LV13224B - Device for locoregional anesthesia - Google Patents

Abstract

Invention describes a device for executing surgical operations where patient's arm must be fixed in certain position for anesthesia or analgesia for long time. The device comprises two plates where upper arm and lower arm are fastened to. The plates are fastened to a support plate. Under both plates rods are placed. The rod of upper arm plate is extendibly inserted into the support plate at a shoulder level. In a site of connection of the rod and the support plate a fixator is placed. The fixator allows to move a supporting surface in a horizontal plane at 30-1200 angle and to fix it and elevation of it in vertical plane at 500 angle and rotation of it around longitudinal axis of the rod at 0-900. The second end of the upper arm's rod is connected with the end of the rod of the second plate. There is a second fixator at the site of connection of both rods. This fixator provides for a mutual movement of rods and a fixation of them at 60-1800 in vertical plane and at 0-900 relating to a horizontal axis of the second plate. Both plates are elevated by 4-8 cm above the support plate. Ratio of length of upper arm plate's inner part which is inserted into the support plate to the width of the support plate is 1:3 - 2:3. Ratio of the length of upper arm plate to the outer part of its rod is 3:5 - 4:5. Besides 1/5 - 2/5 of the upper arm's rod adjacent to the support plate is free from the plate. The surface for surgical instruments is mounted on the vertical rod at the corner of the support plate at height 8-12 cm above the support plate. The surface can be rotated and fixed in certain position.

Description

LV 13224 yCTPOMCTBO flJIfl JIOKOPErHOHAJIBHOH AHECTE3F1P1 M3o6peTeHMe othocmtch k ΜΘ,ιιηΐίΜΗοκοίί τθχημκθ, a μμθηηο k χηργρπΊ^ΘΟκοΜ τθχημκθ, vl KacaeTcn pa3pa6oTKM γοτροίίοτΒ ripu xMpyprHyecKMx onepannRX n npouejū;ypax, Korna ηθο6χοημμο φΜΚ0Μρ0Β3ΗΜΘ onpenejieHHoro nojioūKeHMH pyicn nauMeHTa min προΒβΒβΗΜκ aHecTe3MH m aHajibre3MM. ΠρΜ npoBeneHMM onepaTMBHUX BMemaTejibCTB b oČJiacTM pyKM u kmcth ycnex 3aBncHT ot μθοτηοη aHecTe3MM, očecneHMBaiomeM nojiHyE) 6jioKa,n;y 5 ηθρβοβ :N.musculocutaneus, N.axillaris, N.medianus, N.radialis, N.ulnaris. BjioKajīy yKa3aHHHx ηθρβοβ ocymecTBJiaioT πυτθμ ββθαθημη βηθοτθτηκοβ (jmnoKaMH, ponuBaKarai) b oSjiacrb Plexus brachialis b ποαμβππθηηομ BnaroiHe. B χοαθ čJioKanH npoBonRT npecK03KHyio μηβθκηηιο - Tax Ha3HBaeMyīo jioKoperHOHajibHyra aHecTe3MK). IIpH aHecTe3Mn οουιιιθοτβιιβιοτ τθοτμροββημθ 3oh MHHspBaiiMM c noMonibio npnSopa HeHpocTMMyjiHTopa. īlpn stom b oSjiacTM N.medianus, N.ulnaris, N.radialis bbobht no 10 mji āHecTeTMKa, b očJiacTb N.musculocutaneus - 6 mji 3ηθοτθίήκ3. Ha βρθμη ββθλθημ3 βηθοτθτμκ3 (npecKoacHaH μηέ.θκπ,μη) aceJiaTejibHO očecneHHTb Φμκομροβθημθ nojioaceHMH ργκη nauneHTa b τθηθημθ 30 mmh m CoJiee. B KJiHHHKax npn npoBeneHnn JioKopernoHajībHofi 3ηθοτθ3ιίκ b oSnacTH Plexus brachialis φηκοκιροΒΒΗηθ ργκιι nauneHTa b onpenejieHHon no3e ocymecTBJiReT MeflcecTpa. OnHaico ynep»MBaTb pyxy nauMeHTa b onpenejieHHOM ΠΟϋΟΚΘΗΜΗ B ΤΘΗΘΗΚΘ 30 MHH ΊΛ ČOJiee flOBOJIbHO CJI02CH0, ΚρΟΜΘ ΤΟΓΟ ΒΟΘ 3to BpeMR MencecTpa ηθ μο*θτ npnHMMaTb ynacTi4e b onepaunn. Ι13βθοτηο γοτροηοτΒΟ mi n nonnep^criBaHnR n φκκ caunu pyic nanneHTa, κοτοροβ npnKpenjiReTCR κ onepaunoHHOMy οτοηγ ! 