Lub hlwb ua haujlwm tseem ceeb tshaj plaws hauv tib neeg lub cev thiab yog lub hauv paus tseem ceeb ntawm lub paj hlwb. Thaum nws cov dej num raug tso tseg, txawm tias ua tsis taus pa nrog kev pab ntawm lub ntsws ua pa, cov kws kho mob paub tseeb tias kev tuag.
Anatomy
Lub medulla oblongata tau muab tso rau hauv lub nraub qaum cranial thais thiab zoo li lub qhov muag tsis pom kev. Los ntawm hauv qab no, los ntawm occipital foramen, nws txuas mus rau tus txha caj qaum, los ntawm saum toj no nws muaj ib tug ciam teb nrog cov pons. Qhov twg lub medulla oblongata nyob rau hauv lub cranium yog kom meej meej pom nyob rau hauv daim duab tso tawm tom qab nyob rau hauv tsab xov xwm.
Nyob rau hauv ib tug neeg laus, lub cev nyob rau hauv nws qhov widest qhov chaw yog kwv yees li 15 mm nyob rau hauv txoj kab uas hla, nyob rau hauv tag nrho ntev nws mus txog tsis ntau tshaj 25 mm. Sab nraud, medulla oblongata envelops cov teeb meem dawb, thiab sab hauv nws muaj cov teeb meem grey. Nyob rau hauv nws sab qis muaj cais clots - nuclei. Los ntawm lawv, reflexes yog nqa tawm, npog tag nrho lub cev ntawm lub cev. Cia peb saib ze dua ntawm cov qauv ntawm oblonghlwb.
Nkauj sab
Lub ventral nto yog sab nraud ntawm medulla oblongata. Nws muaj lub khob hliav qab-zoo li tus lateral lobes, expanding upwards. Cov chaw haujlwm tau tsim los ntawm cov kab ke hauv pyramidal thiab muaj qhov nruab nrab qhov tawg.
Lub dorsal nto yog lub hauv qab sab nrauv ntawm medulla oblongata. Nws zoo li ob lub cylindrical thickenings, sib cais los ntawm qhov nruab nrab sulcus, muaj cov fibers uas txuas rau qaum qaum.
Sab hauv
Cia peb xav txog lub cev ntawm medulla oblongata, uas yog lub luag haujlwm rau lub cev muaj zog ntawm cov leeg pob txha thiab tsim cov reflexes. Lub hauv paus ntawm cov txiv ntseej yog ib daim ntawv ntawm grey teeb meem nrog jagged npoo thiab zoo li cov duab ntawm horseshoe. Nws yog nyob rau ntawm ob sab ntawm lub pyramidal qhov chaw thiab zoo li ib tug oval elevation. Hauv qab no yog qhov tsim ntawm reticular, muaj plexuses ntawm paj hlwb. Lub medulla oblongata suav nrog cov nuclei ntawm cov hlab ntsha cranial, chaw ua pa thiab ntshav.
Kernels
Glossopharyngeal paj hlwb muaj 4 nuclei thiab cuam tshuam rau cov kabmob hauv qab no:
- caj pas;
- palatine tonsils;
- saj receptors nyob tom qab tus nplaig;
- sab qaub ncaug;
- kab noj hniav;
- Estachian tubes.
Cov hlab ntsha vagus suav nrog 4 nuclei ntawm medulla oblongata thiab yog lub luag haujlwm rau kev ua haujlwm:
- plab thiab lub hauv siab;
- leeg ntawm lub larynx;
- Auricle daim tawv nqaij receptors;
- hauv plab plab;
- caj dab caj dab.
Cov paj hlwb muaj 1 lub hauv paus, tswj cov leeg sternoclavicular thiab trapezius. Cov paj hlwb hypoglossal muaj 1 nucleus thiab cuam tshuam rau cov leeg ntawm tus nplaig.
Lub luag haujlwm ntawm medulla oblongata yog dab tsi?
Lub reflex muaj nuj nqi ua qhov cuam tshuam rau kev nkag mus ntawm cov kab mob pathogenic microbes thiab stimuli sab nraud, tswj cov leeg nqaij.
Kev tiv thaiv kev tiv thaiv:
- Thaum noj zaub mov ntau dhau, cov tshuaj lom nkag mus rau hauv lub plab, lossis thaum lub vestibular apparatus khaus, ntu ntuav hauv lub medulla muab lub cev rau lub cev kom nws nqus. Thaum lub gag reflex tshwm sim, cov ntsiab lus ntawm lub plab tawm los ntawm txoj hlab pas.
- txham yog qhov tsis muaj qhov cuam tshuam uas tshem tawm cov plua plav thiab lwm yam tshuaj lom neeg los ntawm nasopharynx los ntawm kev nqus sai sai.
- Cov kua paug tawm ntawm qhov ntswg ua haujlwm ntawm kev tiv thaiv lub cev los ntawm kev nkag mus ntawm cov kab mob pathogenic.
- hnoos yog ib qho yuam kev exhalation tshwm sim los ntawm contraction ntawm cov nqaij ntshiv ntawm lub Upper pa ib ntsuj av. Clears bronchi los ntawm phlegm thiab mucus, tiv thaiv lub trachea los ntawm txawv teb chaws khoom nkag mus rau hauv nws.
