6 курс / Медицинская реабилитация, ЛФК, Спортивная медицина / Миофасциальные_боли_и_дисфункции_Руководство_Том_1

Глава 4 /Длительно существующие вредные факторы 293

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52.Carney MW : Psychiatric aspects of folate deficiency. Chapter 42. In: Folic Acid in Neurology, Psychiatry, and Internal Medi­ cine. Edited by Botez M l, Reynolds EH. Raven Press, New York, 1979 (pp. 480— 482).

53.Carney MW , Williams D G , Sheffield BF:

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61.Ciaccio E1: The vitamins. Chapter 62. In:

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63.Crook WG; Can what a child eats make him dull, stupid, or hyperactive? J Learn Disabil 13:281-286, 1980.

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69.Dickerson JW: Vitamin requirements in dif­ ferent clinical conditions. Biblthca Nutr Dic­ ta 55:44-52, 1985.

70.Diffrient N, Tilley AR, Bardagiy JC: Humanscale 1/2/3. Massachusettes Institute of Technology Press, Cambridge, 1974 (pp. 19-22).

71.Dillman E, Johnson DG, et a l: Catecho­ lamine elevation in iron deficiency. Am J Physiol 2J7R297-R300, 1979.

72.Dipalma JR: Vitamin toxicity. Am Fam Phys 18:106-109, 1978.

73.Donaldson RM Jr.: Serum Bu and the diag­ nosis of cobalamin deficiency. N Engl J Med 299:827-828, 1978.

74.Dong BJ, Hauck WW, et a l: Bioequiva­ lence of generic and brand-name levothyroxine products in the treatment of hy­ pothyroidism. JAMA 2771205-1213, 1997.

75.Dreosti IE: Magnesium status and health.

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76.Driskell IА: Vitamin В6 status of the elderly. Chapter 16. In: Human Vitamin B6 Require­ ments. National Academy of Sciences, Washington, 1978 (pp. 252-255).

77.Driskell JA, Chnsley BM , et at.: Plasma pyridoxal phosphate concentrations of men fed different levels of vitamin B-6. Am J Clin Nutr 4*122-126, 1988.

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81.Ellis JM, Presley J: Vitamin B6: The Doc­ tor’s Report. Harper & Row, New York, 1973 (pp. 74-78).

82.EUis JM, Folkers K, et al.: Response of vi­ tamin B-6 deficiency and the carpal tunnel syndrome to pyridoxine. Proc Natl Acad Sci USA 79:7494— 7498, 1982.

83.Engle WK: Ponderous-purse disease. N Engl J Med 299:557, 1978.

84.Erbe RW: Inborn errors of folate metabo­

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89.Fong T: Problems associated with megadose vitamin C therapy. West J Med 134:264, 1981.

90.Ford LT, Goodman FG: X-ray studies of the lumbosacral spine. South Med J 59:1123-1128, 1966.

91.Fordyce WE: Behavioral Methodsfor Chron­ ic Pain and Illness, С. V. Mosby, Saint Louis, 1976 (pp. 72-73).

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93.Fox BA, Cameron AG: Food Science, Nutri­ tion and Health. Ed. 6. Edward Arnold, London, 1995.

94.Franzblau A, Rock СL, et al.: The relation­

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97.Ginter E. Ascorbic acid synthesis in certain guinea pigs. Int J Vitamin Res 46:173—179, 1976.

98.Ginter E: Chronic marginal vitamin C defi­ ciency: biochemistry and pathophysiology.

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99.Ginter E; What is truly the maximum body pool size of ascorbic acid in man? Am J Clin Nutr 33:538, 1980.

100.Goldsmith GA: Curative nutrition: vita­ mins. Chapter 7. In: Nutritional Support of Medical Practice. Edited by Schneider HA, Anderson CE, Coursin DB. Harper Sc Row, Hagerstown, MD., 1977 (pp. 103—106).

101.Ibid. (pp. 108-109).

102.Ibid. (pp. 113-114).

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106.Guard O, Dumas R, Audry D, et al.: [Clin­ ical and pathological study of a case of sub­ acute combined degeneration of the cord with folic acid deficiency). Rev Neurol (Par­ is) 137:435-446, 1981.

107.Hall СА; Function of vitamin В12 in the central nervous system as revealed by con­ genital defects. Am J Anaesth 54:121 — 127, 1990.

