Saliva ua lub luag haujlwm tseem ceeb hauv tib neeg lub cev. Nrog nws cov kev pab, chewed zaub mov yog glued ua ke, nqos, nrog rau kev xaav ntawm saj thiab kev tiv thaiv ntawm cov hniav enamel los ntawm kev puas tsuaj. Thiab cov qog tshwj xeeb zais cov qaub ncaug, uas yuav tau tham tom qab.
Nyob hauv nruab nrog cev uas tsim cov qaub ncaug
Cov ducts ntawm cov qog qaub ncaug ntws mus rau hauv qhov ncauj kab noj hniav, muab faib ua loj (muaj cov qauv ntawm lub cev) thiab me, uas nyob rau hauv ntau qhov chaw ntawm cov mucous membrane.
Me me suav nrog: labial, buccal, molar, lingual thiab palatal. Loj yog hu ua ob parotid, submandibular thiab sublingual. Qhov loj tshaj plaws yog ob lub qog parotid.
Physiology
Cov qog qaub ncaug, nyob rau hauv cov txheej txheem ntawm salivation, tso tawm ib qho zais cia los ntawm cov kav dej mus rau hauv lub qhov ncauj kab noj hniav, uas muaj cov enzymes koom nrog hauv kev zom: amylase, proteinase, lipase, thiab lwm yam. lawvsib tov rau hauv tib neeg lub qhov ncauj thiab tsim cov qaub ncaug, uas tsim cov khoom noj bolus thiab muab qhov pib ntawm kev zom zaub mov.
Parotid salivary qog
Ob lub qog no suav tias yog qhov tseem ceeb tshaj plaws. Lawv pw nyob ib ncig ntawm lub puab tsaig ceg thiab koom nrog hauv thawj theem ntawm kev zom zaub mov, tso tawm qhov xav tau ntawm kev tso tawm. Lawv yog hom serous thiab tsim ptyalin. Lawv cov secretions nkag mus rau hauv qhov ncauj kab noj hniav los ntawm cov ducts ntawm parotid salivary qog.
Cov kabmob no nyob tom qab ceg ntawm lub puab tsaig qis thiab nyob rau hauv pem hauv ntej ntawm cov txheej txheem mastoid txuas mus rau lub tuam tsev pob txha. Lawv muaj feem cuam tshuam nrog kev ua haujlwm ntawm kev ua haujlwm ntawm cov hlab ntsha ntawm lub ntsej muag, yog li yog tias lawv txoj haujlwm raug cuam tshuam, kev ua haujlwm tsis zoo ntawm lub ntsej muag cov leeg tuaj yeem tshwm sim.
Los ntawm cov ducts excretory ntawm cov qog qaub ncaug parotid, yuav luag ib feem tsib ntawm tag nrho cov qaub ncaug nkag mus rau hauv qhov ncauj. Qhov hnyav ntawm lawv yog li ntawm 20-30 g.
Submandibular caj pas
Cov qog qaub ncaug submandibular tsim cov kua qaub thiab cov kua qaub. Txawm hais tias qhov tseeb tias lawv me dua li parotid, qhov sib faib ntawm salivary kua uas tsim los ntawm lawv yog 70%. Nws nkag mus rau hauv lub qhov ncauj kab noj hniav los ntawm cov secretory organ nrog kev pab los ntawm lub submandibular kwj dej, uas yog lub duct rau cov salivary qog.
Kev piav qhia ntawm lub caj pas sublingual
Sublingual lossis sublingual yog cov qog loj hauv qab tus nplaig. Lawv feem ntau koom nrog hauv kev tso tawm ntawm hnoos qeev. Tsis zoo li lwm cov qog loj, cov kav dejlub caj pas salivary sublingual yog yooj yim dua. Nws tsis yog li ntawd ntau haiv neeg thiab branched tawm. Nws tsis suav nrog cov ducts intercalary thiab dav hlau ntws tawm.
Salivary ducts ntawm 8 mus rau 20 qhib los ntawm cov qog sublingual mus rau hauv qhov ncauj. Txog li 5% ntawm tag nrho cov qaub ncaug dhau los ntawm lawv.
Structure of the parotid glands
Cov parotids yog cov qog alveolar nyuaj. Txhua tus ntawm lawv muaj ib tug lobed qauv thiab yog them nrog fascia, uas kaw lawv mus rau hauv ib tug nyias capsule tsim.
Cov kab mob excretory ntawm parotid salivary gland qhib rau hauv lub qhov ncauj kab noj hniav nyob rau hauv daim ntawv ntawm ib tug me me qhov nyob rau hauv pem hauv ntej ntawm lub thib ob loj molar ntawm lub puab tsaig sab sauv. Nws ntev yog 6 cm thiab nyob rau hauv txoj kev mus rau lub qhov ncauj kab noj hniav nws kis tau los ntawm qhov chaw ntawm masticatory nqaij, cov ntaub so ntswg adipose ntawm lub puab tsaig thiab buccal nqaij. Qee lub sij hawm cov duct no tuaj yeem ua rau bifurcate.
