Zigawo chiwindi. Kapangidwe ndi ntchito ya chiwindi

Chiwindi ndi chiwalo wachiwiri kukula mu thupi - yekha khungu wamkulu komanso ankawonjezereka. Chiwindi ntchito ingakhalepo chakudya chimbudzi, ndi kupukusa chakudya, chitetezo chokwanira ndi kusunga zakudya m'thupi. Chiwindi ndi chiwalo chofunika kwambiri popanda zimene zimakhala za thupi mofulumira kufa chifukwa chosowa mphamvu ndi zakudya. Mwamwayi, iye ali ndi nzeru zosaneneka buluzi ndi kukula mofulumira kwambiri kuti abwezeretse Ntchito yawo ndi kukula. Tiyeni tiyang'ane pa kapangidwe ndi ntchito ya chiwindi kwambiri.

Macroscopic thunthu anthu

Chiwindi ndi ufulu anthu pansi chifundamtima ndipo ali ndi mawonekedwe triangular. Ambiri ake kulemera lili kumanja, ndi mbali yaing'ono chabe ya izo chimafikira kupitirira mzere pakati pa thupi. Chiwindi imakhala zofewa kwambiri, cheza chofiirira bulauni minofu unazunguliridwa mu kapisozi minofu connective (Glisson kapisozi). Iwo ali ndi kumakula ndi peritoneum (serous Kakhungu) wa zonse m'mimba, amene amateteza amagwira m'malo mwa pamimba. Wapakati kukula kwa chiwindi - pafupifupi 18 masentimita m'litali ndi zosaposa 13 makulidwe.

peritoneum The chikugwirizana chiwindi m'mbali zinayi: inatsekeratu mitsempha, lamanzere ndi lamanja triangular mitsempha ndi mitsempha chonse. mankhwala awa osati m'lingaliro anatomical; kani, iwo ali wothinikizidwa dera m'mimba nembanemba, amene amathandiza chiwindi.

• Lonse inatsekeratu mitsempha zikugwirizana ndi chigawo chapakati cha chiwindi kuti chifundamtima.

• ili malire lateral ya kumanzere ndipo lobes lamanja, anachoka ndi ufulu Mitsemphayi triangular kulumikiza thupi ndi chifundamtima.

• The mtolo wopindidwa chimafikira downwardly ku kabowo kudzera m'mphepete kutsogolo kwa chiwindi ndi pansi pake. Pansi pa thupi yokhota kumapeto mitsempha imagwiritsidwa mitsempha kuzungulira ndi zikugwirizana chiwindi kuti umbilicus lapansi. The mitsempha kuzungulira ndi otsalira a mtsempha umbilical, omwe amanyamula magazi m'thupi pa chitukuko embryonic.

Chiwindi tichipeza lobes awiri osiyana - lamanzere ndi lamanja. Iwo anapatukana ndi gulu yokhota kumapeto. The Lobe lamanja 6 zina zazikulu kuposa kumanzere. Aliyense gawo lagawidwa m'magulu, amene nawonso, anawagawa zigawo chiwindi. Motero, thupi lagawidwa pawiri, kumabungwe 5 8 zigawo. Choncho owerengedwa zigawo chiwindi Roma manambala.

gawo bwino

Monga tanena ndi Lobe lamanja la chiwindi pafupifupi nthawi 6 kuposa kumanzere. Amakhala ndi kumabungwe awiri akuluakulu: lamanja lateral gawo ndi ufulu paramedian gawo.

Kumanja gawo lateral lagawidwa zigawo ziwiri lateral omwe si contiguous ndi Lobe kumanzere kwa chiwindi: lamanja lateral gawo verhnezadny kachigawo (VII gawo) ndi lateral gawo nizhnezadny (VI gawo).

Kumanja paramedian gawo amadziwikanso kumaphatikizapo zigawo ziwiri: avareji ndi apakatikati verhneperedny zigawo nizhneperedny chiwindi (VIII ndi V, motero).

