Filosiliva

Ngaahi mahaki ʻo e méfilosiliva ko e ola ia ʻo e múltiples mo e ngaahi founga pathological kehekeheógicos. Ko e mamahi ko e tupuʻanga ia ʻo e más Komuún ʻo e LesióN ʻo e Méfilosiliva.

Fakatatau mo hoʻo patogénesis, Ngaahi Mahaki ʻo E MéʻE lava ke fakahaaʻi ʻe he filosiliva ʻa e ngaahi moto kehekehe, sensory pe ngaueón autonóMaʻuʻanga Fakamatala.

ʻAati ko ʻeniíʻOku nofotaha ʻa e ʻasi ʻi he anatomyíA ʻo e Méfilosiliva. Ko e ngaahi fakamatala ʻoku ʻi ai e líNicas BáSicas ʻo e ngaahi sipinga angamaheni ʻo e méFilosiliva dula fakafuofuaʻián ʻoku fekauʻaki mo e ngaahi tafaʻaki mahuʻinga ʻo e anatomyíko ha ʻo e tuʻa.

Ko e méʻOku tuʻu ʻa e filosiliva ʻi loto ʻi he Kanali filosiliva, Ko e ha ʻa eá faʻu ʻe he ngaahi luo ʻo e 7 cervical vertebrae, 12 ToaáCicas, 5 Lumbar, pea mo 5 Sacral, ʻa ia ʻoku ne faʻu fakataha ʻa e tuʻa.

Ko e méʻOku aʻu atu ʻa e filosiliva dula mei he Kau tangata Magnum ʻo aʻu ki he tuʻunga ʻo e ʻuluaki mo e ua vélumbar rtebrae (ʻi hono fāʻeleʻí, Kae ʻoua kuo aʻu ki he fika ua mo e tolu Vélumbar rtebrae).

AnatomíA mo e ngaahi konga ʻo e méfilosiliva

Ko e méʻOku kau ʻi he filosiliva ʻa e ngaahi meʻa ko ʻeni 31 Ngaahi Konga:

• 8 ngaahi konga cervical (C)
• 12 Ngaahi konga ʻa TOAácicos pe dorsals (T)
• 5 ngaahi konga lumbar (L)
• 5 Ngaahi konga Sacral (S)
• 1 CoC kongaíkouti fakasiokālaf (Co) – vestigial pe

ʻOku kau ʻi he ngaahi neave ʻo e filosiliva ʻa e laíSensory e CES ki he neave, ʻoku hu ki he méfilosiliva dula ʻi he tuʻunga takitaha, mo e RAsíMoto ʻa e CES, ʻOku maʻu ia mei he médula ʻi he tuʻunga takitaha.

ʻOku fakahingoa ʻa e ngaahi neave ʻo e filosiliva pea hiki ia ʻo fakatatau ki he tuʻuʻanga ʻo honau fotunga.ón mei he Kanali filosiliva.

ʻI he sipinga c1- 7 ʻOku maʻolunga ange ʻa e neave ʻi heʻenau Vértebras takitaha.

ʻI he C8 ʻoku nau ʻuluaki tuʻu hake ʻi he vahaʻa ʻo e séPtima VéCervical mo Toa rtebraáCica.

Ko e toenga ʻo e ngaahi neave ʻi lalo ʻi heʻenau v.értebras takitaha.

Ko e kolo dorsal ʻo sipinga c1 – 4 ʻOku tuʻu ia ʻi he vahefonuaóSuboccipital n.

C1 kau ʻi he innervación ʻo e múkia scules, kau ai ʻa e ʻulu ʻo e múSculo complexo lalahi.

ʻOku C2 ʻa e ongoón ʻo e tuʻa ʻo e ʻulu mo e kili ʻo e tumuʻaki, fakataha mo e innervacióN moto ki ha ngaahi múkia.

C3 – C5 tokoni ki he akoóN ʻo e neave Falaniseénico mo innervate ʻa e diaphragm.

Mei he C5- T1 ʻomi ʻe he moto ʻa e control ki he ngaahi faingataʻa ʻi ʻolunga moúNgaahi Scules ʻoku fekauʻaki.

