Plexus wesibeletho amagatsha awo: lokuphatselene nesakhiwo nemsebenti

Kunzima overestimate ukubaluleka kanye nokubaluleka plexus wesibeletho. amagatsha awo enophephela ingxenye imisipha zokuphefumula ukuqinisekisa ukuhambisana isithenjwa umsebenzi imisipha entanyeni. Ngakho-ke, lo zokugula we plexus wesibeletho we imisebenzi ebalulekile ingase kahle.

nokwakheka

plexus wesibeletho ibhangqwe isakhiwo ezakhiwe amagatsha phambi elingenhla wesibeletho umgogodla emsipheni izimpande. amagatsha awo kwahambisana izihibe ezintathu arcuate interconnecting izinqamu ukwakha plexus.

Eminye imithombo sihlanganise ngayo ehlombe ehlanganisa Ingxenye engezansi wesibeletho emsipheni izimpande futhi thoracic ezimbili engenhla. Kulezi imithombo okukhulunywa cervico-brachial plexus ehlanganisa imizwa umgogodla wesibeletho izingxenye umgogodla, kanye engenhla thoracic izinzwa ezimbili umgogodla.

Ukuma kwendawo yendlela

Ulwazi nesimo sendawo we plexus wesibeletho kusiza ukuqonda lapho izimo zezokwelapha eziholela ukungasebenzi kwekhono izimpande zawo. Ukuze ongoti, lolu lwazi oluyigugu ngoba, ngokwazi projection we plexus, kuba lula ukugwema nomthelela omubi kuye phakathi nezinqubo ezihlukahlukene zezokwelapha.

plexus wesibeletho elise ezingeni phezulu ezine amathambo nomgogodla wesibeletho. Wambozwa ohlangothini ezilingene phambi imisipha sternocleidomastoid, lihlale kanye phambili ohlangothini iqembu Imisipha yentamo ezijulile.

Sakhiwo Umsebenzi

Kusukela wesibeletho amagatsha plexus aqukethe kokubili afferent futhi efferent yezinzwa, babesebenza njengoba imisebenzi ebucayi kanye motor.

Ngakho, nge ukunqotshwa takhiwo plexus wesibeletho uzohlupheka kokubili lezi zindawo.

amagatsha motor

Kwemisipha noma motor izinzwa plexus wesibeletho, ekhelini ku Imisipha yentamo eseduze, kuholele ukunyakaza kwabo; futhi ngaphezu kwalokho, iqhaza ukwakheka okubizwa ngokuthi entanyeni izihibe ehlanganisa egatsheni ukwehla we emsipheni hypoglossal , kanye izinzwa, esukela empandeni plexus emsipheni. Umsebenzi Its innervation imisipha, okuyinto zitholakala ezansi maqondana ithambo hyoid.

Kufanele kushiwo ukuthi, futhi trapezoid, futhi imisipha sternocleidomastoid nayo innervated yi izinzwa, esukela impande motor we plexus wesibeletho.

Bebona umnyango

Ezizwelayo wesibeletho plexus innervation inikezwa yi okuthiwa isikhumba amagatsha alo, okuyimali indlebe ezinzwa ezinkulu, nerve transverse nezinzwa encane occiput wesibeletho supraclavicular.

ezinzwa phrenic

Lena enye legatsha le plexus wesibeletho, okuyinto ine isici esithakazelisayo: njengengxenye emsipheni phrenic has kokubili fibre motor, ekhelini e diaphragm nokukubangela ukuhambisa, futhi ebucayi, ukuhlinzeka innervation kuya pericardium, pleura futhi peritoneum.

Lokhu ezinzwa yaziwa njengenye egatsheni obaluleke kunayo ukuthi zakha plexus wesibeletho, njengoba iqondiswe diaphragm, futhi nakanjani kuholela ekulahlekelweni paresis beso obuhlukahlukene kobukhulu noma ukukhubazeka. isimo esinjalo. emtholampilo wabonakaliswa nokuvaleka kwemigudu yokuphefumula, kuze ezinzima yayo.

