ʻO ka diaphragm ka mākala nui i nā mīkini o ka hanu ʻana.

ʻO ka diaphragm kahi mākala hoʻoikaika ʻia ma lalo o nā akemāmā. Hoʻokaʻawale ia i ka umauma umauma mai ka lua o ka ʻōpū. I ke ʻano o ka dome, ua māka ʻia me nā domes ʻelua ma ka ʻākau a me ka hema. Asymmetrical lākou, ʻo ka diomexmatic pono kome he 1 a 2 knm ke kiʻekiʻe ma mua o ka kome hema.

Hana ʻia ka diaphragm o ka tendon kikowaena, ke kikowaena o ka diaphragm a i ʻole ke kikowaena phrenic. Ma ka periphery, hoʻopili nā olonā i ka pae o ka sternum, nā iwi ʻaoʻao a me ka vertebrae.

Loaʻa iā ia nā orifices kūlohelohe e ʻae ai i ka hele o nā mea a i ʻole nā ​​kīʻaha mai kekahi lua i kekahi. ʻO kēia ka hihia, no ka laʻana, me ka esophageal, aortic a i ʻole nā ​​inferior vena cava inferior. Hoʻokomo ʻia ia e ke aʻalolo phrenic e kumu iā ia e ʻaelike.

ʻO ka diaphragm ka mākele hanu nui. Hoʻopili ʻia me nā mākala intercostal, hōʻoia ia i nā mīkini o ka hanu ʻana e ka hoʻololi ʻana i nā neʻe o ka hoʻoulu a me ka pau ʻana.

Ma ka hoʻoulu manaʻo, ʻaelike ka diaphragm a me nā mākala intercostal. E like me ka mea e ʻaelike ai, hoʻohaʻahaʻa ka diaphragm a pālahalaha. Ma lalo o ka hana o nā mākala intercostal, piʻi i luna nā iwi ʻaoʻao i hāpai i ka iwi ʻaoʻao a hoʻokuʻi i ka sternum i mua. Hoʻonui ka thorax i ka nui, hoʻemi ke kaomi o loko i ke kumu no kahi lewa no ka lewa waho. Hualoaʻa: komo ka ea i loko o nā akemāmā.

ʻO ke alapine o ka diaphragm contraction e wehewehe ai i ka helu hanu.

Ma ka hanu ʻana, hoʻomaha ka diaphragm a me nā mākala intercostal, e iho ana i nā iwi ʻaoʻao i ke kū ʻana o ka diaphragm i kona kūlana mua. Ma ka liʻuliʻu, hoʻohaʻahaʻa ʻia ka iwi ʻaoʻao, hoʻoliʻiliʻi kona nui e hoʻonui ai i kona kaomi o loko. ʻO ka hopena, hoʻi i nā māmā a pakele ka ea mai iā lākou.

ʻO Hiccups : kuhikuhi i kahi kuʻuna o nā kuʻikahi manawaleʻa a hana hou o ka diaphragm e pili ana me ka pani ʻana o ka glottis a me ka hoʻoliʻiliʻi pinepine ʻana o nā mākala intercostal. Kū koke kēia reflex a kāohi ʻole. Nā hualoaʻa i loko o ke kaʻina o ke ʻano sonic "hics". Hiki iā mākou ke hoʻokaʻawale i nā mea i kapa ʻia he benic hiccups i hala ma mua o kekahi mau kekona a i ʻole mau minuke, a me nā hiccup mau, ʻoi aku ka liʻiliʻi, hiki ke hala mai nā hola he nui a i kekahi mau lā a pili pinepine i ka poʻe ma mua o 50 mau makahiki.

Haki post-traumatic : hū ka diaphragm ma hope o ka hōʻeha ʻana i ka thorax, a i ʻole nā ​​ʻeha e nā pōkā a i ʻole nā ​​mea kaua pahi. Kū pinepine ka haki ma ka pae o ka dome hema, ʻo ka dome ʻākau e hūnā hapa ʻia e ke ake.

Hernia transdiaphragmatic : kū i luna o kahi ʻōpū i loko o ka ʻōpū (ʻōpū, ate, ʻōpū) ma o kahi orifice i ka diaphragm. Hiki i ka hernia ke lilo i congenital, ka lua ma kahi e hele ai ka mea neʻe i kahi kino malformation mai ka wā hānau. Hiki ke kiʻi ʻia, ʻo ka lua ka hopena o ka hopena i ka wā o kahi ulia alanui e laʻa me; i kēia mea ke kamaʻilio nei mākou no ka diaphragmatic eventration. He kūlana laha ʻole kēia e pili ana i hoʻokahi o 4000 mau pēpē.

