Uburyo bwo kubaga Scapulari yo mu mfuruka

· Uburyo bwo kuvura indwara hakoreshejwe uburyo bwa 'anatomie'

Imbere ya scapula hari fossa ya subscapular, aho imitsi ya subscapularis itangirira. Inyuma hari ridge ya scapular igenda inyuma n'izamuka gato, igabanyijemo supraspinatus fossa na infraspinatus fossa, kugira ngo imitsi ya supraspinatus na infraspinatus ifatanye. Inyuma y'ridge ya scapular ni acromion, ikora acromioclavicular attachment hamwe na acromion ya clavicle hakoreshejwe ubuso burebure bwa ovoid articular. Iruhande rw'inyuma rw'ridge ya scapular rufite agace gato ka U, kanyuramo umugozi mugufi ariko ukomeye wa suprascapular, aho imitsi ya suprascapular inyura, kandi aho imitsi ya suprascapular inyura. Uruhande rw'inyuma (agace k'inyuma) rw'agace k'inyuma nirwo rufite ubunini kandi rujya hanze rugana ku muzi w'ijosi rya scapula, aho rukora agace k'inyuma gafite inkombe ya glenoid y'ingingo y'urutugu.

· Ibimenyetso

1. Gukuraho ibibyimba byo mu ruhago rw'imbere.

2. Gucamo ibice by'ikibyimba kibi cya scapula mu gace utuyemo.

3. Ingufu nyinshi zo mu gituza n'ubundi busembwa.

4. Gukuraho igufwa ryapfuye mu gihe cy'indwara ya scapular osteomyelitis.

5. Indwara yo gufata imitsi yo mu bwoko bwa Suprascapular.

· Imiterere y'umubiri

Ahantu hato ho guhagarara, hahengamye kuri dogere 30 ugana ku buriri. Igice cyo hejuru cyangiritse gipfundikirwa n'igitambaro gisukuye kugira ngo kibashe kwimurwa igihe icyo ari cyo cyose mu gihe cyo kubagwa.

· Intambwe z'imikorere

1. Gukata igice cyo hejuru muri rusange bikorwa ku ruhande rw'umugongo wa scapulari muri supraspinatus fossa no hejuru ya infraspinatus fossa, kandi gukata igice cyo hejuru gishobora gukorwa ku nkombe yo hagati ya scapula cyangwa uruhande rwo hagati rwa subscapularis fossa. Gukata igice cyo hejuru n'icyo hejuru bishobora guhuzwa kugira ngo bikore ishusho ya L, ishusho ya L ihinduriwe, cyangwa ishusho yo mu rwego rwa mbere, bitewe n'uko bikenewe ko hagaragazwa ibice bitandukanye bya scapula. Iyo hakenewe gusa ko impande zo hejuru n'izo hasi za scapula zigaragara, gukata gato bishobora gukorwa mu duce duhuye (Ishusho ya 7-1-5 (1)).

2. Gukata igice cyo hejuru n'icy'imbere. Imitsi ifatanye n'agace k'inyuma n'umupaka wo hagati iracibwa mu buryo burambuye cyangwa mu buryo burambuye mu cyerekezo cy'icibwa (Ishusho ya 7-1-5 (2)). Niba supraspinatus fossa igomba kugaragara, imitsi y'imitsi yo hagati ya trapezius ibanza gukatwa. Periosteum icibwa ku buso bw'amagufwa ya gonad ya scapular, hamwe n'urutonde rw'ibinure hagati yabyo byombi, kandi supraspinatus fossa yose igaragara mu gukata imitsi ya supraspinatus, hamwe n'imitsi ya trapezius iri hejuru. Mu gihe ukata imitsi yo hejuru y'imitsi ya trapezius, ugomba kwitonda kugira ngo utangiza imitsi ya parasympathetic.

