Factori Etiologici Ai Anomaliilor Adm

8/19/2019 Factori Etiologici Ai Anomaliilor Adm

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FACTORI ETIOLOGICI AI ANOMALIILOR ADM

-CURS 4+5-

1.FACTORI GENERALI:

• Genetici• Metaboici

• En!oc"ine

#.FACTORI LOCALI $FUNCTIONALI%&ate"a"ea '(nctiio" ADM:

• Re)*i"atie ei)ta *o)ibiitatea

• De,(titie (no" ob icioa)e

• Ma)ticatie

• Fonatie

Facto"ii ,ene"ai a( ca*acitatea !e a !ete"ina *otentia( !e c"e)te"e/caitatea c"e)te"ii ca"e *oate )a )("ina int"-(n inte"a !e ti*/ !("ata )i "it(

c"e)te"ii. 0"eenti inca !in *e"ioa!a eb"iona"a.

0"in co*a"atie/ 'acto"ii '(nctionai a( ca*acitatea !e a in2(enta caitati

'enoen( !e c"e)te"e $)e i*"ia in !i"ectia !e c"e)te"e%. 0"eenti !(*a oent(

na)te"ii $)(nt *o)ibie *"eentia )i *"o3aia%.

Facto"ii '(nctionai o" in2(enta !i' !int"e )t"(ct("ie ADM (b '(nctie !e

oent( !eota"ii a ca"e e )("*"in) ace)ta/ !a" )i in '(nctie !e an(iti

*a"aet"i ca"e ca"acte"ieaa !i)'(nctia "e)*ectia: !("ata/ inten)itate/ o!( in

ca"e )e !e)'a)oa"a )i eeent(-an(e a ADM a)(*"a ca"(ia actioneaa.

1.FUNCTIA RES0IRATORIE

• DINAMICA

o Ae"( *a"c(",e caie "e)*i"ato"ii )(*e"ioa"e $caitate

naaa+nao'a"in,e%/ )('e"in! o!i3ca"i caitatie )i cantitatie/

ca"e a( "o( !e a- a!a*ta a con!itiie i*()e !e "e)*i"atia

*(ona"ao Ace)te o!i3ca"i )(nt "eaiate *"in an(ite *a"tic(a"itati ca"e

tin !e *a)a( ae"ian nao'a"in,ian:a% A"itect("a t"aiect((i anatoic )t"abat(tb% F(nctiie e*iteiae !e a ace)t niec% F(nctiie ,an!(a"e!% F(nctiie ee"citate !e te)(t( eno)e% Ine"atie

a% AR6ITECTURA 0ASA7ULUI NA8OFARINGIAN

• Ro&"e,a"ea iteei !e t"anit a ae"((i

• Acea)ta )e "eaieaa *"in )ciba"ea !i"ectiei *a)a((i ae"ian )i

o!i3ca"i !e caib"(


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b% FUNCTIA E0ITELIALA

• Ei)tenta ciio"/ca"e ee"cita o *"ia *("i3ca"e a ae"((i.

• F(nctia e co*etata !e )ec"etia (n(i (c() bacte"io)tatic $!in

,. Caici'o"e%

• A t"eiea 'enoen:a*a"e (n 'enoen !e ti"a/ !ato"ita iteei

ae"((i !in caitatie naae/ ca"e ant"eneaa *e"io!ic !"ena"eaae"((i !in )in()("ie aia"e )i inoc(i"ea in con)ecinta a

ace)t(iac% FUNCTIA GLANDULARA

• Ro&(ecta"ea ae"((i

• Cantitate )ec"etie9#4 o"e& /5 L

• Te)(t( eno) e"ecti !e a ace)t nie &: "o: incai"e ae"

• Ine"atie: a ace)t nie )e inci! a"c("i "e2ee. La nie( 3eca"(i

eta )e *"ie)c )ti(i ca"e "e,eaa acea)ta actiitate "e2ea $e

int"etin(ta !e contact( cooanei !e ae" c( (coa)a *it(ita"a/

*"ec( )i !e caitatea ace)t(i ae"%.

