Pehea e lawe ai ke koko i ka pancreas?

ʻO ke kahe koko lawe ʻia ka pancreas mai nā loko i nā maʻi hepatic maʻamau, splenic a maikaʻi loa o ka nehe mesenteric. ʻO kahi loea ʻo A. rancreaticoduodenalis, he lala ia o ka arela gastro-duodenal, e hoʻohālikelike ʻia i nā lālā anterior a me nā hua posterior, e hoʻopili ana i ka hopena o ka hopena me nā lālā like o ka lalo o ka pancreatic-duodenal artery, e puka ana mai ka mesenteric maikaʻi loa, a hana i ka anterior a me nā posterior arterial. Mai lākou e haʻalele ana mai ka 3 a hiki i ka 7 mau hāmeʻa e hāʻawi ana i ke poʻo pancreas a me duodenum. ʻO ke kino a me ka huelo o ka pancreas e loaʻa ke koko mai ka splenic artery, e hāʻawi ana iā lākou mai 2 a 9 mau lālā pancreatic (rr. Pancreatici).

He kikoo maikaʻi puka ma waena o ka splenic, luna a me mesendic inferior, waiho i ka uaua gastric, i ka kahe ana o ka vein portal. Pono e hoʻomaopopo pono e pili pū nā veins o ke kino a me ka huelo o ka pancreas me nā veins o ka kelepa adrenal hema a me ka retroperitoneal luna, i.e. me ka punawai o ka vena cava inferior (port-caval anastomosis).

Lomi kahawai ka pili ʻana i nā ʻāpana kūloko o ka hana mua (lnn. pancreaticoduodenales superiores et inferiores, pancreatici superiores et inferiores, splenici, retropylorici), a me nā nodes o ke kaina o ka lua, ʻo ia nā neli celiac (lnn. coeliaci).

ʻĀpono Lawe ʻia ka pancreas i nā naaniani o nā nīnū liilii o nā nunui a me nā mea liʻiliʻi, kahi i pani ʻia i loko o ka ganglia o ka celiac plexus a hoʻokokoke i ka lālani. ʻO nā palihalelo neʻe parasympathetic mai nā nū i hala (ʻo ka hapa nui mai ka hema) he preganglionic. Eia kekahi, ʻo ka mesenteric maikaʻi loa, splenic, hepatic a me nā plexuses nerve renal e komo pū ana i ka hohonu o ka pancreas. Kuhi ka hapanui o nā wahie a puni i ka parenchyma o ka nui i ka pōʻai e puni ana iā ia. (E nānā i ka pauku ʻōnaehana Nīkio Nū Mīkini).

Mākala (lien, splen)

ʻO ke kahe koko Hāʻawi ʻia ka spleen e ka splenic artery - he lālā o ka ʻōpala celiac. Holo ka wahī i ka hema ma ka ʻaoʻao o luna o ka pancreas, hāʻawi iā ia i rr. lihualia. Ma kahi kokoke i nā ʻīpuka o ka spleen, hāʻawi ka pua splenic i ka pōkole pōkole a waiho i nā lika gastro-omental. ʻO kekahi manawa i ka neʻe ʻana o kēia mau lāʻau ma ka wahi o ka puka spleen mai nā lālā o ka arela splenic.

He kikoo maikaʻi. ʻO ka vlen splenic ka lōʻihi o ke anawaena o 2 mau manawa ma mua o ke kīlea, a aia nō ma ka hapa nui ma lalo. Ke hala nei mai ka hema a ma ka ʻaoʻao hema o ka pancreas, hoʻohui nā vein splenic ma hope o ke poʻo o ka pancreas me ka urinal mesenteric maikaʻi loa, ka haku ʻana i ka pahu nui o ka vein portal.

Lomi kahawai aia ma nā nīnani lymph apana o ka mua mua, aia ma nā ʻīpuka o ka spleen (lnn. splenici). ʻO nā nīnūnū kūhelu āpau ko nā celiac lymph node e pili ana i ke kumu o ka ʻōpala celiac.

I loko o loko lelo i pili celiac, waiho diaphragmatic, waiho i ka plexus nerve adrenal. Ke kū nei nā lālā mai nā kumuwaiwai mai ka plexus splenic a puni i ka splenic artery. (E nānā i ka pauku ʻōnaehana Niboga Vegetative).

