Kapangidwe ka dzanja ndi dzanja. Kapangidwe anatomical dzanja

Kuwerenga mosamala kapangidwe ka dzanja, komanso dipatimenti ina ya ubongo wathu minofu ndi mafupa, ndi m'malo zovuta. Amakhala ndi nyumba zazikulu zitatu: mafupa, minofu ndi Mitsemphayi akugwira mafupa. The burashi ali m'magulu atatu, ndicho dzanja, zala ndi pastern.

M'nkhani ino tikambirana burashi: kapangidwe, minofu, mafupa manja. Tiyeni tiyambe ndi malongosoledwe a mafupa m'madipatimenti zosiyanasiyana.

carpal fupa

Popeza manja ndi kuchita zolondola kwambiri ndi zosamvetsetseka kayendedwe, Mafupa dzanja ndi kovuta. The dzanja - 8 mafupa ka mawonekedwe osasamba, anakonza mizere iwiri. Mu chithunzi m'munsimu inu mukhoza kuwona dongosolo la manja.

The proximal articular pamwamba angapo a mitundu, kuti utali wozungulira otukukira kunja. Amakhala ndi mafupa, kuwerenga kuchokera wachisanu ndi chala choyamba: pisiform, triangular, semilunar ndi navicular. Lotsatira mzere - wapotalikira. Izo zikugwirizana ndi olowa proximal wa mawonekedwe osasamba. Mzere wapotalikira tichipeza mafupa zinayi: trapezoidal, polygonal, capitate ndi hamate.

pastern fupa

Dipatimenti imeneyi imakhala ndi tubular mafupa 5 metacarpal, kumasonyezanso kapangidwe zosamvetsetseka manja. Mafupa a mafupa yaitali zovuta. Aliyense ali ndi thupi, m'munsi ndi mutu. Metacarpal fupa la chala 1 ndi wamfupi kusiyana ndi ena ndi chachikulu. The chachiwiri metacarpal fupa - motalikitsa. Ena yafupika m'litali monga mtunda kuchokera woyamba kwambiri kwa m'mphepete mwa chigongono. Grounds kwa pamwamba mafupa pastern athandize ndi mafupa kupanga polumikizira. The metacarpals woyamba ndi wachisanu ndi oyenerera ndi pamalo articular ndi akalumikidzidwa chishalo, pamene ena - mosabisa. Tinthu metacarpal fupa kukhala ndi articular padziko (hemispherical) linanena ndi phalanges proximal chala.

mafupa chala

Zala, koma choyamba, chomwe phalanges awiri okha ndipo ali avareji, pali 3 phalanx: wapotalikira, proximal ndi pakati (wapakatikati). Yachidule - wapotalikira; Proximal - motalikitsa. Kumapeto wapotalikira ali mutu wa phalanx, ndi proximal - maziko ake.

Sesamoid mafupa burashi

Mkati mwa tendon, koma mafupa amenewo ndi sesamoid oyenerera pakati pa phalanx proximal ya chala chachikulu ndi fupa ake metacarpal. Palinso sanali okhazikika sesamoid mafupa. Iwo lili pakati pa phalanx proximal zala wachisanu ndi wachiwiri ndi mafupa metacarpal. Kawirikawiri mafupa sesamoid ili pamwamba palmar. Koma nthawi zina angapezeke pa nsana. Pisiform fupa ndi analangizanso maganizo pamwamba. mafupa Sesamoid ndi njira zawo kumawonjezera phewa minofu mphamvu, kuwakonda.

Ife takambirana Kapangidwe ka dzanja ndi dzanja mafupa, tsopano ife tikubwera kwa zida za ligamentous.

dzanja olowa

Amakhala zozungulira fupa ndi mzere proximal mafupa carpal: triangular, semilunar ndi navicular. The ulna ndi lowonjezera ndi chimbale articular ndipo alibe kuwonjezera ku dzanja olowa. Udindo waukulu mu mapangidwe chigongono masewero fupa ulnar. Ngakhale polumikizira - mtengo. Dzanja olowa mu mawonekedwe - elliptical. N'zotheka atigwira, adduction burashi, flexion ndi kutambasuka. Small chabe rotational kayendedwe (10-12 madigiri) komanso zitheka mu olowa izi, koma ikuchitika chifukwa cha elasticity wa articular chichereŵechereŵe. Kudzera minofu zofewa n'zosavuta kuona kudula wa dzanja limodzi umene uli zimadziŵika ndi ulnar ndi mbali zozungulira. Ndi mawondo akhoza kumufufuza trihedral recess pakati pa mafupa ndi ulna mutu. Ndi mbali zozungulira - kusiyana pakati pa malleoli ndi lateral ulnar styloid.

