Madzi a pancreatic

Mchere wofunikira kwambiri wokumba ndi madzi a pancreatic . Ntchito ya chimbudzi chomanga chofunikira kwambiri ichi chitha kufufuzidwa pogwiritsa ntchito fistula ya duct yake, malinga ndi njira yomwe I.P. Pavlov idapereka. Chifukwa cha ichi, chidutswa cha khoma la duodenum chomwe chimatseguka, chimadulidwa ndikutchingira pakhungu lam'mimba, ndipo kukhulupirika kwamatumbo kumayambiranso. Mchere wa alkaline wotuluka kuchokera ku fistula umawononga khungu ndikusokoneza machiritso a suture. Chifukwa chake, pambuyo pa opareshoni, nyamayi imafunikira chisamaliro mosamala.

Madzi a pancreatic amatha kupezeka muzochitika zowawa. Kuti muchite izi, tsegulani zamkati mwa nyama ndikuyiyika chubu momwe timadziti timatuluka kulowa mumtsempha.

Pancreatic Madzi Achipangidwe

Trypsin ndi puloteni yovuta ndipo imakhala ndi proteinase (trypsin itself), yomwe imaphwanya mamolekyulu, ndi ma polypeptidases, omwe amaphwanya zinthu zomwe zimapangitsa kuti zinthu ziwonongeke - albumoses ndi peptones. Imakola gawo lalikulu la chotsiriziracho kukhala peptides kapena ma amino acid. Amakhulupirira kuti chancosin ya pancreatic juwisi, yomwe imagwira mapuloteni amkaka, nawonso ndi gawo la trypsin (chymotrypsin). Trypsin imachotsedwa mu mawonekedwe osagwira, ndiye kuti imayendetsedwa ndi enzyme yapadera - enterokinase, yopangidwa ndi ziwalo zam'mimba. Chifukwa chake, trypsin imafalitsa zotsatira zake mtunda wawukulu kudutsa matumbo, momwe mumakhala othandizira kulikonse. Oyeserera a Trypsin amathanso kukhala ma organic acid omwe amapezeka mu bile ndikupangidwira pakuwonongeka kwa michere, mafuta acids ndi amino acid

Enzyme ya nuc tafadhali imaphwanya ma nucleic acid.

Madzi a pancreatic amylase amatha kugaya wowuma ndi glycogen kuti amere. Maltose amathyoledwa ndi maltase mpaka glucose.

Lactase amachita pamkaka wa mkaka.

Pancreatic juisi mafuta enzyme - lipase imaphwanya mafuta apakati kuti glycerol ndi mafuta acids.

Pancreatic secretion regulation

Machitidwe akudya mwachangu amathandizira kulekanitsa madzi. Zoyeserera zodyetsa m'maganizo agalu okhala ndi fistula ya zikondamoyo zinawonetsa kuti patatha mphindi 2-3 atayamba kudyetsa, kulekanitsa madzi kumayamba. Komabe, kuchotsa kwakukulu kwa madzi kumachitika pamene zomwe zili mkati mwake zimalowa kuchokera m'mimba kupita mu duodenum. Zambiri kuchokera pamalowo http://wiki-med.com

Kulekanitsidwa kwa madzi a pancreatic, poyankha kudya kwa hydrochloric acid pamimba, Pavlov amawona ngati Reflex. Amakhulupirira kuti hydrochloric acid imagwira pama receptor a duodenum, omwe amachititsa kuti madzi azigawanika. Pambuyo pake, zidatsimikiziridwa kuti kulekanitsa kwa madzi a pancreatic kumachitika mchikakamizo cha mahomoni apadera - secretin, yomwe imapangidwa mucous membrane wa duodenum mothandizidwa ndi hydrochloric acid ndipo amadzibisa kuti ayike magazi. Izi zimatsimikiziridwa ndikuti kuphipha kwa mucous membrane wa matumbo awa mu njira yofooka ya hydrochloric acid, yomwe imalowetsedwa m'magazi, imathandizira kubisala kwa madzi a pancreatic. Komabe, pali umboni wosonyeza kuti siriyo siimagwira m'mitsempha yodutsayo. Iyo, zikuwoneka kuti, imagwira gland osati mwachindunji, koma kudzera mu mathero a mitsempha. Madzi a pancreatic pang'ono, koma olemera kwambiri mu michere ndi ma enzymes, amasiyanikanso ndikulipiritsa kwa kumapeto kwa mitsempha ya vagus ndi magetsi amagetsi.

