The msempha, nthambi kung'ambika: kufotokoza ndi zithunzi

Msempha - chotengera yaikulu ya thupi kumabweretsa magazi kuchokera ventricle kumanzere ndipo ndicho chiyambi cha kufalitsa zokhudza zonse.

The msempha kuzindikiridwa angapo m'madipatimenti:

• m'mwamba (ndime ascendens aortae) anapambulwa;
• Dzanja ndi nthambi ya Chipilala kung'ambika;
• kunsi (ndime descendens aortae) dipatimenti, amene nawonso, ndi mbali thoracic ndi m'mimba.

Kung'ambika Chipilala ndi nthambi zake

1. nthambi Truncus brachiocephalicus ku Chipilala kung'ambika kwa chichereŵechereŵe pa 2 m'mphepete bwino. Pamaso pake ndi brachiocephalic bwino Vienna, ndipo kumbuyo - ndi trachea. Pambuyo pa kumaliseche a brachiocephalic thunthu ukupita mmwamba ndi kumanja, kupereka pafupi sternoclavicular ufulu olowa nthambi ziwiri: subclavian ndi ufulu wamba carotid mtsempha wamagazi bwino.
2. Common carotid mtsempha wamagazi (kumanzere) - mmodzi wa nthambi ya Chipilala kung'ambika. Monga ulamuliro, nthambi izi ndi yaitali kuposa wamba carotid mtsempha wamagazi bwino 20-25 millimeters. mtsempha wamagazi njira akuthamanga kumbuyo scapula, sublingual ndi sternoclavicular-mastoid minofu, ndiye ndondomeko yopingasa wa vertebrae khomo lachiberekero. Kunja chotengeracho pali mitsempha vagus ndi jugular (mkati) Vienna, izo kugona medially ku kum'mero, trachea, pharynx, m'phuno, chithokomiro ndi England parathyroid. M'dera chithokomiro chichereŵechereŵe (gawo chapamwamba) aliyense wa mitsempha wamba carotid amapereka mkati ndi kunja carotid mitsempha kuti ndi diameters pafupifupi wofanana. Place kuitana magawano mtsempha wamagazi bifurcation, panthawi ino komanso mabodza intercarotid glomerulus (tulo chromaffin thupi, carotid chitsulo) - nyumba anatomical ndi miyeso 1.5 × 2.5 mm, omwe amaperekedwa ndi kuchuluka kwa chemoreceptors ndi maukonde capillary. M'chigawo cha kumaliseche lakunja la mtsempha wamagazi ndi carotid ali ndi kutambasuka yaing'ono, wotchedwa carotid nkusani.
3. Kunja carotid mtsempha wamagazi ndi imodzi mwa nthambi ziwiri osachiritsika carotid mtsempha wamagazi wamba. nthambi izo kwa womarizira m'dera tulo wa makona ya (chapamwamba m'mphepete mwa chithokomiro chichereŵechereŵe). Poyamba, ili basi medial kwa mtsempha wamagazi mkati carotid, kenako ofananira kwa izo. Kuyambira carotid mtsempha wamagazi kunja imagona pansi minofu sternocleidomastoid, ndi somnolence makona m'dera - subcutaneous minofu pa khosi ndi fascia khomo lachiberekero (mbale pamwamba pake). Ili medially ku digastric (zapambuyo ake pamimba) ndi stylohyoid, carotid (kunja) mtsempha wamagazi mu khosi dera mandibula (mull parotid England) lagawidwa awiri nthambi osachiritsika: ndi maxillary ndi mtsempha wamagazi zachiphamaso mwakanthawi. Komanso, pa akunja yake atria carotid zinagwira angapo nthambi: gulu kutsogolo - kutsogolo, pamwamba ndi lingual mtsempha wamagazi chithokomiro, zapambuyo gulu - zapambuyo khutu occipital ndi mtsempha wamagazi clavisternomastoid ndipo amawachitira pakati pa mtsempha wamagazi akwera pharyngeal.

Nthambi ya msempha thoracic

gawo ili, monga tanenera kale, ndi mbali ya kutsika msempha. Iwo lili mediastinum zapambuyo, umadutsa ndime msana. Nthambi ya msempha thoracic ndi kuperekedwa mu magulu awiri; parietal ndi choipidwa (choipidwa).

nthambi choipidwa

nthambi choipidwa kwa msempha awa akuimira magulu otsatirawa:

1. nthambi Bronchial (2-4 zidutswa). Kuyambira khoma kutsogolo kwa msempha mu dera wina wa nthambi ya mitsempha intercostal lachitatu. Kuyamba zipata za mapapo onse, intrabronchial anapanga wolumikizira maukonde kupereka wa bronchi, connective minofu mapangidwe (chimango) a m'mapapo, ndi kum'mero, ndi pericardium, ndi m'mapapo mwanga ziwiya khoma (mitsempha ndi mitsempha). Mu minofu m'mapapo nthambi bronchial kupanga anastomoses ndi nthambi za mitsempha m'mapapo mwanga.
2. nthambi Esophageal (zidutswa 3-4). Pafupifupi 1.5 dyne cm, ndi kutsirizitsa pa mpanda wa kum'mero (gawo lake thoracic). nthambi kuyamba kwa msempha thoracic m'chigawo cha 4-8 thoracic vertebrae. Anastomoses anapanga ndi diaphragmatic chapamwamba, m'munsi ndi chapamwamba chithokomiro, mediastinal mitsempha, komanso kumanzere inatsekeratu mtsempha wamagazi za mtima.
3. nthambi Mediastinal (mediastinal) akhoza osiyanasiyana malawi, impermanent. Nthawi zambiri monga mbali ya nthambi pericardial. kotunga mwazi wa CHIKWANGWANI ikuchitika, ndi mediastinal lymph mfundo kumbuyo khoma (kumbuyo) pericardium. Fomu anastomoses ndi nthambi pamwamba.
4. nthambi Pericardial (zidutswa 1-2), woonda ndi waufupi. Kung'ambika nthambi kuchokera kutsogolo khoma, pericardium krovosnabzhaya (kumbuyo kwake). Fomu anastomoses ndi mitsempha mediastinal ndi esophageal.

nthambi parietal

1. Diaphragmatic chapamwamba mtsempha wamagazi anakafika ku kung'ambika magazi imagwiridwa pleura ndi lumbar gawo la msempha. United mu anastomoses ndi diaphragmatic m'munsi, thoracic mkati ndi kutsikira mitsempha intercostal.
2. mitsempha Intercostal kumbuyo (10 awiriawiri) nthambi ku khoma kung'ambika ndi pambuyo 3-11 malo intercostal. Awiri otsiriza chimafikira pansi pa nthiti 12 (i.e., ndi subcostal) ndipo akulowa anastomosis ndi nthambi lumbar wolumikizira. Woyamba ndi wachiwiri intercostal danga kupereka womwe ndi mtsinje subclavian. Intercostal mtsempha wamagazi lamanja pang'ono yaitali kuposa kumanzere ndi kupita pansi pa pleura costal mpaka ngodya, pokhala ili posteriorly wa zapambuyo mediastinum, akudutsa mozungulira pamalo kutsogolo kwa matupi vertebral. Mu nthiti mitu ya mitsempha intercostal achoke nthambi dorsal kwa minofu ndi khungu za mmbuyo, kwa chingwe msana (kuphatikizapo m'chimake) ndi msana. Ku nthiti kumathandiza kupeza ngodya zabwino mitsempha ndi pakati pa mkati ndi kunja minofu intercostal, anagona poyambira costal. Mitsempha mu malo 8 intercostal ndipo m'munsi mwake kugona pansi m'mphepete ziwalo, nthambi mu nthambi lateral kwa minofu ndi khungu la magawo lateral m'chifuwa, ndipo pambuyo kupanga anastomoses ndi nthambi intercostal zapambuyo wa thoracic mtsempha wamagazi (mkati). 4-6 intercostal nthambi mtsempha wamagazi kupereka chifuwa. mitsempha Intercostal kupereka magazi kwa pachifuwa chapamwamba, ndipo atatu m'munsi - pa zakulera ndi m'mimba mpanda (kutsogolo). Wachitatu bwino mtsempha wamagazi intercostal amatumiza mphukira amene amapita bronchus lamanja, ndi kwa 1-5 × mitsempha intercostal kuwonjezera nthambi kuti kupereka magazi kwa bronchus kumanzere. 3-6 TH intercostal mtsempha wamagazi kungadzutse mitsempha esophageal.

nthambi msempha m'mimba

M'mimba gawo la msempha - kupitiriza pachifuwa gawo lake. Umayamba kwa mlingo wa thoracic linkawonongeka 12, umadutsa ndi kung'ambika diaphragmatic kutsegula ndi itha dera la 4 lumbar linkawonongeka. M'mimba dipatimenti inali kutsogolo kwa vertebrae lumbar, pang'ono kumanzere kwa mzere apakatikati, ndi retroperitoneal. Kudzanja lamanja lake uli ndi dzenje (kapena pansi) wa Vienna, kutsogolo - kapamba, ndi yopingasa gawo la duodenum ndi yaing'ono intestine mesenteric mizu.

nthambi parietal

Kuonetsetsa zotsatirazi nthambi parietal wa msempha m'mimba:

1. Diaphragmatic m'munsi mtsempha wamagazi (kumanja ndi kumanzere) nthambi ku msempha m'mimba pambuyo kuchoka ake ku orifice kung'ambika ndi phrenic kutsatira zakulera (ndege pansi) zotero ndipo ndi padziko.
2. Lumbar mitsempha (4 zidutswa) ku chiyambi cha msempha 4 pafupi ndi chapamwamba lumbar vertebrae kotunga magazi pamwamba anterolateral m'mimba, msana, ndi kutsikira kumbuyo.
3. Apakatikati mtsempha wamagazi sacral imasiyana ndi msempha m'chigawo cha kugawikana ake mu mitsempha wamba iliac (5 lumbar vertebrae) motere gawo m'chiuno wa sacrum, krovosnabzhaya coccyx, sacrum ndi m. iliopsoas.

nthambi choipidwa

Kuonetsetsa zotsatirazi nthambi choipidwa wa msempha m'mimba:

1. Celiac thunthu zimachokera kwa msempha m'chigawo cha 12 thoracic kapena lumbar vertebrae 1, diaphragmatic pakati pa miyendo lamkati. Izo ntchito pa mzere apakatikati pansi pa ndondomeko xiphoid (pamwamba ake). M'dera la thupi la thunthu kapamba celiac amapereka nthambi zitatu: kumanzere chapamimba, kwa chiwindi ndi mtsempha wamagazi splenic wamba. Truncus coeliacus wazunguliridwa ndi nthambi dzuwa plexus wokutidwa kutsogolo kwa peritoneum parietal.
2. Adrenal mtsempha wamagazi pafupifupi nthunzi, mphanda kwa msempha basi pansipa thunthu celiac ndipo amapereka England adrenal.
3. Upper nthambi mesenteric mtsempha wamagazi pa msempha m'chigawo cha 1st lumbar linkawonongeka, zapambuyo kuti kapamba. Iwo kukufika pa duodenum (kutsogolo padziko) ndipo akutumiza nthambi ku duodenum ndi kapamba, kutsatira mizu pakati pa mapepala mesenteric yaing'ono intestine, amapereka nthambi woonda kwa perfusion ndi m'matumbo (kumanja) matumbo.
4. mitsempha aimpso ochokera kwa 1st lumbar linkawonongeka. mitsempha izi kungadzutse mitsempha m'munsi adrenal.
5. Yamchiberekero mtsempha wamagazi (machende) kuwonjezera basi pansipa mitsempha ya aimpso. Kudutsa zapambuyo kwa peritoneum parietal, kuwoloka ureters, ndipo pambuyo mtsempha wamagazi kunja iliac. Mu akazi, yamchiberekero mtsempha wamagazi mwa mitsempha kuti suspends ndi n'kuwasanganiza, wotumidwa kwa Ukalawu ndi mazira, ndi amuna - mu gawo la chingwe spermatic kudzera m'njira inguinal kupita machende a.
6. Mtsempha wamagazi nthambi otsika mesenteric wachitatu m'munsi mwa msempha m'mimba m'dera la 3 lumbar linkawonongeka. mtsempha wamagazi Izi amapereka m'matumbo (mbali kumanzere).

atherosclerosis kwa msempha

Atherosclerosis wa msempha ndi nthambi zake - ndi kudwala kuti amakhala ndi kukula kwa mipukutuyi mu lumen mtima, amene kenako akutitsogolera kuti kuchepetsa wa lumen ndi mapangidwe magazi kuundana.

Zenizeni kudwala ndi vutoli mu chiŵerengero cha tuzigawo twa zamadzimadzi, cha kuchuluka kwa mafuta m'thupi, umene unayikidwa monga mipukutuyi wa msempha ndi nthambi kung'ambika.

zinthu kukulitsa monga kusuta fodya, shuga, chibadwa, asamapereke.

maonekedwe a atherosclerosis

Nthawi zambiri, atherosclerosis sikuchita waledzera, lomwe ndi chifukwa chachikulu kwa msempha (komanso m'madipatimenti, nthambi za msempha), kukula kwa minofu ndi ulusi zotanuka. Kukula kwa zolengeza kumabweretsa overloading mtima, amene kumaonekera ndi kukakhala kuthamanga, kutopa, palpitations mtima.

Ndi Kukula kwa ndondomeko matenda imafika ku nthambi kung'ambika Chipilala pambuyo pake ndi zigawo kumtunda, kuphatikizapo mitsempha yomwe kulimbikitsa mtima. Pankhaniyi, inu zizindikiro zotsatirazi: angina pectoris (chifuwa ululu limene laperekedwa mu tsamba phewa kapena mkono, kufupika kwa mpweya), matenda m'mimba ndi ntchito impso, kuthamanga kwa magazi kudumpha, m'makona ozizira, chizungulire, kupweteka mutu, kawirikawiri kukomoka, kufooka mu manja.