ʻO ka sternum (mai ka Latin sternum, mai Greek sternon) kahi iwi o ka thorax i lilo i ka iwi iwi ʻaoʻao ma kāna ʻāpana waena.

ʻO ka sternum he iwi pālahalaha aia i mua o ka thorax, i ka midline o ke kino (ma ka waena). Hoʻākāka ʻia ia ma kēlā me kēia ʻaoʻao me nā iwi mua ʻehiku a me nā clavicle kahi e hana ai i ka ami sternoclavicular. Kau ʻia ma luna o ka ʻili ma lalo o ka ʻili, aia ia i mua o kahi ʻāpana nui o ka puʻuwai.

Hana ʻia ka umauma mai ka hoʻohui o ʻekolu mau iwi iwi:

• Le lawelawe sternal,
• Ke kino o ka umauma,
• Ke kaʻina hana xiphoid.

ʻEkolu mau hōʻailona anatomical koʻikoʻi:

• Hoʻomaopopo ka notch jugular i ka lihi luna o ka sternum. Māmā maʻalahi ia ma lalo o ka ʻili, ʻo ia ka hollow a mākou e ʻike ai ma ke kumu o ka ʻāʻī.
• Aia ka ʻaoʻao sternal i ka palena o ka manubrium sternal a me ke kino. Pēlā nō hoʻi i palpable, kū i waho i ke ʻano o kahi kualapa papamoe.
• ʻO ka ami sternal lalo, aia ia ma ka hui ma waena o ke kino o ka sternum a me ke kaʻina xiphoid.

Hoʻopili ka sternum i ka hoʻokumu ʻia ʻana o ka iwi iwi o ka iwi iwi ʻaoʻao. Hui pū nā iwi ʻaoʻao a me ka vertebrae thoracic me ia e hoʻopiha ai.

Haki ʻo Sternum :

Pili nā haʻihaʻi Sternum me ka ʻehaʻeha, pololei a ʻaʻohe paha. Hiki ke hopena pololei ma muli o kahi ulia kaʻa (ka kāʻei noho e kaomi ana i ka umauma a i ʻole ka hopena o kahi hoʻokele) a i ʻole pili i nā haʻuki. Hiki i nā kumu pololei ʻole o nā haʻihaʻi ke kūlohelohe i ka poʻe ʻelemākule me ka osteoporosis, no ka laʻana. Ua ʻike ʻia nā haki pilikia ma nā haʻuki e pili ana i nā hana o ke kino o luna. Hiki i kēia mau haki ka umauma ke hana i kahi kaʻawale a i ʻole e hoʻopili ʻia me nā ʻeha ʻē aʻe.

- Hoʻokaʻawale ʻia: hoʻopili wale ʻia ka sternum. ʻO ka hapanui o nā maʻi e ola hou loa ma hope o nā pule he nui.

- Hoʻopili ʻia me nā ʻeha ʻē aʻe: pili ʻelua hapakolu o nā haʻihaʻi sternum me nā pathology koʻikoʻi e hiki ai ke make i 25 a 45% o nā hihia (3). Hiki i kēia mau hōʻeha ke hoʻopili wale i nā aʻa a hōʻea i lalo i ka iwi ʻaoʻao (nā iwi iwi, nā puʻuwai, nā māmā a me nā ʻāʻī, a pēlā aku.).

Hōʻalo Sternoclavicular : ka hemo o ka ami ma waena o ka clavicle a me ka sternum, ʻehā mau manawa ia o ka pinepine ma mua o ka acromioclavicular

ʻO kaʻeha hope : he mau kumu lākou he nui a hiki i kekahi manawa ke ʻike ʻia i ka sternum. ʻO kēia mau ʻeha ma muli o ka maʻi puʻuwai (e like me ka myocardial infarction) a i ʻole ka maʻi maʻi (eg pulmonary embolism) a koi ʻia i ka lāʻau lapaʻau wikiwiki.