Ma pancreatic juisi yopatukana ma feed osiyanasiyana ndi ofanana ndi ma gastric juisi olekanitsa ma curve, popeza kupatukana kwa madzi a kapamba kumapangitsidwa ndi hydrochloric acid, komanso kuchuluka kwa kuphatikiza kwa madzi a pancreatic kumadalira kuchuluka kwa madzi am'mimba omwe amalowa m'matumbo.

Zikondwerero

Zikondwerero - chitsulo chachiwiri chachikulu pamakina am'mimba, kukula kwake ndi 60-100 g, kutalika ndi 15-22 cm.

Mphepoyi imakhala ndi utoto wofiirira, wobera, mpaka kolowera kuchokera ku duodenum 12 kupita ku ndulu. Mutu wake waukulu umapezeka mkati mwa bokosi la akavalo lopangidwa ndi duodenum 12. Kutikisaku kumakutidwa ndi chifuwa chopepuka.

Zikondazo zimakhala ndi tiziwalo timene timatulutsa timadzi tambiri: exocrine ndi endocrine. Gawo lokhala ndi chimbudzi limatulutsa 500-700 ml ya pancreatic juice masana, lomwe limakhala ndi ma enzymes omwe amathandizira kugaya mapuloteni, mafuta ndi chakudya. Gawo la endocrine la kapamba limapanga mahomoni omwe amawongolera chakudya komanso mafuta metabolism (ma insulins, glucagon, somatostatin, etc.).

Gawo lazopanda pancreas ndi tinthu tating'onoting'ono ta alveolar-tubular, ogawika magawo ndi kulumikizana kocheperako kwambiri komwe kumachokera ku kapisozi. Acinuses opangidwa ndi acinocyte (ma pancreatic cell) amapezeka pafupi ndi lobules. Maselo amayanjana kwambiri.

Acinus wokhala ndi duct yophatikizira ndi gawo lochita komanso lothandiza la mbali ya khunyu. Chinsinsi chake chimalowa ndikuwala kwa ma acinus. Kuchokera pazitsitsi zomwe zayikidwazo, chinsinsi chimalowa pazitseko za intralobular. Tizilombo tating'onoting'ono tomwe timazunguliridwa ndi minyewa yolumikizana yotayirira imalowa kulowa m'makumba amtunduwu, omwe amalowerera mumkamwa mwa kapamba ndipo, polumikizana ndi duct wamba wa bile, amalowa ndi lumen ya duodenum.

Gawo la endocrine la kapamba limapangidwa ndimagulu a ma cell - ma pancreatic islets. Chiwerengero cha ma pancreatic islets mu akulu chimachokera ku 1 mpaka 2. Ntchito ya endocrine gawo la kapambafotokozedwa mu gawo la Endocrine System.

Mapangidwe, kapangidwe kake ndi zinthu za pancreatic madzi

Zikondamoyo zamunthu pamimba yopanda kanthu zimabisala pang'ono zobisika. Akalandira chakudya kuchokera m'mimba kulowa duodenum 12, kapamba amunthu amatulutsa msuzi pafupifupi 4,7 ml / min. Masana, malilogalamu 1.5-2,5 amadzimadzi a kapangidwe kake amamasulidwa.

Madzi ndi madzi opanda mandala owoneka ndi madzi okwanira 987 g / l. Pancreatic madzi amchere alkaline (pH = 7.5-8.8). Madzi a pancreatic amatenga gawo pazandale ndi zamchere pazakudya zam'mimba zopezeka m'mimba mu duodenum 12, ali ndi michere yambiri yomwe imakumba mitundu yonse ya michere.

Gome. Zigawo zikuluzikulu za pancreatic secretion

Zizindikiro

Feature

Mphamvu yapadera, g / ml

NSO - ₃ - mpaka 150 mmol / L, komanso Ca 2+, Mg 2+, Zn 2+, NRA₄ 2-, ZONSE₄ 2-

Trypsin, chymotrypsin, carboxypeptidase A ndi B, elastase

Lipase, phospholipase, cholesterolipase, lecithinase

Kubisala kwa madzi a pancreatic kumawonjezeka kwambiri pambuyo pa mphindi 2-3 mutatha kudya ndikumatha maola 6-14. Kuchuluka kwake, kapangidwe kake kamadzimadzi, komanso mphamvu ya katulutsidwe kamatengera kuchuluka ndi chakudya. Kwambiri acidity ya zakudya zam'mimba zomwe zimalowa mu duodenum, timadzi tokoma kwambiri timatulutsa.

Pancreatic secretion magawo

Kubisirana kwa kapamba mukakhudzidwa ndimakudya kumakhala ndi mawonekedwe ndipo pamadutsa magawo angapo.

