The nemamiriro ruoko uye chiningoningo. The anatomical nemamiriro ruoko

A kunyatsoongorora nemamiriro ruoko, uyewo mimwe dhipatimendi wedu zvetsandanyama nemapfupa ezvinhu, zviri nani kunzwisisa. Inoitwa chikuru hurongwa matatu: mabhonzo, tsandanyama uye nemarunda vanobatisisa mapfupa. The mumakwenzi ane mapoka matatu, kureva, chiningoningo, minwe uye pastern.

Munyaya ino, tichakurukura bhurasho: chidziro, tsandanyama, zvenguvo ruoko. Ngatitange nematsananguriro mapfupa mumadhipatimendi aro akasiyana.

carpal pfupa

Sezvo maoko kuita zvikuru yakarurama uye oma kufamba, mapfupa mamiriro ruoko ndiyewo zvakaoma. The chiningoningo - mapfupa 8 duku kwemashifiti chimiro, akarongwa misara miviri. Mumufananidzo pazasi unogona kuona chimiro rworudyi.

The proximal articular pose zvinoverengeka siyana, kuti convex nharaunda. Inoitwa mapfupa, tichiverenga kubva weshanu napagumwe roruoko: pisiform, mativi, semilunar uye navicular. Napamusara Next - distal. It chinobatanidza kuti proximal vadyi kwemashifiti chimiro. The distal mutsara ine mapfupa zvina: trapezoidal, polygonal, capitate uye hamate.

pastern pfupa

Dhipatimendi iri rinoumbwa tubular 5 metacarpal mapfupa, uyewo unoratidza oma nemamiriro ruoko. Marangwanda mapfupa refu yakaoma. Mumwe nomumwe wavo ane muviri, ane nechigadziko uye musoro. Metacarpal bvupa wa1 munwe rakapfupika kupfuura vamwe uye ari makuru. Wechipiri metacarpal mapfupa - wakarebesa. Vamwe vari kuderedzwa nokureba kwakaenzana nomumwe kunoita kubva uye kuswedera pamucheto kugokora wokutanga. Chikonzero pamusoro mapfupa pastern nekutaura pamwe mapfupa achiumba chiningoningo. Wekutanga wechishanu metacarpals vanokodzera pamwe articular hukawanika pamwe Chigaro zvitarisiko, apo vamwe - sandarara. Bits metacarpal pfupa yakaruma articular pamusoro (hemispherical) articulated pamwe proximal munwe phalanges.

chigunwe mapfupa

munwe nerimwe, kunze wokutanga, chine phalanges maviri chete uye ine avhareji, pane 3 phalanx: distal, proximal uye pakati (zvenguva). Pfupi - distal; Proximal - wakarebesa. Panguva distal mugumo ane musoro phalanx, uye proximal - nheyo dzaro.

mapfupa Sesamoid mumakwenzi

In mukati menyika mudzira, kunze mapfupa avo vane sesamoid vanoda pakati proximal phalanx pamusoro thumbs wayo metacarpal pfupa. Panewo vasiri zvachose sesamoid mapfupa. Vari chiri pakati proximal phalanx rechishanu uye wechipiri minwe uye mapfupa metacarpal. Kazhinji mapfupa sesamoid iri Palms pamusoro. Asi dzimwe nguva vanogona kuwanikwa ari shure. Pisiform pfupa riri ndiverenge pamusoro maonero. mapfupa Sesamoid vavo pezvakaitwa kuwedzera mafudzi tsandanyama simba, akabatana navo.

Tava akaongororwa sechivako ruoko chiningoningo mapfupa, ikozvino tinosvika ligamentous midziyo.

chiningoningo joini

Inoitwa TOUR pfupa uye proximal mutsara mapfupa carpal: mativi, semilunar uye navicular. The ulna iri nechimwe chinonzi articular Disc uye haaratidzi kuti chiningoningo rwakashodoka. The huru muchinangwa paumbwe kugokora kunoita ulnar pfupa. Nepo chiningoningo - danda. Wrist pejoinhi chimiro - elliptical. Zvinokwanisika kutapa, adduction mumakwenzi, flexion uye anoshanda. Small pusa rotational kufamba (10-12 madhigirii) kunobvirawo ari muhudyu ichi, asi rinoitwa anoonga elasticity yacho articular shwashwa. Kuburikidza nyoro zvinyama zviri nyore kuona mutswe ari chiningoningo muhudyu, riri detectable pamwe ulnar uye TOUR mumativi. With gokora anogona Vanotsvangadzira trihedral rusesi pakati pfupa uye ulna musoro. With TOUR divi - musiyano pakati malleoli uye lateral ulnar styloid.

