Kodi kapamba amatenga gawo lanji?

Zikondamoyo zamunthu (lat. páncreas) - chida cham'mimba, cholocha chachikulu kwambiri, chomwe chimagwira ntchito zina. Ntchito ya exocrine ya chiwalo imadziwika ndi chinsinsi cha madzi a pancreatic omwe ali ndi michere yam'mimba. Popanga mahomoni, kapamba amatenga gawo lofunikira pakukhazikitsa mafuta, mafuta ndi metabolism ya protein.

Ntchito

Zofotokozera za kapamba zimapezeka zolemba za akatswiri akale. Chimodzi mwazomwe amafotokozera pancreas amapezeka mu Talmud, pomwe amatchedwa "chala cha Mulungu." A. Vesalius (1543) motere akufotokozera kapamba ndi cholinga chake: "pakatikati pa mesentery, pomwe magawidwe oyamba amitsempha yamagazi amapezeka, ndimatumbo lalikulu lomwe limathandiza mokhazikika kukhala nthambi yoyamba komanso yofunika kwambiri yamitsempha yamagazi." Pofotokoza za duodenum, Vesalius amatchulanso za glandular body, yomwe, malinga ndi wolemba, imathandizira ziwiya za m'matumbo awa ndikumamwetsa mkati mwake ndi chinyezi chomata. Zaka zana pambuyo pake, duct wamkulu wa kapamba adafotokozedwa ndi Wirsung (1642).

Ntchito kusintha |Pancreas - Kufotokozera

Zikondwerero - Ichi ndi chiwalo chokhazikika, koma chaukali, chopangidwa ndi lobules zambiri. Pancreas imapezeka kumbuyo kwa m'mimba, ndipo malire ake amayendayenda ndi duodenum. Kutalika kwake, gland iyi ndi 15 cm yokha ndipo imalemera pafupifupi 80 g, komabe, imatulutsa zinsinsi zopitilira 1.4 pancreatic patsiku (gawo la kapamba). Kupanga mandimu kumayamba maola 1-3 mutatha kudya. Nthawi yamatendawa, kukula kwake kumakhala kochulukirapo kapena kocheperako, chomwe ndi chimodzi mwazofunikira pakuwonongeka kwa ziwalo.

Udindo waukulu wa kapamba mu thupi la munthu ndi gawo lofunikira kwambiri m'matumbo a anthu ndipo limakhala malo apadera pakati pa zotulutsa za endocrine. Sizachilendo chifukwa sizigwira ntchito monga endocrine gland, yomwe imapanga mahomoni ofunikira m'thupi (lipocoin, insulin, glucagon).

Ndilimodzi mwazinthu zazikulu zothandiza kugaya chakudya: imatulutsa ndikugawa madzi a pancreatic ku duodenum, yomwe imakhala ndi ma enzymes ofunikira pakugaya bwino. Kapamba amawongolera chakudya chamafuta, mafuta ndi mapuloteni.

Ndiye kodi kapamba amatenga gawo lanji mthupi la munthu:

- Zimatengera gawo logaya chakudya. Mu ma lobules a chiwalochi ndi maselo omwe amapanga ma enzyme omwe amaswa mapuloteni, mafuta ndi chakudya mu duodenum. Komanso, katulutsidwe katemera wa pancreatic kamakhala ndi ma bicarbonate ion, ofunikira kuti muchepetse acidic yomwe yalowa m'mimba kulowa m'matumbo.

- Amayang'anira kagayidwe kachakudya mthupi.

Kapamba ndi insulin

Cancreas m'thupi la munthu ndimomwe imapangitsa ma mahomoni ofunikira kwambiri: insulin - mahomoni omwe amachepetsa shuga la magazi komanso amathandizira kwambiri metabolism yamafuta. Hormoniyi ndiyofunikira osati thanzi, njira za carbohydrate ndizosatheka popanda iwo. Potsutsana ndi kupanga insulin, shuga imayamba. Nthawi zambiri, msuzi wa shuga umasinthidwa bwino ndi chithandizo ndipo nthawi zambiri kapamba amakhala mwamtendere.

