Ngentende eliphezulu eVienna. Inkqubo le Vena cava awongamileyo. Eliphezulu aphansi Vena cava

Inkqubo yegazi yinxalenye ebalulekileyo yomzimba wethu. Ngaphandle kokuba nobomi akunakwenzeka ngamalungu oluntu kunye namalaphu. Igazi uyasondla umzimba wethu mpilo kwaye inxaxheba bonke basabele metabolic. Imikhumbi kwaye imithambo izithuthi yenziwa 'amafutha ngamandla', kudlala indima ebalulekileyo, ngoko nkqu capillary lincinane kufuneka asebenze ngamandla.

Kuphela intliziyo ibaluleke ngaphezu

Ukuze siqonde olujikeleza wentliziyo, kufuneka ukwazi kancinane yesakhiwo yayo. intliziyo-yomntu ezine usananisile yi isahlulelo kubini ezimbini: asekhohlo nasekunene. Kwisiqingatha ngasinye kukho intendelezo ventricle. Kwakhona kwabelwane ulwahlulo, kodwa kwemithambo, avumele intliziyo okumpompa igazi. isixhobo lwemithambo intliziyo imelwe efaka ezine: neempahla ezimbini (nesetyenzwe ophantsi Vena cava) ingena intendelezo ngasekunene nangasekhohlo - lung ezimbini.

Inkqubo yegazi entliziyweni bubonakaliswe aorta ngakumbi isiqu nezengekho miphungeni. Ngokutsho aorta elandisiweyo ukususela ventricle ngasekhohlo, igazi ingena kuzo zonke amalungu kunye nezihlunu umzimba ngaphandle emiphungeni. Ukususela ventricle ilungelo lihamba igazi pulmonary kwi kwisangqa encinane nokuhamba kwegazi, wayesalusa bronchi kunye alveoli emiphungeni. Leyo yindlela igazi atyhutyhela emzimbeni.

isixhobo intliziyo lwemithambo: engasentla kuthembeke Vienna

Njengoko intliziyo umthamo encinane, ngoko ke isixhobo ezinemigca kwindawo yalapha kunika eliphakathi-ertyisi, kodwa imithambo zamafu-sibiyelweyo. Kule sobuKristu mediastinum intliziyo kubhaliwe waphila, eyakhiwe yi ezo yegazi brachiocephalic ekhohlo nasekunene. Ibizwa ngokuba engasentla emgongxweni eVienna yaye libhekisela kwegazi. Ubukhulu bayo sifikelela ku-25 mm kunye ubude cm-5 ukuya 7.5.

Ngentende Vienna eliphezulu ibekwe nzulu ngokwaneleyo em- pericardial. Ukuya ekhohlo benqanawa leyo aorta zinyuka ilungelo - pleura mediastinal. Ngasemva kwawo imi phezu Icipande nengcambu kwemiphunga ekunene. Thymus ndlala kunye nemiphunga ekunene ingabekwa ngaphambili. A nolwalamano olusenyongweni ngokwaneleyo kwakugcwele ucinezelo kwaye ngoko ngokonakala nokuhamba kwegazi.

Ngentende Vienna eliphezulu lungena ngokukhululekileyo intendelezo ekunene kwinqanaba le ubambo yesibini kwaye uqokelela igazi ukusuka entloko, entanyeni kunye namalungu aphezulu esifubeni neengalo. Akukho mathandabuzo ukuba lo impahla encinane kubaluleke kakhulu kwinkqubo yokujikeleza yabantu.

Yintoni iimpahla ebonisa inkqubo eliphezulu Vena cava?

Siphethe imithambo yegazi zikufutshane entliziyweni, ngoko ukunyenyiswa amagumbi entliziyweni ukuba zincamathele kuyo. Ngenxa kwezi ntshukumo ezikhethekileyo kwinkqubo, uyinqaba ezimbi xi umlinganiswa.

Izikhephe ifakiwe Vena cava ophezulu:

• abaqhubi ezininzi, osusela eludongeni esiswini;
• imikhumbi ukondla intamo kunye Isifuba;
• imithambo ze umbhinqo kunye nezandla negxalaba;
• imithambo yendawo intloko kunye nentamo.

Naziphi kunye ekudibaneni

Yintoni omlambo i-Vena cava awongamileyo? Imijelo eziziintloko kuchazwe imithambo brachiocephalic (ekunene ekhohlo) uMbumbi ngenxa ezo yegazi jugular kwaye subclavian lwangaphakathi ngaphandle lwezivalo. Ngenxa xi eliphantsi rhoqo kuzo kukho umngcipheko yokungena umoya e inxeba. Le brachiocephalic eVienna idlule emva isiphatho kwentamo kunye thymus, yaye emva kwaso buti brachiocephalic novulelweyo carotid umthambo. Ekunene cu eponymous yegazi eqala uhambo lwayo ukusuka ilunga sternoclavicular kwaye ezikufutshane ukuya kwikona eliphezulu pleura ekunene.

Kwakhona, yokufika na unpaired Vienna, nto leyo lixhotyiswe valve ke emlonyeni wayo. Oku Vienna esuka esiswini, uze esusela kwicala lasekunene lomzimba vertebral yaye uvalo, ilandelayo emva kuvuleke iminxunya ukuya ekudibaneni kunye Vena cava awongamileyo. Athwala igazi zokuqokelelwa yegazi intercostal kunye namaziko thoracic. Unpaired eVienna ilala ekunene kwi iinkqubo ezinqamlezayo ngayo amalungu omqolo thoracic.