108.Hallbeig L, Brune M, Eriandsson M, et al: Calcium effect of different amounts on non­ heme and hemeiron absorption in humans.

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110.Harris AD, Heatley RV: Nutritional distur­ bances in Crohn’s disease. Postgrad Med 59.690-697, 1983.

111.Haskell BE: Analysis of vitamin B(. Chapter 4. In* Human Vitamin BARequirements. Na­ tional Academy of Sciences, Washington, 1978 (pp. 61, 67).

112.Healton EB, Savage DG, et al.: Neurologic aspects of cobalamin deficiency. Medicine 70:229-245, 1991.

113.Herbert V: The 1986 Herman Award Lec­

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115. Herbert V; Experimental nutritional folate

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116.Herbert V: Biochemical and hematologic le­ sions in folic acid deficiency. Am J Clin Nutr 20:562-569, 1967.

117.Herbert V: Drugs effective in megaloblastic anemias; vitamin Bl2 and folic acid. Chapter 64. In: The Pharmacological Basis of Thera­

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119.Herbert V: The nutritional anemias. Hosp Pract 15:65-89, 1980.

120.Herbert V, Colman N: Hematological as­ pects of folate deficiency. Chapter 9. In:

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121.Herbert V, Colman N, Jacob E: Folic acid and Vitamin B,2. Chapter 6J. In: Modem Nutrition in Health and Disease. Ed. 6. Edit­ ed by Goodhart RS, Shils ME. Lea & Febiger, Philadelphia, 1980 (pp. 229—255).

122.Hercbeig S, Galen P, et al.: Essential min­ eral and trace element nutritive methodolo­ gy: iron. In: Nutritional Status Assessment.

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132.Ianuzzo D, Patel P, et a l: Thyroidal trophic influence on skeletal muscle myosin. Nature 270:14-76, 1977.

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146.Kim JC: Ultrastructural studies of vascular and muscular changes in ascorbic acid defi­ cient guinea-pigs. Lab Anim /7:113—117, 1977.

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ЧАСТЬ 2

ГОЛОВНАЯ БОЛЬ И БОЛЬ В ОБЛАСТИ ШЕИ

ГЛАВА 5

Обзор области головы и шеи

Бернадетт Д ж агер (B ernadette Jaeger)

П ри участии Д эвида Г. С и м он са (D avid G . Sim ons) и Л оис С им онс (Lois Sim ons)

ВВЕДЕНИЕ К ЧАСТИ 2

В части 2 данного «Руководства» внима­ ние сосредоточено на функциональном состоянии мышц головы и шеи, из кото­ рых боль отражается в расположенные выше части туловища. В часть 2 «Руково­ дства» включены все мышцы головы и многие мышцы шеи, в том числе Грудино- ключично-сосцевидная, трапециевидная, ромбовидная, двубрюшная мышцы и дру­ гие мышцы верхнего отдела шеи, подза­ тылочная и околопозвоночные мышцы. Лестничные мышцы и мышцы, поднимаю­ щие лопатку, не рассматриваются, по­ скольку они отражают боль по направле­ нию вниз. О них мы поговорим в части 3 «Руководства». Манипуляции на других мышцах шеи и головы, контроль особых функциональных нарушений в области шеи и головы и решение проблем боли могут зависеть от результативности воз­ действия и на эти мышцы (лестничные мышцы и мышца, поднимающая лопатку). Может, например, случиться так, что врач не сумеет адекватно растянуть грудино­ ключично-сосцевидную мышцу, если в контралатеральной мышце, поднимаю­ щей лопатку, локализуется миофасциаль­ ная триггерная точка. Растягивание клю­ чичной головки грудино-ключично-сосце­ видной мышцы может вызывать болез­ ненное реактивное укорочение контрала­ теральной мышцы, поднимающей лопат­

ку, и ограничивать полное растягивание грудино-ключично-сосцевидной мышцы. Нелеченые миофасциальные триггерные точки, расположенные в мышце, подни­ мающей лопатку, могут поддерживать су­ ществование триггерных точек в верхней части трапециевидной мышцы.

Не следует забывать о том, что первично миофасциальные триггерные точки вызы­ вают увеличение мышечного тонуса, кото­ рый ограничивает величину растягивания пораженной мышцы. Таким же образом миофасциальные триггерные точки могут вызывать ограничение функции скелет­ ных мышц. Главная задача лечения— восстановить их нормальную функцию.

