Kodi magazi amapezeka bwanji ku kapamba?

Kupereka magazi kapamba imachitika kuchokera ku dziwe la hepatic, splenic and super mesenteric. A. rancreaticoduodenalis apamwamba, omwe ndi nthambi ya gastro-duodenal artery, agawika magawo awiri ndi nthambi zam'mbuyo, zomwe zimalumikiza kumapeto ndi nthambi zofananira zam'munsi zapancinic-duodenal. Kuchokera kwa iwo kumachoka ku 3 mpaka 7 mitsempha yopereka mutu wa kapamba ndi duodenum. Thupi ndi mchira wa kapamba amalandila magazi kuchokera ku splenic artery, yomwe imawapatsa iwo kuyambira 2 mpaka 9 nthambi za pancreatic (rr. Pancreatici).

Kuphulika kwaphokoso amapezeka kudzera mwa spentic, apamwamba komanso otsika mesenteric, minyewa yamanzere yam'mimba, yomwe imaloledwa mwa mitsempha ya portal. Tiyenera kudziwa kuti mitsempha ya thupi ndi mchira wa kapamba ndizolumikizana bwino ndi mitsempha ya kumanzere kwa adrenal gland ndi malo a retroperitoneal, i.e. ndi machitidwe otsika vena cava (port-caval anastomosis).

Lymph ngalande limapezeka m'malo oyamba a dongosolo loyambirira (lnn. pancreaticoduodenales superiores et inferiores, spancici, retropylorici), komanso m'malo amtundu wachiwiri, omwe ndi celiac node (lnn. coeliaci).

Zopezeka Zikondamoyo zimanyamula ulusi wachisoni wamalingaliro akulu ndi ang'ono amkati, omwe amasokonezedwa mu ganglia ya celiac plexus ndikuyandikira gland. Ulusi wamitsempha ya parasympathetic yochokera ku mitsempha ya vagus (makamaka kuchokera kumanzere) ndi preganglionic. Kuphatikiza apo, ma mesenteric apamwamba, splenic, hepatic ndi kumanzere kwa impso amagwira nawo ntchito yopulumutsira kapamba. Mitsempha yambiri yamanjenje imalowetsedwa mu ndulu moyanjana mozungulira mzere wake. (Onani gawo la Vegetative Nervous System).

Spleen (zabodza, utsi)

Kupereka magazi ndulu imaperekedwa ndi splenic artery - nthambi ya mtengo wa celiac. Khomalo limathamangira kumanzere pafupi m'mphepete mwa kapamba, ndikupatsako. ransgeatici. Pafupi ndi zipata za ndulu, dzungu limapereka gastric yotseka komanso mbali yakumanzere. Nthawi zina mitsempha imeneyi imalowa m'dera la chipata chotsekeka kuchokera kunthambi za spellic artery.

Kuphulika kwaphokoso. Mitsempha ya splenic imakhala ndi mulifupi mwake maulendo awiri kuposa mtsempha wam'mimba, ndipo imapezeka nthawi zambiri pansi pake. Kudutsa kuchokera kumanzere kupita kumanja kutsogolo kwa kapamba, msempha wamphongo umalumikizana kumbuyo kwa mutu wa kapamba ndi msempha wapamwamba kwambiri, ndikupanga thunthu lalikulu la mitsempha yapa portal.

Lymph ngalande limapezeka m'malo a lymph node a dongosolo loyamba, lomwe lili pazipata za ndulu (lnn. splenici). Malo a sekondale ndi ma celiac lymph node omwe amakhala mozungulira muzu wa thunthu la celiac.

Mu kupatula ndulu zimakhudza celiac, lamanzere diaphragmatic, lamanzere adrenal nerve plexus. Nthambi zomwe zimachokera ku izi zimapanga splenic plexus yozungulira mozungulira dzanzi. (Onani gawo la Vegetative Nervous System).

