Diaphragm bụ akwara dị mkpa na arụ ọrụ nke iku ume.

Diaphragm bụ akwara na-akpali akpali nke dị n'okpuru ngụgụ. Ọ na-ekewa oghere obi na oghere afọ. N'ọdịdị nke dome, a na-aka ya akara na domes abụọ n'aka nri na n'aka ekpe. Ha bụ asymmetrical, dome diaphragmatic aka nri na-adịkarị 1 ruo 2 cm dị elu karịa dome aka ekpe.

Ihe mejupụtara diaphragm bụ akwara etiti, etiti akwara nke diaphragm ma ọ bụ etiti phrenic. Na mpụta, eriri akwara na-ejikọta na ọkwa nke sternum, ọgịrịga na vertebrae.

O nwere orifices eke nke na-enye ohere igafe akụkụ ahụ ma ọ bụ arịa site n'otu oghere gaa na nke ọzọ. Nke a bụ ikpe, dịka ọmụmaatụ, na akụkụ esophageal, aortic ma ọ bụ nke dị ala vena cava orifices. A na-eme ya site na akwara phrenic nke na-eme ka ọ gbasaa.

Diaphragm bụ isi akwara iku ume. Ejikọtara ya na mọzụlụ intercostal, ọ na-eme ka usoro iku ume site n'ịgbanwe mmegharị nke mkpali na njedebe.

Site n'ike mmụọ nsọ, diaphragm na akwara intercostal na-agbakọ. Ka ọ na-agbakọ, diaphragm na-agbada ma gbawaa. N'okpuru ọrụ nke akwara intercostal, ọgịrịga na-arị elu nke na-ebuli ọgịrịga ahụ ma na-akpali sternum n'ihu. Ụra ahụ na-abawanye na nha, nrụgide dị n'ime ya na-ebelata nke na-akpata oku maka ikuku n'èzí. Nsonaazụ: ikuku na-abanye na ngụgụ.

Ugboro nke nkwekọrịta diaphragm na-akọwa ọnụọgụ iku ume.

Na iku ume, diaphragm na akwara intercostal na-ezu ike, na-eme ka ọgịrịga ahụ gbadata ka diaphragm na-ebili azụ n'ọnọdụ mbụ ya. Nke nta nke nta, ọgịrịga ahụ na-ebelata, olu ya na-ebelata nke na-eme ka nrụgide dị n'ime ya dịkwuo elu. N'ihi ya, ngụgụ na-alọghachi azụ, ikuku na-esikwa na ha pụọ.

Ọkpụkpụ : na-akọwapụta usoro nke mkparịta ụka spasmodic na-adịghị anabata na ugboro ugboro nke diaphragm jikọtara ya na mmechi nke glottis na mgbe mgbe mkparịta ụka nke akwara intercostal. Mgbanwe a na-apụta na mberede na enweghị njikwa. Ọ na-ebute usoro nke njirimara sonic "hics". Anyị nwere ike ịmata ọdịiche nke ihe a na-akpọ hiccups na-adịghị mma nke na-adịru ihe karịrị sekọnd ole na ole ma ọ bụ nkeji, na hiccups na-adịghị ala ala, nke na-adịkarị obere, nke nwere ike ịdịru site na ọtụtụ awa ruo ọtụtụ ụbọchị na nke na-emetụtakarị ndị mmadụ karịrị afọ 50.

Mgbawa nke post-traumatic : mgbawa diaphragm nke na-ewere ọnọdụ na-eso trauma na thorax, ma ọ bụ mmerụ ahụ site na mgbọ ma ọ bụ ngwa agha. Mgbawa na-emekarị n'ogo nke akụkụ aka ekpe, akụkụ aka nri na-ezobe akụkụ nke imeju.

Transdiaphragmatic hernia : ịrị elu nke akụkụ dị n'ime afọ (afọ, imeju, eriri afọ) site na orifice na diaphragm. Ahịhịa ahụ nwere ike ịbụ ọmụmụ, oghere nke akụkụ ahụ na-akwaga na-agafe bụ ihe na-adịghị mma dị ugbu a site na ọmụmụ. Enwere ike nweta ya, oghere ahụ bụ nsonaazụ nke mmetụta n'oge ihe mberede okporo ụzọ dịka ọmụmaatụ; N'okwu a, anyị na-ekwu maka mmemme diaphragmatic. Ọ bụ ọnọdụ a na-adịghị ahụkebe nke na-emetụta ihe fọrọ nke nta ka ọ bụrụ otu n'ime ụmụ ọhụrụ 4000.

