Anatomy: lumbar plexus na alaka ya

Na anyị na ozu na ọ dịghị ihe n'ekpere - Nne Nature elekọta ya nke ọma. Ọ bụ ezie na, dị ka e kwuru site na ụfọdụ, a ahu dị ka ihe odide ntụkwasị bụ nke nta, na ọ bụ omume na-ebi ndụ a jupụtara ndụ na-enweghị ya. Ma ajụjụ ugbu a bụ banyere na, na banyere ọrụ dị mkpa egwuri site lumbar plexus, ma ọ bụ plexus lumbalis. Ọ lekwasịrị anya a ụyọkọ nke akwara endings pelvis ma na ala na nsọtụ.

mkpali Filiks na mpaghara ebe a na-ebu neuralgia, nke na-ekpuchi ala ọkara nke ahu. Ọtụtụ mgbe n'otu oge e nwere ihe mgbu. Iji ịghọta n'ụzọ doro anya otú enweghị nchịkwa Filiks mkpa ka maara na Mmebe nke a ngalaba.

definition

Lumbar plexus bụ a collection of ọtụtụ ụdị nke irighiri akwara. Na ya guzobere atụ atọ ndị mbụ spinal irighiri akwara. Nwere obere ebe a nwekwara ike nkejikotara 12 alaka thoracic na 4 alaka nke spinal akwara. Large muscle emep uta eri na-ebe lumbar plexus dị. Anatomy agụnye ịchọta akwara alaka n'ihu transverse Filiks nke lumbar vertebrae.

Ndị a akwara na-ahụ maka akụkụ ụfọdụ nke innervation nke muscle emep uta eri, gụnyere anụ ahụ nke peritoneum. Ọzọkwa, ha na-metụtara akpụkpọ elu nke mpụga genitalia, na medial elu nke adị ka okporo ụkwụ, ndị anteromedial akụkụ nke ụkwụ. Total na nkebi nke a na e nwere ọtụtụ di iche iche nke akwara endings:

• iliohypogastric;
• ilioinguinal;
• femoral-mmekọahụ;
• mpụta;
• obturator;
• Femoral.

Tụlee a obere ihe banyere ihe ha na-na ebe ụgha. Conventionally, niile irighiri akwara nwere ike kewara abụọ hà iche iche.

Atọ ndị mbụ akwara

Iliohypogastric akwara nke lumbar plexus ii na n'ihu ọgịrịga 12 na otu lumbar akwara alaka. Site ha na ha gabiga psoas muscle, na mgbe ahụ abịa na kọntaktị na n'ihu elu nke quadratus lumborum, ịbụ nso na akụrụ ya. Ọzọkwa akwara na-agba si n'elu na ala, na-eburu ya direction azụ n'ihu. On ụzọ iliac crest jupụtara na transverse abdominal mọzụlụ na mgbe dị n'agbata ya na esịtidem oblique abdominal muscle emep uta eri. A n'ihu ụzọ bụ na-ama n'etiti abụọ oblique uru.

Na miri emi inguinal mgbanaka iliohypogastric akwara nwekwara penetrates esịtidem oblique muscle na akaị sara mbara efere mpụga oblique muscle. Mgbe nke ahụ gasịrị, ọ alaka n'ime cutaneous ejiji abdominal mgbidi dị n'elu pubic symphysis. Ya na ọrụ na-agụnye innervation nke ọtụtụ ndị uru nke afo. Ọzọkwa nwalere irighiri akwara na akpụkpọ na hip, buttock, ihu abdominal mgbidi dị n'elu pubis.

Ọzọ alaka ụlọ ọrụ, bụ nke si si n'ihu nke akwara mgbọrọgwụ, ma ọ bụ ubé ala karịa aga, a na-akpọ ilioinguinal akwara, na-gụnyere na lumbar plexus. Anatomy of ya ndị ikom na ndị inyom na-dị iche iche. A ike mmekọahụ akwara-agabiga inguinal kanaal na etịbede n'ime obere cutaneous alaka ma na-ebupụta nke apata nso scrotal akwara mkpụrụ ndụ. Ikpeazụ maka innervation nke anụ ahụ nke amụ na scrotum na akụkụ. Women nwere otu njedebe nke Central ụjọ usoro jikọtara ikpa ke pubis na labia egbugbere ọnụ.