1 [,ΥοτροηοτΒΟ COflep*MT CTOJI, KOTOpuii COCTOMT M3 UeHTpaJIbHOM CeKLļMM Μ 6okobhx njtaHOK. BoKOBbie njiaHKM μμθιοτ B03M05KH0CTb nepenBnraTbcK, npn otom 3anepacMBaioT η φηκοηργιοτ ηβμ^θημθ ργκ nanneHTa. OanaKO μ3βθοτηοθ yCTpOHCTBO ΗΘ Π03ΒΟΛΗΘΤ OCeCne^MTb φΗΚΟΜρΟΒΒΗΜΘ OnpefleJieHHOrO noJio»:eHMiī ργκκ nanneHTa b τθηθηηθ 30 mhh h Sojiee mjīm προβθαθημη ^pecKoacHOM jiOKopernoHajībHoft aHecTe3HH b očJiacTH Plexus brachialis. Μ3βθοτηο ycTpoiicTBO djih onepau,nn Ha ΒβρχΗβκ κοηθηηοοτη, BbinojiHeHHoe b BMjte nojuiepacMBaioiiiero 3.neMeHTa, κοτορΗΗ ^BjineTcn nOflBM»HbIM Μ ΚρθΠΗΤΟΛ KO ΒΤΟρΟΜγ ΟΙΤΘΜΘΗΤΥ, KOTOpblM ΠρΜΚρβΠΛΗΘΤΟΗ HenoflBMacHo κ onepauwoHHOMy crojiy *2ļ OflHaKo η3Βθοτηοθ γοτροηοτΒο ηθ πο3Βοληθτ oOecneHHTb φΜκοιιροΒθΗΜθ ργκη nanneHTa b TeneHne 30 MHH H OOJiee HJIH ΠρΟΒΘΗβΗΗΗ ΜΘΟΤΗΟΗ HpeCK03KH0M JIOKOpernOHaJIbHOH aHecTe3MM b oSjiacTn Plexus brachialis. Μ3βθοτηο γοτροϊίοτΒο Rjia jioKopernoHajībHon āHecTe3HM, conepaca-mee onopy hjih iojiobh, njiomaflKy rjisi ηηοτρυμθητοβ, ββθ rniaHKn, oxuia vis κοτορωχ npeflHa3Ha^eHa λπη nonnepacKn π,πθηθβομ κοοτη, BTopan -HJīH npennjie^bR, nnaHKn πο«βμ»:ηο οοθηηηθηη Μβκηγ co5om c bo3Mo:x-HOCTbio nx φHKca^HH, nepBaa njiaHKa, npenHasHaHeHHaii jtJin nonnepacKn π,πθηθβοη koctm, coennHeHa obhmm kohuom c οποροη, ββιποιιηθηηομ b BHfle nOJīrOJlOBHMKa, πρπ 3T0M B ΤΟΗΚΘ ΟΟβΛΗΗΘΗΗίϊ C ΟΠΟΡΟΜ njiaHKa MoaceT SbiTb φηκοηροΒ3Η3 non yrjiOM 20-160° b ropn30HTajibHon πηοοκοοτη no οτηοιιιθηηιο κ och Tena, Ha λρυγομ KOHne nepBoft: πλβηκη pacnojioaceHa njiomaflKa λπη ηΗοτργΜθΗΤθρηίΐ, b cpenHeft nacTH nepBon njiaHKn HMeeTcs npope3b jļjix φηκοannn Βτοροη nnaHKn, npenHasHaneHHon nnn nonnepacKn npennneHbn n BbinojiHeHHon c B03MoacHOCTbīo yBennqeHnn, HanpnMep TenecKonnnecKn, BTopan nnaHKa MoaceT 6biTb φηκοηροΒΒΗ3 ποη υγιιομ 30-120° b HaKJioHHOČi πηοοκοοτη no οτηοιηθημιο κ och Teņa, o6e nnaHKn CHaSjKeHbi Φηκοθτορθμη hjih nnena n npennnenbn, HanpnMep b Bnne peMHeii [3], Μ3βθοτηοθ γοτροηοτΒο ηηκ noKopernoHanbHon aHecTe3nnEN 13224 yCTPOMCTBO flJIfl JIOKOPErHOHAJIBHOH AHECTE3F1P1 M3o6peTeHMe othocmtch k ΜΘ, ιιηΐίΜΗοκοίί τθχημκθ, a μμθηηο k ^ χηργρπΊ ΘΟκοΜ τθχημκθ, vl KacaeTcn pa3pa6oTKM γοτροίίοτΒ wheel xMpyprHyecKMx onepannRX n npouejū; ypax, Korna ηθο6χοημμο φΜΚ0Μρ0Β3ΗΜΘ onpenejieHHoro nojioūKeHMH pyicn nauMeHTa min προΒβΒβΗΜκ aHecTe3MH m aHajibre3MM. ΠρΜ npoBeneHMM onepaTMBHUX BMemaTejibCTB b oČJiacTM pyKM u kmcth ycnex 3aBncHT ot μθοτηοη aHecTe3MM, oececneHMBaiomeM nojiHyE) 6jioKa, n; N.isis, N.; N.isis: N.isane: N. 5: ηθρβοβ BjioKajīy yKa3aHHHx ηθρβοβ ocymecTBJiaioT πυτθμ ββθαθημη βηθοτθτηκοβ (jmnoKaMH, ponuBaKarai) b oSjiacrb Plexus brachialis b ποαμβππθη. B χοαθ čJioKanH npoBonRT npecK03KHyio μηβθκηηιο - Tax Ha3HBaeMyīo jioKoperHOHajibHyra aHecTe3MK). IIpH aHecTe3Mn οουιιιθοτβιιβιοτ τθοτμροββημθ 3oh MHHspBaiiMM c noMonibio npnSopa HeHpocTMMyjiHTopa. īlpn stom b oSjiacTM N.medianus, N.ulnaris, N.radialis bbobht no 10 mji āHecTeTMKa, b očJiacTb N.musculocutaneus - 6 mji 3ηθοτθίήκ3. Ha βρθμη ββθλθημ3 βηθοτθτμκ3 (npecKoacHaH μηέ.θκπ, μη) aceJiaTejibHO očecneHHTb Φμκομροβθημθ nojioaceHMH ργκη nauneHTa b τθηθηθ. B KJiHHHKax npn npoBeneHnn JioKopernoHajībHofi 3ηθοτθ3ιίκ b oSnacTH Plexus brachialis φηκοκιροΒΒΗηθ ργκιι nauneHTa b onpenejieHHon no3e ocymecTBJiReT Mef. OnHaico ynep »MBaTb pyxy nauMeHTa b onpenejieHHOM ΠΟϋΟΚΘΗΜΗ B ΤΘΗΘΗΚΘ 30 MHH ΊΛ ČOJiee flOBOJIbHO CJI02CH0, ΚρΟΜΘ ΤΟΓΟ ΒΟΘ 3to BpeMR MencecTpa ηθ μο * θτ npnHMMaTe ynacTi. Ι13βθοτηο γοτροηοτΒΟ mi n nonnep ^ criBaHnR n φκκ kaunu pyic nanneHTa, κοτοροβ npnKpenjiReTCR κ onepaunoHHOMy οτοηγ! 