Mboro (kubva kuLatin pelvis) ibhande remabhonzo rinotsigira huremu hwemuviri uye rinoumba makutano pakati pehunde nemakumbo ezasi.

Chifuva, kana kuti pelvis, ibhande rebhonzo riri pasi pedumbu rinotsigira musana. Inogadzirwa kubva pakubatanidzwa kwemapfupa maviri ecoxal (hip bone kana iliac bone), sacrum uye coccyx. Mabhonzo ehudyu ndiwo pachawo mhedzisiro yekubatanidzwa kwemapfupa matatu: ilium, ischium uye pubis.

Mapfupa ehudyu anobatana kuseri kwesacrum, nemapapiro eilium, pamwero wesacroiliac joints. Mupendero wepamusoro webapiro ndiyo iliac crest, ndiyo poindi yekupinza mhasuru dzemudumbu. Iyo iliac spines inonzwisisika paunoisa maoko ako muhudyu yako.

Mabhonzo maviri ehudyu anosangana kumberi pamwero wepubis. Vanobatana pamwe chete ne pubic symphysis. Munzvimbo yakagara, isu tinoiswa pamatavi e-ischio-pubic (bazi repubis uye ischium).

Iyo pelvis yakabatanidzwa nemakumbo ezasi pamwero wehudyu kana coxofemoral joint: acetabulum (kana kuti acetabulum), chikwata cheC-shaped joint cavity, inogamuchira musoro wemukadzi.

Gumbo rakaita sefunnel, mboro yakakamurwa kuita matunhu maviri: mboro hombe nemboro diki. Bheseni hombe chikamu chepamusoro, chakaganhurwa nemapapiro eilium. Bheshi duku riri pasi pemapapiro aya.

Iyo mhango inoganhurwa nemazaru maviri:

• musuwo wekumusoro unova buri repamusoro pedhishi. Inoratidza shanduko pakati pehombe nediki pelvis. Inokodzera munzvimbo yakaganhurwa kubva kumberi kuenda kumashure nekumusoro kumucheto kwe pubic symphysis, iyo arched mitsetse uye promontory ye sacrum (yekumusoro kumucheto) (3).
• Iyo yakaderera strait ndiyo yakaderera kuvhura kwebheseni. Inoumba dhaimondi. Iyo inogumira mberi nemuganhu wakaderera we pubic symphysis, pamativi nematavi eischiopubic uye ischial tuberosities, uye pakupedzisira shure nemuromo we coccyx (4).

Muvakadzi vane pamuviri, zviyero zvebheseni uye straits zvakakosha data kutarisira kupfuura kwemwana. Iwo majoini e sacroiliac uye pubic symphysis zvakare anowana kushanduka kushoma kuburikidza nekuita kwemahomoni kukurudzira kuzvara.

Pane misiyano pakati pemadziva echirume neechikadzi. Mboro yemukadzi ndeye:

• Yakafara uye yakawanda yakatenderedzwa,
• Shallower,
• Iyo pubic arch yakawedzera kutenderera nekuti kona yakaumbwa yakakura,
• Iyo sacrum ipfupi uye coccyx yakatwasuka.

Mboro inzvimbo yekupinzwa mhasuru dzakasiyana-siyana: tsandanyama dzemadziro edumbu, dzemagaro, kuzasi kumashure uye mhasuru zhinji dzezvidya.

The pelvis inzvimbo inodiridzwa zvakanyanya nemidziyo yakawanda: iyo mukati iliac artery iyo yakakamurwa kunyanya mu rectal, pudendal kana ilio-lumbar artery. Iwo pelvic tsinga dzinosanganisira pakati pevamwe iyo yemukati nekunze iliac vein, yakajairika, rectal ...

