· Gukoresha Anatomy
Imbere ya scapula hari fossa ya subcapular, aho imitsi ya subcapularis itangirira.Inyuma yinyuma yinyuma kandi igenda hejuru gato ya scapular ridge, igabanijwemo supraspinatus fossa na infraspinatus fossa, kugirango ihuze imitsi ya supraspinatus na infraspinatus.Impera yinyuma yumusozi ni acromion, ikora acromioclavicular ifatanije na acromion iherezo rya clavicle ikoresheje ubuso burebure bwa ovoid.Urwego rwo hejuru rwimisozi ya scapular rufite akantu gato U-kameze nka U, kanyuzwamo na ligamente ngufi ariko itoroshye ya transrascapular ligament, munsi yumutima wa suprascapular unyura, kandi hejuru yimitsi iva hejuru.Impande zegeranye (axillary margin) z'umusozi wa scapular nini cyane kandi zigenda zerekeza hanze mu mizi y'ijosi rya scapular, aho ikora agace ka glenoid hamwe n'inkombe ya glenoide y'urutugu.
· Ibyerekana
1. Kwanga ibibyimba byiza.
2. Gutembera hafi yibibyimba bibi bya scapula.
3. Scapula ndende nubundi bumuga.
4. Kurandura amagufwa yapfuye muri scapular osteomyelitis.
5. Indwara ya Suprascapular nerv entrapment syndrome.
Umwanya wumubiri
Umwanya ukunda cyane, uhengamye kuri 30 ° kugeza kuryama.Igihimba cyo hejuru cyanduye kizingiye hamwe nigitambaro cya sterile kugirango gishobore kwimurwa igihe icyo aricyo cyose mugihe cyo kubaga.
Intambwe zo gukora
1. Guhinduranya transvers muri rusange bikozwe kumisozi ya scapular muri fossa ya supraspinatus no mugice cyo hejuru cya infraspinatus fossa, kandi igice kirekire kirashobora gukorwa kuruhande rwagati rwa scapula cyangwa kuruhande rwa meda ya subcapularis fossa.Ibice bihinduranya kandi birebire birashobora guhurizwa hamwe kugirango bigire L-shusho, L-ihindagurika, cyangwa icyiciro cya mbere, bitewe no gukenera amashusho yibice bitandukanye bya scapula.Niba gusa impande zo hejuru na hepfo ya scapula zigomba gushyirwa ahagaragara, uduce duto dushobora gukorwa mubice bijyanye (Ishusho 7-1-5 (1)).
2. Kangura fassiya yimbere kandi yimbitse.Imitsi ifatanye n'umusozi wa scapular n'umupaka wo hagati irazunguruka mu buryo butandukanye cyangwa ndende mu cyerekezo cyo gutemwa (Ishusho 7-1-5 (2)).Niba supraspinatus fossa igomba gushyirwa ahagaragara, fibre yimitsi yo hagati ya trapezius yo hagati irabanza.Periosteum yatewe hejuru yamagufwa ya gonap scapular, hamwe nigice kinini cyibinure hagati yibi byombi, kandi fossa ya supraspinatus yose igaragazwa no gutandukana kwa subperiosteal gutandukanya imitsi ya supraspinatus, hamwe nimitsi ya trapezius irenze.Mugihe utera fibre yo hejuru yimitsi ya trapezius, ugomba kwitondera kutangiza imitsi ya parasimpatique.
3. Iyo imitsi ya suprascapular igomba guhishurwa, gusa fibre yo mugice cyo hejuru cyo hagati yimitsi ya trapezius irashobora gukururwa hejuru, kandi imitsi ya supraspinatus irashobora gukururwa buhoro buhoro hasi itiyambuye, kandi imiterere yera yera igaragara ni transrascapular transvers. ligament.Iyo imiyoboro ndengakamere bimaze kumenyekana no kurindwa, ligamenti ya suprascapular transvers ligament irashobora gucibwa, kandi scapular notch irashobora gushakishwa kubintu byose bidasanzwe, hanyuma imitsi ya suprascapular irashobora kurekurwa.Hanyuma, imitsi ya trapezius yambuwe isubizwa hamwe kugirango ifatanye na scapula.
4. Niba igice cyo hejuru cya infraspinatus fossa kigomba gushyirwa ahagaragara, fibre yo hepfo na hagati yimitsi ya trapezius hamwe n imitsi ya deltoid irashobora guterwa mugitangiriro cyimisozi ya scapular hanyuma igasubira hejuru no hepfo (Ishusho 7-1- 5 (3)), hanyuma imitsi ya infraspinatus imaze kugaragara, irashobora gukonjeshwa munsi (Ishusho 7-1-5 (4)).Iyo wegereye impera yimpera yimpera ya skapular gonad (ni ukuvuga munsi ya glenoid), hagomba kwitabwaho imitsi ya axillary na posterior rotator humeral arteri inyura kumurongo wa kane ukikijwe na teres ntoya, teres nini, umutwe muremure ya triceps, nijosi ryo kubaga rya nyababyeyi, kimwe na rotate scapulae arteri yinyura muri foramen ya mpandeshatu ikikijwe na bitatu bya mbere, kugirango bitabaviramo ibikomere (Ishusho 7-1-5 (5)).
5. Kugaragaza umupaka wo hagati wa scapula, nyuma yo gutera fibre yimitsi ya trapezius, imitsi ya trapezius na supraspinatus isubizwa inyuma kandi hanze hamwe no kwamburwa subperiosteal kugirango yerekane igice cyo hagati ya fossa ya supraspinatus nigice cyo hejuru cyumupaka wo hagati ;n'imitsi ya trapezius na infraspinatus, hamwe n'imitsi nini ya latalis yometse ku mfuruka yo hasi ya scapula, yambuwe mu buryo budasubirwaho kugira ngo yerekane igice cyo hagati cya infraspinatus fossa, inguni yo hasi ya scapula, n'igice cyo hepfo y'umupaka wo hagati. .
Igicapo 7-1-5 Inzira ya dorsal scapular igaragara
(1) gukata;(2) gutema umurongo w'imitsi;(3) guca imitsi ya deltoid kumusozi wa scapular;(4) kuzamura imitsi ya deltoid kugirango ugaragaze infraspinatus na teres ntoya;(5) kwiyambura imitsi ya infraspinatus kugirango ugaragaze icyerekezo cya dorsal ya scapula hamwe na anastomose y'amaraso
6. Niba fossa ya subcapular igomba gushyirwa ahagaragara, imitsi ifatanye nigice cyimbere cyumupaka wo hagati, ni ukuvuga scapularis, rhomboide na serratus imbere, igomba gukurwaho icyarimwe, kandi scapula yose irashobora kuzamurwa hanze.Mugihe cyo kurekura umupaka wo hagati, hagomba kwitonderwa kurinda ishami ryamanuka ryimitsi ya karotide ya transvers na nervice ya dorsal scapular.Ishami rimanuka ryimitsi ya karotide ihindagurika ikomoka kumitsi ya tiroyide ya tiroyide kandi ikagenda ikava mu mfuruka yo hejuru ya scapula ikagera ku mfuruka yo hepfo ya scapula ikoresheje scapularis tenuissimus, imitsi ya rhomboide n'imitsi ya rhomboide, kandi imitsi ya rotator scapulae ikora imitsi ikungahaye cyane. umuyoboro mu gice cya dorsal cya scapula, ugomba rero gufatanwa neza hejuru yamagufwa kugirango ucyure subperiosteal.
Igihe cyo kohereza: Ugushyingo-21-2023
