Hoʻohana akepaʻa. 'Ole a me ka hana ana o ke ake

'O ke akepa'a ka mea nui loa i loko o ke kino - akā, nui a'oi aku ka nui o ka'ili. Ake papa hiki ho i ka ai digestion, pūnao, e hoʻonele a me ka waiho waho pūnaewele o māhuaola i loko o ke kino. 'O ke akepa'a he mea ola nui, a me ka pau'ole o nā kino a me nā mea'ai. 'O ka pōmaika'i, he mana hiki ke ho'oula hou a hiki ke ulu koke i ka loa'a'ana o kāna mau hana a me kona nui. E nānā hou i ka hanana a me nā hana o ke ake.

'O ke anatomi Macroscopic o kahi kanaka

'O ke akepa'a o kahi kanaka aia ma ka'ākau ma lalo o ka diaphragm a he'ano ho'ohālike kona. Aia ka hapa nui o kona nui ma ka'ao'ao'ākau, a'o kahi hapa li'ili'i wale nō ke hele ma mua o ka laina waena o ke kino. 'O ke ake ma loko o nā mea'olu'olu,'ele'ele'ula'ula, i ho'opili'ia i loko o ka capsule kikola. Ua uhi'ia a ho'oulu'ia e ka perrinone (serous membrane) o ka lua o ka'ōpū, e mālama ana a ho'opa'a'ia i loko o ka'ōpū. 'O ka nui o ke ana o ke ake i kahi 18cm ka lō'ihi a'a'ole'oi aku ma mua o 13 i ka lahilahi.

'O ka peritoneum e pili i ke akepa'a i nā wahi'ehā: ke li'una li'ili'i, ka hema a me nā'ā'ī li'ili'i kūpono, a me ka ligament li'ili'i. 'A'ole kēia mau mea i nā mea wale nō i ke'ano anatomical; Akā, ua ho'okau'ia nā wahi o ka membrane abdominal e kāko'o i ke ake.

• Ho'opili kahi ligament li'ili'i āpau i ka hapa nui o ke akepa'a i ka diaphragm.

• Ma nā'ao'ao āpau o ka loe hema a me ka'ākau pololei,'o ka hema a me ka'ākau pono e ho'ohui i ke kī i ka diaphragm.

• Kuhi ka ligament li'ili'i mai ka diaphragm mai ka lihi mua o ke ake a hiki i lalo. Ma ke kumu o ka'ōpiopio, ka ligament li'ili'i e hana i ka ligament li'ili'i a pili i ke ake i ka piko. 'O ka ligament li'ili'i ke koena o ka māmā umbilical e lawe ai i ke koko i loko o ke kino i ka manawa o ka ulu'ana o ka'ōpū.

'O ke akepa'a he'elua lobe ka'awale - ka hema a me ka'ākau. Ua ho'oka'awale lākou i kekahi i kekahi. 'O ka māhele kuleana e pili ana i 6 mau manawa'oi a'e ma mua o ka hema. Ua pu'unaue'ia kēlā me kēia māhele i nā'āpana, a ma ka'ao'ao, ua māhele'ia i nā'āpana o ke ake. No laila, ua māhele'ia ke kikowaena i'elua mau'āpana, 5 mau me'a a me 8 mau'āpana. I ka manawa like, ua helu'ia nā'āpana o nā hua'ani Latin.

E kuleana like

E like me ka mea i'ōlelo'ia ma luna nei,'o ka lo'i'ākau o ke akei he 6 mau manawa'oi aku ka nui ma mua o ka hema. 'Elua mau lālā nui:'o ka'ākau pololei o ka'ākau a me ka māmā maika'i.

Ho'omāhele'ia ka lālā laulā'ākau i loko o nā'āpana laulā'elua'a'ole i ka palena ma ka'ao'ao hema o ke ake: o ka'ao'ao ma luna a me ka hope o ka'ākau'ākau (mahele VII) a me ka mahele hope ha'aha'a (segment VI).

'O ka lālā paramedia pono he'elua mau mahele: ka waena waena a me nā'ākau o lalo o ke akepa'a (VIII a me V,).