Iron imatsimikizira chimbudzi chokhazikika, chimayendetsa kagayidwe kazinthu, imagwira nawo ntchito zina zofunika. Chifukwa cha michere yomwe imatulutsidwa kuchokera ku madzi a pancreatic, mafuta, mapuloteni komanso chakudya chamagulu omwe amalowa mthupi kudzera mu chakudya amapakidwa. Munthawi yabwino, ma enzyme amalowa mu duodenum ndikuyamba ntchito yawo kumeneko. Koma pamene kapamba amachitika, ma enzyme amayambitsidwa kumayambiriro, akadali m'mapamba. Tiziwalo ta tinyezi titha kuwonongeka podzigaya tokha, ndipo nthawi zina ngakhale chikhansa cham'mimba chikuchitika - necrosis yama cell ambiri a kapamba.

Pancreas malo

Chiwalochi chimapezeka mu diaphragm - pomwe gawo la thoracic la msana limadutsa lumbar, mutu wake umakhala pang'ono kumanja kwa msana ndipo mchira umapita kumanzere. Chifukwa chake, ngati mutu wa kapamba wakupsinjika, umapweteka kwambiri m'dera la hypochondrium, thupi limapweteka pakati ("pansi pa supuni"), ndipo ngati mchira wakhudzidwa, mu hypochondrium wamanzere. Koma nthawi zambiri gland yonse imavutika, ndipo ululu umakhala mu hypochondrium wamanzere ndi epigastrium.

Udindo wa kapamba m'mimba

Kapangidwe kazinthu kakang'ono kokhala ndi maselo am'mbuyomu. Parenchyma imaphimba chiwalo chonse ndikuigawa kuti ikhale yolumikizira. Ma labules amakhala ndi acini ndi zisumbu za Langerhans. Mitsempha yamagazi ndi mitsempha yodutsa mkati zimadutsa mbali mbali zosiyanasiyana.

Ntchito za exocrine zimayimiriridwa ndi maselo a acinus, omwe nawonso amawonekera pakupanga madzi a pancreatic. Kwa tsiku munthu wamkulu wathanzi limatulutsa pafupifupi theka ndi malita awiri a madzi.

Kapangidwe ndi kagwiridwe kake ka kanyumba ndicholinga choti azitengapo gawo logaya chakudya. Kuchepa pang'ono kwa minyewa ya ziwalozo kumakhudza chimbudzi komanso chikhalidwe cha thupi.

Chifukwa chiyani kapamba amafunikira? Madzi am'mimbamo amatulutsidwa kuti timize chakudya chomwe chimatsikira m'mimba kudzera kummero. Madzi a pancreatic amapangidwa ndi kapamba, amayenda ndi papilla wamkulu kupita mu duodenum. M'mimba, pansi pa kukondoweza kwa chakudya cham'mimba, juwisi wovuta, chakudya chimasweka ndikuyenda bwino mu duodenum, momwe madzi a pancreatic amapezeka kale. Chimodzi mwazinthuzi ndi kusakhazikika kwa zomwe zili m'mimba, zomwe zimakhalabe ndi zotsalira za timadziti, chifukwa cha zamchere zamchere. Izi zimatha mpaka madzi onse a m'mimba atisiya chakudya chogayidwa. Pophwanya malamulo, maphunzirowa amasokonekera ndipo pamatuluka matumbo a asidi osapatsa kanthu komanso chakudya.

Nthawi yomweyo, kugawanitsa chakudya ndi michere ya hydrolytic kumapitiliza:

• proteinase imakhudza mapuloteni ndikuwaphwanya ma amino acid,
• lipase imakhudzidwa ndikuwonongeka kwa mafuta kukhala mafuta acids apamwamba ndi glycerin,
• carboxyhydrase imakhudza chakudya chamagalasi, kusanduliza shuga.