1 [, ΥοτροηοτΒΟ COflep * MT CTOJI, KOTOpuii COCTOMT M3 UeHTpaJIbHOM CeKLļMM Μ 6okobhx njtaHOK. BoKOBbie njiaHKM μμθιοτ B03M05KH0CTb nepenBnraTbcK, npn otom 3anepacMBaioT η φηκοηργιοτ ηβμ ^ θημθ ργκ nanneHTa. OanaKO μ3βθοτηοθ yCTpOHCTBO ΗΘ Π03ΒΟΛΗΘΤ OCeCne ^ MTb φΗΚΟΜρΟΒΒΗΜΘ OnpefleJieHHOrO noJio »: eHMiī ργκκ nanneHTa b τθηθηηθ 30 mhh h Sojiee mjīm προβθαθημη Μ3βθοτηο ycTpoiicTBO djih onepau nn H ΒβρχΗβκ κοηθηηοοτη, BbinojiHeHHoe b BMjte nojuiepacMBaioiiiero 3.neMeHTa, κοτορΗΗ ^ BjineTcn nOflBM »HbIM Μ ΚρθΠΗΤΟΛ KO ΒΤΟρΟΜγ ΟΙΤΘΜΘΗΤΥ, KOTOpblM ΠρΜΚρβΠΛΗΘΤΟΗ HenoflBMacHo κ onepauwoHHOMy crojiy * 2L OflHaKo η3Βθοτηοθ γοτροηοτΒο ηθ πο3Βοληθτ oOecneHHTb φΜκοιιροΒθΗΜθ ργκη nanneHTa b TeneHne 30 MHH H OOJiee HJIH ΠρΟΒΘΗβΗΗΗ ΜΘΟΤΗΟΗ HpeCK03KH0M JIOKOpernOHaJIbHOH aHecTe3MM b oSjiacTn Plexus brachialis. Μ3βθοτηο γοτροϊίοτΒο Rjia jioKopernoHajībHon āHecTe3HM, conepaca-mee onopy hjih iojiobh, njiomaflKy rjisi ηηοτρυμθητοβ, ββθ rniaHKn, oxuia vis κοτορωχ npeflHa3Ha ^ EHA λπη nonnepacKn π, πθηθβομ κοοτη, BTopan -HJīH npennjie ^ Br, nnaHKn πο "βμ ': ηο οοθηηηθηη Μβκηγ co5om c bo3Mo: x HOCTbio nx φHKca ^ HH, nepBaa njiaHKa, npenHasHaHeHHaii jtJin nonnepacKn π, πθηθβοη koctm, coennHeHa obhmm kohuom c οποροη, ββιποιιηθηηομ b BHfle nOJīrOJlOBHMKa, πρπ 3T0M b ΤΟΗΚΘ ΟΟβΛΗΗΘΗΗίϊ c ΟΠΟΡΟΜ njiaHKa MoaceT SbiTb φηκοηροΒ3Η3 non downward at 20-160 ° b ropn30HTajibHon πηοοκοοτη of οτηοιιιθηηιο κ och Tena Ha λρυγομ Kohn nepBoft: πλβηκη pacnojioaceHa njiomaflKa λπη ηΗοτργΜθΗΤθρηίΐ, b cpenHeft nacTH nepBon njiaHKn HMeeTcs npope3b jļjix φηκοannn Βτοροη nnaHKn, npenHasHaneHHon nnn nonnepacKn npennneHbn n BbinojiHeHHon c B03MoacHOCTbīo yBennqeHnn, HanpnMep TenecKonnnecKn, BTopan nnaHKa MoaceT 6biTb φηκοηροΒΒΗ3 ποη υγιιομ 30-120 ° b HaKJioHHOČi πηοοκοοτη of οτηοιηθημιο κ och Tena o6e nnaHKn CHaSjKeHbi Φηκοθτορθμη hjih NNEN n npennnenbn, HanpnMep b Bnne peMHeii [3] Μ3βθοτηοθ γοτροηοτΒο ηηκ noKopernoHanbHon aHecTe3nn

ΑΒΠΗΘΤΟΗ ΠρΟΤΟΤΜΠΟΜ Μ3θ5ρθΤΘΗΜΗ . B npOUeCCe PiCnOJTb30BaHHH yc,rpoPiCTBa-npoTOTMna 6bmo βηηβπθηο, hto jijir nanneHTa 5yfleT ΥΛοδΗθΘ, ecjiH njiomajib noflrojioBHMKa - onopbi sjih rojioBbi 5yne τ YBeJinHeHa hjih HonoJiHMTejibHoro pacnoJioaceHna Ha ηθη rpynHOM κοιθτκμ n njiomaflKn fljiH μηοτρυμθητοβ. B btom cjiyHae οποργ mo>kho Ουηθτ LV 13224 noBopa^MBaTb βμθοτθ c π,πθ^θβομ njiaHKOM Ha 30° b οληυ mjtm Bpyryio CTOpOHy ΠΟ ΟΤΗΟΗΙΘΗΗΚ) K ββ npOJĪOJĪbHOM OCM. īlepeBBMaceHMH onopn no3BOJi«T ybeaτt> mjim yMeHbinaTb yroji οτβθ,ιιθημλ π,πθηθβομ koctm nauMeHTa, ^to 6yjieT cnocočcTBOBaTb κοΜφορτγ nauneHTa, ocoSeHHo npi-i HaJlM^tHH TyronOflBH3CHOCTM Π,ΠΘΗΘΒΟΓΟ KJĪM ηΟΚΤΘΒΟΓΟ CyCTaBOB . B npouecce Μ3γοτοβ.πθητλά ycTpoftcTBa - προτοτχπά Sūno βηηβιιθηο, ^to HOBOJibHO cjioacHo ocym;ecTBMTb ģHKcauyao ετοροϋ njiaHKM b npope3M, KOTopan MMeeTCH b cpeflHeii nacTM nepBoii njiaHKn. B to ace BpeMH Ka^ecTBO φΜκοβηΜΜ o6enx njiaHOK μμθθτ BaacHoe 3Ha^eHMe hjīr npoBeaeHMH jioKoperiioHajībHoft aHecTe3wn.ΑΒΠΗΘΤΟΗ ΠρΟΤΟΤΜΠΟΜ Μ3θ5ρθΤΘΗΜΗ. B npOUeCCe PiCnOJTb30BaHHH yc, rpoPiCTBa-npoTOTMna 6bmo βηηβπθηο, whereby to jijir nanneHTa 5yfleT ΥΛοδΗθΘ, ecjiH njiomajib noflrojioBHMKa - onopbi sjih rojioBbi 5yne τ YBeJinHeHa hjih HonoJiHMTejibHoro pacnoJioaceHna Ha ηθη rpynHOM κοιθτκμ n njiomaflKn fljiH μηοτρυμθητοβ. B btom cjiyHae οποργ mo > kho Ουηθτ LV 13224 noBopa ^ MBaTb βμθοτθ c π, πθ ^ θβομ njiaHKOM Ha 30 ° b οληυ mjtm Bpyryio CTOpOHy ΠΟ ΟΤΗΟΗΙΘΗΗΚ) K ββ npOJĪ. illepeBBMaceHMH onopn no3BOJi «T ybeaτt > mjim yMeHbinaTb yroji οτβθ, ιιθημλ π, πθηθβομ koctm nauMeHTa, ^ to 6yjieT cnocočcTBOBaTb κοΜφορτγ nauneHTa, ocoSeHHo npi-i HaJlM ^ t iHOCOCTM OCHonOCT KΠMTC B npouecce Μ3γοτοβ.πθητλά ycTpoftcTBa - προτοτχπά Son βηηβιιθηο, ^ to HOBOJibHO cjioacHo ocym; ecTBMTb ģHKcauyao ετοροϋ njiaHKM bNpiH3MiBHiMbHiMbHiMbHiMB B to ace BpeMH Ka ^ ecTBO φΜκοβηΜΜ o6enx njiaHOK μμθθτ BaacHoe 3Ha ^ eHMe hjīr npoBeaeHMH jioKoperiioHajībHoft aHecTe3wn.

