He aha ka peritoneum? Wehewehe, anatomy a me nā mea i loko
ʻO ka peritoneum he mea lahilahi, aneane ʻālohilohi, mesothelial serous membrane i loaʻa i loko o ka ʻōpū e hana i ke kapa o ka ʻōpū o ka ʻōpū a me kahi ʻāpana o ka pelvic cavity (parietal peritoneum), a uhi pū kekahi i kahi hapa nui o ka viscera i loko (visceral peritoneum. ), ʻoiai i ka manawa like e hoʻopili ai iā lākou i nā paia o ka lua (viscera ligaments)
Loaʻa ka huaʻōlelo peritoneum mai ka ʻōlelo Helene περί (perì) ʻo ia hoʻi a puni a me τονείος (tonéios) ʻo ia hoʻi ka uhi ʻia, ʻo ia hoʻi mai ka huaʻōlelo τείνω (téinō), e uhi: ʻoiaʻiʻo, ʻo ka peritoneum ka mea e uhi ana a puni nā kino o ka opu a me ka paia opu.
ʻO ka peritoneum ka mea nui loa o nā membrane serous a, no kona hoʻonohonoho ʻana, ʻoi aku ka paʻakikī
Loaʻa kēia paʻakikī ma mua o nā mea āpau ma kahi o ka hoʻopaʻa ʻana i hoʻokahi okana me kahi ʻano like ʻole o ka ʻili, e like me ke ʻano me ka pleura e uhi ana i nā māmā a i ʻole ka pericardium e uhi ana i ka puʻuwai, ʻo ia ka mea like o ka ʻōpū, ua uhi ʻia ka peritoneum i kekahi mau mea. nā kinona, i hoʻonohonoho ʻia a hoʻonohonoho ʻia i nā ʻano like ʻole a me nā ʻano like ʻole.
ʻO ka peritoneum visceral, e like me kēia irregularity, hana pū kekahi i nā ʻāpana nui ma waena o nā ʻāpana; ʻO kahi hiʻohiʻona koʻikoʻi ka omentum nui, e hohola ana me he apron ma luna o ka nui o ka ʻōpū, e hoʻomaka ana mai ka curvature nui o ka ʻōpū.
Hana ʻia ka peritoneum me kahi papa papa o nā mesothelial cell i kākoʻo ʻia e nā ʻāpana lahilahi o ka ʻiʻo hoʻohui extraperitoneal, a ma kekahi mau ʻāina i waiwai nui i nā lobules momona, e like me ka puʻupaʻa, ka ʻāina inguinal, kekahi mau kope o ka peritoneum a me waho. ka ʻili o ka ʻōpū nui; ʻikeʻia e hana ana kēia mau momona momona i kahi hana pale a kākoʻo no nā kino. ʻAʻole lawelawe ka peritoneum ma ke ʻano he pale a me ke kākoʻo no ka viscera o ka ʻōpū, akā he 'conduit' no ke koko a me nā moku lymph a me nā aʻalolo o ka ʻōpū o ka ʻōpū.
ʻO ka peritoneum, e like me nā membrane serous ʻē aʻe, he lamina mau ʻano lahilahi
Ma muli o kona kūlana i loko o ka ʻōpū o ka ʻōpū, ua ʻokoʻa ʻia i loko
- parietal peritoneum, ka papa o waho, e laina ana i ka ʻili o loko o nā paia o ka ʻōpū-pelvic cavity;
- visceral peritoneum, ka papa o loko, e uhi ana i ka hapa nui o ka viscera i loko o ka ʻōpū o ka ʻōpū.
Aia ma waena o kēia mau papa ʻelua kahi ākea, i kapa ʻia ʻo ka peritoneal cavity (a i ʻole hollow), i pani piha ʻia a no laila ua piha ʻia kahi lua virtual me kahi liʻiliʻi (e pili ana i 50 ml) o kahi wai serous e hana me he lubricant. ʻO nā papa ʻelua e paheʻe pū me ka ʻole o ka hakakā ʻana.
