Kutarisa Kwakazara paThoracodorsal Nerve

Vanhu vane zviratidzo zvekurwadziwa senge kupfura, kubaya, kana manzwiro emagetsi kune latissimus dorsi yekumusoro kumashure kunogona kukonzerwa nekukuvara kwetsinga kune thoracodorsal nerve. Kuziva anatomy uye zviratidzo zvinogona kubatsira varapi vehutano kugadzira chirongwa chekurapa chinoshanda?

Thoracodorsal Nerve

Uyewo anozivikanwa sa tsinga yepakati pescapular kana iyo yakareba subscapular nerve, inobuda kubva muchikamu chebrachial plexus uye inopa mota innervation/kushanda kune latissimus dorsi tsandanyama.

Anatomy

Iyo brachial plexus inetiweki yetsinga dzinobva muzongoza mumutsipa. Mitsipa inopa zvakanyanya kunzwa uye kufamba kwemaoko nemaoko, neimwe kune rumwe rutivi. Midzi yaro mishanu inobva munzvimbo dziri pakati pechishanu kusvika yechisere yekervical vertebrae uye yekutanga thoracic vertebra. Kubva ipapo, vanogadzira chimiro chakakura, vozopatsanura, kubatanidza, uye kupatsanura zvakare kuti vagadzire tutsinga tudiki uye tsinga dzetsinga pavanenge vachifamba vachidzika nehapwa. Kuburikidza nemutsipa nechipfuva, tsinga dzinozobatana dzoita tambo nhatu dzinosanganisira:

• Lateral cord
• Medial tambo
• Shure tambo

Iyo posterior cord inoburitsa matavi makuru uye madiki anosanganisira:

• Axillary nerve
• Radial nerve

Madiki mapazi anosanganisira:

• Superior subscapular nerve
• Inferior subscapular nerve
• Thoracodorsal nerve

Chimiro uye Chinzvimbo

• Iyo thoracodorsal nerve matavi kubva kumashure kwetambo muhapwa uye inofamba ichidzika, ichitevera subscapular artery, kune latissimus dorsi muscle.
• Inobatana nepamusoro peruoko, yotambanudzira kuseri kwehapwa, ichiita axillary arch, yobva yawedzera kuita gonyotatu hombe inomonerera mbabvu nekumashure.
• Iyo thoracodorsal nerve inorara mukati me latissimus dorsi, uye mupendero wezasi unowanzosvika padyo nechiuno.

Kusiyana

• Kune nzvimbo yakajairwa uye kosi ye thoracodorsal nerve, asi tsinga dzemunhu hadzina kufanana mumunhu wese.
• Iyo tsinga inowanzotanha kubva kumashure kwetambo yebrachial plexus kubva pamapoinzi matatu akasiyana.
•  Nekudaro, akasiyana subtypes akaonekwa.
• Iyo thoracodorsal nerve inopa teres hombe tsandanyama munenge 13% yevanhu. (Brianna Chu, Bruno Bordoni. 2023)
• Iwo ma lats anogona kunge ane isingawanzo anatomical musiyano inozivikanwa se a Langer's arch, chinova chikamu chekuwedzera chinobatana nemhasuru kana matishu epamusoro peruoko pasi penzvimbo inobatana.
• Mune vanhu vane izvi zvisiri izvo, iyo thoracodorsal nerve inopa basa / innervation) kune arch. (Ahmed M. Al Maksoud et al., 2015)

basa

Iyo latissimus dorsi muscle haigone kushanda pasina thoracodorsal nerve. The tsandanyama netsinga zvinobatsira:

• Gadzirisa musana.
• Dhonza huremu hwemuviri paunokwira, kushambira, kana kuita zvekudhonza.
• Batsira nekufema nekuwedzera mbabvu panguva yekufema uye kubata kana uchifema. (Encyclopaedia Britannica. 2023)
• Tenderedza ruoko mukati.
• Dhonza ruoko nechepakati pemuviri.
• Wedzera mapepa nekushanda ne teres huru, teres minor, uye posterior deltoid muscles.
• Hunza pasi bhanhire repafudzi nekukwenya musana.
• Kukotama kudivi nekutsemura musana.
• Isa chiuno kumberi.

