Fontanelles - ikukula

Chingwe chofufutira ndikukhotera kwakunja kwa malo ofewa a khanda (fontanelle).

Chigobacho chimapangidwa ndi mafupa ambiri, 8 mu chigaza chomwecho ndi 14 kumaso. Amalumikizana kuti apange khola lolimba, lamfupa lomwe limateteza ndikuthandizira ubongo. Madera omwe mafupa amalumikizana amatchedwa sutures.

Mafupa salumikizana molimbika pobadwa. Izi zimathandiza kuti mutu usinthe mawonekedwe kuti uthandizire kudutsa njira yoberekera. Masuteti amawonjezerapo mchere m'kupita kwanthawi ndi kuumitsa, molumikizana bwino ndi mafupa a chigaza palimodzi.

Mwa khanda, malo omwe suture ziwiri zimalumikizana amapanga "malo ofewa" wokutidwa ndi nembanemba wotchedwa fontanelle (fontanel). Ma fontanelles amalola kukula kwaubongo ndi chigaza mchaka choyamba cha khanda.

Nthawi zambiri pamakhala ma font angapo pamutu wa mwana wakhanda. Amapezeka makamaka kumtunda, kumbuyo, ndi mbali zamutu. Monga ma suture, ma fontelles amalimba pakapita nthawi ndikutseka, madera olimba.

• Fontanelle kumbuyo kwa mutu (posterior fontanelle) nthawi zambiri imatseka nthawi yomwe khanda limakwanitsa miyezi 1 mpaka 2.
• Ma fontanelle omwe ali pamwamba pamutu (anterior fontanelle) nthawi zambiri amatseka pakati pa miyezi 7 mpaka 19.

Ma fontanelles amayenera kukhala olimba komanso opindika pang'ono mkati mpaka kukhudza. Fontanelle yolimba kapena yotuluka imachitika madzi akamakula muubongo kapena ubongo umafufuma, ndikupangitsa kupanikizika mkati mwa chigaza.

Pamene khanda likulira, kugona pansi, kapena kusanza, mawonekedwe ake amatha kuwoneka ngati akuphulika. Komabe, amayenera kubwerera mwakale khanda likakhala bata, mutu.

Zifukwa zomwe mwana akhoza kukhala ndi ma bulging fontanelles ndi monga:

• Encephalitis. Kutupa (kutupa) kwaubongo, nthawi zambiri chifukwa cha matenda.
• Hydrocephalus. Kukhazikika kwamadzimadzi mkati mwa chigaza.
• Kuwonjezeka kwachangu.
• Meningitis. Kutenga ziwalo zomwe zimaphimba ubongo.

Ngati fontanelle ibwerera kumaoneka bwino mwanayo atakhala wodekha ndikukhala mutu, sizowoneka bwino kwambiri.

Nthawi yomweyo, chisamaliro chadzidzidzi chimafunikira kwa khanda lililonse lomwe lili ndi bulan fontanelle, makamaka ngati limachitika ndi malungo kapena kugona tulo mopitilira muyeso.

Wothandizira zaumoyo azichita mayeso a thupi ndikufunsa mafunso okhudza mbiri yazachipatala ya mwana, monga:

• Kodi "malo ofewa" amabwereranso mwakale khanda likakhala bata kapena mutu?
• Kodi imaphulika nthawi zonse kapena imabwera ndikumapita?
• Munayamba liti kuzindikira izi?
• Ndi ma fontanelles bulge (pamwamba pamutu, kumbuyo kwa mutu, kapena china)?
• Kodi ma fontanelles onse akutuluka?
• Ndi zisonyezo zina ziti zomwe zilipo (monga kutentha thupi, kukwiya, kapena ulesi)?

Mayeso azomwe angachitike ndi awa:

• Kujambula kwa CT pamutu
• Kujambula kwa MRI pamutu
• Mpampu ya msana (kuponyera lumbar)

Malo ofewa - akutuluka; Kukula kwazithunzi

• Chibade cha mwana wakhanda
• Kukula kwazithunzi

Wokhulupirika NK. Khanda lobadwa kumene. Mu: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, olemba. Nelson Textbook of Pediatrics. Wolemba 21. Philadelphia, PA: Elsevier; 2020: chap 113.

Rosenberg GA. Edema wamaubongo ndi zovuta zamayendedwe amadzimadzi a cerebrospinal. Mu: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, olemba. Neurology ya Bradley mu Kuchita Zachipatala. Wachisanu ndi chiwiri. Philadelphia, PA: Elsevier; 2016: chap 88.

Somand DM, Wofalitsa WJ. Matenda apakati amanjenje. Mu: Makoma RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018: mutu 99.