Ezi ziqwempu zesibindi. Ubume kunye umsebenzi wesibindi

Kwesibindi, lelona candelo yesibini ngobukhulu emzimbeni - kuphela ulusu mkhulu kwaye usinda. umsebenzi kwesibindi bungabangela ukwetyisa ukutya, ukutya, okukwazi kunye nokugcinwa izondlo emzimbeni. Isibindi ilungu ebalulekileyo ngaphandle apho nezihlunu umzimba ngokukhawuleza bafe ngenxa yokuswela amandla kunye nezondlo. Ngethamsanqa, yena linamandla engakholelekiyo ukuvuselela kwaye ukukhula ngokukhawuleza kakhulu ukuze ukubuyisela umsebenzi wabo kunye nobukhulu. Makhe sijonge isakhiwo kunye nomsebenzi kwesibindi ngakumbi.

komzimba womuntu kokukhulu

Isibindi lilungelo lomntu phantsi uvalo kwaye ngokumila ngunxantathu. Uninzi ubunzima bayo kubekwe kwicala lasekunene, yaye kuphela inxalenye encinane nangabo ngaphaya komgca phakathi komzimba. Kwesibindi iquka soft kakhulu, izihlunu, ezipinki-bumdaka abhijelwe capsule yethishyu nokuqina (Glisson capsule). Kubhaliwe zigutyungelwe yomelezwa peritoneum (inwebu serous) ye kwisisu, elikhusela kwaye obambelela kuko endaweni ngaphakathi esiswini. I-avareji Ubukhulu kwesibindi - malunga ne-18 cm ubude kwaye akukho ngaphezulu kwe-13 ngokomelela.

Le peritoneum liqhagamshelene isibindi kwiindawo ezine: lungu coronary, ekhohlo nasekunene lungu ezingoonxantathu kunye lungu ngeenxa zonke. Ezi zinto azikho kuphela ngengqiqo yokwakheka; kunoko, ke zixinaniswe kummandla esiswini le inwebu, elixhasa isibindi.

• lungu Wide coronary inxulumanisa ngundoqo kwesibindi ukuya uvalo.

• Indawo kwimida osecaleni yasekhohlo kunye isithinzi ekunene, nemisipha olunxantathu ekhohlo nasekunene uqhagamshele umzimba kunye uvalo.

• I-inyanda bent liqalela downwardly ukusuka beso ngokusebenzisa ngohlangothi ngaphambili kwesibindi ukuya ezantsi kwayo. Emazantsi umzimba lungu egosogoso Ulobumba lungu engqukuva ifaka wesibindi ukuya umbilicus. Eli lungu Round intsalela Kwangale yosana, eli liyithweleyo igazi emzimbeni ngexesha kuphuhliso osandul.

Kwesibindi iqulathe isithinzi ezimbini ezahlukeneyo - ekhohlo nasekunene. Bona yahlukanisiwe ukusuka kwenye nenye band egosogoso. Nomhlehlo lungelo 6 amaxesha ezinkulu kuno ekhohlo. isabelo nganye yahlulwe kumacandelo, mvisiswano leyo, kwelinye icala, yahlulwe iinxalenye esibindini. Ngenxa yoko, umzimba yahlulwe kubini, amacandelo 5 kunye namacandelo-8. Ngoko ke ababalwayo ziqwempu zesibindi Amanani roman.

olusekunene

Njengoko kukhankanyiwe ngasentla, nomhlehlo lasekunene isibindi malunga amaxesha 6 mkhulu ekhohlo. It iqulathe amacandelo amabini: icandelo ekunene osecaleni kunye necandelo ekunene paramedian.

icandelo Ekunene lateral yahlulwe ngokwamacandelo amabini osecaleni ezo nto kunayo kunye nomhlehlo lasekhohlo kwesibindi: ekunene osecaleni kwicandelo verhnezadny iqhekeza (VII ingxenye) kunye nizhnezadny kwicandelo osecaleni (VI ingxenye).

icandelo Ekunene paramedian nayo iqulathe amacandelo amabini: avareji kunye udibaniso verhneperedny ziqwempu isibindi nizhneperedny (VIII kunye V, ngokulandelelanayo).