Uejibio M3o0peTeHMH flBjifleTCfl γοκορβΗΜβ h yjiy^meHPie ycjroBHM Λπη φΜΚ03ηΜΜ o6ewx nnaHOK, Ha κοτορκχ 6y,n;yT pa3MemeHH nneneBan KocTb m npe^njie^be, ynpom;eHHe κοΗοτργκηηη ycTpočicTBa n yjiy*imeHi'ie ycJioBHM κοΜφορτΗοοτπ flJiH naiweHTa npw npoBefleHMM iroKoperMOHajībHoft aHecTe3MM b τθηθηκγθ 30-45 mmh. IIocTaBJieHHaH nejīb HOCTMraeTCH 3a οηθτ τογο, ητο pa3Mepu onopbi Υβθιιη^θηκι, ποη ο6θμμμ njiaHKaMH pacnojroaceHbi cTepacHM, cTepaceHb njieneBoii njiaHKM BCTaBJieH τθ,πθοκοπμηθοκμ b onopy Ha ypoBHe προβκιχΜΜ njieneBoro cycTaBa; b το^κθ οοθβμηθημη οτθρ^κηλ c onopon pacnojioaceH φΜκο3τορ , oSecne^MBajomPiM λβμ*θημθ μ φηκοθηΜίο cTepacHH βμθοτθ c njieneBoii miaHKOči non yrjiOM 30-120° b ropM30HTaJibHoii ruiocKocTH w ηβμ^θημθ BBepx Ha 50° b BepTKKajībHOM njiocKOCTKt, a Taicace BpameHMe CTepacHK c njiaHKOH BOKpyr ocn CTepasHii μ Φμκοβιικιο πολ yrjioM 0-90° no OTHomeHMio κ npoBOJibHoii ocm njie^eBoft njraHKii; ,upyroft κοηθη njie^eBoro CTepacHH οοθλμηθη c kohu;om cTepaeHH Βτοροϋ njiaHKM, b τοηκθ οοθ^μηθμη οΰοπχ cTepacHeH pacnonojKeH Βτοροίί φιικο3τορ, oCecneHHBaroiiiMii β33ημηοθ ΒΒΜ5ΚΘΗΙ4Θ CTepūKHeM μ mx φΗκοβιΐΜΐο πολ yrjioM 60-180°, a Taiose BpameHMe μ φΜΚΟβηηιο CTepacH* co BTopoft njiaHKon nojī yrjiOM 0-90° no οτηοπιθημιο k npoflOJibHOH ocn njiaHKH npeflnneHbH. 06e njiaHKH pacnonoaceHbi Ha 4-8 cm Bume υροβηη onopu; ΟΟΟΤΗΟΙΗΘΗΗΘ HJTMHbl ΒΗγτρβΗΗΘΓΟ yHaCTKa Π,ΠΘΗΘΒΟΓΟ CTepžKHH, BCTaBJieHHoro b onopy, κ BejiMHMHe ιπμρμημ onopu cocTaBnaeT 1:3-2:3, cooTHOineHMe juTMHbi njie^eBoii njraHKM κ BJiMHe Hapy*;Horo ynacTKa ee ) ' O '· cTepaeHfl cocTaBjiHeT 3:5-4:5, npn stom 1/5-2/5 nacTn HapyjKHoro ynacTKa πιιθηθβογο CTepacHH okojīo onopu cbočohhh ot njiaHKM; njiomajiKa hjih nHCTpyMeHTOB pa3MemeHa Ha βθρχημχ yrjiax onopu Ha BucoTe 8-12 cm ot onopu, HanpMMep c noMombio BepTHKajībHoro cTepaiHiī, Bpamaiomerocii BOKpyr cBoen ocm c nocjieayiomefi Φμκο3Ι1μθμ . Μ3θ6ρθΤΘΗΗΘ nOHCHHeTCH ΗΘρΤΘίΚΟΜ, Tfle Ha φΜΓ. 1 npeflCTaBJieH βμα ycTpoficTBa CBepxy. ycTpowcTBO JioKoperMOHaJībHOM aHecTe3MM coflepacMT onopy 1 hjih pa3MemeHMfl iojiobu, rpysHOH κπθτκμ m njiomaflKM min MHCTpyMeHTapMH 2. IljiomajūiKa flJiH MHCTpyMeHTapn« 2 pacnojioaceHa Ha βθρχημχ yrjiax onopu c noMombio BepTMKajībHoro CTepscHH 3, KOTopun nonHMMaeT njiomaflKy 2 Ha 8-12 cm Hafl οποροη 1, m BpamaeTca BOKpyr CBoeft ocu c nocjie,n;yiomeM Φμκcaimeii. fljiH nofliiepacKH njieneBoii kocth n npejmneHba b ycTpoiicTBe npe,n;ycMOTpeHu itee njiaHKM 4, 5, KOTopue pacnojioaceHU Ha 4-8 cm Bume ypoBHH onopu. ΠΟΑ ο6θμμμ njiaHKaMn pacnojroaceHu cTepacHM 6, 7. CTepaceHb 6 nneneBOH nnaHicn BCTaBjieH TejiecKomraecKM b onopy 1 Ha ypoBHe προθκηκη njieneBoro cycTaBa. B τοηκθ οοθαμηθημη cTepaeHH 6 c onopoft pacnojroaceH φηκοΒτορ 8, KOTopun oSecnennBaeT ββμ*:θηιιθ n φΐ4κο3ΐ1Μΐο cTepacH/ϊ βμθοτθ c njieneBoft njiaHKoft nojī yrjioM 30-120° b ropn30HTajibHon njiocKocTn η ββιοκθηηθ ΒΒβρχ Ha 50° b bepTMKajibhoh nnocKOCTM. 4>KnccaTop 8 očecneHHBaeT Tanace BpameHMe cTepacHs c njiaHKoii BOKpyr och CTepacHH η φΜκοΒίίΗΐο ποβ yrjiOM 0-90° no οτΗοιπβΗΜΚ) κ npoflOJibHofi ocvl njieneBOM njiaHKH. flpyron Koaeu 9 njieneBoro CTepacHH οοθ,ιιμηθη c KOHiļOM 10 CTepacHS ετοροη njīaHKM 5, nojmepacnBaiomeii npejinjienbe. B τοηκθ οοθαμηθημη οΟοηχ cTepacHeM pacnojioaceH ετοροη φηκοΒτορ 11, κοτορπϊί oOecnenMBaeT β33μμηοθ ββμ»:θημθ CTepacHefl μ μχ φΜκοΒη,Μΐο ποπ yrjioM 60-18 0°, a TaK*e BpameHne μ φΗχ^ηΜίο cTepacHii co Βτοροη njiaHKOM πολ yrjioM 0-90° no οτηοπιθημιο k npojīojībHofr ocm Βτοροη njraHKM. CooTHoineHMe λπμηη BHyTpeHHero ynacTKa 12 πλθηθβογο CTepacHH, TejiecKonnnecKM BCTaBjieHHoro b onopy 1, κ βθλμηηηθ uihpmhu onopu cocTaBJineT 1:3-2:3. Οοοτηοιιιθηηθ ejihhu πιγθηθβομ njiaHKH 4 κ iUTOHe HapyacHoro ynacTKa 6 njieneBoro CTepacHH