Fente kūwaho : kakaʻikahi ka malformation o ka sternum, o ke kumu i ʻike ʻole ʻia. I ka wā o ke ola embryonic, hopena ia i kahi kīnā i ka fusion o nā iwi kī i hoʻokumu ʻia i ka sternum, kahi e hana mau ʻia ai mai luna a lalo e hoʻopau loa ai. ʻO ke keʻoki ʻana ma nā pule mua ma hope o ka hānau ʻana pani ʻia ka umauma a pēlā e pale ai i ka puʻuwai a me nā moku nunui ma hope o ia.

Hyperternosis Sternocostoclavicular . Hoʻololi ia i ke kāne waena waena. ʻO ka ʻōuli nui ka hōʻeha ʻeha ma ka umauma.

Tumors o ka umauma : Hiki ʻole ke loaʻa nā iwi iwi o ka paia umauma ma ka umauma a iwi iwi paha. Hōʻike kēia ʻano tumo iwi ma mua o 5% o nā iwi ʻāʻī āpau (6).

ʻO nā pathologies o ka sternum ma muli o ka trauma kūwaho a i ʻole nā ​​maʻi kaka ʻole o nā kumu ʻike ʻole ʻia. No laila he mea paʻakikī ke pale aku iā lākou.

Pahu kūwaho: ka hana o ka hoʻokomo ʻana i kahi nila i ka umauma e hoʻoneʻe i ka iwi iwi. Aia i loko o kēia mākia nā hunaola hematopoietic i kapa ʻia, aia ma ke kumu o nā pūnana koko like ʻole. ʻO ka anamanaʻo keʻena hoʻokolohua o kēia mau pūnaewele ka myelogram. Hoʻohana ʻia ia e kuhi i kahi maʻi maʻamau i loko o kekahi o nā kaola o ke koko. Hiki ke hoʻokō ʻia kēia puncture i ka iwi o ka pelvis, a laila he puncture lumbar.

Nā hōʻike kiʻi:

• Radiography: kahi hana kiʻi olakino e hoʻohana ai i nā kukuna X. ʻO ka radiography o ka sternum a i ʻole sternoclavicular ami kahi hōʻike maʻamau o ke kuhikuhi ʻana i nā pathologies e pili ana i ka trauma.
• Scanner: ke kiʻi kiʻi ʻana i loko o ka "scanning" kahi ʻāpana i hāʻawi ʻia o ke kino i mea e hana ai i nā kiʻi ʻāpana, mahalo i ka hoʻohana ʻana o kahi kukuna X-ray. ʻLelo pū mākou e pili ana i ka tomography compute a i ʻole CT scans. Hāʻawi kēia hōʻike i kahi hiʻohiʻona maikaʻi o ka iwi medullary a me nā mea palupalu o ka hui a puni ka hono.
• MRI (kiʻi resonance ʻumeume) Hāʻawi ia i nā kiʻi kikoʻī o ka iwi mineralized o ka sternum.
• Bint scintigraphy: ke kiʻi kiʻi ʻana i loko o ka lawelawe ʻana i ka mea maʻi i kahi tracer radioactive i pālahalaha ʻia i loko o ke kino a i ʻole nā ​​ʻokena e nānā ʻia. No laila, ʻo ka mea hoʻomanawanui nāna e "hoʻokuʻu" i ka pāhawewe e lawe ʻia e ka hāmeʻa. Hiki i ka scintigraphy ke nānā pono i nā iwi a me nā hono. I nā hihia o ka sternum, hoʻohana ʻia ia kikoʻī no ka ʻike o ka sternocosto-clavicular hyperostosis.

Ua koho ʻia he 5% o ko ka honua heluna he "sternal form", a i ʻole sternal perforation, a i ʻole he wehe ākea ma ke kino o ka umauma. ʻO kēia lua, e like me ka mea i waiho ʻia e ka pōkā e hele ana i ka umauma, ua wehewehe maoli ʻia e kahi kīnā i ka ossification (8,9).