Una chapamwamba Vienna. Kachitidwe ka aakulu vena cava. Chapamwamba ndipo m'munsi vena cava

Mitsempha ya magazi ndi mbali yofunika ya thupi lathu. Popanda sikutheka umoyo wa ziwalo ndipo zimakhala. Magazi chakudya m'thupi mwathu ndi mpweya ndi kumaphatikizapo zochita zonse kagayidwe kachakudya. Ziwiya ndi mitsempha kuti zoyendera ikuchitika 'mphamvu mafuta, mbali yofunika kwambiri, ngakhale capillary chaching'ono ntchito mphamvu.

Only mtima n'kofunika kwambiri kuposa

Kuti timvetse dongosolo mtima wa mtima, muyenera kudziwa pang'ono dongosolo lake. mtima zinayi munthu lagawidwa ndi kugawa mu amachepetsa ziwiri: lamanzere ndi lamanja. Mu theka lililonse pali atrium ndi ventricle. Iwo nawo kugawa, koma ndi mavavu, motero mtima kutulutsa magazi. Venous chipangizo mtima ukufanizidwa ndi mitsempha zinayi: ziwiya ziwiri (wapamwamba komanso otsika vena cava) ikuyenda mu atrium lamanja ndi lamanzere - awiri m'mapapo.

Mitsempha ya magazi mu mtima ukufanizidwa ndi msempha ndi thunthu m'mapapo mwanga. Malinga ndi msempha anakafika ku ventricle kumanzere, magazi ukufika ziwalo zonse ndipo zimakhala za thupi kupatula m'mapapo. Kuchokera ventricle lamanja la chimachititsanso m'mapapo mwanga mtsempha wamagazi magazi mu bwalo ka magazi, kudyetsa bronchi ndi alveoli a m'mapapo. Umu ndi mmene magazi amazungulira mu thupi.

Venous chipangizo mtima: chapamwamba mphako Vienna

Ngati mtima wa buku laling'ono, ndiye chipangizo mtima amatipatsanso pakati-kakulidwe, koma mitsempha wandiweyani mipanda. Mu zapambuyo mediastinum mtima ndi moyo, popangidwa ndi maphatikizidwe wa lamanzere ndi lamanja mitsempha brachiocephalic. Njirayi imatchedwa chapamwamba mphako Vienna ndipo amatanthauza kufalitsa zokhudza zonse. awiri wake umafika 25 mamilimita ndi kutalika kwa masentimita 5 7.5.

Chapamwamba mphako Vienna ili akuya kwambiri mu M'mimbamo pericardial. Lamanzere chotengera ndi kukwera msempha ndi bwino - mediastinal pleura. Kuseri kwa icho paima zapambuyo padziko lamanja m'mapapo mizu. Thymus England m'mapapo bwino inali kutsogolo. A ubwenzi mokwanira pafupi zinadzala ndi psinjika choncho kuwonongeka kwa magazi.

Chapamwamba mphako Vienna amalowa atrium pa mlingo wa nthiti wachiwiri ndipo amatenga magazi mutu, khosi ndi mbali chapamwamba chifuwa ndi manja. Palibe kukaika kuti chotengera kameneka ndi zofunika kwambiri mu dongosolo anthu magazi.

Kodi ziwiya chimasonyeza dongosolo la kuposa vena cava?

Kunyamula mitsempha magazi zakukhudzani mtima, kotero zosangalatsa mwa zipindazo mtima ngati adzadziphatika kwa izo. Chifukwa kayendedwe izi wapadera mu dongosolo, wamphamvu kuthamanga khalidwe negative.

Ziwiya m'gulu aakulu vena cava:

• akuwauza angapo, anakafika ku khoma m'mimba;
• ziwiya kudyetsa khosi ndi thorax;
• mitsempha ya lamba phewa ndi manja;
• mitsempha ya m'dera mutu ndi khosi.

Pophatikizana ndi confluence

ndi makhwawa a aakulu vena cava chiyani? The makhwawa chachikulu kutchulidwa mitsempha brachiocephalic (kumanja ndi kumanzere) anapanga chifukwa maphatikizidwe wa mkati mitsempha jugular ndi subclavian ndi opanda zingwe zoimbira. Chifukwa nthawi zonse amayenda mochedwerako mwa iwo pali chiopsezo cha mpweya kulowa pa chilonda. Lamanzere brachiocephalic Vienna akudutsa kumbuyo chogwirira cha sternum ndi thymus, ndipo mmbuyo ndi brachiocephalic thunthu ndi kumanzere carotid mtsempha wamagazi. Kumanja eponymous magazi ulusi akuyamba ulendo wake kuchokera kwa olowa sternoclavicular ndi pafupi m'mphepete kumtunda kwa pleura bwino.

Komanso kuchuluka ndi unpaired Vienna, amene okonzeka ndi mavavu kuti ndi m'kamwa mwake. Vienna umachokera pamimba, ndiyeno chochokera kumanja kwa thupi vertebral ndi kudzera chifundamtima, awa kumbuyo kum'mero kwa confluence ndi aakulu vena cava. Mawuwa magazi mndandanda wa mitsempha intercostal ndi ziwalo thoracic. Unpaired Vienna lagona bwino pa njira yopingasa wa vertebrae thoracic.