RES0IRATIA ORALA $RO%

&obicei icio) at(nci can! n( ei)ta ob)t"(ctie-"e)*i"atie ita: "e)*i"atie noct("na o"aa

MECANISM RO

o 0"e)(*(ne an(a"ea continentei abiae ca"e ant"eneaa !(*a

)ine a*a"itia !eeciib"((i int"e b(e/ *oitia )a,itaa )i

e"ticaa a an!ib(ei )i iba. Din oent( in ca"e an!ib(a

i)i o!i3ca *oitia/ a*a"e !eeciib"( int"e ()c(at("a

ete"na $ci"c(o"aa% )i inte"na $in,(aa%o De obicei/ *oitia an!ib(ei e cobo"ata )i in "et"o*()ie/ iba

)e a2a int"-o *oitie oa)a/ ia" *e ona ante"ioa"a: Fie )e *"oiecteaa *e INCISI;II SU0&< 0RODENTIE

SU0ERIOARA inte"inci)i&


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)(*e"ioa"a (n!e toti !! ate"ai )e a2a ai M !ecat no"a + C

ecto*ic/ IL i*it !e 01/ 01 )i 0#%& eiaia"e !e ,"(*o Ca )i eo(tie/ no(-na)c(t( *oate "e)*i"a )i in,iti in acea)i

ti* $,ota )i a"in,ee )e a2a int"-o *oitie (t ai inata%.

Daca "e)*i"atia o"aa )e in)taeaa in *e"ioa!a !e c"e)te"e/

e'ectee ei o" 3 !i'e"ite atat ca ,"aitate/ cat )i...... . ace)tein2(ente )e *ot a*"ecia !e a nie( !eota"ii *(ona"e *ana

a anatoia )i t"o3citatea CRS. CAU8E FREC;ENTE RO

o Ob)t"(ctie:

;e,etatii a!enoi!e

Deiatia !e Se*tebe" "inite c"onice

Ai,!ae i*e"t"o3ce

An(ite a'o"atii ae coaneo" naae

-ace)t tabo( cinic *oate 3 a*i3cat !e ei)tenta

obicei("io" icioa)e/ at(nci can! )(nte 'ao"iati !e (nte"en ato*ic:

-'acie) a!enoi!ian&


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• Na"ine *en)ate

• =(e !e obicei ai *ai!e9*ot 3 )i (t ai "o)ii

$ai "a"%/ 3)("ate

• Eent(a "a,a!e coi)("ae/ c(9'a"a ei(ni

o!ontae/ *acient( *"einta !e obicei o "eactiitate

)ca(ta

TRATAMENT

o Ca(e ob)t"(ctie&< t"ata ci"(",ica $in!e*a"ta"ea

ob)t"(ctiei%> e)te *"eenti )i c("ati: a!enoi!ectoie/

ai,!aoi!ectoie (niate"aa9biate"aa/ co"ecta"ea !eiatiei !e

)e*t can! e)te )eni3catia. Te"a*ie o"to!ontica !ento-'aciaa:

• Mioace ecano-o"to!ontice

• Di)*oitie '(nctionae $'oo)e)c o *a"te a 'o"teo"

ADM *ent"( a cent"aia acea 'o"ta *e ona !e

inte"e): Mio,ina)tica

Decon!itiona"e

A*a"at("a '(nctionaa: *ac(ta ; c(

'ene)t"atii *ent"( "e)*i"atie $*e

a)("a ce )e !econ!itioneaa/ e o

?%

•Obiectie:

o In!e*a"ta"ea ob)t"(ctiei

o Ree!(ca"ea '(nctiei "e)*i"ato"ii:

Recaib"a"ea FN

Recaib"a"ea nao'a"in,iana$a*a"e in

ti*% Re*o. co*e((i an!ib(o-in,(o-

ioi!ian Se a)ociaa/ can! e)te ca(/

,ina)tica "e)*i"ato"ie $co"ecteaa )i

!e'ectee *o)t("ae%. La",i"ea 19o

*a"te&

#.FUNCTIA DEGLUTITIEI

Act 3ioo,ic *"in ca"e bo( aienta" 'o"at in caitatea b(caa

)t"abate caie !i,e)tie )(*e"ioa"e *ana a int"a"ea in e)o'a,


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Se "eaieaa atat *ent"( ici!e/ cat )i *ent"( )oi!e/ !a" e o '(nctie

ca"e )e "eaieaa c( o an(ita '"ecenta/ *e"anent/ o!i3can! !oa"

