Ibvi rakabatana

01. Pfupa rekugadzira chimiro

The the Knee Joint Inemapfupa mana: Iyo femur, tibia, Patella naFibla.

Iyo ine 3 compartments: medial tibiofemal compartment, iyo inotevera tibioferal compartment, uye iyo patelloferal compartment, uye matatu compartment inogovera synovial cavity.

02.Joint chimiro

Type: Kutakura Kubatanidzwa

Iyo ibvi ine 3 majoini: Iyo medal tibiofemory yakabatanidzwa, iyo yakazotevera tibiofEral Joint uye Patefemorel Joint.

Iyo TibioFemOral Joint inobatanidza iyo distal femur kune tibia, uye distal femur tapers kuti iite medial echikadzi condyle uye yekaunzi yekadzi. Iyo tibia ndeyekuti yakatetepa, asi vanhu vanofarira vanoisa pasi penzvimbo yepedyo neicho projecting echikadzi condyles.

Iyo yechikadzi condyles inoparadzaniswa neIntercondylar Fossa, inozivikanwa zvakare seyechikadzi groove kana echikadzi talus.

Iyo Patella ifudzi yembeu yakanyorwa mukati meiyo tendon yeiyo quadriceps tsandanyama uye inoumba yakabatanidzwa neiyo trochanthed groove.

Iyo inoshanda kusimudzira iyo mechancal kuwana kweiyo quadriceps mhasuru. Musoro weiyo fibula iri mukati mebvi capsule asi hazviwanzo kushanda sehuremu-kuremerwa ngura. Iyo yechikadzi condyles uye tibiial plateau fomu iyo yakabatana mutsara.

03. Joint Kugadzikana

Kugadzikana kwebvi rakabikwa rinochengetwa nemhando dzakasiyana siyana dzepamhepo dzinopawo dziviriro yekudzivirira mukati mejoini.

Iyo tibia uye femur yakafukidzwa nekuvhundutsa-inotora Hyaline cartilage mukati mebvi rebvi.

-Iye disc-yakavezwa gare gare uye mediel mevisci inopa imwezve yekuvhundutsa kusimuka uye zvakare kugovera masimba pabvi mumbiko mukati memubatanidzwa.

-Iye anterior crucate ligament (ACL) uye posterior cruciate ligament (PCL) inosimbisa anterior-posterior uye yekuwedzera-yekuwedzera kufamba.

-The Medial Collateral Ligament uye Lidereral Colateral Liginter inodzika iyo ibvi mune yavo ndege.

-Zvirongwa zvimiro zvinodzika ibvi dzinosanganisira iyo iliotibial bundle uye chikamu cheiyo yepashure peyakagarwa runyanga.

04. Budsae uye Cytics Zvivakwa

Zvikamu zvakati wandei zvinowanzoitika zvinowanzo kuwanikwa kutenderedza pabvi, kusanganisira Tendon Sheath Cysts uye Synovial Burspae. Tendon Shehat Cysts ari benmalses makatsemurwa nedambudziko fibrous connective tishu uye ine mucus.

Iyo popliteal cyst (kureva, cyst's cyst) ndiyo yakajairika synovial cyst instst mumuviri. Iyo inotangira kubva kuBersa pakati peMocial musoro weGastrocnemius Muscle uye Semimemberbranosus Tendon. Popliteal Cysts kazhinji anowanzo syymptomatic asi anowanzobatanidzwa neIntra-articular kusagadzikana kwebvi.

Kune mana anowanzoumbwa bursae pamberi pebvi. Iyo suprapatellar bursa yakave proximal kune iyo kabvi capsule uye iri pakati peiyo rectus femoris tendon uye femur, uye traffic yayo nebvi rakabatanidzwa muvanhu vakuru vazhinji. Iyo prepartellar bursa yakangova anterior kune patella. Iyo Superficial Infatollar BursaLeflar Inhema kune iyo Dislar chikamu chePatellar Tendon uye neTibial Tendros, nepo yakadzika Infellar burs iri pakati pechikamu chePatellar tendon uye iyo anterior tibiel tubority. Burse repamusoro rinogona kupiswa nekunyanyisa kana kushungurudzika, vakanyanyisa kupfugama, nepo kunyanyisa kwebvi rekuwedzera kunogona kutungamira mukuzvimba kwakadzama kwerapa, sekudzokororwa kusvetuka kana kumhanya.

