III - 2 Tibia, fibula, tarsiene, metatarsiene şi falange

8/13/2019 III - 2 Tibia, fibula, tarsiene, metatarsiene şi falange

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III – 2 TIBIA, PERONEUL, TARSIENE, METATARSIENE ŞI FALANGE

TIBIA

- os lung, perece, nes!"e#r!c$ se %r#!cule%&' super!or cu (e"urul )! !n(er!or cu %s#r%g%lul$

- punere% *n po&!+!e

- (%+% !n#ern'

- (%+% e#ern'

- (%+% pos#er!o%r'

- "%rg!ne% %n#er!o%r' – cre%s#% #!.!e! S !#%l!c, super!or conc%/' *n %(%r'$ super!or –

#u.ero&!#%#e% #!.!e! #en0onul ro#ul!%n

- "%rg!ne% e#ern' – l!g1 !n#erosos

- "%rg!ne% !n#ern' – "%! pronun+%#' !n(er!or

%pone/ro&% g%".!er'

- ep!(!&% pro!"%l'

super!or – e#re"!#%#e% "%! /olu"!no%s'

%n#er!or – "%rg!ne% %scu+!#'!n#ern – (%+% c%re se con#!nu' !n(er!or cu o proe"!nen+'

234 super!o%re – l!g1 l%#er%l !n#ern %l %r#1 genunc!ulu!

– l%.% 0e g5sc' !nser+!% "1 se"!#en0!nos, "1 cro!#or,

"1 0rep# !n#ern 6m gracilis7

34 !n(er!o%re – #egu"en#e$

234 super!o%r' – conc%/' – or!g!ne% "1 #!.!%l %n#er!or 6"1 g%".!er

%n#er!or7

34 !n(er!o%r' – con/e' – %lunec' "1 e#ensor! %! 0ege#elor$

cre%s#% sole%rulu! – .u&% super!o%r' 8 supr%(%+% #r!ung!ul%r' super!o%r' –

!nser+!% "1 popl!#eu

– !n#ers#!+!u or!g!ne% "1 sole%r

– .u&% !n(er!o%r' 8 supr%(%+% !n(er!o%r' or!g!ne% "1

#!.!%l pos#er!or )! % "1 (leor co"un %l 0ege#elor sep%r%#e 0e o cre%s#' /er#!c%l'

- #runc! 0e p!r%"!0' cu .%&% *n sus$ 2 con0!l!$

- (%+% super!o%r' – pl%#oul #!.!%l – 2 c%/!#'+! gleno!0e 8 supr%(%+%

!n#ercon0!l!%n' supr%(%+% presp!n%l' 6l!g1 *ncruc!)%# %n#17

sp!n% #!.!e! 8 2 #u.ercul! #!.!%l!

supr%(%+% re#rosp!n%l' 6l!g1 *ncruc!)%# pos#17

- (%+% %n#er!o%r' – #u.ero&!#%#e% #!.!e! – cres#' spre e#ern )! super!or -

#u.erculul !n(r%gleno!0%l 9er0: – !nser+!% "1 g%".!er %n#er!or )! %

#r%c#ulu! !l!o-#!.!%l, "1 #ensor %l (%sc!e! l%#%



- ep!(!&% 0!s#%l' – %pl%#!&%#' %n#ero-pos#er!or$ 2 por+!un!

(%+% %n#er!o%r' – r%por# cu #en0o%nele e#ensor!lor

(%+% pos#er!o%r' – )%n+ !n#ern pen#ru #en0onul "1 (leor co"un %l 0ege#elor

– )%n+ "!;loc!u pen#ru #ensonul "1 (leor propr!u %l %lucelu!