"it( c( ca"e )e "eaieaa !e,(titia N(a"( !e,(titiio":

o -19i>

o

19B )(nt "eaiate in ti*( e)eo"o #9B int"e e)e

o Me!ie&5 in )on

Ti*ii !e,(titiei: B ti*i $(ni"e B c( 4%9 4 ti*i1. Ti*( b(ca

o &*"e)(*(ne t"an)*o"t( bo((i aienta" in 'a"in,e

o Se "eaieaa o(nta"

o =o( e t"an)*o"tat *ana a int"a"ea in 'a"in,e *"in cont"actii

coo"!onate ae ibii/ ob"aio"/ b(eo"/ an!ib(ei )i

co*e((i ioi!iano Deb(teaa *"int"-o in)*i"atie/ !(*a ca"e ("eaa o iniba"e

co*eta a "e)*i"atiei *ana a 3na( ti*((i 'a"in,ian $#%o Fenoenee )(cce)ie ca"e a*a" *"e)(*(n o *a)a"e initiaa a

bo((i *e 'ata !o")aa a ibii/ in "e,i(nea ante"ioa"a/ a*oi

iba ia 'o"a !e ,eab/ ("an! ca (te"io" )a )e )*"iine *ebota )i )a )e in!"e*te cat"e *o)te"io" $'a"in,e%

o Cont"actia M6 "i!ica *an)e( b(ca o!ata c( iba/ ca"e

a*a)a c( o 'o"ta *e =0/ i*in,an! bo( )*"e 'a"in,eo Liba ee"cita *e =0 o *"e)i(ne !e 41-,9c*/ in '(nctie !e

con)i)tenta aienteo". 0"e)i(nea )e ee"cita ai ae) *e

*a"tie ate"ae ae botii.o Ti*( b(ca a !e,(titiei )e )ciba c( a")ta

Faa coecta"ii ici!eo":

• Secti(ne9R cineatica&


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o 19B ante"ioa"a a ibii in contact c( *aat(

o 19B e!ie )e "ec("beaa *t a coecta bo(

aienta" A B-ea ti*

o Contact iba-*aat !("

o

0aat oae "i!icato Si(tan ei)ta cont"actia o"bic(a" a

b(eo"o =(e in contact

o A"ca!e !enta"e in contact

#. Ti*( 'a"in,iano &!e*a)a"ea bo((i !e-a (n,( 'a"in,e(i

o Sc("t &a*"o 1 )ec

o Decan)a"ea (no" "e2ee !ato"ita contact((i bo((i c(

an(ite one ae C= )i 'a"in,eo Re2eee !ete"ina bo( )a *at"(n!a in 'a"in,e )i )a n( )e

intoa"ca a nao'a"in,e )a( a"in,e 19B ante"ioa"a a ibii-contact c( *aat( !("

D! in oc(ie

=(e in contact

0aat oae "i!icat/ inci!e nao'a"in,ee

19B *o)te"ioa"a a ibii )e cont"acta

B. Ti*( e)o'a,iano &t"an)*o"t( bo((i *ana a o"i3ci( ca"!ia

o Deb(t:!e)ci!e"ea o"i3ci((i c"ico'a"in,ian

o 0"e)(*(ne !ecan)a"ea (nei (n!e *e"i)tatice $"o&

!e*a)a"ea bo((i%o Se 3naieaa *"in !e)ci!e"ea "e2ea a o"i3ci((i ca"!ia

o Fata !o")aa a ibii contact 'e" c( *aat(/ *ent"( a

i*ie!ica "e2(( in o"o'a"in,e4. T"ece"ea bo((i *"in o"i3ci( ca"!ia/ in )toac

Fina( !e,(titiei& an!ib(a )e *a)eaa )*ontan in RC "eaata

Din *(nct !e e!e"e eo(ti/ !i' ae ti*((i b(ca c(no)c ("atoa"ee eta*e:

La no(-na)c(t/ *ana in (ni

o De,(titie 3ioo,ica in'antia& c( iba int"e a"ca!ee a!entate> ei)ta

contact int"e iba )i b(e &!e,(titie i)ce"aa 0e"ioa!a !e t"anitie $(ni- 1 an (ate%


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o Co"e)*(n!e c( e"(*tia M1 TEM0

De,(titia at("a $!e ti* a!(t%

o A"ca!e in contact/ iba *a)ata "et"oinci)i )(*e"io"& !e,(titie

)oatica

Eta*e eo(tie ae ti*((i b(ca a !e,(titiei:

- De,(titia c( a"ca!ee in contact a"e oc a in,e"a"ea aienteo"

