Kapangidwe ndi kagwiridwe kake ka kapamba

Nyuwa ya kapamba ndi chiwalo chakumaso cha mtundu wa imvi, chomwe chimapezeka m'mimba, chimagona modutsa pamiyendo ya I-II lumbar vertebrae retroperitoneally, kumbuyo kwa m'mimba, ndikulekanitsidwa nacho ndi thumba lamaso. Komwe kuli kapamba wokhudzana ndi ziwalo zina: kutsogolo ndi m'mimba, kumbuyo kuli msana, kumanzere kuli ndulu, pomwe mchira wa kapamba umalowera, kumanja, kumtunda ndi m'munsi kuli duodenum, wokuta mutu wa kapamba.

Pachitseko chachikondwerero mutu, thupi ndi mchira.

Ntchito ziwiri:
1. Exocrine gland ntchito (chowonjezera). Zikondazo zimatulutsa madzi a kapamba omwe amalowa mu duodenum ndipo amatenga nawo gawo pakusweka kwa magulu onse a ma polima zakudya. Madzi amaphatikiza ma enzymes ambiri (amylase, trypsin, lipase, ndi zina) omwe amasokoneza asidi m'mimba, amatenga gawo limodzi pakupanga chimbudzi. Mukamasala kudya, muchepetsani madzi pang'ono, mukudya, m'malo mwake.
2. Intra-secretory function imayang'anira ntchito yopanga mahomoni (insulin glucagon ndi lipocaine). Glucagon ndi insulin zimagwira kagayidwe kazakudya ndipo zimasunga shuga m'magazi munthawi yochepa. Lipocaine amalimbikitsa kapangidwe ka phospholipids, komwe kumapangitsa mphamvu ya oxidation yamafuta ndikutchingira mapangidwe a mafuta m'magazi.

Pancreas ili ndi mawonekedwe a alveolar-tubular. Kunja, imakutidwa ndi chifanizo cha minofu yolumikizana, komwe zingwe zopatula pakati paubongo zimapita parenchyma. Pakati pawo pali mitsempha yamagazi, ndere ndi mitsempha. Zosiyanasiyana za gland zimaphatikizapo zigawo za exocrine ndi endocrine.
Gawo la pancreas limayimiridwa ndi pancreatic acini - magawo a gland. Amapangidwa ndi 8-12 exocrine pancreatocytomas kapena acinocyte, kupanga michere.
Gawo la endocrine la gland limayimiridwa ndi ma pancreatic islets omwe ali pakati pa acini ndipo ali ndi mawonekedwe ozungulira kapena ovoid. Zilumbazi zimapangidwa ndi maselo a endocrine (insulocyte) omwe amapanga mahomoni. Chiwerengero chachikulu kwambiri cha zisumbu za pancreatic chimakhazikika mumchira wa gland, chiwerengero chawo chonse ndi 1-2 miliyoni.

Chikhodzodzo. Bile Kupanga, mtengo.
Ndi chida cha kudzikundikira kwa bile kuchokera ku chiwindi, chofunikira pakuwonongeka ndi kuperewera kwa chakudya. Ili kutsogolo kwa poyambira kwautali wa chiwindi, imakhala ndi mawonekedwe a peyala, yomwe imasunga pafupifupi 40-60 ml. bile. Imasiyanitsa pakati pa pansi, thupi ndi khosi.
Khoma la ndulu limakhala ndi ma mucous membrane, minofu zimagwira ndipo imakutidwa ndi peritoneum.

kapangidwe:
- bile zidulo (zoyambira: cholic ndi chenodeoxycholic)
- madzi - 97.5%
- ma elekitirodi
- mchere wamchere
- lecithin
- cholesterol

Ntchito Bile:
- imalepheretsa mphamvu ya pepsin ya madzi a m'mimba,
- imalimbikitsa mafuta, amatenga nawo mbali popanga ma micelles,
- imalimbikitsa kupanga mahomoni am'matumbo (secretin ndi cholecystokinin),
- chimaletsa kudziphatikiza kwa mapuloteni ndi mabakiteriya,
- imalimbikitsa kupanga ntchofu,
- imayendetsa motility ya m'mimba,
- imayendetsa ma enzyme omwe amapukusa mapuloteni, kuphatikizapo trypsin.

