Ihe owuwu ya, onodu ya na oru ya

Pancreas gwakọtara, gụnyere akụkụ endo - na exocrine.

N'ime akụkụ exocrine, a na-emepụta ihe ọ pancụ pancụ pancreatic (ihe dị ka lita 2 kwa onye), na-enwe mgbaze. enzymes (trypsin, lipase, amylase, wdg) na-abanye n'ime mmiri ahụ n'ime duodenum, ebe enzymes na-etinye aka na mmebi nke protein, abụba, carbohydrates na ngwaahịa ikpeazụ.

Ọ na - akpụzi akụkụ bụ isi nke olu nke gland ma bụrụkwa ihe dị mgbagwoju anya nke alveolar-tubular serous gland, nke nwere akụkụ njedebe (pancreatic acini) yana sistemụ akwara dị.

1) Acini - nkeji na arụmọrụ. Ha nwere akpukpo gbara okirikiri (yiri igbe) ma ọ bụ udi ogologo na mkpochapu dị warara. Ogo ya bụ 100-150 microns. N’agbata ha, akwara reticular, ọbara. okpu okpu, akwara. eriri, akwara. ganglia. Cellsdị sel abụọ mebere:

a) Excrine Pancreatocytes (acinocytes) (8-12pcs) - mkpụrụ ndụ buru ibu nke ọdịdị pyramidal. Aka akụkụ akụkụ akụkụ (Mpaghara homogeneous) nwere basophilia, ngwa eji arụ ọrụ na - arụ ọrụ nke ọma - graPS, cytolemma forms folds.

Mkpesa apical akụkụ (Mpaghara zymogenic) ọ bụ carbonphilic, ọ na-achịkọta nnukwu zymogenic (nke nwere proenzymes) granules, cytolemma form microvilli, microfilaments na microtubules dị.

Ngwurugwu a na - ahụkarị na akụkụ basal, nwere 1-2 nucleoli, CG n'etiti granules na nucleus.

b) Mkpụrụ ndụ mkpụrụ ndụ - obere, gbamgbam, nke na-adịkarị n’usoro nke kpakpando, akwara dị na ya, cytoplasm dị nfe, akụkụ ahụ adịghị eto. N'ime acinus, ha dị n'etiti, jikota na ọpụpụ ya na ya, na-akpụ ụdọ ọgbụgba.

2) Sistemụ nke ihe akwara dị gụnyere duct intercalary duct, intralobular ducts, interlobular ducts, na eriri mmiri na-ejikọkarị ọnụ.

a) itinye ntinye - tubes dị warara nke nwere otu oyi akwa dị larịị ma ọ bụ cubic. epithelium

b) ngwa intralobular - etinyere n’ihi mmachi esemokwu intercalation, nke edoziri n’otu ogidi kpuchie ya. ma ọ bụ obere prism. epithelium. Gburugburu RVST, nke ọ na-arịa ọrịa. arịa ọbara na akwara. eriri.

c) interlobular ducts dinara n'ime akụkụ ahụ dị na etiti ahụ n'etiti ọdụ ndị ahụ, nke nwere akwa a na-ejikọ ọnụ. epithelium, nwere goblet na mkpụrụ ndụ endocrine.

d) na-agakarị na-agabiga gland dum, na-emeghe n'ime duodenum na mpaghara Vater papilla. Ejiri epithelium nwere klọọkụ gbara nke ukwuu, nweekwa goblet na sel endocrine, nke dị na mpaghara ya nke ya na akụkụ akụkụ nke gland mucous dị.

DERMA. SKIN GLANDS.

Dermis - akpụkpọ ahụ kwesịrị ekwesị, ọkpụrụkpụ 0,5-5 mm, akụkụ anụ ahụ na - ejikọta. emi odude ke idak ekara ekara ekpat emi enyenede uduot ekpat. E kewapụrụ ya n'igwe abụọ:

1. Ibe oyi akwa Na ngalaba a gosipụtara ya dịka otu papillae na-abanye na epidermis. Ọ dị n'okpuru ya wee guzobe PB neoform ST, na-arụ ọrụ trophic f-ju. Imirikiti papillae na anụ nke n'ọbụ aka na nkwọ. CT nke akwa a nwere mkpo collagen, elastic na reticular files, enwere fibroblasts na fibrocytes, mkpụrụ ndụ macrophages na mast, Tlymf. Enwere akwara mkpụrụ ndụ dị nro na-agbanye na mgbọrọgwụ nke ntutu - akwara nke na-eweli ntutu. Onu ogugu macrophages, nkpuru osisi anakpo ahu na sel ndi ozo immunocompetent na enyere gi aka ime ọrụ nchebe usoro mgbochi.