Iyo pelvic mhango inovharwa zvakanyanya ne: iyo lumbar plexus (semuenzaniso: femoral nerve, lateral ganda rehudyu), iyo sacral plexus (semuenzaniso: posterior ganda tsinga yehudyu, sciatica), iyo pudendal plexus (semuenzaniso: pudendal nerve, penis. , clitoris) uye coccygeal plexus (semuenzaniso: sacral, coccygeal, genitofemoral nerve). Idzi tsinga dzakagadzirirwa viscera yemugodhi (nhengo, rectum, anus, etc.) uye mhasuru dzedumbu, pelvic nemakumbo epamusoro (chidya).

Basa guru repelvis ndere kutsigira huremu hwemuviri wepamusoro. Inodzivirirawo nhengo dzomukati, dundira uye chikamu chedumbu guru. Mafupa ehudyu anotsanangurawo nefupa rehudyu, femur, iyo inobvumira kufamba.

Kutsemuka kwechiuno : inogona kukanganisa bhonzo chero ipi zvayo asi nzvimbo nhatu dzinowanzove dzakanyanya kutarisana nenjodzi: sacrum, pubic symphysis kana acetabulum (musoro wefemur unonyura muchiuno uye unoputsa). Kutyoka kunokonzerwa nekuvhunduka kunotyisa (tsaona yemumugwagwa, nezvimwewo) kana kudonha kwakabatana nefupa fragility (eg osteoporosis) muvanhu vakwegura. Iyo viscera, midziyo, tsinga uye tsandanyama dzepelvis zvinogona kukanganiswa panguva yekutyoka uye kukonzera sequelae (nervous, urinary, etc.).

Hip marwadzo : vane mavambo akasiyana. Zvisinei, muvanhu vanopfuura makumi mashanu, ivo vanowanzobatanidzwa kune osteoarthritis. Kakawanda, kurwadziwa kunobatanidza nehutachiona hwehudyu huchave "chinotsausa", chinowanikwa munzvimbo semuenzaniso mumakumbo, bhutu, kana kunyange mugumbo kana mabvi. Kusiyana neizvi, kurwadziwa kunogona kunzwika muhudyu uye chaizvoizvo kunobva kune imwe nzvimbo iri kure (kumashure kana kugomera, kunyanya).

Pudendal neuralgia : rudo rwepudendal nerve iyo isingagumi munzvimbo yepelvis (urinary tract, anus, rectum, genitals ...). Inoratidzwa nekurwadziwa kusingaperi (kupisa kunzwa, kupera) kunowedzera nekugara. Inowanzobata vanhu vari pakati pemakore makumi mashanu nemakumi manomwe uye chikonzero chechirwere ichi hachina kunyatsozivikanwa: inogona kuve kudzvanywa kwetsinga kana kuvharirwa kwayo munzvimbo dzakasiyana (yakapinzwa pakati pemarunda maviri, mugero pasi pepubic ...) bundu semuenzaniso. Neuralgia inogonawo kukonzerwa nekushandisa zvakanyanya bhasikoro kana kuzvara mwana.

Kufamba kwepelvic panguva yekusununguka

Mafambiro chaiwo muzvikamu zve sacroiliac zvinobvumidza kusangana kwevakadzi:

• Counter-nutation movement: verticalization ye sacrum (kudzokera shure uye kukwidziridzwa kwepromontory) inoitika kana ichibatanidzwa nekufambira mberi uye kuderera kwecoccyx uye kuparadzaniswa kwemapapiro eiriac. Aya mafambiro ane mhedzisiro yekuwedzera iyo yepamusoro strait * uye kuderedza yepasi strait **.
• Nutation kufamba: iyo yekumashure kufamba kunoitika: kufambira mberi uye kudzikisira kwekusimudzira kweiyo sacrum, kudzoka uye kukwidziridzwa kwecoccyx uye kufungidzira kwemapapiro eiriac. Aya mafambiro ane mhedzisiro yekuwedzera iyo yepasi yakamanikana uye kudzikisira iyo yekumusoro yakamanikana.

