Iyo diaphragm ndiyo mhasuru yakakosha mumakanika ekufema.

Iyo diaphragm imhasuru inokurudzira iri pasi pemapapu. Inoparadzanisa mhango yechipfuva kubva mudumbu redumbu. Muchimiro chedome, inotarwa nemadhomu maviri kurudyi nekuruboshwe. Iwo asymmetrical, iyo yekurudyi diaphragmatic dome inowanzoita 1 kusvika 2 cm yakakwirira kupfuura yekuruboshwe.

Iyo diaphragm inoumbwa nepakati tendon, iyo tendon centre ye diaphragm kana phrenic centre. Pakutenderera, mhasuru fibers dzinobatana pamwero we sternum, mbabvu uye vertebrae.

Iine maorifice echisikigo ayo anobvumira kufamba kwenhengo kana midziyo kubva kune imwe mhango kuenda kune imwe. Iyi ndiyo nyaya, semuenzaniso, ine esophageal, aortic kana inferior vena cava orifices. Iyo haina kuvharwa neiyo phrenic nerve inoita kuti iite chibvumirano.

Iyo diaphragm ndiyo mhasuru huru yekufema. Yakabatanidzwa neiyo intercostal tsandanyama, inovimbisa mechanics ekufema nekuchinjanisa mafambiro ekufemerwa uye kupera simba.

Pakufemerwa, diaphragm uye intercostal tsandanyama zvinobatana. Sezvo inobvumirana, diaphragm inodzika uye inoputika. Pasi pekuita kwe intercostal muscles, mbabvu dzinokwira iyo inosimudza mbabvu uye inosundira sternum mberi. Iyo thorax inobva yawedzera saizi, kumanikidza kwayo kwemukati kunoderera izvo zvinokonzeresa kufona kwemhepo yekunze. Mhedzisiro: mweya unopinda mumapapu.

Iyo frequency ye diaphragm contraction inotsanangura mwero wekufema.

Pakufemesa mweya, diaphragm neintercostal tsandanyama zvinonyevenuka, zvichiita kuti mbabvu dzidzike sezvo diaphragm inosimuka ichidzokera panzvimbo yayo yepakutanga. Zvishoma nezvishoma, mbabvu yembabvu inodzikira, huwandu hwayo hunodzikira izvo zvinowedzera kumanikidza kwayo mukati. Izvi zvinoita kuti mapapu adzoke uye mweya unobuda maari.

Hiccups : inoratidzira kutevedzana kwekusazvidira uye kudzokororwa spasmodic contractions ye diaphragm yakabatana nekuvharwa kweglottis uye kazhinji kuputika kweiyo intercostal tsandanyama. Iyi reflex inoitika kamwe kamwe uye isingadzoreki. Izvi zvinoguma nenhevedzano yehunhu sonic "hics". Tinogona kusiyanisa izvo zvinonzi benign hiccups iyo isingapfuuri masekonzi mashoma kana maminetsi, uye iyo isingaperi hiccups, isingawanzo shomeka, inogona kugara kubva maawa akati wandei kusvika mazuva akati wandei uye iyo inowanzobata vanhu vanopfuura makore makumi mashanu.

Post-traumatic ruptures : kuputika kwediaphragm kunoitika zvichitevera kukuvadzwa pachipfuva, kana maronda nemabara kana zvombo zvine mapanga. Kutsemuka kunowanzoitika padanho rekuruboshwe, dome rekurudyi richivanzwa zvishoma nechiropa.

Transdiaphragmatic hernia : kusimuka kwenhengo mudumbu (mudumbu, chiropa, ura) kuburikidza neburi riri mudiaphragm. Iyo hernia inogona kuva yekuberekwa, gomba iro nhengo inotama inopfuura i malformation iripo kubva pakuberekwa. Inogonawo kuwanikwa, gomba rinobva mhedzisiro yekukanganisa panguva yenjodzi yemumugwagwa semuenzaniso; muchiitiko ichi tinotaura nezve diaphragmatic chiitiko. Icho chiitiko chisingawanikwe chinobata angangoita mumwe mu4000 vacheche.