Choyamba, kapena nseru, gawo lotseguka limatsimikiziridwa ndi mtundu, kununkhira kwa chakudya ndi zina zoyipa zomwe zimakhudzana ndi kudya (mawonekedwe a Reflex irritations), komanso zomwe zimapangitsa pakamwa pakulandila mkamwa, kutafuna ndikumeza (mosasamala mawonekedwe a Reflex). Zisonyezero zamitsempha zomwe zimatuluka mu ma receptor zimafika medulla oblongata kenako kudzera mu ulusi wamkati wa vagus zimalowa mu gland ndikuyambitsa kubisala kwake.

Chachiwiri, kapena cham'mimba, gawoli limadziwika chifukwa chakuti chinsinsi cha gland chimakhudzidwa ndikuthandizidwa ndi Reflex kuchokera kumakina- ndi chemoreceptors am'mimba.

Ndi gawo la zomwe zili m'mimba mu duodenum, lachitatu limayamba, kapena matumbo, gawo la secretion limagwirizanitsidwa ndi zochita pa mucous nembanemba wa duodenum 12 zake acidic nkhani. Njira yobisalira imapangidwira kuti ichitike mwachangu pobisalira ka michere ya pancreatic ku mtundu wa chakudya chomwe chatengedwa. Kudya kumapangitsa kuchuluka kwa michere yonse mumadzimadzi, koma kwa mitundu yosiyanasiyana ya chakudya kuwonjezeka kumeneku kumawonetsedwa mosiyanasiyana. Zakudya zomwe zimakhala ndi chakudya chamagulu ambiri zimapangitsa kuchuluka kwa michere (ma enzymes omwe amaphwanya chakudya), mapuloteni - trypsin ndi trinsinogen, zakudya zamafuta - lipase, i.e. kapamba amapanga ndi kuyambitsa enzyme yochulukirapo yomwe imapatsa mphamvu michere m'zakudya.

Chimbudzi m'matumbo aang'ono

Kupukusa m'matumbo aang'ono (duodenum, jejunum ndi ileum) kumathandizira kuti ma hydrolysis azinthu zambiri za chakudya apange ma monomers, mwanjira yomwe michere imatha kuyamwa kuchokera m'matumbo kulowa m'magazi ndi zamitsempha. Chimbudzi mu izo ikuchitika mchikakamizo cha pancreatic madzi michere mu matumbo patsekeke (kugaya chakudya komanso pansi pa zochita za ma enzymes okhazikika pa microvilli ndi glycocalyx mafilimu (chimbudzi cha parietal). Zina mwa michereyi zimapangidwa ndi kapamba, ndipo zina ndi tiziwalo timene timatulutsa khoma lamatumbo. Gawo lomaliza la chimbudzi m'matumbo ang'onoang'ono ndi kudzimbidwa pamatumbo am'mimba (nembanemba chimbudzi), yomwe ikuchitika mothandizidwa ndi michere ya minyewa ya m'mimba khoma lamatumbo ndikuyenderana ndi mayamwidwe a michere.

Udindo waukulu pakukokoloka kwa chakudya m'mimba yaying'ono ndi wa machitidwe omwe amachitika mu duodenum. Chymeic acidic chomwe chimalowa m'mimba chimayimiriridwa ndi zotsalira zomwe zimapangidwa ndimakina ndikugaya pang'ono. Muli mafuta osapatsika mu mawonekedwe a triglycerides, cholesterol esters, phospholipids, mapuloteni omwe amaphatikizidwa ndi ma polypeptides ndi oligopeptides, opukusidwa pang'ono komanso osapatsika mafuta mu mawonekedwe a wowuma, glycogen, CHIKWANGWANI, komanso ma acid okhala ndi michere. Chifukwa chake, kuti chimbudzi chawo chizigwira, chimbudzi chimbudzi chiyenera kutulutsa ma enzyme ambiri ndi zotheka kuti ziwonetsere ntchito yawo ziyenera kupangidwa m'matumbo.

Kapangidwe ka zinthu zoterezi kumayamba chifukwa chakuti chyme chimasinthidwa pang'onopang'ono ndi mabicarbonates a madzi a kapamba, matumbo ndi bile. Zochita za pepsin mu duodenum zimatha, popeza pH yomwe ili mkati mwake imasinthidwa kupita kumalo amchere, mpaka 8,5 (kuyambira 4 mpaka 8.5). Ma bicarbonate, zinthu zina zopanda pake ndi madzi zimasungidwa mu madzi a pancreatic ndi ma epithelial cell a tubules ndi ducts a gland. Kutulutsa kwa bicarbonates kumatengera pH pazomwe zili m'matumbo ndikuwonjezera acidity yake, zinthu zamchere zambiri zimamasulidwa, kutulutsidwa kwa chyme mu jejunum kumachepera.

