U lemoha joang bohloko bo boholo, bo omeletseng le bo bongata?

Lumbosacral methapo ea kutlo motso ho tloha kanale lesapo la mokokotlo ho kena plexus sacral, le pokello ea sciatic mothapo kutu, kahoo ha leha e le efe ho tse tharo amehang, ho ka etsa hore ba bang ba matšoao a tšoanang le matšoao a. Haholo-holo e bonahatsoa ka bohloko ba letheka le leoto, ho tsieleha, ho sisinyeha le ho se sebetse hantle ha reflex le teko e ntle ea ho phahamisa leoto, joalo-joalo, likarolo tse ling hangata li thatafalloa ke ba qalang ho lemoha, e leng se lebisang ho fosahetseng. Ha e le hantle, libaka tsa pathoanatomical le litšoaneleho tsa likokoana-hloko tse tharo ha li lumellane. Ntle le maemo a sa tloaelehang moo tse peli kapa tse tharo li ka etsahalang ka nako e le 'ngoe, litšobotsi tsena hangata li ba bonngoeng ebile lia ikhetha.

Hangata bohloko bo boholo bo amahanngoa le lumbar disc herniation, lumbar spinal stenosis (ho akarelletsa le lateral fossa stenosis), le lihlahala tsa mokokotlo oa mokokotlo.

1 Bohloko bo omeletseng le bohloko ba sehlopha ha se hangata bo hlahisang bohloko bo boholo.

(2) Moeli oa lumbar spine movement: Lumbar spinal stenosis haholo-holo e fokotsa katoloso ea morao, ha litaba tsa lumbar disc li ka fokotsa mokokotlo oa mokokotlo oa mokokotlo, ho phalla pele, le lehlakoreng le amehang. Lihlahala tsa intradural le tsona li ka baka likhato tse fapaneng tsa moeli oa motsamao oa lumbar ka mekhahlelo e fapaneng ea lefu lena. Leha ho le joalo, bohloko bo omeletseng le bohloko ba plexiform ha bo bontše tšobotsi ena.

(3) Tlhahlobo ea mokokotlo oa mokokotlo: Zhao Dinglin et al. o ile a etsa tlhahlobo ea mokokotlo oa mokokotlo ho bakuli ba 200 ba nang le bohloko bo boholo, 'me tekanyo e ntle e ne e feta 95%. Sena se bakoa ke hore mokokotlo oa mokokotlo o boemong ba ho fetela pele, e leng se eketsang tsitsipano le khatello methapong ea methapo e amehileng ka mokotla oa mokokotlo le motso, ho mpefatsa bohloko. Phuputso ha ea ka ea fumana bopaki ba bohloko bo omeletseng kapa bohloko ba plexiform.

(4) Matšoao a sebaka sa mokokotlo oa methapo ea mokokotlo: Boikutlo, ho sisinyeha, le reflexes ea metso ea methapo ea mokokotlo e na le litšobotsi tse hlakileng tsa sebaka ho itšetlehile ka mokokotlo oa mokokotlo. Ka mohlala, maikutlo a letlalo la mokokotlo oa menoana ea pele le ea bobeli ea leoto ha e na thuso haholo ke motso oa methapo ea lumbar, ha karolo e ka morao ea leoto le monoana o monyenyane o sa sireletseha ke motso oa methapo ea sacral 1. Bohloko bo sa tloaelehang, bothata ba kutlo, le li-reflexes li ameha ho feta mefuta e mengata ea bohloko bo omeletseng le bohloko ba lihlopha.

Nakong e fetileng, ho hlahlojoa ha meriana ea bohloko bo omeletseng ho ne ho tloaelehile ho bitsoa 'sciatica' kapa 'sciatic neuritis'. Leha ho le joalo, litsebi tsa morao-rao li fana ka maikutlo a hore liso tsa mokokotlo oa pelvic oa sciatic nerve, tse kang lihlahala, ho khomarela, ho hatelloa ha mesifa ea pudendal, le ho hlohlelletsa ho ruruha, ke tsona lisosa tse ka sehloohong tsa bohloko bo omeletseng. Likarolo tse ka sehloohong tsa bohloko bo omeletseng ha li amehe ke litlhahlobo tse ikemetseng 'me li khetholloa ke ho hloka mongobo.