• De,(titia !e ti* *o)te"io" *aata

o ;a"'( ibii....

o F"ecenta a"e in OA

o Deeciib"e ()c(a"e !i'e"ite/ ei)ta incontinenta abiaa

o 0e !e o *a"te bota e a!anca/ e")ant( ante"io" a

a )(*e"io"o Ca("i "a"e: inte"*oitia ibii int"e a"ca!e in ona ate"aa

•

De,(titia in,(aa9)(bin,(aao In oent( in ca"e in!ii!( in,ite/ )e "eaieaa ac(( int"e iba

)i *an)e(.o Se a)ociaa 'oa"te '"ecent *"eenta ai,!aeo" i*e"t"o3ce

o A"ca!a in'e"ioa"a !eotata in ece)

o Lin,(oincina"e co*en)ato"ie a !! ate"ai. 0oate a*a"e )i '"onta

o Maia"( )(*e"io": i*o!eota"e $co*"e)ie%

o Oc(ie ine")a c( ece*tia IC SU0 + C ECTO0ICI

- Co"eatii int"e !e,(titie )i aniaiie ADM: *"e(n,i"ea )i *e"anentia"ea

)ta!i((i !e !e,(titie in'antia "e*"einta o inca*acitate a co*i((i !e a-)i

a!a*ta i)ca"ie a noie con!itii c"eate !e e"(*tia !enta"a/ con)ecinta a

(nei inta"ie"i in at("ia"ea ne"oa)a )i ()c(a"a.- In '(nctie !e oent( *"o!(ce"ii: Inoc(ie e"ticaa '"ontaa

Inoc(ie ate"aa

Mo!i3ca"i in *an )a,ita9t"an)e")a $co*"e)ie !e aia"/

OD/ *"o,nati) an!ib(a"%

• Eaen( cinic a !e,(titiei- ca"te

• Ree!(ca"ea !e,(titie


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o 0"in !i)*oitie 3e9aoibie

o 0"in ee"citii

o A*a"ate o"to!ontice:

C( )c(t in,(a $!e)c"ie"e+ !eaantae%

Di)*oitie c( te*i $a"c *aatina c( te*i/ te*i *e *aca

)(*e"ioa"a/ ,(tie"a in'e"ioa"a c( te*i%

-ince*an! c( a")ta !e 5 ani/ )e *ot 'ace )e'(i"i )eectie a nie( C @@@

B. FUNCTIA MASTICATORIE

• Cea ai i*o"tanta '(nctie ADM $)e ai n(e)te )i a*a"at a)ticato"%

• Caitatea b(caa&< "o in *"oce)( !e !i,e)tie *"in ai (te ecani)e:

o Inciia+t"it("a"ea aienteo"

o F(nctia ,()tatia

o I*"e,na"ea c( )aia&< 'o"a"e bo aienta"

o Ince*(t( !i,e)tiei *"in an(ite enie $ioi%

• De a )ta!i( !e no(-na)c(t-a!(t/ acea)ta '(nctie eo(eaa

• In *e"ioa!a ie!iat *o)t nataa/ at(nci can! )e "eaieaa aientatia

nat("aa/ a*a"e in o! 3ioo,ic (n )inc"oni) int"e ce"icaa/

ci"c(o"aa )i in,(aa

• Act( )(*t((i *"e)(*(ne # ecani)e:o S(cci(ne

&c"ea"ea !e i! in caitatea b(caa

o 0"e)i(ne

Int"e iba )i b(e

-i*ica i)ca"i coo"!onate ae an!ib(ei $*"o*()ie%/ cont"actii ae

ibii/ b(eo" )i ob"aio"

Aientatia a"ti3ciaa:

o Inconeniente:

n( ae *"o*()ia an!ib(ei t"aai( ()c(a" )ca(t $tot )(*o"t( )ceeta 'acia )e a

!eota in in()/ co*a"ati c( aientatia nat("aa % )ec"etie )aia"a !iin(ata

ae"o'a,ie ai *"eenta !ecat in aientatia nat("aa $)e )at("a

ai "e*e!e% ai '"ecent *"eenta9)ecee ai ,"ae !e "aiti)

ei(ni o!ontae in ti*( ca"iei !e bibe"on


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i(nitate )ca(ta

o !aca acea)ta aientatie a"e "o co"ect $a)ticatie a)ete"ina%&<

!eota"e ADM no"aa: cont"actia a)ete"ine/ *"o*()ia

an!ib(ei/ ei)ta o cont"actie coo"!onata )i eciib"ata a abiae

c( anta,oni)ti $ai ;0%&< *oitia co"ecta )a,itaa a M ani.