Ma pancreatic juice michere amapangidwa ndi epithelium ya acini wa gland. Mapangidwe ake zimatengera mtundu wa chakudya chochulukirapo komanso njira zingapo zoyang'anira.

Pancreatic juisi katulutsidwe ndi malamulo ake

Mitundu yayikulu ya proteinolytic ya pancreatic madzi imasungidwa mu mawonekedwe a zymogens, i.e. wopanda ntchito. Awa ndi trypsinogen, chymotrypsinogen, proelastase, procarboxypeptidase A ndi B. Mphamvu yothandizira ya trypsinogen ndikusintha kwake kukhala trypsin ndi enterokinase (endopeptidase), yopangidwa ndi duodenal mucosa. Mapangidwe a trypsin amodzi ndi autocatalytic. Trypsin imayambitsa kupangika kwa mitundu ya ma chymotrypsin, elastase, carboxypeptidases A ndi B, komanso njira yotulutsira ya enterokinase. Trypsin, chymotrypsin ndi elastase ndi endopeptidases. Amaphwanya mapuloteni ndi ma polypeptides okwera kwambiri mpaka ma peptides ochepa a kulemera ndi amino acid. Carboxypeptidases A ndi B (exopeptidases) akhazikika peptides ku amino acid.

Gome. Hydrolytic zochita za pancreatic michere

The enzyme

Malo opangira hydrogen

Proteolytic

Zomangira zamkati zamkati mwa zotsalira zapafupi za amino acid

Kuongolera kwa chinsinsi cha pancreatic gland

Zachisoni

Zoseketsa

Mitundu ya Reflexes pamlingo

Zomera zam'madzi zamkati

Zoyenera

Parasympathetic

Mahomoni kapena zinthu zolimbitsa thupi

1,2,3,4,5,6,7,8 (onani pansipa)

(onani pansipa)

Kukondoweza

Kubwera

Kukondoweza

Kubwera

Zotsatira zomaliza

Kutenga kwa katulutsidwe

Mtengo wowongolera chinsinsi

Zomwe zimapangidwira pakuyang'anira pancreatic secretion:

Zolimbikitsa kukhala ndi mahomoni:

1 - secretin, 2 - cholecystokinin-pancreosimine, 3 - gastrin, 4 - insulin, 5 - bombesin, 6 - chinthu P (neuropeptide), 7 - mchere wa bile, 8 - serotonin.

Kuchita kanthu kukhala ndi mahomoni:

1 - glucagon, 2 - calcitonin, 3 - ZhIP, 4 - PP, 5 - somatostatin

VIP ikhoza kusangalatsa ndikuletsa pancreatic secretion.

Kukula kwakapangidwe kazachilengedwe ka cellin ndi cholecystokinin-pancreosimine:

Udindo wotsogola wa kupweteka kwa pancreatic secretion ndi wa m'mimba m'mimba: secretin, cholecystokinin-pancreosimine. Achinsinsi amachititsa kuti amasulidwe amadzimadzi ambiri a pancreatic okhala ndi ma bicarbonates, chifukwa amathandizira maselo am'mimba a epithelial a ducts. Cholecystokinin-pancreosimine imagwira makamaka pancreatic acinus pancreatocytes, motero, msuzi wobisika umakhala ndi michere. Achinsinsi opangidwa ndi endocrine S-cell of the wall of duodenum 12 in the state state of activretin, yomwe imayikidwa ndi HCl ya gastric chyme. Kusankha cholecystokinin-pancreosimine yochitidwa ndi ma-I-cell a khoma la duodenal pansi pa kukondoweza kwa zinthu zomwe zimapangidwa ndi hydrolysis yoyambirira ya mapuloteni a chakudya ndi mafuta, komanso ma amino acid.

Chiwindi ndi ntchito yambiri yogwira ntchito ndi endocrine komanso exocrine. Ndiye chimbudzi chachikulu kwambiri m'mimba. Monga gland ya endocrine, imatenga gawo mu metabolism ya mapuloteni, mafuta ndi chakudya. Monga exocrine - imatulutsa bile.

Kapangidwe kake ka chiwindi ndi hepatic lobule. Amakhala ndi mitengo ya chiwindi, yomwe, imapangidwa ndi ma cell a chiwindi - hepatocytes. Mizere yayikulu ya bile capillaries imakhala pakati pa mizere ya hepatocytes yomwe imapanga mtanda. Ma capillaries omwe ali pamphepete mwa matabwa a hepatic amadutsa m'mitsempha ya bile. Bile imasungidwa ndi hepatocytes mu lumen ya bile capillaries. Ma capillaries awa ndi machitidwe pakati pa hepatocytes oyandikana. Kuchokera ma bile capillaries, kudzera mu ma lobular kapena ma bullobular bile ducts, bile imalowa m'matumbo akuluakulu a bile omwe amayenda ndi nthambi ya portal.