Глава 5 делится на четыре раздела. Раз­ дел А называется «Путеводитель по по­ раженным мышцам», чтобы помочь чи­ тателю определить, какие мышцы следу­ ет изучать, исходя из локализации боли, ощущаемой пациентом. Раздел Б дает представление о дифференциальной диагностике головной боли, боли в об­ ласти шеи и лица, включая различные ти­ пы головной боли и височно-нижнечелю­ стной патологии, рассматривая и обсуж­ дая современную литературу, посвящен­ ную природе ее происхождения в мыш­ цах, отражения ее из миофасциальных болевых триггерных точек и распределе­ ния по частям туловища и конечностей. Раздел В дает представление о скринин­

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301

302 Часть 2 /Головная боль и боль в области шеи

говом обследовании больного и поднима­ ет проблемы рационального лечения за­ болеваний височно-нижнечелюстного сус­ тава. представляя наиболее простой ме­ тод оценки и исправления неправильного положения или удержания головы, напри­ мер, при переднем ее наклоне, и оценки

А. ПУТЕВОДИТЕЛЬ

ПО ПОРАЖЕННЫМ МЫШЦАМ

В «Руководстве» перечислены мышцы, которые могут отражать боль в различные области головы и шеи (рис. S.1). Этот ри­ сунок используется, чтобы указать об­ ласть, в которой пациент ошушает боль. В «Путеводителе» перечислены все мышцы, из которых боль может отражаться в стро­ го определенную анатомическую область. В круглых скобках указан номер главы, посвященной данной мышие. Аббревиа­ тура ТТ означает триггерные точки.

Мышцы, названия которых выделены жирным шрифтом, отражают эссенциальную боль в эту анатомическую об­ ласть. Обычным шрифтом указаны мышцы, которые могут отражать разли­ тую боль в данную область. Мышцы расположены в данном списке таким образом, что те из них, которые наибо­ лее часто вызывают боль в какой-либо области, находятся выше по списку.

Боль в области темени

Грудино-ключично-сосцевидная мыш­ ца, грудинная часть (7)

Ременная мышца шеи (1S)

Боль в области задней поверхности головы

Трапециеввдная мышца (6) Груднно-ключичио-сосцевцдпая мыш­

ца, грудинная часть (7)

Груднно-ключичио-сосцевцдпая мыш­ ца, ключичная часть (7)

Полуостистая мышца головы (16) Полуостистая мышца шеи (16) Ременная мышца шеи (15) Группа подзатылочных мыши (17) Затылочные мышцы (14) Двубрюшная мышца (12) Височная мышца (ТТ4) (9)

Боль в области виска

Трапециевидная мышца (ТТ,) (6)

неблагоприятной биомеханики в отноше­ нии миофасциальных триггерных точек. Раздел Г посвящен общим способам ле­ чения, эффективного при хронической боли в области головы, шеи и лица, вызы­ ваемой, по крайней мере частично, мио­ фасциальными триггерными точками.

Грудино-ключично-сосцевидная мыш­ ца, грудинная часть (7)

Височная мышца (ТТ, 2.з) (9) Ременная мышца шеи (15) Группа подзатылочных мышц (17)

Полуостистая мышца головы (16)

Головная боль в области лба

Грудино-ключично-сосцевидная мыш­ ца, ключичная часть (7)

Грудино-ключично-сосцевидная мыш­ ца, грудинная часть (7)

Полуостистая мышца головы (16)

Лобная мышца (14)

Большая скуловая мышца (13)

Боль в области уха и височно-нижнечелюстного сустава

Латеральная крыловидная мышца (11) Жевательная мышца (глубокая часть)

(8)

Грудино-ключично-сосцевидная мыш­ ца, ключичная часть (7)

Медиальная крыловидная мышца (10)

Боль в области глаза и надбровья

Грудино-ключично-сосцевидная мыш­ ца, грудинная часть (7)

Височная мышца (ТГ,) (9) Ременная мышца шеи (15)

Жевательная мышца, поверхностная часть (8)

Группа подзатылочных мышц (17)

Затылочная мышца (14) Круговая мышца глаза (13) Трапециевидная мышца (ТТ,) (6)

Боль в области щеки и полости рта

Грудино-ключично-сосцевидная мыш­ ца, грудинная часть (7)

Жевательная мышца (поверхностная часть) (8)

Латеральная крыловидная мышца (11) Трапециевидная мышца (ТТ,) (6)

Жевательная мышца, глубокая часть (8)

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