Ubume ngesandla esihlahleni. Isakhiwo yokwakheka esandleni

Ukuhlola isakhiwo ngesandla, kwakunye naziphi na isebe kwinkqubo yethu musculoskeletal, kuba kunokuba nzima. It iqulathe izakhiwo ezithathu eziphambili: amathambo, izihlunu kunye nemisipha ukuba ubambe amathambo. Brush iye sezigaba ezintathu, ezizezi, iwotshi, iminwe kunye pastern.

Kweli nqaku, siza kuxubusha brush: isakhiwo, izihlunu, amalungu esandleni. Masiqalise kunye nenkcazelo amathambo kumasebe alo ahlukeneyo.

ithambo carpal

Ekubeni izandla kufuneka ukwenza intshukumo oluchanileyo kakhulu kwaye ngendlela entsonkothileyo, isakhiwo lithambo ngesandla nalo kunzima kakhulu. Sosana - 8 amathambo ezincinane isimo engagunyaziswanga, ezicwangciswe imikrozo emibini. Kumfanekiso ongezantsi uyakwazi ukubona ubume isandla sokunene.

I proximal articular phezu eziliqela ngeendlela, endaweni engaba khaxa. It iqulathe amathambo, ukubala ukusuka yesihlanu ukuya ubhontsi: pisiform, ezibunxantathu, semilunar kunye navicular. kumqolo olandelayo - distal. Idibanisa leziNdlu proximal semilo engagunyaziswanga. I Umqolo distal iqulathe amathambo ezine: trapezoidal, polygonal, capitate kunye hamate.

ithambo pastern

Eli sebe ubunjwe tubular amathambo 5 metacarpal, naye ubonisa isakhiwo entsonkothileyo esandleni. Amathambo of amathambo elide sinzima. Ngamnye kubo unomzimba, isiseko kunye nentloko. lithambo Metacarpal ngomnwe 1 mfutshane kunezinye kwaye okukhulu. Ithambo metacarpal yesibini - ixesha elide. Abanye ziyancipha ngobude nomgama ukusuka yokuqala kufutshane elunxwemeni engqinibeni. Izizathu amathambo pastern ngasentla ngesiNgesi kunye namathambo uyila esihlahleni. I metacarpals yokuqala sesihlanu bafanelekile kunye nomphezulu articular ngeemilo yesali, ngoxa abanye - flat. Amasuntswana metacarpal bone ukuba i umphezulu articular (hemispherical) ngokucacileyo kunye phalanges ngomnwe proximal.

amathambo yeminwe

umnwe nganye, ngaphandle kweyokuqala, equka phalanges amabini kuphela kwaye umlinganiselo, kukho 3 yokuhlasela: distal, proximal kunye ophakathi (intermediate). Eyona imfutshane - distal; Proximal - ixesha elide. Ekupheleni distal sinentloko le ndlela yokuhlasela, kwaye proximal - isiseko salo.

amathambo Sesamoid ibrashi

Kumbindi imicu, ngaphandle kwezo namathambo sesamoid elahliweyo phakathi yokuhlasela proximal ze ubhontsi kunye ithambo layo metacarpal. Kukwakho non-permanent amathambo sesamoid. Bona ephakathi yokuhlasela proximal neminwe yesihlanu yesibini kunye namathambo metacarpal. Ngokuqhelekileyo amathambo sesamoid ibekwe phezu palmar. kodwa ngamanye amaxesha ingafunyanwa kwi ngasemva. bone Pisiform nayo ngqo imboniselo ngasentla. amathambo Sesamoid kunye neenkqubo zabo kwandisa amandla igxalaba kwezihlunu, nca kuzo.

Siye kwakhona isakhiwo isandla kunye kwisihlahla amathambo, ngoku sifikile apparatus ligamentous.

sosana joint

Le ibandakanya bone iphiramidi ebonisa ukrozo proximal amathambo carpal: ezibunxantathu, semilunar kunye navicular. Le ulna ke zincediswe articular disc kwaye alibandakanyi entlanganweni esihlahleni. Indima iphambili ekubunjweni engqinibeni lidlala ithambo ulnar. Nangona iwotshi - ug. Sosana elidityanelweyo imilo - okweqanda. Kuyinto nemithathu kunokwenzeka, adduction brush, flexion kunye ukwandiswa. intshukumo encinane ukujikeleza kwisixando (degrees 10-12) nazo kunokwenzeka kweli joint, kodwa ngenxa mbo njengoko luthambe le intlala articular. Esebenzisa kwizihlunu ezithambileyo Kulula ukubona noqhoqhoqho welungu kunene, nto leyo ubonwe kunye ulnar kunye namacala iphiramidi. Ngengqiniba unako ukufuna lokungahlangani trihedral phakathi ithambo kunye intloko ulna. Nge icala iphiramidi ebonisa unxibelelwano - umsantsa phakathi malleoli kunye osecaleni ulnar styloid.