Mukamamwa chakudya, Reflex imayendetsa ntchito ya kapamba. Kungoyambira kudya, ndipo nduluyo yabisa kale madzi ndikuitumiza ku duodenum. Kuperewera kwa zakudya m'thupi, kuperewera kwa chakudya, chimfine, kuledzera ndi zinthu zina zimayambitsa mikhalidwe yosinthika. Chifukwa chake, pali matenda ambiri omwe amagwirizana ndi matenda opuwala a ziwalo.

Ntchito ya endocrine

Chiwalo cha alveolar chimadzipatula ndi parenchyma, chopanga magawo. Amakhala ndi minyewa yolumikizana, mitsempha ya mitsempha ndi mitsempha yamagazi. Ichi ndiye maziko a gawo la endocrine la kapamba. Gawo lachiwiri likuyimiridwa ndi zisumbu za Langerhans, omwe ndi maselo othandizira shuga. Chiwerengero chonse cha osapitilira miliyoni, ndi zaka, chiwerengero chawo chimachepera.
Chowonadi chodabwitsa: ngati mabwalo a Langerhans sakugwira ntchito moyenera pokakamizidwa ndi chakudya chosayenera, mowa, etc., maselo amenewa amasinthidwa ndi minofu yolumikizira kapena adipose.

Ntchito za endocrine za kapamba zimachitika chifukwa cha ntchito za zisumbu za Langerhans, zomwe zimakhala ndi endocrinocyte ndi insulocytes. Mitundu yotsatirayi imasiyanitsidwa:

1. maselo. Ntchitoyi idakhazikitsidwa ndikupanga glucagon. 10-30% yokha yonse.
2. Β maselo. Gwirizanitsani insulin. (60-80%).
3. Maselo Δ amatulutsa somatostatin. 3-7%.
4. Maselo a D1 amachititsa VIP (vaso-matumbo peptide) .5-10%.
5. Maselo a PP amapanga pancreatic polypeptide. 2-5%.

Palinso mtundu wina wamaselo mu kuchuluka kochepa komwe kamakhala ndi tyroliberin, gastrin ndi somatoliberin.
Kodi ntchito ya endocrine imagwira bwanji kapamba?

The kapangidwe ka kapamba madzi amaphatikiza ma proenzymes:

• proteinases - trypsin, chymotrypsin, carboxypeptidase,
• amylase, maltase, lactase - pakuwonongeka kwa chakudya,
• mafuta lipase
• kuti muwone ma acid a nucleic - ribonuclease ndi deoxyribonuc tafadhali.

Ma proenzymes ndi mtundu wa enzyme wolowera. Zotsalira zitatha kulowa m'mimba, mahomoni otulutsidwa amayamba kuchitapo kanthu. Izi, zimatsogolera ku kukhazikitsa kwa ma proenzymes ndikumasulira kwawo mu ma enzymes. Makina osokoneza bongo oterewa ndi chifukwa choti gland imadziteteza ku zotsatira za ma enzymes ake pazinthu zake.

Ntchito za endocrine za kapamba zimakhudzana mwachindunji ndi zochitika za mahomoni omwe amatulutsidwa m'mwazi zochuluka zomwe zingakhale zokwanira kugaya mitundu ina ya chakudya.

1. Insulin imawongolera zomwe zili ndi shuga m'misempha ndi m'maselo.
2. Glucagon imagwira pakhungu la glycogen, mafuta ndi kuwonjezera shuga m'magazi.
3. Somatostatin amachepetsa kupanga bile, amakhudza kuchepa kwa mahomoni ena,
4. VIP imayang'anira dongosolo lonse la chimbudzi cha chakudya, imawonjezera mapangidwe a bile.

