Aorta, aortic ceg: piav qhia thiab duab

2024 Tus sau: Curtis Blomfield | [email protected]. Kawg hloov kho: 2023-12-16 21:10

Lub aorta yog lub nkoj loj tshaj plaws hauv tib neeg lub cev uas nqa cov ntshav los ntawm sab laug ventricle thiab yog qhov pib ntawm cov kab mob hauv lub cev.

Muaj ntau lub chaw haujlwm hauv aorta:

• ascending (pars ascendens aortae) department;
• arch thiab ceg ntawm aortic arch;
• descending (pars descendens aortae) department, uas, nyob rau hauv lem, muab faib mus rau hauv lub hauv siab thiab plab mog.

Aortic arch thiab nws cov ceg

1. Truncus brachiocephalicus ceg tawm ntawm lub aortic koov ntawm qib ntawm pob txha mos ntawm sab xis thib ob. Nyob rau hauv pem hauv ntej ntawm nws yog txoj cai brachiocephalic leeg, thiab tom qab nws yog lub trachea. Tom qab tso tawm, lub pob txha brachiocephalic nce mus rau sab xis, muab ob ceg hauv thaj tsam ntawm txoj cai sternoclavicular sib koom: txoj cai subclavian thiab txoj cai carotid artery.
2. Cov kab mob carotid uas muaj kab mob (sab laug) yog ib qho ntawm cov ceg ntawm lub aortic koov. Raws li txoj cai, ceg no yog 20-25 millimeters ntev dua li cov hlab ntsha carotid. Txoj kev ntawm cov hlab ntsha khiav tom qab scapular-hyoid thiab sternocleidomastoid cov leeg, tom qab ntawd nce cov txheej txheem ntawm lub ncauj tsev menyuam vertebrae. Sab nraud ntawm lub hlab ntsha yog cov hlab ntsha vagus thiab lub jugular (internal) leeg, sab hauv ntawm nws dagcov hlab pas, trachea, pharynx, larynx, parathyroid thiab thyroid caj pas. Nyob rau hauv thaj tsam ntawm cov thyroid pob txha mos (nws sab sauv), txhua yam ntawm cov hlab ntsha carotid muab cov hlab ntsha sab hauv thiab sab nraud carotid, uas muaj kwv yees li tib txoj kab uas hla. Qhov chaw ntawm kev faib cov hlab ntsha yog hu ua bifurcation, nyob rau hauv qhov chaw no kuj yog lub intersleepy glomerulus (carotid glomus, carotid caj pas) - ib tug anatomical tsim nrog qhov ntev ntawm 1.5 x 2.5 hli, uas yog nruab nrog ntau chemoreceptors thiab ib tug network ntawm capillaries.. Muaj qhov me me nyob hauv thaj chaw uas cov hlab ntsha sab nraud tuaj, hu ua carotid sinus.
3. Cov hlab ntsha sab nraud carotid yog ib qho ntawm ob ceg ceg ntawm cov hlab ntsha carotid. Nws ceg tawm ntawm qhov kawg hauv cheeb tsam ntawm daim duab peb sab carotid (lub ntug sab sauv ntawm cov thyroid pob txha). Thaum xub thawj, nws nyob me ntsis nruab nrab rau hauv cov hlab ntsha carotid, thiab tom qab ntawd mus rau nws. Qhov pib ntawm cov hlab ntsha sab nraud nyob rau hauv cov leeg sternocleidomastoid, thiab hauv thaj tsam ntawm daim duab peb sab carotid - nyob rau hauv cov leeg nqaij subcutaneous ntawm lub caj dab thiab lub ncauj tsev menyuam fascia (nws cov phaj saum npoo). Nyob rau sab hauv los ntawm cov leeg digastric (nws lub plab tom qab) thiab cov leeg nqaij stylohyoid, cov hlab ntsha carotid (sab nrauv) nyob rau hauv cheeb tsam ntawm caj dab ntawm mandibula (hauv txheej ntawm lub caj pas parotid) tau muab faib ua ib khub ntawm cov ceg ntoo: lub maxillary thiab temporal superficial hlab ntsha. Nyob rau hauv tas li ntawd, nyob rau hauv nws cov chav kawm, lub carotid sab nraud atria muab nce mus rau ib tug xov tooj ntawm ceg: lub anterior pab pawg neeg - lub ntsej muag, thyroid superior thiab lingual hlab ntsha, lub posterior pawg - lub posterior pob ntseg, occipital thiab sternocleidomastoid hlab ntsha, thiab lub pharyngeal ascending hlab ntsha. tawm mus rau nruab nrab.