– )%n+ e#ern – pen#ru #en0onul "1 #!.!%l pos#er!or

(%+% e#ern' – %r#!cul%re cu peroneul

(%+% !n#ern' – "%leol% !n#ern' - (%+% e#ern' 6#r!ung!ul%r'7 %r#!cul%r' cu %s#r%g%lul

- (%+% !n#ern' - su.#egu"en#%r'

- (%+% pos#er!o%r' – )%n+ul pen#ru #en0onul "1

peron!er pos#er!or

(%+% !n(er!o%r' – %r#!cul%re cu #rolee% %s#r%g%l!%n'

- eplor%re "%nu%l' #u.erculul %n#er!or$ con0!l!!, cre%s#% #!.!e!, "%leol% !n#ern'$

PERONEUL

Punerea în poziţie:

o In(er!or ep!(!&% ce% "%! #ur#!#'

o In#ern (%+% %r#!cul%r' % %ces#e! e#re"!#'+!

o Pos#er!or "%rg!ne% e#re"!#'+!! !n(er!o%re *n %prop!ere% c're!% se g'se)#e o (ose#'1

DIAFIZA• For"' pr!s"' #r!ung!ul%r', cu 4 (e+e6e#ern', !n#ern' )! pos#er!o%r'7 )! 4 "%rg!n!6%n#er!o%r',

e#ern' )! !n#ern'7$

• FA<A E=TERN>

In 234 super!o%re es#e sco.!#', se !nser' ")1lungul )! scur#ul peron!er! l%#er%l!

?n 34 !n(er!o%r' pre&!n#' o cre%s#' o.l!c' ce o *"p%r#e *n 2 por+!un!

o un% %n#er!o%r' #r!ung!ul%r' ce /!ne *n r%por# cu p!ele%

o un% pos#er!o%r', *n (or"' 0e )%n+ ce con#!nu' )%n+ul peron!er!lon

• FA<A INTERN>

2

con0!lul e#ern – pos#ero-l%#er%l (%c!es %r#!cul%r!s (!.ul%r!s

con0!lul !n#ern – pos#er!or !nser+!% #en0o%nelor 0!rec# )! or!&on#%l %l

"1 se"!"e".r%nos

p!lonul #!.!%l

"%leol% !n#ern'



Pre&!n#' o cre%s#' long!#u0!n%l' !n#eroso%s' pe c%re se !nser' membrana

interosoasă %ce%s#% *"p%r#e (%+% !n#ern' *n 2 por+!un!

o Un% %n#er!o%r' pe c%re se !nser' ")

- e#ensor co"un %l0ege#elor

- e#ensor propr!u %l %lucelu!

- peron!erul %n#er!or

o Un% pos#er!o%r' pe c%re se !nser' "). gambier posterior

• FA<A POSTERIOAR>

Es#e con/e' )! rugo%s'

Se !nser' super!or mş. solear )! *n por+!une% "!;loc!e ")1 flexor propriu al

halucelui

•

MARGINILE %n#er!o%r', pos#er!o%r' )! !n#ern'- 0el!"!#e%&' (e+ele peroneulu!• EPIFI@A PRO=IMAL>6APUL PERONEULUI7

Es#e un!#' 0e 0!%(!&' pr!n g5#

Pre&!n#' !n#ern o faţetă articulară p# con0!lul e#ern %l #!.!e!

Pos#er!or )! *n %(%r% %ces#e! (%+e#e se %(l' apofiza stiloidă pe c%re se !nser' ")1

.!ceps crur%l

An#er!or 0e %po(!&' se %(l' faţeta prestiliană

• GTUL 6OLUL PERONEULUI7

Le%g' c%pul 0e corpul peroneulu!

Pe (%+% s% e#ern' #rece nervul sciatic popliteu etern6%ces# r%por# epl!c'

pos!.!l!#%#e% le&'r!! %ces#u! ner/ *n (r%c#ur!le 0e col7

• EPIFI@A CISTAL>

Es#e repre&en#%#' 0e o prelung!re /olu"!no%s' *n (or"' 0e l%nceDmaleola

externă c%re pre&!n#'

(%+' !n#ern' pre&!n#' -%n#er!or o supr%(%+' %r#!cul%r' p# #!.!e )! %s#r%g%l

-pos#er!or o 0epres!uneD foseta digitală p# !nser+!!

l!g%"en#%re

(%+% e#ern' es#e *"p'r+!#' 0e o cre%s#' /er#!c%l' *n 2 por+!un!

un% %n# ce /!ne *n r%por# cu #egu"en#ele

un% pos#1 cre con#!nu' )%n+ul peron!er!lor

/5r(ul "%leole! co.o%r' pe un pl%n !n(er!or /5r(ulu! "%leole! #!.!%le 2 "%rg!n!