Pamene pali anomalies owonjezera mtima kumanzere vena kuposa Vienna. Zikatero, mwina ankaona olumala kuchuluka kuti wosachita katundu pa hemodynamics lapansi.

Zotengera za mutu ndi khosi mu dongosolo

Internal jugular Vienna - ziri ndithu mtsempha waukulu, membala ku aakulu vena cava. Zinali iye amene amatenga magazi kuchokera mu mitsempha ya mutu ndi mbali ya khosi. Umayamba pafupi chigaza ndi foramen jugular, akupita pansi, ndipamene ndi a vagus mitsempha ndi mtsempha wamagazi carotid neurovascular mtolo.

Jugular mtsempha makhwawa anawagawa intracranial ndi extracranial. Pakuti intracranial monga:

• meningeal mtsempha;
• diploic mtsempha (kudyetsa chigaza);
• ziwiya onyamula magazi ndi maso,
• kukhotakhota mtsempha (mkati khutu);
• mitsempha ubongo.

Ndi mitsempha diploic monga zosatha (kumbuyo ndi kutsogolo), mazunzo, occipital. mitsempha onsewa kunyamula magazi Dura ndi m'njira za m'mphuno si mavavu.

ndi makhwawa extracranial:

• Vienna kutsogolo onyamula magazi kuchokera makutu labial, masaya, makutu;
• zanizhnechelyustnaya Vienna.

Pharyngeal mtsempha, chithokomiro ndi wapamwamba mitsempha lingual ikuyenda mu mkati jugular mtsempha wachitatu pakati pa khosi kumanja.

Upper nthambi mtsempha m'gulu dongosolo

Pa dzanja mitsempha anawagawa kwakuya, minofu vutoli, ndipo chabe, kudutsa pafupifupi nthawi yomweyo pansi pa khungu.

Magazi umayenda kuchokera mosavuta mu dorsal mtsempha wa dzanja, kenako plexus venous, amene anapanga ndi ziwiya pamwamba. Mutu ndi mtsempha waukulu - ndi subcutaneous ziwiya manja. Waukulu Vienna limachokera ku palmar Chipilala ndi plexus venous wa burashi pa mbali kumbuyo. Umadutsa ndi mkono mtsempha ndi ndipamene chigongono medial, amene ntchito jekeseni mtsempha.

Vienna palmar arcs anawagawa awiri ulnar kwambiri ndi chotengera zozungulira, amene kuphatikiza pafupi chigongono olowa ndi analandira ziwiri za m'mapewa mtsempha. Kenako phewa m'zotengera axillary pochitika. Subclavian Vienna akupitiriza axillary ndipo alibe nthambi. Iwo olumikizidwa kwa fascia ndi periosteum wa nthiti choyamba, potero kuwonjezeka chilolezo ake dzanja linasankhidwa. kotunga magazi a mtsempha yatenganso kuli nthambi ziwiri.

Zotengera za chifuwa

Intercostal cava bodza mu malo intercostal, ndipo magazi anali asonkha M'mimbamo thoracic ndi gawo zapambuyo pa khoma m'mimba. zitini Awa ndi makhwawa ndi intervertebral msana mtsempha. Iwo anapanga kuchokera plexus peresenti unali mu ngalande msana.

Inakhala plexus mobwerezabwereza anastomosing Mitsempha mzake, anakafika ku una occipital pamwamba pa sacrum lapansi. Mu kumtunda kwa ndime msana plexus zazing'ono kukula mu mitsempha zazikulu ndi kugwera mu msana ndi khosi.

Zifukwa psinjika a aakulu vena cava

Chifukwa matenda monga aakulu syndrome vena cava, ndi njira pathological monga:

• khansa (adenocarcinoma, khansa ya m'mapapo);
• metastases mu khansa;
• chifuwa chachikulu;
• retrosternal khosi lotupa ya chithokomiro England;
• chindoko;
• minofu zofewa sarcoma, ndi ena.

Nthawi zambiri psinjika kumachitika chifukwa zikamera wa zotupa zilonda mpanda wa m'mitsempha kapena metastasis ake. Thrombosis akhoza kuyambitsa kuwonjezeka kuthamanga mu lumen kuti 250-500mm.rt.st, kuika chotupa ndi imfa ya mitsempha anthu.

Kodi zizindikiro matenda?

Symptomatology wa matendawa akhoza kuyamba mofulumira popanda chenjezo. Kumachitika pamene dzenje chapamwamba Vienna occluded atherosclerotic thrombus. Nthawi zambiri, zizindikiro kuonjezera pang'onopang'ono. Wodwalayo:

• mutu kapena chizungulire;
• kutsokomola ndi kuwonjezeka kufupika kwa mpweya;
• ululu pachifuwa;
• kunyansidwa ndi dysphagia;
• kusintha mu nkhope;
• kukomoka;
• kutupa kwa mitsempha chifuwa ndi khosi;
• kutupa ndi puffiness wa nkhope;
• cyanosis a nkhope kapena chifuwa.

Kwa matenda a matenda ndi zofunika kudutsa pang'ono kafukufuku. Kukhazikika bwino radiography ndi Doppler ultrasound. Iwo akhoza kugwiritsidwa ntchito kuti agwire zosiyanasiyana matenda ndi chithandizo choyenera opaleshoni.