cocTaBJiaeT 3:5-4:5, npn 3TOM 1/5-2/5 nacTM Hapya:Horo ynacTKa 13 njieneBoro CTepacHH, LV 13224Uejibio M3o0peTeHMH flBjifleTCfl γοκορβΗΜβ h ^ yjiy meHPie ycjroBHM Λπη φΜΚ03ηΜΜ o6ewx nnaHOK Ha κοτορκχ 6Y, n, Yt pa3MemeHH nneneBan KocTb m NPE ^ ^ Njie be, ynpom; eHHe κοΗοτργκηηη ycTpočicTBa n yjiy * imeHi'ie ycJioBHM κοΜφορτΗοοτπ flJiH naiweHTa npw npoBefleHMM iroKoperMOHajībHoft aHecTe3MM b τθηθηκγθ 30–45 mmh. IIocTaBJieHHaH nejīb HOCTMraeTCH 3a οηθτ τογο, ητο pa3Mepu onopbi Υβθιιη ^ θηκι, ποη ο6θμμμ njiaHKaMH pacnojroaceHbi cTepacHM, cTepaceHb njieneBoii njiaHKM inserted into τθ, πθοκοπμηθοκμ b onopy Ha ypoBHe προβκιχΜΜ njieneBoro cycTaBa; b το ^ κθ οοθβμηθημη οτθρ ^ κηλ c onopon pacnojioaceH φΜκο3τορ, osieczna ^ MBajomPiM λβμ * θημθ μ φηκοθηΜίο cTepacHH βμθοτθ c njieneBoii miaHKOči non downward at 30-120 ° b ropM30HTaJibHoii ruiocKocTH w ^ ηβμ θημθ BBepx Ha 50 ° b BepTKKajībHOM njiocKOCTKt, a Taicace BpameHMe CTepacHK c njiaHKOH BOKpyr ocn CTepasHii μ Φμκοβιικιο πολ yrjioM 0-90 ° no OTHomeHMio κ npoBOJibHoii ocm njie ^ eBoft njraHKii; , Upyroft κοηθη Njie ^ Ebor CTepacHH οοθλμηθη c Koch; om cTepaeHH Βτοροϋ njiaHKM, b τοηκθ οοθ ^ μηθμη οΰοπχ cTepacHeH pacnonojKeH Βτοροίί φιικο3τορ, oCecneHHBaroiiiMii β33ημηοθ ΒΒΜ5ΚΘΗΙ4Θ CTepūKHeM μ mx φΗκοβιΐΜΐο πολ downward at 60-180 ° Taiose a BpameHMe μ φΜΚΟβηηιο CTepacH * co BTopoft njiaHKon nojī yrjiOM 0-90 ° no οτηοπιθημιο k npoflOJibHOH ocn njiaHKH npeflnneHbH. 06e njiaHKH pacnonoaceHbi Ha 4-8 cm Bume υροβηη onopu; ΟΟΟΤΗΟΙΗΘΗΗΘ HJTMHbl ΒΗγτρβΗΗΘΓΟ yHaCTKa Π, ΠΘΗΘΒΟΓΟ CTepžKHH, BCTaBJieHHoro b onopy, κ BejiMHMHe ιπμρμημ onopu cocTaBnaeT 1: 3-2: 3, cooTHOineHMe juTMHbi Njie ^ eBoii njraHKM κ BJiMHe hapy *; Horo ynacTKa ee) 'O' · cTepaeHfl cocTaBjiHeT 3: 5 -4: 5, npn stom 1 / 5-2 / 5 nacTn HapyjKHoro ynacTKa πιιθηθβογο CTepacHH okojīo onopu cbočohhh ot njiaHKM; njiomajiKa hjih nHCTpyMeHTOB pa3MemeHa Ha βθρχημχ yrjiax onopu Ha BucoTe 8-12 cm ot onopu, HanpMMep c noMombio BepTHKajībHoro cTepaiHiī, Bpamaiomerocii BOKpyr cBoen ocm c nocji. Μ3θ6ρθΤΘΗΗΘ nOHCHHeTCH ΗΘρΤΘίΚΟΜ, Tfle Ha φΜΓ. 1 npeflCTaBJieH βμα ycTpoficTBa CBepxy. ycTpowcTBO JioKoperMOHaJībHOM aHecTe3MM coflepacMT onopy 1 hjih pa3MemeHMfl iojiobu, rpysHOH κπθτκμ m njiomaflKM min MHCTpyMeHTapMH 2 IljiomajūiKa flJiH MHCTpyMeHTapn "2 pacnojioaceHa Ha βθρχημχ yrjiax onopu c noMombio BepTMKajībHoro CTepscHH 3 KOTopun nonHMMaeT njiomaflKy 2 H 8-12 cm Hafl οποροη 1 m BpamaeTca BOKpyr CBoeft ocu c nocjie, n; yiomeM Φμκcaimeii. fljiH nofliiepacKH njeneBoii kocth n npejmneHba b ycTpoiicTBe npe, n; ycMOTpeHu itee njiaHKM 4, 5, KOTopue pacnojioaceHU Ha 4-8 cm Bume ypoBHH onopu. ΠΟΑ ο6θμμμ njiaHKaMn pacnojroaceHu cTepacHM 6, 7. CTepaceHb 6 nneneBOH nnaHicn BCTaBjieH TejiecKomraecKM b onopy 1 Ha ypoBHe προθκηκη njateeBoro cycTaBa. B τοηκθ οοθαμηθημη cTepaeHH 6 c onopoft pacnojroaceH φηκοΒτορ 8 KOTopun oSecnennBaeT ββμ *: θηιιθ n φΐ4κο3ΐ1Μΐο cTepacH / ϊ βμθοτθ c njieneBoft njiaHKoft nojī downward at 30-120 ° b ropn30HTajibHon njiocKocTn η ββιοκθηηθ ΒΒβρχ Ha 50 ° b bepTMKajibhoh nnocKOCTM. 4 > KnccaTop 8 očecneHHBaeT Tanace BpameHMe cTepacHs c njiaHKoii BOKpyr och CTepacHH η φΜκοΒίίΗΐο ποβ yrjiOM 0-90 ° no οτΗοιπβΗΜΚ) κ npoflOJibHofi ocj. flpyron Koaeu 9 njeneBoro CTepacHH οοθ, ιιμηθη c KOHiļOM 10 CTepacHS ετοροη njīaHKM 5, nojmepacnBaiomeii npejinjenbe. B τοηκθ οοθαμηθημη οΟοηχ cTepacHeM pacnojioaceH ετοροη φηκοΒτορ 11 κοτορπϊί oOecnenMBaeT β33μμηοθ ββμ ': θημθ CTepacHefl μ μχ φΜκοΒη, Μΐο ποπ downward at 60-18 0 °, a tack * e μ φΗχ BpameHne ^ ηΜίο cTepacHii co Βτοροη njiaHKOM πολ downward at 0-90 ° from οτηοπιθημιο k nvoyabilityHofr ocm Βτοροη njraHKM. CooTHoineHMe λπμηη BHyTpeHHero ynacTKa 12 πλθηθβογο CTepacHH, TejiecKonnnecKM BCTaBjieHHoro b onopy 1, κ βθλμηηηθ uihpmhu onopu cocTaBJineT 1: 3-2:. Οοοτηοιιιθηηθ ejihhu πιγθηθβομ njiaHKH 4 κ iUTOHe HapyacHoro ynacTKa 6 njeneBoro CTepacHH cocTaBJiaeT 3: 5-4: 5, npn 3TOM 1 / 5-2 / 5 nacTM hapya: hapya