'O ka'ao'ao mahele

'Oiai'o ka loina hema o ka'ōiwi ka mea li'ili'i ma mua o ka'ākau, e'oi a'e ana nā'āpana. Ua māhele'ia i'ekolu mau lālā: ka hema hema, ka'ao'ao hema, ka lālā papahana hema.

'O ka mahele'ākau hema he hapa ho'okahi: ka'āpana caudate o ka lobe hema (I).

Ho'omoe'ia ka lālā laulā hema mai kahi'āpana: ka'ao'ao hope o ka lobe hema (II).

Ho'olāhele'ia ka māhele pā'ani hema i nā'āpana'elua: nā'ao'ao āpau a me ka mua o ka lobe hema (IV a me III, ma kēlā me kēia).

Hiki iā'oe ke'ike i ke'ano o ka hanana o ke ake ma ke kiko o nā ki'i ma lalo nei. Eia kekahi la'ana, i loko o ka huahelu hō'ike kekahi i ke ake, i māhelehele'ia i nā'āpana a pau. Ua helu'ia nā'ao'ao o ke akepa'a i ka huina. 'O nā helu a pau e pili ana i ka helu o ka Latin.

Hō'ike 1:

Bile capillaries

'O nā tubula e lawe ana i ka bele ma o ke ake a me ka'alelepa, ua kapa'ia'o nā capillaries bile a hana'ia i kahi kūhaka - ka bile duct system.

'O ka bile i hana'ia e nā pūpū o ke akewa e ho'oku'u'ia i nā kahawai microscopic - nā capillaries bile, i hui pū'ia i loko o nā'āpana bile nui. Ho'opili'ia kēia mau'ālele bile, me ka waiho'ana i nā lālā hema a me nā lālā pololei e halihali ana i ka bele mai ka'ao'ao hema a me ka'ākau o ke ake. Ma hope aku ua ho'ohui'ia lākou i ho'okahi o nā ma'i hepatic, kahi e holo ai ka bile.

'O ka hopena hepatic i nā hope hope loa e pili ana i ka lepa o ka lepera mai ka gallbladder. Lawe pū lākou i ke alanui bile like'ole, e halihali ana i ke alanui i ka duodenum o ka'ōpū li'ili'i. 'O ka hapa nui o ka bale i hana'ia i ke akepa'a e ho'iho'i'ia i loko o ka pilikino e ka peristalsis, a noho mau i ka gallbladder a hiki i ka manawa e koi'ia ai no ka'eli'ana.

'O ke kahekala holo'oko'a

He mea like'ole ke koko o ke ake. Komo mai ke koko i loko o ia mau mea mai nā kumu'elua: ke koko kīpoki a me ka hanu hepatic (koko koko).

Ka puka pā o Vienna hāpai koko mai ka spleen, opu, pancreas, ka laau awaawa, bladder, ka poe liilii, a me ka naʻau liʻiliʻi omentum. Ke komo i loko o nā puka o ke ake, ua māhele'ia ka huelo momona i loko o ka moku nui, kahi i hana'ia ai ke koko ma mua o ka holo'ana i nā'ao'ao o ke kino. Ke hele nei nā kinikōki o ke ake, ke'oki nei ke koko i loko o nā ma'i hepatic, a ma laila e komo ai i loko o ka māwae hollow a ho'i hou i ka na'au.

'O ka ate ho'i he pūnaewele pono'ī kona a me nā li'ili'i li'ili'i e hā'awi ana i ka oxygen i kona kino e like me nā mea'ē a'e.

Nā Lobu

'O ka'ao'ao o loko o ke ake i loko o 100,000 mau'enehana lawelawe hexagonal, i kapa'ia'o lobules. 'O kēlā me kēia melonā he pūpū waena ia e ho'opuni'ia e nā'eke hepatic portal 6 a me 6 mau kuamoho hepatic. Ho'opili'ia kēia mau kī'aha koko e kahi hui like'ole like'ole. E like me ka'ōlelo ma ka huila, e ho'oku'i aku ana lākou mai nā kola o ka puka a me ke an'a ma kahi o ka piko.