The Lobe kumanzere

Ngakhale kuti kumanzere Lobe a chiwindi ndi wocheperako kusiyana kumanja, tichipeza nambala yaikulu ya zigawo. Iwo agawidwa m'magulu atatu: dorsal kumanzere, anasiya lateral, anachoka gawo paramedian.

Kumanzere dorsal gawo tichipeza gawo imodzi: caudate gawo la Lobe kumanzere (I).

Kumanzere gawo lateral kwambiri, aumbike mwa gawo imodzi: zapambuyo gawo la Lobe kumanzere (II).

Anachoka gawo paramedian lagawidwa zigawo ziwiri: zigawo lalikulu ndipo kutsogolo kwa Lobe kumanzere (IV ndi III, motero).

Kupenda mosamalitsa kapangidwe ka chiwindi mungathe segmental ku machenjerero otsatirawo. Mwachitsanzo, Chithunzi wina chikusonyezera chiwindi, amene zowoneka mbali zake zonse. zigawo The liwerengedwa mu chithunzi chiwindi. chiwerengero lililonse limafanana ndi chiwerengero cha Latin gawo.

Chithunzi 1:

ya ndulu capillaries

Tubules onyamula ya ndulu ndi chiwindi ndi ndulu, ya ndulu otchedwa capillaries ndi kupanga dongosolo nthambi - dongosolo biliary.

Ya ndulu imatulutsidwa ndi maselo a chiwindi, ukuyenda mu njira tosaoneka - ya ndulu capillaries, amene amaphatikizidwa mu ducts ikuluikulu ya ndulu. ducts ya ndulu awa ndiye chikugwirizana ndi mzake, kupanga lalikulu nthambi lamanzere ndi lamanja kuti kunyamula ya ndulu kumanja ndi kumanzere chiwindi lobes. Kenako iwo amagwirizana mu chimodzi kwa chiwindi ritsa, amene bere ya ndulu onse.

Common kwa chiwindi ritsa, potsiriza akulowa enaake ritsa ku ndulu ya. Pamodzi kupanga wamba ya ndulu ritsa onyamula ya ndulu kwa duodenum za m'mimba yaing'ono. Ambiri ya ndulu opangidwa ndi chiwindi, ndi kuika kumbuyo mu enaake ritsa peristalsis, ndipo amakhalabe ndulu mpaka ndiye, mpaka chofunika chimbudzi.

mitsempha ya magazi

Chiwindi Perfusion wapadera. Magazi amalowa kuti zinthu ziwiri: m'mitsempha zipata (magazi venous) ndi kwa chiwindi mtsempha wamagazi (wolumikizira magazi).

Chipata Vienna amanyamula magazi ndulu, m'mimba, kapamba, chikhodzodzo ndulu, intestine ang'ono ndi omentum. Akafika makomo a m'chiwindi, venous Vienna lagawidwa chiwerengero chachikulu ziwiya, kumene magazi kukonzedwa Musanayambe mbali zina za thupi. Kusiya maselo a chiwindi, magazi Akusonkhanitsa mitsempha kwa chiwindi, amene akugwa mu vena cava, ndi kubwerera ku mtima.

Mu chiwindi alinso dongosolo yakeyake mitsempha ndi mitsempha yaing'ono kuti apulumutse mpweya mu zimakhala mwa iye chimodzimodzi monga thupi ina.

magawo

Kapangidwe mkati mwa chiwindi ndizo pafupifupi 100,000 yaing'ono hexagonal mayunitsi zinchito kudziwika monga magawo. Aliyense lobule imakhala mtsempha chapakati, kwa chiwindi zipata atazunguliridwa 6 6 mitsempha kwa chiwindi ndi mitsempha. Mitsempha izi imakhudzana ndi zambiri machubu izi capillary - sinusoids. Ngati masipoko a njinga, iwo kuyambira mitsempha zipata ndi mitsempha kwa m'mitsempha chapakati.

