Lub qhov quav yog qhov kawg ntawm txoj hnyuv uas lub cev tawm cov quav (piv txwv li cov khoom seem ntawm cov khoom pov tseg).
Tus qauv ntawm tib neeg lub qhov quav
Lub qhov quav yog txwv los ntawm sphincters, uas yog tsim los ntawm cov leeg. Xws li cov leeg nqaij yog tsim nyog los tswj qhov qhib thiab kaw ntawm qhov quav. Muaj ob lub sphincters nyob rau hauv tib neeg lub cev:
- Internal, muaj cov tuab ntawm cov leeg du ntawm lub qhov quav thiab tsis raug rau kev nco qab. Nws qhov ntev yog los ntawm ib thiab ib nrab mus rau peb thiab ib nrab centimeters.
- Sab nraud, tsim los ntawm cov leeg striated thiab tswj los ntawm lub siab. Nws qhov ntev txawv ntawm ob thiab ib nrab mus rau tsib centimeters.
Lub qhov quav xaus nrog lub qhov quav, uas yog ib qho kev hloov pauv ntawm cov scaly mucous hauv ob sab phlu ntawm cov kwj deg anorectal rau hauv daim tawv nqaij ntawm perineum. Cov tawv nqaij nyob ib ncig ntawm lub qhov quav yuav ntau pigmented (piv txwv li cov xim tsaus nti) thiab wrinkled vim muaj sab nraud sphincter.
Nyob rau hauv me nyuam yaus, lub qhov quav yog nyob dorsally ntau dua li cov neeg laus, txog nees nkaum millimeters ntawm lub coccyx. Txoj kab uas hla ntawm lub qhov quav feem ntau yog peb mus rau raucentimeters, thiab qhov ntev ntawm cov channel txawv ntawm peb mus rau tsib centimeters. Ntxiv nrog rau sphincters, lub qhov quav obturator apparatus suav nrog cov leeg uas nqa lub qhov quav thiab cov leeg ntawm lub plab diaphragm.
Hauv cov qauv ntawm lub qhov quav, peb ntu tuaj yeem paub qhov txawv:
- Cov mucosa nyob rau hauv seem no yog muab nrog longitudinal folds, nruab nrab ntawm cov crypts (qhov quav qhov quav) pom, qhov qhib ntawm lub qhov quav glands mus.
- Thaj chaw npog los ntawm squamous stratified epithelium.
- tshooj no yog them nrog stratified keratinized squamous epithelium thiab tau muab nrog ntau cov qog sebaceous thiab hws, nrog rau cov plaub hau.
Thaj chaw ntawm lub qhov quav thiab qhov quav muaj qhov tsim cov hlab ntsha, nrog rau ntau lub paj hlwb, uas tso cai rau koj txhob txwm ncua kev tso quav thiab feem ntau ua rau cem quav neurogenic.
Anus topography
Cov qauv uas cuam tshuam ncaj qha nrog lub qhov quav kwj dej yog lub qhov quav ampulla thiab cov hnyuv sigmoid. Lub qhov quav kwj dej yog nyob rau hauv lub perineum. Nyob rau hauv pem hauv ntej, lub qhov quav yog nyob ib sab mus rau lub seminal vesicles, ampullae ntawm lub vas deferens, lub zais zis thiab lub caj pas prostate nyob rau hauv cov txiv neej. Hauv cov poj niam, qhov chaw mos thiab lub tsev menyuam nyob rau pem hauv ntej. Lub kwj dej xaus nrog lub qhov quav. Tom qab, lub sphincter sab nraud yog txuas mus rau lub coccyx los ntawm txoj kev ntawm lub analococcygeal ligament.
Nyob hauv thaj tsam ntawm perineum, tom qab thiab ob sab ntawm lub qhov quav, muaj cov kab mob ischiorectal fossae, zoo li lub prism thiab muaj cov ntaub so ntswg fatty, uas.cov hlab ntsha thiab cov hlab ntsha hla dhau. Nyob rau hauv lub frontal seem, pits muaj cov duab peb sab. Cov phab ntsa sab nraud ntawm fossa yog tsim los ntawm obturator nqaij thiab ischial tuberosity (sab hauv), cov phab ntsa nruab nrab yog tsim los ntawm sab nraud sphincter thiab cov leeg uas tsa lub qhov quav. Cov phab ntsa tom qab ntawm fossa yog tsim los ntawm cov leeg coccygeal thiab nws cov pob khoom tom qab, uas ua rau lub qhov quav, thiab phab ntsa sab nrauv yog tsim los ntawm cov leeg nqaij ntawm perineum. Cov ntaub so ntswg adipose, uas nyob hauv kab noj hniav ntawm ischiorectal fossa, ua haujlwm ntawm lub hauv ncoo elastic.