Nkwalite nke dome diaphragmatic : dome aka nri na-adịkarị 1 ruo 2 cm dị elu karịa dome aka ekpe. Enwere "nrị elu nke dome aka nri" mgbe anya karịrị 2 cm site na dome aka ekpe. A na-enyocha anya nke a na X-ray obi nke ewepụtara na mkpali miri emi. Anyị na-ekwu maka "ebuli elu nke aka ekpe" ma ọ bụrụ na ọ dị elu karịa aka nri ma ọ bụ nanị n'otu ọkwa ahụ. Ọ nwere ike igosipụta pathology extra-diaphragmatic (nsogbu ventilashị ma ọ bụ embolism pulmonary dịka ọmụmaatụ) ma ọ bụ ọrịa diaphragmatic (ọnya traumatic nke akwara phrenic ma ọ bụ hemiplegia dịka ọmụmaatụ) (5).

Tumors : ha dị ụkọ. Ọtụtụ mgbe ndị a bụ etuto ahụ na-adịghị mma (lipomas, angio na neurofibromas, fibrocytomas). N'ime etuto ahụ dị njọ (sarcomas na fibrosarcomas), a na-enwekarị mgbagwoju anya site na mgbawa nke pleural.

Ọrịa Neurological : Ihe ọ bụla mebiri ihe owuwu dị n'etiti ụbụrụ na diaphragm nwere ike ịkpata nsonaazụ na ọrụ ya (6).

Dịka ọmụmaatụ, ọrịa Guillain-Barré (7) bụ ọrịa autoimmune nke na-egbu egbu nke na-awakpo sistemu ụjọ ahụ, ya bụ, irighiri akwara. Ọ na-egosipụta onwe ya site n'adịghị ike nke anụ ahụ nke nwere ike ịga n'ihu mkpọnwụ. N'ihe gbasara diaphragm, akwara phrenic na-emetụta ya na nsogbu iku ume na-apụta. N'okpuru ọgwụgwọ, ihe ka ọtụtụ n'ime ndị ọ metụtara (75%) na-enwetaghachi ike anụ ahụ ha.

Amyotrophic n'akụkụ sclerosis, ma ọ bụ ọrịa Charcot, bụ ọrịa na-adịghị ahụkebe nke akwara ahụ na-aga n'ihu na-akpọnwụ n'ihi mmebi nke akwara moto nke na-eziga iwu maka ịkwaga na uru ahụ. Ka ọrịa ahụ na-aga n'ihu, ọ nwere ike imetụta uru ahụ dị mkpa maka iku ume. Mgbe afọ 3 ruo 5 gachara, ọrịa Charcot nwere ike ịkpata ọdịda iku ume nke nwere ike ibute ọnwụ.

Naanị hiccups nwere ike ịbụ isiokwu nke usoro ole na ole. O siri ike igbochi ọdịdị ya nke na-enweghị usoro, ma anyị nwere ike ịgbalị ibelata ihe ize ndụ site n'izere iri nri ngwa ngwa, yana ịṅụbiga mmanya ókè, mmanya ma ọ bụ ihe ọṅụṅụ carbonated, ọnọdụ nrụgide ma ọ bụ mgbanwe mberede na okpomọkụ.

Diaphragm siri ike ịmụ gbasara onyonyo (8). Ultrasound, CT na / ma ọ bụ MRI na-abụkarị mgbakwunye na redio ọkọlọtọ iji kwado na mezie nchoputa nke pathology.

Radiography: usoro onyonyo ahụike nke na-eji X-ray. Nyocha a enweghị mgbu. A naghị ahụ diaphragm ahụ ozugbo na x-ray obi, mana enwere ike mata ọnọdụ ya site n'ahịrị nke na-egosi oghere imeju n'akụkụ aka nri, ngụgụ-afọ-spleen n'aka ekpe (5).

Ultrasound: usoro nyocha ahụike nke dabeere na iji ultrasound, ụda ụda na-adịghị ahụ anya, nke na-eme ka o kwe omume "ile anya" n'ime ime ahụ.

MRI (ihe onyonyo resonance magnet): nyocha ahụike maka ebumnuche nyocha nke emere site na iji nnukwu ngwaọrụ cylindrical nke a na-emepụta oghere magnetik na ebili mmiri redio iji mepụta onyonyo ziri ezi, na 2D ma ọ bụ 3D, nke akụkụ ahụ ma ọ bụ akụkụ dị n'ime (ebe a). diaphragm).

Scanner: Usoro nyocha nyocha nke mejupụtara imepụta onyonyo akụkụ akụkụ nke akụkụ ahụ, na-eji eriri X-ray. Okwu a bụ “scanner” bụ n'ezie aha ngwaọrụ ahụ, mana anyị na-ejikarị ezo aka n'ule ahụ (mgbakọ onyonyo ma ọ bụ CT scan).

N'ime ahụ mmadụ, a na-ejikwa okwu diaphragm na-ezo aka na iris nke anya. Iris na-achịkwa oke ọkụ na-abanye na anya. Ọrụ a bara uru ka atụnyere diaphragm nke igwefoto.