2. Mesh oyi akwa (ihe bụ isi akụkụ nke dermis) bụ nke mejupụtara B neoform ST mepụtara ma nwee network dị okpukpu atọ nke nnukwu ngwongwo dị ike nke eriri collagen na-emekọrịta na netwọk nke eriri na-agbanwe. Na-eme na-akwado ọrụ, na-enye ike anụ ahụ. Ihe cellular bụ fibroblasts.

Ọkpụkpụ anụ ahụ - Ngwakọta nke epidermis. Nyefee ahụ ọkụ, chebe akpụkpọ ahụ pụọ na mmebi, nyefee ngwaahịa nke metabolic na ahụ.

1. Gwe glands achọtara n'ihe fọrọ nke nta ka ọ bụrụ ebe niile anụahụ dị. Onu ogugu kariri nde 2.5. Anyi na-aputa ihe dika 500-600 ml nke nchapu ubochi. Na nhazi ya anaghị apụtakarị ngwa ngwa. Ha mejuputara uzo di ogologo na ogweghi okpukpo pere mpe, agbaghari na udi nke glomerulus. Dayameta nke glomerulus bụ 0.3-0.4 mm. Akụkụ ngwụcha dị na mpaghara miri emi nke retali oyi akwa nke dermis na mpaghara yana anụ ahụ dị n'okpuru, ebe akụkụ ahụ dị na –emeghekwa n'elu anụ ahụ site na nke a na-akpọ ọsụsọ pore.

Dabere na usoro nzuzo Ọkpụkpụ ọsụsọ na-ekewa n'ime eccrine (merocrine) na apocrine.

A) Mkpokoro nke okpolọk - tubular dị mfe, dị na anụ ahụ mpaghara niile (akpụkpọ ahụ n'egedege ihu, ihu, aka na aka), nke dị omimi. zoo hypotonic ọsụsọ na-zoro ezo. Ngalaba njedebe gụnyere ụdị sel abụọ:

- nzuzo ụdị pyramidal, kee ihe dị n'ime, ekewa n'ime:

mkpụrụ ndụ - nke buru ibu, n’elu akpụkpọ ala, enwere mitochondria na glycogen, na-ahụ maka mbupu mmiri

mkpụrụ ndụ gbara ọchịchịrị pere mpe, bara ụba na grads, enwere grasia di iche iche, ihe ndi ozo na-adi ya.

- mkpụrụ ndụ myoepithelial Usoro na-abaghị uru, na-ebu filain anụ ahụ, na-ekere òkè na nhazi nzuzo.

Ducretory ducts - na-eduzi, ha bụ epithelium bilayer na-etolite ya, ụdị sel abụọ:

- akụkụ - polygonal udi, ya na ihe gbara ya gburugburu, mitoch., Ribosomes,

- enweghị atụe - polygonal udi, ya na isi nwere emebi emebi, ihe ndi n’eto n’iru na imeghari onwe ya.

B) Agụmakwụkwọ nke chi ụgha - albuolar tubular dị mfe, dị na ụfọdụ ebe (na armpits, ọkpọiso, ụkwụ, akụkụ ahụ). emesoro guzobere n’oge uto, ọsụsọ na-agba mmiri nwere ihe dị n’ime ya.

Ngalaba njedebe: a) mkpụrụ ndụ myoepithelial, b) mkpụrụ ndụ sekọnd bụ oxygenphilic, a na-achịkọta ihe nzuzo ahụ na akụkụ apical. Ducretory ducts A ga - ebipu otu mkpụrụ ndụ dị ka ọkpọ nke gland eccrine.