Aliyense sinusoid umadutsa minofu chiwindi, muli mitundu iwiri yaikulu ya maselo maselo Kupffer ndi hepatocytes.

• Tizipinda Kupffer ali choyimira cha macrophage. Mu mawu osavuta, iwo mumpanda ndi kuphwanya akale, nsanza maselo ofiira kudutsa yoweyula sine.

• hepatocytes (maselo chiwindi) ndi cuboidal zaminyewa maselo, yomwe ili pakati sinusoids ndi akupanga ambiri a maselo chiwindi. Hepatocytes kuchita ambiri a ntchito za chiwindi - kagayidwe, yosungirako, chimbudzi ndi kupanga ya ndulu. Ting'onoting'ono kusonkhanitsa ya ndulu, lotchedwa capillaries ake, sinusoids kuthamanga kufanana tsidya lina la hepatocytes.

chiwembu chiwindi

chiphunzitso ndife bwino. Tiyeni tiwone momwe icho chikuwonekera chiwindi anthu. Photos ndi mafotokozedwe a iwo angapezeke m'munsimu. Popeza chithunzi sangathe kusonyeza thupi kwathunthu, timagwiritsa ntchito ochepa. Ndi bwino ngati zithunzi ziwiri zikusonyeza gawo lomwelo la chiwindi.

Chithunzi 2:

chiwerengero 2 amalembedwa chokha chiwindi anthu. Photos Pankhaniyi sizikanakhala Chotero, kuyang'ana pa chithunzi chake. Zotsatirazi ndi manambalawo, ndipo ukufanizidwa ndi chithunzi ichi:

1 - chabwino kwa chiwindi ritsa; 2 - chiwindi; 3 - kumanzere kwa chiwindi ritsa; 4 - wamba kwa chiwindi ritsa; 5 - wamba ya ndulu ritsa; 6 - kapamba; 7 - pancreatic ritsa; 8 - ndi duodenum; 9 - sphincter wa Oddi; 10 - ndi enaake ritsa; 11 - ndulu.

Chithunzi 3:

Ngati muona kuti Buku la mapu a thunthu anthu, inu mukudziwa kuti ili pafupifupi m'chithunzithunzi chomwechi. Apa, chiwindi ankaimira kutsogolo:

1 - m'munsi dzenje Vienna; 2 - yokhota kumapeto mitsempha; 3 - Lobe bwino; 4 - kumanzere Lobe; 5 - wozungulira mitsempha; 6 - ndulu.

Chithunzi 4:

chithunzi Izi zikusonyeza chiwindi pa linzake. Kachiwiri, Atlas of Human Anatomy lili pafupi chitsanzo:

1 - ndulu; 2 - ndi Lobe bwino; 3 - kumanzere Lobe; 4 - ndi enaake ritsa; 5 - kwa chiwindi ritsa; 6 - mtsempha wamagazi kwa chiwindi; 7 - kwa chiwindi zipata Vienna; 8 - wamba ya ndulu ritsa; 9 - m'munsi dzenje Vienna.

Chithunzi 5:

Fanizo limeneli likusonyeza mbali yaing'ono kwambiri chiwindi. Ena mafotokozedwe: nambala 7 mu zimakwana amasonyeza wa ku chipata - gulu kuti zimalunzanitsa pamodzi kwa chiwindi zipata mtsempha, mtsempha wamagazi kwa chiwindi ndi ya ndulu ritsa.

1 - kwa chiwindi sinusoid; 2 - chiwindi maselo; 3 - chapakati Vienna; 4 - kuti m'mitsempha kwa chiwindi; 5 - ya ndulu capillaries; 6 - matumbo capillaries; 7 - «wa ku chipata»; 8 -pechenochnaya chipata Vienna; 9 - mtsempha wamagazi kwa chiwindi; 10 - ya ndulu ritsa.