Hip osteoarthritis (kana coxarthrosis) : inofananidzwa nekupfeka kwecartilage pamwero wekubatana pakati pemusoro wefemu uye pfupa rehudyu. Uku kuparadzwa kunofambira mberi kwekashwa kunoratidzwa nekurwadziwa mujoini. Iko hakuna marapirwo angabvumira kukura kwekashwa. Hip osteoarthritis, kana coxarthrosis, inokanganisa vanenge 3% yevanhu vakuru.

Vakweguru vanomiririra huwandu hwevanhu vari panjodzi yekutyoka kwepelvic nekuti ivo vanonyanya kuoneswa kudonha uye mapfupa avo akanyanya kusimba. Izvi zvakafanana kune vanhu vane osteoporosis.

Kudzivirira kudonha hakusi nyore, asi zvinokurudzirwa kushandisa chikafu chakapfuma mucalcium uye vhitamini D kusimbisa mapfupa uye kurwisa osteoporosis. Kune vanhu vakwegura, zvakakosha kubvisa chipingamupinyi chipi nechipi munharaunda yavo chinogona kuva chikonzero chekudonha kwechisimba (kubviswa kwemateti) uye kugadzirisa maitiro avo (kuiswa kwembariro muzvimbuzi, kupfeka shangu dzinobata tsoka) . Zvinokurudzirwawo kudzivisa tsika yemitambo iri pangozi yekuwa kwechisimba (parachuting, kutasva bhiza, nezvimwewo) (10).

Kuongororwa kwekiriniki: kana kuputsika kwepelvic kuchifungidzirwa, chiremba anotanga aita kuongororwa kwekliniki. Semuenzaniso, achatarisa kana pane marwadzo pakuunganidza majoini e sacroiliac (pakati pe ilium ne sacrum) kana kuremara kwechikamu chezasi.

Radiography: nzira yekurapa yekufungidzira inoshandisa X-rays. Frontal and lateral radiography inoita kuti zvikwanise kuona zvimiro zvemapfupa uye nhengo dziri muchiuno uye kuratidza kutsemuka semuenzaniso.

MRI (magnetic resonance imaging): kuongororwa kwekurapa kwechinangwa chekuongorora kunoitwa pachishandiswa cylindrical mudziyo hombe umo magineti uye masaisai eredhiyo anogadzirwa. Iko radiography isingaibvumire, inoburitsa mifananidzo chaiyo. Inonyanya kushandiswa mumamiriro ekurwadziwa kwehudyu uye pubic. Kuona nhengo, MRI inogona kusanganiswa nejekiseni rekusiyanisa chigadzirwa.

Pelvic ultrasound: nzira yekufungidzira inovimba nekushandiswa kweiyo Ultrasound kuona chimiro chemukati chenhengo. Panyaya yepelinha, ultrasound inoita kuti zvikwanise kuona nhengo dzomukati (bladder, ovary, prostate, midziyo, nezvimwewo). Muvakadzi, inowanzoitika kuongororwa kwekutevera pamuviri.

Scanner: nzira yekuongorora yekufungidzira iyo inosanganisira "kuvheneka" nzvimbo yakapihwa yemuviri kuitira kugadzira mifananidzo yakachinjika, nekuda kwekushandiswa kwe X-ray danda. Izwi rekuti "scanner" ndiro zita remuchina wekurapa, asi rinowanzoshandiswa kutumidza bvunzo. Isu tinotaurawo nezve computed tomography kana computed tomography. Kana iri pelvis, CT scan inogona kushandiswa kutsvaga kutsemuka kusingaonekwe pa x-ray kana kuyera pelvimetric (pelvic dimensions) mumadzimai akazvitakura.

Kwenguva yakareba, kuva nepelvis hombe kwaibatanidzwa nekubereka uye nekudaro kwaionekwa semupimo wekunyengedza.

Mazuva ano, pane zvinopesana, pelvis yakamanikana inosarudzwa kune mufananidzo weiyo yakakurumbira saizi 36.