· Rasas anatomy
Pamberi penguruve ndiyo subscappular fossa, uko iyo subscappularis mhasuru inotanga. Kumashure kwechigaro chekunze uye zvishoma kumusoro kwekufamba scapular ridge, iyo yakakamurwa kuita supraspinatus fossa uye infraspinatus fossa, nekuda kwekusungwa kweSupraspinatus uye infraspinatus zvichiteerana. Kupera kwekunze kweiyo scapular ridge ndeyekudzvinyirira, iyo inoumba macromiclarular yakabatanidzwa neakaperera magumo eClavicle kuburikidza nehurefu hwechiratidzo. Iyo yakakwirira mhuru ye scapular righlar ine diki iwe-yakavezwa nhunzi, iyo inoyambuka not asi yakaoma trasverpapular Ligraskular Ligraskular Ligraskular Ligrascaps. Iyo yakazotevera margin (axillary margin) yeiyo scapular ridge ndiyo inotakura uye inofamba kunze kumidzi yemutsipa wemugodhi, uko inogadzira glenoid notch nemucheto weiyo glenoid yefudzi.
Zvinoratidza
1. Zvitendero zve benign scapular tumory.
2. Kubvumidzwa kwenzvimbo yekukuvara kwehunhu hwe scapula.
3. Yakakwira scapula uye zvimwe deformiti.
4. Kubviswa kwepfupa rakafa mune scapular osteomyelitis.
5. Supraparappular nerve Begrapment Syndrome.
· Zvepamusoro Positi
Semi-prone chinzvimbo, yakarongedzwa pa 30 ° kumubhedha. Iyo yakakanganisika yepamusoro gumbo rakaputirwa netauro rakashata kuitira kuti inogona kutamiswa chero nguva panguva yekushanda.
Matanho Ekusamavhini
1. A transverse incision inowanzogadzirwa pamwe ne supapular ridge mu suprapinatus fossa foss Iyo yekudzvinyirira uye refuitudinal incation inogona kusanganiswa kuti iite l-chimiro, ichipindirwa l-chimiro, kana chimiro chekutanga-chikamu, zvichienderana nekudikanwa kwekuona kwezvikamu zvakasiyana zvezvikamu zvakasiyana zvechipfuva. Kana chete makona ekumusoro uye akadzika e scapula inoda kufumurwa, zvidiki zvidiki zvinogona kuitwa munzvimbo dzinoenderana (Mufananidzo 7-16 (1)).
2. Inzira iyo yepamusoro uye yakadzika fascia. Makwikwi akasungirirwa kune scapular ridge uye medial muganho anoiswa zvinokonzeresa kana akareba munzira yeiyo incision (Fig. 7-16 (2)). Kana iyo supraspinatus fossa ichifanira kufumurwa, iyo mafaira epakati trapezius tsandanyama inoshandisirwa kutanga. Iyo periosteum yakaiswa pamusoro peiyo bony pamusoro gonad, ine mutete wemafuta pakati pezviviri, uye zvese zve supraspinatus fosssosteal disceds yeSuprapinatus tsandanyama Kana uchimutsa mafuti epamusoro eiyo trapezius tsandanyama, hanya inofanira kutorwa kuti isakuvadza iyo parasympathetic nerve.
3 Kamwe midziyo yeSuprascapular uye nerves yakaonekwa uye yakachengetedzwa, iyo suprascapular transverse ligament inogona kuve yakabviswa, uye iyo scapular notch inogona kuongororwa chero zvivakwa zvisina kujairika, uye iyo suprascapular nerve inogona kuzosunungurwa. Pakupedzisira, iyo yakasvibiswa trapezius tsandanyama inotsauswa back pamwe chete kuti ibatanidzwe kune scapula.
4. Kana chikamu chepamusoro chevanonyadzisa Paunenge uchisvika kumagumo epamusoro weiyo axillary margin yeiyo gonad (kureva kuti glenoid nerudzi rwechinyakare. VaRosheni vakomberedzwa nevatatu vekutanga, kuti vasazvikuvadza (Fig. 7-16 (5)).
5 Uye iyo trapezius uye infraspinatus tsandanyama, pamwe chete neyekukura kweteralis yakanangana nekona yepamhepo yeiyo infraspinatus fossa fossa
Mufananidzo 7-1-5 nzira yeDorsal Scapular Exosure
(1) incision; (2) incision yemutsara wemutsara; . . (5) Kubvarura Infrappinatus tsandanyama kuratidza iyo dorsal chikamu che scapula ine vascular anastomosis
6. Kana iyo subscapular fossa ichizofumurwa, iyo svina yakabatanidzwa pamuganho wepamhepo, kureva, scapularis, marombodhi uye Seratus anterior, anofanira kunge achibviswa panguva imwe chete, uye pfuma yese inogona kusimudzwa kunze. Paunenge uchisunungura muganho wepamhepo, kutarisira kunofanirwa kutorwa kuti udzivirire bazi rezvinyorwa zvekutapudza carotid uye dorsal scapular nerve. Iyo inoburitswa davi reCarotid Artery rinotanga kubva kuTrunk neTrunk neScapula neScapula Network muCodal Chikamu cheScapula, saka inofanira kuomerera pamusoro pepfupa kune iyo subferosteal proyer.
Kutumira Nguva: Nov-21-2023