Movement wa dzanja olowa ndi yogwirizana ntchito srednezapyastnogo olowa lili pakati pa mizere wapotalikira ndi proximal. pamwamba pake ndi kobvuta mawonekedwe osasamba. Pamene flexion ndi kutambasuka sayenda buku ukufika madigiri 85. Kuchepetsa wa burashi mu olowa pamwamba ukufika madigiri 40 atigwira - 20. dzanja olowa akhoza kukumana circumduction, i.e. zozungulira kuyenda.

olowa Izi zingatheke ngati Mitsemphayi ambiri. Iwo zili pakati pa mafupa munthu, komanso pa lateral, medial, ndipo kumbuyo kwa palmar pamwamba pa dzanja la. Ina mitsempha (utali wozungulira ndi ulna) ndi mbali zofunika kwambiri. Pa ulnar ndi zozungulira mbali ya flexor retinaculum ili pakati okwera fupa - gulu lapadera. Ndipotu, zilibe ntchito kwa mafupa dzanja, monga thickening wa fascia lapansi. Retinaculum flexor dzanja mzere kwasanduka ngalande, amene makamu mitsempha apakatikati ndi tendons wa flexor digitorum. Tipitirize pofotokoza thunthu manja.

zimfundo Carpometacarpal

Iwo mosabisa, iwo ali wofooka. Kupatulapo ndi anzake a chala choyamba. Osiyanasiyana zoyenda mfundo carpometacarpal - zosaposa madigiri 5-10. Iwo okha zoyendayenda, T. Kwa. The Mitsemphayi bwino anakamba. Inali pamwamba palmar, iwo apanga khola palmar Mitsemphayi kulumikiza pakati pa fupa metacarpal ndi dzanja. Pali pa tchire arcuate mitsempha, ndi lateral ndi zozungulira. Capitatum chapakati ku Mitsemphayi, ndi wotetezedwa ambiri Mitsemphayi. Palmar anayamba kuposa kumbuyo. Mitsemphayi kumbuyo kulumikiza mafupa a polumikizira. Iwo amapanga makapisozi thickening amene TACHIMATA ndi zimfundo pakati pa mafupa awa. Intercostals zili mu mzere wachiwiri mafupa carpal.

The chala carpometacarpal olowa aumbike mwa maziko a woyamba metacarpal fupa ndi polygonal. The articular kali ndi chishalo mawonekedwe. olowa Izi tikhoza kuchita zochita zotsatirazi: atigwira, adduction, muyike pena (retrograde zoyenda), otsutsa (otsutsa) ndi circumduction (yozungulira). Volume amvetse kayendedwe, chifukwa chakuti chala zimatsutsana ndi ena onse, ali kwambiri. madigiri 45-60 ya sayenda carpometacarpal anzake a chala chachikulu atigwira ndi pa actuation, ndi pa gulu kubwerera ndipo Mosiyana - 35-40.

Kapangidwe ka dzanja: metacarpophalangeal zimfundo

Otchedwa mfundo anapanga mitu burashi metacarpals ndi nawo zapansi wa phalanges proximal. Iwo ali ozungulira, ndi atatu nkhwangwa matanthauzo perpendicular wa kasinthasintha padziko limene extension flexion, atigwira ndi adduction, komanso lamulo zozungulira (circumduction). Kulera ndi achoke n'zotheka madigiri a 45-50 ndi flexion ndi kutambasuka - pa 90-100. mafupa awa ndi Mitsemphayi ina mbali, amene amawalimbikitsa. Palmar kapena yophunzitsa ndi mbali palmar ya kapisozi pa. ulusi awo imachitika mogwirizana ndi ulusi zozama yopingasa mitsempha kuti kumathandiza divergence mu mbali zosiyana za atsogoleri a mafupa metacarpal.

zimfundo Interphalangeal dzanja

Iwo trochlear mawonekedwe ndi olamulira awo a kasinthasintha kuwonjezera transversely. Extension ndi flexion zotheka padziko nkhwangwa izi. The proximal interphalangeal zimfundo ndi buku la flexion ndipo powunikiridwa m'chiphiphiritso, wofanana madigiri 110-120, wapotalikira - 80-90. zimfundo Interphalangeal bwino analimbikitsidwa ndi ina mitsempha.