Mwa munthu wathanzi, 0,5-1.2 l ya bile imatulutsidwa patsiku. Katulutsidwe kabwino ndikopitilira, ndipo kulowa kwake mu duodenum kumachitika pak ukugaya. Popitirira kugaya, bile limalowa mu ndulu. Bile amatchedwa juisi yogaya chakudya.

Tsiku Lomwe Likuwonjezeka: 2016-09-06, Views: 1263 | Kuphwanya lamulo laumwini

Makhalidwe wamba

M'mbuyomu, kapamba ankangomuwona ngati minofu. Munali m'zaka za zana la 19 zokha pomwe anapezeka kuti akupanga chinsinsi chake, chomwe chimayang'anira chimbudzi. Kafukufuku yemwe wasayansi N. Pavlov adavumbula ndi zofunikira zofunika zomwe kapamba amapanga mthupi la munthu.

Mu Latin, lungu limatchedwa kapamba. Chifukwa chake, matenda ake akuluakulu ndi kapamba. Ndizofala kwambiri, chifukwa kugwira kwina kwa kapamba kumalumikizana ndi ziwalo zina zonse zam'mimba. Kupatula apo, amalumikizana ndi ambiri aiwo.

Gland ya pancreas imatchedwa, ngakhale munthu atakhala wowongoka, amapezeka kumbuyo kwa m'mimba. Ichi ndi chiwalo chokulirapo - kukula kwa kapamba nthawi zambiri amayambira masentimita 16 mpaka 22. Ali ndi mawonekedwe apamwamba, osongoka. Kutalika kwake sikupitirira 7 cm, ndipo kulemera kwake ndi 70-80 g. Kupanga kwa kapamba kumachitika kale miyezi itatu ya chitukuko cha fetal, ndipo mwa kubadwa kwa mwana kukula kwake ndi 5-6 mm. Pofika zaka khumi, amachulukitsa ndi katatu.

Malo

Ndi anthu ochepa omwe amadziwa momwe kapamba amawonekera, ambiri sadziwa komwe ali. Chiwalo ichi ndichotetezedwa kwambiri kuposa zina zonse zam'mimba, chifukwa chimakhala chakuya. Kutsogolo kwake, kumakutidwa ndi m'mimba, pakati pawo pamakhala mafuta - omentum. Mutu wa gland ndi, titero kunena kwake, wokutidwa mu duodenum, ndipo kumbuyo kwake, msana ndi minofu ya msana imateteza.

Zikondwererozi zimapezeka mozungulira, zimadumphira malo onse oyandikira. Gawo lake lalikulu kwambiri - mutu - uli pamlingo wa 1 ndi 2 wa lumbar vertebrae kumanzere. Kuchuluka kwa kapamba kumakhala pakati pakati pa navel ndi gawo lamunsi la sternum. Ndipo mchira wake umafikira ku hypochondrium kumanzere.

Zikondazo zimayanjana kwambiri ndi ziwalo zambiri komanso zombo zazikulu. Kuphatikiza pamimba, imalumikizana mwachindunji ndi duodenum, komanso ndi bile ducts. Kumbali inayo, imagwira impso yakumanzere ndi adrenal gland, ndipo ndi kutha kwake - ndulu. Mitsempha ya aorta, ya impso ndi ya vena cava yotsika mtengo imayandikira kumbali yakumbuyo kumbuyo, ndipo chotupa chachikulu cha mesenteric kutsogolo. Zimakhudzanso ndi plexus yayikulu ya mitsempha.

Mphamvu ya kapamba wamunthu ndizovuta kwambiri. Kuphatikiza poti minofu yake imapangidwa ndi mitundu ingapo ya maselo ndipo imayimira mawonekedwe okhala ndi matumba ambiri, imakhala ndi magawo atatu. Palibe malire omveka pakati pawo, koma munthu wathanzi labwino amatha kuwona kuti gland ili ndi mawonekedwe a comma omwe amapezeka kumtunda kwa m'mimba. Ili ndi mutu - iyi ndi gawo lake lalikulupo, makulidwe ake omwe nthawi zina amafika 7-8 cm, a thupi ndi mchira.