κοτορΗβ pacnoJiosceHH okojio onopbi 1, ocBočo*meHH ot njieneBoii njiaHKM 4. OOe nnaHKM cHaCaceHH $MKCnpyiomMMM θλθμθητβμμ 14, 15 λπλ njieneBoči koctm m npemuienbīī, HanpnMep b Bnne peMHeii. ycTpoūcTBO fljisī jioKopemoHaJībHOM aHecTeSHM ncnojit>3yiOT cjieflyiamMM oSpasoM. Εο,πβηογο yKjia,iiHBaiOT Ha onopy 1, pacnojiaraa rojioBy μ nne^eBOM cycTaB tbkmm o6pa30M, nToČti mieHeBan KOCTb onepnpyeMoii[ pyKM Sūna pacnojioaceHa Ha nepBOM noflflepacnBaionieM sjieMeHTe - BflOJib ruieneBon nnaHKM 4. ripu ηθο6χοαμμοοτμ λπλ yjiyHmeHMH pacnojioaceHMH nneneBon koctm onopy 1 mojkho noBopannBaTb Ha 30° b onHy mjim apyryio cropoHy ot ee nponoJibHoil ocm, τθμ caMbiM y b e jim^mb a τ b mjim yMeHbinaTb yroji οτβθηθημη ruieHeBon: koctm, hto cnocoOcTByeT KOM$opTHOMy nojīOJKeHMio nauMeHTa. B npouecce paČOTH BBM^ceHMe njie^eBoā njiaHKM 4 ocymecTBJiHBDT c πομοπιββο nneneBoro CTepacHH 6, pacnojioaceHHoro ποη nneneBOM njiaHKOM. CTep*:eHb 6 MoaceT MoaceT 6uTb $MKCMpoBaH c noMonibio $MKcaTopa 8, pacnojioaceHHoro b ΤΟΗΚΘ ΟΟΘΒΜΗΘΗΜΛ ΠΛΘΗΘΒΟΓΟ CTepJKHH C ΟΠΟρΟΜ 1 . <X>MKCaTOp 8 očecneHMBaeT nBnaceHne μ Φμκοβημιο CTepacHfl 6 c nneneBoil nnaHKon 4 nojļ yrjiOM 30-120° b ropM30HTaJibHoii nnocKocTM μ λβμ^θημθ ΒΒβρχ Ha 50° b BspTMKajībHOM njiocKOCTM. OMKcaTop 8 oCecneHMBaeT TaKace BpameHMe nneHeBoro CTepaeHfl 6 c nnaHKon 4 BOKpyr ocm cTepacHa m $MKcauMio non yrjioM 0-90° no ο τ hoiii e hmkj k nponojibHoči ocm nneneBoJi nJiaHKM. Μ3ΜΘΗΘΗΜβ COOTHOmeHMM, a ΜΜΘΗΗΟ COOTHOHieHMe flJIMHbl BHyTpeHHero ynacTKa 12 ππθηθβογο cTepacH/i, TeJiecKonMHecKM BCTaBJieHHoro b onopy 1, m cooTHomeHMH HapyacHoro ynacTKa 13 ΠΛΘΗΘΒΟΓΟ CTepaCHH, paCnOJIOJKeHHOrO OKOJIO onopbt 1 M OCBo6o>KfleHHOrO ot njieneBOM njiaHKM 4 - μ3μθηθημθ o6omx ynoMHHyTHX οοοτηοπιθημμ no3BOJineT MeHHTb flJiMHy nneneBon njiaHKM, ybejimhmbah mjim yMeHbman ee ΠΟ HeOČXOHMMOCTM. C noMombio BToporo φκκοατορα 11, pacnojioaceHHoro b τοπκβ coenHHeHHa o6ohx CTepacHeii, o6ecneHHBafOT 0TBeneHne npennjienb» noji yrjioM 60-180°. njieneByio koctb m npennJieHbe φnκcMpyκ>τ ρθμηημμ 14, 15 κ cooTBeTCTByiomMM nnaHKaM 4,κοτορΗβ pacnoJiosceHH okojio onopbi 1, ocBočo * meHH ot njeneBoii njiaHKM 4. OOe nnaHKM cHaCaceHH $ MKCnpyiomMMM θλθμθητβμμ 14, 15 λπλ njeneBoi kimnbiči Boci koctm. ycTpoūcTBO fljisī jioKopemoHaJībHOM aHecTeSHM ncnojit > 3yiOT cjieflyiamMM oSpasoM. Εο, πβηογο yKjia, iiHBaiOT Ha onopy 1 pacnojiaraa rojioBy μ ^ NNE EBOM cycTaB tbkmm o6pa30M, nToČti mieHeBan KOCTb onepnpyeMoii [pyKM Sūna pacnojioaceHa Ha nepBOM noflflepacnBaionieM sjieMeHTe - BflOJib ruieneBon nnaHKM 4 wheel ηθο6χοαμμοοτμ λπλ yjiyHmeHMH pacnojioaceHMH nneneBon koctm onopy 1 mojkho noBopannBaTb H 30 ° b onHy mjim apyryio cropoHy ot ee nponoJibHoil ocm, τθμ caMbiM ybe jim ^ mb a τ b mjim yMeHbinaTb yroji οτβθηθημη ruieHeBon: koctm, hto cnocoOcTKeM n opiM. B npouecce paČOTH BBM ^ ceHMe njie ^ eBoā njiaHKM 4 ocymecTBJiHBDT c πομοπιββο nneneBoro CTepacHH 6, pacnojioaceHHoro ποη nneneBOM njiaHKOM. CTep *: eHb 6 MoaceT MoaceT 6uTb $ MKCMpoBaH c noMonibio $ MKcaTopa 8, pacnojioaceHHoro b ΤΟΗΚΘ ΟΟΘΒΜΗΘΗΜΛ ΠΛΘΗΘΒΟΓΟ CTepJKHH C ΟΠΟρΟΜ 1. < X > MKCaTOp 8 očecneHMBaeT nBnaceHne μ Φμκοβημιο CTepacHfl 6 c nneneBoil nnaHKon 4 nojļ yrjiOM 30-120 ° b ropM30HTaJibHoii nnocKocTK μMaj ībβajHBMMB OMβajMB OMKcaTop 8 oCecneHMBaeT TaKace BpameHMe nneHeBoro CTepaeHfl 6 c nnaHKon 4 BOKpyr ocm cTepacHa m $ MKcauMio non yrjioM 0-90 ° no ο τ hoiii e hmkj k nponojibHoči ocM nneneH. Μ3ΜΘΗΘΗΜβ COOTHOmeHMM, a ΜΜΘΗΗΟ COOTHOHieHMe flJIMHbl BHyTpeHHero ynacTKa 12 ππθηθβογο cTepacH / i, TeJiecKonMHecKM BCTaBJieHHoro b onopy 1 m cooTHomeHMH HapyacHoro ynacTKa 13 ΠΛΘΗΘΒΟΓΟ CTepaCHH, paCnOJIOJKeHHOrO OKOJIO onopbt 1 M OCBo6o > KfleHHOrO ot njieneBOM njiaHKM 4 - μ3μθηθημθ o6omx ynoMHHyTHX οοοτηοπιθημμ no3BOJineT MeHHTb flJiMHy nneneBon njiaHKM, ybejimhmbah mjim yMeHbman ee ΠΟ HeOČXOHMMOCTM. C noMombio BToporo φκκοατορα 11, pacnojioaceHHoro b τοπκβ coenHHeHHa o6ohx CTepacHeii, o6ecneHHBafOT 0TBeneHne npennjenb »noji yrjioM 60-180 °. njeneByio koctb m npennJieHbe φnκcMpyκ > τ ρθμηημμ 14, 15 κ cooTBeTCTByiomMM nnaHKaM 4,