4



!"#ELE$UL PI"IORULUI

D 2 o%se 0!spuse !n 4 grupe oso%se c%re 0!n%po! !n%!n#e sun# - #%rs!ene – - "e#%#%rs!ene – - (%l%nge – H

OA!ELE $AR!IENE

D 0!spuse pe 2 r%n0ur! – #%rsul pos# D %s#r%g%l !n sus s! c%lc%neu !n ;os - #%rsul %n# D cu.o!0ul e# s! sc%(o!0ul cu cele 4 cune!(or"e !n#

A!$RA%ALUL

D os neregul%#, cu.!c, %lung!# %n#-pos# s! #ur#!# 0e sus !n ;osPunere !n po&!#!e – %n# – c%pul osulu! - !n( – (%#% cu "ul#e (%#e#e %r#!c - l%# – (%#% c%re pre& o (%#e#% %r#!c #r!ung!ul%r%Pre&!n#% p# 0escr!ere curp, g%# s! c%p"orpul D cu.o!0 cu (e#e - (%#% sup D #rolee p# %r#!c cu ep!(!&% 0!s#%l% % #!.!e! - (%#% !n( D pre& 2 (e#e %r#!c – %n#-!n# s! pos#-!n# "%! "%re D se %r#!c cu (e#ele s!"!l%re 0e pec%lc%neu

- 0esp%r#!#e 0e s%n#ul %s#r%g%lulu! c%re !"preun% cu s!"!l%rul s%u 0e pe c%lc%neu un c%n%l D gro%p% c%lc%neo-%s#r%g%l!%n% 6 l!g%" !n#erosos %s#r%g%lo-c%lc%ne%n7 - (%#% e# D #r!ung!ul%r% se %r#!c cu "%leol% peron!er% - (%#% !n# D (%#e#% %r#!c 0e (or"% une! /!rgule p# %r#!c cu "%leol% #!.!%l% - (%#% pos# D "%rg c%re pre& un s%n# "%rg!n!# 0e 2 #u.ercul! !n# s! e# 1 pr!n s%n# #rece #en0 "sFLE=OR PROPRIU AL ALUELUI - (%#% %n# D se con#!nu% cu g%#ul"apul D o/%l%r, cu %ul "%re #r%ns/ers%l, %n# se %r#!c cu sc%(o!0ul s! pos# cu c%lc%neul%atul D unes#e corpul cu c%pul osulu! D !n#re c%p s! corp se (or"e%&% 2 ung!ur! ung!ul 0e 0ecl!n%#!e s! ung!ul 0e !ncl!n%#!e

"AL"ANEUL

Dcel "%! /ol os #%rs!%n, %lung!# %n#-pos# s! l%#!# #r%ns/ers%l, cu (or"% 0e pr!s"%Pre&!n#% p# 0escr!ere corp, "%re %po(!&% 6con#!nu% corpul !n%!n#e7 , "!c% %po(!&% 6sus#en#%culu" #%rs!7Punere% !n po&!#!e – pos# – e#r ce% "%! /ol - sup – (%#% c%re pre& 2 (%#e#e %r#!c - !n# – (%#% c%re pre& un s%n# "%! %0%nc"orpul D "%! /ol pos# D #u.ero&!#%#e% "%re % c%lc%neulu! D %re (e#e - (%#% sup D pre&!n#% 2 seg" pos# s! %n#

%7 seg" pos# D "%! %lung!# c% cel %n#, !n r%por# cu #esu#ul celulo-gr%sos!n#erpus !n#re #en0onul lu! Ac!lle s! (%#% pos# % %r#!c #!.!o-#%rs!ene

.7 seg" %n# D "%! l%rg, pre& 2 (%#e#e %r#!c %n#-!n# s! pos#-e# D !n#re ele se %(l% un s%n# o.l!c D s%n#ul c%lc%neulu!