Mutu wa gland uli mphete ya duodenum, kumanja kwa midline yam'mimba. Ili pafupi ndi chiwindi ndi chikhodzodzo. Gawo lake lalitali kwambiri limapanga chinthu chokhala ngati mbeza. Ndipo mukapita ku thupi, mitundu yopapatiza, yomwe imatchedwa khosi. Kapangidwe ka thupi la gland ndimapamwamba, ali ndi mawonekedwe. Ili ndiye gawo lake lotalikirapo. Thupi limakhala loonda, losapitirira 5 cm. Ndipo mchira wa kapamba ndi wowonda pang'ono, wopindika pang'ono, ali ndi mawonekedwe a chulu. Ili kumanzere, ndipo imawongoleredwa pang'ono. Mchirawo umafika mpaka kum'mphepete mwa koloni.

Kuphatikiza apo, kapangidwe kake kapamba kumadziwika ndi kukhalapo kwa mitundu iwiri ya minofu. Awa ndi maselo wamba komanso stroma, ndiye kuti, minofu yolumikizana. Mmenemo mumapezeka mitsempha ya magazi ndi zitseko zake. Ndipo ma cell omwe amapanga nawonso ndi osiyana, pali mitundu iwiri ya izo. Aliyense wa iwo amachita ntchito zake.

Maselo a Endocrine amachita ntchito ya intrasecretory. Amapanga mahomoni, ndipo amawataya mwachindunji m'magazi kudzera m'mitsempha yapafupi. Maselo otere amapezeka m'magulu osiyana, omwe amatchedwa islets of Langerhans. Amakhala kwambiri mchira wa kapamba. Zilumba za Langerhans zili ndi mitundu inayi ya maselo yomwe imatulutsa mahomoni ena. Awa ndi ma cell a beta, alpha, delta ndi PP.

Maselo otsala - ma cell a pancreatic - amapanga minofu yayikulu ya England. Amapanga michere yokumba, ndiye kuti, amagwira ntchito ya exocrine kapena exocrine. Pali maselo ambiri otchedwa cell. Amaphatikizidwa kukhala lobules, iliyonse yomwe imakhala ndi duct yayo. Ndipo kenako amaphatikizidwa kukhala amodzi.

Pancreas imakhala ndi ma network ambiri amitsempha yamagazi. Kuphatikiza apo, imakhala ndi chiwerengero chachikulu cha mathero a mitsempha. Izi zimathandizira kuyang'anira ntchito yake, ndikuwonetsetsa kupanga kwachilendo kwa michere ndi mahomoni. Koma makamaka chifukwa cha izi, matenda amtundu uliwonse amtunduwu amatsogolera ku kuwoneka kupweteka kwambiri ndipo nthawi zambiri amafalikira kwa ziwalo zina.

Udindo waukulu wa kapamba mu thupi la munthu ndikuwonetsetsa kuti chimbudzi chayamba. Uku ndiye ntchito yake yachinyengo. Madzi a pancreatic opangidwa mkati mwa gland amalowa m'matumbo am'mimba kudzera mu duct system. Amachoka kuzinthu zazing'ono zonse zomwe zimapanga gawo lililonse la zofunikira.

Ma dancts onse a pancreatic amaphatikizidwa kukhala amodzi wamba, otchedwa Wirsung duct. Makulidwe ake kuyambira 2 mpaka 4 mm, amachoka pamchira kupita kumutu wa kutulutsa pafupifupi pakati, pang'onopang'ono kukulira. M'dera la mutu, nthawi zambiri amalumikizana ndi bile duct. Onsewo amatuluka mu duodenum kudzera papilla wamkulu. Ndimeyi imatsekedwa ndi sphincter ya Oddi, yomwe imalepheretsa zomwe zili m'matumbo kuti zisafike kumbuyo.

Physiology ya kapamba imakhala ndi kupsinjika kwakukulu mu mawonekedwe ake wamba. Chifukwa chake, bile samalowa mkatimo, chifukwa kupanikizika mu ducts ya bile kumakhala kotsika. Ma pathologies ena okha omwe amatha kutsogolera kulowa kwa bile mu kapamba. Uku ndikuphwanya ntchito zake pamene chinsinsi cha pancreatic madzi, kuphipha kwa sphincter ya Oddi, kapena kutsekeka kwa mzere ndi ndulu, kuchichepetsedwa. Chifukwa cha izi, osati kukokomeza kwa madzi a pancreatic mu gland kumachitika, komanso bile limaponyedwamo.