Pancreatic magazi

Kupereka magazi kwa kapamba nthambi za hepatic, splenic komanso masters apamwamba a mesenteric. Pamwamba pamutu wamatumbo kumachitika a. gastroduodenalis, pomwe amachoka a. pancreaticoduodenalis apamwamba, ndikupereka nthambi zakutsogolo ndi kumbuyo.

A. pancreaticoduodenalis otsika nthawi zambiri amayamba kuchokera kumtundu wapamwamba wa mesenteric kapena kuchokera ku nthambi yake. Amagawidwanso kukhala nthambi zakunja ndi zapambuyo. Pamwamba komanso kutsikira mitsempha ya pancreatoduodenal anastomose ndi wina ndi mnzake, ndikupanga timakhonde tambiri, tomwe nthambi zimayambira mpaka mutu wa kapamba ndi duodenum.

Makamaka lalikulu limachokera ku splenic artery komanso nthawi zambiri kuchokera ku hepatic wamba kapamba, a. rapeseatica magna, yemwe kumbuyo kwa thupi la gland amapita m'munsi mwake, pomwe amagawika nthambi zamanja ndi zamanzere. Kuphatikiza pa chotupa ichi, kumchira ndi thupi la zofunitsa kuchokera ku. splenica (lienalis) kuchoka rr. kapamba.

Kapangidwe ka histanc kapamba

Zikondazo zimatulutsa madzi okwanira 1.5 malita a pancreatic patsiku. Kuphatikiza pa iye, zazikulu, zovuta, komanso zopanda ziwalo zina zamthupi zomwe zimatulutsa kuchuluka kwazobisika zimaphatikizapo mammary, lacrimal, salivary yayikulu.

Kutulutsa kwa gland kumachitika chifukwa cha ntchito yomwe imagwira: endocrine ndi m'mimba. Izi ndizotheka chifukwa cha m'mbiri ya kapangidwe ka kanyumba. Lili ndi:

• kuchokera ku lobules (acini), olekanitsidwa ndi septa minyewa yolumikizana, momwe zotengera, ulusi wamanjenje, zonyansa zazing'ono zazing'ono zimadutsa,
• zilumba za Langerhans zomwe zili pakati pa zipini. Zimapangidwa ponseponse mu minofu ya tinyezi tosiyanasiyana, koma zochuluka zimagwera mchira wa chiwalocho.

Ziphuphu zokhala ndi ma ducts ena okhudzana ndi momwe timakhalira ndi maziko a kapamba. Lili ndi:

• ma pancreatocytes ochokera ku 8−12 maselo a mawonekedwe ofanana, okhala ndi mipando yake mpaka pakati,
• duct maselo a epithelial: akaphatikizana, amayamba kupangika.

• nsabwe za acini,
• zapakati
• chodabwitsa,
• kulumikizana
• wamba wirsung duct kapamba.

Kapangidwe ka mpanda wa ma ducts zimatengera kukula kwa duct yokha. Ku Wirsung, kudutsa kutalika konse kwa kutulutsa, pali maselo otchinga khoma omwe amatsekemera madzi a kapamba ndipo amatenga nawo mbali m'dera la endocrine.

Zisumbu za Langerhans zikuyimira kocheperako, koma kosafunikira kwenikweni.

Mbiri yaifupi ya chisumbucho: imakhala ndi mitundu isanu ikuluikulu ya maselo omwe amatulutsa mahomoni. Mtundu uliwonse wa khungu ndi voliyumu yosiyana ndi dera la islet ndipo limapanga mahomoni enaake:

• alpha (25%) - glucagon,
• beta (60%) - insulin,
• delta (10%) - somatostatin,
• PP (5%) - vasoactive matumbo polypeptide (VIP) ndi pancreatic polypeptide (PP),
• maselo a epsilon (ochepera 1%) - ghrelin.

Maselo a Beta ali pakatikati, ena onse amawazungulira mozungulira paripere.

Kuphatikiza pa mitundu ikuluikuluyi, maselo ac200let omwe ali ndi mitundu yosakanikirana ya endo- ndi exocrine amapezeka paliponse.