Cov qauv ntawm lub caj pas submandibular
Nyob hauv nws lub cev, nws ua raws li lub caj pas alveolar-tubular, qhov thib ob loj tshaj plaws ntawm cov kabmob loj uas tso cov qaub ncaug. Nws, zoo li lub parotid, muaj ib tug lobed qauv thiab nyob rau hauv lub submandibular fossa, ncua tshaj lub posterior ciam teb ntawm cov leeg maxillohyoid. Lub hauv paus ntawm cov hlab ntsha ntawm cov qog qaub ncaug, nyob hauv qab lub puab tsaig, nyob ze ntawm ntug ntawm cov leeg no thiab, khoov ib ncig ntawm nws qhov chaw, qhib rau ntawm sublingual papilla.
Cov qauv ntawm lub caj pas sublingual
Cov qauv ntawm lub caj pas no yog tib yam li ntawm lub caj pas submandibular. Nws nyobtam sim ntawd nyob rau hauv lub qhov ncauj mucosa tshaj lub puab tsaig-hyoid leeg. Nyob ntawd nws tsim sublingual quav nyob nruab nrab ntawm lub puab tsaig qis thiab tus nplaig. Tus naj npawb ntawm cov qog no tuaj yeem sib txawv ntawm 18 txog 20. Lawv qhib rau hauv qhov ncauj kab noj hniav raws li sublingual quav. Cov duct tseem ceeb ntawm cov qog qaub ncaug hla mus ze ntawm cov ducts submandibular thiab qhib nrog nws nrog ib qho qhib los yog nyob ze.
Functions
Lub hom phiaj tseem ceeb ntawm cov qog tau piav qhia yog tsim kom muaj qhov tshwj xeeb zais cia. Cov ducts ntawm cov qog qaub ncaug yog tsim los tshem tawm ntawm qhov ncauj kab noj hniav. Yog li, kev ua haujlwm ntawm cov qaub ncaug ducts muab cov hauv qab no:
- qaub ncaug ntub lub qhov ncauj;
- zaub mov liquefies;
- articulation muab;
- suab swm tau kho;
- cov hniav raug tiv thaiv los ntawm kev puas tsuaj (thermal lossis mechanical);
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Kab mob tshwm sim
Muaj ntau yam kab mob uas tuaj yeem cuam tshuam kev ua haujlwm ntawm cov qog ua kua qaub thiab lawv cov ducts. Ntawm lawv, qhov txaus ntshai tshaj plaws yog:
- Kev nthuav dav ntawm cov kav dej. Nws ua rau muaj kev ua txhaum ntawm kev tso tawm ntawm cov kua hauv lub qhov ncauj thiab ua rau cov pob zeb tsim thiab purulent o hauv cov ducts ntawm cov qog qaub ncaug.
- Abscesses. Tus kab mob no cuam tshuam rau cov qog nqaij hlav, thiab yog li ntawd yuav tsum tau mus pw hauv tsev kho mob sai sai tom qab phais.
- Tsim cov pob zeb intraglandular. Thaum lub sij hawm txoj kev loj hlob ntawm tus kab mob, lub duct system ntawm salivary qogntim pob zeb uas ua rau nws nyuaj dhau qhov zais cia.
- Sialoadenitis. Nrog rau qhov pib ntawm tus kab mob, muaj qhov txo qis hauv kev ua haujlwm ntawm cov qog ua kua qaub, ua rau cov txheej txheem inflammatory uas kis tau rau hauv caj pas nws tus kheej thiab nws cov ducts.
- Qhov tsim ntawm polyps uas thaiv txoj hauv kev ntawm kev txav ntawm qhov zais cia. Raws li qhov tshwm sim ntawm cov kua dej tsis tu ncua, kev txhim kho ntawm kev kis kab mob thiab mob pib.
- Sialolithiasis. Cov txheej txheem ntawm cov kab mob no suav nrog kev sau cov ducts ntawm cov qog nrog cov pob zeb, ua rau tib lub txiaj ntsig zoo li polyps.
- Mucocele. Muaj stagnation ntawm qaub ncaug nyob rau hauv lub ducts vim polyps los yog pob zeb.
