Khosi (kuchokera ku Old French col, kuchokera ku Latin collum) ndi dera la thupi lomwe limagwirizanitsa mutu ndi thorax.

Khosi limadulidwa kutsogolo ndi mmero, kumbuyo ndi khosi la khosi, pansi ndi ma collarbones ndi pamwamba ndi mandible.

Pa mulingo wa mmero, khosi limadutsa kumtunda kwa dongosolo la kugaya chakudya, pharynx ndi mmero, ndi kumtunda kwa dongosolo la kupuma, larynx ndi trachea. Palinso zotupa zinayi m'khosi:

• Chithokomiro, chomwe chili kutsogolo kwa trachea, chimatulutsa mahomoni awiri a chithokomiro omwe amagwira ntchito pa metabolism.
• Parathyroid ndi tiziwalo timene timatulutsa timadzi tating'ono tating'ono tating'ono tating'ono tating'ono ta chithokomiro, timatulutsa timadzi timene timagwira ntchito pamlingo wa calcium m'magazi.
• The salivary glands omwe amaimiridwa ndi parotid (yomwe ili kutsogolo kwa makutu) ndi submandibular (yomwe ili pansi pa nsagwada).
• Minofu ya platysma, imaphimba kutsogolo kwa khosi ndipo imalola kusuntha kwa pakamwa ndi kupsinjika kwa khungu la khosi.
• Minofu ya sternocleidomastoid, imatambasulidwa kumbali ya khosi pakati pa sternum ndi collarbone ndi fupa lanthawi. Zimalola kusinthasintha, kupendekera ndi kuzungulira kwa mutu.

Pambuyo pake, mphuno ya khosi imakhala ndi ma vertebrae asanu ndi awiri a msana, owerengedwa kuchokera ku C1 mpaka C7. Amapereka mphamvu ndi kuyenda kwa khosi. Mitsempha iwiri yoyamba, yotchedwa atlas (C1) ndi axis (C2), imakhala ndi morphology yosiyana ndi ma vertebrae ena omwe amawapatsa udindo wofunikira pakuyenda kwa khosi. Atlas imagwirizana ndi fupa la occipital la mutu, lomwe limatithandiza kupendekera mutu wathu kuti tivomereze. Mzere (C2) uli ndi pivot ntchito yomwe imalola kuzungulira kwa ma atlas, motero mutu. Kuyankhulana pakati pa C1 ndi C2 kumapangitsa kuti mutu wapambuyo ukhale wozungulira ngati chizindikiro cha kukana.

Minofu ya khosi

Minofu yambiri imaphimba khosi, imamangiriridwa ku chigaza, khosi lachiberekero ndi collarbones. Amalola kuyenda kwa mutu ndipo nthawi zambiri amakhala ngati chingwe. Timapeza pakati pa ena:

Magazi ndi zinthu zamanjenje

Khosi limawoloka mbali iliyonse ndi mtsempha wamba wa carotid womwe umagawikana mu carotids kunja ndi mkati, mitsempha ya vertebral ndi mitsempha iwiri ya jugular (mkati ndi kunja).

Mitsempha yambiri imayenda pakhosi, makamaka vagus (kapena pneumogastric nerve, gawo la chimbudzi ndi kugunda kwa mtima), phrenic (innervation ya diaphragm) ndi msana (kuyenda ndi kukhudzidwa kwa miyendo) mitsempha.

Udindo waukulu wa khosi ndi kuthandizira ndi kuyenda kwa mutu chifukwa cha mafupa ake ndi minofu.

Chifukwa cha mapangidwe onse omwe ali nawo, amakhalanso ndi gawo lofunikira pakugaya chakudya, kupuma, phonation ndi metabolism.

Matenda a Cervicalgies. Ululu wa khosi ukhoza kukhala ndi magwero ambiri. Iwo, mwachitsanzo, amachokera ku:

• Kuthamanga kwa minofu ndi kuuma kwa minofu: Kuthamanga kwa minofu kwa nthawi yaitali pamapewa ndi kumbuyo kwa khosi zomwe zimakhala zowawa. Nthawi zambiri zimachitika chifukwa chokhala ndi malo kwa maola angapo kapena kusakhazikika bwino.
• Whiplash: Nthawi zambiri amatchedwa whiplash (kuyenda kwa mutu patsogolo, kenako kumbuyo). Zitha kuchitika panthawi ya ngozi ya galimoto kapena kukhudzidwa kwakukulu pamene mukusewera masewera.
• Torticollis: Kutsika kwa minofu ya m'khosi mwangozi. Zimayambitsa kupweteka kwakukulu kwa khosi komanso kutsekeka kwa kayendetsedwe kake. Munthuyo akuwoneka kuti "wakakamira".
• Cervical osteoarthritis: kuwonongeka ndi kung'ambika kwa cartilage yomwe ili m'mphepete mwa fupa lachiberekero. Matendawa amakhudza makamaka anthu opitirira zaka 50 ndipo amachititsa ululu, kupweteka kwa mutu (mutu), kuuma kwa khosi. Ndi matenda aakulu omwe amapita pang'onopang'ono kwa zaka zingapo.