Ko e méDula ToaáKuo CICA 12 ngaahi konga pea fakaʻata ʻa e puleʻi ʻo e thoracoabdominal musculature.

Ko e lumbar mo e ngaahi konga sacral ʻo e méDula maʻu 5 ngaahi kongá takitaha.

Mei he L2- ʻOku ʻoatu ʻa e S2 ki hono puleʻi ʻo e moto ʻi he ngaahi faingataʻa maʻulalo ange peaúNgaahi Scules ʻoku fekauʻaki.

Ko e medullary ko e terminación-ʻa e méfilosiliva.

Pia Mater hokohoko atuúha caudalmente como filum terminale ha través ʻo e houalotu dural pea fakahu ki he coccyx.

Kuo maʻu ʻe he coccyx ʻa e sóʻa e 1 konga ʻo e filosiliva.

Ko e Cauda equina (ʻo e latín, Horsetail) Ko e collectionón laíFilosiliva ʻo e neave CES, sacral mo lumbar ʻa e fefonongaʻaki caudally kimuʻa pea nau toki hu ki heʻenau intervertebral foramina.

Ko e méʻOsi ʻa e filosiliva dula ʻi he ngaahi tuʻunga L1 vertebral – L2.

LaíVentral mo dorsal CES

Ko e sino ʻo e féLula (ko ʻeku ʻuhinga, Ko e Soma) fakafuofuaʻiá ʻi he vaʻakau kimuʻa ʻi he ongo hoaéfilosiliva nquima.

Ko e ngaahi tuʻunga ʻo e ngaahi senita meʻa pe ʻoku ʻi ai e líʻOku mahuʻinga makehe ʻa e ngaahi meʻa ni (ʻOku hoko tautau toko ua ʻa e ngaahi tuʻunga ʻo e filosiliva meʻa peéSYNTHESIS, pea fai ha fakamatala ki he ngaahi kehekehe ʻo e ANATóMicas ʻi innervación):

• BíPorcini – C5 / 6
• Brachioradial – C5 / 6
• TríPorcini – C7 (C6- 8)
• Foʻi tuhu flexors – C8 (C7-T1)
• Tui – L3 (L2- L4)
• Tungaʻi vaʻe – S1 (L5- S2)
• LaíDorsal ʻa e CES (Sensory)

ʻOku tuʻu ʻa e ngaahi sino toʻotoʻo ʻo sensory ngaahi neave ʻi he ganglia ʻo e la.íZ dorsal.

Ko e la kotoa peíʻOku ʻi dorsal z ʻa e tokoni ʻa e ngaahi fale kotoa pe ʻi he tufakiʻanga naunauón ʻo hono konga ʻo e sino ʻoku fekauʻaki mo ia.

ʻOku fakatataaʻi ʻe he mape dermatome ʻa e sensory distributions ki he tuʻunga takitaha. ʻOku kehekehe ʻa e ngaahi mape ko ʻeni ʻo fakatatau ki he méfakaʻaongaʻi kotoa ʻi hono langaón.

Ko e gráʻOku makatuʻunga ʻa e FICAS ʻi he huhuón ti anestéSICOs fakalotofonua ʻi he fakaʻaliʻalión la gangliaíZ dorsal ngaahi haʻi fakafoʻituitui ʻo hypoalgesia hokohoko atuúha longitudinally mei he periphery ki he tuʻa.

ʻOku ʻi ai ha ngaahi mape ʻoku maʻu mei he mékotoa, ko e vakaión ʻo e tufakiʻanga naunauón ʻo herpes zoster kafo pe kongaón quirúLA Rgicaíz, Fakahaaʻi e ngaahi sipinga ʻoku ʻikai toe fakaʻaongaʻi.

Innervación mei ha konga dermatomal ʻe taha ki ha fehulunaki ʻe taha, más ki heún ke ala ki ai ʻi he mamahi.

Founga dermatomes fononga mei he tafaʻaki ki mui ʻo eóRax mo e kete, ʻOku ne fakahehema ke fakatahaʻi ʻa e maʻulalo.