Xa kukho mgaqweni intliziyo extra ngasekhohlo Vena ophezulu eVienna. Kwiimeko ezinjalo, ingathatyathwa wokufika sokuyekisa ukusebenza loo nto kuthwala umthwalo phezu hemodynamics.

Iimpahla intloko entanyeni kwinkqubo

Lwangaphakathi jugular Vienna - ukuba kakhulu apho iphuma khona enkulu, ilungu kwi Vena cava awongamileyo. Yaba yena eqokelela igazi yegazi entloko ngenxalenye entanyeni. Iqala kufuphi yaba lukakayi, foramen jugular, behla, yenza ne lo vagus luvo kunye carotid Umthambo neurovascular bundle.

nemingenela ndlela Jugular zahlulwe zibe intracranial kunye extracranial. Kuba intracranial ziquka:

• ndlela meningeal;
• ndlela diploic (ukondla skull);
• imithambo ethwele igazi emehlweni;
• mibono umthambo (indlebe engaphakathi);
• mithambo lobuchopho.

Efaka diploic ziquka zexeshana (ngasemva kunye ngaphambili), ngokungqalileyo, Occipital. Zonke ezi ngemithambo ethumela igazi kwi Dura kunye sinuses azikho lwezivalo.

zezi nemingenela extracranial:

• Vienna phambi ephethe igazi evela labial emphethweni, izidlele, earlobes;
• zanizhnechelyustnaya eVienna.

Pharyngeal umthambo, lengqula ophezulu ngemithambo zeelwimi ingena ndlela jugular lwangaphakathi wesithathu phakathi entanyeni ekunene.

nemilenze umthambo ifakiwe kwindlela

Kwelinye icala imithambo bohlulwa enzulwini, izihlunu engundoqo, ezingekhoyo, bedlula phantse nangoko ngaphantsi kwesikhumba.

Igazi kwemali evela zomnwe xa amaphiko umthambo isandla, kulandele plexus lwemithambo, oluthi luqokelelane yi izitya kumphezulu. Intloko kunye ndlela iphambili - na izitya ongama izandla. The main eVienna evela kwinqugwala palmar kunye plexus lwemithambo ye brush kwicala umva. Udlula Kwangale ziyenza njani futhi yakha engqinibeni medial, esetyenziswa inaliti efakwa.

Vienna palmar jike bohlulwa babe ezimbini ulnar olunzulu isitya iphiramidi, leyo bahlanganisane kufuphi entlanganweni engqinibeni waza wafumana ezimbini vein egxalabeni. Emva koko nehlombe kwimikhumbi axillary kudlula. Subclavian eVienna uyaqhubeka axillary kwaye akukho namasebe. Elidityaniswe kuyo le ifascia kunye periosteum kwe ubambo yokuqala, ukuze kwandiswe ukusebenza kugqitywe wayo esandleni wathatha. ubonelelo igazi vein kufakwa semigudu ezimbini.

Iimpahla yesifuba

cava bubuxoki Intercostal kwizikhewu intercostal, kwaye negazi eyayiqokelelwe kwisisu thoracic kunye nenxalenye Icipande eludongeni esiswini. Ezi iinkonkxa ezi nemingenela kunye ndlela intervertebral lialio. Bona akhiwa plexus ezinomqolo, emi phakathi lomsele spinal.

Ekuyo plexus ukuba anastomosing ngokuphindaphindiweyo imithambo yegazi omnye komnye, osusela mngxuma Occipital phezulu ukuya phezulu sacrum. Kwinxalenye engentla kumhlathi spinal plexus ezincinane bekhula emithanjeni ezinkulu awele umnqonqo kunye nentamo.

Izizathu ucinezelo le Vena cava awongamileyo

Izizathu zale sifo njengoko superior Vena cava syndrome, iinkqubo zophendlo lwezifo ezifana:

• zomhlaza (adenocarcinoma, umhlaza wemiphunga);
• metastases ngayo umhlaza webele;
• tuberculosis;
• goiter retrosternal le ingaba lengqula;
• negcushuwa;
• nee- kwizihlunu ezithambileyo, kunye nabanye.

Amaxesha amaninzi ucinezelo kwenzeka ngenxa kokuhluma yamathumba amabi, eludongeni Kwangale okanye Ukudlulela yayo. Thrombosis zinokwenza umfutho kwi mithambo ukuya 250-500mm.rt.st, ebenza isichenge komsipha kunye nokufa ngemithambo zabantu.

Ziintoni iimpawu syndrome?

Symptomatology le syndrome ingaqala ngokukhawuleza ngaphandle kwesilumkiso. Oku kwenzeka xa usikrobana eliphezulu Vienna occluded thrombus atherosclerotic. Kwiimeko ezininzi, iimpawu kwandisa ngcembe. Ogulayo:

• intloko ebuhlungu okanye isiyezi;
• isikhohlela ngokungathintithiyo nephika;
• ubuhlungu esifubeni;
• isicaphucaphu kunye dysphagia;
• kutshintsha iimpawu ebusweni;
• niphele;
• iindumbisa yegazi esifubeni emqaleni;
• ukudumba kunye sivakale sidumbile yobuso;
• cyanosis yobuso okanye esifubeni.

Kuba lokufunyaniswa syndrome kuyimfuneko ukuba iphumele isuntswana uphando. esekwe kakuhle ray kunye Doppler ultrasound. Zinokuthi zisetyenziswe ukwenza iyantlukwano Uxilongo kunye nonyango olufanelekileyo yotyando.