ʻO ka visceral peritoneum, me kona mau ʻāpana he nui a puni nā ʻōpū o ka ʻōpū, e hoʻemi ana i ka lua peritoneal i kahi liʻiliʻi liʻiliʻi, kokoke i kahi ākea.
Hoʻopili piha ʻia kekahi mau ʻōpū o ka ʻōpū e ka peritoneum a hāʻawi ʻia me kahi lau pālua, i kapa ʻia ʻo ka meso (e laʻa me ka mesentery no ka ʻōpū liʻiliʻi, mesocolon no ke kolone, mesometrium no ka ʻōpū, a pēlā aku), e hui pū me lākou. i ka peritoneum parietal o ka paia ʻōpū.
I kekahi mau hihia, e like me ka mesentery, ʻo kahi ʻāpana i loaʻa i ʻelua ʻāpana welded o ka visceral peritoneum e hui pū me kahi ʻāpana ʻē aʻe, e ala ana i kahi paʻi e hoʻokomo iā ia iho i ka paia hope o ka ʻōpū ma kahi laina oblique e holo ana mai ka duodenal. -ka hoʻololi ʻana i ka helu iliac akau.
I loko o nā kino ʻē aʻe, e like me ka duodenum a me ka piko a me ka iho ʻana, hana ka peritoneum i kahi lining piha ʻole, waiho ʻia kekahi mau wahi i uhi ʻole ʻia e pili ana me ka paia o ka ʻōpū hope.
Ua māhele ʻia ka peritoneum i ʻelua mau ʻāpana nui, i hoʻopili ʻia e ka epiploic foramen
ʻO ka lua peritoneal nui (a i ʻole peritoneum o ka lua peritoneal pono).
Hōʻike ka mesocolon transverse:
- Hewa supra-mesocolic
- Wahi submesocolic, mahele ʻia i ʻelua hapa asymmetrical, ʻākau a hema, e ka mesentery. ʻOi aku ka liʻiliʻi o ka ʻākau, pani ʻia ma ke kiʻekiʻe o ka cecum, ʻoiai ua wehe ʻia ka hakahaka sub-mesocolic hema i ke pelvis, i māhele ʻia e ka mesosigma.
ʻO ka bursa omental (a i ʻole ka lua peritoneal liʻiliʻi)
Hiki i kekahi ke hoʻokaʻawale:
- Hoʻopili ʻia ka Omentum liʻiliʻi (gastrohepatic omentum a i ʻole epiploon liʻiliʻi) i ka curvature liʻiliʻi o ka ʻōpū a me ke ake (ma o nā ligaments: hepatogastric a me hepatoduodenal, pars flaccida a me pars densa).
- ʻO ka omentum nui (a i ʻole gastrocolic omentum a i ʻole epiploon nui a i ʻole epiploic apron) ke kumu mai ka peritoneum visceral e hoʻopuni ana i ka paia hope a me mua o ka ʻōpū, hoʻomaka ia mai ka curvature nui o ka ʻōpū a iho e like me ka apron i mua o nā puka lou. ʻo ka ʻōpū liʻiliʻi a hiki i ka laina manaʻo e hele ana ma nā ʻāpana iliac anterosuperior, a laila e hoʻopili i ka loop anteroposteriorly a hoʻopili i luna i ke kolona transverse, (4 leaflets i ka huina); hana ia i ka hana o ka hoʻokaʻawale ʻana a me ka pale ʻana i ka ʻōpū.
ʻO ka dimple inguinal
ʻO nā dimples inguinal nā ʻāpana o ka lau parietal o ka peritoneum, ka mea, e kau ana ma ka transverse fascia, e hana i nā dimples ma ka ʻaoʻao o loko o ka paia mua o ka ʻōpū.
Ua māhele ʻia lākou i:
- Outer inguinal dimple: aia kēia ma ka ʻaoʻao o nā moku epigastric haʻahaʻa.