Ab"ai(nea !! e)te e,aa )i 3ioo,ica/ ceea ce 'ace )a )e )tabiea)ca)i a nie inci)i o "eatie co"ecta.

o Daca ae !e-a 'ace c( o a)ticatie te*o"aa&< )(b!eota"e

)ceetica ADM/ a)ticatie in)(3cienta/ ab"ai(nea a"e (n ,"a! ai

"e!() )i )e *oate "eaia c( ti*a"e ati*ice/ an!ib(a "aane *e o

*oitie *o)te"ioa"a/ *ot )a a*a"a *"obee !e *oitiona"e )a,itaa

Mani/ *o)ibia )(*"aaco*e"i"e '"ontaa ai a"e/ a(n,an! *ana a

oc(ii a!anci.

Mecanica a)ticatiei $no(-na)c(t&< a!(t%o NN/ *e"ioa!a a!entata&<

i)ca"i an!ib(a"e ibe"e/ ne)i)teatiate

o!ata c( a*a"itia !! $M# TEM0%/ ince* )a a*a"a i)ca"i

coo"!onate in *an e"tica )i o"ionta $*"o*()ie+"et"o*()ie/

i)ca"i in aa baaa te"inaa/ i)ca"i !e ate"aitate%.

Cobina"ea o" acat(ie)te i)ca"i !e ci"c(!(ctie. Ace)t

ecani) !(ce a 'enoene 3ioo,ice !e ab"ai(ne !enta"a/

ca"e o'e"a ibe"tate oc(aa ca"acte"i)tica DT&< *an !e oc(ie

o"ionta. O!ata c( a*a"itia D0 )e o!i3ca !inaica a)ticatiei )i a*a"

)te"eoti*("i a)ticato"ii:• Mi)ca"i in *an o"ionta& )te"eoti* '"ecato"

• Mi)ca"i in *an e"tica& )te"eoti* tocato"

• I!ea- cobina"e eciib"ata int"e ace)tea

Eta*e a)ticatie:

1.INCI8IA

Reaiata !e '"ontai

0"e)(*(ne ai (te eta*e '(nctionae:

o

Cobo"a"ea an!ib(eio 0"o*()ia an!ib(ei

o Ri!ica"ea an!ib(ei *ana in *oitia CLC a inci)iio"

o Intoa"ce"ea D a !! in'e"io"i c( a(neca"e *e 'etee 0 ae ceo"

)(*e"io"i.

#.TRITURAREA

La nie( !! ate"ai $c()*i!ati%/ *"in i)ca"i !e cic(!(ctie


10/16

0"e)(*(ne (n cic( in 4 ti*i/ )e*a"ati *"in ti*( !e contacte

inte"!enta"e inte"a"ca!iceo T1&'aa ibe"a $!e atac%

0oitiona"e inte"a"ca!ica *"in inte"e!i( aienteo"

o T#& *"e(taoc(a $'aa !e o"ienta"e%

Tot *"in inte"e!i( aienteo"/ c()*iii !! ate"ai )eo"ienteaa 'ata !e cei )(*e"io"i in *oitia co"ecta oc(aa

o TB& (taoc(a

A(neca"ea *anteo" c()*iio" in'e"ioa"e *e cee

)(*e"ioa"eo T4& 'aa !e oc(ie

C()*iii )e )*"iina in 'o)ete/ )e a(n,e in *oitia !inaa

oc(aa/ ca o con)ecinta a an,"ena"ii aia"e co*ete

-toate ace)te 'ae *"e)(*(n i)ca"i coo"!onate ae a)ete"ine/ in,(ae/

ci"c(o"ae )i *"o*()oa"e a an!ib(ei. Re(tat( 3na: con)tit(i"ea bo((i

aienta"

E3cienta a)ticato"ie

• &ca*acitatea ADM !e a t"it("a aientee in '"a,enete cat ai ici

• De*in!e !i"ect *"o*o"tiona !e a"ia a)ticato"ie/ !e inten)itatea )i

n(a"( i)ca"io" a)ticato"ii

• In ceea ce *"ie)te co"eatia !int"e !eota"ea ADM )i ee"cita"ea

'(nctiei a)ticato"ii&< # ti*("i an)abe:o An)ab( an!ib(o-aia"