Chithunzi 6:

Zolembedwa English likumasuliridwa (kumanzere kupita kumanja): lamanja lateral gawo, lamanja paramedian gawo, anachoka gawo paramedian ndipo anasiya gawo lateral. White mawerengero chiwindi owerengedwa zigawo, chiwerengero lililonse limafanana ndi chiwerengero cha gawo Latin:

1 - chabwino kwa chiwindi Vienna; 2 - kumanzere kwa chiwindi Vienna; 3 - pafupifupi kwa chiwindi Vienna; 4 - umbilical Vienna (zotsalira); 5 - kwa chiwindi ritsa; 6 - m'munsi dzenje Vienna; 7 - mtsempha wamagazi kwa chiwindi; 8 - chipata Vienna; 9 - ya ndulu ritsa; 10 - ndi enaake ritsa; 11 - ndulu.

The Maphunziro Akakhalidwe Kazolengedwa a chiwindi

anthu chiwindi ntchito ndi yosiyanasiyana: izo amakwaniritsa mbali yaikulu chimbudzi ndipo thupi, ndipo ngakhale kusungiramo zakudya.

chimbudzi

Chiwindi chimagwira ntchito yogwira mu ndondomeko m'mimba mwa kupanga ya ndulu. Ya ndulu ndi osakaniza a madzi, salt zidulo ya ndulu, mafuta ndi bilirubin pigment.

Pambuyo hepatocytes mu chiwindi kubala ya ndulu, umadutsa ndi ducts ya ndulu ndipo kusungidwa mu ndulu mpaka ndiye, mpaka sanalinso ofunikira. Pamene chakudya munali mafuta umalandira duodenum, maselo mmatumbo kutulutsa timadzi cholecystokinin, yomwe pansi ndi ndulu. Ya ndulu, akuyenderera ya ndulu ritsa akulowa duodenum, kumene lalikulu emulsifies misa mafuta. Emulsification wa mafuta ya ndulu zimapangitsa chunks yaikulu ya mafuta mu tiziduswa tating'ono ting'ono, amene apansi padziko dera choncho mosavuta akonzanso.

Bilirubin anabwera ya ndulu, chiwindi ndi mankhwala a processing wa wolema maselo ofiira. maselo Kupffer mu chiwindi kuti ugwire ndi kuwononga akale, wolema maselo ofiira ndi kachilombo iwo hepatocytes lapansi. M'mbuyomu tsoka la hemoglobin - izo m'magulu a heme ndi globin. Globin mapuloteni zina oipa ndiponso ntchito ngati gwero mphamvu thupi. Iron munali heme gulu sangathe redesigned thupi ndi chabe anatembenukira kwa bilirubin, amene anawonjezera kuti ya ndulu ya. Iwo bilirubin amapereka ya ndulu chosiyana mtundu wobiriwira. mabakiteriya matumbo akupitiriza n'kukhala bilirubin strekobilin bulauni pigment womwe umapereka chimbudzi bulauni.

kagayidwe

Chiwindi hepatocytes mlandu kwambiri za mavuto zovuta zokhudza njira kagayidwe kachakudya. Popeza magazi onse kusiya dongosolo m'mimba, umadutsa ndi kwa chiwindi mtsempha zipata, chiwindi ndi udindo metabolizing chakudya, lipids ndi mapuloteni mu zipangizo biologically zothandiza.

m'mimba dongosolo lathu zimafunika chakudya shuga monosaccharide maselo ntchito ngati gwero mphamvu yaikulu. Magazi kulowa chiwindi kudzera kwa chiwindi mtsempha chipata, ali wolemera kwambiri mu shuga kwa chakudya m'mimba. Hepatocytes kuyamwa ambiri a shuga ndi kusunga monga glycogen macromolecule, ndi nthambi polysaccharide, amene amalola chiwindi kusunga yambiri shuga ndipo mwamsanga kumasula pakati chakudya. Mayamwidwe ndi kutulutsidwa kwa shuga ndi hepatocytes zingawathandize kukhala homeostasis ndipo m'munsi shuga magazi.