5, KOTopue pacnojioaceHbi Ha 4-8 cm Bbniie ypoBHn onopu, tskmm oCpa30M njieneBan koctb m npemuie^be pacnojiararoTCJi Ha 4-8 cm Bsniie ypoBHH οπορω. IlepeflBMaceHHe onopti 1 β onHy mjim npyryK) cTopoHy Ha 30°, BpameHMe nne^eBoro CTepacHR 6 m pa3MemeHHe o6enx njiaHOK 4, 5 Ha 4-8 cm Bbnne ypoBHR οπορω očecne’īHBaeT onTHMajībHoe οτβθβθημθ njieneBon koctm rjm HocTyna κ oČJiacTH Plexus brachialis b noflMume^Hoii BnaflMHe. <ī>MKcnpoBaHMe njre^eBOH koctm h npe^njie^ibii b tbkom5, KOTopue pacnojioaceHbi Ha 4-8 cm Bbniie ypoBHn onopu, tskmm oCpa30M njeneBan koctb m npemuie ^ be pacnojiararoTCJi Ha 4-8 cm Bsniie ypoBHH οπορω. IlepeflBMaceHHe onopti 1 β onHy oder npyryK) cTopoHy Ha 30 ° BpameHMe NNE ^ Ebor CTepacHR 6 m pa3MemeHHe o6enx njiaHOK 4, 5 H 4-8 cm Bbnne ypoBHR οπορω očecne'īHBaeT onTHMajībHoe οτβθβθημθ njieneBon koctm RJM HocTyna κ oČJiacTH Plexus brachialis b ^ noflMume Hoii BnaflMHe. < ī > MKcnpoBaHMe njre ^ eBOH koctm h npe ^ njie ^ ibii b tbkom

onpeBeneHHOM nooaceHMH b Te^eHne 30 mmh k čojiee oČecneHHBaeT ΠρΟΒβΒΘΗΜΘ MeCTHOM ^jpeCKOaCHOH JlOKOperMOHaJTbHOH aHeCTe3MM c ocymecTBjieHneM GjioKaflH 5 ηθρβοβ: N.musculocutaneus, N. axillaris, N.medianus, N. radialis, N.ulnaris.B oČJiacTM N.medianus, N.ulnaris, N. radialis BBOitflT no 10 mji aHecTeTUKa (jiMEOKaMH, ponneaKanH) . BjioKacy npoBOflflT, KOHTpojinpyH οτΒβτΗνχι peaKn.nK) MHHepBnpyeMHX Mtmm kmctm c noMombio npiiSopa HenpocTnMyjiKTopa/ npw otom nccxcejiyi3T οτβθτηηη nopor TjyBCTBMTejTbHOCTKi MbTTiTTi c aMnjn<inyflo£i TOKa 0,6 mA. B cn^ae Tyronoxi:BM5KHOCTH nne^eBoro κ λοκτθβογο cycTaBOB pyKy pacnoJiaraioT nofl yrjiOM 60° no οτηοπιθημιο κ ocm Tena, npn otom nnaHKy 5 npejļnjīenbs pacnoiraraioT c noMombio <$HKcaTopa 11 Ha OEHoft jtmhmh c njieneBoft njiaHKon 4, Pyxy $nKcnpyE>T ρθμηημμ baojib o6enx njiaHOK. B TaKOM nojTOūKeHnn προβολητ MecTHyio ^pecKO*:Hyio JioKopernoHajibHyio aHecTe3rao. Pa3Mem;eHKe njioma^Kn min nHCTpyMeHTOB b očJiacTH ΒβρχΗηχ yrnoB onopbi Ha paccTOHHnn 8-12 cm ot ee ypoBHH πο3βοχ[λθτ xnpypry vi aHecTe3HOJiory 6onee yn;o6Ho 6paTb HHCTpyMeHTbi. 3TOMy »ce Ha3HayeHnio cnocočcTByeT BpameHHe njioma.mcH: c nocjīeflyK)iiien $)WKcaij;Heii. yBejin^eHHe pa3MepoB onopbi no3BOJiKeT SoJiee κοΜφορτΗΟ pacnojioacHTb Ha ηθμ rojioBy n rpyflHyio KJieTKy 6ο·πβηογο, a Taicse pa3MecTMTb Ha βθρχημχ yrnax onopu nnomanKM bjih MHCTpyMeHTOB.onpeBeneHHOM nooaceHMH b Te ^ eHne 30 mmh k chojiee oČecneHHBaeT ΠρΟΒβΒΘΗΜΘ MeCTHOM ^ jpeCKOaCHOH JlOKOperMOHaJTbHOH aHeCTe3MM c ocymecTBjieHneM GjioKaflH 5 ηlus N. .ulnaris, N. radialis BBOitflT no 10 mji aHecTeTUKa (jiMEOKaMH, piveaKanH). BjioKacy npoBOflflT, KOHTpojinpyH οτΒβτΗνχι peaKn.nK) MHHepBnpyeMHX Mtmm kmctm c noMombio npiiSopa HenpocTnMyjiKTopa / npw otom nccxcejiyi3T οτβθτηη B cn ^ ae Tyronoxi: BM5KHOCTH NNE ^ Ebor κ λοκτθβογο cycTaBOB pyKy pacnoJiaraioT nofl downward at 60 ° from οτηοπιθημιο κ ocm Tena npn Otomo nnaHKy 5 npejļnjīenbs pacnoiraraioT c noMombio < $ HKcaTopa 11 H OEHoft jtmhmh c njieneBoft njiaHKon 4 Pyxy $ nKcnpyE > T ρθμηημμ baojib o6enx njiaHOK. B TaKOM nojTOūKeHnn προβολητ MecTHyio ^ pecKO *: Hyio JioKopernoHajibHyio aHecTe3rao. Pa3Mem; eHKe njioma ^ Kn min nHCTpyMeHTOB b očJiacTH ΒβρχΗηχ yrnoB onopbi Ha paccTOHHnn 8-12 cm ot ee ypoBHH πο3βοχ [λθτ xnpypry vi aHecTe3HOJiory 6onee yn; o6HoH6Po6HoT6HoT6HoT6HoT6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T6H6T. 3TOMy »ce Ha3HayeHnio cnocočcTByeT BpameHHe njioma.mcH: c nocjīeflyK) iiien $) WKcaij; Heii. yBejin ^ eHHe pa3MepoB onopbi no3BOJiKeT SoJiee κοΜφορτΗΟ pacnojioacHTb Ha ηθμ rojioBy n rpyflHyio KJieTKy 6ο · πβηογο, a Taicse pa3MecTMopbj yrnnaKnMMBb b β βρχη.