Synovial ndi fibrous m'chimake a tendons chala

Extensor retinaculum, komanso flexor retinaculum, kungathandize kwambiri kulimbitsa udindo wa tendons minofu kudutsa pansi. Zimenezi ndi zoona makamaka pamene ntchito dzanja: mu kutambasuka ake ndi flexion. Nature anafuna kapangidwe ndi woyenera kwambiri dzanja. Tendons ndi tatchulawa thandizo molumikizana ndi pamwamba mkati zace. Kulekana kwa tendons ndi fupa pofuna tayi. Izi zimathandiza kuti ntchito kwambiri ndi amphamvu minofu chidule kupirira nkhawa kwambili.

Kuchepetsa mikangano ndi Pepala la tendons anakafika ku mkono pa tchire la, zimathandiza wapadera tendon m'chimake, amene ali mafupa fibrotic kapena njira fibrotic. Iwo ali synovial m'chimake. Chiwerengero chachikulu kwambiri (6-7) pansi pa extensor retinaculum. Utali wozungulira ndi ulna ndi grooves ofanana malo a minofu tendon. Komanso otchedwa webs fibrous amene kupatukana mitsinje Chrixitu ndi kuwonjezera kwa mafupa a extensor retinaculum.

Palmar synovial m'chimake ndi flexor tendons zala ndi manja. Total synovial nyini imafika ku likulu la kanjedza ndi umalandira phalanx wapotalikira chala wachisanu. Nawa tendons a ofunika komanso chozama flexor digitorum. The chala ali yaitali flexor tendon ili mu nyini synovial padera ndi kudutsa pa chala ndi tendon a. Synovial m'chimake m'dzanja la dzanja minofu yanu mosatsata tendons kuti apite ku chachinayi, lachiwiri ndi lachitatu zala. Only tendon chala wachisanu ali m'chimake synovial, umene uli mbali ya chonse pamodzi.

minofu dzanja

Mu chithunzi m'munsimu inu mukhoza kuwona minofu dzanja. Kapangidwe ka dzanja kumaonekeranso mwatsatanetsatane.

Minofu dzanja yekha kumbali palmar. Iwo agawidwa m'magulu atatu: sing'anga, yaikuluikulu zala.

Popeza kayendedwe chala amafuna mogometsa kwambiri, mu burashi ndi ambiri a minofu lalifupi, complicating kapangidwe ka dzanja. Minofu ya manja a gulu lililonse zafotokozedwa pansipa.

The gulu pakati minofu

Iwo aumbike minofu nyongolotsi-ngati, kuyambira kwambiri digito flexor tendon ndi Ufumuyo kwa phalanx proximal, kapena m'malo zapansi awo kwa wachiwiri kwa chala wachisanu, ngati tikambirana kapangidwe ka dzanja. Minofu ya manja a iwonso kubwera kuchokera kumbuyo ndi palmar interosseous ili pakati pa mafupa a pastern ndi, zaikidwa m'munsi mwa phalanx proximal. Ntchito gulu ili kuti minofu imeneyi zimakhudzidwa flexion wa phalanges proximal chala izi. Chifukwa palmar minofu interossei akhoza kubweretsa chala kwa burashi pakati chala. Ndi intercostals rearmost ndi kuswana mbali yawo.

Minofu ya chala choyamba

gulu ndipamene kukwezedwa kwa chala choyamba. Minofu imeneyi kuyamba padziko pafupi pastern fupa ndi dzanja. Koma chala cha flexor wake lalifupi Ufumuyo pafupi fupa sesamoid, limene lili pafupi m'munsi mwa phalanx proximal. Motsutsana ndi minofu chala apita woyamba metacarpal fupa, ndipo atsogolera chala chachikulu pa mkati mafupa sesamoid.

minofu Small chala

Gulu la minofu ndipamene mkati m'manja mwa okwera a. Zikuphatikizapo: aang'ono chala abductor minofu, kusiyana ndi chala wamng'ono, wamfupi palmar ndi waufupi flexor.

Iwo ndi ochokera ku fupa ozungulira mu polumikizira. Minofu imeneyi amagwira m'munsi mwa chala wachisanu, kapena m'malo phalanx ake proximal, ndipo wachisanu metacarpal fupa. Ntchito yawo umaonekera mutu.

M'nkhani ino ife tayesera molondola kwambiri akuimira dongosolo manja. Kaswili - ndi sayansi zimachititsa kuti amafuna, ndithudi, ndi mosamala kwambiri. Choncho, mafunso ena anakhalabe yosayatsa. Kapangidwe ka dzanja ndi dzanja - mutu kuti chidwi osati madokotala. Kudziŵa m'pofunika mpikisanowo, olimba aphunzitsi, ana asukulu ndi magulu ena a anthu nawonso. Kapangidwe ka dzanja, monga inu mwazindikira, zovuta kwambiri, ndi kuphunzira zingakhale ndithu nthawi yaitali, kudalira njira zosiyanasiyana zopangira.