Kulumikizana koteroko kwa kapamba ndi ndulu kumakhalanso chifukwa chomwe nthawi yotupa imakhudzana ndi ndulu mwa achikulire, jaundice yovuta imawonedwa. Kupatula apo, gawo la duct la bile limadutsa thupi lake ndipo limatha kufinya chifukwa cha edema. Zimatithandizanso kufalitsa matenda kuchokera ku chiwalo chimodzi kupita china.

Nthawi zina, chifukwa cha zovuta zachitukuko zakubadwa, m'modzi mwa ma ducts samalumikizana ndi wamba ndikulowera popanda dodenum pamwamba pamutu pa pancreatic. Kukhalapo kwa duct yowonjezerapo, yomwe imatchedwa Santorius, imawonedwa mwa 30% ya anthu, izi sizoyambitsa matenda. Ngakhale pakutseka duct wamkulu, sangathe kupirira kutulutsa kwa pancreatic madzi, chifukwa chake, ndizopanda ntchito.

Zikondamoyo ndimtundu wa secretion wosakanikirana. Kupatula apo, imakhala ndi maselo osiyanasiyana, mtundu uliwonse womwe umatulutsa mahomoni ena kapena ma enzyme. Ndi msuzi wa pancreatic wotulutsidwa ndimatumbo omwe amathandizira kugaya bwino chakudya. Ndipo timadzi timene timatulutsa timadzi tambiri, timene timatulutsa timadzi timeneti.

Chifukwa chake, kapamba amachita ntchito zingapo:

• amatenga nawo mbali pang'onopang'ono,
• Imapanga ma enzymes ofunika kwambiri am'mapuloteni, mafuta ndi chakudya,
• amatulutsa insulin ndi glucagon kuti azitha kuwongolera shuga.

Kuti zonyansa zigwire bwino ntchito zake, kuphatikiza pazinthu zambiri ndikofunikira. Thanzi lake limatengera magwiridwe antchito a chiwindi, chikhodzodzo, duodenum, kufalitsa magazi moyenera komanso kufalitsa kwa kukhudzidwa kwa mitsempha. Zonsezi zimakhudza ntchito zake, kuchuluka ndi kapangidwe kake. Kukula kwabwinobwino kwa kapamba mwa munthu wathanzi sikuyenera kupitirira masentimita 23. Ndipo kuchuluka kwake kumatha kuwonetsa matenda aliwonse.

Ntchito yogaya

Zikondazo zimatulutsa madzi a pancreatic, omwe amakhala ndi ma enzymes ofunikira pakuwonongeka kwa mapuloteni, mafuta ndi chakudya chamagulu kuchokera ku chakudya. Pazonse, pafupifupi 600 ml ya madzi amapangidwa patsiku, nthawi zina kuchuluka kwake kumatha kuchuluka mpaka 2000 ml. Ndipo mtundu ndi kuchuluka kwa ma enzymes zimatengera mawonekedwe a thanzi la anthu. Kupatula apo, kapamba amatha kusintha ndikulimbikitsa kupanga kwa ma enzymes omwe amafunikira pakadali pano.

Kupanga madzi a pancreatic kumayamba chakudya chikalowa m'mimba. Ngakhale nthawi zambiri njirayi imayamba kale pakuwona chakudya kapena kuchokera pakumwa fungo lake. Nthawi yomweyo, chizindikiritso chimabwera kudzera mu ulusi wamanjenje kupita ku ma cell a gland, amayamba kupanga zinthu zina.

Ma Enzoni omwe kapamba amatulutsa amapangidwa osagwira ntchito, chifukwa amakhala olimba kwambiri ndipo amatha kugaya timinyewa ta minyewa tokha. Amathandizidwa pokhapokha atalowa mu duodenum. Pali enzyme enterokinase. Imayendetsa mwachangu trypsin, yomwe imayambitsa ma enzyme ena onse. Ngati, mwa ma pathologies ena, enterokinase ilowa mu kapamba, ma enzymes onse amayamba kugwira ntchito ndipo minofu yake imayamba kugonjetsedwa. Pali kutupa, ndiye necrosis ndikuwonongeka kwathunthu kwa chiwalo.