Femoral-mmekọahụ na-emetụta ọtụtụ ndị psoas na ọbụna kewara abụọ alaka - mmekọahụ na ụkwụ. Flooring, ma ọ bụghị na-akpọ ka nkpuru akwara eduzi nsoroụzọ ala ma, dị ka ndị spermatic eriri-agabiga inguinal kanaal. Na nwoke, a na-ejikọta ya na muscle, nke bụ maka azụ àkwá, anụ ahụ nke scrotum, nakwa dị ka uru shei na n'elu nke anụ verhnemedialnoy hip ebe. Women lumbar plexus bụ ndokwa dị iche iche - akwara nke a di na nwunye a gburugburu ọgọdọ nke akpanwa nke inguinal kanaal wee zigara akpụkpọ elu nke labia majora.

The alaka nke abụọ nke femoral a nkịtị mmechi chere ihu ala na-aga n'akụkụ nke mpụga iliac akwara ozugbo n'okpuru inguinal ọgọdọ. N'okpuru ya akwara ekewa alaka apata akpụkpọ elu.

The abụọ atọ akwara

N'okpuru ebe e depụtara niile atọ irighiri akwara na-atọ ibu alaka. Nke a mpụta, femoral na obturator irighiri akwara. The mbụ ndepụta dị n'akụkụ nke inguinal ọgọdọ. O nwere ike ịbụ na elu ma ọ bụ n'ime ndị sartorius muscle, mgbe n'okpuru connective anụ ahụ n'ọbọ ya. The akwara bụ maka na uche nke n'akụkụ-ebupụta nke ike a obere n'ihu trochanteric hip ọkpụkpụ na nso mpụta elu nke femur.

N'ịnọgide na-parse kpọmkwem otú lumbar plexus a kpụrụ, ọ dị mkpa iji gaa obturator akwara. Ọ na-aga ala tinyere psoas muscle, ọzọ kpomkwem, na n'ọnụ ọnụ ya na n'ime pelvic ebe. N'abụ ahụ ọbara usoro, ọ na-abịa ọnụ na arịa na femoral n'ógbè obturator kanaal, sitere na Intermedia adductors. The akwara jikọtara a ìgwè nke adductors, ikpere na hip nkwonkwo. Ọzọkwa akwara innervates ihu n'etiti akụkụ nke apata nso ikpere.

Of niile femoral alaka nke lumbar plexus bụ ndị kasị ibu. Ọ na-esite na ókè-ala nke-ise vertebra n'úkwù na otu aha nke muscle emep uta eri. Na-aga na mpụta onu nke muscle, akwara bụ n'okpuru n'etiti abụọ ndị nke ọzọ muscle iche iche: ndị lumbar na iliac, na-aga n'okpuru ikpeazụ shei.

Abịa n'okpuru inguinal ọgọdọ, lumbar plexus irighiri akwara na-ekewa n'ime ọtụtụ alaka na na-metụtara akpụkpọ uru nke n'ihu nke hip, ikpere na hip nkwonkwo.

akụkụ nke ndị nile

Lumbar akwara endings bụ akụkụ nke a usoro a na-akpọ "lumbar-sacral plexus." Alaka nke lumbar, sacral, na coccygeal ngalaba, ji ekpuchi ibe na-etolite abụọ bụ isi plexus: lumbar na sacral. Ebe mbụ okwu bụ ugbu a doro anya, ọ ga-agafere ọzọ definition.

