Anatomy: plexus lumbar amagatsha awo

Emizimbeni yethu akukho engadingekile - Mother Nature anakekela kahle. Nakuba, njengoba kwaphawula u-abanye, umzimba ezifana esithasiselweni, kwaba ezinenani elincane, futhi kungenzeka ukuthi uphila impilo egcwele ngaphandle kwalo. Kodvwa umbuto akusho ukuthi, futhi mayelana indima ebalulekile eyadlalwa plexus lumbar, noma plexus lumbalis. It sigxile yinhlanganisela kwalapho ukhalo futhi emikhawulweni aphansi.

izinqubo ukuvuvukala kule ndawo ahambisana neuralgia, ohlanganisa ingxenye engezansi yomzimba. Ngokuvamile ngesikhathi esifanayo kukhona izinhlungu. Ukuze uqonde ngokucacile ukuthi ungawukhipha kanjani izinqubo sokugembula kudingeka babe nolwazi anatomy womnyango.

definition

plexus lumbar iqoqo izinhlobo eziningana izinzwa. Ngo lasungulwa iqhaza kuqala imizwa ezintathu umgogodla. Ngokwengxenye lapha Ungase futhi zakha emagatsheni 12 thoracic futhi 4 legatsha emsipheni umgogodla. Elikhulu imisipha Imicu yotshani kuyindawo lapho plexus lumbar itholakala. Anatomy Kuhilela ukuthola amagatsha ezinzwa phambi izinqubo transverse of amathambo lumbar.

Lezi imizwa banesibopho ezithile innervation kwemisipha endwangwini, kuhlanganise isikhumba peritoneum. Ngaphezu kwalokho, zihlotshaniswa ebusweni isikhumba Izitho zangasese zangaphandle, ebusweni medial we tibia, eyimfanelo anteromedial senyonga. Ubude kulesi sigaba kukhona izinhlobo eziningana eziyimpumelelo emsipheni:

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

Cabanga okunye okuncane mayelana lokho abayikho kanye lapho amanga. Evamile, bonke izinzwa zingahlukaniswa ngamaqembu amabili alinganayo.

Eyokuqala nezinzwa ezintathu

ezinzwa Iliohypogastric we plexus lumbar akhiwa ngaphambili ubambo 12 nokukodwa lumbar amagatsha emsipheni. Kusukela kubo baba idlule imisipha psoas, bese mbeni ebusweni phambi lumborum quadratus, ngokuba ngakho eduze izinso. Ngaphezu kwalokho ezinzwa esiqala phezulu kuya phansi, ukugcina kwawo emuva uye phambili. Endleleni eya Crest iliac igcwala transverse imisipha besisu bese itholakala phakathi kwaso yangaphakathi etshekile besisu imisipha zesivikelo sesifuba. Indlela okwengeziwe isivele phakathi imisipha emibili etshekile.

Ngo ezijulile indandatho inguinal ezinzwa iliohypogastric futhi lingena yangaphakathi imisipha etshekile futhi umsipha ipuleti ezibanzi yangaphandle imisipha etshekile. Ngemva kwalokho, amagatsha ku ezihlobene cutaneous udonga besisu ngaphezu symphysis pubic. imisebenzi yaso zihlanganisa innervation iningi imisipha esiswini. Futhi ihlolwe nezinzwa esikhumbeni eqolo, buttock, anterior udonga besisu ngaphezu pubis.

Enye legatsha, lapho evela phambi impande emsipheni, kodwa kancane kuka owedlule, ngokuthi ilioinguinal emsipheni, futhi kufakwe plexus lumbar. Anatomy of amadoda ayengaphansi kwakhe nabo abesifazane zihlukile. A ubulili ezinzwa eqinile sidlula umsele inguinal futhi uqalisa amagatsha amancane cutaneous kuwo womabili evele senyonga eduze scrotal ezinzwa. Kugcine obangela innervation kwesikhumba wenduku futhi scrotum ngokwengxenye. Abesifazane ukuphela efanayo isimiso sezinzwa esiyinhloko lihlotshaniswa isikhumba pubis futhi labia izindebe.