Branchesthoracic aorta

ntu no, raws li twb tau hais lawm, yog ib feem ntawm lub aorta nqis. Nws yog nyob rau hauv cheeb tsam ntawm posterior mediastinum, dhau ntawm tus txha caj qaum.

Cov ceg ntawm lub thoracic aorta tau nthuav tawm hauv ob pawg: parietal thiab visceral (visceral).

Cov ceg sab hauv

Cov ceg visceral ntawm lub aorta yog sawv cev los ntawm pawg hauv qab no:

1. Bronchial ceg (2-4 daim). Lawv pib los ntawm phab ntsa anterior ntawm lub aorta nyob rau hauv cheeb tsam ntawm ceg ntawm lub intercostal thib peb hlab ntsha. Nkag mus rau hauv lub qhov rooj ntawm ob lub ntsws, lawv tsim cov hlab ntsha intrabronchial network uas muab cov ntshav mus rau lub bronchi, cov ntaub so ntswg sib txuas (lub hauv paus) ntawm lub ntsws, esophagus, pericardium, phab ntsa ntawm cov hlab ntsws (cov hlab ntsha thiab cov hlab ntsha). Nyob rau hauv lub ntsws cov ntaub so ntswg, bronchial ceg tsim anastomoses nrog ceg ntawm pulmonary hlab ntsha.
2. esophageal ceg (3-4 pieces). Lawv muaj qhov ntev li ntawm 1.5 cm thiab xaus rau ntawm phab ntsa ntawm txoj hlab pas (nws ntu thoracic). Cov ceg no pib los ntawm lub thoracic aorta nyob rau hauv cheeb tsam ntawm 4-8 thoracic vertebrae. Anastomoses yog tsim nrog rau sab phrenic, qis dua thiab sab sauv thyroid, mediastinal hlab ntsha, nrog rau cov hlab ntsha sab laug plawv.
3. Cov ceg ntawm mediastinal (mediastenal) tuaj yeem muaj qhov sib txawv, tsis sib xws. Feem ntau mus ua ib feem ntawm cov ceg pericardial. Nqa tawm cov ntshav mus rau cov ntaub so ntswg, cov qog nqaij hlav ntawm posterior mediastinum thiab phab ntsa (posterior) ntawm pericardium. Anastomoses yog tsim nrog cov ceg uas tau piav saum toj no.
4. Pericardial ceg (1-2 daim) nyias thiab luv. ceg tawm ntawm pem hauv ntejaortic phab ntsa, muab cov ntshav rau pericardium (nws phab ntsa rov qab). Anastomoses yog tsim nrog cov hlab ntsha mediastinal thiab esophageal.