Na-akpụ sacral plexus (plexus sacralis) ewe akụkụ nke n'ihu alaka ụlọ ọrụ, nke na-agba ọsọ si anọ na nke ise lumbar na mbụ na-atọ alaka sacral spinal akwara endings. Ọ baghị uru lumbar plexus emi odude ke pelvis ozugbo connective anụ ahụ n'ọbọ piriformis. Ọ na-anọchi anya n'ụdị a oké efere nke zita udi, onu ire nke nke chere ihu n'ebe Subpiriforme nchawa.

The isi nke triangle bụ banyere pelvic oghere. N'otu oge ụfọdụ nke plexus emi odude n'ihu sacrum, na ndị ọzọ - n'ihu piriformis. On n'akụkụ niile ọ gbara rụrụ connective anụ ahụ. Dị ka ke lumbar region, e nwekwara na-ewetara a set nke akwara endings na ike ma obere na ogologo.

Short sacral akwara

Short alaka irighiri akwara na-anọchi anya ndị na-esonụ:

• gluteal (elu na nke ala);
• mmekọahụ;
• esịtidem obturator;
• ube ekara;
• akwara square apata muscle.

Gluteal akwara lumbosacral plexus na-ekewa n'ime elu na nke ala. Mmalite steamed na gluteal akwara-eche nche na ndị pelvic oghere n'oghere nadgrushevidnoe. The akwara jikọtara obere na-ajụ gluteal uru na emep uta eri jikọọ na fascia lata. Lower akwara ọnụ na akwara ahapụ pelvic Subpiriforme site onu na jikọọ na gluteus Maximus muscle. Ma, e wezụga na ọ na-ejikọrọ na Capsule nke hip nkwonkwo.

Site n'otu oghere Subpiriforme pelvic oghere doo pudendal akwara, na azụ n'akụkụ bypasses na ischium ma na-aga ogologo ischiorectal fossa. Ebe ọ bụ iche n'ime ala rectal na perineal alaka. Ọzọkwa, ụzọ agbụ na mpụga sphincter nke ike na gbasara ike akpụkpọ ebe. Mgbe ikpeazụ na-ahụ maka ndị innervation nke uru ahụ na akpụkpọ ahụ nke perineum na scrotum nke nwoke ahụ. Ubé dị iche iche mere ndokwa nwanyi lumbosacral plexus. Anatomy ji na na perineal alaka ndị a na-labia majora.

Long sacral akwara

Long alaka na-agụnye:

• posterior cutaneous akwara;
• sciatic akwara.

Posterior cutaneous akwara ogwugwu doo pelvis site Subpiriforme onu, ala nso sciatic akwara. Posterior femoral cutaneous akwara nso ala onu nke gluteus Maximus ekewa ala gluteal na perineal akwara alaka. The ala alaka innervates ala buttock akpụkpọ elu.

Posterior cutaneous femoral alaka-agabiga uzo Intermedia semitendinosus na biceps femoral muscle. Ya alaka ijupụta fascia lata na kewara nta site n'ime apata, na-eru ndị popliteal fossa.

Sciatic akwara agwụcha, a akụkụ nke sacral na lumbar plexus, bụ kasị alaka nke ahụ mmadụ na kwesịrị nlebara anya pụrụ iche. Site oghere Subpiriforme akwara-eche nche na ndị pelvis, ọnụ na ndị ọzọ irighiri akwara (ala buttock, mmekọahụ, posterior femoral cutaneous) na sciatic akwara, duziri ala. Olee ihe enyemaka na akara na a diamond ekara ịda mbà n'obi na-akpata ikpere, ọ na-kewara abụọ alaka: na adị ka okporo ụkwụ na fibula n'ozuzu.

tibial alaka

Ọ na-eduzi ekwesị n'ala n'ebe soleus golenopodkolennogo ọwa. N'oge ogologo-ya na akwara ekewa ọtụtụ alaka. Ụfọdụ n'ime ha na-adabara ndị atọ gawa nwa ehi muscle, ndị ọzọ eduzi ndị ogologo flexor muscle emep uta eri na mkpịsị aka na mkpịsị ụkwụ ukwu. E nwere ndị na-ejikọrọ na ala na uru apata.