- papillary stenosis. Vim muaj tus kab mob, cov ducts ntawm cov qog qaub ncaug nqaim nyob rau hauv qhov chaw uas cov zais cia nkag mus rau hauv lub qhov ncauj kab noj hniav, uas ua rau nws stagnation thiab kev loj hlob ntawm cov txheej txheem inflammatory.
txoj kev kho
Nyob rau hauv feem coob, cov kab mob cuam tshuam rau cov qog qaub ncaug thiab lawv cov ducts yog kho los ntawm kev phais. Qhov laj thawj yog vim li cas cov neeg mob tsis tshua nrhiav kev pab thaum ntxov ntawm txoj kev loj hlob ntawm tus kab mob, thiab txij li kev ncua kev kho mob ua rau muaj teeb meem ntawm tus kab mob, tsuas yog tus kws phais tuaj yeem tshem tau lawv.
Kev kho mob phais suav nrog cov haujlwm hauv qab no:
- Lithotripsy. Thaum tus txheej txheem no, tus kws kho mob tsoo pob zeb nyob rau hauv lub caj pas salivary caj pas los yog duct siv ib tug tshwj xeeb apparatus thiab ces tshem tawm lawv.
- Marsupializationducts. Kev kho mob yog ua los ntawm kev qhib cov kab mob qaub ncaug, los ntawm cov pob zeb lossis polyps raug tshem tawm. Txij li tam sim no muaj ntau txoj kev maj mam, marsupialization yog siv tsawg heev thiab tsuas yog nyob rau hauv cov ntaub ntawv uas loj pob zeb los yog ib tug tsim nyob rau hauv qab ntawm lub qhov ncauj. Tom qab cov txheej txheem pathological raug tshem tawm, duct yas phais yog ua.
- kho mob sialoendoscopy. Nws yog ib qho txawv ntawm kev phais endoscopic thiab ua rau nws muaj peev xwm tshem tawm cov pob zeb me me uas tau tsim, nrog rau tshem tawm cov kev txwv (ua kom qis ntawm lumen) ntawm cov ducts. Cov txheej txheem yog ua raws li kev siv tshuaj loog hauv zos los ntawm kev ntxig ib lub raj (lossis ob peb) rau hauv cov kav dej.
- Extracorporeal lithotripsy. Nws yog npaj los cuam tshuam lub pob zeb tsim nyob rau hauv lub duct los ntawm sab nraud nrog kev pab los ntawm ib tug tshwj xeeb emitter. Hauv cov txheej txheem ntawm kev kho mob zoo li no, pob zeb raug rhuav tshem, tsis hais lawv qhov loj npaum li cas. Tom qab crushing, cov pob zeb raug tshem tawm thiab cov ducts yog ntxuav nrog ib tug tshwj xeeb tov los tiv thaiv kev loj hlob ntawm o.
- Endoscopic laser lithotripsy. Txoj kev no yog ua raws li kev cuam tshuam ncaj qha rau cov pob zeb hauv cov kav dej. Crushing yog nqa tawm siv lub laser emitter. Thaum kawg ntawm txoj kev, cov pob zeb raug tshem tawm.
- Tshem tawm cov polyps endoscopically. Cov txheej txheem yog siv lub laser, uas txiav tawm polyps. Nws yog nrov heev vim lub fact tias lub laser, tom qab txiav tawm lub polyp, cauterizes thiab disinfects qhov chaw ntawm qhov kev loj hlob. Tsis tas li ntawd, tsis muaj qhov los ntshav ntawm cov ducts ntawm cov qog qaub ncaug, uas tiv thaiv kev txhim kho ntawm cov teeb meem purulent.
- YEndoscopic dilatation. Nws yog siv nyob rau hauv cov ntaub ntawv uas yuav tsum tau dissect adhesions nyob rau hauv lub caj pas los yog duct uas tsim ntawm caws pliav ntaub so ntswg thaum lub sij hawm ib tug kab mob ntawm cov qog salivary. Cov txheej txheem tso cai rau koj los kho qhov ntws tawm ntawm qhov zais cia yam tsis muaj kev puas tsuaj rau phab ntsa ntawm cov ducts.
Kev kho mob endoscopic rau cov kab mob cuam tshuam rau cov qog ua kua qaub thiab cov ducts yog nrov heev, vim tias lawv tau txais txiaj ntsig zoo thiab tsis tas yuav mus pw hauv tsev kho mob ntxiv. Tsis tas li ntawd, lawv tiv thaiv kev txhim kho ntawm ntau yam teeb meem, uas tso cai rau cov neeg mob rov zoo sai.
Vim tias cov kua qaub ncaug ua lub luag haujlwm tseem ceeb hauv cov txheej txheem ntawm salivation, ib qho kev cuam tshuam hauv lawv txoj haujlwm ua rau muaj qhov tshwm sim loj. Yog li ntawd, thaum thawj qhov kev xav ntawm qhov tsis xis nyob hauv thaj tsam ntawm salivation system, nws yog ib qho tsim nyog los sab laj tus kws kho mob uas tuaj yeem ua qhov kev kuaj mob kom raug thiab sau npe rau txoj kev kho mob zoo.
