Zviri mukati uye Kusakanganiswa kweMidastinum
Chii chinonzi mediastinum uye zvii nezvivako uye masukisi zviripo munzvimbo ino yebhokisi? Ndezvipi zvirwere zvinogona kuitika mu mediastinum? Ndeapi mapoka evanhu vemazuva mashoma kana zviremara zvinowanikwa mune zvikamu zvitatu zve mediastinum?
Tsanangudzo: Mediastinum
Iyo miviri inzvimbo iri mubhokisi pakati pemapapu ane mwoyo, chikamu chemhepo ine simba ( trachea ), sophagus , uye midziyo huru kusanganisira kukwira aorta (aritari huru inotakura ropa kubva kuruboshwe rwemwoyo iri munzira yayo kuenda kune imwe yose yemuviri) uye kurudyi uye kuruboshwe kumapuraneti-zvikamu zvose nhengo dziri muchifuva kunze kwemapapu.
Ikowo kumusha kune akawanda lymph nodes uye nerve. Shoko rokuti mediastinum rinoshandurwa se "midway" muLatini, achitaura kune chikamu chepakati chebhokisi.
Iwe unogona kufungidzira iyi nzvimbo nekuona diaphragm sepasi, pfupa (sternum) sepamberi, mutezo yeropa inopinda uye inobva mumwoyo seyopamusoro, uye mushure (iyo vertebral column) semushure.
Chimiro - Chirevo chemukati chinoparadzaniswa kuva zvikamu zvitatu:
- Anterior - Anterior mediastinum iripo kune rumwe rutivi rworuboshwe uye ine mishonga mishoma uye lymph nodes.
- Mukati - Pakati pe mediastinum ndiyo chikamu chikuru, uye ine mwoyo, midzi yeropa kusanganisira iyo inofamba kubva pamapapu kusvika pamwoyo, uye lymph nodes.
- Posterior - Inonzi posterior mediastinum inosimba, mishonga yakawanda yeropa uye nerve, uye miviri yemaviri yepakati .
Mamiriro Ekubatsira Mediastinum
Kune zvakawanda zvehutano zvinogona kuchinja zvivako mu mediastinum.
Zvimwe zvezvi zvinosanganisira:
- Kanzira - Kanza yakadai se lymphomas (zvose Hodgkin's lymphoma uye isiri Hodgkins lymphomas), mamwe majekiseni emagemukari, uye thymomas (kanzira ye thymus gland) inowanikwa mu mediastinum.
- Uturu hwemhondi - Benign germ cell tumors yakadai sematatomas uye dermoid cysts inogona kuitika munharaunda ino.
- Zvirwere zvinouraya lymph nodes (lymph nodes dzinokonzerwa nekenza) - Kanzira dzakadai sekenza yemapapu dzingapararira kune lymph nodes munharaunda ino (miviri yemasikirini uye chetracheobronchial lymph nodes.)
- Lymphadenopathy - "Dzuka" lymph nodes mu mediastinum inogona kuitika nedzimwe zvirwere, kunyanya zvirwere zvehutachiona.
- Aneurysms - Thoracic aortic aneurysms inenge yakashata inosanganisira mediastinum.
- Nzira kukanganisa - Mitsipa inopfuura nepakati ye mediastinum inogona kukuvadzwa, somuenzaniso nokudzvinyirira kubva mumarara kana kenza lymph nodes mune ino.
Masse Mediastinal
Vanhu vazhinji vanowanzotanga kutarisa apo kuongorora kunenge kwaitwa kuti kuongorore zviratidzo zvine chokuita nebhokisi, zvakadai sokukanganiswa, kufema kwepfufu, kana zvimwe zviratidzo. Mazhinji mashoma mu mediastinum maduku uye haana zviratidzo. Kana dzakakura dzinogona kukonzera kuporesa kusakwana (kunetseka kufema kana kuwana oxygen yakakwana kumatumbu) pamwe nematambudziko emwoyo, zvakadai sedonhi muropa kana kupera kweropa.