Femoral-ubulili ogcwele kakhulu psoas ngisho ihlukaniswe amagatsha amabili - i ngokobulili ithanga. Zaphansi, ngaphandle kwalokho okuthiwa njengoba emsipheni imbewu iqondiswe bathele, njengoba intambo spermatic sidlula umsele inguinal. Esikhathini wesilisa, ihlobene imisipha, okuyinto unomthwalo nokuvusa amaqanda, isikhumba scrotum, kanye igobolondo esinamanzi kanye ebusweni isikhumba verhnemedialnoy hip ndawo. Zabesifazane lumbar plexus is ngokufanako - emsipheni yombhangqwana nge umsipha esiyindilinga esibelethweni umsele inguinal bese ithunyelwa ebusweni isikhumba majora labia.

Igatsha wesibili femoral lokhu Ukuvalwa ezivamile zibheke phansi futhi uya ohlangothini zangaphandle iliac Umthambo ngokushesha ngezansi umsipha inguinal. Ngezansi ezinzwa yayo ihlukane amagatsha ithanga isikhumba ebusweni.

Eyesibili nezinzwa ezintathu

Ngezansi kunohlu zonke izinzwa ezintathu amagatsha amathathu emikhulu. Lokhu lateral, femoral futhi obturator izinzwa. Uhlu lokuqala itholakala ohlangothini we umsipha inguinal. Kungaba phezu noma ngaphakathi imisipha sartorius, kuyilapho ngaphansi zezinzwa izicubu emgodleni. Emsipheni unesibopho nozwela ohlangothini evele of ezinqeni kancane okwengeziwe trochanteric hip amathambo sekusondele ebusweni lateral ka kunawo wonke.

Ukuqhubeka ukuhlwaya kwakhiwa kahle indlela plexus lumbar is, kubalulekile ukuya emsipheni obturator. Uya phansi kanye imisipha psoas, ngokunembile, emphethweni waso futhi endaweni okhalo. Ukujoyina isimiso sokujikeleza kwegazi, kuziwa kanye izitsha esifundeni femoral we-canal obturator, esukela Intermedia adductors. Emsipheni lihlotshaniswa iqembu adductors, nedolo hip amalunga omzimba. Futhi ezinzwa innervates ubuso engxenyeni phakathi kwethanga eduze kwedolo.

Kuzo zonke legatsha femoral we plexus lumbar iyona enkulu kunazo zonke. It kuvela emngceleni owesihlanu vertebra okhalweni egameni efanayo kwezintambo zesivikelo sesifuba kwemisipha. Ukuya ngosiko lateral imisipha, emsipheni ingezansi phakathi kulawa amanye amaqembu amabili imisipha: i-lumbar futhi iliac, Ukucwiliswa igobolondo zokugcina.

Coming ngaphansi umsipha inguinal, lumbar plexus nezinzwa zihlukaniswe amagatsha eziningi ezihlobene isikhumba nemisipha phambi hip, nedolo hip amalunga omzimba.

yingxenye yalo lonke

Lumbar kwalapho bayingxenye ngohlelo olubizwa ngokuthi i "plexus lumbar-sacral." Amagatsha lumbar, sacral, neminyango coccygeal, kwahlanganiswa omunye nomunye ukwakha plexus ezimbili eziyinhloko: lumbar futhi sacral. Njengoba ngangingalazi leli gama lokuqala manje kucace, kungashiwo komunye definition.

Ngo obumba plexus sacral (plexus sacralis) ithatha ingxenye phambi legatsha, okuyisona kusuka lumbar lesine nelesihlanu futhi owokuqala legatsha lwesithathu sacral umgogodla kwalapho kuhlangana khona imizwa. Ngokusobala lumbar plexus itholakala ukhalo ngqo zezinzwa izicubu emgodleni piriformis. Umelelwa ngesimo ipuleti obukhulu ukuma elingunxantathu, beyizidalwa eziphakeme kunazo zonke nozobamba maqondana Subpiriforme umqhewu.

