Plexus khomo lachiberekero ndi nthambi zake: kapangidwe ndi ntchito

N'zovuta Musaone tanthauzo ndi kufunika kwa plexus khomo lachiberekero. nthambi zake anathamangitsidwa mbali ya minofu kupuma ndi kuonetsetsa kugwilizana ndi kutchulidwa ntchito minofu ya m'khosi. Choncho, kudwala wa plexus khomo lachiberekero ntchito yofunika mododoma.

thunthu

Khomo lachiberekero plexus ndi wophatikizidwa ndi zovuta popangidwa ndi nthambi kutsogolo kwa chapamwamba khomo lachiberekero msana mizu mitsempha. nthambi zake lowonjezera ndi zingwe zopota atatu arcuate interconnecting akapunthwa kupanga plexus.

Magwero ena kuphatikiza ndi phewa wopangidwa mwa theka m'munsi mwa khomo lachiberekero mizu mitsempha ndi awiri chapamwamba thoracic. Mu zinthu zimenezi otchulidwa cervico-brachial plexus wopangidwa mwa msana misempha khomo lachiberekero zigawo msana, ndi awiri chapamwamba thoracic misempha msana.

zimachititsa chilumbachi

Kudziwa zimachititsa chilumbachi wa plexus khomo lachiberekero kumathandiza kumvetsa zimene matenda zimalambira kukanika a mizu yake. Kwa akatswiri, nkhani imeneyi ndi ofunika kwambiri chifukwa, podziwa ziyerekezo wa plexus, ndi kosavuta kupewa kungasokoneze iye pa njira zosiyanasiyana mankhwala.

Khomo lachiberekero plexus ili pa mlingo wa pamwamba vertebrae anayi a msana khomo lachiberekero. Akulalikidwa ndi mbali lateral ndi kutsogolo sternocleidomastoid minofu, izo chili ndi kutsogolo mbali ya gulu la minofu kwambiri khosi.

Kapangidwe ndi Limagwira

Popeza khomo lachiberekero nthambi plexus ali onse afferent ndi efferent ulusi mitsempha, iwo ntchito ngati ntchito yovuta galimoto.

Choncho, ndi kugonjetsedwa kwa nyumba ya plexus khomo lachiberekero adzavutika madera awiri amenewa.

nthambi za galimoto

Akulu kapena galimoto misempha khomo lachiberekero plexus, nthambi kufupi ndi minofu khosi, zotsatira mu gulu lawo; ndi kuwonjezera, mbali mu mapangidwe otchedwa khosi zingwe zopota ongokhala kutsika nthambi ya mitsempha hypoglossal , ndi ulusi mitsempha, anakafika ku muzu wa mitsempha plexus. Ntchito yake innervation minofu, zomwe zili pansi ndi ulemu kwa fupa hyoid.

Tiyeneranso munanena kuti, ndi trapezoidal, ndi minofu sternocleidomastoid amadziwikanso innervated ndi ulusi mitsempha, anakafika ku galimoto muzu wa plexus khomo lachiberekero.

poona dipatimenti

Tcheru khomo lachiberekero plexus innervation amaperekedwa ndi otchedwa khungu nthambi zake, kutanthauza lalikulu khutu mitsempha, mitsempha yaing'ono occiput yopingasa khomo lachiberekero ndi supraclavicular misempha.

phrenic mitsempha

Izi ndi nthambi ina ya plexus khomo lachiberekero, amene ali mbali chidwi: monga mbali ya mitsempha phrenic ali ndi galimoto CHIKWANGWANI, nthambi mu zakulera ndi kuzipangitsa kuti asamuke, ndi zowopsya, kupereka innervation kwa pericardium, pleura ndi peritoneum.

mitsempha ichi chimatengedwa ngati nthambi yofunika kwambiri anthu kuti apange plexus khomo lachiberekero, motsogoleredwa ndi chifundamtima, ndipo zivute zitani kumabweretsa imfa paresis kabowo osiyanasiyana mwamphamvu kapena ziwalo. chikhalidwe otere kukomoka akuwonetseredwa kulephera kupuma, mpaka aakulu ake.