Dermatomes

Dermatomes clíKo e meʻa mahuʻinga pe ʻa e ngaahi meʻa ko ʻeni:

• Sipinga c2 mo e C3 – Posterior ʻulu mo e kia
• C4 mo e T2 – hoko atu ki he niʻihi keheí ʻi ʻolunga he tóRax
• T4 pe T5 – Nipples
• T10 – pito
• Ngaahi faingataʻa ʻi ʻolunga – C5 (anterior uma), C6 (motuʻa tuhú), C7 (ʻuluʻulutuhu ífakahokohoko fakamotuʻalea mo e konga), C 7/8 (foʻi tuhu mamá), C8 (foʻi tuhu kiate auñMaʻuʻanga Fakamatala), T1 (Konga ʻi loto ʻo e uma), T2 (konga ʻi loto ʻo e nima ʻi ʻolunga), T2 / 3 (armpit)
• Ngaahi faingataʻa maʻulalo ange – L1 (anterior alanga ʻi ʻolunga – loto), L2 (Anterior alanga ʻi ʻolunga), L3 (tui), L4 (ʻIkai ke leleiéMedial olo), L5 (ʻI mui he vaʻe), L5 (louhiʻi vaʻe ʻo e 1-3), S1 (Louhé 4, 5; ʻIkai ke leleiéPeau ʻo e tafaʻaki)
• S3/sipinga c1 – Anʻoku ou

Lahi e ngaahi macrosc ʻoku fai ki ai e faingataʻaóʻOku Mahinongofua ʻa e Spades ʻi he fukahi méfilosiliva. Ko e máʻOku fakaʻilongaʻi ʻe he s ʻa e anterior ʻi loto fissure, Ko e ha ʻa eá nofoʻi ʻe he foʻi kalava anterior filosiliva.

ʻOku ʻikai ke fuʻu ʻiloa ʻa e posterior kaa loto hala groove. Anterior mo posterior ʻa e neave rootlets ʻi he anterolateral mo e posterolateral grooves.

Konga ki tuʻa ʻo e méfilosiliva

Ko e konga ki tuʻa ʻo e méʻOku faʻu ʻaki e filosiliva ʻa e meʻa hinehina, ka ko e konga ʻi loto ʻoku faʻu ʻaki ia ʻa e meʻa lanu Kulei.

ʻOku kau ʻi he meʻa hinehina ʻa 3 Fiefiaíʻasi: posterior, lateral mo e anterior. ʻOku ʻi ai ha ngaahi tohitufa ʻoku ʻalu hake mo ʻalu hifo.

ʻOku faʻa fakahingoa ha vahaʻataimi ʻe he kautahaón ʻo e tupuʻanga mo e ikuʻanga; Hangē ko ʻení, ʻOku originates ʻa e tohitufa corticospinal ʻi he cortex pea fakaʻosi ʻi heéfilosiliva.

ʻE lava ke vahevahe ʻa e meʻa lanu Kulei ki he 10 ʻu laʻipepa/kuta pe 4 ngaahi kongokonga:

• Anterior pe ventral Hoane (ko ʻeku ʻuhinga, moto neurons; láKeliʻanga VIII, IX, mo e konga ʻo e VII)
• Posterior pe dorsal Hoane (ko ʻeku ʻuhinga, ko ha konga sensory; lámaina ʻoku ou – MAMATA)
• Souni taukei (ko ʻeku ʻuhinga, ʻOku fekauʻaki neurons; láKo ʻeku VII)
• Lateral meʻatui (ko ʻeku ʻuhinga, ko ha konga ʻo e souni, ʻI he ngaahi konga ʻa Toaácicos mo e lumbar, ʻI he feituʻu ʻoku tuʻu ai ʻa e SIMP neuronsáTicas).

Ko e neurons ʻo e meʻa lanu Kulei ʻo e méFilosiliva dula fokién ʻoku fokotuʻutuʻu ia ʻi he ngaahi kolomu pe núCleos.

Ko e koloa gelatinous mo núSensory cleo ʻa e totonu ʻi he loloa kotoa ʻo e méfilosiliva pea maʻu e ngaahi ongo ʻo e mamahi.

Meʻa kehe núCleos, hange ko núCleo ʻa kalake, fakafuofuaʻián lolotonga sóʻi ha ngaahi konga pau.