Tus qauv ntawm tus poj niam lub qhov quav
Nyob rau hauv poj niam lub cev, lub qhov quav yog nyob ib sab ntawm qhov chaw mos nyob rau hauv pem hauv ntej thiab yog sib cais los ntawm lub tom kawg los ntawm ib tug nyias txheej ntawm Denovillier-Salishchev. Vim tias cov qauv no ntawm lub qhov quav thiab qhov quav hauv cov poj niam, ob qho tib si kis kab mob thiab cov qog nqaij hlav nkag tau yooj yim los ntawm ib lub kab noj hniav mus rau lwm qhov, uas ua rau muaj kev tsim ntawm lub qhov quav fistulas vim muaj ntau yam kev raug mob los yog perineal ruptures thaum yug menyuam.
Cov qauv ntawm lub qhov quav hauv cov poj niam txiav txim siab nws cov duab hauv daim ntawv ntawm lub tiaj tus lossis me ntsis protruding tsim. Qhov no yog vim lub fact tias nyob rau hauv tus txheej txheem ntawm tus me nyuam, cov nqaij ntshiv ntawm lub perineum so, thiab cov nqaij ntshiv ntawm lub qhov quav poob lawv lub peev xwm los cog lus.
Txoj qhov quav ntawm tus txiv neej
Tus qauv ntawm tus txiv neej lub qhov quav muaj qee qhov sib txawv. Hauv cov txiv neej (tshwj xeeb tshaj yog cov txiv neej) lub qhov quav zoo li lub funnel. Lub anterior phab ntsa ntawm lub qhov quav kwj dej yog nyob ib sab ntawm lub qhov muag teev ntawm lub urethra thiab lub apex ntawm lub prostate.qog. Tsis tas li ntawd, cov sphincter ntawm cov txiv neej yog tuab dua li cov poj niam.
Kev ua haujlwm ntawm lub qhov quav thiab qhov quav
Lub qhov quav yog lub luag haujlwm tshem tawm cov khoom pov tseg ntawm lub cev. Tsis tas li ntawd, nws absorbs kua. Yog li, nrog lub cev qhuav dej thiab nias cov quav, txog plaub litres ntawm cov kua ib hnub rov qab los rau lub cev. Ua ke nrog cov kua, microelements yog reabsorbed. Lub qhov quav ampulla yog qhov tso dej rau cov quav, cov khoom sib txuam uas ua rau cov phab ntsa hauv plab hnyuv loj, tsim cov hlab ntsha impulse thiab, vim li ntawd, qhov xav kom defecate (defecation).
Thiab tam sim no hais txog lub luag haujlwm ntawm lub qhov quav. Nyob rau hauv tas li nro, nws sphincters tswj kev tso quav (defecation) thiab tso gases los ntawm txoj hnyuv (flatulence).
Pathologies ntawm qhov quav
- Tumour.
- Hernias.
- Ntau yam mucosal defects (cysts, anal fissures, ulcers).
- cov txheej txheem mob (abscesses, paraproctitis, proctitis, fistulas).
- Congenital mob (qhov quav atresia).
Sphincter spasm
Raws li cov qauv ntawm lub qhov quav, qhov tshwm sim ntawm pathologies ntawm qhov no ntawm txoj hnyuv kuj yog yam ntxwv. Ntawm cov tsos mob, feem ntau sphincter spasm (sab nraud lossis sab hauv), uas yog mob thiab tsis xis nyob hauv qhov quav.
Qhov ua rau tus mob no yog:
- kev puas siab puas ntsws;
- npaum cem quav;
- mob o nyob rau hauv qhov chaw ntawm sab hauv lossis sab nraudsphincter;
- xub innervation.
Raws li lub sijhawm, faib:
- Ntev spasm, tus cwj pwm los ntawm qhov mob hnyav, uas tsis raug tshem tawm los ntawm kev noj tshuaj zoo tib yam.
- Kev mob spasm - lub sij hawm luv luv mob mob hauv qhov quav, tawg mus rau pob qij txha los yog coccyx.
Txawm li cas los xij, qhov spasm tuaj yeem yog:
- primary (vim muaj teeb meem neurological);
- secondary (vim muaj teeb meem hauv plab nws tus kheej).
Kev tshwm sim ntawm cov tsos mob no yog:
- pom qhov mob vim kev ntxhov siab;
- mob thaum tso quav tso tseg lossis nrog dej sov;
- qhov mob yog mob, nyob hauv qhov quav thiab tawm mus rau coccyx, pelvis (perineum) lossis plab.
Kev kuaj mob ntawm cov txheej txheem pathological
- Computed tomography tuaj yeem kuaj pom polyps thiab lwm yam kab mob pathological.
- Biopsy yog siv los txiav txim qhov malignancy ntawm cov txheej txheem qog.
- Anoscopy (rectomanoscopy) yog siv los ntsuas qhov mob ntawm lub qhov quav mucosa, nrog rau kev noj cov khoom siv rau biopsy.