ʻO ke kahe koko pancreatic

Ka hāʻawi koko i ka pancreas nā lālā o nā maʻi hepatic maʻamau, splenic a maikaʻi aʻe o ka areria mesenteric. Aia ma luna o ke poʻo o ka papa ʻa i kūpono a. gastroduodenalis, kahi e haʻalele ʻo a. ʻO ka luna o ka pancreaticoduodenalis, hāʻawi i nā lālā mua a i hope.

Hoʻomaka ʻo A. pancreaticoduodenalis inferior mai ka arele mesenteric maikaʻi loa a mai kona lālā. Hoʻokaʻawale ʻia ia i nā ʻāpana a me nā pihi. ʻO luna a i lalo Nā mākela pancreatoduodenal kahi anastomose me kēlā me kēia, e hana ana i nā hā o nā arterial, kahi e kū ai nā lālā a hiki i ke poʻo o ka pancreas a me ka duodenum.

Ke haʻalele nui nei i kahi nui mai ka splenic artery a emi iki mai ka maʻi hepatic maʻamau pancreas, a i. rapeseatica magna, ma hope o ke kino o ka lepa i ka ʻaoʻao lalo, kahi i hoʻokaʻawale ʻia i nā lālā ʻākau a hema. I ka pono i kēia artery, i ka hiapo a me ke kino o ka gland mai a. splenica (lienalis) haʻalele rr. pancreatici.

Ka mōʻaukala o ka pancreas

Hoʻokumu ka pancreas i 1,5 lita o ka wai o ka pancreatic i kēlā me kēia lā. Ma kahi o ia, ʻo ka nui, paʻakikī, a hoʻokaʻawale i nā kumulāʻau ʻē aʻe o ke kino e hana i ka nui o nā mea huna e pili ana i ka mammary, lacrimal, ka salivary nui.

ʻO ka anatomy o nā kinipona ma muli o ka hana pālua e hana ai: ʻo ka endocrine a me ka digestive. He hiki nō kēia ma muli o ka hana mōʻaukala o ka organ parenchyma. Aia ia:

• mai lobules (acini), hoʻokaʻawale ʻia e ka hoʻohui ʻokoʻa septa, i loko o nā moku, nā nerve nerve, nā puʻuwai pancreatic liʻiliʻi.
• mokupuni o Langerhans aia ma waena o ka acini. Hoʻonohonoho ʻia lākou ma nā kelepa kelepona me nā pālima like ʻole, akā hāʻule ka nui o ka nui i ka huelo o ke aʻa.

ʻO Acinus me nā kāpili excretory liʻiliʻi i ke kumu o ka hapa exocrine o ka pancreas. Aia ia:

• ʻO nā pancreatocytes mai nā lela 8 cells12 o kahi ʻano conical, kahi i kū me kā lākou mau ʻāpana i ke kikowaena,
• duct epithelial cell: i ka wā e hui pū ai, hana ʻia kahi ʻōnaehana excretory.

• kaina o ka acini,
• hoʻopukaʻina
• pauleila
• interlobar
• maʻamau wirsung duct pancreas.

Kuhi ʻia ke ʻano o nā paia o nā pale i ka nui o ke kāpae ponoʻī. I loko o Wirsung, e hele ana i ka lōʻihi holoʻokoʻa o ka pala, aia nā mea pili i loko o ka paia i huna i nā ʻāpana wai pancreatic a komo i loko o ka hoʻoponopono endocrine kūloko.

ʻO nā kahakai o Langerhans e hōʻike i kahi hapa liʻiliʻi, akā ʻaʻohe hapa nui i ka mea nui.

ʻO ka mōʻaukala pōkole o ka islet: ua mau ka 5 o nā ʻano nui o nā cell e huna i nā hormone. Kēia mea ʻano pālolo o kēlā me kēia kekona i kahi kaona o ka mokupuni a hana i kahi hormone kūikawā:

• alpha (25%) - glukagon,
• beta (60%) - insulin,
• delta (10%) - somatostatin,
• ʻAno (5%) - he polypeptide intestinal vasoactive (VIP) a me ka polypeptide pancreatic (PP),
• nā huina epsilon (ma mua o 1%) - ghrelin.

Aia nā kikowaena Beta ma ke kikowaena, ʻo ke koena e puni iā ​​lākou a puni ka periphery.

Ma kahi o kēia mau ʻano nui, aia nā cell acaminelet me nā hana end end a a me nā hana exocrine ma ka periphery.