Ra*o"ta"ea )tatica )i !inaica a an!ib(ei 'ata !e

aia" )i )ceet( c"anio-'aciao An)ab( !ento-aeoa"

Inte"e!iat *"in )t"(ct("ie !ento-*a"o!ontae

Rei!entiat:

• 0"e)i(ne a)(*"a o)((i aeoa"&


11/16

• In ti*( a)ticatiei/ !! )(nt )(*()i a an(ite *"e)i(ni 'oa"te a"i.

0a"o!onti( a"e o ca*acitate !i)c"iinato"ie *"o*"ioce*tia/ )(*o"tan!

*"e)i(ni !e : Inci)ii $B# ,%

Canini $B5 ,%

0M $44 ,% M1 $4 ,%

M# $4 ,%

• a F/ 'o"tee !eotate !e oa"i& #9B !in =

Ree!(ca"ea '(nctiei a)ticato"ii:

• Ee"citii:

o Utiia"ea (no" aiente c( con)i)tenta c"e)c(ta $e: 'oo)i"ea

,(ei !e e)tecat%o U"a"ea ace)to" ee"citii e)te )ca!e"ea *"a,((i !e )en)ibiitate

*a"o!ontaa ca ("a"e a c"e)te"ii 'o"tei $in a*"oiati o (na/

cobo"a"e *"a, c( 4J%o Daca ee"citiie n( )(nt e'ect(ate ce *(tin -H (ni/ a

a*"oiati # )a*taani !e a inceta"e )e "eine a *"a,( initia

• La nie !enta"/ )(b in2(enta a)ticatiei/ a*a" !e*a)a"i )i o!i3ca"i

a!a*tatie.

• Con)ecinta !i"ecta a a)ticatiei& i)ca"ea !e int"(ie&< # 'ae:

Faa 1

• Mai a*a

• Mai "a*i!a

• A)i,("ata !e a(n,i"ea 3b"eo" *a"o!ontae

Faa #

• Mai enta

•

Mai ? in a*it(!ine• A)i,("ata !e !e'o"a"ea ea)tica a o)((i aeoa"

t"actionat !e 3b"ee *a"o!ontae

-cee !o(a 'ae )(nt ai ? in a*it(!ine *e a)("a ce

ibat"ani/ !a" c( *"eca!e"e ce-a !e-a !o(a.

Mecani)e *"in ca"e a)ticatia in2(enteaa !eota"ea ADM:


12/16

o Cont"actia ()c(a"a

Toti an,"enati in "eaia"ea act((i a)ticato"

Can! e)te inten)a/ e,aa/ )iet"ica )i eciib"ata/ )e a)i,("a

con!itiie (nei !eota"i !ien)ionae )i *o)t("ae co"ecteo C"e)te"ea a2(((i )an,(in

La nie( oneo" a ca"e )e "eaieaa cont"actia $con)ecinta a cont"actiei ()c(a"e%

o Cantitatea !e )aia

Ca"e a"iaa in '(nctie !e con)i)tenta aienteo" )i !e ti*(

cat )e "eaieaa '(nctia a)ticato"ie

ATRE8IE&i*)a con,enitaa a (nei 'o"ati(ni anatoice

-a)ticatia in)(3cienta/ a)ticatia (niate"aa/ ei)tenta (n(i an(it

)te"eoti* a)ticato"/ *"e'e"inta *ent"( o an(ita con)i)tenta

aienta"a9ti*("i !e aiente/ !(c a o!i3ca"i )eni3catie a)(*"a c"e)te"ii

aia"e $bocae oc(o-a"tic(a"e/ incon,"(ente/ etioo,ie ca"ioa)a/ i*)a !e

)t"(ct("a"e *a"o!ontaa/ a*oitie ,ene"aiata%

-ee*e !e boca oc(o-a"tic(a": )(*"aaco*e"i"e e"ticaa !e M1/ an,"ena

ine") in ona '"ontaa9ate"aa $o *"obea !e oc(ie iiteaa o i)ca"e

a"tic(a"a%.