Movement welungu izihlahla ngokusondeleyo ukuya entlanganweni umsebenzi srednezapyastnogo ibekwe phakathi kwemiqolo distal kunye proximal. kumphezulu wayo intsonkothile imilo ezitenxileyo ezinokwenzeka. Xa flexion nokwandiswa ukushukumiseka umthamo kufika kumgomo we 85. Ukuncitshiswa brush kwi joint ngasentla kufika kumgomo we 40 nokuxhwilwa - 20. Leli kwisihlahla nise circumduction, ngamanye motion setyhula.

Leli lunga kuqiniswa nemisipha ezininzi. Bona zibekwe phakathi amathambo ngamnye, ngokunjalo phezu osecaleni, medial, yaye emva palmar phezu esihlahleni. lungu izibambiso (radius lengalo) zidlala indima ebaluleke kakhulu. Ngomhla ulnar kunye iphiramidi ebonisa amacala retinaculum flexor ibekwe phakathi ezisezintabeni ngethambo - iqela okhethekileyo. Eneneni, awusebenzi kumalungu ngesandla, njengoko ukuqina le ifascia. Retinaculum flexor sosana ifolo iba emjelweni, nginginya lo luvo median kunye nemisipha digitorum flexor. Siyaqhubeka ukuchaza kwendlela ezakhiwe ngayo ngesandla.

amalungu Carpometacarpal

Ba tyaba, ukuba ingasebenzi. Le Okungumahluko odibeneyo ubhontsi. Range sesicelo amalungu carpometacarpal - akukho ngaphezu degrees 5-10. Bathi kuphela ukuhamba, t. To. Le nemisipha ziphuhliswa kakuhle. Isendaweni phezu palmar, zakha nemisipha ozinzileyo palmar yokungena phakathi thambo metacarpal kunye esihlahleni. Khona ngebrashi arcuate lungu, kwaye osecaleni ziqu. Capitatum ngundoqo nemisipha, oko Ndafumana inani elikhulu nemisipha. Palmar kuphuhliswa ngcono kakhulu angasemva. nemisipha bakhulise ukudibanisa amathambo esihlahleni. Bakha njengezingxobo ukuqina ezo isale ucishe la mathambo. Intercostals ibekwe kumqolo wesibini amathambo carpal.

Nasesithupheni joint carpometacarpal eyenziwe isiseko wethambo yokuqala metacarpal kunye polygonal. Imiphezulu articular zezi imilo undim. Le zithi ukusebenza iintshukumo ezilandelayo: nokuxhwilwa, adduction, misa (eshukumayo retrograde), inkcaso (inkcaso) kunye circumduction () ekhonkcwe kwisiqu. Umqulu ukuqonda iintshukumo, ngenxa yokuba ubhontsi oluchasene bonke abanye, inyuswe kakhulu. 45-60 degrees of ukushukumiseka carpometacarpal odibeneyo ukuthinjwa lobhontsi naphezu actuation, kwaye ngexesha intshukumo ukubuyela nokulungisa - 35-40.

Ubume esandleni: amalungu metacarpophalangeal

amalungu ebizwa kumiswa iintloko brush metacarpals kunye inxaxheba neziseko phalanges proximal. Ba ungqukuva, ibe nemigca enqamleze ezintathu macala nkqo ye ukujikeleza kuyo ukwandiswa kunye flexion, ukuthwala kunye adduction, kwakunye isindululo setyhula (circumduction). Ukuzisa nokufuduswa kunokwenzeka izidanga 45-50 kunye flexion kunye nokwandiswa - ngo 90-100. Ezi amalungu kufuneka nemisipha collateral emacaleni, siyixhase kubo. Palmar okanye Izandiso i kwicala palmar le philisi. ngefayibha zabo zimanyene kunye Imicu lungu ezinqamlezayo enzonzobila ukuba uthintele divergence kwi kumacala ahlukeneyo iintloko amathambo metacarpal.

amalungu Interphalangeal esandleni

Bona trochlear imilo kunye axis zabo ujikelezo ukwandisa transversely. Ulwandiso kunye flexion kunokwenzeka nale nangeempahla ezibukhali zesinyithi. Amalungu interphalangeal proximal abe umthamo flexion nokwandiswa, lingana degrees 110-120, distal - 80-90. amalungu Interphalangeal komelezwa kakuhle kakhulu lungu akananto.

esingxotyeni synovia ezinezikhondo of imisipha yeminwe

Extensor retinaculum, kwakunye retinaculum flexor, kudlala indima ebalulekileyo ekomelezeni ukuma imisipha izihlunu abapasa ngaphantsi. Oku kuyinyaniso ngakumbi xa usebenza ngesandla: Extension yayo flexion. Nature isakhiwo esenzelwe unobuchule kakhulu isandla. Imisipha ke inkxaso-zikhankanywe apha ngasentla kunye kumphezulu zawo. Ukwahlulwa imisipha ukusuka ithambo ukuthintela neqhina. Oku kukuvumela ukuba umsebenzi makuqhutyekwe womelele imisipha ukumelana ezininzi ndinyanzelekile.