ʻO ke kiʻekiʻe o kahi dome diaphragmatic : ʻo ka dome kūpono he maʻa mau ia 1 a 2 cm ke kiʻekiʻe ma mua o ka hale hema. Aia kekahi "kiʻekiʻe o ka dome kūpono" ke ʻoi aku ka mamao ma kahi o 2 cm mai ka dome hema. Kuhi ʻia kēia mamao ma kahi pahu X-ray i lawe ʻia i loko o ka hoʻoulu hohonu. 'Lelo mākou no "ke kiʻekiʻe o ka dome hema" inā ʻoi aku ke kiʻekiʻe ma mua o ka ʻākau a maʻalahi paha ma ka pae like. Hōʻike paha ia i kahi pathology keu-diaphragmatic (nā maʻi hoʻoliʻiliʻi a i ʻole embolism pulmonary) a i ʻole kahi pathology diaphragmatic (nā ʻeha traumatic o ke aʻalolo phrenic a i ʻole hemiplegia paha) (5).

ʻO nā Tumors : kākaʻikahi loa lākou. ʻO ka hapanui pinepine kēia he mau tumign benign (lipomas, angio a me neurofibromas, fibrocytomas). I nā puʻupuʻu malignant (sarcomas a me fibrosarcomas), loaʻa pinepine kahi komplication me ka pleural effusion.

Nā pathology Neurological : Kekahi hōʻino i kahi hanana i kū ma waena o ka lolo a me ka diaphragm hiki ke loaʻa nā hopena i kāna hana (6).

ʻO kahi laʻana, ʻo Guillain-Barré Syndrome (7) kahi maʻi autoimmune hōʻeha e hōʻeha i ka ʻōnaehana nūhou ākea, ʻo ia hoʻi nā aʻa. Hōʻike ia iā ia iho e ka nāwaliwali o ka muscle i hiki ke hele a hiki i ka paralysis. I ka hihia o ka diaphragm, hoʻopili ʻia ke aʻalolo phrenic a ʻike ʻia nā haunaele hanu. Ma lalo o ka mālama ʻana, ka hapanui o nā poʻe i hoʻopilikia ʻia (75%) e hoʻōla i ko lākou mau hiki kino.

ʻO scotrosis lateral ʻo Amyotrophic, a i ʻole ka maʻi ʻo Charcot, kahi maʻi neurodegenerative i hōʻike ʻia e ka lolo palolo ma muli o ka hoʻoliʻiliʻi o nā neurons kaʻa e hoʻouna i nā kauoha no ka neʻe ʻana i nā mākala. Ke holo nei ka maʻi, hiki ke hoʻopili i nā mākala e pono ai no ka hanu ʻana. Ma hope o 3 a 5 mau makahiki, hiki i ka maʻi o Charcot ke kumu i ka hanu ʻole e hiki ai i ka make.

Hiki i nā hiccups ke lilo i kumuhana o kekahi mau ana. He paʻakikī ke pale aku i kona helehelena a kaulike ʻole, akā hiki iā mākou ke hoʻāʻo e hoʻoliʻiliʻi i nā makaʻu ma ka hōʻole ʻana i ka ʻai wikiwiki ʻana, a me ka paka nui loa, ka wai ʻona a me nā mea inu kalapona, nā hanana kaumaha a i ʻole nā ​​hoʻololi koke ʻana o ka mahana.

He paʻakikī ka diaphragm e hoʻopaʻa haʻawina ma ke kiʻi (8). Hoʻohui pinepine ʻo Ultrasound, CT a me MRI paha i ka radiography maʻamau e hōʻoia a hoʻomaʻemaʻe i ke kuhi o kahi pathology.

Radiography: kahi hana kiʻi olakino e hoʻohana ai i nā kukuna X. ʻAʻole ʻeha kēia hōʻike. ʻAʻole ʻike pono ʻia ka diaphragm ma ka umauma x-ray, akā hiki ke ʻike ʻia i kona kūlana e ka laina e kaha ana i ke kuʻina ate-ake ma ka ʻākau, āke-ʻōpū puʻuwai ma ka hema (5).

ʻO Ultrasound: kahi ʻano kiʻi olakino e pili ana i ka hoʻohana ʻana o ultrasound, nā hawewe kani hiki ʻole ke lohe ʻia, kahi e hiki ai ke "ʻike" i loko o ke kino.

MRI (kiʻi resonance ʻume mākenēki): ninaninau lāʻau no nā hana diagnostical i hoʻohana ʻia me ka hoʻohana ʻana i kahi mea hana cylindrical nui kahi e hana ʻia ai kahi māla mehana a me nā nalu lekiō e hana i nā kiʻi kikoʻī, i 2D a i ʻole 3D, o nā ʻāpana o ke kino a i ʻole nā ​​mea i loko (ʻaneʻi ka diaphragm).

Scanner: kahi hana kiʻi diagnostic i loko o ka hoʻokumu ʻana i nā kiʻi ʻāpana o kekahi ʻāpana o ke kino, e hoʻohana ana i kahi kaola X-ray. ʻO ka huaʻōlelo "scanner" ʻo ia ka inoa o ka hāmeʻa, akā hoʻohana pinepine mākou e kuhikuhi i ka hoʻokolohua (compute tomography or CT scan).

I ke anatomi kanaka, hoʻohana ʻia ka huaʻōlelo diaphragm e kuhikuhi ai i ka iris o ka maka. Hoʻopili ka iris i ka nui o ke kukui i komo i ka maka. Kūpono kēia hana ke hoʻohālikelike ʻia i ka diaphragm o kahi kāmela.