Nomhlehlo ekhohlo

Ngaphandle kwento yokuba lobe lasekhohlo isibindi incinane ekunene, ukuba yakhiwe inani elikhulu komsindo. Yahlulahlulwe yaba ngamacandelo amathathu: amanakani ngasekhohlo, wemka osecaleni, icandelo paramedian ngasekhohlo.

Ekhohlo icandelo amaphiko iquka icandelo: i caudate icandelo nomhlehlo ekhohlo (I).

Ekhohlo icandelo lateral kakhulu, kwenziwa ngayo icandelo: i ngomva icandelo nomhlehlo ekhohlo (II).

Icandelo paramedian ngasekhohlo yahlulwe ngokwamacandelo ezimbini: ziqwempu isikwere kunye phambi nomhlehlo ekhohlo (IV kunye III, ngokulandelelanayo).

Uqwalaselo olubukhali isakhiwo isibindi segmental ungakwazi kwi izikimu ezilandelayo. Ngokomzekelo, Umfanekiso enye ibonisa isibindi, nto leyo abangaboniyo yahlulwe zonke iinxalenye zayo. Ezi ziqwempu ezinonjolwe ngayo esibindini mzobo. inombolo ngamnye ingqinelana kwinani Latin ingxenye.

Figure 1:

emithanjeni enyongweni

Tubules ababethwele inyongo sisibindi kunye senyongo, duct ekuthiwa emithanjeni kwaye zenze isakhiwo branched - inkqubo biliary.

Enyongweni yenziweyo iiseli isibindi, eziphuma imijelo ezincinane - emithanjeni inyongo, apho angena imibhobho emikhulu inyongo. Ezi bile duct ke idityaniswe omnye komnye, wakha amasebe amakhulu ekhohlo nasekunene ukuba bayithwale inyongo ngasekunene kunye isithinzi zesibindi ngasekhohlo. Kamva ke bamanyene duct eziqhelekileyo hepatic, leyo ungenamandla yonke enyongweni.

duct Common hepatic, ekugqibeleni izibandakanya duct esinganyangekiyo ukusuka senyongo. Bebonke bakha bile duct eqhelekileyo ephethe inyongo ukuya duodenum ye emathunjini amancinci. Uninzi enyongweni yenziweyo isibindi, mababulawe umva kulo bile peristalsis esinganyangekiyo, kwaye lihlale senyongo de kube ngoko, de kufuneka ukuba ukwetyisa.

kwegazi

Kwesibindi Perfusion unique. Igazi engena kuwo evela kwimithombo ezimbini: Kwangale Portal (igazi lwemithambo) kunye Umthambo hepatic (igazi lwemithambo).

Isango eVienna ethwala igazi ukusuka udakada, isisu, injeke, inyongo isinyi, emathunjini amancinci omentum. Xa ingena emasangweni kwesibindi, lwemithambo eVienna yahlulahlulwe inani elikhulu iimpahla, apho igazi kusetyenzwa phambi kokugqithela kwezinye amalungu omzimba. Ukushiya iiseli ophezu kwesibindi, igazi buthathwa imithambo hepatic, apho iwele cava Vena, kwaye ibuyisela entliziyweni.

Esibindini kananjalo inkqubo yaso kwemithambo yegazi ezincinane ukuhambisa ioksijini ancedisana kwayo ngendlela efanayo njengawo nawuphi na umzimba.

izilayi

Isakhiwo lwangaphakathi kwesibindi iquka nama-100,000 iiyunithi ezincinane ezinamacala ezisebenzayo eyaziwa ngokuba ngamacetyana. lobule nganye iqulathe emthanjeni engundoqo, portal hepatic engqongwe 6 6 imithambo hepatic yegazi. Ezi imithambo yegazi zinxulunyaniswa ezininzi ngale mibhobho capillary - sinusoids. Kanye iiasi kwevili, awabonisi ukusuka yegazi portal kunye imithambo ekuyeni ndlela iphambili.

sinusoid nganye udlula inwebu kwesibindi, equlethe iindidi ezimbini eziphambili iiseli: iiseli Kupffer kunye hepatocytes.

