The Anatomy of Neck and Back Pain
Nhamba dzakawanda dzemitsipa dzinotumira mashoko kune uye kubva muuropi dzinotora iyo ruzivo kuburikidza nemutsara wepelinha, iyo yakaputirwa mufuti rekudzivirira re vertebrae , pakati pekuzarurirwa (foramina) inobvumira kuderera kwemasinga emidzi. Izvo zvipfeko zvinoramba zvichienderera mberi kuti zvigadzire hurongwa hwehutachiona hwemhirizhonga.
Dzimwe nguva miviri yemoya inogona kuomeswa nekukura kwebonyoro kubva kune vertebrae, kana kupera kwe vertebra imwe pamusoro peimwe inopetesa kuvhura (foramen) kuburikidza noutano inotanga.
Apo izvi zvinenge zvichiitika, ruzivo rwemitsipa rwakakuvara mune izvo zvinonzi radiculopathy . Zviratidzo zvinoguma zvakasiyana, zvichienderana nenzvimbo yeropa remidzi.
Anatomy yeSpinal Column
Kunyange zvazvo kune zvimwe zvakasiyana pakati pevanhu, nokuda kwechikamu chikuru, isu tose tine mavara manomwe emutsipa wedu, anonzi cervical vertebrae. Pasi apa pane veritabhae yeminzwi (yakabatanidzwa nenyundo), uye zvadaro zvishanu verumibrae. Ikupedzisira lumbar vertebra yakabatanidzwa ku sacrum, bone guru rinobatsira kuumba denderedzwa.
Izwi racho rinowanzopfupiswa kusvika pane nhamba uye tsamba, kuverenga kubva kumusoro kwemupaka kusvika pasi. Semuenzaniso, C5 inoreva chikamu chechipiri chebererebra kubva kumusoro kwepamusoro. T8 inoreva kuti 8th thotic vertebra ichibva pasi kubva kuC7 (yekupedzisira yemirasi yembeu vertebra).
Nenzira yakawanda, mitsetse midzi inodanwa zita refupa riri pamusoro pavo. Somuenzaniso, mutsara unobva pakati pe 4th uye 5th lumbar vertebrae ingadai yakanzi L4.
Iyo mishonga yemukati yakasiyana, kunyange: kunyange kune 7 chete yemirasi yeververvous, pane 8 mishonga yecervical, iyo yekutanga iripo pane yekutanga vertebra yemudzimai. Saka mumutsipa, mitsetse iyo inonyorwa mushure meiwo vertebrae pasi pavo. Kuti zvive zvakajeka, zvinowanzonyanya kutsanangura nerve midzi nokutarisa zvose vertebrae, semuenzaniso (C7-T1), asi vanachiremba vakawanda havaiti izvi mumitambo yezuva nezuva.
Mutsipa wepelineni pachawo zvirokwazvo unoburukira kuL1 muvanhu vakuru, uko inoguma muchitarisiko chinonzi conus medullaris. Mitsipa inoenderera mberi ichidonhera kubva pano, asi, inotenderera mu sac ye cerebrospinal fluid. Izvi zvinounganidza zvinonzi "cauda equina", chiLatini "muswe wemabhiza," iyo mitsipa yakasununguka yakafanana yakadaro kusvikira ichibuda kunze kweyambu yepamusoro pakati peiyo vertebrae.
Radiculopathy Symptoms
Mutsipa wega wega wega unobuda iwoyo mutsara wesimbi unotakura mameseji kubva muuropi kuti aite mishonga inofamba, uye anogamuchira mharidzo kubva kune dzimwe nzvimbo dzeganda. Nemhaka yeizvi, zvinokwanisika kutarisa pane imwe nzvimbo iyo radiculopathy iri kuitika, zvichienderana nezviratidzo zvinowanikwa. Uyezve, radiculopathies inenge inoshungurudza nguva dzose, asi dzimwe dzakawanda zvinetso zvepfungwa hazvisi.
