Arteries rokumusoro richiripo. Midziyo yokumusoro richiripo

Kupa muviri pamwe okisijeni, musoro, makumbo uye maoko evanhu muviri rwakapa ropa rive hurongwa. Anosanganisira muzvizhinji rwengarava. Subclavian tsinga yokumusoro kumugumo kunobuda mediastinum pakutanga mucheto mberi. The akasiya kunopfuura rworudyi uye anotanga gwara kutsemuka Arch. Right - zvakananga kubva brachiocephalic hunde.

Kuyambuka sternum tsandanyama, tsinga kuyambukira pamafudzi, branching munzvimbo kugokora muhudyu nenzira mbiri. Maererano kwaari akaita ropa Kusasvika honokono uye ruoko.

axillary tsinga

A. axillaris ndiyo inotevera mugove subclavian mudziyo anobva kubva yokunze penyika rezasi rumbabvu. Zvinotora nzvimbo rusesi hapwa uye fudzi tsandanyama akapoteredzwa chishongo. Axillary tsinga runoyerera mukati pasi pamafudzi nemarunda chokuita Lat. Zvichienderana vaizviti kugova rusvingo pamberi mwoyo, kune vatatu kadhi axillary yeropa.

Brachial tsinga dhipatimendi

A. brachialis uyewo vachinzi dzakasiyana ari arteries yokumusoro muviri. Sekaiichi yapfuura mugove anoramba axillary tsinga okumusoro wamativi (Photo kunoratidza nzvimbo yaro). Tanga inogona kurondwa kubva pasi pectoralis guru, ari kuenderera mberi coracoid. Tsinga inopfuura kuti pamberi papfudzi tsandanyama uye runoparadzanisa kupinda TOUR uye ulnar munzvimbo.

TOUR tsinga

A. radialis rinobva pedyo mutswe-kufanana buri iri unobva danda uye kugokora mapfundo nguva mberi rapfuura tsinga inopfuura pakati tsandanyama uye pronator. Pulsation nyore mukati ngarava iri akarova panguva yechitatu pasi mugove honokono, apo chobudira pedyo nomumativi vakaparadzana chete ganda. Uyezve tsinga dzinenge dziine styloid TOUR akatevedzana mugove uye riri kuna rwemberi mumakwenzi, muchindwi nepano pakakoromoka mu mapfupa.

The ulnar tsinga mugove

A. ulnaris, kufanana zvisaririra arterial anatomi rokumusoro muzvidimbu kunosvika papfudzi mugove munzvimbo kugokora muhudyu mune negomba pfupa coronoid muitiro. Next, mudziyo inoitwa pasi pronator teres tsandanyama, panguva imwe chete kupa payo neropa Via pamatavi maviri. The mirayiridzo chinopa simba yakadzika uye zvachero digitaalinen flexor, anomhanyira akaererana ulnar etsinga. Kuburikidza musiyano pakati nechigadziko uye nokuda flexor tsandanyama duku munwe tsinga iri romukati pemvura emichindwe ndokuguma nokushamwaridzana yepazasi chikamu TOUR mudziyo. Pamwe chete zvinoumba bhurasho huri chinhu chakakombama.

Rubatso ropa kuyerera kusvika arteries ari hunde uye okumusoro nemakumbo kana kukundwa

Movement pakati rubatso akaparadzirwa ikabuda zvakadyiwa apo chikamu chokutanga zviri tsinga kwayo Kuchinja kupinda vertebral akaona Kuvapo chimbichimbi stenosis kana occlusion. chirwere kwakadaro wakanzi chirwere subclavian-vertebral dzichiba. Full ropa kuyerera zvikanganiso maoko axillary kana mudziyo zvinogoneka kana pane tsinga anastomoses yokumusoro richiripo uye pafudzi iri musana ino.

Mhando idzi chinotsiva dzinosanganisira anastomoses:

• Pakati transverse chipande bazi tsinga kubva hurongwa pasi clavicle uye nechityu tireotservikalnogo pakakoromoka acromial mudziyo axillary chikamu hurongwa.
• Pakati remuromo tsinga transverse dzaizotungamirira okupedzisira nzvimbo subclavian emuviri uye rakafukidza reza mudziyo.

In maronda brachial tsinga kushanda zvakadzama papfudzi mudziyo. matavi awo vawedzere kunharaunda kugokora nechepasi uye pamusoro rubatso hurongwa uye dzinoumba guru richikurukura anastomoses.