Kumila unxantathu imayelana ukuvuleka okhalo. Ngesikhathi esifanayo ezinye plexus itholakala phambi sacrum, kanye nezinye - e piriformis phambi. Kuzo zonke izinhlangothi lizungezwe ezicutshini okuxekethile. Njengoba esifundeni lumbar, kukhona tiveta kwalapho ukuthi kungaba kokubili lamafisha.

izinzwa iDemo sacral

Dlala nezinzwa legatsha ukumela lokhu okulandelayo:

• gluteal (engenhla nengezansi);
• ubulili;
• obturator yangaphakathi;
• ipheya emise;
• ezinzwa ethangeni square kwemisipha.

izinzwa Gluteal plexus lumbosacral zihlukaniswe yasenhla nemithombo yasenzansi. Umsuka steamed nge gluteal Umthambo akube kusakhulunywa ngaye ingaphakathi okhalo nge nadgrushevidnoe ukuvulwa. Emsipheni lihlotshaniswa imisipha amancane naphakathi gluteal yemisipha exhunywe kwi-lata fascia. Lower emsipheni kanye Umthambo kokushiya Subpiriforme okhalo ngokusebenzisa imbobo futhi ixhunywe ku-imisipha gluteus maximus. Kodwa ngaphandle ukuthi ehlangene capsule we ngokuhlanganyela hip.

Ngembobo efanayo Subpiriforme ingaphakathi okhalo eshiya emsipheni pudendal, ohlangothini emuva Bypasses le ischium futhi uya ngqo fossa ischiorectal. Lapha-ke lihlukaniswa ephansi amagatsha rectal futhi isizalo. Ngaphezu kwalokho, owokuqala ziboshwe i sphincter kwangaphandle ingquza nobendunu isikhumba endaweni. Ngenkathi yokugcina banesibopho innervation kwemisipha isikhumba perineum futhi scrotum yomzimba besilisa. Kancane ehlukile ahlelwe zesifazane plexus lumbosacral. Anatomy ungachazwa ukuthi igatsha isizalo elihlobene ne-majora labia.

izinzwa Long sacral

legatsha Long kuhlanganisa:

• posterior ezinzwa cutaneous;
• emsipheni sciatic.

Posterior cutaneous ezinzwa isiphetho eshiya ukhalo ngu Subpiriforme imbobo, phansi eduze emsipheni sciatic. Posterior femoral ezinzwa cutaneous onqenqemeni engezansi maximus gluteus luhlukaniswe gluteal ephansi futhi isizalo amagatsha emsipheni. Igatsha aphansi innervates ephansi buttock isikhumba ebusweni.

Posterior cutaneous legatsha femoral sidlula inkatho Intermedia semitendinosus futhi biceps kwemisipha femoral. emagala aso igcwale fascia lata futhi ihlukaniswe yaba amancane ngaphakathi senyonga ukufinyelela fossa popliteal.

Sciatic ezinzwa siphetfo, ingxenye plexus sacral kanye lumbar, kuyinto yegatsha elikhulu umzimba womuntu ufanelwe ukuqashelwa okukhethekile. Ngokusebenzisa izimbobo Subpiriforme ezinzwa akube kusakhulunywa ngaye ukhalo, kanye nezinye izinzwa (buttock ephansi, ubulili, posterior cutaneous femoral) kanye Umthambo sciatic, iqondiswe phansi. Cishe ngokuvumelana ukucindezeleka okwedayimane ukuthi ngemva kwamadolo, ihlukaniswe yaba amagatsha amabili: tibia futhi fibula jikelele.

legatsha tibial

It is iqondiswe thwi phansi ngase isiteshi soleus golenopodkolennogo. Bonke ubude bayo emsipheni ihlukane amagatsha eziningi. Ezinye zazo yilezi ofanele emithathu ephethwe ithole imisipha, omunye iqondiswe flexor eside imisipha Imicu yotshani iminwe big uzwane. Kunalabo axhunyiwe nge phansi nasemathangeni.