Pambuyo pake, ziwiya za bile zimapangika pang'onopang'ono ndipo mafomu a hepatic duct m'dera la chipata cha chiwindi. Kuchokera pa duct iyi, bile imatha kulowa kudzera mu cystic duct mu ndulu kapena mu duct wamba wa bile. Kuchekera uku kumatsegukira mu duodenum m'dera la duodenal nipple (isanayende, wamba duct ya kawirikawiri imagwirizanitsa ndi pancreatic). Pamalo pakamwa pa wamba duct ili sphincter wa Oddi.

Limagwirira a bile mapangidwe:

Mchere Wamchere: mu hepatocytes kuchokera ku cholesterol, ma asidi achilengedwe apamwamba amapangidwa - cholic ndi chenodeoxycholic. Mu chiwindi, ma asidi onsewa amaphatikizana ndi glycine kapena taurine ndipo amathandizidwa ndi mchere wamtundu wa glycolic ndi potaziyamu wa taurocholic acid.Mchere wamchere ndi Na umasungidwa mwachangu mu lumen ya bile canaliculi, kenako madzi amatsata osmotic anzawo gradient. Pankhani imeneyi, zinthu zonse zomwe zimatha kubisirana mu duct ya bile zimatha mphamvu ya choleretic. Nthawi yomweyo, ena a bile (pafupifupi 40% ya buku lonse) amapangidwa mosasamala kanthu za ma bile acid.

Pakatikati mwa matumbo ang'onoang'ono, pafupifupi 20% ya ma asidi asukulu oyambira amadzimadzi am'mimba amakhala - deoxycholic ndi lithocholic. Apa za 90-95% bile acid amagwira ntchito mwachangu ndikubweza kudzera m'matumbo a portal kupita ku chiwindi. Njirayi imatchedwa hepato-matumbo kufalikira kwa bile acid. 2-4 g ya ma asidi a bile amatenganso mbali kuzungulira uku, kuzungulira kumeneku kumachitika mobwerezabwereza 6-10 m'maola 24. Munthawi imeneyi, pafupifupi 0,6 g wa bile acid amamuthira ndowe m'malo mwake ndipo umasinthidwa ndikuyambiranso m'chiwindi.

Zojambulajambula: bilirubin, biliverdin ndi urobilinogen ndi zinthu zowola m'chiwindi cha hemoglobin. Biliverdin amapezeka ndulu ya anthu mu kuchuluka. Bilirubin samapezeka m'madzi chifukwa chake amatengedwa ndi magazi kupita ku chiwindi mogwirizana ndi magaziin. Mu hepatocytes, bilirubin imapanga madzi osungunuka am'magazi a glucuronic acid komanso yochepa ndi sulfate. Masana, 200-300 mg ya bilirubin imatulutsidwa mu duodenum, pafupifupi 10-20% ya ndalamayi imabwezedwanso mwanjira ya urobilinogen ndipo imaphatikizidwa ndi kufalikira kwa hepatic-intestinal. Ma bilirubin otsalawo amamuchotsera ndowe.

K + ndi Cl - Kusinthana mwaulere pakati pa bile ndi plasma. Kusinthana kwa HCO₃ - amapezeka pakati pa Cl -, chifukwa chake pali ma bicarbonate ambiri mu bile kuposa ma chloride.

Kuyenda kwa bile mu zida zapanja ndi chifukwa:

Kusiyana kwapanthawi yamavuto ndi duodenum,

Mkhalidwe wa zowonjezera biliary thirakiti.

Pali ma sphincters atatu: a) m'khosi mwa ndulu - maLutkins sphincter, b) pakutsutsana kwa ma cystic komanso wamba bile ducts - the Mirizzi sphincter, c) kumapeto kwa gawo wamba la duct - the Oddi sphincter. Mlingo wa kukakamiza mu ndulu za bile umatsimikizika ndi kuchuluka kwa kudzaza ndi bile yokhala ndi kupindika kwa minofu yosalala ya ma ducts ndi khoma la ndulu. Kupanikizika mu duct ya bile yachilendo kumayambira pakati pa 4 mpaka 300 mm pamadzi, ndikudya - 150-260 mm mzere wamadzi, womwe umatsimikizira kutuluka kwa bile kudzera potseguka lotseguka la Oddi kulowa mu duodenum.