Kēlā me kēia sinusoid hele ma ke akepaʻa'aʻaʻa, a he mau nui ke ano o na keena: aeee Kupffer a me hepatocytes.

•'O nā pūnaewele ho'opunipuni kekahi'ano o ka macrophage. Ma nā'ōlelo ma'alahi, hopu lākou a wāwahi i ka'elemakule, i ke'oke'o i nā ki'eki'ena'ula'ula ulaula e hele ana i loko o nā pilina.

• Hepatocytes (pūpū hepic) nā pūnaewele epithelial cuboidal e waiho nei ma waena o ka pilina a ho'opa'a i ka hapa nui o nā pū i loko o ke ake. Ho'oponopono nā Hepatocytes i nā hapa o nā hanana - ka hana'ana, ka mālama'ana, ka'eli'ana a me ka hana bile. Nā'āpana pele li'ili'i, i kapa'ia kona capillaries, e kūlike me ka pilina ma kekahi'ao'ao o nā hepatocytes.

'O ke kumuhana

Ua'ike mua mākou iā mākou iho me kēia kumumana'o. E nānā iā kāua i ke'ano o ke ake. Nā ki'i a me nā'ike o lākou e'ike'ia ma lalo nei. No ka hiki'ole i ke ki'i ho'okahi ke hō'ike pono i ke kino, ho'ohana nui mākou. Hiki ke'ike'ia nā ki'i'elua i kahi'ao'ao o ke ake.

Hō'ike 2:

'O ka helu 2 ka'ōpū o ke kanaka. 'A'ole i kūpono nā ki'i o kēia hihia, no laila e no'ono'o ai ma ke kākau'ana. Ma lalo nā ki'i, a hō'ike'ia ma kēia ki'i:

1 - kapu kūpono hepēpī; 2 - hā'e; 3 - ka hepatic hema; 4 - ka hopena hepatic ma'amau; 5 - ka lō'ihi bile nani; 6 - pancreas; 7 - ke kapu o ka pancreas; 8 - duodenum; 9 - sphincter of Oddi; 10 - ka hopena o ke kī'aha; 11 - ka hua'ona.

Hō'ike 3:

Inā ua'ike'oe i ke ki'i o ke anatomi o ke kanaka,'ike'oe e pili ana i nā ki'i like. Hiki ke hō'ike i ka hāiwi i mua:

1 - lalo puha Vienna; 2 - ka ligament li'ili'i; 3 - kuleana kūlike; 4 - ka māhele hema; 5 - ho'ohui li'ili'i; 6 - ka hua'ona.

Hō'ike 4:

Ma kēia huina, ua'ike'ia ka hanana ma kekahi'ao'ao. Eia hou, ke'ano o ke anatomia o ke anatona kanaka e like me ke'ano like'ole:

1 - nā pūpū'ona; 2 - ka māhele kuleana; 3 - ka māhele hema; 4; 5 - kapu hepīpī; 6 - ka hepatic; 7 - he kī'aha hepīpī portal; 8 - ka lō'ihi bile nani; 9 - ka ho'oku'u ha'aha'a.

Hō'ike 5:

Hō'ike kēia ki'i i kahi wahi li'ili'i o ke ake. 'O kekahi mau ho'ākāka:'o ka paukū 7 ma ka huina ke hō'ike i kahi portal triad - kahi hui e hui pū i ka vepal portal vein, ka hepatic i ke kalo a bile.

1 - ka hepatic sinusoid; 2 - nā pūpū hepīpī; 3 - ke kī waena; 4 - i ka ma'i heppa; 5 - bile capillaries; 6 - mai nā capilaries kino; 7 - "puka'ekolu"; 8 -hepatic portal vein; 9 - ka hepatic; 10 - bile duct.

Kii 6:

Ua unuhi'ia nā puke ma ka'ōlelo Pelekānia (mai ka hema a ke'ākau):'o ka lālā'ākau'ākau, ka lālā paramedics pono, ka lālā palekana hema a me ka lālā laulā hema. Ua helu nā helu ke'oke'o i nā'āpana o ke ake, a ua like kēlā me kēia helu i ka helu o ka Latin:

1 - nā kī'aha heppa pololei; 2 - ka ma'i hepatic hema; 3 - ka'ōma'a hepesa ma mua; 4 - umbilical vein (ho'omaha); 5 - kapu hepīpī; 6 - nā mea lalo loa; 7 - ka hepatic; 8 - kekona puka; 9 - bile hana; 10 - ka hopena o ke kī'aha; 11 - nā pūpū.