2. Sebaceous glands- dị mfe, nke edobere, alveolar, na - ejikọkarị na ntutu isi, gbasaa ebe niile, etolite n'oge mgbanwe nwoke.

Ngalaba njedebe - alveoli, ụdị sel abụọ:

- basal - obere, basophilic, nwee ike nkewa,

- sebocytes - nke buru ibu, nke nwere lipids, na-ebibi, na-aghọ ihe nzuzo - sebum.

Ductret - obosara, mkpụmkpụ, na-adọtị akpụ akpụ epithelium.

Pancreas anatomy na topography

N'ime mmadụ, gland a dị n'ime oghere dị n'azụ, na afọ ya na ntakịrị aka ekpe. Ọ nwere udi nke comma na pinkish-agba ntụ.

Iron nwetara aha ya n'ihi ugba nke onodu ya n’ahu: oburu na mmadu atukwasiri ya n’azu, o gha adi n’okpuru afo. Enwere akụkụ atọ nke gland - isi, ahụ na ọdụ:

1. Isi nọ n'akụkụ akpukpo ukwu nke osisi duodenum. Na nsọtụ isi na ahụewela ezumike n’anụ ahụ, eriri ala Portal na-agafe ebe a.
2. Anụ ahụ nwere ụdị nke trimral prism. Mgbidi dị n'akụkụ akụkụ ahụ afọ nke afọ ma na-eduzi ntakịrị elu. Mgbidi n'azụ chere ihu n'ọkpụkpụ. Ọ bụ na njikọta yana arịa nke oghere afọ na anyanwụ plexus. Mgbidi dị ala n'okpuru ogwe aka ya.
3. Ọdụ nwere udi nke ube. N'akuku ya bu ọnu-uzọ nke akwara.

A na - enye obara obara site n’ọtụtụ ebe. Isi na-enweta ihe oriri site na akwara dị ala na nke elu. A na-enye ahụ na ọdụ ahụ ọbara site na alaka nke splenic artery. Mpụpụ site na akwara nke sitere na ọbara anụ ahụ, site ebe ọbara na-abanye n'ime sistem veinal.

A na-eme iwu ojoo site na usoro ọmịiko na parasympathetic. Parasympathetic ciki na-anọchi anya ya site na ngalaba nke akwara ahụ, nwere ọmịiko - site na celiac plexus.

Ọdịdị nke akụkọ ihe mere eme nke akụkụ ahụ

Ọkpụkpụ ihe ochie (anụ ahụ) nke gland dị mgbagwoju anya ma nwee ọdịdị alveolar-tubular. A na - ekewa ihe niile mejupụtara akụkụ ahụ. N’etiti oghere ndị ahụ bụ arịa ọbara na akwara. Na mgbakwunye, enwere obere duves nke gland tinyere nke a na-achịkọta ihe nzuzo.

Site na njirimara na ọrụ nhazi, a na-ekekarị akụkụ ahụ niile ụzọ abụọ - endocrine na exocrine.

Akụkụ exocrine nke pancreas mejupụtara ụyọkọ sel - acini. Ha bụ akụkụ nke lobules. Usoro duct na-ejikọ acini nwere njikọ. A na-anakọta dupe intralobular na interlobular, ndị ahụ, n'aka nke ha, ga-abanye na isi mmiri.

A na-anọchi anya akụkụ endocrine site n'agwaetiti Langerhans. Akụkụ ndị a nke mkpụrụji bụ ụyọkọ akwara mkpụrụ ndụ - insulocytes. Dabere na morphology na ọrụ, mkpụrụ ndụ ndị a kewara n'ọtụtụ subtypes - alfa, beta, delta, D-sel, PP-sel.

Sistemu akwara pancreatic

Ahụ nwere usoro dị mgbagwoju anya nke ihe ọ theụ theụ ya na-abanye n'ime eriri afọ.

Isi mmiri, na-agafe akụkụ ahụ dum, a na-akpọ Virsungova. Iri akwara a na-abanye n'ime oghere duodenum. N’ebe a, enwere akwara dị nwayọ - sphincter, nke na - egbochi ịbanye na mmiri mkpụrụ osisi gastric na bile n’ime gland.