Nthawi zina, pamene wathuyo plexus khomo lachiberekero, makamaka, phrenic mitsempha kudwala kuwawonetsera khunyu clonic mu chifundamtima, amene kunja kuoneka ngati hiccup a.

kotunga magazi

Ndiwo nyumba mphamvu ya kumtunda kwa msana khomo lachiberekero ndinu nthambi wamng'ono wa mtsempha wamagazi vertebral, amene kutenga chiyambi kuchokera mtsempha wamagazi ndi subclavian, limatuluka pamodzi msana mmwamba, nalowa M'mimbamo cranial, ndi kupereka m'litali nthambi lonse ntchito yobweretsa magazi kwa nyumba anatomical a msana khomo lachiberekero.

The kudwala wa plexus khomo lachiberekero

Zizindikiro za plexus khomo lachiberekero kuonekera mu mawonekedwe a thupi, kwenikweni ndi matenda trophic. zovuta kumvetsa chifukwa cha osakaniza zizindikiro mu mapangidwe ulusi mitsempha ndi ntchito zosiyanasiyana. Kuphwanya zokhudza malamulo, amene amapereka nthambi kuti innervate plexus khomo lachiberekero. Anatomy ndi chotero kuti ndi kugonjetsedwa kwa aliyense mizu zowawa ntchito zonse zitatu.

kuvulala zotheka

1. Vutoli, monga dislocation kapena subluxation wa vertebrae khomo lachiberekero, kusupuka kapena kuvulala neonatal kubadwa.
2. The psinjika syndrome mu psinjika neoplasm, zidutswa fupa, hematoma kapena bandeji (ngati molakwa kukopedwa nthambi immobilization).
3. Opatsirana ndi yotupa zotupa kuti akhoza kukumana plexus khomo lachiberekero wa misempha msana pambuyo matenda (nsungu matenda, chimfine chotupa, zilonda zapakhosi, chindoko).
4. Otani etiology wa plexitis khomo lachiberekero. Chotero chimake ndi zotheka ndi zotupa nkhanza mwadongosolo mowa, kapena nkhani ya poizoni heavy.
5. Aakulu hypothermia (hypothermia) zingachititse kutukusira kwa mitengo ikuluikulu ya mitsempha.
6. Matupi awo sagwirizana kapena autoimmune kugonjetsedwa pamene chikoka aukali maselo chitetezo cha m'thupi molakwika anatumiza kwa mwini mantha minofu wake wa thupi.
7. matenda aakulu zokhudza zonse zimene zingawatayitse kutupikana wa makungwa mitsempha.

mawonetseredwe

Pakati zotupa ndi matenda a plexus khomo lachiberekero tingaone:

• Unilateral.
• Amgwirizano.

Nthawi zonse pamene infestation ndi plexus khomo lachiberekero nthambi, yodziwika ndi mota, kwenikweni ndi matenda trophic wa innervation mu zone ya ziwalo. Kudwala akudutsa mu mbali yake lotsatira chitukuko:

• Neuralgic siteji. Mawonetseredwe kugwirizana ndi mkwiyo wa makungwa mitsempha. Childs ndi pachimake isanayambike ululu mu maonekedwe a mbali m'munsi mwa nkhope yochokera kwa khutu ndi occipital dera, komanso kusokonekera yochokera kwa dzanja kufikira mosavuta pa. Kutanthauzira ululu Chofanana mbali akhudzidwa. ukuwonjezeka odwala kwambiri ndi kayendedwe yogwira ndi chabe; m'moyo wa mtendere zingabweretse mpumulo, koma ululu pa mpumulo, ndipo ngakhale usiku, si kutha kwathunthu. Ululu limodzi ndi paresthesia, kuzirala kwa khungu matenda ndi kutentha tilinazo mu zone innervation anakhudzidwa muzu mitsempha.
• Manjenje siteji. Gawo paresis ndi ziwalo (malinga ndi kukula kwa zotupa) amakhala ndi zizindikiro za misempha khomo lachiberekero dysfunctions apanga plexus khomo lachiberekero. Chifukwa zotupa za mitsempha phrenic ndipo adamsunga hiccups, chifukwa cha kusowa kugwirizana minofu, amavutika ndi kuyan'anila expectoration; matenda a mawu, kupuma - mpaka kufupika kwambiri chifukwa cha mpweya ndi Zikavuta, matenda kupuma, mpaka kulephera kupuma. matenda Trophic chifukwa kutupa ndi bluish coloration wa khungu, kusintha turgor awo; Komanso, mkhutu thukuta kwa mtima wake. A nthawi yaitali matenda amatha kutsogolera kusintha atrophic minofu ya lamba phewa, zotsatira mu mapangidwe zina ndi kabwerebwere dislocation wa phewa olowa; kapena ziwalo za nyama za khosi, mwamphamvu kwambiri chifukwa cha imbaenda imfa ya minofu khomo lachiberekero amatha kugwira ntchito zawo: mutu wodwalayo mu Zikavuta akhoza kutsamira kutsogolo kuti chibwano ndi pafupi sternum lapansi. Amenewa zotupa kwambiri yogwira kuyenda kupyolera minofu anakhudzidwa sizingatheke; paokha kukweza mutu wake wodwala.
• Kuchepetsa sitepe. Pa nthawi imeneyi, matenda a ntchito mantha kuyamba pang'onopang'ono achire. Nthawi zina, kuchira unkachitika chosakwanira, ndi zochitika yotsalira mu mawonekedwe a paresis kapena ziwalo za zotumphukira-mtundu (authunthu waulesi), ndi kusintha atrophic minofu (mawu a matenda a zotsatira yotsalira mu mawonekedwe a paresis zotumphukira ayenera kukhala ndi kumasonyeza wathuyo mitsempha mizu).

Zotsatira yotsalira:

• Aulesi (zotumphukira) paresis kapena ziwalo za nyama khosi ndi phewa lamba, kabwerebwere dislocation wa olowa phewa ndi khalidwe mutu kaimidwe chifukwa minofu ofooka khosi.
• Matenda a minofu kamvekedwe; omangana ndi spasms mu nthambi ya khomo lachiberekero plexus innervated minofu magulu.
• msokonezo kwenikweni mu mawonekedwe a paresthesias ndi ululu hypersensitivity m'dera la imalandira innervation plexus.
• matenda Trophic wa khungu ndipo zimakhala zofewa okhala m'madera okhudzidwa.

mankhwala ochititsa dzanzi

Khomo lachiberekero plexus ochititsa dzanzi amalola opaleshoni pa khosi, chithokomiro, gulu zoopsa Mitsempha brachiocephalic, gunshot mabala, khansa.

Popeza khosi kutsogolo pa apakatikati mzere khomo lachiberekero nthambi plexus anastomose, ochititsa dzanzi tcheru mizu kumbuyo m'mphepete sternocleidomastoid minofu ikhale ndi mbali zonse. Zimenezi zimathandiza kuchita ochititsa dzanzi kuphatikizapo zikunena lalikulu pa zigawo zakuya za zimakhala za khosi (kuphatikizapo laryngectomy, kuchotsa zotupa khansa).

Kuti tiyambe zotsatira za nthambi mankhwala oletsa ululu wa plexus khomo lachiberekero, analola zina Letsani pamwamba pa nthambi mitsempha, akuyang'ana kutsogolo kwa khosi.

Kuchita mwai onsewa ochititsa dzanzi anachita njira zapambuyo, kuyambira ntchito mwayi lateral (jekeseni wa njira mankhwala ochititsa mu danga subdural) amagwirizana ndi Mwina mkulu wa mavuto ndi m'malo lalikulu, kotero njira ya mwayi lateral, chifukwa pogwiritsa ntchito nkhani.