Ukujonga ngokubanzi kwiNerve yeThoracodorsal

Abantu abafumana iimpawu zentlungu ezifana nokudubula, ukuhlatywa, okanye ukuva kombane kwi-latissimus dorsi yomqolo ongaphezulu kunokubangelwa kukwenzakala kwentsholongwane kwi-thoracodorsal nerve. Ngaba ukwazi i-anatomy kunye neempawu kunokunceda ababoneleli bezempilo baphuhlise isicwangciso sonyango esisebenzayo?

Inzwa yeThoracodorsal

Yaziwa nangokuthi i-nerve ye-subscapular ephakathi okanye i-nerve ye-subscapular ende, ihluma ukusuka kwindawo ye-brachial plexus kwaye ibonelela nge-motor innervation/ukusebenza imisipha ye-latissimus dorsi.

Anatomy

I-brachial plexus yinethiwekhi yemithambo-luvo ephuma kumqolo wentamo. Imithambo-luvo inika uninzi lweemvakalelo kunye nokunyakaza kweengalo nezandla, enye kwicala ngalinye. Iingcambu zayo ezintlanu zivela kwiindawo eziphakathi kwesihlanu ukuya kweyesibhozo i-vertebrae yomlomo wesibeleko kunye ne-thoracic vertebra yokuqala. Ukusuka apho, benza isakhiwo esikhulu, emva koko bahlule, badibanise kwakhona, kwaye bahlukane kwakhona ukuze benze i-nerve encinci kunye nezakhiwo ze-nerve njengoko zihamba phantsi kwe-armpit. Ngentamo kunye nesifuba, imithambo-luvo ekugqibeleni ijoyina kwaye yenze iintambo ezintathu ezibandakanya:

• Intambo esecaleni
• Intambo ephakathi
• Intambo yangasemva

Intambo yangasemva ivelisa amasebe amakhulu kunye amancinci aquka:

• I-Axillary nerve
• I-radial nerve

Amacandelo amancinci abandakanya:

• I-nerve ephezulu ye-subscapular
• I-nerve ye-subscapular engaphantsi
• I-thoracodorsal nerve

Ubume kunye neNdawo

• Amagatsha e-thoracodorsal nerve aphuma kwintambo yangasemva kwi-armpit kwaye ahamba ehla, elandela umthambo ongaphantsi kwe-subscapular, ukuya kwi-latissimus dorsi muscle.
• Idityaniswe nengalo engaphezulu, yolule ngasemva kwekhwapha, yenze i-axillary arch, ize ke iye yande ibe ngunxantathu omkhulu ojikeleza iimbambo nomqolo.
• I-thoracodorsal nerve ilele nzulu kwi-latissimus dorsi, kwaye umda ongezantsi ufikelela kufutshane esinqeni.

Umahluko

• Kukho indawo esemgangathweni kunye nekhosi ye-thoracodorsal nerve, kodwa iimbilini zomntu azifani kumntu wonke.
• I-nerve ngokuqhelekileyo ihlahlela intambo yangasemva ye-plexus ye-brachial ukusuka kumanqaku amathathu ahlukeneyo.
•  Nangona kunjalo, ii-subtypes ezahlukeneyo ziye zachongwa.
• I-nerve thoracodorsal inika i-teres enkulu yemisipha malunga ne-13% yabantu. (UBrianna Chu, uBruno Bordoni. 2023)
• I-lats ingaba nokwahluka kwe-anatomical enqabileyo eyaziwa ngokuba yi-a Ilitye likaLanger, eyinxalenye eyongezelelweyo edibanisa nezihlunu okanye izicubu ezidibeneyo zengalo ephezulu ngaphantsi kwendawo yokudibanisa eqhelekileyo.
• Kubantu abanale nto ingaqhelekanga, i-thoracodorsal nerve inikezela umsebenzi / innervation) kwi-arch. (Ahmed M. Al Maksoud et al., 2015)

itheko

I-latissimus dorsi muscle ayikwazi ukusebenza ngaphandle kwe-thoracodorsal nerve. Uncedo lwemisipha kunye nemithambo-luvo:

• Zinzise umva.
• Tsala ubunzima bomzimba xa ukhwela, uqubha, okanye utsalwa phezulu.
• Ncedisa ngokuphefumla ngokwandisa iimbambo ngexesha lokuphefumla kunye nokufinyela xa ukhupha umoya. (Encyclopaedia Britannica. 2023)
• Jikelezisa ingalo uye ngaphakathi.
• Tsala ingalo uye embindini womzimba.
• Ukwandisa amahlombe ngokusebenza kunye ne-teres enkulu, i-teres minor, kunye nemisipha ye-deltoid yangasemva.
• Yehlisa umbhinqo wamagxa ngokugoba umqolo.
• Ukugobela ecaleni ngokugoba umqolo.
• Nyakazisa i-pelvis phambili.