Ogologo Wirsung duct dị na 16 ruo 20 cm, obosara ya dị iche site na 4 mm na isi ruo 2 mm na caudal. Ọkpụkpụ nke duct na-ekwughachikarị ọdịdị nke gland. Mana mgbe ụfọdụ, ọ nwere ike were akwa ma ọ bụ S-udi.

N'aka, obere ducts na-abanye n'ime ya - interlobular na intralobular. N'ime eriri Wirsung, ụzọ 30 ruo 50 nke tubules pere mpe nwere ike imepe.

Ọpụpụ Wirsung na-ejikọkarị ọnụ ọnụ choledochus. N'ebe ụfọdụ, oghere ndị a nwere ike ịnọ otu ebe dị anya site na 1-2 from cm site na ibe ha. A naghị ele akụkụ a anya dị ka ihe ojoo ma na-eme na 20-30% nke ngụkọta mmadụ.

Ihe dị iche iche dị n’ime otu ahụ nwere ike ịbụ nkewa nke Wirsung na ngalaba abụọ. Ha na-ekewapụ onwe ha na-enwe oghere abụọ na-apụ apụ. Featuresdị atụmatụ ọmụmụ a anaghị ahụkarị.

Na etiti akụkụ nke isi ahụ nwere mgbakwunye santorinium ọzọ. N'ihe dị ka otu ụzọ n'ụzọ atọ nke ndị mmadụ, ọ nwere ike mepee onwe ya na lumen nke duodenum ma mepụta ara santorinia, ebe enzymes na-apụ apụ. Ọ bụrụ na atrophy nke eriri abụọ ahụ, nke ọzọ na-eburu ọrụ ya. N’agbata ọwa ozi ndị ọzọ na lumen nke duodenum bụ Helly sphincter. Ọ na-egbochi mmiri ịreatụ mmiri na mmiri a na-egbu idochi n’ime oghere nke ọwara.

Onye isi gland nwere usoro nke ihe ana - eme ka aru ya di nma. Enwere ụdị atọ n’ime ha - nke dị elu, nke ala na nke izugbe. Ọwa ndị dị elu enweghị ọwapụta nke ha ma soro ndị dị ala na-emekọ ihe, na-akpụpụta obere duep.

Isonye na usoro nri

Ọrụ exocrine (exocrine) nke gland bụ mmepụta nke enzymes diges. Ihe ndị a bụ ihe ndị na-arụ ọrụ n’ime ihe ndị na-arụ ọrụ ngwa ngwa nke na-eme ka mbibi protein, carbohydrates na abụba ghara ịdị ngwa. Mkpụrụ ndụ ndị mejupụtara acini na -emepụta ihe ọreatụ pancụ na-egbu egbu, nke, yana bile, na-akụri nri n’akụkụ ya ndị dị mfe ma na-akwalite mmụba ya.

A na-emepụta enzymes ndị a n'ime sel nke sistemu exocrine:

1. A na-eji Trypsin mebie protein.
2. Maka ndakpọ nke carbohydrates dị mgbagwoju anya - amylase, maltase, invertase, lactase.
3. Maka mmebi nke abụba - lipase.

Ozugbo nri akpụ batara n’ahụ, mmepụta nke enzymes ndị a malitere. Usoro ahụ na-ewe awa asaa ruo awa iri na abụọ.

Ọnụ ọgụgụ enzymes emepụtara na-adabere n'ụdị nri. Dịka ọmụmaatụ, mgbe ị na-eri nri ndị nwere abụba, ịmịpụta lipase na-abawanye, wdg.

Ọrụ endocrine

Ọrụ intra-nzuzo (endocrine) bụ mmepụta nke homonụ. N’adịghị ka enzymes diges, homonụ na-abanyeghị n’ime usoro nri, kama na-abanyekwa n’ọbara, ebe ha gbasara n’ahụ niile na-emetụta ahụ na sistem.. A na-emepụta homonụ ọ bụla n'ụdị sel insulocyte:

1. Mkpụrụ ndụ Alfa bụ maka ọrụ nke glucagon homonụ.
2. Mkpụrụ ndụ Beta na - emepụta insulin.
3. Mkpụrụ ndụ Delta bụ maka nrụpụta nke somatostatin.
4. Mkpụrụ ndụ D1 na - arụpụta ihe VIP (vaso-intestinal polypeptide).
5. Mkpụrụ ndụ PP na - arụ ọrụ polypeptide pancreatic.