'O ke kino o ke ake

He'ano like'ole nā hana o ke akepa'a kanaka: he mea ko'iko'i nui ia i ka digestion, ka hana pono, a me ka mālama'ana i nā mea'ai.

'Ie'ia

'O ke ake i loko o ke ka'ina hana o ka'omi'ana ma ka hana'ana i bile. Bile mea i ka läÿau, o ka wai, paʻakai o ka bile nāʻakika, naʻokoko a me ka bilirubin pigment.

Ma hope o ka loa'a'ana o nā hepatocytes i loko o ka ate, e hele ana ia i nā alanui bile a e noho mau i loko o ka pūpū ma hope o ka mea e pono ai. Ke hele ka'ai i nā momona i ka duodenum, nā pū o ke duodenum e ho'oku'u i ka cholecystokinin hormone, e pili ana i ka gallbladder. E hele ana i ka leodenum, kahi e ho'onele ai i nā momona nui. 'O ka momona momona o ka pele e ho'ololi i nā momona nui o nā momona i loko o nā'āpana'u'uku i loa'a kahi'āpana li'ili'i li'ili'i a no laila ua ma'alahi ka hana.

'O Bilirubin, kahi e noho ana i ka bele, he huahana ia o ka hana'ana ma ke akepa'a o nā kele'ula'ula ulaula. 'O nā pūpuni Kupffer i loko o ka hanana hopu a ho'ohiolo i nā'elemakule, ua uhi'ia i ke koko'ula'ula a hā'awi'ia aku i nā hepatocytes. I ka hopena, ua ho'oholo'ia ka hopena o hemoglobin - ua māhele'ia i mau hui heme a me ke kele. Ho'opau'ia ka'ene'oki o ke kalapona a ho'ohana'ia e like me ke kumu waiwai no ke kino. Hiki'ole ke hana'ia e ka'ōpili i ka hui hao o ka heme a ho'ololi wale'ia i ka bilirubin, i ho'okomo'ia i ka bile. 'O bilirubin ka mea e hā'awi ana i ka balele i kona'ano'ōma'oma'o. Ho'opili hou nā huapīpī kino i ka bilirubin i loko o ka pua'a'ula'ula o ka cynocysts, e hā'awi ana i ka'alani i ke'ano'ele'ele.

Ke ku'ina

Ho'omaopopo'ia he nui o nā hana pa'akikī e pili ana i nā ka'ina hana metabolic i nā hepatocytes o ke ake. Ma muli o ke koko a pau, e waiho ana i ka'ōnaehana lepo, hele i loko o ka vepal portal hepatic, ke kuleana o ka ate me ka ho'ohālike i ka wai'ahu, lipids a me nā protein i loko o nā mea waiwai.

Ho'opi'i ka'ōnaehana'ōpona i nā huapona i loko o ka monosaccharide glucose, kahi e ho'ohana'ia ai nā pūnaewele e like me ke kumu waiwai. 'O ke koko e komo ana i ke akepa'a ma o ka heinalic portal he waiwai nui loa i ka glucose mai ka'ai i ho'opili'ia. Ho'opili ka Hepatocytes i ka hapa nui o kēia glucose a mālama'ia e like me macromolecules o glycogen, he polysaccharide ālai'ia e hiki ai i ke akepa'a ke mālama nui i ka glucose a ho'oku'u koke i waena o nā mea'ai. 'O ka ho'oku'u a me ka ho'oku'u'ana o ka glucose e nā hepatocytes e kāko'o i ka homeostasis a me ka nui o nā kulukū koko.