• Iiseli Kupffer na uhlobo lwe macrophage. Ngamagama alula, bathimba nokwahlula phantsi ubudala, ezigugileyo iiseli ezibomvu edlula iliza sine.

• hepatocytes (iiseli kwesibindi) iiseli cuboidal epithelial, ezithi zibekwe phakathi sinusoids kwaye iquka isininzi leseli esibindini. Hepatocytes benza uninzi imisebenzi kwesibindi - nethe, ukugcinwa, yokwetyiswa imveliso inyongo. ingqokelela Tiny of inyongo, eyaziwa ngokuba emithanjeni yayo, sinusoids kuqhutywa kunye kwelinye icala hepatocytes.

scheme kwesibindi

Ithiyori thina bayawazi. Makhe sibone ukuba ikhangeleka njani isibindi yabantu. Iifoto kunye neenkcazelo zazo zifumaneka apha ngezantsi. Ukususela omnye umfanekiso akakwazi ukubonisa ngokupheleleyo umzimba, sisebenzisa ezimbalwa. Kulungile ukuba imifanekiso emibini ibonisa inxalenye enye kususwa kunye nezintso ezo.

Umfanekiso 2:

Inani 2 ephawulwe ngokwayo isibindi yabantu. Amafoto kule meko bekuya kuba efanelekileyo, ngoko, khangela umfanekiso wakhe. la manani Ezi zilandelayo, kwaye limelwe eli nani:

1 - ekunene duct hepatic; 2 - isibindi; 3 - washiya duct hepatic; 4 - ye bile eqhelekileyo hepatic; 5 - enyongweni duct eqhelekileyo; 6 - pancreas; 7 - duct nepancreatic; 8 - i duodenum; 9 - sphincter of Oddi; 10 - ye bile esinganyangekiyo; 11 - senyongo.

Umfanekiso 3:

Ukuba ubona emaphini ukwakheka zabantu, uyazi ukuba iqulethe malunga nomfanekiso efanayo. Apha, isibindi umele phambi:

1 - esezantsi kuthembeke Vienna; 2 - lungu ukugoba; 3 - lobe ngasekunene; 4 - washiya lobe; 5 - lungu ngeenxa zonke; 6 - senyongo.

Umfanekiso 4:

Lo mfanekiso ubonisa isibindi kwelinye icala. Kwakhona, Atlas of Human Anatomy iqulethe phantse indlela efanayo:

1 - senyongo; 2 - nomhlehlo ngasekunene; 3 - washiya lobe; 4 - ye bile esinganyangekiyo; 5 - oku- hepatic; 6 - Umthambo hepatic; 7 - hepatic portal Vienna; 8 - enyongweni duct eqhelekileyo; 9 - asezantsi eVienna vuphukuphuku.

Umfanekiso 5:

Lo mzekeliso ubonisa yinxalenye encinane kakhulu esibindini. Ezinye iinkcazo: inani 7 mzobo ubonisa portal triad - iqela olumanyanisa portal umthambo hepatic, Umthambo hepatic kunye inyongo duct.

1 - sinusoid hepatic; 2 - cells isibindi; 3 - Central Vienna; 4 - le ndlela hepatic; 5 - emithanjeni enyongweni; 6 - emithanjeni emathunjini; 7 - «triad portal»; 8 -pechenochnaya isango Vienna; 9 - Umthambo hepatic; 10 - ye bile duct.