Radiyopathies yakawanda inokonzerwa nekushanduka kwakanyatsonaka mumagadzirirwo emakona emutsetse we vertebral. Miti yemagetsi inorambidzwa kubva pakuchinja zvikuru nokuti yakasimbiswa ne ribcage. Nokuda kwechikonzero ichi, radiurupathies inonyanya kuonekwa inoitika mumuromo wechikanda uye lumbar spine.
Cervical Radiculopathies
Mitsipa iyo inobva pamutsipa wepelinha mumutsipa inobva kune vertebral foramina kuti iite pattern intermixing inonzi brachial plexus.
Kubva ipapo, mishonga inopfuurira kuenda kunononoka ganda nemisungo yoruoko. Nezvinangwa zvinoshanda, iyo inokosha zvikuru yenzara midzi iri muruoko iC5, C6, uye C7. Zvakakosha kuziva kuti vanenge makumi maviri kubva muzana zvehutachiona hwehutachiona hunosanganisira mazinga maviri kana kupfuura.
C5: The deltoid (mushupa wepafudzi unosimudzira ruoko kubva mumuviri) hauna kubatwa nemisungo inobva kuC5. Mukuwedzera kune utera husina simba, iyi radiculopathy inogona kutungamirira kumapfupa mufudzi nepamusoro.
C6: C6 radiculopathy inogona kukonzera kushaya simba mune biceps uye zvidzidzo zvemaoko. Mukuwedzera, pangangodaro kuve nekunzwa kusinganzwisisiki mukati meikorodho neminwe yapakati, pamwe nechomwe chikamu chepamberi.
C7: Anenge hafu (46 kubva muzana) yezvose zvinokonzera radiculopathies dzinosanganisira mutsara uyu. Iko kushayiwa simba kunowanikwa mumashure ekunyengera kunotambanudza ruoko. Ikoko kunogonawo kuva nekurasikirwa kwekunzwa mune rumwe rutivi rworuoko, zvakadai sedon'i.
Lumbar Radiculopathies
Mitsetse iyo inobva muNeural foramina mu lumbar spine inotanga kuumba lumbar plexus, yakaoma anastomosis yemitsipa yakasiyana. Kubva ipapo, mishonga iyi inoramba ichienda kunononoka ganda nemisungo yegumbo.
L4: The iliopsoas , iyo inoshandura chiuno, inogona kunge isina simba, sezvingaita se quadriceps inowedzera gumbo pamabvi. Mabvi uye chikamu chemuzasi makumbo angavewo akaenzana.
L5: Kukwanisa kusimudza pfungwa yegumbo kubva pasi kunogona kuderedzwa, uye kumusoro kwepamusoro petsoka kunogona kupera. Iyi nerve midzi inobatanidzwa munenge 40 kusvika 45 muzana ye lumbosacral radiculopathies.
S1: Kukwanisa kuratidza rutsoka kusvika pasi (sekunge iwe uchizoenda kumagetsi) kunowedzera simba, uye kunogona kunge kuine kupera kwechingano chiduku uye chetsoka. Iyi nerve midzi inobatanidzwa munenge 45 kusvika ku50 muzana ye lumbosacral radiculopathies.
Isu takangobva kuongororodza mararamiro emitsipa anobva mumutsipa wepelinha. Apo patakakurukura zvimwe zvezviratidzo, hatina kutotanga kutsvaga zvikonzero zvakasiyana-siyana zveuropathy kana kurapa kwavo. Nepo marwadzo mazhinji ekurwadziwa anoenda ari oga, kana utera huri kukura, chiratidzo chekuti chirwere chinotyisa chinogona kudanwa.
Sources:
Kushandisa AR, Sander HW, Clinical Approach Periipheral Neuropathy: Anatomic Localization uye Kuongorora Kuongororwa. Continuum; Bhuku 18, No 1, February 2012
Blumenfeld H, Neuroanatomy kuburikidza neCliniki Cases. Sunderland: Sinauer Associates Publishers 2002