H



D pre&!n#% rugo&!#%#! p# !ns "s PECIOS - (%#% !n( 6pl%n#%r%7D "%! l%rg% pos#, pre&!n#% 4 #u.ero&!#%#! %n# s! 2 pos# %7 #u.ero&!#%#e% %n# D !ns pl%nul pro(un0 %l l!g%" c%lc%neo-cu.o!0!%n !n( .7 #u.ero&!#%#e% !n# D !ns "s SURT FLE=OR PLANTAR s!ACCUTOR AL ALUELUI c7 #u.ero&!#%#e% e# D !ns "s ABCUTOR AL CEGETULUI MI - (%#% e# D l% un!re%34 %n# cu 234 pos# pre& #u.erculul e# D !n%po!% s! !n%!n#e%

c%ru!% se g%ses#e c%#e un s%n# - pos# D #en0 "s

LUNG PERONIER LATERAL - %n# D #en0 "sSURT PERONIER LATERAL - (%#% !n# D pre&!n#% un s%n# o.l!c !n ;os s! !n%!n#e D s%n#ul c%lc%ne%n !n#ern – pr!n el#rec /%sele, ner/!! s! #en0 "s 0e pe (%#% pos# % g%".e! !n 0ru"ul spre pl%n#%&ica apo'iza D pre&!n#% – (%#% sup D %r#!c cu %s#r%g%lul - (%#% !n( D pre& un s%n# pr!n c%re %lunec% #en0 FLE=ORULUI PROPRIU ALALUELUI

- "%rg!ne !n# D l!.er% pre& un s%n# pr!n c%re %lunec% #en0 FLE=ORULUIOMUN AL CEGETELOR - .%&% D 0e !"pl%n#%re e# !n c%lc%neu - (%#% %n# D corespun0e "%r!! %po( s! pre& o supr%(%#% %r#!c p# cu.o!0 - (%#% pos# D !ns #en0 lu! Ac!lle 6 #en0 0!s#%l %l #r!cepsulu! sur%l7

!"AFOIDUL

( os scur# , s!#u%#e !n%!n#e% %s#r%g%lulu! !n sp%#ele cune!(or"elor s! !n%un#rul cu.o!0ulu!D (or"% 0e .%rc%, pre& - (%#% pos# D conc%/e se %r#!c cu c%pul %s#r%g%lulu! - (%#% %n# D con/e% pre& 4 (%#e#e %r#!c p# cele 4 cune!(or"e

- e#re"!#%#e% !n# D pre& un #u.ercul pe c%re se !ns #en0 0!s#%l %l "s GAMBIERPOST - e#re"!#%#e% e# D corespun0e cu.o!0ulu!

"U)OIDUL

Dos scur#, s!#u%# !n%!n#e% c%lc%neulu! s! !n%po!% sc%(o!0ulu! s! % cune!(or"elor , pe "%rg e# % p!c!orulu!D (or"% %p cu.!c% cu (e#e – (%#% supD !ns "s PECIOS - (%#% !n( 6pl%n#%r%7D pre& o cre%s#%$!n%po!% e! se %(l% un s%n# pr!n c%re #rece"s PERONIER LUNG - !n0%r%#ul e! pre& o por#!une rugo%s% pe

c%re se !ns l!g%" c%lc%neo-cu.o!0!%n !n( - (%#% %n# D pre& 2 (%#e#e %r#!c p# %r#!c cu "e#%#%rs!enele H s! - (%#% pos# D %re o supr%(%#% %r#!c p# c%lc%neu - (%#% !n# D pre& 2 (%#e#e %r#!c p# sc%(o!0 s! %l #re!le% cune!(or" - (%#% l%# D re0us% l% o "%rg su.cu#%n%#%