- blinking thiab tearing yog kev tiv thaiv reflexes ntawm lub qhov muag uas tshwm sim thaum sib cuag nrog txawv teb chaws neeg sawv cev thiab tiv thaiv lub cornea kom qhuav.
Tonic reflexes
Cov chaw ntawm medulla oblongata yog lub luag haujlwm rau tonic reflexes:
- static: lub cev txoj haujlwm hauv qhov chaw, kev sib hloov;
- statokinetic: kho thiab khoreflexes.
Food reflexes:
- tso kua txiv rau plab;
- sab;
- nqos.
Lub luag haujlwm ntawm medulla oblongata yog dab tsi?
- hlab plawv reflexes tswj kev ua haujlwm ntawm lub plawv cov leeg thiab cov ntshav ncig;
- ua pa ua pa kom ua pa ntawm lub ntsws;
- conductive - yog lub luag haujlwm rau lub suab ntawm cov leeg pob txha thiab ua raws li kev soj ntsuam ntawm kev hnov qab.
Symptoms of the lesion
thawj cov lus piav qhia ntawm lub cev ntawm lub medulla tau pom nyob rau xyoo pua 17th tom qab tsim lub tshuab tsom. Lub cev muaj ib tug complex qauv thiab muaj xws li cov chaw tseem ceeb ntawm lub paj hlwb, nyob rau hauv cov ntaub ntawv ntawm kev ua txhaum ntawm tag nrho cov kab mob raug kev txom nyem.
- Hemiplegia (cross paralysis) - tuag tes tuag taw ntawm sab caj npab thiab sab laug ib nrab ntawm lub cev lossis rov ua dua.
- Dysarthria - txwv kev txav ntawm lub cev ntawm kev hais lus (dhau, palate, nplaig).
- Hemianesthesia - txo qis rhiab heev ntawm cov leeg nqaij ntawm ib nrab ntawm lub ntsej muag thiab loog ntawm sab qis ntawm lub cev (nqho).
Lwm cov cim qhia ntawm medulla oblongata tsis ua haujlwm:
- kev raug ntes;
- unilateral paralysis ntawm lub cev;
- kev tawm hws;
- memory poob;
- paresis ntawm lub ntsej muag nqaij;
- tachycardia;
- txo lub ntsws ua pa;
- retraction ntawm qhov muag;
- tub kawm ntawv constriction;
- inhibition ntawm tsim ntawm reflexes.
Alternating Syndromes
Kev tshawb fawb ntawm lub cev ntawm lub cev ntawm medulla oblongata tau pom tias thaum sab laug lossis sab xis ntawm lub cev puas lawm, hloov pauv (alternating) syndromes tshwm sim. Cov kab mob tshwm sim los ntawm kev ua txhaum ntawm kev ua haujlwm ntawm cov hlab ntsha cranial ntawm ib sab.
YJackson Syndrome
Txhim kho nrog kev ua haujlwm tsis zoo ntawm lub nuclei ntawm cov hlab ntsha hypoglossal, tsim cov ntshav txhaws hauv cov ceg ntawm cov hlab ntsha subclavian thiab vertebral.
Symptoms:
- tuag tes tuag taw ntawm cov leeg nqaij;
- tsis txaus lub cev muaj zog teb;
- tus nplaig paresis ntawm ib sab;
- hemiplegia;
- dysarthria.
Avlis Syndrome
Kev kuaj pom muaj kev puas tsuaj rau thaj tsam pyramidal ntawm lub hlwb.
Symptoms:
- tus tuag tes tuag taw;
- nqhis dej tsis meej;
- dysarthria.
Schmidt Syndrome
tshwm sim nrog kev ua haujlwm tsis zoo ntawm cov chaw tsav tsheb ntawm medulla oblongata.
Symptoms:
- trapezius paralysis;
- vocal qaum paresis;
- kev hais lus tsis sib haum.
Wallenberg-Zakharchenko Syndrome
Txhim kho thaum muaj kev ua txhaum ntawm kev muaj peev xwm ntawm cov leeg nqaij ntawm lub qhov muag thiab kev ua haujlwm tsis zoo ntawm cov hlab ntsha hypoglossal.
Symptoms:
- vestibular-cerebellar hloov pauv;
- paresis ntawm palate;
- txoov ntsej muag rhiab;
- skeletal leeg hypertonicity.
YGlick Syndrome
Kev kuaj pom muaj kev puas tsuaj loj rau lub hlwb qia thiab nuclei ntawm medulla oblongata.
Symptoms:
- txo qiskev pom;
- spasm ntawm lub ntsej muag nqaij;
- nqhis dej tsis meej;
- hemiparesis;
- mob pob txha hauv qab ob lub qhov muag.
Cov qauv histological ntawm medulla oblongata zoo ib yam li tus txha caj qaum, nrog rau kev puas tsuaj rau lub nuclei, tsim kom muaj kev hloov pauv thiab lub cev muaj zog ntawm lub cev cuam tshuam. Txhawm rau txiav txim siab qhov kev kuaj mob tiag tiag, cov cuab yeej siv thiab kev kuaj sim tau ua tiav: lub hlwb tomography, kuaj cov kua cerebrospinal, pob txha taub hau radiography.