Umfanekiso 6:

Imibhalo e IsiNgesi eliguqulelwa ngokuthi (ekhohlo ukuya ekunene): icandelo ekunene osecaleni, icandelo ekunene paramedian, icandelo paramedian ngasekhohlo kunye necandelo lateral ngasekhohlo. Amanani White isibindi ziqwempu babalwayo, inombolo ngamnye ingqinelana kwinani ingxenye Latin:

1 - ekunene hepatic Vienna; 2 - washiya hepatic Vienna; 3 - avareji hepatic Vienna; 4 - enkabeni Vienna (okwendalo); 5 - oku- hepatic; 6 - esezantsi kuthembeke Vienna; 7 - Umthambo hepatic; 8 - esangweni Vienna; 9 - ye bile duct; 10 - ye bile esinganyangekiyo; 11 - senyongo.

I zomzimba kwesibindi

umsebenzi isibindi babantu zahlukahlukene kakhulu: ukuba ugcwalisa indima enkulu yokwetyiswa ukutya, kwaye nkqu nokugcinwa kwezondlo.

ekugayeni

Isibindi ludlala indima ebonakalayo kwinkqubo yokwetyisa ngokusebenzisa imveliso inyongo. Bile ngumxube amanzi, iityuwa ye asidi duct, cholesterol kunye yibilirubin ebala.

Emva kokuba hepatocytes esibindini zivelisa inyongo, udlula i bile duct kwaye zigcinwa senyongo de kube ngoko, de ingasafuneki. Xa ukutya amanqatha egqitha duodenum, iiseli duodenal ukuveza cholecystokinin hormone, leyo buyasikhulula isingxobo senyongo. Bile, lihambe bile duct kuya duodenum, apho amakhulu emulsifies mass ngamanqatha. Emulsification we bile kwamafutha kwenza izigaqa enkulu kwamafutha ziingceba ezincinane, indawo umphezulu asezantsi kwaye ke ngoko kube lula ukuba lizisebenzise.

Yibilirubin ukhona enyongweni, isibindi imveliso processing of the oselehagele ngaphandle iiseli ezibomvu. iiseli Kupffer esibindini ukubamba abatshabalalise, zigugile iiseli endala ezibomvu ayidlulisele ukuba le hepatocytes. Kwixesha elidlulileyo isiphelo mpilo - yahlulahlulwe yaba ngamaqela heme kunye globin. Globin protein ngakumbi enomgangatho isetyenziswa amandla emzimbeni. Iron-aqulethe iqela heme ayikwazi ngokutsha umzimba nje waguquka yibilirubin, nto leyo idityaniswe enyongweni. It yibilirubin unika enyongweni umbala ezahlukileyo oluhlaza. iintsholongwane isisu zitshintshele ngakumbi yibilirubin strekobilin ebala emdaka leyo anika ilindle omdaka.

lokugaya

hepatocytes Isibindi omangalelwe ezininzi iingxaki ezinzima ezinxulumene neenkqubo metabolic. Ekubeni lonke igazi abashiya inkqubo yokucola ukutya, ucanda le portal iphuma hepatic, isibindi linoxanduva metabolizing iikhabhohayidrethi, lipids kunye neeproteni ngendlela izinto eziphilayo luncedo.

Inkqubo yethu yokwetyisa uyazifohloza carbohydrate zibe monosaccharide iswekile ukuba iiseli zisetyenziswa njengomthombo wamandla. Igazi ngokungenisa kwesibindi nge portal umthambo hepatic, utyebile kakhulu glucose ekutyeni kwetyiswe. Hepatocytes ukumunca inkoliso glucose sikugcine njengoko glycogen macromolecule, a polysaccharide branched, nto leyo evumela isibindi ukugcina izixa ezikhulu glucose yaye ngokukhawuleza ndimkhulule phakathi izidlo. Ukufunxeka kunye nokukhululwa glucose ngu hepatocytes kukunceda ugcine homeostasis kunye iswekile yegazi esezantsi.