- Anorectal manometry. Raws li cov qauv ntawm lub qhov quav (saib daim duab saum toj no), cov leeg nqaij (sphincters) ntawm lub qhov quav tau kuaj pom. Feem ntau, cov leeg ntawm qhov quav yog qhov siab tshaj plaws kom tswj tau qhov quav thiab flatulence. Txog li yim caum-tsib feem pua ntawm cov basal anal tone yog ua los ntawm lub qhov quav sphincter. Nrog tsis txauslos yog tsis muaj kev sib koom tes ntawm cov leeg ntawm lub plab mog thiab cov sphincters ntawm lub qhov quav, dyschezia tsim, uas yog manifested los ntawm ib tug nyuaj defecation thiab cem quav.
- kuaj lub qhov quav. Txoj kev no tso cai rau koj txheeb xyuas hernias, prolapse ntawm txoj hnyuv, tsev menyuam, hemorrhoids, fistulas, tawg thiab lwm yam pathologies ntawm lub qhov quav thiab qhov quav.
- Anus ultrasound. Raws li txoj kev tshawb no, nws muaj peev xwm xav tias muaj cov neoplasms, txiav txim siab lawv qhov chaw thiab qhov loj me, kuaj pom hemorrhoids, thiab lwm yam.
Kev tsis xis nyob ntawm lub cev
Cov qauv anatomical ntawm lub qhov quav yog xws li cov tawv nqaij hauv cheeb tsam no tshwj xeeb tshaj yog cov kab mob, thiab cov kab mob pathogenic tuaj yeem nyob hauv nws cov quav yog tias tsis ua raws li kev nyiam huv, nquag cem quav lossis raws plab, ua rau tsis xis nyob, khaus, khaus, tsis hnov tsw thiab mob.
Txhawm rau txo cov kev tshwm sim no thiab tiv thaiv lawv, koj yuav tsum:
- Ntxuav lub qhov quav thiab daim tawv nqaij ib ncig ntawm nws nrog dej tsis muaj xab npum (tom kawg tuaj yeem ua rau tawv nqaij qhuav thiab, vim li ntawd, ua rau muaj kev tsis xis nyob ntau dua). Kev nyiam yuav tsum tau muab tshuaj tsuag "Kavilon" lossis siv cov ntaub so dej tsis muaj cawv (vim daim ntawv tso quav tso quav ua rau tawv nqaij).
- daim tawv nqaij ib ncig ntawm lub qhov quav yuav tsum qhuav.
- Nws yog ib qho tsim nyog los tsim kom muaj kev cuam tshuam rau kev nkag mus ntawm noo noo. Piv txwv li, kev siv cov tshuaj Dimethicone tau pom zoo, uas tsim cov yeeb yaj kiab tiv thaiv ntawm daim tawv nqaij ncig lub qhov quav.
- Siv cov hmoov tshuaj (xws li talc lossis pob kws). Thovlawv yuav tsum tau siv rau cov tawv nqaij ua ntej ntxuav thiab qhuav.
- Siv cov ris tsho hauv qab lossis cov ntaub nqus dej pov tseg.
- Kev siv "ua pa" ris tsho hauv qab thiab khaub ncaws ua los ntawm cov khoom siv ntuj, txiav dawb, uas tsis txwv kev txav mus los.
- Yog tias muaj quav quav, hloov khaub ncaws tam sim.
Kev kho mob
Lub hom phiaj ntawm qhov no lossis qhov kev kho ntawd nyob ntawm tus kab mob. Nrog spasms ntawm sphincters, ua ntej ntawm tag nrho cov, cov ua rau lawv raug tshem tawm. Tsis tas li ntawd, cov tshuaj laxatives, tshuaj tua kab mob, tshuaj tua kab mob thiab tshuaj tua kab mob hauv daim ntawv ntawm cov tshuaj pleev / suppositories, nrog rau kev kho lub cev, electrosleep, daim ntawv thov, zaws, microclysters. Yog tias kev kho mob tsis zoo, kev phais mob tau ua.
Hemorrhoids yog kho nrog tshuaj suppositories tshwj xeeb thiab tshuaj pleev, nrog rau txoj kev phais. Congenital pathologies (qhov quav atresia) yuav tsum tau phais tam sim. Cov qog nqaij hlav ntawm lub qhov quav yog kho nrog kev sib txuas ntawm hluav taws xob thiab tshuaj tua kab mob, nrog rau kev phais tshem tawm cov qog. Cov kab nrib pleb hauv qhov quav yog kho tau zoo nrog kev siv da dej tshwj xeeb, noj zaub mov zoo, kho cov tshuaj suppositories thiab cream, nrog rau kev phais. Hernias thiab prolapses ntawm lub qhov quav yog tshem tawm los ntawm txoj kev phais.