Hāʻawi ke koko Arterial

ʻAʻohe o nā pancreas ponoi kāna mau moku arterial. ʻO ke kaʻina o ke koko mai ka aorta (ʻo kona ʻōpū). ʻO nā lala kaleli celiac mai ia mea, hoʻokaʻawale i nā moku e hoʻolako i ka hoʻokahe koko arterial i ka pancreas. Kūkulu lākou i kahi kikooho holoʻokoʻa o nā arteri liʻiliʻi-kaliber a me nā arterioles. ʻO ka huina e komo i ke kahe koko:

• luna o mua a me nā pou nā pihi o ka pancreas,
• haʻahaʻa haʻahaʻa pancreatoduodenal me nā ʻāpana o mua a me nā pihi,
• haʻahaʻa haʻahaʻa loa,
• puki dorsal
• kuahiwi o ka huelo.

ʻO kēlā me kēia moku kīpeka i loko o nā kaola o kahi kū liʻiliʻi ʻoi aʻe a hiki i nā arterioles liʻiliʻi a me nā capillaries i pili i ke kahe o ke koko i kēlā me kēia lobre o ka pancreas.

Hoʻolaha ʻia ka alawai lymphatic ma loko o nā moku lymphatic e holo ana ma nā moku koko: kahe lymph e kahe ana i ka pancreatoduodenal a me nā pancreas lymph nodes, a laila i loko o ka celiac a me ka splenic.

He kikoo maikaʻi

Mai nā lobules a me nā mokupuni, hoʻopili ʻia ke koko venousric i loko o ke kinikona ke komo ʻana i ka ʻoihana ākea o nā venules a me nā veins i komo i ka pūnaehana o ka vena cava inferior a me nā vein portal. I ka hoʻomaka, hele i ke koko:

• ma o ka mesenteric (luna a lalo)
• pīpī splenic
• waiho iā gastric
• waihona

ʻO ke koko Venous ma hope o ke kahe ʻana o ka ate ma o ka vena cava inferior e komo ai i ka puʻuwai kūpono, e hoʻopau ana i kahi kaila nui.

ʻO nā maʻi mole pelreatic

He mea paʻakikī e hoʻoholo i ka ʻike ʻana i nā maʻi o ke kaomi a me ka naʻau o ka pancreas. ʻAʻole kūʻokoʻa kēlā ʻano kuʻuna, akā e ulu i ka hopena o nā maʻi koʻikoʻi o ka ʻōnaehana cardiovascular. I kēlā mau hanana, nā hōʻiliʻili o nā pathology i lalo i ke alo.

Hana ʻia ka maʻi maʻi me ka mālama ʻana i nā maʻi i hala me ke kahe o ke kahe koko. Hoʻokumu lākou i nā loli i ka parenchyma me ka hala lohi o nā maʻi pancreatic maʻamau a ke hoʻololi nei iā lākou me ka hono hoʻopili - hoʻoulu ka fibrosis, pau ʻole nā ​​hana a pau. ʻO ka pancreas kahi hui i ʻike ʻia i nā hopena o waho a me waho. ʻO kahi hoʻololi i ke kākoʻo koko a i ʻole ka pono e alakaʻi i ka maʻi nui.

Nā kumu a me nā hōʻailona o nā maʻi

ʻO nā loli i nā kiko o ka pancreas e pili ana i nā maʻi luhi e kū nei:

• me ka atherosclerosis,
• me ka puuwai hema ʻole,
• me ka hypertension arterial ma muli o ka atherosclerosis.

Hiki ke kumu o ka ulu me ka lōʻihi o ka hoʻomohala ʻana i ka maʻi diabetes mellitus, a i ʻole ke pancreatitis aʻeha koke e ala hou mai no nā kumu ʻole. ʻO kahi mea hoʻonāukiuki he myocardial infarction.

ʻO ka trombosis vascular pancreatic he pilikia. Hoʻopumu ʻia nā thrombosis i ka hypertension i loko, thrombophlebitis, infarction myocardial. ʻO ka haunaele kuʻi ʻia e loaʻa me ka atherosclerosis, ke hoʻololi ʻia nā paia o nā kīʻaha koko o nā caliber ʻokoʻa.

Me ka loaʻa ʻole o ka puʻuwai kūpilikiʻi, loaʻa ʻole ka hala ʻole o ke kahe o ka mana o ke koko, e alakaʻi ana i ka edema pancreatic, he nui nui ka nui o kona nui, a me nā hana. Ke hele nei kahi hanana maʻi ma ka parenchyma, kahi i hōʻoia ʻia e ka hoʻomāhuahua ʻana me ke kūpaʻa o ke koko a me nā diastases iʻa.