Movement of chiningoningo joinhi chokuita basa srednezapyastnogo vadyi iri pakati distal uye proximal misara. pamusoro wayo rakaoma mugari chimiro. Kana flexion uye uyewo kufamba vhoriyamu rinosvika madhigirii 85. Rutapudzo ari mumakwenzi ari kumusoro vadyi ari rinosvika madhigirii 40 kutapa - 20. The chiningoningo vadyi chaidzo circumduction, i.e. tenderera inofamba.

vagari Izvi vanosimbiswa vakawanda nemarunda. Vari chiri pakati mafupa nomumwe, uyewo pamusoro lateral, medial, uye seri Palms pechiso chiningoningo. Rubatso shwashwa (nharaunda uye ulna) kuridza basa rinokosha. Pazuva ulnar uye TOUR mativi flexor retinaculum riri pakati kwakadzikira pfupa - boka rinokosha. Kutaura zvazviri, zvinoita hairevi ruoko majoini, sezvo thickening ari fascia. Retinaculum flexor chiningoningo muforo anochinja kupinda canal, iyo inoshanyirwa muMedhia akapiwa etsinga nemarunda flexor digitorum. Tinoramba kutsanangura anatomi choruoko.

Carpometacarpal majoini

Vane sandara, ivo vakaneta. Kusara ndiyo vadyi yacho thumbs. Range inofamba carpometacarpal majoini - hapana kupfuura 5-10 inegumi. Ivo zvishoma famba, t. To. The nemarunda vari zvakanaka yakatanga. Zvayaiva pamusoro Palms pamusoro, zvinoumba yakatsiga Palms nemarunda unobatanidza pakati metacarpal pfupa uye chiningoningo. Itai kuruoko arcuate shwashwa uye lateral uye TOUR. Capitatum ndiyo musimboti nemarunda, izvozvo yakasimbiswa vakawanda nemarunda. Palms yakatanga nani zvikuru pane rwemberi. Rear nemarunda kubatanidza mapfupa chiningoningo. Zvinoumba thickening capsules izvo zvinenge zvakazara majoini pakati mapfupa aya. Intercostals dziri mu mutsara mapfupa carpal wechipiri.

Napagumwe roruoko carpometacarpal joinhi inoumbwa mujinga wokutanga metacarpal pfupa uye polygonal. The articular hukawanika vari Chigaro chimiro. vagari Izvi zvinogona kuita zvinotevera zviito: kutapa, adduction, reposition (retrograde inofamba), kushorwa (kushorwa) uye circumduction (nemakwara). Volume kubata kufamba, nokuti kuti napagumwe roruoko inoshora ose vamwe, ichiwedzerwa kwazvo. 45-60 madhigirii kufamba carpometacarpal vadyi pamusoro thumbs kutapa uye pamusoro actuation, uye panguva yokudzoka kufamba uye musiyano - 35-40.

Nemamiriro ruoko: metacarpophalangeal majoini

Akadana majoini vari kuumbwa bhurasho misoro metacarpals pamwe kutora chikamu Nezvigadziko proximal phalanges. Vane idenderedzwa, vane matatu kungoreva perpendicular nematemo kutenderera pakavakirwa chiwedzerwa uye flexion, kutapa uye adduction, uyewo dzeraundi inofamba (circumduction). Kuunza uye kubvisa zvinogoneka muna 45-50 madhigirii uye flexion uye anoshanda - pa 90-100. majoini izvi rubatso nemarunda kumativi, iyo anovasimbisa. Palms kana Extensions ndivo Palms divi Kamudzira. fibers dzavo dzakarukwa fibers yakadzika transverse shwashwa kuti kunotadzisa kuti kusiyana uku kunoita iri siyana mativi misoro mapfupa metacarpal.

Interphalangeal pezvisungo zvenguvo ruoko

Ivo trochlear chimiro uye akabatana avo kutenderera amunzwire transversely. Extension uye flexion zvinogoneka kumativi namasanhu izvi. The proximal interphalangeal majoini vane bhuku flexion uye uyewo akaenzana 110-120 madhigirii, distal - 80-90. Interphalangeal majoini zvakanaka vanosimbiswa anondibatsira shwashwa.

Synovial uye fibrous mumuhara kuti nemarunda neminwe

Extensor retinaculum, uyewo flexor retinaculum, inoita basa rinokosha mukusimbisa nzvimbo tsandanyama nemarunda unopfuura pasi. Izvi ndezvechokwadi kunyanya kana kushanda ruoko: kwaro chiwedzerwa uye flexion. Nature aida Chimiro iri nomazvo chaizvo ruoko. Nemarunda ndiwo rutsigiro dzataurwa pamusoro apa pavanoparidza yomukati pamusoro wayo. Kupatsanura nemarunda kubva pfupa kudzivirira netayi. Izvi zvinobvumira kunyatsodzidza basa uye simba tsandanyama marwadzo kutsungirira yakawanda dzvinyiriro.