Ukunciphisa ungquzulwano isiliphu of imisipha elandisiweyo ukususela ziyenza njani kwi brush, igalelo imicu esingxotyeni ezizodwa, apho ulithambo-fibrotic okanye iindlela fibrotic. Zezona esingxotyeni synovia. Inani elikhulu (6-7) ongaphantsi retinaculum extensor. Radius and ulna babe vee ezithiywe indawo imicu kwezihlunu. Njengoko ngokunjalo ebizwa ngokuba yi-webs ezinezikhondo leyo kwahlula amajelo enye kwenye wandise ukuya namathambo retinaculum extensor.

Palmar esingxotyeni synovia kukho imisipha flexor neminwe kunye nezandla. Iyonke lobufazi synovia kudlulela embindini entendeni kwaye ufikelela yokuhlasela distal ngomnwe yesihlanu. Nazi ke nemisipha and enzonzobila flexor digitorum. Nasesithupheni uba flexor imicu elide ibekwe kwi lobufazi lwamalunga ngaphandle watyhutyha kwi ngomnwe kunye imicu. esingxotyeni synovia entendeni izihlunu isandla sakho ngoku, ndayihluthwa nemisipha ukuya lwesine, iminwe wesibini nowesithathu. Kuphela imicu ngomnwe yesihlanu esingxotyeni salo lwamalunga, nto leyo ukwandiswa lilonke.

imisipha ngesandla

Kumfanekiso ongezantsi uyakwazi ukubona izihlunu ngesandla. Ubume esihlahleni kuboniswa banzi.

Izihlunu esandleni kuphela kwicala palmar. Zahlula ngokwamaqela amathathu: medium, iminwe ezinkulu nezincinane.

Ekubeni iminwe ifuna ngqo enkulu, kwi brush linani elikhulu izihlunu elifutshane, nzima isakhiwo ngesandla. Izihlunu izandla nganye yala maqela kuxoxwa ngezantsi.

Iqela phakathi izihlunu

It abunjwe izihlunu umbungu-like, ukuqala anzongonzongo digital flexor imicu kwaye ziqhotyoshelwe apha kule ndlela yokuhlasela proximal, okanye mandithi neziseko zazo ukusuka yesibini ukuya ngomnwe wesihlanu, xa siqwalasela isakhiwo ngesandla. Izihlunu izandla aba nabo bavela emva palmar interosseous, ibekwe phakathi amathambo pastern, eqhotyoshelwe kwisiseko yokuhlasela proximal. Umsebenzi weli qela kukuba ezi izihlunu abandakanyeka flexion le phalanges proximal ezi iminwe. Ngenxa kwizihlunu palmar interossei angazisa ngomnwe ukuya ngomnwe brush eliphakathi. Kunye intercostals rearmost cala zizalele.

Izihlunu ubhontsi

Eli qela yakha ubume ubhontsi. Ezi izihlunu uqale ngeenxa kufutshane ithambo pastern kunye esihlahleni. Ke nasesithupheni flexor yakhe emfutshane kuqhotyoshelwe kufuphi ithambo sesamoid, nto leyo imi kufutshane kwisiseko yokuhlasela proximal. Uthelekiswa imisipha nobhontsi iya ithambo yokuqala metacarpal, kwaye ikhokelela nasesithupheni phezu mathambo engaphakathi sesamoid.

imisipha yeminwe Small

Eli qela izihlunu yakha ngaphakathi entendeni ephakamileyo. Ezi ziquka: umsipha umnwe abductor encinane, ngokungafaniyo kunye Ucikicane, palmar elifutshane flexor elifutshane.

Bona sivela ithambo ezingqonge kwi esihlahleni. Ezi izihlunu zincamathele kwi siseko ezinzwaneni yesihlanu, okanye mandithi yokuhlasela yayo proximal, kwaye ithambo yesihlanu metacarpal. umsebenzi wabo kubonakaliswe isihloko.

Kweli nqaku siye sazama kakhulu ngokuchanileyo ukumela isakhiwo ngesandla. Human - yinto inzululwazi esisiseko esifuna, Kakade ke, uhlolisiso ngenyameko ngakumbi. Ngoko ke, eminye imibuzo wahlala mbane. Ubume isandla kunye iwotshi - isihloko eyithandayo kuphela kumagqirha. Ulwazi kuyimfuneko yabadlali, abahlohli ukufaneleka, abafundi kunye nezinye iindidi zabantu. Ubume ngesandla, njengoko uye waphawula, kakhulu entsonkothileyo, nokufunda kunokuba kakhulu ixesha elide, sithembele kwiintlobo ngeentlobo zemithombo yolwazi.