The kasị mwute ọgwụgwụ esịne ke sacral na lumbar plexus, ejikọrọ na Capsule nke ikpere nkwonkwo, interosseous akpụkpọ ahụ nke ala ụkwụ, ụkwụ, ukwu ọkpụkpụ. The kasị alaka nke tibial alaka mwute bụ medial cutaneous akwara nke caviar. Ọ departs si na alaka na zitere n'okpuru akpụkpọ elu na ji ekpuchi na caviar cutaneous akwara, nke n'aka nke na-abịa site nkịtị peroneal akwara.

N'ihi nke mmakọ nke abụọ ọnụ bụ guzobe nke sural akwara. Ọ na mbụ na-enwe n'akụkụ ụkwụ na mgbe na-agba tinyere mpụta oke nke ụkwụ. Mgbe a na isi enye ama a na-akpọ mpụta dorsal cutaneous akwara maka innervation nke anụ na ebe ndị a.

Total peroneal alaka

Ọ na-aga a obere nya n'olu nke fibula na ebe popliteal fossa. Ịga n'ihu na lumbar plexus na alaka ya, ọ bụ uru na-arịba ama na n'ọnọdụ a ikpeazụ kewara abụọ isi alaka:

• elu elu;
• miri emi.

N'elu akwara ala. Ọ bụ maka na innervation nke obere na ogologo peroneal uru. N'elu-ahapụ a ọwa, akwara na-aga n'azụ n'akụkụ ụkwụ, ebe ọ na-ekewa ndị medial na márá n'azụ akpụkpọ mmechi.

The medial akwara onunu mmetụta ọsọ ọsọ anụ azụ n'akụkụ ụkwụ nso ya n'akụkụ onu, na azụ n'akụkụ nke anụ 2 na nke 3 nke mkpịsị aka. N'ihi cutaneous innervation n'azụ n'akụkụ ebupụta 3, 4 na nke 5 kwekọrọ na n'etiti mkpịsị aka cutaneous akwara ogwugwu.

Deep akwara abatakwa n'ihu oghere intermuscular septum adị ka okporo ụkwụ na-esonyere ndị homonymous akwara rushes ala. akwara abahade n'ogo nke ala ụkwụ ole na ole endings na jikọọ ọgọdọ ihu muscle na ogologo uru nke abua. Odika na ókè nke mbụ ifịk intertarsal ọdịiche rearmost akwara nwere alaka abụọ na innervate akpụkpọ elu nke nkpisi-aka-1 na nke 2.

enweghị nchịkwa ọnọdụ

Otu n'ime ihe ndị kasị ọrịa na e meriri lumbosacral plexus, nke a na-ejikọta ya na-apị ma ọ bụ ịda iwu nke sciatic akwara. Na nke a, ndị kasị ibu akwara abịakọrọ, na-eme na ụkwụ nke ike mgbu. Fọrọ nke nta mgbe ndị daa ọrịa pụtara nanị n'otu akụkụ, na adịkarịghị pụtara na abụọ-kwadoro ụdị. The nwoke ọkara nke ihe a kpọrọ mmadụ nke ọrụ na-jikọrọ a arọ anụ ahụ na-arụ ọrụ, bụ na elu n'ihe ize ndụ ebe.

Na nkà mmụta ọgwụ, ọrịa na-ezo dị ka sciatica, n'oge nchoputa nwere ike nkewa dị ka sciatica , ma ọ bụ sciatica. Aha a sitere n'okwu Grik «ishia», nke pụtara "oche." The sciatic akwara na Latin na-akpọ ka - nervus ishiadicus.

symptomatology

Isi mgbaàmà nke na-ekwu imeri lumbar plexus dị ike mgbu ike na ụkwụ, nke nwere ike ime dị iche iche n'obiọma. Ọtụtụ mgbe, mgbe a mgbu siri nnọọ ike na onye na-efunari nsụhọ. N'ọnọdụ ndị ọzọ, ihe mgbu nwere ike ọkụ, ịma ma ọ bụ ịcha okike. Ọ dịkwa ike mgbaàmà:

• Ndị ziri ezi na ọnọdụ bụ ekwe omume na-adabere na ndị merụrụ ahụ ụkwụ na-edina nwere anya n'ihi na a ala ọnọdụ.
• Pain abịa ukwuu n'ime n'abalị, karịsịa mgbe na-arụ ọrụ na oyi na-atụ ihu igwe.
• Mgbe ụfọdụ, ndị daa ọrịa mbụ hụrụ na azụ n'akụkụ nke apata, na mgbe na-abịa ụkwụ na ụkwụ.
• Ọ bụrụ na ị ogologo na-ke n'otu ọnọdụ (ịgha ụgha, ọdụ), na ihe mgbu na-abawanye, ọ bụ na-apụta ìhè na ogologo-eje ije.
• Nje, ụkwara, na-achị ọchị, kwa, akpasu mgbu.
• Mgbe e kwesịrị ekwesị preparations ma ọ bụ mgbe ọnụ mmapụta mgbu ọgụ laara loin.

Ọtụtụ mgbe pinched spain lumbosacral plexus-aga n'efu na pụrụ iduga gait nsogbu, ime ka sweating ụkwụ. I nwekwara ike na-eche a tingling ma ọ bụ na-ere sensashion nke ụkwụ na ala ụkwụ. Ọtụtụ mgbe n'otu oge ruru ka ọrịa ikpere bụ fọrọ nke nta agaghị ekwe omume gbagọrọ agbagọ. The otu nwere ike kwuru banyere ndị na mkpịsị ụkwụ na ụkwụ, nke na-adịghị bugharia.

nchọpụta nsogbu

Kpebisie ike na mmebi nke sciatic akwara ga-enyere doro anya adakarị picture, nke na-akọwa a ndidi na a n'ikuku na dọkịta. Ọ bụla ọkachamara ga-achọpụta na-agbanwe ọdịdị nke akaị na-aghọ nkọ, na uche n'akụkụ nke onye ọrịa ọdọhọde. Mgbe ụfọdụ, ihe mbụ nnyocha adịghị ekwe ka ezi ihe nchoputa nke ọrịa pụta. Na nke a, ndị ọzọ ọmụmụ na-mkpa, otu nke bụ:

• X-ìhè;
• agbakọrọ tomography;
• MRI;
• ultrasound;
• radioisotope Doppler nke ọkpụkpụ azụ.

N'ihi CT, nke bụ a ọzọ zuru ezu X-ray usoro, ọbụna obere mgbanwe na ọkpụkpụ azụ nwere ike achọpụtara.

Ma mgbe ụfọdụ, mgbe a na-amụ na-contraindicated, dọkịta na-edepụta MRI nke lumbosacral plexus.

ọgwụgwọ

Ka tufuo daa ọrịa malitere otu n'ime mmadụ abụọ agwọ ọrịa - mgbanwe ma ọ bụ ịkpa. Ma mgbe nile na-amalite na-akpa usoro, nke na-agụnye a dịgasị iche iche nke dị iche iche ihe. Na nnukwu sciatica atụ aro bed fọdụrụ na a ike matarasị na a kacha nta nke ọrụ ahụ na nri. Ị mkpa na-eji ọkụ, ọ bụghị na-atọkwa ụtọ, ọ bụghị na-ese siga na-adịghị grilled, ukwuu n'ime mmiri mmiri oriri (anụ akwukwo nri ofe na mmiri ara ehi porridge).

Drug ọgwụgwọ na-agụnye na ochichi nke ọgwụ ọjọọ, kenyere na ịga dibịa. Ka anya dị ka ihe mgbu na-amalite na ya laa azụ, ọ na-egosi physiotherapy. All omume na-ahọrọ na-adabere ọdịdị nke ọrịa.