Kukwidziridzwa kwedome diaphragmatic : dome rekurudyi rinowanzoita 1 kusvika 2 cm yakakwirira kupfuura yekuruboshwe. Kune "kukwirira kwedome rekurudyi" kana chinhambwe chichipfuura 2 cm kubva kuruboshwe. Chinhambwe ichi chinotariswa pachifuva X-ray yakatorwa mukufemerwa kwakadzika. Tinotaura nezve "kukwidziridzwa kwedome rekuruboshwe" kana riri pamusoro pekurudyi kana kuti padanho rimwe chete. Inogona kuratidza imwe-diaphragmatic pathology (ventilation disorders kana pulmonary embolism semuenzaniso) kana diaphragmatic pathology (zvinoshungurudza zvipembenene zve phrenic nerve kana hemiplegia somuenzaniso) (5).

Tumor : ivo vashoma kwazvo. Kazhinji kazhinji aya mamota asingafadzi (lipomas, angio uye neurofibromas, fibrocytomas). Mumamota akashata (sarcomas uye fibrosarcoma), pane kazhinji kacho kukanganiswa nepleural effusion.

Neurological pathologies : Chero kukuvadzwa kwechimiro chiri pakati pehuropi uye diaphragm kunogona kuve nemhedzisiro pakushanda kwayo (6).

Semuenzaniso, Guillain-Barré syndrome (7) chirwere chinoputika che autoimmune chinorwisa peripheral nervous system, nemamwe mazwi tsinga. Inozviratidza nekushaya simba kwetsandanyama izvo zvinogona kusvika pakuoma mitezo. Panyaya ye diaphragm, iyo phrenic nerve inobatwa uye kukanganiswa kwekufema kunooneka. Pasi pekurapwa, ruzhinji rwevanhu vakabatwa (75%) vanodzoreredza masimba avo emuviri.

Amyotrophic lateral sclerosis, kana Charcot's disease, chirwere chetsinga chinoratidzwa nekuoma kwetsandanyama zvishoma nezvishoma nekuda kwekuparara kwemotor neurons iyo inotumira mirairo yekufambisa kune tsandanyama. Sezvo chirwere ichi chichikura, chinogona kukanganisa tsandanyama dzinodiwa pakufema. Mushure memakore matatu kusvika mashanu, chirwere cheCharcot chinogona kukonzera kutadza kufema izvo zvinogona kutungamirira kurufu.

Hiccups chete inogona kuva nyaya yezviyero zvishoma. Zvakaoma kudzivirira kutaridzika kwayo kusingaite, asi isu tinogona kuedza kuderedza njodzi nekudzivisa kudya nekukurumidza, pamwe nefodya yakawandisa, doro kana zvinwiwa zvine carbonated, mamiriro ekushushikana kana shanduko yekushisa kamwe kamwe.

Iyo diaphragm yakaoma kudzidza pamifananidzo (8). Ultrasound, CT uye / kana MRI inowanzowedzera kune yakajairwa radiography kusimbisa uye kunatsa kuongororwa kwechirwere.

Radiography: nzira yekurapa yekufungidzira inoshandisa X-rays. Ongororo iyi hairwadzi. Iyo diaphragm haioneki zvakananga pachipfuva x-ray, asi chinzvimbo chayo chinogona kuzivikanwa nemutsara unoratidza mapapu-chiropa interface kurudyi, mapapu-mudumbu-spleen kuruboshwe (5).

Ultrasound: unyanzvi hwekufungidzira hwezvokurapa hunobva pakushandiswa kwe ultrasound, mafungu asinganzwisisike, anoita kuti zvikwanise "kuona" mukati memuviri.

MRI (magnetic resonance imaging): kuongororwa kwekurapa kwezvinangwa zvekuongororwa kunoitwa pachishandiswa cylindrical mudziyo hombe umo magineti nemasaisai eredhiyo anogadzirwa kugadzira mifananidzo chaiyo, mu2D kana 3D, yenhengo dzemuviri kana nhengo dzemukati (pano iyo diaphragm).

Scanner: nzira yekuongorora yekufungidzira iyo inosanganisira kugadzira mifananidzo yakachinjika yeimwe chikamu chemuviri, uchishandisa X-ray danda. Izwi rekuti "scanner" ndiro zita remudziyo, asi isu taigara tichireva bvunzo (computed tomography kana CT scan).

Muchimiro chemunhu, izwi rokuti diaphragm rinoshandiswawo kureva iris yeziso. Iyo iris inodzora huwandu hwechiedza chinopinda muziso. Iri basa rakakosha kuti rifananidzwe nediaphragm yekamera.