3. Iyo umutsi wo hejuru y'inyuma ugomba kugaragara, imitsi yo hagati y'igice cyo hejuru cy'imitsi ya trapezius ni yo yonyine ishobora gukururwa hejuru, kandi umutsi wa supraspinatus ushobora gukururwa buhoro buhoro hasi nta gukurwaho, kandi imiterere yera igaragara ni umutsi wo hejuru w'inyuma. Iyo imitsi n'imitsi yo hejuru imaze kumenyekana no kurindwa, umutsi wo hejuru w'inyuma ushobora gucibwa, kandi agace k'inyuma k'inyuma gashobora gusuzumwa kugira ngo harebwe imiterere idasanzwe, hanyuma umutsi wo hejuru w'inyuma urashobora kurekurwa. Amaherezo, imitsi ya trapezius yakuwemo irasukwa hamwe kugira ngo ifatanye na scapula.

4. Niba igice cyo hejuru cya infraspinatus fossa kigiye kugaragara, imitsi yo hasi n'iyo hagati y'imitsi ya trapezius n'imitsi ya deltoid ishobora gucibwa mu ntangiriro y'agace k'umugongo ka scapulari hanyuma ikongera ikazamuka no hasi (Ishusho ya 7-1-5 (3)), kandi nyuma y'uko imitsi ya infraspinatus igaragaye, ishobora gucibwamo (Ishusho ya 7-1-5 (4)). Iyo yegereye impera y'agace k'umugongo ka scapulari gonad (ni ukuvuga munsi ya glenoid), hagomba kwitabwaho imitsi yo mu gatuza n'imitsi yo mu gatuza inyura mu gice cy'umugongo cya quadrilateral foramen ikikijwe na teres minor, teres major, umutwe muremure wa triceps, n'ijosi ryo kubaga rya humerus, ndetse n'imitsi ya rotator scapulae inyura mu gice cy'umugongo cya mpandeshatu kizungurutswe n'imitsi itatu ya mbere, kugira ngo bitayitera imvune (Ishusho ya 7-1-5 (5)).

5. Kugira ngo hagaragare umupaka wo hagati wa scapula, nyuma yo gukata imitsi y'imitsi ya trapezius, imitsi ya trapezius na supraspinatus isubizwa inyuma cyane no hanze binyuze mu gukata subperiosteal kugira ngo hagaragare igice cyo hagati cya supraspinatus fossa n'igice cyo hejuru cy'umupaka wo hagati; kandi imitsi ya trapezius na infraspinatus, hamwe n'imitsi ya vastus lateralis ifatanye n'inguni iri munsi ya scapula, irakurwamo subperiosteally kugira ngo hagaragare igice cyo hagati cya infraspinatus fossa, inguni iri munsi ya scapula, n'igice cyo hasi cy'umupaka wo hagati.

Ishusho ya 7-1-5 Inzira yo kugaragara kwa scapulari yo mu mfuruka

(1) gukata; (2) gukata umurongo w'imitsi; (3) guca imitsi ya deltoid ku gice cyo hejuru cy'umugongo; (4) kuzamura imitsi ya deltoid kugira ngo hagaragare infraspinatus na teres minor; (5) gukuramo imitsi ya infraspinatus kugira ngo hagaragare igice cyo hejuru cy'umugongo w'umugongo hamwe n'imitsi igabanya ubukana bw'amaraso.

6. Niba fossa ya subscapular igomba kugaragara, imitsi ifatanye n'urwego rw'imbere rw'umupaka wo hagati, ni ukuvuga scapularis, rhomboids na serratus anterior, igomba gukurwaho icyarimwe, maze scapula yose ikazamurwa hanze. Mu gihe cyo kurekura umupaka wo hagati, hagomba kwitabwaho kurinda ishami rimanuka ry'imitsi ya carotide inyura hejuru n'imitsi ya scapular yo mu gice cy'inyuma. Ishami rimanuka ry'imitsi ya carotide inyura hejuru rituruka ku gice cy'ijosi rya tiroyide kandi rigenda riva ku nguni yo hejuru ya scapula rijya ku nguni yo hasi ya scapula binyuze muri scapularis tenuissimus, imitsi ya rhomboid na rhomboid, kandi umutsi wa scapulae uzenguruka ugakora urusobe rw'imitsi mu gice cy'inyuma cya scapula, bityo ugomba gufatanywa neza ku buso bw'igufwa kugira ngo igishishwa cya subperiosteal gikure.