Tizilombo timeneti timatulutsa michere yambiri. Zina mwazo zimatha kuphwanya mapuloteni, ma amino acid, ma nucleotide, ena amathandizira pakugaya mafuta komanso kuperewera kwa chakudya:

• Mitsempha - ribonuclease ndi deoxyribonuc tafadhali kuphwanya DNA ndi RNA ya nyama yakunja yomwe imalowa m'mimba.
• Mapuloteni amakhudzidwa ndi kuwonongeka kwa mapuloteni. Pali mitundu yambiri ya ma enzyme awa: trypsin ndi chymotrypsin zimaphwanya mapuloteni amenewa omwe adapangidwira kale m'mimba, carboxypeptidase imaphwanya ma amino acid, ndipo elastase ndi collagenase imaphwanya mapuloteni osakanikirana ndi michere.
• Ma enivolous omwe amawononga mafuta ndizofunikira kwambiri. Uku ndi lipase, yomwe kuwonjezera apo imakhudzidwa ndikupanga mavitamini osungunuka a mafuta, ndi phospholipase, imathandizira kuyamwa kwa phospholipids.

Ma enzyme ambiri omwe amabisidwa ndi kapamba kuti agwetse chakudya. Amylase amathandizira kuyamwa kwa glucose, kuphwanya zovuta zam'mimba, ndi lactase, sucrose ndi maltase secrete glucose pazomwe zimagwirizana.

Ntchito ya mahormoni

Anthu ochepa amaganiza kuti kapamba ndi chiyani. Nthawi zambiri amaphunzira za izi pomwe mtundu wina wa matenda amawonekera. Ndipo chodziwika kwambiri mwa izi ndi matenda ashuga. Matendawa amayambitsidwa ndi matenda obowoleza a shuga. Njira imeneyi imaperekedwa ndi insulin, timadzi tomwe timapangidwa ndi kapamba palokha. Ngati kapangidwe kake kasokonekera, kuchuluka kwa shuga m'magazi kumawonjezeka.

Maselo ena a kapamba omwe amapezeka kuzilumba za Langerhans amatulutsa mahomoni kuti athandizire kuyamwa kwa chakudya chamthupi, komanso kusintha momwe kagayidwe kazinthu zimayambira.

• Insulin imalimbikitsa kutembenuka kwa glucose kukhala glycogen. Izi zimatha kudzikundikira minofu yamatumbo ndi chiwindi, ndikusunthika ndikofunikira.
• Glucagon imakumana ndi zotsutsana: imaphwanya glycogen ndikusintha kukhala glucose.
• Somatostatin ndiyofunikira kuti atchotsere kuchuluka kwama mahomoni ena ndi ma enzyme ena.
• Pancreatic polypeptide imathandizira kupanga madzi am'mimba.

Munthu aliyense ayenera kumvetsetsa zomwe ntchito kapamba amachita. Amatenga nawo mbali kagayidwe kachakudya, amasunga shuga wambiri, amapereka chimbudzi. Kuphwanya kosiyanasiyana kwa ntchito yake kumakhudza thanzi komanso kuchepetsa moyo wamunthu.

Udindo wa kapamba m'thupi

Aliyense amadziwa kuti munthu amalandira zinthu zofunika mthupi limodzi ndi chakudya.Komabe, muzinthu zopangidwa ndi zakudya izi zimakhala ndi mawonekedwe osokoneza, ndipo ndizosatheka kuzigwira popanda kugwiritsa ntchito michere. Zikondazo zimatulutsa madzi amamba a pancreatic, omwe kudzera mu cancion duct (canal) amalowa mu duodenum. Pamenepo, zogulitsazo zimasungidwa kumayiko omwe amafunika kumiza. Mankhwala, izi zimatchedwa exocrine pancreatic function.

