Vertex ndiye gawo lakumtunda la chigaza, chomwe chimatchedwanso sinciput. Vertex ndiye pamwamba pamutu, gawo lakumtunda kwa cranial box, mwa anthu komanso m'matupi onse am'mimba kapena ngakhale mu arthropods. Vertex, yomwe imadziwikanso kuti chigaza cha chigaza, imapangidwa ndi mafupa anayi mwa anthu.

Vertex imapanga, mwa ma vertexes, kuphatikiza munthu, komanso tizilombo, pamwamba pa chigaza. Nthawi zina amatchedwa cranial cap, vertex ndiye, mu anatomy, gawo lapamwamba la bokosi lamiyendo: ndipamwamba pamutu. Amatchedwanso sinciput.

Mu anatomy, mwa anthu, cranial vertex imakhala ndimafupa anayi a chigaza:

• fupa lakumaso;
• mafupa awiri a parietal;
• zochitika za occipital. 

Mafupawa amalumikizana pamodzi ndi suture. Suture ya coronal imalumikiza mafupa akutsogolo ndi a parietal, sagittal suture ili pakati pa mafupa awiri a parietal, ndipo lambdoid suture imalumikizana ndi mafupa a parietal ndi occipital.

Monga minofu yonse ya mafupa, vertex ili ndi mitundu inayi yamaselo:

• mikwingwirima;
• nyamakazi;
• malire m'malire;
• nyamayi. 

Kuphatikiza apo, matrix ake akunja amawerengedwa, ndikupangitsa kuti minofu iyi ikhale yolimba. Kuphatikiza apo, izi zimapangitsa kuti ma X-ray azioneka bwino, motero kuphunzirira mafupa ndi x-ray.

Vertex imagwira nawo ntchito poteteza ubongo, kumtunda kwake. M'malo mwake, vertex pokhala mnofu wamfupa, chifukwa chake minofu ya mafupa, imagwira ntchito.

Zowonadi, minofu ya mafupa ndi imodzi mwamphamvu kwambiri m'thupi, chifukwa chake imatha kupirira zovuta zamankhwala. Umu ndi momwe vertex imagwirira ntchito yoteteza kuubongo pamutu pamutu.

Zowonjezera zam'mimba hematoma

Matenda omwe amakhudza vertex amapangidwa ndi extmatural hematoma, yomwe nthawi zambiri imatsata kudabwitsidwa kwakukulu komwe kumayambitsa kuphulika kwamitsempha yomwe ili pamwamba pa meninges. Hematoma iyi imapangidwa ndimagazi omwe amakhala pakati pa fupa la chigaza ndi nthawi yayitali, kapena mbali yakumapeto kwa meninges, envelopu yoteteza ubongo. Chifukwa chake ndikuwonongeka kwa magazi pakati pa mafupa a chigaza omwe amapanga vertex ndi nthawi yayitali yaubongo.

Extra-dural hematoma yomwe imapezeka ku vertex ndiyosowa, ndi gawo lochepa chabe la ma hematomas ena owonjezera. Zowonadi, hematoma yamtunduwu imangokhudza vertex mu 1 mpaka 8% yamatenda onse a hematoma owonjezera. Zitha kuyambika ndikung'ambika kwa sagittal sinus, ngakhale ma hematomas akunja kwa vertex omwe amawonekera mwadzidzidzi anafotokozedwanso m'mabuku.

Extra-dural hematoma (EDH) ya vertex ili ndi zovuta zamankhwala, chifukwa chake kupezeka kwamatenda ndizovuta. Matendawa amatha kukhala ovuta kapena osatha.

Magwero a kutuluka kwa magazi atha kulumikizidwa, monga tanenera kale, kuti ang'ambe mu singittal sinus, koma zomwe zimayambitsa magazi amathanso kukhala ochepa. Zizindikiro zofala kwambiri ndimutu wopweteka kwambiri, womwe umakhudzana ndi kusanza.

Kuphatikiza apo, EDH ya vertex yalumikizidwa ndi hemiplegia, paraplegia, kapena hemiparesis. Hematoma yowonjezerayi ya vertex imakhalabe yosowa.

Matenda ena

Matenda ena omwe angakhudze vertex ndi mafupa, monga zotupa zoyipa kapena zoyipa, matenda a Paget kapena ngakhale fractures, zikachitika zoopsa. Zotupa kapena pseudotumors za cranial vault, makamaka, ndi zotupa zomwe zimakumana ndimomwe zikuchitika pakadali pano ndipo kupezeka kwake kumakhala kopanda tanthauzo. Amakhala oopsa.

Hematoma yowonjezerapo yomwe ili pamlingo wa vertex itha, kutengera kukula kwa hematoma, momwe wodwalayo aliri komanso zina zomwe zimapezeka mu radiological, zitha kuchitidwa opaleshoni. Chisamaliro chachikulu chiyenera kutengedwa panthawi ya opareshoni, chifukwa kung'ambika kwa sagittal sinus kumatha kubweretsa kuwonongeka kwakukulu kwa magazi komanso kuphatikizika.

Matenda ena a vertex amathandizidwa pogwiritsa ntchito mankhwala othandiza kupweteka, kapena opaleshoni, kapena, ngati ali ndi chotupa, ndi opaleshoni, kapena chemotherapy ndi radiotherapy pakakhala chotupa. zoyipa za fupa ili.

Kuzindikira kwa hematoma yowonjezerapo yomwe ili pamlingo wa vertex kumatha kuyambitsa chisokonezo cha matenda. Kujambula kwa CT (computed tomography) kwa mutu kumatha kuthandizira kuzindikira. Komabe, muyenera kusamala kuti musalakwitse ndi artefact kapena subdural hematoma.

M'malo mwake, MRI (magnetic resonance imaging) ndichida chodziwitsa bwino chomwe chingatsimikizire izi. Kuzindikira koyambirira komanso kuchiritsidwa mwachangu kwa hematoma yakunja kumatha kuthandiza kuchepetsa kufa komanso matenda omwe amapezeka chifukwa cha matendawa.

Pozindikira matenda ena am'mafupa, chithunzi chachipatala chimakonda kugwirizanitsidwa ndi zida zojambulira kuti muzindikire kuti wasweka kapena wasweka, kapena chotupa chosaopsa kapena chowopsa, kapena matenda a Paget.

Mlandu woyamba wa extra-dural vertex hematoma udanenedwa mu 1862, ndi Guthrie. Ponena za mlandu woyamba wofotokozedwa m'mabuku asayansi omwe MRI idagwiritsidwa ntchito pozindikira hematoma yowonjezerapo ya vertex, idachokera ku 1995.

Pomaliza, zidapezeka kuti pathophysiology ya hematoma yomwe imakhudza vertex ndiyosiyana kwambiri ndi ma hematomas owonjezera omwe amapezeka m'malo ena a chigaza: inde, ngakhale magazi ochepa angafunike kuchitidwa opaleshoni. , hematoma ikakhala mu vertex, pomwe nthawi yaying'ono, asymptomatic hematoma yomwe ili m'malo ena a chigaza singafunike kuchitidwa opaleshoni.