The diaphragm ndi minofu yofunikira mu makina opuma.

The diaphragm ndi minofu yolimbikitsa yomwe ili pansi pa mapapo. Amalekanitsa chifuwa cha chifuwa kuchokera pamimba. M'mawonekedwe a dome, imakhala ndi ma dome awiri kumanja ndi kumanzere. Ndi asymmetrical, dome lamanja la diaphragmatic nthawi zambiri limakhala lalitali 1 mpaka 2 cm kuposa dome lakumanzere.

The diaphragm imapangidwa ndi tendon yapakati, malo a tendon a diaphragm kapena phrenic center. Pamphepete, ulusi wa minofu umalumikizana pamlingo wa sternum, nthiti ndi vertebrae.

Lili ndi ma orifices achilengedwe omwe amalola kuti ziwalo kapena ziwiya zidutse kuchokera pamphuno kupita kwina. Izi ndizochitika, mwachitsanzo, ndi kutuluka kwa mtsempha, kung'ambika kapena pansi pa vena cava. Imasungidwa ndi mitsempha ya phrenic yomwe imapangitsa kuti igwirizane.

The diaphragm ndiye minofu yayikulu yopuma. Zogwirizana ndi minofu ya intercostal, zimatsimikizira makina opuma posintha kayendedwe ka kudzoza ndi kutuluka.

Pa kudzoza, minofu ya diaphragm ndi intercostal imalumikizana. Ikalumikizana, diaphragm imatsika ndikukhazikika. Pansi pa machitidwe a intercostal minofu, nthiti zimakwera mmwamba zomwe zimakweza nthiti ndikukankhira kutsogolo kwa sternum. The thorax ndiye amakula kukula, kuthamanga kwake kwamkati kumachepa zomwe zimayambitsa kuyitana kwa mpweya wakunja. Zotsatira: mpweya umalowa m'mapapo.

Kuchuluka kwa kugunda kwa diaphragm kumatanthawuza kupuma kwa mpweya.

Akamapuma, minofu ya m'khosi ndi ya m'mimba imamasuka, zomwe zimapangitsa nthiti kutsika pamene diaphragm ikukwera kubwerera kumene inali. Pang'onopang'ono, nthiti imatsika, kuchuluka kwake kumachepa zomwe zimawonjezera mphamvu yake yamkati. Zotsatira zake, mapapu amatuluka ndipo mpweya umatuluka.

Zovuta : imawonetsa kutsatizana kotsatizana kochitika modzidzimutsa komanso kobwerezabwereza kwa diaphragm komwe kumayenderana ndi kutseka kwa glottis ndipo nthawi zambiri kupindika kwa minofu yapakati. Reflex iyi imachitika mwadzidzidzi komanso mosakhazikika. Zimabweretsa mndandanda wamtundu wa "hics" wodziwika bwino. Tikhoza kusiyanitsa zomwe zimatchedwa benign hiccups zomwe zimakhala zosaposa masekondi kapena mphindi zochepa, ndi kukomoka kwanthawi yayitali, kosowa kwambiri, komwe kumatha kuyambira maola angapo mpaka masiku angapo ndipo nthawi zambiri kumakhudza anthu opitilira zaka 50.

Kuphulika kwapambuyo pa zoopsa : Kuphulika kwa diaphragm komwe kumachitika pambuyo pa kuvulala pa chifuwa, kapena kuvulala ndi zipolopolo kapena zida zachitsulo. Kuphulikako nthawi zambiri kumachitika pamlingo wa dome lakumanzere, dome lakumanja limabisika pang'ono ndi chiwindi.

Transdiaphragmatic chophukacho : kutuluka kwa chiwalo cha m'mimba (m'mimba, chiwindi, matumbo) kupyolera mumtsinje wa diaphragm. Chophukacho chikhoza kukhala chobadwa nacho, dzenje lomwe chiwalo chosamukira chimadutsa ndi cholakwika chomwe chilipo kuyambira pakubadwa. Itha kupezekanso, dzenje ndiye zotsatira za kukhudzidwa pa ngozi yapamsewu mwachitsanzo; M'nkhani ino tikambirana za diaphragmatic zochitika. Ndi matenda osowa kwambiri omwe amakhudza pafupifupi mwana mmodzi mwa ana 4000.