Chakudya chimawonongeka motsogozedwa ndi ma enzyme a hydrolytic, omwe amachititsa kuti michere ikhale ndi madzi. Madzi a pancreatic amakhala ndi mitundu yonse yama hydrolases, iliyonse yomwe imagwira ntchito inayake. Agawidwa m'magulu anayi:

1. Lipases (lipolytic enzymes). Amaphwanya mafuta pazigawo zovuta - mafuta ochulukirapo am'mafuta ndi glycerin, zimapereka kuchuluka kwa mavitamini osungunuka a mafuta A, D, E, K.
2. Mapuloteni (ma protein enzymes - carboxypeptidase, chymotrypsin, trypsin) amathandizira ma enzymes omwe amawononga mapuloteni ku amino acid.
3. Nyukiliya. Ma enzyme amenewa amaphwanya ma nucleic acid ndipo “amapanga” ma genetic awo.
4. Ma carbohydrate (michere ya amylolytic - amylase, lactase, maltase, invertase). Ndizofunikira pakuwonongeka kwa chakudya cham'magazi kwa glucose.

Makina a kapamba ndizovuta kwambiri. Ma enzymes am'mimba amayamba kupangika mwachangu pamlingo wina mkati mwa mphindi 2-3 chakudya chikamalowa m'mimba, zonse zimatengera kuchuluka kwa mapuloteni, mafuta ndi chakudya m'matumbo. Ngati muli ndi chiwerengero choyenera cha bile, kupangira madzi a pancreatic okhala ndi ma enzymes kumatha maola 12.

Ntchito ya Endocrine imachitika chifukwa cha ntchito ya insulocytes - maselo apadera azisumbu a Langerhans. Ma insulocytes amatulutsa mahomoni angapo:

Ma mahormone amalowa m'magazi ndipo amatenga nawo gawo pa kayendedwe ka carbohydrate metabolism m'thupi. Glucagon imakhudzidwa ndi njira za metabolic, insulin imapereka njira yogwiritsira ntchito zinthu zosavuta, zimathandiza kukhalabe ndi shuga m'magazi.

Pogwira ntchito pancreatic moyenera, insulin ndi glucagon imayendetsa kayendedwe ka wina ndi mnzake.

Popeza magwiridwe antchito achilengedwe amtunduwu, zikuwonekeratu kuti zochitika zake zofunikira m'njira zambiri zimapatsa mwayi kukula ndi kukula kwa thupi la mwana.

Matenda wamba a kapamba

Pakakhala vuto lililonse la kapamba - kusintha kwa maumbidwe, kutupa kapena kuvulala - kulephera kumachitika pakapangidwe ka michere ndi mahomoni, chifukwa chomwe ntchito yofunikira m'thupi la munthu imasokonekera. Mu ana, matenda amtundu wa gland nthawi zambiri amagwirizanitsidwa ndi kusintha kwakuthwa kwa zakudya (kusinthira ku chakudya chodyetsa, chiyambi cha kuchezera kwa sukulu ya kindergarten kapena sukulu).

Matenda ofala kwambiri a pancreatic gland (onse akulu ndi ana):

1. Pancreatitis ndi kutukusira kwa tiziwalo tamatumbo, timayendera limodzi ndi kuphwanya kwa mankhwalawa. Zizindikiro zazikulu za matendawa ndizopweteka m'mimba, kusanza, nseru, etc.
2. Matenda a shuga amapezeka pamene maselo amisukulu ya Langerhans amasiya kugwira ntchito mwachizolowezi, chifukwa chomwe kuchuluka kwa glucose m'magazi kumakwera. Zizindikiro zazikulu za matendawa ndi kuchepa thupi, ludzu, mapangidwe amkodzo, etc.

Mu mwana, matenda a kapamba monga benign cysts, abscesses, ndi fistulas amathanso kuonekera.

Zizindikiro zotsatirazi nthawi zambiri zimawonetsa kusokonezeka kwa kayendedwe ka chiwalochi mwa ana:

• kupindika
• mawonekedwe a mkamwa winawake,
• kutsegula m'mimba
• kufooka
• ukufalikira
• chisangalalo
• nseru
• kupweteka m'mbali, kumbuyo, kutsikira kumbuyo, m'mimba,
• kusanza, etc.