Iyo medial chikamu chebvi inotongwa neye goosefoot bursa, iyo semimemberbrosus bursa, uye iyo suprapetallar bursa. Iyo goosefoot bursa iri pakati peTibial kumira kweiyo testeral tibil clateral ligament ligpress uye iyo distal fuluni yejasi, mitezo yemunhuwo uye semitendinosus tsandanyama. Iyo semimemberbrenosus iri pakati peSemimemberbrhanus Tendon uye Suprapatellar Cinki, uye Suprapatellar Cinki ndiyo Bursa Bursa Mubvu uye iri pamusoro pePatella uye pane yakadzika nzvimbo yeiyo quadriceps tsandanyama.

05 Joint Range of Motion

Kuti uongorore kushandira mabvi ekugadzikana, ita kuti murwere atore nzvimbo yekunyepedzera uye yakanyanya fox kuti chitsitsinho chiri padyo nenhepasi pegomba rakawanda sezvinobvira; Iyo yakajairika angle yekuperetera inenge 130 °.

Kuti uongorore kuwedzerwa kwebvudzi ana murwere anofungidzira nzvimbo yekugara uye kuwedzera mabvi ebvi. Kuwedzeredza kwebvi pamusoro pegumbo rakatwasuka kana kusarerekera chinzvimbo (0 °) zvakajairika kune vamwe varwere asi vanoteedzerwa hyperextension. Overeverextension ye isingapfuure 3 ° -5 ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ° ndeye mharidzo yakajairika. Hyprextension inopfuura iyi renji inonzi ibvi Retroflexion uye iri mharidzo isina kujairika.

Iyo Homas Bvunzo inoedza iyo yekuchinjika kweiyo quadriceps uye hip inofamba-famba.

Kana iyo hip yekubhururuka chibvumirano chiripo, chidya cheiyo yekudhara yakadzika mhedziso yekukwira yakananga kune iyo ceiling kwete yekubhururuka kana pasi petafura yekuongorora.

Iyo kona yekona yekati kune tafura yekubvunzira inoratidza iyo degree rehuputi hwekubhururuka.

Kana quadriceps tightness iripo, gumbo rezasi remhirizhonga rinobvisa patafura yekubvunzira. Iyo kona yakaumbwa neyedhonza yepazasi gumbo neivhu plumb mutsara unoratidza iyo degree re quadriceps kusawirirana.

06. Kuongororwa kwekutonga kwakabatanidzwa

Posteridhi Dhirowa Test - Iyo Yepashure Dhawa Muedzo unoitwa nemurwere muchinzvimbo cheSupine, Hip rakakanganisika rakashandurwa kusvika ku45 °, ibvi rakashandurwa kusvika 90 Muongorori anotora iyo yemurwere proximal tibia nemaoko maviri mune denderedzwa paunenge uchiisa zvigunwe zvemaoko ese maviri pane thumbs emaoko maviri pane thumbs. Simba rekuseri rinobva rashandiswa kune iyo proximal tibia. Kufamba kwekutumira kweTibia kweanopfuura 0.5-1 cm uye kwekutumira kwekutungamira kwakakura kupfuura iyo yedanho rine hutano rinoratidza kusarudzika kana kubvaruka kwakazara kwebvi rekutenderera kwebvi.

Quadriceps Active Exction Test - Inosimbisa tsoka yemurwere.

Tibial yekunze inotenderera bvunzo - iyo tibial yekudziya kwekutenderedza bvunzo inoshandiswa kuona pakona yekudzokera kumashure uye kuvapo kwekupindirana kwePoseri Firtar kukuvara. Iyo tibia inongoerekana yaendeswa kunze kwe30 ° uye 90 ° yebvi yekubhururuka. Muedzo wakanaka kana iro rutivi rwakakanganisika zviri kunze kwekusingaperi kupfuura 10 ° -15 ° kupfuura kudivi rine hutano. Kubatsira pa30 ° yebvi yekubhururuka uye isina kunaka pa00

07. PeriARCICAR LAGaments

Joint capsule ligaments

Patellar Ligament, Medial Patellar Ligament, Lateral Patellar Ligament

Intracapsular Ligaments

anterior cruciate ligament, posterior crucate ligament

Extracapsular ligaments

medial collateral ligament, yakazotevera kuwirirana Ligament, popliteal oblique ligament, fibral colateral ligament

08. Kunaka kwechibatanidzwa

Neurovascular chimiro

Bundu reNeurle rine huwandu hwePopliteal, popliteal vein, uye tibier nerve (kuenderera mberi kweiyo sciatic nerve) inofamba ichangobva kumabvumirano yebvi.

Iyo yakajairika peroneal nerve idavi rapfuura reSciatic nerve.

09. Zvinosanganiswa nemhasuru

Anterior gare gare

Quadriceps inosanganisira rectus femoris, vastus medhielis, vastus yakatevera, uye yepakati femoris.