Ukuphela sizwele kufakwe plexus sacral kanye lumbar, exhunywe ne capsule we ngokuhlanganyela amadolo, ulwelwesi interosseous we ephansi umlenze, iqakala, ithambo shin. Igatsha elikhulu egatsheni tibial ebucayi iyona medial ezinzwa cutaneous ka caviar. Isuka kusukela lelo gatsha futhi wathumela ngaphansi kwamanzi kwesikhumba futhi kwahlanganiswa caviar ezinzwa cutaneous, nakho livela ezivamile emsipheni peroneal.

Waba yini umphumela wesibindi nokuhlanganiswa terminals ezimbili Ukwakheka kwezitho emsipheni sural. Waqale labetibambile ohlangothini iqakala bese egobhoza margin lateral we unyawo. Kuleli qophelo wayeseboshwe ebizwa ngokuthi i-lateral amaphiko emsipheni cutaneous obangela innervation kwesikhumba kulezi zindawo.

Ubude legatsha peroneal

Lenza kancane entanyeni we fibula endaweni lapho fossa popliteal. Ukuqhubeka ne plexus lumbar namagatsha alo, kuyafaneleka ukuthi okwamanje wokugcina ihlukaniswe amagatsha ezimbili eziyinhloko:

• olukha phezulu;
• ezijulile.

Surface ezinzwa phansi. He is obangela innervation kwemisipha peroneal lamafisha. Lapho esehamba kulesi siteshi, nerve uya ohlangothini ezingemuva ngezinyawo, lapho ihlukanisa phakathi medial futhi Lesisemkhatsini ezingemuva isikhumba Ukuvalwa.

I medial ezinzwa izimpahla isikhumba ebucayi emuva uhlangothi ngezinyawo eduze uhlangothi lwalo onqenqemeni, futhi ohlangothini emuva kwesikhumba 2 neye-3 womnyaka iminwe. Ukuze innervation cutaneous ezingemuva ohlangothini evele 3, 4 no-5 kulingana iminwe Lesisemkhatsini cutaneous emsipheni isiphetho.

ezinzwa Deep engena ukuvulwa phambi intermuscular septum tibia futhi sihambisane Umthambo homonymous odlula phansi. ezinzwa uhlukanisa ezingeni umlenze encane ukuze eziyimpumelelo ambalwa ukuxhuma imisipha tibialis anterior kanye imisipha omude nasezinzwanini. Cishe ngaleso umngcele esebenzayo intertarsal igebe ezinzwa lokuqala rearmost inamagatsha ezimbili innervate isikhumba ebusweni umunwe 1 no-2.

izimo zokucabanga okubangelwa isifo

Omunye izifo ezivame kakhulu linqotshiwe plexus lumbosacral, okuyinto lihlotshaniswa pinching noma ukwephula emsipheni sciatic. Kulokhu, emsipheni ngobukhulu onomfutho, okubangela unyawo ubuhlungu eqinile. Cishe njalo zokugula kwenzeka kuphela ohlangothini olulodwa, futhi kuyaqabukela kwenzeka ngesimo amabili emaceleni. Ingxenye besilisa lesintu lapho komsebenzi ixhumene umsebenzi okhandlayo, uku okusezingeni eliphezulu endaweni ingozi.