Kuti kapamba azigwira ntchito bwino, amafunikira kuwunika momwe alili ndipo, ngati nkotheka, apange momwe angagwirire ntchito yake:

• kutsatira mfundo za kadyedwe koyenera
• chepetsa kumwa kwa kusuta, mafuta, okazinga,
• kukana kapena kuchepetsa kumwa mowa, tiyi wamphamvu, khofi, mandimu, ndi zina zotere.
• muchepetse zakudya zamafuta nthawi yogona
• kuphika ndi zonunkhira zochepa, mchere ndi zonunkhira,
• Imwani madzi okwanira (1.5-2 malita amadzi patsiku),
• chepetsa kumwa kwa chokoleti, zotsekemera ndi ufa (ayisikilimu, makeke, masikono, maswiti, ndi zina).
• letsa kumwa zamkaka zomwe sizili zachilengedwe (zotsekemera ndi ma curds, ndi zina zotere),
• masitolo okanira, ma ketchups, mayonesi,
• phatikizani zakudya zina zakudya m'zakudya, kupatula zipatso zouma ndi zipatso.

Poyerekeza ndi ana, ndikokwanira kusunga zikhalidwe zomwe zimakhudzana ndi zaka, kupewa maswiti odyetsa kwambiri, komanso kupatula chakudya chokhacho pachakudya cha ana.

Mu matenda a pancreatic gland, mwana, ngati wodwala wamkulu, adamulamula kudya No. 5.

Chidule cha makolo

Zakudya zoyenera molumikizana ndi moyo wathanzi ndizofunikira kwambiri kuti chitukuko cha mwana chizigwira bwino, komanso kugaya chakudya komanso kusapezeka kwa matenda am'mimba.

Kanema wachidziwitso pancreatic anatomy:

Chingwe choyamba cha mzinda wa Odessa, chikalata chachipatala pamutu wakuti "Pancreas":

Ntchito zazikuluzikulu za kapamba

Zikondamoyo m'mimba zogaya ndi gawo lachiwiri lalikulu kwambiri pambuyo pa chiwindi pakufunika komanso kukula, lomwe lili ndi ntchito ziwiri zofunika. Choyamba, imapanga mahomoni awiri akuluakulu, popanda iwo kagayidwe kazakudya kamene kamakhala osagwiritsa ntchito - glucagon ndi insulin. Izi ndiye zomwe amatchedwa endocrine kapena ntchito yowonjezera ya England. Kachiwiri, kapamba amalimbikitsa chimbudzi cha zakudya zonse zomwe zimalowa mu duodenum, i.e. Ndi chida chogwiritsa ntchito mphamvu zowonjezera.

Iron imatulutsa madzi omwe amakhala ndi mapuloteni, kufufuza zinthu, ma electrolyte ndi bicarbonates. Chakudya chikalowa m'matumbo a duodenum, msuziwo umalowanso mmalo mwake, womwe ndi ma amylase, lipases ndi mapuloteni, omwe amatchedwa ma pancreatic enzymes, amaphwanya michere ndikuthandizira kuyamwa kwawo ndi makoma a matumbo ang'onoang'ono.

Zikondazo zimapanga pafupifupi malita 4 a madzi a kapamba tsiku lililonse, omwe amayanjanitsidwa ndendende ndi kuperekedwa kwa chakudya m'mimba ndi duodenum. Makina ovuta a kapamba omwe amagwira ntchito amaperekedwa ndi kutengapo gawo kwa ziwalo za adrenal, parathyroid ndi chithokomiro cha chithokomiro.

Ma mahomoni opangidwa ndi ziwalo izi, komanso mahomoni monga secretin, pancrosin ndi gastrin, omwe ndi zotsatira za chimbudzi, amazindikira kusintha kwa kapamba pamtundu wa chakudya chomwe atengedwa - kutengera zomwe zimapezeka, chitsulo chimapanga ma enzymes omwewo omwe amatha kupereka kugawa kwawo kogwira mtima kwambiri.

Kapangidwe ka kapamba

Dzinalo lolankhulidwa limalongosola malo ake mthupi la munthu, monga: pansi pamimba. Komabe, mwakutero izi zingakhale zothandiza kwa munthu amene ali paudindo waukulu. Mwa munthu woyimirira, m'mimba komanso kapamba ndizofanana. Kapangidwe ka kapamba kumawonekera bwino mu chithunzi.