Posterior Side

Hamstrings

Inosanganisira Biceps Femoris, semitendinosus naSemimemberbronosus;

Gastrocnemius.

Anteromarial

Tibialis anterior.

Nhema dzinochengetedza kusimba kwebvi, kusanganisira quadriceps, kusanganisa tsandanyama, hamstrings, hamsrings hamore yemukati, biceps foman, semitendinosus, uye Semimembranosus.

10. Kuongororwa mumuviri

1. Kuongororwa kwekuona

Cherekedza kufamba uye kuyamwa kwemabvi ebvi pakakanganisika neparutivi rwakatarisana nemurwere, uye teerera kune kana paine madhiri ekuzvimba kweganda, uye zvisina kujairika gait, nezvimwe.

2. Palpation

Tarisa marwadzo uye kupisa saiti, kudzika, chiyero uye zvakasikwa, nedivi rakakanganisika yemurwere munzvimbo yakazorora zvakanyanya sezvinobvira.

3. Moblization

Tarisa uone kufamba kwebvi kubudiswa kuburikidza nemabasa anoshanda uye anongoita emurwere.

4. Kuyerwa

Kuyera kureba kwechikamu chimwe nechimwe chegumbo uye urefu hwese, kutenderera kwegumbo, kusarudzika kwemhasuru, kurasikirwa kwenzvimbo dzekunzwa, etc., uye kuita zvinyorwa uye zvimire.

5. Kuongororwa kwakakosha

 - Kuyambuka Patella bvunzo: Cherekedza kana paine fungidziro mune mabvi emurwere akabatanidzwa.

Kuongorora maitiro

Mushure mekunyudza Suprapatellar Bursa Burs kuti ibvumidze mvura, kana paine mvura yakabatanidzwa, patella ichaburitswa, patella ichave nekuputika kana kuyamwisa kana kuyerera nekuda kwesimba rekushayiwa

- Dhizaina bvunzo: kuti uone kana paine kukuvadza kune inokweretesa ligament.

Anterior Drawer Test: Murwere wakarara pamubhedha, Knee Flexion 90 °, tsoka dzakapetwa pamubhedha, ramba wakazorora. Muongorori patsoka dzemurwere kuti zviitwe, maoko akabata mhuru yemberi, yakadai seyenzi yekunyepedzera

Posteri Drawer Test: Murwere ari kumusana wake, anokotama pabvi kuma 90

- Kuongorora bvunzo: kujekesa kana paine kukuvara kweiyo meniscus yebvi.

Knee Joint Kugaya Test: Nzira yemuviri inoshandiswa kutarisa yeLateral Colateral ligament ligament Lignteral Lighteral Lighteral Lighteral ligament ligament Lights uye Meniscus kukuvara kwebvi rakabatana.

Murwere ari munharaunda inochinjika nebvi rakakanganisika rakachinjika pa 90 °.

1. Kutenderera kusimudza bvunzo

Muongorori anodzvinyirira mhuru pamusoro pehudyu yemurwere uye akabata chitsitsinho nemaoko maviri kusimudza mhuru pamwe neiyo mhuru, ichiri kuita nzvimbo yemukati uye yekunhuhwirira kwemukati; Kana marwadzo ikaitika pamativi ese ebvi, anofungidzirwa kuve akazotevera kuwirirana Ligament yekukuvara.

2. Rotary compression bvunzo

Muongorori akabata tsoka dzengarava rakakanganisika nemaoko maviri, kuti ibvi rakakanganisika rikashandurwa pa 90 ° uye mhuru iri munzvimbo yakatwasuka negwara kumusoro. Wobva wanyura mabvi akabatanidzwa pasi uye kutenderera mhuru mukati uye kunze panguva imwe chete. Kana paine marwadzo ari pane yemukati uye ekunze kwebvi rakabatanidzwa, zvinoratidza kuti vanhu vemukati uye vekunze vakakuvadzwa.

Kana ibvi iri mukunyanyisa kushanduka, posterior nyanga dzeMeniscus ruture rinofungidzirwa; Kana iri pa 90 °, yepakati prepedate inofungidzirwa; Kana marwadzo ikaitika kana achisvika pachinzvimbo chakatwasuka, anterior rengu nyoro rinofungidzirwa.

- Lalteral kushushikana bvunzo: kutarisa murwere wekukuvara kune iyo yakazotevera kuwirirana Lignament.

Iyo yakazotevera mabvi kusagadzikana bvunzo ndeyekuongororwa kwemuviri unoshandiswa kutarisa iyo yakazotevera ligaments yemabvi ebvi.