Kwezokwelapha, lesi sifo ubizwa ngokuthi sciatica, ngesikhathi kungase uphethwe labizwa ngokuthi sciatica , noma sciatica. Leli gama livela egameni lesiGreki elithi «ishia», okusho "isihlalo." Emsipheni sciatic ngesiLatini ibizwa ngakho - nervus ishiadicus.

symptomatology

Uphawu oyinhloko ekhombe ukuba anqobe plexus lumbar ninamandla ubuhlungu ezinqeni imilenze, okuyinto kungavuka okunhlobonhlobo. Ngokuvamile, lapho le ubuhlungu yakhe sinamandla kakhulu kangangokuba umuntu ulahlekelwa ukwazi. Kwezinye izimo, kuba buhlungu zivutha, wagwaza noma ukusika nemvelo. Libuye izimpawu kungenzeka:

• Isikhundla uqotho akunakwenzeka ancike umlenze walimala kwase lihleli kudingeke afune isikhundla ntofontofo.
• Ubuhlungu iza ikakhulukazi ebusuku, ikakhulukazi ngemva kokusebenza kubanda.
• Kwezinye izimo, lo zokugula iqale ukubonakala ohlangothini ezingemuva ethangeni, bese kuza emlenzeni unyawo.
• Uma eside ukuba endaweni efanayo (amanga, ehlezi), ukwanda ubuhlungu, kubuye kube sobala ngesikhathi ukuhamba isikhathi eside.
• Sneezing, ukukhwehlela, behleka kakhulu, avuse ubuhlungu.
• Ngemva kokuthola lezi amalungiselelo afanele noma ngemva ukwehla asalile ubuhlungu ukuhlaselwa kudlule loin.

Ngokuvamile babancwebe emgogodleni lumbosacral plexus hhayi uhambe ngeze futhi kungaholela ukuphazamiseka Gait futhi abangele ukujuluka zezinyawo. Ungase futhi uzizwe umuzwa esibuhlungu noma avuthayo ezihlahla unyawo nomlenze aphansi. Ngokuvamile ngesikhathi esifanayo ngenxa yokugula amadolo cishe akunakwenzeka goba. I Kungashiwo okufanayo mayelana izinzwane nezinyawo, okungadingi uphendukisa.

ukuhlola

Nquma umonakalo emsipheni sciatic kuzosiza isithombe esicacile emtholampilo, echaza isiguli edilini ngesikhathi udokotela. Noma yimuphi uchwepheshe uzophawula ubunjalo nokushintsha umsipha ikhaliphe, futhi ukuzwela ohlangothini lapho isiguli ekhononda. Ngezinye izikhathi, i-kuhlolwa kokuqala awumvumeli umuntu ukusazi ngokunembile isifo esikuphethe lesi sifo sekukhona. Kulokhu, izifundo ezengeziwe kudingeka, phakathi awo:

• X-ray;
• computed tomography;
• MRI;
• ultrasound;
• radioisotope scan sokukhubazeka komgogodla.

Ngenxa CT, okuyinto olunemininingwane ethe xaxa-X-ray indlela, ngisho izinguquko ezincane kabuhlungu emgogodleni kungatholakala.

Kodwa kwezinye izimo, lapho kulolu cwaningo is contraindicated, udokotela ekunika MRI we plexus lumbosacral.

ukwelashwa

Ukuze balahle zokugula yakhetha omunye ukwelashwa ezimbili - olandelanayo noma op. Kodwa ngaso sonke isikhathi uqale nge indlela yokuqala, okuhlanganisa uhla izenzakalo ezahlukene. Ngo sciatica acute Kunconywa embhedeni ukuphumula phansi esiphontshini niqinile ubuncane umsebenzi nokudla. Udinga ukusebenzisa afudumele, hhayi okubabayo, hhayi ngibhema hhayi eyosiwe, ukudla ikakhulukazi okusamanzi (inyama yemifino isobho ubisi iphalishi).

Ukwelapha ngokwemithi kuhilela ukuthatha imithi enqunywe udokotela wakho. Ngokushesha nje lapho ubuhlungu buqala ukuqeda, ukuvivinya umzimba kukhonjiswa. Zonke izivivinyo zikhethwe kuye ngokuthi uhlobo lwesifo.