Mecani)ee *"in ca"e a)ticatia in2(enteaa a*a"itia (nei anoaii/ !a" )i

ecani)ee *"in ca"e anoaia *oate )a in2(entee ee"cita"ea '(nctiei

a)ticato"ii )e "e'e"a a:o Re!(ce"ea a"iei a)ticato"ii *oate )a a*a"a *"in:

Decaa )a,ita inte"aia"

Oc(ie ine")a '"ontaa c( inoc(ie Inoc(ie e"ticaa '"ontaa

• &

C( cat boca( e ai a*"oa*e !e !ete"inant( *o)te"io" $ATM%/

c( atat a !ete"ina o t"a(a oc(aa ai a"e a)(*"a ATM

$e:an,"enae ine")e&(",ente o"to!ontice% T"ataent o"to!ontic:

o Se *(ne *"obea inat("a"ii 'acto"((i !("e"o) $t"ata ei(nio"

o!ontae/ ,in,iae/ *a"o!ontae%o Ree!(ca"ea ieaa:

Mo!i3ca"ea "it((i aienta"

E!(ca"ea !e a)ticatie $)a 3e e'ect(ata biate"a%


13/16

o Co"ecta"ea anoaiei DM/ ca"e a" aea ca "e(tat a"i"ea a"iio"

a)ticati/ a)i,("a"ea i)ca"io" !e ci"c(!(ctie $("a"e a !eboca"ii

oc(ae%

4.FUNCTIA FONATORI

Fonatia& ei)ia !e )(nete a"tic(ate. Ace)tea )(nt ca"acte"iate !e ("ato"ii

*a"aet"ii:

- Inten)itate $cat !e ta"e%- Inatie $)()9o)%- Tib"( $!e*in!e !e

caitatie !e "eonanta%- D("ata

Mecani)ee ca"e '(n!aenteaa ei)ia !e )(nete a"tic(ate:

1. Teo"ia ca)ica a3"a ca )(netee )(nt *"o!()e !e ib"atia *a)ia a co"io"

ocae at(nci can! ae"( t"ece *"int"e ee.#. Teo"ia ne("o-()c(a"a e*ica ei)ia !e )(nete *"in ib"atia actia a co"io"

ocae ca ("a"e a !ecan)a"ii !e i*()("i ne"oa)e in ne"ii "ec("enti/ ca"e

)(nt t"an)i)e a nie( co"io" ocae $ a"i )i ti"ooca%.

• Co"i ocae& 'o"ati(ni ()c(o-ten!inoa)e/ a)eate a nie(

a"in,e(i/ in *oitie !e "e*a() int"e ee )e 'o"eaa (n )*ati(& "ia,oti!i).

• Cont"actia actia a co"io" ocae- 4 'ae:

De*a"ta"e co"i& ab!(ctie

Eon,a"e aia

A*"o*ie"e-a!!(ctie

Ai*i"ea co"io"-acoa"ea

• La NN/ ne"ii "ec("enti )(nt e,ai. 0e a)("a ce co*i( ince*e )a

o"bea)ca/ "ec("ent( )tan, )e a(n,e)te )i !eine ai ,"o) $"ec("enti

e,ai ca a NN&< (ti. Rec("ent( )tan, t"ece *e )(b aa.)(bcaie .

E)te ai (n, c( 1 c )i ai ,"o)%

- In!icee ne("o-()c(a":o In)*i"atie&


14/16

- 0aiion( 'a"in,o-b(ca )ca!e inten)itatea )(net((i. Dete"ina cont"o(

a)(*"a ace)te inten)itati. 0e !e ata *a"te/ in '(nctie !e oc( )i o!( in ca"e

)e 'o"eaa )(netee/ o"bi !e ocae )i con)oane.- ;ocae& )(nete *"o!()e !i"ect *"in cont"actia a"iabia a co"io" ocae. S(nt

!i'e"ite in '(nctie !e oc( (n!e )e 'o"eaa )i !e ()c(at("a i*icata in

a"tic(a"ea o". Se *ot 'o"a a nie abia/ a nie( ibii/ in *o"ti(nea)(*e"ioa"a $i*ica"ea "eonato"((i naa% 9 in'e"ioa"a a caitatii b(cae

$"eonato" b(ca%.- Ti*("i: ocae *aatae/ e!iae )i ea"e. In '(nctie !e caib"( *aiion((i

'a"in,o-b(ca: inci)e/ !e)ci)e/ iocii- Con)oane& *"o!()e in !i'e"ite )e,ente aa *aiion((i 'a"in,o-b(ca/ in

'(nctie !e inte"actia cooanei !e ae" c( ace)te )e,ente. 0"in cont"actiie

a'e"ente/ *ot 3: abiae/ abio-!enta"e/ in,(o-*aatae/ in,(o-!enta"e.