Herniated disc : diski ya herniated imagwirizana ndi kutuluka kwa gawo la intervertebral disc. Ma disks awa amapereka kusinthasintha kwa gawoli ndipo amakhala ngati zosokoneza pakachitika ngozi. Dothi la herniated limapezeka pamene diski imafooketsa, ming'alu, kapena kuphulika ndipo mbali ina ya gelatinous nucleus imaphulika. Zitha kukhudza dera lililonse la msana. Pankhani ya khosi, timalankhula za herniated cervical disc.

Kutupa

Angina: matenda pakhosi, makamaka makamaka mu tonsils. Ikhoza kufalikira ku pharynx yonse. Angina amayamba chifukwa cha kachilombo - izi ndizofala kwambiri - kapena mabakiteriya ndipo amadziwika ndi zilonda zapakhosi.

Laryngitis: kutupa kwa larynx, makamaka m'mawu. Kuyankhula ndiye kumakhala kowawa. Pali mitundu iwiri ya laryngitis: pachimake laryngitis ndi aakulu laryngitis, ndipo pali kusiyana pakati pa mwana ndi wamkulu laryngitis.

Pharyngitis: kutupa kwa pharynx, nthawi zambiri chifukwa cha matenda ofatsa, omwe amayamba chifukwa cha ma virus kapena mabakiteriya. Pamene kutupa kumakhudzanso mphuno mucous nembanemba, amatchedwa nasopharyngitis.

Cyst: Chotupa ndi chibowo chomwe chimakhala ndi zinthu zamadzimadzi kapena zolimba zomwe zimapangika m'chiwalo kapena minofu. Ma cysts ambiri sakhala a khansa. Pakhosi, chofala kwambiri ndi chotupa cha thyroglossal thirakiti (3) (pafupifupi 70% ya congenital anomalies m'derali). Wa chiyambi embryonic, ndi chifukwa cha matenda chitukuko cha chithokomiro pa masabata oyambirira a mimba. Mu 50% ya milandu imachitika asanakwanitse zaka 20. Matendawa nthawi zambiri amakhala ovuta kwambiri.

Lymphadenopathy (lymph nodes): nthawi zambiri, iyi ndi lymph node yomwe imatupa chifukwa cha matenda, monga chimfine chosavuta mwachitsanzo. Komabe, pali zina zambiri zomwe zingayambitse "kutupa" komwe kumachitika pakhosi kapena pakhosi. Choncho m'pofunika kukaonana ndi dokotala mu kukayika pang'ono kuti mudziwe chiyambi.

Ma pathologies a chithokomiro

Goiter: kutanthauza kuwonjezeka kwa kukula kwa chithokomiro. Ndizofala, makamaka mwa amayi. Goiter palokha si matenda. Zitha kupezeka mu matenda osiyanasiyana.

Chithokomiro cha chithokomiro: Si zachilendo kuti tinthu tating'ono tipangike m'chithokomiro, pazifukwa zomwe sizikudziwikabe. Amapatsidwa dzina la nodule ya chithokomiro.

Khansara ya chithokomiro: Khansara ya chithokomiro ndi khansa yosowa kwambiri. Pali milandu 4000 yatsopano ku France pachaka (ya khansa ya m'mawere 40). Zimakhudza amayi pa 000%. Khansara imeneyi nthawi zambiri imapezeka adakali aang'ono. Mankhwalawa amakhala othandiza kwambiri pochiza 75% ya milandu.

Hypothyroidism: zotsatira za kusakwanira kwa mahomoni opangidwa ndi chithokomiro. Anthu omwe amakhudzidwa kwambiri ndi matendawa ndi amayi omwe ali ndi zaka 50.

Hyperthyroidism: imatanthawuza kupangidwa kwakukulu kwa mahomoni ndi chithokomiro. Ndizochepa kwambiri kuposa hypothyroidism. Kwa anthu omwe ali ndi hyperthyroidism, metabolism yawo imagwira ntchito mofulumira. Akhoza kukhala ndi mantha, kusuntha matumbo pafupipafupi, kugwedezeka ndi kuchepa thupi, mwachitsanzo.