In maronda arteries uye mutsinga rokumusoro mutezo panzvimbo honokono kuumbwa vakawanda anastomoses. Munzira kutevera ropa iri midziyo nharaunda uye ulna zvokudya periarticular nzvimbo yakarongwa nokubatsira branching kwendangariro. Ivo pamwe chete pomumbure, diverging kubva brachial tsinga. With chinhu chakakombama vascular lesion bhurasho ndanyarara hangu mapazi akawanda Palms anastomoses pakati maoko kugokora uye TOUR arteries.

Anastomoses Zvinoshingaira mune compensatory zviito chimwe hurongwa, izvo kwakakanganiswa ropa riyerere ari arteries ose okumusoro migumo. Yezvakaita kuzvitsinhanisa pakati rubatso kuparadzirwa kwakavandudza chaizvo. The pangozi kupfuura kukudzwa uku sechinhu zvikamu rezasi chikamu axillary uye brachial arteries rokumusoro nharaunda kumusoro kusvika kupi mudziyo zvakadzama. Inokuvadza kubva nemaonero nokudzorerwa ropa wedzerai anoonekwa kuti kutyorwa kuvimbika zvomene Palms chematenga. mamwe makuvaro All uye zvirwere dzinotyora ropa nokuyerera achishandisa rubatso romugove anobvisa kukura ischemia maoko.

Nzira dzekufambisa kuitisa kuongorora

Doppler Ultrasound pakati arteries vaikudzwa wamativi rinoitwa kudzidza mamiriro varwere. Ongororo axillary uye brachial aortas kuita namano uchishandisa chinozunguzirwa ane kakawanda 4 MHz, uye mamiriro ari ulnar uye TOUR vascular mudziyo iri zvazvakaipira pamwe kushanda nesimba 8 MHz. Inoitwa palpation of arteries: vakasiyana midziyo makumbo, rokumusoro chikamu kweropa ino inogona kurondwa mune zvinenge munzvimbo dzose:

• axillary tsinga hunde uye okumusoro nemakumbo vari nyore ari dzegirini;
• Fudzi mudziyo ezvinhu probed pamusoro mugove refu pakati papfudzi uye biceps tsandanyama mapfupa, mu buri kugokora, ropa pulsation riri kuona uye radiocarpal nedunhu muchanza.

Kuona padanho kuparadzwa yokumusoro kumugumo arteries anogona nzwisa nzvimbo pamwe muti mapazi. In inowanzotorwa hurumende simba ruoko kunoitika pamusoro huru mhando yezwi rubatso ropa rive riri kuitwa nyaya pamusoro stenosis rwengarava ropa kana occlusions.

Zvairatidza kunorapwa

Rokuvakazve midziyo pamwe zvinokosha zvarakasiya basa rinoitwa zvakasimba maererano kunenge. Arteries yokumusoro muzvidimbu ischemia vari pasi ndoda, izvi nokuda kwechirwere akaderera mutoro pamusoro pavo, zvichienzaniswa muviri uremu uye yokufutisa kuita pamusoro makumbo. Uyezve, rubatso ropa rive riri dzakabudirira munyika yokumusoro chikamu mutumbi, mapfudzi uye maoko pamusoro chete ezvinhu ari mumuhara uye lumbar muzongoza nani.

Huru uye chinokosha chiratidzo kuti kuvhiya kupindira mune arteries kunoonekwa sechinhu chirwere anokakavara ischemia uye yakanyanya kutyisidzira zvakakodzera kushanda yokumusoro muviri. Dzimwe nguva mamiriro ezvinhu anoteverwa kutyisidzira upenyu murwere. Based arterial, hemodynamic, kurapwa zviratidzo asarudza nhamba zvairatidza kuti kuvhiya.

Arteries rokumusoro muzvidimbu vari pasi kumanikidzwa rokuvakazve, kana mugumisiro basa ramaoko pane nguva mazhinji kuneta muvanhu, kutungamirira kushingaira mararamiro. chiratidzo ichi ndicho inokanganisa basa, akazoita mararamiro murwere. Zvairatidza kufungawo nomumwe zvechadenga muviri, kushanda manyorerwo, uye kuvapo concomitant zvirwere.

Kana murwere asingadi kumbotambudzika marwadzo panguva zororo, taita yakasvikawo dzomunharaunda zvazvinoita uye zvayo kuchirapa nevasori, akagadzwa vascular pedutu. Dzimwe nguva mamiriro ezvinhu kuipa somugumisiro rakavhurika vasiri kuporesa maronda uye maronda, vemunyika vari minwe uye chiningoningo. Kuvhiya ari pamberi anoitwa chero zvazvingava nokurapwa, rokuvakazve iri basa chete zvayo yokupedzisira zvabuda.