- Aia ma waena o nā moku epigastric haʻahaʻa a me ka ligament umbilical lateral (obliterated umbilical artery);
- ʻO ka dimple inguinal i loko: aia ma waena o ka ligament umbilical lateral a me ka ligament umbilical median (obliterated urachus).
Ka hoʻokaʻawale ʻana o nā hale peritoneal
Hoʻonohonoho ʻia nā hale i loko o ka ʻōpū ma ke ʻano he intraperitoneal, retroperitoneal a i ʻole infraperitoneal e pili ana i ka uhi maoli ʻia e ka peritoneum visceral a me ka hele ʻana a i ʻole ka ʻole o nā mesenteries.
ʻO nā ʻōnaehana intraperitoneal ka mea maʻamau, ʻoiai ua paʻa nā hale retroperitoneal i ko lākou kūlana.
ʻO kekahi mau ʻano, e like me nā puʻupaʻa, ua wehewehe ʻia ʻo 'primarily retroperitoneal', aʻo nā mea ʻē aʻe, e like me kahi hapa nui o ka duodenum a me ka pancreas (koe wale ka huelo, ʻo ia ka intraperitoneal), ua manaʻo ʻia he 'secondarily retroperitoneal' , ʻo ia hoʻi, ua ulu kēia mau ʻōpū ma ke ʻano he intraperitoneal a ma hope, me ka nalowale ʻana o kā lākou meso, lilo i retroperitoneal.
Nā Pathologies
E like me nā ʻāpana ʻē aʻe, pili pū ka peritoneum i nā pathologies, e komo pū ana me ka maʻi a i ʻole ka maʻi maʻi, diffuse a circumscribed inflammatory kaʻina hana (peritonitis, perivisceritis, abscesses), o kahi ʻano kikoʻī a kikoʻī paha.
Kakaʻikahi ka maʻi ʻaʻai mua, e like me nā fibromas, lipoma, myxomas, mesothelioma, sarcomas, a me ka lua ma muli o ka metastases mai nā kino ʻē aʻe.
ʻO ka pneumoperitoneum, e like me ka pneumothorax i loko o ka ʻōpū o ka ʻōpū, ʻo ia ka loaʻa ʻana o ke kinoea i loko o ka lua peritoneal, hiki ke hana ʻia i ka wā o nā perforations o ka ʻōpū a i ʻole ka ʻōpū; hana kēia i kahi kūlana koʻikoʻi koʻikoʻi, e like me ka hui pū ʻana me nā perforations e kahe pinepine ka wai mai ka ʻōpū a i ʻole ka ʻōpū, hiki ke hoʻoulu i kahi ʻano peritonitis koʻikoʻi.
ʻO ka Peritonitis kahi maʻi ʻeha o ka membrane a / a i ʻole ka peritoneal cavity i loaʻa i nā hihia o ka perforations a i ʻole nā maʻi ʻeha o ka viscera ʻōpū, a i ʻole nā mea ʻelua.
He maʻi ia e alakaʻi ai i kahi kiʻi koʻikoʻi koʻikoʻi a koi pinepine i ka hana ulia pōpilikia.
ʻO ka Ascites kahi hōʻiliʻili nui o ka wai i loko o ka lua peritoneal.
ʻO nā alahaka pili he mau hale fibrotic reactive e alakaʻi ai i nā hoʻololi i ke anatomy maʻamau a me ka physiology o ka ʻōpū liʻiliʻi.
Dialysis Peritoneal
Ma kahi ʻano dialysis, i kapa ʻia ʻo peritoneal dialysis, hoʻokomo ʻia kahi hopena ma o ka catheter i loko o ka lua peritoneal.
Waiho ʻia kēia wai i loko o ka ʻōpū no kekahi manawa i mea e komo ai i nā toxins uremic, a laila hoʻopau ʻia me ka hopena ma o ka catheter i hoʻohana mua ʻia.
Loaʻa kēia 'hoʻomaʻemaʻe' i ka nui o nā capillaries i loko o ka membrane peritoneal ma o ke ʻano o ka molecular diffusion o nā mea.
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