Mafuta zidulo (lipids), magazi kudutsa chiwindi, m'mimba ndiponso chosakanikirana ndi hepatocytes kutulutsa mphamvu mu mawonekedwe a ATP. Glycerol, chigawo chimodzi cha zamadzimadzi mu hepatocytes kusandulika shuga mwa ndondomeko gluconeogenesis. Hepatocytes angathe kubala lipids monga mafuta, phospholipids ndi lipoproteins, amene ntchito ndi maselo ena a m'thupi. Ambiri mwa mafuta opangidwa ndi hepatocytes, linachokera ku thupi ndi mbali ya ya ndulu.

mapuloteni zakudya unagwa mu amino zidulo a dongosolo m'mimba ngakhale asanaikidwe umasamutsidwa ku kwa chiwindi mtsempha zipata. zidulo kwa amino adalowa chiwindi, kagayidwe kachakudya amafuna processing patsogolo kugwiritsidwa ntchito ngati gwero mphamvu. Hepatocytes anali woyamba amachotsedwa kwa amino gulu la amine ndi uzidzatenga amoniya, amene pamapeto pake n'kukhala urea.

Urea si poizoni kuposa amoniya, ndipo akhoza olekanitsidwa mu mkodzo monga mankhwala akungotaya chimbudzi. Mavesi a zidulo kwa amino unagwa mu ATP kapena n'kukhala mamolekyulu atsopano a shuga mwa ndondomeko gluconeogenesis.

detoxification

Popeza magazi kuchokera ku ziwalo m'mimba umadutsa zipata a chiwindi magazi, zili magazi ulamuliro hepatocytes ndi kuchotsedwa zinthu zambiri zomwe zingakhale poizoni, pamaso iwo angafikire zina za thupi.

Michere mu hepatocytes kutembenuza ambiri a poizoni awa (mwachitsanzo, mowa kapena mankhwala osokoneza bongo) mu metabolites awo anafooka. Pofuna kukhala mlingo wa mahomoni mu malire homeostatic, chiwindi komanso metabolizes ndipo amachotsa ku mahomoni makope opangidwa ndi zopangitsa mu thupi yekha.

yosungirako

Chiwindi amapereka kusungiramo zambiri zofunika zakudya, mavitamini ndi mchere kuwapeza mwazi wa HIV mwa dongosolo zipata kwa chiwindi. Shuga chimadzera mu hepatocytes mchikakamizo cha timadzi insulin ndi kusungidwa ngati polysaccharide glycogen. Hepatocytes ungalowenso ndi mafuta zidulo wa triglyceride ndi ingested. Kusungiramo zinthuzi akulola chiwindi kukhalabe homeostasis shuga m'magazi.

chiwindi wathu zimasunga mavitamini ndi mchere (mavitamini A, D, E, K ndipo B 12, ndi mchere chitsulo ndi mkuwa) pofuna otaya zonse zinthu zofunika zimakhala thupi.

kupanga

Chiwindi ndi udindo yopangira angapo zigawo zikuluzikulu zofunika nyama ya madzi a m'magazi: prothrombin, fibrinogen ndi albumin. Prothrombin ndi fibrinogen mapuloteni ndi coagulation zinthu kumatanthauza mapangidwe magazi kuundana. Albumins ndi mapulotini kukhala magazi isotonic sing'anga kotero kuti maselo thupi osati timataya madzi pamaso pa mthupi.

asanazolowere

ntchito chiwindi pamene dongosolo thupi m'thupi kudzera ntchito ya maselo Kupffer. maselo Kupffer ndi macrophages, phagocytes mononuclear kupanga mbali ya dongosolo pamodzi ndi macrophages a ndulu ndi lymph mfundo. maselo Kupffer mbali yofunika, monga mabakiteriya kukonzedwa, bowa, tizilombo, maselo nsanza ofiira ndi zinyalala ma.