Pain kubva coronary tsinga chirwere, uye zvinyama necrosis maronda anoratidza kudiwa kuvhiyiwa, chiremba inorangarira munhu anatomical parameters. Kazhinji contraindication kuti rokuvakazve ndiyo akwegura murwere.

Mhando remapazi

Anatomy arteries yokumusoro nemakumbo anobvumira kuderera pamusoro vascular maronda dzakasiyana-siyana:

• chikuru yokunzvenga nevoruzhinji kuti pave circuitous mugero pakati migove utano yeropa yokunzvenga mugove dzakachinja ari mudziyo;
• kuchinja panguva proximal axillary yeropa uye brachycephalic hunde kuti nzira chibharumu chivezwa;
• revascularization Kuvhiya kushandisa microsurgical zviridzwa anoteererwa zvishoma kakawanda.

Technology vascular ndavhiyiwa

The oparesheni rinoitwa pasi zvavo kana omunharaunda yokutindivadza. To shunt anowanzodanwa kushandiswa zvinhu saphenous femoral tsinga. Nokunyima murwere ari mudziyo akanga rakapotsa hapana zvainoita ropa wedzerai rezasi richiripo. Kusarudza yakaitwa inobva pakuti femoral mutsinga haawanzopiwi mwoyo atherosclerosis uye dhayamita kwayo hombe zvakanaka wakanyatsokodzera pakusikwa yokunzvenga nzvimbo.

For coronary kutsemuka yokunzvenga kutora dzakawanda womukati thoracal tsinga uye TOUR kurutivi rworuboshwe. Mushure vendu vari njodzi mudziyo kuti cheka panzvimbo kuisa shunt. mavanga ake sutured kuti yeropa kudzorera ropa riyerere. Pashure imwe nguva avhiyiwa rinoitwa inodzokororwa bvunzo.

Kushandisa x-mwaranzi kuona mamiriro midziyo

Pamuganhu tichibatanidza Kuvhiya uye mushonga yenyukireya hunokura uye anovandudza chirango itsva, kuratidza pacharo somunhu vascular kuvhiyiwa pahwaro nemwaranzi chokupfeka. X-ray kuongorora mafungu vose dziripo vakasununguka yokumusoro kumugumo arteries, mutsinga uye awo, node nzira. Nzira dzekufambisa pakudzidza vascular gadziriro vari kuva nemwaranzi ekisiposha:

• radionuclide;
• Ultrasound;
• rinobva resonance;
• X-ray.

Nzira idzi kubvumira kuziva miedzo kutyorwa zvavo kwemajoini chikumbiro enzanisa mashoko anenge kuti mukwanisi mumwe, izvo zvinoita kuti tikwanise kuwana yakatsiga zvikuru zvawanikwa. Morphology yokumusoro kumugumo arteries ari kuongororwa ranzi nzira, kushandiswa akadaro abudirire kuti Pakusarudza ropa riyerere mafungu. Kutongwa X-ray zvakawanika kunze wezvokurapa Micro-akavhiyiwa kumidziyo, vanonzi endovascular kururamiswa, inomiririra rinogona kutsiva kuvhiyiwa vamwe kuchinja mutsinga.

kupomba kutsvakurudza hematopoietic hurongwa

Mwoyo ndiwo vascular hurongwa rwose, saka atadze kushanda zvakanaka pakati yeropa uye mutsinga dzinongoita pakutsvaga zvokurwara kuti nhego iyi. Hunde tsinga kuongororwa kuti repamusoro kumugumo Kukosha peripheral kupomba mwero uye kumanikidzwa. midziyo Small Kazhinji pakutanga iongororwe nemaziso kushandisa palpation unyanzvi, zvichiguma runofarira vanoratidza chinooneka pulsation, somuenzaniso panyaya yacho carotid tsinga iri mumutsipa. Zvisinei, kunyanya ongororo iri kuziva kwemwoyo wose peripheral midziyo. chakarurama uku kunorondedzerwa mune TOUR, brachial, axillary, femoral, popliteal arteries pamakumbo uye makumbo. The zvachose kukosha kupomba kakawanda anoonekwa kuti pamusoro arteries ari chiningoningo rwakashodoka.