Kuderera kwemitambo kukweshera uye pitikoti pamusoro nemarunda pakukoka kubva honokono pamusoro mumakwenzi, zvinobatsira chaiyo mudzira mumuhara, izvo pfupa-fibrotic kana fibrotic makwara. Ndivo synovial mumuhara. Nhamba huru (6-7) riri pasi extensor retinaculum. Nharaunda uye ulna vane grooves kuti panguo nzvimbo yacho tsandanyama mudzira. Uyewo vainzi Matandira fibrous izvo kuparadzanisa migero kubva mumwe nokurebesa kuti mapfupa extensor retinaculum.

Palms synovial mumuhara vari flexor nemarunda minwe uye maoko. Total synovial nyinyo kunosvika kune nechepakati emichindwe zvasvika distal phalanx wechishanu nomunwe. Heano nemarunda zvomene uye rakadzika flexor digitorum. Napagumwe roruoko ane refu flexor mudzira riri synovial nyinyo oga uye achipfuura ari munwe chete mudzira. Synovial mumuhara muchanza ruoko rwako tsandanyama vari kunyimwa nemarunda kuti vaende wechina, zvigunwe wechipiri newechitatu. Chete mudzira wechishanu munwe ane synovial mumuhara, inova kuwedzera nhamba.

ruoko tsandanyama

Mumufananidzo pazasi unogona kuona ruoko netsandanyama. The nemamiriro chiningoningo kunoratidzwa zvizere.

Tsandanyama muruoko chete Palms divi. Ivo vanokamurwa muzvikwata zvitatu: unosvikirwa, zvikuru nezviduku minwe.

Sezvo nomunwe kufamba zvinoda zvakarurama kwazvo, mumakwenzi kunokosha nhamba pfupi tsandanyama, complicating sechivako ruoko. Tsandanyama ramaoko nerimwe mapoka kukurukurwa pazasi.

The pakati boka tsandanyama

Zvinonzi akaumba honye-kufanana tsandanyama, kutangira kubva pakadzika digitaalinen flexor mudzira uye dzakabatana proximal phalanx, kana pane nezvigadziko zvadzo kubva wechipiri wechishanu munwe, kana tikafunga sechivako ruoko. Tsandanyama ramaoko ava vanobva musana uye Palms interosseous, riri pakati mapfupa pastern, vasiyana mujinga proximal phalanx. Mashandiro boka iri kuti tsandanyama munyaya flexion pamusoro proximal phalanges eminwe izvi. Nokuda Palms interossei tsandanyama anogona kuuya munwe kuti pakati nomunwe bhurasho. With rearmost intercostals wavo kurutivi maberekero.

Tsandanyama of thumbs

boka iri anoumba kukwidziridzwa napagumwe roruoko. tsandanyama idzi vanotanga kumativi pedyo pastern pfupa uye chiningoningo. Kana napagumwe roruoko rwake pfupi flexor vasiyana pedyo sesamoid pfupa, riri pedo mujinga proximal phalanx. Rinosiyaniswa napagumwe roruoko tsandanyama anoenda wokutanga metacarpal pfupa, uye anotungamirira thumbs iri yomukati mapfupa sesamoid.

Small chigunwe tsandanyama

Ichi boka tsandanyama anoumba mukati muchanza kukwidziridzwa. Idzi dzinosanganisira: duku munwe abductor tsandanyama, rinosiyaniswa duku munwe, pfupi Palms uye pfupi flexor.

Zvakatanga kubva akapoteredza mapfupa ari chiningoningo. tsandanyama aya vasiyana mujinga wechishanu toe, kana panzvimbo yayo proximal phalanx, uye wechishanu metacarpal pfupa. basa ravo zvinoratidzwa zita.

Munyaya ino isu vakaedza zvikuru zvakarurama vanomirira nemamiriro ruoko. Anatomy - icho sayenzi chinokosha chinoda, Chokwadi, imwe kunyatsoongorora. Naizvozvo, vamwe mibvunzo akaramba unlit. Nemamiriro ruoko uye chiningoningo - nyaya chinokunakidza kwete chete kuvarapi. Zivo zvakakodzerawo kuti vatambi, kugwinya varayiridzi, vadzidzi uye vamwe Mapato evanhu. The nemamiriro ruoko, sezvo iwe wakaona, zvikuru kunzwisisa, uye kudzidza kunogona zvikuru nguva refu, kuvimba zvakasiyana-siyana zvinyorwa.