Ultrasound chiwindi: wakudziko ndi kupatuka

Chiwindi amagwira ntchito zambiri zofunika m'thupi mwathu, kotero ndikofunika kuti wakhala ponseponse. Popeza kuti chiwindi sangathe kudwala, chifukwa alibe mathero mitsempha, inu simungakhoze kuwona momwe zinali chiyembekezo. Iwo amangokhala kuphwanyaphwanya, pang'onopang'ono, koma mapeto zidzakhala zosatheka kuchiza.

Pali matenda chiwindi imene inu mulibe ngakhale amaganiza kuti panali chinachake mpaka kalekale. Munthu angathe kukhala nthawi yaitali ndipo kuti ndinu wathanzi, koma mapeto likukhalira kuti ali ndi matenda enaake kapena khansa chiwindi. Ndipo izi sizisintha.

Ngakhale chiwindi ndi ali katundu kuti achire, Tamarayo konse kuthana ndi matenda. Nthawi zina amafuna thandizo lanu.

Kupewa mavuto achabechabe, nthawi zina zokwanira kukaonana ndi adokotala ndi kuchita ultrasound a chiwindi, mlingo chimene pansipa. Kumbukirani kuti chiwindi kugwirizana ndi matenda owopsa monga chiwindi, kuti popanda mankhwalawa kungachititse nthawi pathologies aakulu monga matenda enaake ndi khansa.

Tsopano tiyeni mwachindunji ku US ndi malamulo ake. Mkuluyo woyamba amayang'ana kuti awone ngati chiwindi ndi zimene kukula kwake ndi kuchepetsa.

Kukula enieni a chiwindi sangakhoze mwachindunji ngati kwathunthu muzione thupi zosatheka. okwana kutalika kwa thupi sayenera upambana 18 cm. madokotala kuchiza mbali payokha chiwindi.

Tiyeni tiyambe ndi choona kuti chiwindi ultrasound ayenera kuoneka bwino lomwe awiri a cholowa, komanso kumabungwe amene amakhala wogawanika. Pa Mitsemphayi yemweyo (ndiko kuti, Mitsemphayi zonse) ayenera kukhala kuwoneka. phunziro imathandiza madokotala kuphunzira zigawo zonse eyiti payokha, kuyambira nawonso, akhoza mophweka.

Wakudziko miyeso ya lamanja ndi kumanzere Lobe

The Lobe kumanzere akhale za 7 masentimita makulidwe ndi za 10 cm mu msinkhu. Kukula kukula limanena za matenda mwina kuti muli kutupa chiwindi. The Lobe komwe ndi mlingo - 12 masentimita makulidwe ndi masentimita 15 m'litali, monga momwe mukuonera kwambiri kumanzere.

Kuwonjezera thupi, madokotala ayenera kuonanso ya ndulu ritsa, komanso ziwiya lalikulu magazi a chiwindi. Kukula kwa ya ndulu ritsa Mwachitsanzo, ayenera kukhala osapitirira 8 mm, zipata Vienna - 12 mamilimita ndi dzenje Vienna - 15 mm.

Madokotala osati ziwalo miyeso, komanso matabwa ake, contours thupi ndi minofu.

thunthu anthu (chiwindi, amene ali chiwalo zovuta) - ndithu chinthu chosangalatsa. Palibe chidwi kwambiri kuposa kumvetsa kapangidwe lokha. Nthawi zina ngakhale kukupulumutsani ku matenda osafunika. Ndipo ngati muli tcheru, mavuto zikhoza kupewedwa. Ulendo kwa dokotala - si monga wowopsa ngati zikuoneka. Khalani wathanzi!