Kuyerwa BP indekisi

Kana isu kutaura nevamwe zvakasiyana siyana midziyo, soro tsika kupa huru arteries rokumusoro richiripo. Mugore peripheral midziyo diki uye indekisi ukoshi uchaderedzwa. Systolic kumanikidzwa iri dziya mu (nenguva vachisimudza mutoro kupomba) uye diastolic (panguva mafungu kuora). Musiyano pakati pavo kunokosha paakati iri ongororo. Nyanzvi dzinofungidzira kuti fungidzira mugumisiro nokuda simba uye voltage kufamba kweropa. The yepamusoro Nhamba idzi, dzakanga kweropa.

Kutsunga venous dzvinyiriro uye kufamba kweropa

The zvakawedzera chokubuda ropa chinofamba kuburikidza mutsinga kurudyi atrium ukuwo, musimboti kumanikidzwa inowedzerawo. Kana kutyora, rinozivikanwa mwoyo kukundikana, kuzvimba uye kuwedzera peripheral nemidziyo ropa, izvi zvose zvisati zvaitika vari mumutsipa. The kumanikidzwa kunowedzera apo kodzero ventricular kukundikana, valvular chirwere, pericarditis uye vazhinji nevamwe cardiac pathologies. Mazvikokota kuzvimba mutsinga muruoko inofungidzira huwandu kufurirwa nechepakati tsinga.

Nemaziso kuzvimba mutsinga dziri muruoko, unogona kuona kana iwe akadonhedza nayo pazasi padanho atrium kuruboshwe. Kurera kukwirira bhurasho kuti vanopfuura 10 masendimita pamusoro zvakadini akati zvekupfakira anoratidza midziyo usimbe uye kuderedza ropa rive.

Kudzidza arteries

Kusagadzikana peripheral ropa wedzerai rinenge hurongwa kunotibvumira kutaura zvishomanana occlusion tikafunga atherosclerosis kuvapo. Kazhinji, mabatiro ropa zvirwere zvakadai chokuita zera nokuda Kuipa anondibatsira zvitengeswa. Arteries rokumusoro muzvidimbu kuratidza kutyorwa avo zviratidzo zviri inoratidza claudication, inova harbinger chirwere wokutanga. Murwere akaona nechitarisiko marwadzo apo tichifamba nemhuru, mune mamwe pfari izvi munhu havatsvaki. Over nguva, akaderedza mutoro nguva chiito, izvo zvinoitika pasina kurwadziwa.

Zviratidzo kwakadaro anowanzoramba ari kukundwa dzomunyika iliac uye femoral nemidziyo, kana kwacho mberi, kurwadza kwacho kuitika kunyange zororo. Zvishoma kunoderedza marwadzo zviratidzo achideredza ruoko kana gumbo mu hunyambiri nzvimbo, kunyange kuwedzera venous kumanikidzwa vanotsamwisa vemo edema.

kuongorora chirwere kuti venous

Rinozivisa kukanganisa kwavo kupfuura ropa riyerere pashure occlusion chokuita thrombosis, phlebitis kana kunze kumanikidzwa. The kwokutanga rokuongorora rinoitwa pachishandiswa palpation. Rubatso midziyo kutsiva ropa sangano, zvava kuonekwa pasi ganda, zvichienderana nzvimbo inokosha zvirwere. Kuti tizive ropa riyerere mirayiridzo kusunda tsinga anastomosis, uye pashure achisunungura zvisaririra muenzaniso mberi kupora kufamba.

Vascular Doppler Ultrassom Study

Hwaro mudzimu kweguyo nzira kunzvera akaisa wefizikisi anozivikanwa Doppler maturo. Its nezvinozoitika kushandura kakawanda pakati ultrasonic chiratidzo zvinoberekwa kuchinja nzvimbo svikiro vakasarudzwa nokuda zvichiratidza dzavo. Kusarudza wechipiri kufamba inzwi rine maitikiro.

Kana kuongororwa tsinga pakati okumusoro kuviri, asi akaratidza zviratidzo vanotumirwa kubva ropa nezvimedu uye mafungu kushandura norudaviro anoratidza kuti Urume kuyerera mwero mumidziyo. Modern mano inoshandiswa Doppler mumwe chete inzwi emitter, pamwe chete catcher yacho yairatidza nemafungu. Murabhoritari zvidzidzo kunobva Vector chezvinonhuwira kufamba achitevedza vakachengeta mutsetse nokukurumidza.