Insulin na glucagon na - egbochi metabolism metabolism. Homonụ ndị ọzọ na-enye njikwa nke anụ ahụ. Usoro a nke ijikwa homeostasis bụ otu n'ime ihe dị mfe na mmalite.

Anomalies n’otutu akụkụ ahụ

N'ihi mgbanwe mgbanwe na ọrụ nke parenchyma ma ọ bụ ọgba aghara nke akwara mmiri, ọrịa siri ike nke usoro nri diges na-ebilite.

Nsogbu a na - ahụkarị bụ mkpọchi nke ọwapụta mmepụta ma ọ bụ ọzọ. Na nke a, eriri nke akwara gbasaa. Ihe ọ juiceụụ Pancreatic na-achịkọ na ha, nke na-eduga n'ịba ụba na ibu yana mmepe nke usoro mkpali.

Site na mmụba na dayameta nke wirsung duct, ọrịa siri ike nwere ike ịmalite - nnukwu ọrịa ma ọ bụ ọrịa na-adịghị ala ala ma ọ bụ neoplasms ọjọọ.

Pathology nke pancreas

Ọrịa pancreatic bụ ihe juru ebe niile taa. N'etiti ha, ọ bụ ọdịnala ịmata ọdịiche:

1. Ọrịa pancreatitis. Ọrịa a na - aputa n'ihi mmụba nke ihe ọreatụ pancụ nke mmiri akwara na mgbochi nke ihe akwara mmiri. Nke a na - ebute ihe isi ike na mwepụta nke enzymes n'ime duodenum. N'ihi ya, ndị enzymes na-amalite ime nri anụ ha. Parenchyma edema etolite. Ọ na - amalite ịpị anụ ahụ. Site n'inye ezi ọbara, usoro mkpali na-agbasa ngwa ngwa. Oria a na –eme ihe mgbu n’apata n’apata nke ukwu. Ihe kpatara ọrịa ahụ nwere ike ịbụ nri na-akwadoghị, ị alcoholụbiga mmanya na-egbu egbu, ọrịa gallstone.
2. Ọrịa akwara nke Pancreatic nwere ike ịghọ nhịahụ nke ọrịa pancreatitis nke nnukwu. Ejiri ọnọdụ a site na mmepe nke usoro necrotic na anụ ahụ gland. A na-esikarị pathology site na peritonitis.
3. Ọrịa na-adịghị ala ala bụ ọrịa na-akpata afọ ojuju. Ejiri mara nke ezughi oke nke ọrụ nzuzo nke akụkụ ahụ, sclerosis nke ihe akwara ahụ na usoro nke okwute n'ime ha. Ọrịa nwere ike ibu (na-ebilite n'ihi mmanya mmanya ọgwụ, adịghị edozi ahụ nri), nke abụọ - megide ndabere nke usoro ndị ọzọ na-efe efe na mkpali ahu. Na-emegide usoro mmerụ ahụ, ọrịa pancreatitis post-traumatic nwere ike ịmalite.
4. Cysts nke anụ ahụ glandular nwere ike inwe mmalite dị iche - traumatic, mkpali, parasitic.
5. Ngwakọta nke anụ ahụ nwere ike ịbụ ma homonụ na-arụ ọrụ ma arụ ọrụ. A na-achọpụta ọnya tum tum na-arụ ọrụ nke homonụ - insulinoma, gastrinoma, glucagonoma - achọpụtabeghị. A na - ahụkarị ya mgbe onye ọrịa chọpụtara ọrịa shuga. Okpokoro nke isi gland na-akpasu iwe ugboro ugboro.

Mgbagha nke ọrịa pancreatic nwere ike ịbụ ọrịa endocrine dị njọ - ọrịa shuga. Usoro a na usoro a na - ebute nsogbu nke carbohydrate na abụba metabolism. Iji tụọ ọnọdụ nke gland, a na-eji ultrasound, yana ọmụmụ ihe banyere mmiri na mmamịrị nke mmiri.