fatty (lipids), igazi acandacanda isibindi, kwetyiswe kwaye wendele yi hepatocytes ukuba avelise amandla e uhlobo ATP. Glycerol, isisahlulo lipid kwi hepatocytes aguqula iswekile ngokusebenzisa inkqubo gluconeogenesis. Hepatocytes nako ukuvelisa lipids ezifana cholesterol, phospholipids kunye lipoproteins, ezisetyenziswa yi ezinye iiseli wonke umzimba. Uninzi cholesterol eziveliswa hepatocytes, lithatyathwe emzimbeni njengenxalenye inyongo.

iiproteni nokudla ziba acid kwinkqubo yokwetyisa phambi kokuba idluliselwe portal ndlela hepatic. Acid engena kwesibindi, yokucolwa ifuna ngaphambi kokuba ingasetyenziswa njengomthombo wamandla. Hepatocytes zaye kuqala isuswe kwiqela acid of the ngomdla kwaye ukuyijika ibe ammonia, nto leyo ekugqibeleni ajikwa urea.

Urea lingaphantsi yityhefu ngaphezu ammonia, kwaye idla umchamo njenge imveliso kuyinkcitha ukwetyisa. Inxalenye eseleyo acid ziba ATP okanye ziguqulwa zibe molekyuli ezintsha glucose ngokusebenzisa inkqubo gluconeogenesis.

ubuthi

Ekubeni igazi izitho zokugaya udlula le portal ye ukuhamba kwegazi isibindi, isiqulatho igazi hepatocytes zolawulo, wazisusa izinto ezininzi ezinokuba ityhefu, phambi kokuba ukufikelela wonke umzimba.

Enzyme hepatocytes ukuguqula ezininzi buthi (umzekelo, utywala okanye iziyobisi) zibe metabolites lutho. Ukuze agcine umgangatho hormone kwemida homeostatic, isibindi kwakhona metabolizes kwaye amaxolo asuswa hormone ejikeleza eveliswa ngamadlala emzimbeni ngokwakhe.

indawo yokubeka

Isibindi ibonelela yokugcina ezininzi izondlo ezibalulekileyo, iivithamini kunye neeminerali zingafumaneka igazi ukosuleleka ngokusebenzisa inkqubo portal hepatic. Iglucose ithuthwa ngayo hepatocytes phantsi yempembelelo insulin hormone kwaye igcinwe njengoko glycogen polysaccharide. Hepatocytes kwakhona ukufunxa uyadinga asidi le triglyceride tapeworm. Ukugcinwa kwezi zinto kuvumela isibindi ukugcina homeostasis glucose egazini.

isibindi yethu igcina iivithamini kunye neeminerali (neevithamini A, D, E, K no-B-12, kunye neeminerali ngentsimbi nobhedu) ukwenzela ukuqinisekisa ukuhamba rhoqo kwezinto ezibalulekileyo kwizihlunu zomzimba.

production

Isibindi unoxanduva ngokuvelisa zinamacandelwana aliqela protini ebalulekileyo plasma yegazi: prothrombin, lwefibrinogen kunye albumin. Prothrombin kunye lwefibrinogen iiproteni ezi zinto coagulation inxaxheba ekubunjweni egazi. Albumins ziiproteni ukugcina igazi isotonic medium ukuze iiseli zomzimba musa azuze okanye ukuphelelwa ngamanzi phambi kwiincindi zomzimba.

okukwazi

Imisebenzi isibindi amajoni omzimba ingena umsebenzi iiseli Kupffer. Iiseli Kupffer na macrophage, ziiphagocytes mononuclear eziyinxalenye yale nkqubo kunye macrophage le udakada kunye zamanzi. iiseli Kupffer kudlala indima ebalulekileyo, njengoko iintsholongwane ukuqhubekekiswa, nomngundo, amakhalane, iiseli ezibomvu ezigugileyo kunye nobutyobo zeselula.