Ntchito zophatikizana za insulin ndi glucagon zimawongolera kuchuluka kwa shuga m'magazi.
Kodi ntchito yowonjezera ya kapamba ndi chiyani? Imagwira ntchito yochititsa manyazi, yomwe imakhazikitsidwa pakugawa michere mthupi lonse mothandizidwa ndi madzi (magazi, lymph). Mchitireni kapamba komanso secretin. Ntchitoyi ndikuwongolera katulutsidwe ka madzi a pancreatic.

Ntchito yachinsinsi imakhalapo chifukwa cha kupezeka kwa madzi a pancreatic, omwe amakhala ndi michere ndi michere:

• 98% madzi
• urea
• mapuloteni (albin, globulins),
• bicarbonate
• kufufuza zinthu (calcium, sodium, phosphorous, chloride),
• uric acid
• shuga

Chifukwa cha mchere, chilengedwe chamchere chimapangidwa.

Chiyanjano cha magwiridwe antchito ndi kapangidwe ka gland

Ntchito za kapamba zimatengera mawonekedwe a kapangidwe kake komanso malo a ziwalo zam'mimba. Makonzedwe olondola a ziwalo zimathandizira kupunthika kwapamwamba kwambiri kwa chakudya komanso kubisala kwazinthu zina zofunika za enzymatic ndi zinthu zina zomwe zimakhudzana ndi kugaya chakudya.

Ziwalo za kapamba zimagawidwa pamsonkhano: mutu, thupi ndi mchira.

Mutu umakhala kuzungulira kwa duodenum. Imalumikiza chiwindi ndi kapamba kudzera papilla yayikulu ndi ma ducts osiyanasiyana, kuphatikizapo bile duct.

Thupi la chiwalo limakutidwa ndi peritoneum kutsogolo, ndipo mchira umadutsana ndi ndulu.

Pokakamiza chakudya, chiwalo chimagwira ntchito yofunika kwambiri. Popanda icho, ndizosatheka kusintha macromolecules am'magawo kukhala magawo ang'onoang'ono omwe amatha kulowa m'magazi. Cleavage kwa monomers amalola kuyamwa kwawo m'matumbo ang'ono. Chimbudzi chokha chimagawika munjira ndi makina. Madzi a pancreatic, limodzi ndi madzi a m'mimba ndi bile, amatenga gawo lofunika kwambiri pakuwonongeka kwa chyme (mtanda wazakudya) mkati mwa mamolekyulu.

Ntchito za kapamba m'thupi la munthu zimagwira ntchito yofunika kwambiri. Ngati pali chiwopsezo cha ziwalo zina zilizonse, kulephera kwa ntchito yathupi lonse kumachitika.

Matenda a kapamba

Zosintha mu kapamba mu thupi la munthu zimagwirizanitsidwa ndi amoyo wamoyo, nthawi zambiri sizowonjezera zam'tsogolo, matenda a autoimmune ndi mtundu wina wolephera pawokha.

Kutengera ndi ntchito zomwe kapamba amachita, matenda amtunduwu omwe amalumikizidwa mwanjira inayake ndi ntchito ya gulu la maselo, katulutsidwe ka michere kapena matenda a ziwalo zoyandikana nawonso amapezeka.

Kuchepa kwa magwiridwe antchito ya exocrine kumayambitsa matenda opatsirana amachokera kumayendedwe osiyanasiyana. Nthawi zambiri amatsogolera kumakhalidwe osayenera, kukonda zakumwa ndi chakudya m'malo ambiri komanso osanenepetsa, zakudya zamafuta ndi mafuta.

Matenda otupa amatchedwa pachimake, pancreatitis yayitali komanso zovuta zawo. Mchitidwewu umakhudza magwiridwe amodzi a gawo limodzi ndi gawo logaya chakudya. Kukula kwa kapamba nthawi zambiri kumakhala kofulumira, ngakhale mawonekedwe osakhazikika amabisika kwa zaka ndi zizindikiro zofatsa zomwe munthu samvera. Mankhwalawa a kapamba amtundu uliwonse, gawo lalikulu limadyedwa ndi zakudya zomwe zimabwezeretsa mphamvu yogwira ntchito kwa chiwalo.