Magazi ochepa

Zikondamoyo sizikhala ndi zake zonyamula ziwalo. Njira yoperekera magazi imachokera ku aorta (gawo lake lam'mimba). Thunthu la celiac limabowolerana, ndikugawana ziwiya zomwe zimapereka magazi kwa kapamba. Amapanga maukonde onse a mitsempha yaying'ono yamagetsi ndi ma arterioles. Onse omwe akukhudzidwa ndi magazi:

• ziwiya zapamwamba zakunja ndi zam'mbuyo za kapamba,
• m'munsi pancreatoduodenal mtsempha wamagazi ndi nthambi zakunja ndi zapambuyo,
• mitsempha yam'munsi yapancreatic,
• dorsal pancreatic
• kugwedezeka kwamchira.

Iliyonse ya ziwiya zotere imayiyika m'mitsempha yaing'ono yaying'ono mpaka ma arterioles ang'ono kwambiri ndi ma capillaries omwe akukhudzidwa ndi magazi ku gawo lililonse la kapamba.

Mitsempha ya Lymphatic imachitika kudzera m'mitsempha ya m'mimba yomwe imayenda m'mitsempha yamagazi: zamitsempha zimayenderera mumagawo a pancreatoduodenal ndi ma pancreas lymph, kenako kulowa mu celiac ndi splenic.

Kuphulika kwaphokoso

Kuchokera ku boles ndi ma islets, magazi a venous ophatikizidwa ndi kaboni diokosijeni amalowa kudzera pa intaneti yokhala ndi nthambi zambiri zamitsempha yama minyewa ndi mitsempha yolowera mu dongosolo la infa ya vena cava ndi mitsempha ya portal. Poyamba, magazi amadutsa:

• kudzera mesenteric (kumtunda ndi wotsika),
• Mitsempha ya splenic
• chapamimba
• portal

Magazi a venous atadutsa m'chiwindi kudzera mu vena cava wotsekemera amalowa mumtima, ndikumaliza magazi ambiri.

Matenda a pancreatic

Ndikosavuta kudziwa komwe kumayambitsa matenda am'magazi komanso kupezeka kwa kapamba. Psychology yotereyi siyodziyimira payekha, koma imayamba chifukwa cha matenda oopsa a mtima. Zikatero, zisonyezo za matenda oyambira zimadziwika.

Kuzindikira kumachitika chifukwa cha matenda omwe alipo omwe amayamba ndi kuchepa kwa magazi. Amayambitsa kusintha kwa parenchyma ndi kufa pang'onopang'ono kwa maselo othandizira pancreatic ndikusintha m'malo mwa minyewa yolumikizana - ma fibrosis amatulutsa, ziwalo zonse zimagwira. Kasitomala ndi chiwalo chomwe chimakhudzidwa ndi zinthu zazing'ono zakunja ndi zamkati. Kusintha kulikonse kwamagazi kapena zakudya kumabweretsa matenda akulu.

Zomwe zimayambitsa ndi zizindikiro za zovuta

Zosintha mu tiziwalo ta kapamba zimakhudzana ndimatenda am'mimba omwe amachitika:

• ndi atherosulinosis,
• ndi kulephera kwa mtima,
• ndi ochepa matenda oopsa chifukwa cha atherosulinosis.

Choyambitsa chimatha kukhala pang'onopang'ono komanso kwa nthawi yayitali kukhala ndi matenda osokoneza bongo, kapena pancreatitis yovuta kwambiri yomwe imayamba mwadzidzidzi popanda chifukwa chodziwika bwino. Chochititsa chidwi ndi kuphwanya myocardial.

Pancreatic vascular thrombosis ndiyowopsa. Thrombosis imawonjezera matenda oopsa, thrombophlebitis, infarction ya myocardial. Kusokonezeka kwa magazi kumachitika ndi atherosclerosis, pamene makoma amitsempha yama calibers osiyanasiyana amasinthidwa.