1 Mahlaba a tlase a mahlaseli a kotsi a hlaha ha khatello e tebileng ea lehae e sebelisoa, 'me ho hlakile hore mefuta ea eona e kholo ho feta bohloko bo boholo. Hoo e ka bang 60% ea lehlakore le kulang le tsamaisana le ntlha ea rouge (tibial nerve course) le ntlha ea peroneal (e tloaelehileng ea methapo ea kutlo) khatello le bohloko bo boholo. Ha ho na khatello e totobetseng le bohloko ba percussion sebakeng se tlaase sa lumbar.

(2) Teko ea ho potoloha ha maoto a ka tlaase: Teko ea ho potoloha ka hare e ntle haeba e bakoa feela ke ho khomarela ho tsoa. Haeba mesifa ea pudendal e boetse e ameha, ho potoloha ka ntle ho boetse ho molemo.

Matšoao a sebaka se omeletseng a bonahala e le likhaello tsa kutlo, motlakase, le reflex sebakeng sa methapo ea tibial le peroneal nerve innervation area. Mefuta e mengata ea ho kenya letsoho e pharaletse ebile e lekanyelitsoe ho metso ea methapo ea mokokotlo ka har'a lumbar 4 ho sacral 2.

(4) Bohatsu ba Plantar: Mathata a methapo ea kutlo hangata ha a ame karolo eohle ea semela. Leha ho le joalo, ho ea ka Zhao Dinglin le lipalo-palo tse ling, ho feta 90% ea linyeoe tse bohloko tse omeletseng li bonts'a bohatsu ba limela.

Bohloko ba Plexus : bo ka bakoa ke lihlahala, ho ruruha ho sa foleng, le mafu a adnexal pelvis, a ka amang plexus ea sacral mme a fella ka matšoao. Methapo e tloaelehileng ka ho fetisisa e amehang ke sciatic nerve trunk, femoral nerve trunk, le methapo e phahameng ea gluteal.

(1) Bohloko ba mefuta e mengata: Tabeng e tšoanang, bohloko ba sciatica, serope, sacral le lengole bo ka ba teng. Matšoao ana a ka hlaha ka nako e le 'ngoe kapa ka ho fapanyetsana, ho itšetlehile ka ho teba ha liso. Ho ka 'na ha e-ba le phapang ka tekanyo ea ho kenya letsoho pakeng tsa likutu tse' maloa tsa methapo.

(2) Lumbosacral percussion test: Phapang pakeng tsa teko ena le bohloko bo boholo ke hore ha ho buuoa ho sebelisoa sebakeng sa lumbosacral, mokuli ha a utloe bohloko feela empa hape o ikutloa a phutholohile. Ka lehlakoreng le leng, liso tsa pelvic tse nkang sebaka li baka bohloko, hangata bo matla.

(3) Tlhahlobo ea pelvic: Bohloko ba pelvic bo atile haholo ho bakuli ba basali; ka hona, tlhahlobo ea mafu a basali e hlokahala ho kenyelletsa mafu a gynecological pele ho etsoa tlhahlobo. Ho feta moo, ho kenyelletsa lihlahala, palpation ea pelvic le, ha ho hlokahala, tlhahlobo ea anal e lokela ho etsoa. Li-orthopantomograms le lifilimi tsa oblique tsa pelvis li lokela ho nkoa ka mor'a ho hloekisa enema. Barium enema kapa cystography e ka sebelisoa bakeng sa ba belaelloang hore ba na le lihlahala tsa mala kapa tsa moroto.

(4) Liphetoho tsa Reflex: Reflex ea lengole le Achilles tendon reflex e ka 'na ea fokola kapa ea nyamela ka nako e le' ngoe.