'O ka momona acids (lipids) o ke koko e lilo ana i ke ake, e ho'oma'ema'e a ho'omohu'ia e nā hepatocytes e hā'awi ai i ka ike ma ke'ano o ka ATP. 'O Glycerin, kekahi o nā mea lipid, i ho'ololi'ia e nā hepatocytes i loko o ka glucose ma ke ka'ina o ka gluconeogenesis. Hiki i nā Hepatocytes ke hana i nā lipids pēlā i ka cholesterol, phospholipids a lipoproteins e ho'ohana'ia e nā pūnaewele'ē a'e i loko o ke kino. 'O ka hapa nui o ka cholesterol i hana'ia e nā hepatocytes, ua ho'oku'u'ia mai ke kino e like me kahi mea bile.

Ho'omo'a'ia nā mea ho'omalu pilikino i nā amino acids e ka'ōnaehana ho'opalapiha ma mua o ka ho'oili'ia'ana i ka veal portal vein. 'O ka amino acids e komo i loko o ke ake i kahi hana ma'amau i mua o ka hiki ke ho'ohana'ia e like me ke kumu waiwai. Ho'opuka mua'o Hepatocytes i ka amino mai ka amino acids a ho'ololi'ia i ka amonia, a ho'oponopono'ia i ka Urea.

'O ka mea'awa'awa'ole ka mea'awa'awa ma mua o ka amonia, a hiki ke ho'oku'u'ia me ka mimi e like'ole me ka waiwai'ole o ka'ōpala. 'O nā koena o nā amino acids i kāpili'ia i ATP ai'ole ia i ho'ololi'ia i loko o nā kinoliki glucose hou ma o ke ka'ina hana o ka gluconeogenesis.

Ho'oponopono'ia

Ma ke koko o nā'ōpena'alea e hele ai i loko o ke kīpili o ke akepa'a, nā mana hepatocytes e mālama i ke koko me ka wehe'ana i nā mea mea'ino i mua o ka hiki'ana iā lākou ke koena o ke kino.

'O nā enzymes i nā hepatocytes e ho'ololi i kēia mau toxins (pēlē, nā wai'ona a me nā lā'au lapa'au) i loko o kā lākou mau pono hana. No ka mālama'ana i ke ki'eki'e o nā hormones i nā palena homeostatic, e ho'oku'u a ho'oku'u'ia ka ate mai ka holo'ana o nā hormones i hua'ia e nā hue o kāna'ōpū.

Pale

'O ke akepa'a ka ho'olako'ana i nā mea'ai e pono ai, nā huame'a a me nā minela, i loa'a mai ke kahe'ana i ke koko ma o ka pūnaewele puka hepic. Lawe'ia ka glucose ma nā hepatocytes ma lalo o ka mana o ka insulin ka hormone a mālama'ia ma ke'ano o glycogen polysaccharide. Ho'opili ka Hepatocytes i nā wai'ona momona mai nā triglycerides i ho'ohehe'e'ia. Hiki i ka mālama'ana o kēia mau mea i ka mālama i ke akepa'a e mālama i ka homeostasis glucose i loko o ke koko.

Ho'okomo'ia ko mākou hanana i nā huaora a me nā minela (hua A, D, E, K a me B 12, a me nā minera o ka hao a me ke keleawe) i mea e ho'omau ai i kēia mau mea nui i nā kino o ke kino.

'O ka production

'O ke akepa'a ke kuleana o ka hana'ana i nā kinona waiwai nui o ka plasma koko: prothrombin, fibrinogen a albumin. 'O nā kinipona Prothrombin a me nā fibrinogen ke kāohi nei i nā mea i pili i ka hana'ana i ka thrombi. 'O nā huapalapala ka mea e kāko'o ana i ke kaiapona isotonic o ke koko i'ole e loa'a ai i nā pūnaewele ka wai'ole i mua o nā wai o ke kino.

Immunity

'O ke akewa he hana ia o ka pūnaewele immune ma o ka hana o nā pūmole Kupffer. 'O nā pūpuni Kupffer kekahi macrophage e lilo ana i kekahi o nā mononuclear phagocytes o ka pūnaewele me nā macrophages o nā'ōpū me nā lymph. Pono nā pūnaewele Kupffer i kahi ko'iko'i nui, no ka hana'ana i ka bacteria, ha'ani, pale, nā pūpū koko i'ōwili'ia, a me nā hua o ka palaka.

