002