Chinzvimbo: Nhema dzevarwere supine pamubhedha wekubvunzwa, uye gumbo rakakanganisika rinotumirwa zvinyoronyoro kuitira kuti gumbo rakakanganisika kuti gumbo rakaiswa kunze kwemubhedha.

Joint chinzvimbo: ibvi rinoiswa munzvimbo yakawedzerwa yakazara uye iyo 30 ° yakashandurwa chinzvimbo.

Kumanikidza chikumbiro: Mumbendekete mapendekete maviri, muongorori akabata ruoko rwezasi rwemurwere nemaoko emukati uye kuti ibwe rakabatanidzwa,

Kana marwadzo ikaitika mubvi rakabatanidzwa panguva yekushushikana kwekushandisa, kana kuti kana inversion uye yekushambidzika nekona inowanikwa Kana iyo yekutonhorwa kwekutenderera yekutenderera iri nani, zvinoratidza kuti nzira dzepfungwa dzakatwasuka hadzina kugadzikana, uye panogona kunge paine maronda ezvemukati medu ligament, medial mamiscus uye kubatana kapu; Kana iyo yekutenderera yemukati yekutambika inoziva, inoratidza kuti inotevera nzira yakatwasuka haina kugadzikana, uye panogona kuve nekukuvara kusvika kune yakazotevera meniscus kana yekunyora nzvimbo cartilage.

11. Knee kufungidzira

1. X-ray bvunzo

yaishandiswa kutarisa mapundu uye degenerive osteoarthropathy. Kurema-kuremerwa (kumira) chinzvimbo knee kujoina uye side tarisa firimu kunogona kucherechedza pfupa, ibvi rakabatanidzwa uye zvichingodaro.

2. Computt Tomography (CT)

CT SCAN inogona kubatsira kuongororwa matambudziko mapfupa uye zvikanganiso zvakavanzika. Rudzi rwakakosha rweCT scan inogona kunyatsoziva gout, kunyangwe kana iyo Joint isina kupamiswa.

3. Ultrasound

Inoshandisa mafungu emisikidzwa kuti abudise mifananidzo chaiyo-yenguva yeiyo yakapfava materu matombo mukati uye kutenderedza ibvi. Ultrasound inogona kuona zvimedu zvekuchinja senge mastolling mastolling margins, cartilage kuora, synovitis, poplite lossa kuzvimba, uye kusuwa kwevanhu.

4. Magnetic Resonance kufungidzira (MRI)

Iyi bvunzo inobatsira kuongororwa zvinyoro nyoro kukuvara, senge ligaments, tendon, cartilage uye tsandanyama.

Laboratory bvunzo: Kana chiremba anofungidzirwa utachiona kana kuzvimba, kuongororwa kweropa uye dzimwe nguva anthrocentesis °, maitiro anobvisa huwandu hwemvura kubva kubvi rakabatanidzwa pakubata kweBabhoritari, rinogona kudikanwa.

12. Zvikonzero zvinokonzeresa nezvekurwadziwa kwakabatana

1. Kukuvara-zvine chekuita

Ligment kukuvara kwakadaro senge anterior uye posterior kuderera kweLigament uye inodarika Ligment Liginth uye misodzi; kukuvara kweMeniscus; Patellar Tendonitis uye misodzi; pfupa dzinobhururuka uye zvichingodaro.

2. Arthritis-inoenderana

osteoarthritis inokonzerwa nekupfeka uye kubvarura kwejointa cartilage; Rheumatoid arthritis inokonzerwa nemidziyo yekudzivirira system ichirwisa majoini; gout inokonzerwa nekuumbwa kwemakristasi kubva kune yakakwira uric acid inokanganisa majoini.

3. Zvimwe zvinokonzeresa

synovitis ichikonzera kurwadziwa pamwe nekuzvimba; Matambudziko ePatefari akadai sekuratidzira uye kupfeka cartilage. tumors inopinda muchipinda; Edema inokonzerwa nekuzvimba, nezvimwewo.; kureba kusingagumi; iliotibial fascia syndrome inokonzerwa nekudzokorora kupokana kunotungamira pakurwadziwa kunze kwebvi.

13. Kazhinji yakashandiswa nzira dzekurapa

1.Conservation kurapwa

-Kutarura uye kuBraking

-Cold uye inopisa compress

-Drug kurapwa

-Physhing kurapwa

-Exercise kurapwa

-Sezvera zvekubatsira zvishandiso

2.Surgery

-Artscopic kuvhiya

-Arthroplasty

3.ther kurapwa

-Traditional Chinese mushonga (TCM)

-Inwejira kurapwa