Anatomically, chiwalocho chimakhala ndi mawonekedwe, chomwe chimafanana ndi comma. Mankhwala, magawano wamba a ziwalo m'magawo atatu amavomerezeka:

• Mutu wopanda 35 mm, moyandikana ndi duodenum, ndipo wopezeka mulingo woyamba - III wa lumbar vertebra.
• Thupi limakhala lopangika mosiyanasiyana, osayeza 25 mm ndikuwonekera pafupi ndi I lumbar vertebra.
• Mchira wokhala ndi kukula osapitirira 30 mm, wotchulidwa mawonekedwe a conical.

Kutalika kokwanira kwa kapamba munthawi yabwinobwino kuli kosiyanasiyana mwa 160-230 mm.

Gawo lake lokwera kwambiri ndi mutu. Thupi ndi mchira pang'onopang'ono, zimathera pazipata za ndulu. Magawo onse atatuwa amaphatikizidwa ndi kapisozi - chipolopolo chopangidwa ndi minofu yolumikizira.

Kusintha kwa kapamba mu thupi la munthu

Zokhudzana ndi ziwalo zina, kapamba amapezeka munjira yolingalira kwambiri ndipo amapezeka mu retroperitoneal patsekeke.

Anatomically, msana umadutsa kumbuyo kwa chithokomiro, kutsogolo - m'mimba, kumanja kwake, kuyambira pansi ndi pamwamba - duodenum, kumanzere - ndulu. Mimba ya msempha, a lymph node, ndi celiac plexus ili kuseri kwa kapamba. Mchira umapezeka kumanja kwa ndulu, pafupi ndi impso kumanzere ndi kumanzere kwa adrenal gland. Chikwama cha sebaceous chimalekanitsa kutulutsa ndi m'mimba.

Komwe kuli kapamba wokhudzana ndi m'mimba ndi msana akufotokozera kuti mu gawo lowopsa ululu wammbuyo umatha kuchepetsedwa m'malo okhala wodwalayo, atatsamira pang'ono. Chiwonetserochi chikuwonetsa bwino kuti ndi mawonekedwe a thupili, katundu pa kapamba ndizochepa, popeza m'mimba, kutuluka mphamvu chifukwa cha mphamvu yokoka, sikukhudza chisa chake chifukwa cha kuchuluka kwake.

Kapangidwe ka histanc kapamba

Pancreas ili ndi mawonekedwe a-alveolar-tubular, chifukwa cha ntchito ziwiri zazikulu - kutulutsa madzi a pancreatitis ndi mahomoni achinsinsi. Pamenepa, gawo la endocrine, pafupifupi 2% ya kuchuluka kwa ziwalo, ndi gawo lakudziko, pafupifupi 98%, limasungidwa ku England.

Gawo la exocrine limapangidwa ndi pancreatic acini ndi dongosolo lovuta la ma ducts. Ziphuphuzi zimakhala ndi ma pancreatocytes pafupifupi 10 ophatikizika wina ndi mzake, komanso maselo a centroacinar (epithelial cell) a ma excretory ducts. Kupyola mu ma ducts awa, chinsinsi chomwe chimapangidwa ndi gland chimalowa koyamba mu ma ducts amkati, kenako ndikulowetsa ma interlobular, ndipo, pomalizira pake, chifukwa cha kusakanikirana, kulowa mkati mwamphamvu kwambiri.

Gawo lakumapeto kwa kapamba limakhala ndimalo omwe amatchedwa a Langerans omwe amakhala mchira ndipo lili pakati pa acini (onani chithunzi):

Zilumba za Langerans sizinthu koma kanthu wamba kwamaselo omwe mulifupi mwake ndi 0,4 mm. Chuma chonse chimakhala ndi miliyoni miliyoni ya maselo amenewa. Zisumbu za Langerans zimasiyanitsidwa ndi acini pogwiritsa ntchito minyewa yopyapyala, ndipo zimabooleredwa ndi miyeso yambiri.

Maselo omwe amapanga zilumba za Langerans amapanga mitundu isanu ya mahomoni, pomwe mitundu iwiri, glucagon ndi insulin, zimapangidwa kokha ndi kapamba, ndikuchita mbali yayikulu pakuwongolera njira ya metabolic.