Conditions

Iyo thoracodorsal nerve inogona kukuvadzwa chero kupi munzira yayo nekushungurudzika kana chirwere. Zviratidzo zvekukuvara kwetsinga zvinogona kusanganisira: (U.S. National Library yeMishonga: MedlinePlus. 2022)

• Marwadzo anogona kuva kupfura, kubaya, kana kunzwa magetsi.
• Chiveve, kurira.
• Kushaya simba uye kurasikirwa kwebasa mumasumbu akabatanidzwa uye nhengo dzemuviri, kusanganisira wrist uye kudonha kwemunwe.
• Nekuda kwenzira yetsinga kuburikidza nehapwa, vanachiremba vanofanirwa kungwarira kune akasiyana eanatomical kuti varege kukuvadza tsinga panguva yekuitwa kenza yemazamu, kusanganisira axillary dissection.
• Iyo nzira inoitwa kuongorora kana kubvisa malymph nodes uye inoshandiswa mukuita kenza yemazamu uye mukurapa.
• Maererano neongororo, 11% yevanhu vane axillary lymph node dissection vakakuvadzwa kune nerve. (Roser Belmonte et al., 2015)

Breast Reconstruction

• Mukuvhiyiwa kwekuvakazve mazamu, ma lats anogona kushandiswa seflap pamusoro pekuisirwa.
• Zvichienderana nemamiriro ezvinhu, iyo thoracodorsal nerve inogona kusiiwa yakasimba kana kuparadzaniswa.
• Vezvechiremba havana kubvumirana kuti ndeipi nzira ine mhedzisiro yakanaka. (Sung-Tack Kwon et al., 2011)
• Pane humwe humbowo hwekuti kusiya tsinga yakasimba kunogona kuita kuti tsandanyama ibatane uye ibvise iyo implant.
• An intact thoracodorsal nerve inogonawo kukonzera atrophy yemhasuru, iyo inogona kutungamirira kune kushaya simba kwefudzi uye ruoko.

Graft Inoshandiswa

Chikamu chethoracodorsal nerve chinowanzo shandiswa mukugadzirisa tsinga kudzoreredza basa mushure mekukuvara, izvo zvinosanganisira zvinotevera:

• Musculocutaneous nerve
• Accessory nerve
• Axillary nerve
• Iyo tsinga inogona zvakare kushandiswa kudzoreredza tsinga kushanda kune triceps tsandanyama muruoko.

Rehabilitation

Kana iyo thoracodorsal nerve yakakuvara kana kukuvadzwa, kurapwa kunogona kusanganisira:

• Braces kana splints.
• Physical therapy yekuvandudza huwandu hwekufamba, kuchinjika, uye simba remhasuru.
• Kana paine kudzvanyirirwa, kuvhiyiwa kunogona kudikanwa kuderedza kumanikidza.

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Kuongorora Integrative Medicine

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References

Chu B, Bordoni B. Anatomy, Thorax, Thoracodorsal Nerves. [Yakagadziridzwa 2023 Jul 24]. Mu: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Inowanikwa kubva: www.yori.nlm.nih.gov/books/NBK539761/

Al Maksoud, A. M., Barsoum, A. K., & Moneer, M. M. (2015). Langer's arch: isingawanzo anomaly inokanganisa axillary lymphadenectomy. Nyaya yekuvhiya nyaya mishumo, 2015(12), rjv159. doi.org/10.1093/jscr/rjv159

Britannica, Vapepeti veEncyclopaedia. “latissimus dorsi“. Encyclopedia Britannica, 30 Mbudzi 2023, www.britannica.com/science/latissimus-dorsi. Yakasvika 2 Ndira 2024.

US National Library yeMishonga: MedlinePlus. Peripheral neuropathy.

Belmonte, R., Monleon, S., Bofill, N., Alvarado, M. L., Espadaler, J., & Royo, I. (2015). Yakareba thoracic nerve kukuvara muvarwere vekenza yemazamu vanobatwa neaxillary lymph node dissection. Tsigiro yekuchengetedza mugomarara: yepamutemo magazini yeMultinational Association yeRutsigiro Kuchengeta muCancer, 23 (1), 169-175. doi.org/10.1007/s00520-014-2338-5

Kwon, S. T., Chang, H., & Oh, M. (2011). Anatomic nheyo ye interfascicular nerve splitting ye innervated partial latissimus dorsi muscle flap. Chinyorwa chepurasitiki, reconstructive & aesthetic surgery : JPRAS, 64(5), e109–e114. doi.org/10.1016/j.bjps.2010.12.008