T(b("a"i 'onato"ii )i ei)tenta anoaiio" DM:

o O t(b("a"e 'onato"ie !e )ine )tatatoa"e n( *oate !ete"ina o

anoaie. Daca ei)ta o anoaie )i ei)ta o t(b("a"e 'onato"ie/

ai intai co"ecta anoaia/ a*oi "ee!(ca !i)'(nctia 'onato"ie

$o,o*e!% Mo!i3ca"i !e *"on(ntie

• Di)aii

• &)e "e'e"a in )*ecia a *"on(ntia (no" con)oane

ca"e/ ai ae) in )it(atia (nei inte"*oitii/

a,"aeaa o anoaie ei)tenta $e: ei)tenta

*etic((i/ )i,ati)((i% Mo!i3ca"i !e )ono"itate

• Rinoaii $inci)e9!e)ci!e%

• Inci)e: oce na"inata $a*a"e in ob)t"(ctie

t"anito"ie9anatoica%

• De)ci)e: co(nica"e int"e )e,ent( naa )icaitatea b(caa $!e)*icat("i ante"ioa"e/ totae )a(

*o)te"ioa"e% T(b("a"i !e "it

o =abaiti

o ="a!iaie

o taiaie

Nece)itati !e t"ataent


15/16

o Stabii"ea ca"ei a'ecti(ni a a*a"(t *"ia $t(b("a"ea

'onato"ie9anoaia DM%o Ce *(te 'ace noi !*! te"a*e(tic

o C( a'ecteaa !i)*oiti( o"to!ontic co"ectia t(b("a"ii 'onato"ii

o T"eb(ie )a c(noa)te *a)ii )i !("ata "ee!(ca"ii t(b("a"ii

'onato"ii

O=ICEIURI ;ICIOASE

o De*"in!e"i ca"e *"in an(ite ca"acte"i)tici *ot in2(enta ne'ao"abi

c"e)te"ea )i !eota"ea ADMo 0ana a a")ta !e 4-5 ani/ )(nt con)i!e"ante in iite no"ae

$*a)ticitatea o)oa)a *e ca"e )ceet( o *"einta *ana a acea)ta

a")ta/ *e"ite co"ectia )*ontana%.o S(nt ea(ate ca 3in! ne,atie/ in '(nctie !e inten)itatea c( ca"e )e

"eaieaa/ !("ata !e ti*/ ti*( obicei((i icio)/ anie"a !e "eaia"eo Ee*e: RO/ )(cci(nea/ inte"*oitii $c(9'a"a )(cci(ne%/ atit(!ini

*o)t("aeo RO icioa)a n(ai in i*)a ob)t"(ctiei

o SUCCIUNEA- !e )ine )tatatoa"e9 a)ociata c( ate obicei("i )a(

ecani)e icioa)e. S(cci(ne )i *"e)i(ne&

S(cci(ne c( inte"*oitie: toate/ oc(ie !e)ci)a/ !aca ei)ta

)*"iin )i *e an!ib(a&< "et"o,natie an!ib(a"a.

o INTER0O8ITII


16/16

A(tot"o*e $a*a"tin ADM%:

• Inte"ne iba

• Ete"ne-ob"ai/ b(e

6ete"ot"o*e: obiecte $!e,et/ c"eion/ *i%

SDR =RODI& oc(ie in,(aiata biate"aa. Ei)ta o !eota"e aia"a

t"an)e")aa in ece) )i !eota"e an!ib(a"a t"an)e")aa in)(3cienta.

o ATITUDINI 0OSTURALE

Di("ne:

• Lo"!oa ce"icaa

• S*"iin( ba"biei *e *(n

• S*"iin( ca*((i *e ob"a

Noct("ne:

• Do"it in !ec(bit ate"a c( ca*( *e *(n

• Dec(bit !o")a c( ca*( in i*e"eten)ie

• Ca*( in i*e"2eie

-t"ataent( atit(!ini *o)t("ae:

-,ina)tica e!icaa !e co"ectie

-e!(ca"ea "e)*i"atiei

Factori Etiologici Ai Anomaliilor Adm

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