Zera remunhu uye nzvimbo yehutachiona hwemukati ndeyekukosha pakuongorora kufungidzirwa. Muvana, vanhu vanoita zvepakati vanowanzoitika kakawanda mumashure ekugadzirisa midastinum uye vanowanzova vasina kunaka (vasina kenza.) Kusiyana neizvi, masuzhinji evanhu vevanhu vevanhu vakuru vanhu vanowanzowanzova muhutano hwekare, uye vanowanzovhiringidza (kanzira.)
Zvimwe zvinokonzera mashoma ezvipakati zvichienderana nenzvimbo zvinosanganisira:
- Anterior mediastinum - Tumors muzvikamu izvi zvinogona kusanganisira thymomas (tumoramusi ye thymus, nhengo mubhokisi iyo yakakura zvikuru muhuduku asi inonyangarika inopera kune vanhu vakuru), lymphomas, uye masheji.
- Mid mediastinum - Lymph node yakakura ndiyo inowanzokonzera mashoma mukati me mediastinum. Izvi zvinokonzera mishonga inogona kunge yakabatana nemukondombera. Bronchogenic cysts inogonawo kuonekwa munharaunda ino, pamwe nekushaya simba kwepfungwa zvakadai se-aorta yakawedzerwa.
- Posterior mediastinum - Canopers eesophageal nezvimwe zvisingaenzaniswi zvinogona kuonekwa mushure me mediastinum, uye lymph nodes yakakura inogona kuonekwawo pano. Mimwe mikana inosanganisira sarcomas uye ectopic thyroid tissue (utachiona hwemapupa ari kukura mune imwe nzvimbo kunze kwetachiona chetachiona.
Kansa yemaperembudzi inogona kukonzera mashoma mune chero chikamu che mediastinum. Zvakakosha kucherechedza kuti pane zvakawanda zvinokonzera kusakanganisika mu mediastinum, uye kakawanda kuwedzerwa kuongororwa kunodikanwa kutsanangura chikonzero chaicho.
Mitemo Inobatanidza Mediastinum
- Pneumomediastinum inoreva kuvapo kwemweya mu mediastinum, inowanzobatana nekuwa kwepapu (pneumothorax.)
- Mediastinitis izwi rinoreva chirwere chinosanganisira mediastinum.
Maitiro - Mediastinoscopy
Nekenza yekenza yemapapu uye lymphomas, vanachiremba vanowanzotarisa mediastinum kuti vaone kana kenza ipi yakapararira munzvimbo ino. Imwe nzira inobvumira vanachiremba kufungidzira kuti iyi inonzi " mediastinoscopy" . Kana kenza yakapararira kune nodes mu mediastinum inowanzobatwa zvakasiyana kune kenza isina kupararira kune ino; kuvapo kwemuviri wemasikirini emakemikari kwakakosha mukugadzirwa kwemukenza wemapapu .
Mediastinoscopy yaiva nzira yakajairika yeavo vakaonekwa vane mhapamu yemapapu, asi ruzivo rwakadaro dzimwe nguva runogona kuwanikwa iye zvino kuburikidza nePET scan.
Mienzaniso: Joy yakaitwa nenzira yekuona kana kanha yemapapu yake yakapararira kune lymph nodes mu mediastinum yake.
> Sources:
> Barrington, S., uye R. Kluge. FDB PET yeTradio Monitoring muHodgkin uye Kwete-Hodgkin Lymphomas. European Journal yeNuclear Medicine uye Molecular Imaging . 2017 Apr 14. (Epub mberi kwechinyorwa).
> Berry, M. Kubvunzurudzwa kweMasiddie Masikati. Kusvika pari zvino. Updated 09/28/16. http://www.uptodate.com/contents/approach-to-the-adult-patient-with-a-mediastinal-mass
> Li, W., van Boven, W., Annema, J., Eberl, S., Klomp, H. uye B de Mol. Kutungamirirwa kweMasa Masheji Makuru: Kuvhiya uye Kuongorora Anesthesiological. Zvinyorwa zveTrracic Disease . 2016. 8 (3): E175-84.
> US National Library of Medicine. Medline Plus. Midastinal Tumors. Updated 05/20/16. https://medlineplus.gov/ency/article/001086.htm