Kukwera kwa dome diaphragmatic : dome lakumanja nthawi zambiri limakhala lalitali 1 mpaka 2 cm kuposa lamanzere. Pali "kukwera kwa dome lakumanja" pamene mtunda ukuposa 2 cm kuchokera kumanzere. Mtunda uwu umayang'aniridwa pa X-ray pachifuwa chotengedwa mozama kwambiri. Timalankhula za "kukwera kwa dome lakumanzere" ngati kuli kokwezeka kuposa kumanja kapena pamlingo womwewo. Zitha kuwonetsa matenda owonjezera a diaphragmatic (kuvuta kwa mpweya wabwino kapena pulmonary embolism mwachitsanzo) kapena matenda a diaphragmatic (zotupa zowopsa za phrenic nerve kapena hemiplegia mwachitsanzo) (5).

Mimba : ndi osowa kwambiri. Nthawi zambiri izi ndi zotupa zoipa (lipomas, angio ndi neurofibromas, fibrocytomas). Mu zotupa zowopsa (sarcoma ndi fibrosarcoma), nthawi zambiri pamakhala vuto ndi pleural effusion.

Neurological pathologies : Kuwonongeka kulikonse kwa kapangidwe kamene kali pakati pa ubongo ndi diaphragm kumatha kukhala ndi zotsatira zake pakugwira ntchito kwake (6).

Mwachitsanzo, matenda a Guillain-Barré (7) ndi matenda omwe amachititsa kuti thupi liziyenda bwino lomwe limasokoneza dongosolo la mitsempha, mwa kuyankhula kwina minyewa. Imadziwonetsera yokha mwa kufooka kwa minofu komwe kumatha mpaka kufa ziwalo. Pankhani ya diaphragm, mitsempha ya phrenic imakhudzidwa ndipo kusokonezeka kwa kupuma kumawonekera. Polandira chithandizo, ambiri mwa anthu omwe akhudzidwa (75%) amachira.

Amyotrophic lateral sclerosis, kapena matenda a Charcot, ndi matenda a neurodegenerative omwe amadziwika ndi kufota kwa minofu pang'onopang'ono chifukwa cha kuwonongeka kwa ma neuroni omwe amatumiza mauthenga osuntha kupita ku minofu. Pamene matendawa akupita patsogolo, amatha kukhudza minofu yofunikira kupuma. Pambuyo pa zaka 3 mpaka 5, matenda a Charcot amatha kuyambitsa kulephera kupuma komwe kungayambitse imfa.

Ma hiccups okha akhoza kukhala nkhani ya miyeso yochepa. N'zovuta kuteteza maonekedwe ake omwe ali mwachisawawa, koma tingayesere kuchepetsa kuopsa kwake popewa kudya mofulumira, komanso kusuta fodya, mowa kapena zakumwa zoledzeretsa, zovuta kapena kusintha kwadzidzidzi kutentha.

The diaphragm ndizovuta kuphunzira pa kujambula (8). Ultrasound, CT ndi / kapena MRI nthawi zambiri zimaphatikizanso ndi ma radiography kuti atsimikizire ndikuyeretsa matenda a matenda.

Radiography: njira yojambula zamankhwala yomwe imagwiritsa ntchito ma X-ray. Kuwunikaku sikupweteka. The diaphragm sichimawonekera mwachindunji pachifuwa cha x-ray, koma malo ake amatha kudziwika ndi mzere womwe umawonetsa mawonekedwe a chiwindi cha mapapu kumanja, mapapo-m'mimba-ndulu kumanzere (5).

Ultrasound: njira yowonetsera zachipatala pogwiritsa ntchito ultrasound, mafunde osamveka bwino, omwe amachititsa kuti "awone" mkati mwa thupi.

MRI (magnetic resonance imaging): kuyezetsa kwachipatala pazolinga zowunikira zomwe zimachitika pogwiritsa ntchito chipangizo chachikulu chomwe chimapangidwa ndi maginito ndi mafunde a wailesi kuti apange zithunzi zolondola kwambiri, mu 2D kapena 3D, za ziwalo zathupi kapena ziwalo zamkati (apa diaphragm).

Scanner: njira yowunikira yomwe imakhala ndi kupanga zithunzi zapagawo linalake la thupi, pogwiritsa ntchito mtengo wa X-ray. Mawu oti "scanner" kwenikweni ndi dzina la chipangizocho, koma timakonda kunena za mayeso (computed tomography kapena CT scan).

M’thupi la munthu, mawu akuti diaphragm amagwiritsidwanso ntchito ponena za m’diso. Miyendo imayang'anira kuchuluka kwa kuwala komwe kumalowa m'diso. Ntchitoyi ndiyofunika kuifananitsa ndi chithunzithunzi cha kamera.