Ke kuhi o nā kinai: nā mea ma'amau a me nā mea'ino

He hana nui ka hanana i loko o ko mākou kino, no laila he mea nui ka ma'a mau. Ma muli o ka hiki'ole ke hō'eha i ke ake, no ka mea,'a'ohe mau a'a i loko o laila,'a'ole'oe e'ike i ke'ano o ka lilo o ka mea i mana'o'ole'ia. Hiki ke emi iki, akā, akā i ka hopena, hiki'ole ke ho'ōla.

Nui nā ma'i o nā ma'i, i'ole'oe e mana'o i kahi mea hiki'ole ke hana'ia. hiki Man noho i ka lōʻihi manawa a me ka noonoo oe ia oe iho ola, akā, ma ka hopena e huli mai ia he cirrhosis a ake maʻi 'aʻai. 'A'ole hiki ke ho'ololi kēia.

'Oiai'o ke akepa'a a he waiwai ho'i kāna e ola ai,'a'ole'o ia e pale aku i kēlā mau ma'i. I kekahi manawa, makemake'o ia i kāu kōkua.

E pale lapuwale pilikia, i kekahi manawa, e lawa e kipa i kekahi kauka, a hana ultrasound o ke akepaa, o ka uku o ka i ua ho'ākāka 'ia ma lalo nei. E hoʻomanaʻo i ke akepaʻa pili me ka noho pilikia loa maʻi e like me hepatitis, i me ka pono lapaʻau ke alakai manawa no ka loa pathologies e like me cirrhosis a me ka maʻi 'aʻai.

Ano, e ka e hele pololei i ka US a me kona kūmau. Ke akamai mua nana e ike ina o ke ake, a mea kona nui ua offset.

Ke mau ka nui o ke akepaʻa hiki ole e hoakaka ia me ka piha visualize i ke kino ole i ke Akua. huina kino lōʻihi e ole mamua o 18 knm. kahuna lapaau he hana kēlā me kēia wahi kaawale akepaʻa.

E ka hoʻomaka me ka mea i ke akepaʻa ultrasound e e akaka hiki elua o kona kaʻana like 'ana, e like me na nāʻoihana e a lakou i maheleia. Ma ka ia ligaments (i ka mea, a pau na ligaments) pono,ʻaʻole e hiki. Ka like apono 'kauka e noiʻi i nā mea a pau ewalu Hoʻohana kaawale, no ka mea,, hoi, hiki ke eaaei ike.

Kūmau Ana o ka akau, a me ka lobe hema

Ka haʻalele lobe E e pili ana i 7 knm ma ka mānoanoa, a ma kahi o 10 knm i loko o kona kiʻekiʻe. Mahuahua ka nui mai nei e pili ana i ola pilikia o hiki mai ia oe i li nui o ke akepaʻa. Ka akau lobe, i mea no ka uku - ma kahi o 12 knm ma ka mānoanoa, a i ka 15 knm ka lōʻihi, e like me 'oe ke' ike no ka nui loa aku hema.

Ma waho aʻeo ia i ke kino, kauka pono nānā a me ka bile leki uea, e like me na moku nui ke koko o ke akepaʻa. I ka nui o ka bile leki uea, no kekahi laʻana, e e mai oi ma mua o 8 mm o, Ka nū Vienna - ma kahi o 12 mm o, a me ka puha Vienna - 15 mm.

No kauka mea,ʻaʻole nā loko wale nō o nā Ana, akā, i kona 'ole, kino contours a me'aʻaʻa.

Kanaka'anatomia (akepaa, a mea he loa luna 'hui, kēia) - muli o kona kulana he kupaianaha mea. ʻAʻohe mea oi hana hoihoi ma mua o ka maopopo i ka 'ole iho. I kekahi manawa ka mea, ke hiki e ho'ōlaʻoe mai ka hua'ōlelo i makemake maʻi. A ina oe e makaala oukou, na pilikia hiki ke käpae '. Hele i ke Kauka - ia mea,ʻaʻole like scary me ka mea āu e. E hoʻokaʻaʻike ola!