Nzira kuongororwa

Nokuti nzira hakurevi chaiwo pre-kurapwa, asi haikwanise kuongorora murwere pamberi purulent ganda zvirwere, uye anogumbura maronda. Treatment nguva zvinotora kusvika maminitsi 40 nguva.

Human pamusoro musana wake, ganda apo arteries ndivo ropa romugove nharaunda okumusoro wamativi, zvakazorwa gobvu gel rukoko soluble munzvimbo aqueous svikiro. Izvi zvaida kuti kuvandudza conductivity pamusoro ultrasonic anonongedzera uye pave chipingamupinyi nokuda panopindwa zvakawandisa mhepo munharaunda kutsvakurudza. By kumanikidza Switch kuti nzvimbo dzokudzidza nyanzvi anoita reciprocating uye dzeraundi kufamba pamusoro ganda.

Murwere nhema achiri, kuti arege tsvedzesa mufananidzo zvabuda, dzimwe nguva chiremba wako angada kurega kufema kuti yechipiri kuwana kunzwisisa. Procedure Doppler Ultrasound pamusoro arteries repasi ehomwe okumusoro Zara zvachose nyarara uye haakonzeri kusagadzikana murwere mumwe. Kungoda gel mushure kuvhara rinobviswa napkin.

Zvikonzero nzvera midziyo

Kana uchida kuongorora kweropa ezvinhu muviri pane vakawanda zvinoratidza:

• chitarisiko achirwadziwa maoko pasina anozivikanwa uye pachena zvikonzero, kunetswa mune ganda wanda;
• chirwere of vaitungamirira nzira atherosclerosis akanunura kwokutanga;
• Various rheumatic zvirwere, nekuti icho kwakakanganisa migove midziyo;
• thrombosis vaitungamirira aortas rokumusoro muviri, maoko uye namaoko;
• compression pakati arteries vaikudzwa wamativi (mapikicha dambudziko nzvimbo zvinogona kuonekwa mumufananidzo);
• nokufungirana pamusoro benign uye nyanyisa neoplasms ari mutsinga;
• vachiberekwa malformations of kweropa hurongwa;
• Akaziva chapfuura yokunzvenga zvikamu huru nhungamiro uye mapazi.

Zvakabuda pakutsvakurudza

Kana kwebasa bvunzo ropa rukova kutungamirirwa Switch, kakawanda zviri chiratidzo inova huru, uye sangano iri negwara zvinoderedza ukoshi zviratidzo. The mudziyo anomuchinja kuti kunooneka kupomba semhinduro magetsi, izvo chinogadzirwa mune ultrasonic mudziyo uye akaratidza kuti kuona paTV.

Ultrassom, duplex uye triplex kushanda pakuvheneka anoongorora arteries uye mutsinga okumusoro wamativi, iro anatomi iro vakaidzwa kukuvara, kuongorora kwavo womukati marongerwo uye kukura kuyambuka dhayamita. Nokushandisa nzira yakapa mashoko akavimbika pamusoro hemodynamics ari kweropa ezvinhu, hunobvumira kuona midziyo ropa riri chidzitiro. Kudzidza chinobatsira kuziva marongerwo uye mamiriro ezvinhu parusvingo uye chaiyo nzvimbo remafuta akawandisa plaques.

In adzidze arteries yokumusoro mutumbi duplex midziyo nzira inogona kushandiswa modes maviri. In wokutanga musimboti, mudziyo unoshanda somunhu kwakajairika Ultrasound muchina unobvumira nemaziso kuronda zviri kuongororwa mamiriro. Musimboti wechipiri anoshandisa Doppler nzira mapofu ari spectral nzira.

Kana uri kushandisa triplex ongororo, ipapo kune mbiri dzataurwa pamusoro apa nzira inowedzera yechitatu nzira ruvara Mapping. Nzira visualizes ropa riyerere munzvimbo nokuongororwa. Kutaura zvazviri, izvi Ultrasound mufananidzo, mavara, zvichienderana arambe achirema ari Urume kupfuura uye ayo marefu-nokukurumidza unongotaura.

Mukugumisa, zvinofanira kucherechedzwa kuti ano nzira pakuongorora varwere kuziva anomalies uye ukama arteries uye mutsinga kunokosha zvakwakanakira pamusoro kushandiswa kare kundorondedzera nzira. Magadzirirwo unobvumidza US yomuchipatara kuzvishandisa zvakananga padivi pomubhedha murwere, hapana chinokuvadza nemwaranzi kumurwere.