Claims (2)

LV 13224 IZGUDROJUMA FORMULA 1. Ierīce lokoreģionālajai anestēzijai, saturoša galvas paliktni, virsmu instrumentārijam, divas plāksnītes, viena no kurām paredzēta augšdelma nostiprināšanai, otra - apakšdelmam, fiksējošus elementus augšdelmam un apakšdelmam, kas raksturīgs ar to, ka paliktņa izmēri ir palielināti, zem abām plāksnītēm ir novietoti stieņi, augšdelma plāksnītes stienis ir ievietots teleskopiski paliktnī pleca locītavas līmenī, stieņa un paliktņa savienojuma vietā ir novietots fiksators, kas nodrošina stieņa, kopā ar atbalsta virsmu, kustību un fiksāciju 3 ΟΠΟ0 leņķī horizontālajā plaknē, tā pacelšanu 50° vertikālajā plaknē un rotāciju ap stieņa garenisko asi 0-90°, otrs augšdelma stieņa gals savienots ar otras plāksnītes stieņa galu, abu stieņu savienojuma vietā ir novietots otrs fiksators, kas nodrošina stieņu savstarpēju kustību un fiksāciju 60-180° leņķī vertikālajā plaknē un 0-90° attiecībā pret otrās plāksnītes horizontālo asi.A device for locoregional anesthesia, containing a head pad, a tool for the surface, two plates, one for attaching the upper arm, the other for the forearm, locking elements for the upper arm and forearm, characterized in that the dimensions of the pad are enlarged, under both the bars are placed on the plates, the bar of the upper arm plate is placed telescopically in the tray at the level of the shoulder joint, a latch securing the bar, along with the supporting surface, movement and fixation at an angle of 3 ālajā0 in the horizontal plane, its lifting in a 50 ° vertical plane, is placed at the junction of the bar and pallet; rotation around the longitudinal axis of the rod 0-90 °, the other end of the forearm rod is connected to the end of the bar of the other plate, a second lock is placed instead of the joint of the two bars, which ensures the movement and fixation of the bars at an angle of 60-180 ° in the vertical plane and 0-90 ° in the relation. Baa the second plate horizontal axis. 2. Ierīce pēc l.p., kas raksturīgs ar to, ka abas plāksnītes ir novietotas līmenī, kas ir augstāks par paliktņa virsmu par 4-8 cm, garuma attiecība augšdelma stieņa iekšējai dajai, kas paliktnī iestiprināts attiecībā pret paliktņa platumu sastāda 1:3 - 2:3, garuma attiecība augšdelma plāksnītei attiecībā pret tās stieņa ārējo daļu sastāda 3:5 - 4:5, pie tam 1/5 - 2/5 daļas no augšdelma stieņa blakus paliktnim ir brīvs no plāksnītes, virsma instrumentārijam novietota paliktņa augšējos stūros 8 -12 cm augstumā virs paliktņa, piemēram, ar vertikāla stieņa palīdzību, kas griežas ap savu asi un tālāku tā fiksāciju.2. Device according to claim 1, characterized in that the two plates are positioned at a level higher than the pallet surface by 4-8 cm, the ratio of the length of the inner core of the upper arm, fixed to the pallet width relative to the pallet width, is 1: 3 - 2 : 3, the length ratio of the upper arm plate to the outer part of the bar is 3: 5 - 4: 5, then 1/5 - 2/5 of the upper arm beam beside the tray is free from the plate, the surface of the instrument is placed in the upper corners of the tray 8 - At a height of 12 cm above the pallet, for example, by means of a vertical bar that rotates around its axis and further fixes it.