Sternum (kuchokera ku Latin sternum, kuchokera ku Greek sternon) ndi fupa la chifuwa chomwe chimapanga nthiti pakati pake.

Sternum ndi fupa lathyathyathya lomwe lili kutsogolo kwa chifuwa, pakatikati pa thupi (pakati). Imafotokoza mbali iliyonse ndi nthiti zisanu ndi ziwiri zoyambirira komanso ndi ma clavicles momwe amapangira cholumikizira cha sternoclavicular. Yoyikidwa pamtunda pansi pa khungu, ili patsogolo pa gawo lalikulu la mtima.

Pachifuwa pake amapangidwa kuchokera pakuphatikizika kwa zidutswa zitatu zamathambo:

• Gwiritsani ntchito mwamphamvu,
• Thupi la chifuwa,
• Njira ya xiphoid.

Pali zizindikilo zitatu zofunika kutengera:

• Chotsalira cha jugular chimayang'ana kumtunda kwa sternum. Ndi yosavuta kugundana pansi pa khungu, ndiye dzenje lomwe timamva pansi pa khosi.
• Mbali yakutsogolo ili kumalire a sternal manubrium ndi thupi. Palpable, ndi chimaonekera mu mawonekedwe a lokwera yopingasa.
• Mgwirizano wapansi wam'munsi, womwe umakhala pamphambano pakati pa thupi la sternum ndi njira ya xiphoid.

Sternum imatenga nawo gawo pakupanga mafupa a nthiti. Nthitizi ndi mafupa amtundu wa thoracic amaphatikizana nawo kuti amalize.

Kuphulika kwa Sternum :

Kuphulika kwa Sternum kumalumikizidwa ndi zoopsa, kaya zachindunji kapena zosazungulira. Zomwe mungachite zimachitika chifukwa cha ngozi yagalimoto (lamba wokhala pampando akukakamira pachifuwa kapena chiwongolero) kapena zokhudzana ndi masewera. Zomwe zimayambitsa kusweka zimatha kuchitika zokha mwa okalamba omwe ali ndi kufooka kwa mafupa, mwachitsanzo. Kupsinjika kwamaganizidwe kwadziwikanso kwa othamanga pambuyo pobwerezabwereza masewera olimbitsa thupi. Mafupa a m'chifuwa amatha kuchitika payekha kapena kumalumikizidwa ndi zovulala zina:

- Wakutali: kokha sternum imakhudzidwa. Odwala ambiri amachira atatha milungu ingapo akuchira.

- Yokhudzana ndi kuvulala kwina: magawo awiri mwa atatu amtundu wa sternum fractures amakhudzana ndi zovuta zomwe zimatha kufa mu 25 mpaka 45% yamilandu (3). Kuvulala kumeneku kumangokhudza ziwalozo kapena kufikira mkatikati mwa nthiti (nthiti zovulala, mtima, mapapo ndi kuwonongeka kwa msana, etc.).

Kusokonezeka kwa Sternoclavicular : kusokonezeka kwa mgwirizano pakati pa clavicle ndi sternum, ndi wocheperapo kanayi kuposa acromioclavicular.

Kupweteka pachifuwa : ali ndi zifukwa zingapo ndipo nthawi zina amatha kumverera mu sternum. Zowawa izi zimachitika chifukwa cha matenda amtima (mwachitsanzo, infarction ya myocardial infarction) kapena matenda amitsempha (mwachitsanzo kupindika m'mapapo mwanga) ndipo amafunikira chithandizo chamankhwala mwachangu.

Zowonongeka zakunja : malformation osowa a sternum, osadziwika. Pa nthawi ya moyo wa mayi, zimabweretsa vuto pakulumikizana kwa mafupa omwe amafunsidwa kuti apange sternum, yomwe nthawi zambiri imachitika kuyambira pamwamba mpaka pansi kutseka kwathunthu. Kuchita opaleshoni m'masabata oyamba atabadwa kutseka chifuwa cha m'mawere motero kumateteza mtima ndi zotengera zazikulu kumbuyo kwake.

Stenocostoclavicular hyperostosis : Matenda achilendo osadziwika, amachititsa hypertrophy ndi kufinya kwa sternum, collarbones ndi nthiti zoyamba. Amakondera mosankha munthu wazaka zapakati. Chizindikiro chachikulu ndikutupa kowawa pachifuwa.

Zotupa za pachifuwa : Zotupa zamafupa za khoma lachifuwa sizimapezeka kwambiri pachifuwa kapena pakhosi. Mtundu wa chotupa cha mafupa umaimira zosakwana 5% mwa zotupa zonse za mafupa (6).

Matenda a sternum amayamba chifukwa cha zoopsa zakunja kapena matenda achilendo osadziwika. Chifukwa chake kumawoneka kovuta kuwaletsa.

Kubowola kwakunja: kuyesera kulowetsa singano m'chifuwa kuti muchotse mafuta m'mafupa. Mafupawa ali ndi maselo otchedwa hematopoietic, omwe ali pachiyambi cha maselo osiyanasiyana a magazi. Kufufuza kwa ma cell awa ndi myelogram. Amagwiritsidwa ntchito kuzindikira zachilendo mu umodzi mwamizere yamagazi. Kubowoleza kumeneku kumatha kuchitidwanso mu fupa la mafupa a chiuno, kenako ndikuboola lumbar.

Kuyerekeza mayeso:

• Mafilimu: njira yojambula yachipatala yomwe imagwiritsa ntchito X-ray. Mafilimu ojambula a sternum kapena sternoclavicular joints ndi kufufuza koyenera kwa matenda omwe amapezeka ndi zoopsa.
• Sikana: Njira yojambulira yomwe imakhala ndi "sikani" gawo lomwe lapatsidwa la thupi kuti lipangitse zithunzi zogwirizana, chifukwa chogwiritsa ntchito X-ray. Timalankhulanso za computed tomography kapena CT scans. Kufufuza uku kumapangitsa kuwonetseratu kwa fupa la medullary komanso minofu yofewa yolumikizira komanso mozungulira cholumikizira.
• MRI (kujambula kwamatsenga): kuyezetsa kuchipatala kuti mudziwe ngati mukugwiritsa ntchito chida chachikulu chomwe chimagwiritsa ntchito maginito ndi ma wailesi. Amapereka zithunzi zenizeni za fupa la mchere wa sternum.
• Scintigraphy ya mafupa: njira yolingalira yomwe imaphatikizapo kupatsa wodwalayo tracer tracer yomwe imafalikira mthupi kapena m'ziwalo zomwe zimayesedwa. Chifukwa chake, ndi wodwala yemwe "amatulutsa" cheza chomwe chimatengedwa ndi chipangizocho. Scintigraphy imapangitsa kuti aziwona mafupa ndi malo olumikizirana. Nthawi ya sternum, imagwiritsidwa ntchito makamaka popewa sternocosto-clavicular hyperostosis.

Akuyerekeza kuti 5% ya anthu padziko lapansi ali ndi "mawonekedwe amwano", kapena opindika mwamphamvu, kapena potseguka pathupi la chifuwa. Bowo ili, lofanana ndi lomwe linasiyidwa ndi chipolopolo chopyola pachifuwa, limafotokozedwa ndikulakwitsa kwa ossification (8,9).