Conditions

I-thoracodorsal nerve inokulimala naphi na kwindlela yayo ngokwenzakala okanye izifo. Iimpawu zomonakalo wemithambo-luvo zinokubandakanya: (IThala leeNcwadi leSizwe laseMelika laseMelika: iMedlinePlus. 2022)

• Iintlungu ezinokuba kukudutyulwa, ukuhlatywa, okanye ukuziva kombane.
• Ubundisholo, ukubetha.
• Ubuthathaka kunye nokulahlekelwa ngumsebenzi kwimisipha ehambelanayo kunye namalungu omzimba, kubandakanywa nesandla kunye nokuhla kweminwe.
• Ngenxa yendlela ye-nerve kwi-armpit, oogqirha kufuneka baqaphele ukuhluka kwe-anatomical ukuze bangonakalisi ngengozi i-nerve ngexesha leenkqubo zomhlaza wesifuba, kuquka i-axillary dissection.
• Inkqubo yenzelwe ukuvavanya okanye ukususa i-lymph nodes kwaye isetyenziselwa ukubeka umhlaza webele kunye nakunyango.
• Ngokophononongo, i-11% yabantu abane-axillary lymph node dissection bafumana umonakalo kwi-nerve. (URoser Belmonte et al., 2015)

Ukubuyiswa kwesisu

• Kutyando lokwakhiwa ngokutsha kwebele, iilathi zingasetyenziswa njengeflap phezu kofakelo.
• Ngokuxhomekeke kwiimeko, i-thoracodorsal nerve inokushiywa injalo okanye inqunywe.
• Uluntu lwezonyango aluzange luvumelane malunga nokuba yeyiphi indlela eneziphumo ezilungileyo. (Sung-Tack Kwon et al., 2011)
• Kukho ubungqina bokuba ukushiya i-nerve intact kunokubangela ukuba i-muscle ivume kwaye ikhuphe i-implant.
• I-nerve ye-thoracodorsal engaguqukiyo inokubangela i-atrophy ye-muscle, enokuthi ibangele ubuthathaka kunye nengalo.

Ukusetyenziswa kweGrafti

Inxalenye ye-thoracodorsal nerve idla ngokusetyenziswa kwi-nerve graft reconstruction ukubuyisela umsebenzi emva kokulimala, okubandakanya oku kulandelayo:

• Umthambo we-Musculocutaneous
• I-accessory nerve
• I-Axillary nerve
• I-nerve ingasetyenziselwa ukubuyisela ukusebenza kwe-nerve kwisihlunu se-triceps engalweni.

kwimo

Ukuba i-thoracodorsal nerve yenzakele okanye yonakele, unyango lungabandakanya:

• Izikrweqe okanye iiplagi.
• Unyango lomzimba ukuphucula uluhlu lwentshukumo, ukuguquguquka, kunye namandla emisipha.
• Ukuba kukho uxinzelelo, utyando lunokufuneka ukunciphisa uxinzelelo.

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Ukuphonononga i-Integrative Medicine

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Ucaphulo

Chu B, Bordoni B. Anatomy, Thorax, Thoracodorsal Nerves. [Ihlaziywe 2023 Jul 24]. Ku: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Ifumaneka kwi: www.ncbi.nlm.nih.gov/books/NBK539761/

Al Maksoud, A. M., Barsoum, A. K., & Moneer, M. M. (2015). I-Langer's arch: i-anomaly enqabileyo ichaphazela i-axillary lymphadenectomy. Ijenali yeengxelo zetyala lotyando, 2015(12), rjv159. doi.org/10.1093/jscr/rjv159

Britannica, Abahleli be-Encyclopaedia. “latissimus dorsi“. Encyclopedia Britannica, 30 Nov. 2023, www.britannica.com/science/latissimus-dorsi. Ifikeleleke nge-2 kaJanuwari 2024.

IThala leeNcwadi leSizwe leLizwe lase-US: i-MedlinePlus. I-peripheral neuropathy.

Belmonte, R., Monleon, S., Bofill, N., Alvarado, M. L., Espadaler, J., & Royo, I. (2015). Ukwenzakala okude kwe-thoracic nerve kwizigulane zomhlaza webele zinyangwa nge-axillary lymph node dissection. Ukunyamekelwa kweNkxaso kumhlaza : iphephancwadi elisemthethweni le-Multinational Association of Supporting Care in Cancer, 23 (1), 169-175. doi.org/10.1007/s00520-014-2338-5

Kwon, S. T., Chang, H., & Oh, M. (2011). Isiseko se-anatomic se-interfascicular nerve splitting ye-latissimus dorsi ye-muscle flap engapheliyo. Ijenali yeplastiki, utyando oluhlaziyiweyo kunye nobuhle : JPRAS, 64(5), e109–e114. doi.org/10.1016/j.bjps.2010.12.008