ʻO ka mea koʻikoʻi ka hopena i ka hoʻonāukiuki i ka hoʻokahe koko i ka waiʻona. Hoʻopilikia ia i kahi hoʻopulapula mau ʻana i nā moku liʻiliʻi, no ka mea ʻoi aku nā kuleana o ke kino e loaʻa i nā mea e pono ai a me nā oxygen. Ke alakaʻi nei kēia i ko lākou make a hiki i kahi kumu o nā necrosis holoʻokoʻa.

Hoʻohana ʻia

ʻAʻohe lāʻau lapaʻau kūikawā no ka pīkī i ke koko a hoʻomohala a hoʻomohala i nā loli i ka pancreas. Hoʻohana ʻia ka maʻi lalo. Me kahi puʻupuʻu nui loa, ke hoʻomaka ka hoʻololi ʻana a i ʻole ʻo necrotic e hoʻomaka i ka parlinyma pancreas, i hōʻoia ʻia e nā haʻawina hana a me nā keʻena hana noiʻi, ua kau ʻia kahi hana paʻakikī o ka pancreatitis. Aia i ka:

• ka haʻawina hoʻolako - helu helu 5,
• enzyme replacement therapy
• inā pono - antispasmodics, painkillers a me nā lākaʻi e pale ai i ka hana o ka waikila hydrochloric.

Inā ʻaʻole mālama ʻia ka mālama ʻana, a me ka hoʻopiʻi a me nā pilikia lahilahi, nui ka maʻi ma ke ʻano maʻi. ʻO kēia ma muli o ka make o nā mokupuni o Langerhans a me ka pau ʻana o ka syntetika o ke hormon nui - insulin.

ʻO nā hopena hopena o ka hanaʻino i ka hohonu o ka pancreas

Hoʻokomo ʻia ka pancreas parenchyma me kahi laulā o ka ʻili o nā ʻōpū o nā ʻōpū. ʻO ka pancreas, e like me nā hui āpau, e kaohi ʻia e ka ʻōnaehana nerve parasympathetic - nā lālā o ka nerve vagus kūpono (n. Vagus dexter). Hoʻonohonoho lākou i ka hana exocrine - ka hana a me ka huna ʻia o nā enzyme. ʻO nā neʻe a me ke kino e hele mai ana mai kāna mau iwi hoʻonaninani i ka hana ʻana o nā hana o ka huina.

Hoʻopili ʻia ʻo ia me ka keʻena launa ma o nā liʻiliʻi liʻiliʻi e ulu ana mai nā palapala noi:

• mauʻu splenic
• maʻiila
• celiac
• mesenteric luna.

ʻO ka māhele komo o ka pūnao e alakaʻi i ka hopena kūʻē: ʻo ka huhū o ka ʻōpala celiac e hōʻeha ai i ka hōʻea ʻana o ka ʻāpana pancreatic. Akā ʻo ka lōʻihi o ka hōʻike ʻana i nā pūhaka sela me ke piʻi ʻana o ka hoʻonaʻauao o nā hana enina.

ʻO nā kīʻaha koko e hāʻawi ana i ke koko i ka pancreas e pili ana me nā fibathetic fibers: hoʻoponopono lākou i ka leo o nā pā venous.

ʻO nā lapalapa, ka mea e pili ana i ka pulu glandular e hana ana i ka mea huna pancreatic me nā enzymes, hoʻokaʻawale ʻia e nā ʻāpana, kahi i waiho ʻia i nā kino puʻupuʻu o Fater-Pacini.

ʻO nā mokupuni o Langerhans, nona nā ʻāpana e hoʻohālikelike i nā hormone nui 11, e hoʻokaʻawale i loko o ka acini e nā sela ganglion o nā hanana kūwaho autonomic.

Hoʻopilikia ka hōʻeha i nā neʻe i kekahi pae e alakaʻi i ka hoʻomohala ʻana o ka maʻi hemodynamic a me ka neurovegetative ma ka pancreas. Hoʻopilikia kēia i nā loli i ka hoʻopili maoli wale nō, akā i loko o ke anatomically a me ka hana pono nā mea ʻē aʻe e pili pū ana me ia. He paʻakikī ka hoʻolālā ʻana i kēlā mau hihia a lōʻihi loa.