Intra secretory pathology nthawi zambiri imalumikizidwa ndi kusagwira ntchito kwa maselo a ziwalo. Mwachitsanzo, ma cell a β cell amasiya kugwira ntchito mokwanira ndipo matenda a shuga amakula.

Mitundu yocheperako yamatenda imakhala ndi cystic fibrosis, khansa ndi kapangidwe ka cysts ndi pseudocysts omwe ali ndi zovuta zosiyanasiyana.
Chochita chilichonse cha kapamba: zamanyazi, endocrine, exocrine ndi chinsinsi, amavutika ndi zosokoneza mu kapangidwe kake kapena kuthekera kwa ntchito ya thupi. Amakhala odalirana komanso ngati aphwanya ntchito ya wina, wina adzavutika.

Ntchito yogaya

Ngati timalankhula za momwe kapamba m'munthu amagwirira ntchito, ntchito zake mthupi sizingakhale zochulukirapo. M'mbuyomu, tinkakhulupirira kuti kuthyoka kwa zinthu zopindulitsa kumachitika m'mimba, ndipo zatsimikiziridwa kuti njirayi ndiyambiri matumbo. Ndipo mu izi, zikondamoyo zimasewera chimodzi mwamaudindo akuluakulu, chifukwa zimasunga mandala ndi ma enzyme kuti awonongeke mapuloteni, mafuta ndi chakudya.

Ntchito ya ma enzyme:

• lipase ndi enzyme yomwe imakuthandizani kuti muwononge mafuta,
• lactase, maltase ndi amylase zimatha kulekanitsa chakudya,
• trypsin imaphwanya mapuloteni.

Chiwerengero cha ma enzyme zimatengera chakudya. Ngati chakudyacho ndi chamafuta, lipase yambiri imapangidwa. Ndi kuchuluka kwa mapuloteni, trypsin amapangidwa ochulukirapo. Chakudya chikalowa m'mimba, madzi am'mimba amayamba kupanga mkati mwake. Ichi ndi chizindikiro choti ayambe kupanga ma enzyme.

Madzi ophatikizika a pancreatic, olemeretsedwa ndi michere, amalowa mu duodenum ndikusakanikirana ndi bile. Kenako pakubwera njira yogawa chakudya kuti ikhale tizinthu tochepa tomwe timatha kuyenda m'matumbo.

Udindo wa endocrine

Ndikofunikira kumvetsetsa zomwe ntchito ya kapamba ali mu endocrine system. Matenda a mahomoni zoyipa kwambiri pa ntchito ya chamoyo chonse. Kapamba mwa anthu amatulutsa mahomoni asanu:

• Glucagon - kupanga ma alpha maselo,
• Insulin - yopangidwa m'maselo a beta,
• Somatostatin - aphatikize maselo a delta,
• Pancreatic polypeptide - yopangidwa m'maselo a PP,
• Ma polypeptides amkati - ma nucleate m'maselo a D1.

Ma cell omwe amapanga mahomoni amatchedwa insuloids. Homoni wodziwika kwambiri, insulin, amachititsa shuga wamagazi a anthu. Ngati insulini singapange zokwanira, ndiye kuti munthu amapanga matenda amtundu wa 1 shuga. Kupanda kutero, amatchedwa shuga wodalira insulin.Ngati insulini ikapangidwa mopitirira muyeso, kuledzera kwa thupi kumachitika, zomwe zimatha kukhala chizungulire, kusiya kuzindikira.

Glucagon amachita mosiyana ndi insulin. Somatostatin imaletsa kupanga zochulukirapo kwamahomoni osiyanasiyana.