Kwezinye izimo, lapho abathintekayo plexus wesibeletho, futhi ikakhulukazi, phrenic ezinzwa zokugula ububonisa nokuquleka clonic e diaphragm, okuyinto ngaphandle nibonakala kubantu nilungile avele njengoba inwabi.

liningi igazi

Umthombo oyinhloko amandla izakhiwo engxenyeni engenhla yomgogodla wesibeletho kukhona amagatsha encane Umthambo vertebral, okuyinto, ukuthatha umsuka kusukela Umthambo subclavian, liphume kanye yomgogodla phezulu, engena ezindlini ngezindlu ngalo ingaphakathi cranial, futhi unikeza wonke obuphelele Namahlumela awo ukuze igazi eligciniwe kuya izakhiwo yokwakheka yomgogodla wesibeletho.

I zokugula we plexus wesibeletho

Izimpawu plexus wesibeletho avele ifomu motor, sezinzwa neziyaluyalu trophic. Ukuba yinkimbinkimbi kubangelwa inhlanganisela zimpawu kwetinhlavu yezinzwa zinemisebenzi eyahlukene zibuye. Ukwephulwa ephathelene nokuqhutshwa, onikeza amagatsha ukuze innervate plexus wesibeletho. Anatomy kangangokuthi nge ukunqotshwa ngamunye izimpande ahlupheke yonke imisebenzi emithathu.

ukulimala okungase kwenzeke

1. Nosizi, njengokuhlukunyezwa dislocation noma subluxation ka amathambo wesibeletho, nemihuzuko noma ukulimala lapho umuntu ezalwa ezisanda kubelethwa.
2. Lesi sifo kokucindezelwa e kokucindezelwa neoplasm, izinsalela, hematoma noma ibhandishi (uma Udwebe ngokungalungile esitho immobilization).
3. izilonda ezithathelwanayo kanye ukuvuvukala ezingaba ibhekane plexus wesibeletho of izinzwa emgogodleni ngemva ngegciwane (herpes ukutheleleka, lesion zomkhuhlane, umphimbo obuhlungu, ugcunsula).
4. omsakazo Toxic ka plexitis wesibeletho. i samuntu okunjalo kungenzeka nge ehlelekile izilonda kabi utshwala noma esimweni esindayo ubuthi metal.
5. hypothermia Sinzima (hypothermia) kungabangela ukuvuvukala iziqu emsipheni.
6. ukunqotshwa Allergic noma sokuhlasela kwamasosha omzimba lapho ithonya nolaka omzimba amaseli ngephutha ethunyelwe izicubu sakhe sezinzwa somzimba.
7. izifo letindzala ezibangela ukungondleki Izinzwa iziqu.

ukubonakaliswa

Phakathi izilonda nezifo we plexus wesibeletho bungabonakala:

• Sohlangothi olulodwa.
• Bilateral.

Zonke izimo lapho KWAMAGUNDANE futhi plexus wesibeletho amagatsha, elinesimo motor, sezinzwa neziyaluyalu trophic ka innervation ezonini abafanele. Pathology sihamba ngo isigaba saso esilandelayo sokuthuthuka:

• isigaba Neuralgic. Izenzo ezihlobene ngokucasuka we iziqu emsipheni. Ngokuvamile lapho kuqala okukhulu nobuhlungu obukhulu ukubukeka ohlangothini engezansi ebusweni imbuthuma endlebeni nesifunda occipital, kanye engazinzile imbuthuma kuya ingalo phansi kalula. Kwasendaweni ubuhlungu oluhambisana ohlangothini ethintekile. Abagulela ukufa inyuka kakhulu nge ukunyakaza yekwentiwa; isimo sokuthula angaletha impumuzo ezinye, kodwa ubuhlungu lapho esephumule, ngisho ebusuku, ingabe usekhona ngokuphelele. Ubuhlungu ephelezelwa paresthesia, Ukupholisa ngalesi sifo isikhumba kanye lokushisa ukuzwela ezonini innervation abathintekayo emsipheni impande.
• isigaba kofé uhlangothi. Isinyathelo paresis kanye nokukhubazeka (kuncike kobukhulu izilonda) libhekene izimpawu imizwa wesibeletho dysfunctions akha plexus wesibeletho. Ngenxa izilonda emsipheni phrenic futhi eqaphela hiccups, ngenxa yokuntuleka kokuxhumana imisipha, nobunzima nge ukwephulwa expectoration; iziyaluyalu izwi, ukuphefumula - kuze kufushane okunzima umoya futhi ezimweni ezimbi kakhulu, iziyaluyalu zokuphefumula, kuze nokuvaleka kwemigudu yokuphefumula. iziyaluyalu trophic kubangele ukuvuvukala kanye coloration bluish kwesikhumba, ushintsha turgor zabo; Ngaphezu kwalokho, kahle ajulukayo maqondana oluqinisayo yayo. A isikhathi eside lesi sifo umthofu efanela izinguquko atrophic of imisipha kwebhande ehlombe, eliphumela kumiswa okuqhubekayo dislocation komkhuba ehlombe ngokuhlanganyela; noma ukukhubazeka kwemisipha entanyeni, kobukhulu okunzima okuholela ekulahlekeni imisipha wesibeletho bayakwazi ukwenza imisebenzi yabo: ikhanda lesiguli ezimweni ezinzima ungakwazi ukuncika phambili ukuze kwesilevu kuyinto eseduze sternum. Lapho enjalo izilonda ezijulile ukunyakaza asebenzayo ngokusebenzisa izicubu abathintekayo akunakwenzeka; ngokuzimela aphakamise ikhanda lakhe njengasekuqaleni ngakho isiguli bengayi.
• Isinyathelo ukunciphisa. Kulesi sigaba, iziyaluyalu imisebenzi sezinzwa baqala kancane kancane alulame. Kwezinye izimo, yokutakula laligujwa akuphelele, ne izenzakalo asalile ngesimo paresis noma ukukhubazeka we-peripheral-hlobo (imvelo evilaphayo), kanye nezinguquko atrophic imisipha (obekwe ngayo sitholakele imiphumela asalile ngesimo paresis neuropathy kufanele ibe inkomba ethintekile emsipheni impande).

imiphumela asalayo:

• Evilaphayo (neuropathy) paresis noma ukukhubazeka kwemisipha entanyeni nesiphanga ibhande, dislocation komkhuba joint ehlombe isici ikhanda ukuma ngenxa Imisipha yentamo ababuthakathaka.
• Ukuphazamiseka imisipha ithoni; amajaqamba futhi zibe amagatsha wesibeletho plexus innervated imisipha amaqembu.
• thuthuva Ukudideka ngesimo paresthesias nobuhlungu hypersensitivity endaweni sezinzwa innervation plexus.
• iziyaluyalu trophic we isikhumba nezicubu ezithambile abaningi babephephile ezindaweni ezithintekile.

izinzwa

Wesibeletho plexus izinzwa kuvumela ukuhlinzwa entanyeni, yegilo, kwakheka imithambo yegazi brachiocephalic iqembu elimele, okudutshulwa, umdlavuza.

Kusukela phambi entanyeni emgqeni lesemkhatsini wesibeletho amagatsha plexus anastomose, izinzwa izimpande ebucayi emva onqenqemeni sternocleidomastoid imisipha kufanele enziwe zombili. Lokhu kukuvumela ukwenza izinzwa kuhlanganise ukungenelela esikhulu izingqimba ezijulile izicubu entanyeni (kuhlanganise Ukukhishwa kwamalaka akumshiyanga nje, ukususwa umdlavuza izimila).

Ukuze ngcono umphumela amagatsha izinzwa we plexus wesibeletho, bavunyelwe ezengeziwe Ukuvinjwa ebusweni amagatsha kwenzwa zibheke kwegilo ngaphambili entanyeni.

Ukuze enze zonke lezi manipulations izinzwa kwenziwe indlela anterior, kusukela ukusetshenziswa ukufinyelela lateral (umjovo we isixazululo izinzwa endaweni subdural) lihlotshaniswa awokuthi a yezinkinga esikhundleni sina, ngakho inqubo ukufinyelela lateral, ngoba angifundanga ukuthunga nje usebenzisa izici.