Ultrasound isibindi: nanjengokwesimo kwaye ukutenxa

Isibindi wenza imisebenzi ebalulekileyo emzimbeni wethu, ngoko ke kubaluleke kakhulu ukuba bekusoloko eqhelekileyo. Ngenxa yokuba nesibindi agule, kuba akukho kwalapho, ungabona ukuba njani na imeko ithemba. Kusenokuba phula nje phantsi, ngokuthe ngcembe, kodwa ukuphela kwayo kuya kuba nzima ukunyanga.

Kukho inani izifo zesibindi apho u nga ucinga ukuba kukho into noqhekeko. Umntu angaphila ixesha elide kwaye ucinga usempilweni, kodwa ukuphela kwayo kwenzeka ukuba ukuqina okanye umhlaza wesibindi. Yaye oku akuyi kutshintsha.

Nangona isibindi kwaye ipropati ukuze achache, yena akazange akwazi ukumelana nezifo ezifana. Ngamanye amaxesha ufuna uncedo lwakho.

Ukuze siphephe iingxaki engento, maxa wambi nje ngokwaneleyo ukutyelela ugqirha wenze ultrasound kwesibindi, izinga leyo ichazwe ngezantsi. Khumbula ukuba isibindi ezinxulumene izifo eziyingozi kakhulu ezifana ne-hepatitis, ukuba ngaphandle unyango olufanelekileyo ixesha kunokukhokelela ngenxa ezimbi ezibukhali ezifana kwesibindi kunye nomhlaza.

Ngoku makhe aye ngqo US kunye nezithethe zalo. I ingcali lokuqala ukhangela ukubona ukuba isibindi kwaye yintoni ubukhulu layo neyalo.

Ubungakanani ngqo kwesibindi ayikwazi acaciswe nombono ngokupheleleyo umzimba engenakwenzeka. ubude emzimbeni mayingagqithi-18 cm. yooGqirha ngayo inxalenye ngamnye ngokwahlukeneyo isibindi.

Masiqalise nesibakala sokuba ultrasound isibindi kufuneka ibonakale ngokucacileyo ezimbini yesabelo wayo, kwakunye namacandelo bahlukene kuyo. Xa nemisipha efanayo (oko kukuthi, zonke nemisipha) kufuneka ubonakale. Uphononongo ivumela oogqirha ukuba ukufunda onke amacandelo asibhozo ngokwahlukeneyo, kuba, nabo, ekulula ukuyibona.

KwiSithethe Ubukhulu lwelungelo kunye nomhlehlo ekhohlo

Nomhlehlo ushiye kufuneka ube malunga 7 cm ngokomelela malunga-10 cm ngobude. Ukwandisa ubukhulu ithi ngeengxaki zempilo mhlawumbi ukuba ukudumba kwesibindi. Nomhlehlo sokunene, nto leyo izinga - malunga 12 cm ngokomelela ukuya kwi-15 cm ubude, njengokuba ubona lukhulu ngasekhohlo ngakumbi.

Ukongeza umzimba, oogqirha kufuneka kwakhona kunye inyongo bile, kwakunye imithambo yegazi ezinkulu esibindini. Ubungakanani we bile duct wenziwamkhulu, umzekelo, kufuneka ungabi ngaphezu kwe-8 mm, portal Vienna - malunga 12 mm wancothuka usikrobana Vienna - 15 mm.

Ukuze oogqirha nje kuphela amalungu dimensions kodwa isakhiwo yayo, imisele umzimba kwithishyu.

komzimba Human (kwesibindi, nto leyo ilungu entsonkothileyo kakhulu) - kakhulu into ebangel 'umdla. Akukho nto umdla ngaphezu ukuqonda isakhiwo ngokwaso. Ngamanye amaxesha usenokude ukukusindisa kwizifo ezingafunekiyo. Ukuba ke nina qwa, iingxaki uya kuziphepha. Uhambo kugqirha - ayikho nje kuyoyikisa njengoko kubonakala. Hlala uphilile!