phab ntsa

1. Cov hlab ntsha phrenic superior, uas tawm ntawm lub aorta, muab lub pleura thiab lub lumbar ntu ntawm lub aorta nrog cov ntshav. Lawv muab tso ua ke rau hauv anastomoses nrog lub diaphragmatic inferior, internal thoracic thiab intercostal inferior hlab ntsha.
2. Cov hlab ntsha hauv nruab nrab ntawm lub cev (10 khub) tawm ntawm phab ntsa aortic tom qab thiab ua raws li hauv 3-11 qhov chaw intercostal. Cov khub kawg dhau los hauv qab 12th tav (uas yog, nws yog subcostal) thiab nkag mus rau hauv ib qho anastomosis nrog cov ceg lumbar arterial. Thawj thiab thib ob qhov chaw intercostal yog muab los ntawm cov hlab ntsha subclavian. Cov hlab ntsha intercostal txoj cai yog me ntsis ntev dua li ntawm sab laug thiab khiav hauv qab lub pleura mus rau lub kaum sab xis, nyob tom qab mus rau posterior mediastinum, pw ntawm qhov chaw sab hauv ntawm lub cev vertebral. Ntawm lub taub hau raug nqi, cov ceg dorsal tawm ntawm cov hlab ntsha intercostal mus rau cov leeg thiab daim tawv nqaij ntawm sab nraub qaum, mus rau qaum qaum (xws li nws daim nyias nyias) thiab txha nraub qaum. Los ntawm cov ces kaum costal, cov hlab ntsha khiav nruab nrab ntawm cov leeg sab hauv thiab sab nraud intercostal, pw nyob rau hauv tus nqi qis. Cov hlab ntsha nyob rau hauv thaj tsam ntawm 8th intercostal qhov chaw thiab hauv qab nws pw hauv qab cov tav tav, ceg rau hauv cov ceg ntoo rau cov leeg thiab cov tawv nqaij ntawm sab nraud ntawm lub hauv siab, thiab tom qab ntawd tsim anastomoses nrog cov ceg ntoo intercostal anterior los ntawm thoracic (sab hauv.) hlab ntsha. 4-6 cov hlab ntsha intercostal muab cov ceg rau cov qog mammary. Cov hlab ntsha sab sauv nruab nrab muab cov ntshav mus rau hauv siab, thiab peb cov hlab ntsha hauv qab muab cov diaphragm thiab lub plab.phab ntsa (pem hauv ntej). Qhov thib peb txoj cai intercostal hlab ntsha muab tawm ib ceg uas mus rau sab xis bronchus, thiab ceg tawm ntawm 1-5th intercostal cov hlab ntsha uas muab cov ntshav mus rau sab laug bronchus. Lub 3rd-6th cov hlab ntsha intercostal ua rau cov hlab ntsha ntawm cov hlab ntsha.

ceg ntawm lub plab aorta

Lub plab ntu ntawm lub aorta yog txuas ntxiv ntawm nws qhov thoracic. Nws pib ntawm qib 12th thoracic vertebra, dhau los ntawm lub aortic diaphragmatic qhib thiab xaus rau hauv cheeb tsam ntawm 4th lumbar vertebra.

thaj tsam plab yog nyob rau pem hauv ntej ntawm lub lumbar vertebrae, me ntsis mus rau sab laug ntawm midline, nyob retroperitoneally. Nyob rau sab xis ntawm nws yog cov vena cava (tsis zoo) cov hlab ntsha, nyob rau hauv pem hauv ntej - txiav txiav, kab rov tav ntu ntawm duodenum thiab mesenteric hauv paus ntawm txoj hnyuv me.

phab ntsa

Cov ceg parietal hauv qab no ntawm lub plab aorta yog qhov txawv:

1. Cov hlab ntsha phrenic inferior arteries (txoj cai thiab sab laug) ceg ntawm lub plab aorta tom qab nws tawm ntawm lub aortic diaphragmatic qhib thiab ua raws li lub diaphragm (nws lub dav hlau qis) rau pem hauv ntej, nce thiab mus rau sab.
2. Lumbar hlab ntsha (4 daim) pib los ntawm aorta hauv cheeb tsam ntawm 4 lub lumbar vertebrae, muab cov ntshav mus rau qhov chaw anterolateral ntawm lub plab, qaum qaum thiab sab nraub qaum.
3. Lub sacral nruab nrab cov hlab ntsha tawm ntawm lub aorta nyob rau hauv cheeb tsam ntawm nws faib mus rau hauv lub iliac cov hlab ntsha (5th lumbar vertebra), raws li lub pelvic ib feem ntawm lub sacrum, muab lub coccyx, sacrum thiab m. iliopsoas.

Visceral ceg

Cov ceg visceral hauv qab no ntawm lub plabaorta:

1. Lub cev celiac pib los ntawm lub aorta hauv cheeb tsam ntawm 12th thoracic lossis 1st lumbar vertebrae, nruab nrab ntawm cov diaphragmatic crura. Nws yog npaj rau ntawm midline nqes los ntawm cov txheej txheem xiphoid (nws apex). Hauv thaj tsam ntawm lub cev ntawm tus txiav, lub cev celiac muab tawm peb ceg: sab laug plab, kab mob siab, thiab cov hlab ntsha splenic. Truncus coeliacus yog ib puag ncig los ntawm cov ceg ntoo ntawm lub hnub ci plexus thiab npog rau pem hauv ntej los ntawm parietal peritoneum.