Kupweteka kwa khosi kumakhudza 10-20% ya anthu akuluakulu. Kuti muchepetse ndikupewa mavutowa, ndizotheka kuchita masewera olimbitsa thupi ochepa tsiku lililonse omwe amatha kukhala zizolowezi.

Kwa ma pathologies ena, monga laryngitis, malingaliro ena amatha kukulepheretsani kudwala. Kwa ena, zakudya zokhala ndi ayodini zimalepheretsa kuperewera, zomwe ndi chiopsezo cha nodule ya chithokomiro mwachitsanzo. Komano, chifukwa cha matenda ena monga khansa ya chithokomiro kapena goiter, palibe njira yodzitetezera.

Kujambula kwachipatala:

• Cervical ultrasound: njira yojambula zamankhwala pogwiritsa ntchito ma ultrasound, mafunde osamveka, omwe amalola "kuwona" mkati mwa thupi. Kuyezetsa kutsimikizira kukhalapo kwa chotupa, mwachitsanzo, kapena khansa ya chithokomiro (kuyeza kwa gland, kukhalapo kwa nodule, etc.).
• Scanner: Njira yojambulira yomwe imaphatikizapo "kusanthula" dera lomwe laperekedwa la thupi kuti lipange zithunzi zapakatikati pogwiritsa ntchito mtengo wa X-ray. Mawu akuti "scanner" kwenikweni ndi dzina la chipangizo chachipatala, koma nthawi zambiri amagwiritsidwa ntchito ponena za mayeso. Timalankhulanso za computed tomography kapena computed tomography. Itha kugwiritsidwa ntchito kudziwa kukula kwa chotupa kapena kukhalapo kwa chotupa mwachitsanzo.
• MRI (magnetic resonance imaging): mayeso azachipatala kuti adziwe matenda omwe amachitidwa pogwiritsa ntchito chipangizo chachikulu chomwe chimapangidwa ndi maginito ndi mafunde a wailesi kuti apange zithunzi zolondola kwambiri, mu 2D kapena 3D, za ziwalo za thupi (pano khosi ndi mafunde ake). zamkati). MRI imapereka zithunzi zambiri za msana wa khomo lachiberekero, mitsempha ndi minofu yozungulira. Ikhoza kugwiritsidwa ntchito pozindikira kuvulala kwa msana, chophukacho cha khomo lachiberekero kapena chotupa cha msana mwachitsanzo.

Laryngoscopy: kuyesa kochitidwa ndi dokotala kuti ayang'ane kumbuyo kwa mmero, mphuno ndi zingwe zapakhosi pogwiritsa ntchito endoscope (chida chopyapyala chonga chubu chokhala ndi kuwala ndi lens). Iwo ikuchitika kufunafuna Mwachitsanzo zimayambitsa ululu pakhosi, magazi kapena matenda khansa.

Exploratory cervicotomy: Kuchita opaleshoni komwe kumaphatikizapo kutsegula khosi kuti achotse chotupa kapena lymph node yomwe chikhalidwe chake sichidziwika kapena kufufuza matenda.

Chithokomiro-stimulating hormone (TSH) assay: TSH assay ndiye chizindikiro chabwino kwambiri chowunika matenda a chithokomiro. Amagwiritsidwa ntchito pozindikira hypo- kapena hyperthyroidism, kuyang'anira matenda a chithokomiro kapena amachitidwa mwa anthu omwe ali ndi goiter.

Mlingo wa mahomoni a chithokomiro (PTH): Hormoni ya parathyroid (yotulutsidwa ndi tiziwalo timene timatulutsa timadzi ta parathyroid) imakhala ndi gawo lalikulu pakuwongolera kashiamu m'thupi. Mlingo umalimbikitsidwa ngati muli ndi hypercalcemia (mwachitsanzo, calcium yochuluka kwambiri m'magazi kapena miyala ya impso.

"Mnyamata wa Giraffe" (7) ndi momwe mnyamata wazaka 15 wa ku China amatchulidwira, yemwe ali ndi sitiroko yayitali kwambiri padziko lonse lapansi yokhala ndi fupa lachiberekero la 10 m'malo mwa 7. Izi ndi zotsatira za malformation yomwe imayambitsa kupweteka kwa anyamata ndi kuvutika kuyenda (kuponderezana kwa mitsempha pakhosi).

Nyamalikiti, yokhala ndi khosi lalitali, ndiyo nyama yapamtunda yaitali kwambiri. Potha kufika mamita 5,30 kwa amuna ndi 4,30 mamita kwa akazi, giraffe komabe ili ndi chiwerengero chofanana cha khosi lachiberekero monga nyama zoyamwitsa, ndiko kunena kuti 7, yomwe imayesa pafupifupi 40 cm iliyonse (8) .