"UNEIFOR&ELE

( sun# 4 , s!#u%#e !n#re sc%(o!0, cu.o!0 s! pr!"ele "e#%#%rs!ene1C!n%un#ru !n %(%r% sun# nu"ero#%#e cuPri*ul cunei'or* D cel "%! /ol, s!#u%#e pe "%rg !n# % p!c!orulu!, !n#r sc%(o!0 s! pr!"ul "e#% D (or"% 0e cu! cu .%&% !n( 6pl%n#%r7 s! /%r(ul 6cre%s#%7 sup 60ors%l7

D %re H (e#e 0!n c%re 4 sun# %r#!c 6%n#, pos# s! e#7 s! un% ne%r#!c 6!n#7 D .%&% pre& un #u.ercul p# !ns "s GAMBIER POST



Al +oilea cunei'or* 6"!cul cune!(or"7 D s!#u%#e !n#re pr!"ul s! %l #re!le% cune!(or", !n#re sc%(o!0 s! %l#re!le% "e#%#%rs!%n D pre& H (e#e %r#!c 6pos#, %n#, !n# s! e#7, o .%&% 6sup7, s! o "%rg

pl%n#%r% 6cre%s#% !n(7Al treilea cunei'or* D s!#u%#e !n#re cu.o!0 s! %l 0o!le% cune!(or", !n#re sc%(o!0 s! %l #re!le% "e#% D %re H (e#e %r#!c , .%&% 60ors%l7, "%rg!ne 6pl%n#%r7

OA!ELE &E$A$AR!IENE

D sun# , nu"ero#%#e 0!n%un#ru !n %(%r%D o%se lung!, p%r%lele !n#re ele, 0!r!;%#e 0!n%po! !n%!n#e s! 0e sus !n ;os, %r#!c !n%po! cu #%rsul %n# (or"%n0%r#!c #%rso-"e#%#%rs!%n% 6%r#!c lu! L!s(r%nc7 In%!n#e cu pr!"ele (%l%nge %le0ege#elor D se %r#!c !n#re ele l% n!/elul e#re"e pos# pr!n (e#ele l%# %r#!cD (or" !n#re ele H sp%#!! o/%l%re %lung!#e D sp !n#eroso%se ocup%#e 0e "s INTEROSOSI"aractere in+ivi+uale

Pri*ul *etatarsian D scur#, gros, pre& - l% n!/elul e#re"!#%#!! pro!"%le D #u.ercul e# "%re pe c%re se !ns #en0 LUNGULUI PERONIER LATERAL - %po(!&% !n# p# !ns "s GAMBIER ANT - (%#e#% %r#!c p# pr!"ul cune!(or"

Al +oilea *etatarsian D cel "%! !ngus# s! "%! lung D l% n!/elul e#re"!#%#!! pro pre& (%#e#e %r#!c p# cune!(or"e s! "e#% s! 4Al treilea *etatarsian D "%! pu#!n lung c% %l 0o!le% s! "%! lung c% %l p%#rule%

D e pro pre& (%#e#e %r#!c p# "e#% 2, H s! cune!(or"ul Al patrulea *etatarsian D ( #ur#!# #r%ns/ers%l D e pro pre& (%#e#e %r#!c p# cu.o!0, %l #re!le% s! %l c!nc!le% "e#% s! %l#re!le% cune!(or" Al cincilea *etatarsian D scur#, pu#!n /ol D e pro pre& un #u.ercul pe c%re se !ns "s SURT PERONIERLATERAL D pos# pre& 2 supr%(e#e %r#!c p# cu.o!0 s! p# %l H-le% "e#%

FALAN%ELE

D p!ese oso%se %r#!c, (or" scele#ul 0ege#elor D sun# !n nr 0e , pr!"ul nu"!n0u-se %luceD sun# c%#e 4 p# (!ec%re 0ege# e (%c%n0 0ege#ul "%re c%re nu %re 0ec%# 2D sun# o%se scur#e c%re con#!nu% 0!rec#!% "e#% s! 0!n%!n#e !n%po! se 0!s#!ng(%l%ng%, (%l%ng!n% s! (%l%nge#%

III - 2 Tibia, fibula, tarsiene, metatarsiene şi falange

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