Ndi kulephera kwa mtima komwe kulipo, kuphwanya kwa venous kutuluka kwa magazi kumachitika, komwe kumayambitsa pancreatic edema, kukula kwake kwakukulu, komanso kusagwira ntchito. Kutupa kumachitika mu parenchyma, yomwe imatsimikiziridwa ndi kuwonjezeka kopanda magazi ndi mkodzo diastases.

Choopsa kwambiri chomwe chimayambitsa kuphwanyidwa kwa magazi ndi mowa. Zimayambitsa kuchepera kwa ziwiya zazing'onoting'ono, chifukwa zomwe maselo amthupi amasiya kulandira michere ndi mpweya wabwino. Izi zimawatsogolera kuti afe ndipo amatha kuyambitsa necrosis kwathunthu.

Chithandizo cha matenda a mtima

Palibe chithandizo chamankhwala chovutitsidwa chamkati ndi kusintha kwa kapamba. Matenda oyambira amathandizidwa. Ndi njira yofikira patali, pamene kusintha kwamatenda kapena ma necrotic amayamba mu kapamba wa pancreas parenchyma, wotsimikiziridwa ndi maphunziro ogwira ntchito ndi a labotale, mankhwala ovuta a kapamba amalembedwa. Mulinso:

• chakudya chokakamizidwa - tebulo nambala 5,
• enzyme m'malo mankhwala
• ngati kuli kotheka - antispasmodics, painkillers ndi mankhwala omwe amaletsa kupanga hydrochloric acid.

Ngati chithandizo sichikuchitika, komanso ngati pali vuto lalikulu la matenda otaya magazi, matenda a shuga amayamba pakapita nthawi. Izi zimachitika chifukwa cha kufa kwa timabwaloli ta Langerhans komanso kuchepa kwa kapangidwe ka mahomoni akuluakulu - insulin.

Zotsatira za kuwonongeka kwa kosungidwa kwa kapamba

Pancreas parenchyma imakhala ndi netiweki yama nerept receptors. Zikondamoyo, monga ziwalo zonse, zimayendetsedwa ndi dongosolo lamanjenje lamanjenje - nthambi za vagus nerve (n. Vagus dexter). Amayang'anira ntchito ya exocrine - kupanga ndi kubisalira kwa michere. Zovuta zam'mimba zomwe zimachokera kumapeto kwake a mitsempha zimathandizira kupanga ma enzyme.

Amalumikizidwa ndi dipatimenti yachifundo kudzera pazingwe zazing'ono zomwe zimachokera ku ma plexuse:

• zamankhwala
• otupa
• celiac
• chapamwamba mesenteric.

Gawo lazachifundo lamanjenje limabweretsa zotsatirapo zotsatirazi: kuyamwa kwa thunthu la celiac kumapangitsa kutsekeka kwa katulutsidwe ka madzi a pancreatic. Koma kukhudzana kwanthawi yayitali ndi maselo a tsinde kumayendera limodzi ndi kuchuluka kwa michere.

Mitsempha yamagazi yomwe imapereka magazi ku zikondamoyo imalumikizidwa ndi ulusi womvera chisoni: imayendetsa kamvekedwe ka makoma a venous.

Ma labules, opangidwa ndi minyewa ya glandular yomwe imatulutsa katulutsidwe ka pancreatic ndi ma enzyme, amalekanitsidwa ndi magawo, omwe amayikidwa matupi odzitukumula a Fater-Pacini.

Zilumba za Langerhans, zomwe maselo ake amapanga mahomoni ofunikira 11, amakhala ndi mbali imodzi ndi acini ndi magulu a zigawenga za dongosolo la ziwopsezo zam'magazi.

Kuwonongeka kwa mitsempha pamlingo uliwonse kumabweretsa kukula kwa zovuta za hemodynamic ndi neurovegetative mu kapamba. Izi zimapangitsa kusintha kwakukulu osati mu zofunikira zokha, komanso mu ziwalo zolumikizana komanso zimagwira ntchito zina. Kuchiza pazinthu zotere kumakhala kovuta komanso kumakhala kwa nthawi yayitali.