Zizindikiro za matenda apamba: kupweteka mu hypochondrium, nseru, zosasangalatsa wowawasa mkamwa, kuwonongeka. Zizindikiro izi zikaonekera, muyenera kukaona dokotala wa gastroenterologist.

Ngati wodwala azindikira pakamwa pokhapokha pouma, khungu lake limatha kuzindikira kukula kwa matenda ashuga. Kenako muyenera kulumikizana ndi endocrinologist.

Ndi vuto lililonse la kapamba, ntchito zonsezi zimavutika. Ngati kuwonongeka kwa endocrine ntchito kwachitika, wodwalayo amakula shuga. Ngati kuwonongeka kwa ntchito m'mimba kumayambira, mafupa a kapamba. Iliyonse mwa matendawa imachiritsidwa mokwanira. Ikani mankhwala osiyanasiyana ndi mfundo za zakudya zoyenera. Pobwezeretsa ntchito ya thupi, ntchito yofunika kwambiri imachitika ndi kukumbukiridwa kwa zakudya zochiritsa.

Pamodzi ndi kapamba, chiwindi ndi ndulu zimatha kugawidwa ngati ziwalo zosakanikirana.

Udindo wa chiwindi ndi ndulu

Chiwalo chofunikira mthupi la munthu ndicho chiwindi.. Imagwira ntchito zambiri pakugwira bwino ntchito kwa thupi. Zitha kugawidwa kukhala zakunja, zamkati ndi zotchinga:

• Udindo wakunja kwa chiwindi ndikupanga bile kuti lizigaya chakudya. Popeza amapangidwa m'chiwindi, bile limadziunjikira mu chikhodzodzo, kenako limalowa m'matumbo.
• Ntchito yamkati ya chiwindi imakhala pakupanga kwa magazi ndi mahomoni. Komanso chiwindi chimakhudzidwa ndi metabolism. Mu chiwalo ichi, kutha kwa mahomoni ndikusintha kwa ma hormonal a munthu kumachitika.
• Ntchito yolepheretsa ndikupukuta poizoni yemwe amalowa mthupi la munthu.

Mwinanso chinthu chodabwitsa kwambiri kwa munthu wamba ndi ndulu. Aliyense amadziwa kuti ali ndi ulamuliro wotere, koma ochepa amadziwa zomwe zimapangidwira. Mwachidule pang'onong'ono, titha kunena kuti ndi "chosungira" cham'mapulatifomu ndikupanga ma lymphocyte. Chifukwa chake, limagwira gawo lalikulu pakupanga magazi ndi chitetezo chokwanira cha anthu.

Pankhani ya matenda, ndikofunikira kulumikizana ndi akatswiri apadera.

Ntchito ya pancreatic

Pancreas ili ndi maudindo awiri mthupi:

• exocrine - imapanga ma enzymes oyamwa chakudya. Amaphwanya mapuloteni, mafuta ndi chakudya chamafuta ndipo amakhala okangalika atalowa m'matumbo ang'onoang'ono. Pancreatic secretion imathandizira kuti asidi asaberekedwe m'mimba, omwe amalola ma enzyme kuti achite ntchito yawo,
• endocrine - amatulutsa mahomoni - insulin ndi glucagon, omwe amawongolera kuchuluka kwa shuga m'magazi. Insulin imapangidwa pambuyo pa chakudya kapena ndi shuga wambiri. Ngati glucose ndi wotsika, kapamba amakankhira glucagon m'magazi. Izi zimapangitsa kuti maselo a chiwindi atulutse shuga omwe amasungidwa ndikupatsa thupi mphamvu.

Mwachizolowezi, michere ya pancreatic siigwira mpaka itafika m'matumbo aang'ono. Koma, pakayamba kutupa, amayamba kuchita zinthu osasiya kapamba, ndipo amayambitsa ziwopsezo zake. Anthu akuti "amadzidya yekha kuchokera mkati." Chifukwa chake pali matenda osachiritsika kapena kapamba.