2. Cov hlab ntsha nruab nrab ntawm adrenal yog ib chav chav uas tawm ntawm lub aorta hauv qab lub cev celiac thiab muab cov qog adrenal.
3. Cov kab mob mesenteric zoo tshaj plaws tawm ntawm lub aorta ntawm 1st lumbar vertebra, posterior mus rau pancreas. Tom qab ntawd nws dhau los ntawm duodenum (nws qhov chaw sab nrauv) thiab muab cov ceg ntoo rau duodenum thiab txiav txiav, tom qab ntawm cov nplooj ntawv ntawm cov hauv paus mesenteric ntawm cov hnyuv me, muab cov ceg rau cov ntshav rau cov me thiab cov hnyuv (txoj cai) ntawm cov hnyuv..
4. Lub raum cov hlab ntsha pib los ntawm 1st lumbar vertebra. Cov hlab ntsha no ua rau cov hlab ntsha qis qis dua.
5. Cov hlab ntsha ntawm zes qe menyuam (cov noob qes) tawm hauv qab cov hlab ntsha ntawm lub raum. Dhau tom qab ntawm lub parietal peritoneum, cov ureters hla, thiab tom qab ntawd cov hlab ntsha sab nraud iliac. Hauv cov poj niam, cov hlab ntsha ntawm zes qe menyuam, los ntawm ligament uas ncua lub zes qe menyuam, mus rau cov hlab ntsha thiab zes qe menyuam, thiab hauv cov txiv neej, ua ib feem ntawm cov phev qaum los ntawm cov kwj dej inguinal, lawv mus rau cov noob qes.
6. Cov hlab ntsha mesenteric inferior ceg tawm hauv qis thib pebplab aorta nyob rau thaj tsam ntawm 3rd lumbar vertebra. Cov hlab ntsha no muab cov hnyuv (sab laug).

Atherosclerosis ntawm aorta

Atherosclerosis ntawm lub aorta thiab nws cov ceg yog ib qho kab mob uas tshwm sim los ntawm kev loj hlob ntawm cov plaques hauv lumen ntawm cov hlab ntsha, uas tom qab ua rau lub lumen nqaim thiab tsim cov ntshav txhaws.

Cov kab mob yog ua raws li qhov tsis txaus ntseeg ntawm qhov sib piv ntawm cov lipid feem, ntawm kev nce hauv cov roj cholesterol, uas tau tso rau hauv daim ntawv ntawm aortic plaques thiab aortic ceg.

Cov laj thawj ua rau muaj kev haus luam yeeb, ntshav qab zib, kev xeeb tub, lub cev tsis ua haujlwm.

YKev tshwm sim ntawm atherosclerosis

Ntau zaus, atherosclerosis tshwm sim yam tsis muaj cov tsos mob pom tseeb, uas cuam tshuam nrog qhov loj ntawm lub aorta (nrog rau cov chaw haujlwm, ceg ntawm lub aorta), tsim cov leeg nqaij thiab elastic txheej. Kev loj hlob ntawm cov plaques ua rau lub plawv ntau dhau, uas yog tshwm sim los ntawm kev kub siab, qaug zog, nce lub plawv dhia.

Nrog rau kev loj hlob ntawm cov kab mob pathology, cov txheej txheem txuas ntxiv mus rau cov ceg ntawm aortic koov ntawm qhov nqis thiab nce mus, suav nrog cov hlab ntsha uas pub lub plawv. Hauv qhov no, cov tsos mob hauv qab no tshwm sim: angina pectoris (qhov mob rov qab uas tawm mus rau lub xub pwg hniav lossis caj npab, ua tsis taus pa), plab zom mov thiab lub raum ua haujlwm, dhia hauv ntshav siab, mob khaub thuas, kiv taub hau, mob taub hau, ua tsis taus pa, tsis muaj zog. caj npab.