Imithambo ye-jugular itholakala entanyeni: iyimithambo yegazi ephelelwa umoya-mpilo kusuka ekhanda kuya enhliziyweni. Imithambo ye-jugular inenombolo emine, ngakho-ke itholakala ezingxenyeni ezingemuva zentamo. Kukhona umthambo we-jugular wangaphakathi, umthambo we-jugular wangaphandle, umthambo we-jugular wangemuva kanye nomthambo wangaphakathi we-jugular. Leli gama lisetshenziswa nguRabelais, encwadini yakhe IGargantua, ngo-1534, ngaphansi kwenkulumo ethi “veniyajula“, Kepha kuvela esiLatini”emphinjeniOkuchaza "indawo lapho intamo ihlangana namahlombe". I-pathologies yemithambo ye-jugular ayivamile: kubikwe kuphela izimo ezehlukile ze-thrombosis. Ngokufanayo, ukucindezelwa kwangaphandle kuhlala kungavamile kakhulu. Uma kwenzeka ukuvuvukala, ukuqina noma ubuhlungu obuzwakalayo entanyeni, ukuxilongwa okuhlukile kwe-thrombosis kungenziwa, noma ngokuphambene nalokho, ngezithombe zezokwelapha ezihambisana nokuhlolwa kwelebhu. Uma kwenzeka i-thrombosis, ukwelashwa nge-heparin kuzoqalwa.

Imithambo ye-jugular itholakala nhlangothi zombili zezingxenye ezingemuva zentamo. Ngokwe-etymologically, leli gama livela egameni lesiLatini emphinjeni okusho ukuthi "umphimbo", ngakho-ke empeleni "indawo lapho intamo ihlangana khona namahlombe".

Umthambo we-jugular wangaphakathi

Umthambo wangaphakathi wejugular uqala ezansi kogebhezi, ngaphambi kokuba wehlele kuthambo lekhola. Lapho, khona-ke ijoyina umthambo we-subclavia futhi ngaleyo ndlela izokwakha isiqu semithambo ye-brachiocephalic venous. Lo mthambo wangaphakathi we-jugular ujule kakhulu entanyeni, futhi uthola imithambo eminingi ebusweni nasentanyeni. Izono eziningana, noma imigudu ye-venous, ye-dura, ulwelwesi oluqinile noluqinile oluzungeze ubuchopho, lunomthelela ekwakhekeni kwalo mthambo we-jugular wangaphakathi.

Umthambo we-jugular wangaphandle

Umthambo we-jugular wangaphandle uqhamuka ngemuva nje komhlathi ongezansi, eduze kwe-mandible mandible. Bese ijoyina isisekelo sentamo. Kuleli zinga, lizobe selingenela emthanjeni we-subclavia. Lo mthambo wangaphandle we-jugular ugqama entanyeni lapho umfutho we-venous ukhuphuka, njengoba kwenzeka ngokukhwehlela noma ukudonsa kanzima, noma ngesikhathi sokuboshwa kwenhliziyo.

Imithambo ye-jugular yangaphambili nangemuva

Lena imithambo emincane kakhulu.

Ekugcineni, umthambo we-jugular wangaphandle ofanele kanye nomthambo wangaphakathi we-jugular ofanele zombili zingena emthanjeni ofanele we-subclavia. Umthambo we-jugular wangaphakathi wesokunxele kanye nomthambo we-jugular wangaphandle wesokunxele womabili angena emthanjeni we-subclavia ongakwesokunxele. Khona-ke, i-subclavia vein yesokudla ijoyina i-brachiocephalic vein yesokudla, lapho umthambo we-subclavian wesokunxele ujoyina umthambo we-brachiocephalic wesobunxele, futhi imithambo ye-brachiocephalic yesokudla nesobunxele iyogcina ihlangene yomibili ukuze yakhe i- superior vena cava. Le vena cava enkulu futhi emfushane iyona ehambisa igazi eliningi elingenayo umoya-mpilo lisuka engxenyeni yomzimba ngaphezu kwe-diaphragm liye ku-atrium engakwesokudla yenhliziyo, ebizwa nangokuthi i-atrium efanele.

I-jugular veins inomsebenzi we-physiological wokuletha igazi kusuka ekhanda kuya esifubeni: ngakho-ke, indima yabo ukuletha igazi le-venous, eliphelile emoyeni, libuyele enhliziyweni.

Umthambo wangaphakathi oyindilinga

Ngokuqondile, umthambo wangaphakathi wejugular uqoqa igazi elivela ebuchosheni, ingxenye yobuso kanye nendawo engaphakathi entanyeni. Akuvamile ukuthi ilimale ekulimaleni kwentamo ngenxa yokujula kwayo. Ekugcineni, inomsebenzi wokukhipha ubuchopho, kepha nama-meninges, amathambo ogebhezi, imisipha nezicubu zobuso kanye nentamo.

Umthambo we-jugular wangaphandle

Ngokuqondene ne-jugular yangaphandle, ithola igazi elidonsa izindonga ze-skull, kanye nezingxenye ezijulile zobuso, kanye nezifunda ezingemuva nezingemuva zentamo. Umsebenzi wayo uhlanganisa ngokunembe kakhudlwana ekukhipheni isikhumba sekhanda nesikhumba sekhanda nentamo, imisipha yesikhumba yobuso nentamo kanye nomgodi womlomo kanye nepharynx.

I-pathologies ye-jugular veins iphenduka ingavamile. Ngakho-ke, ingozi ye-thrombosis ayivamile kakhulu futhi izingcindezi zangaphandle nazo zehluke kakhulu. I-Thrombosis ukwakheka kwamahlule emithanjeni yegazi. Eqinisweni, izimbangela zokuvama kwe-thrombosis ye-venous jugular ngokuzenzekelayo, ngokusho kukasosayensi u-Boedeker (2004), zimi kanje:

• imbangela exhunywe nomdlavuza (50% wamacala);
• imbangela ye-para-infectious (30% yamacala);
• ukuluthwa izidakamizwa (10% wamacala);
• ukukhulelwa (amacala ayi-10%).

Uma kusolwa i-venous thrombosis ye-jugular, kuzodingeka:

• qala i-heparinization yesiguli (ukuphathwa kwe-heparin okusiza ukubambezela ukunqamuka kwegazi);
• sebenzisa i-antibiotic ebanzi.

Ngokuvuvukala, ukuqina, noma ubuhlungu entanyeni, udokotela kufanele acabangele, lapho enza ukuxilongwa okwehlukile, ukuthi kungaba yi-venous thrombosis kuleyo ndawo yomzimba. Ngakho-ke kuyadingeka ukwenza uphenyo olunzulu. Ngakho-ke, ukusola komtholampilo kwe-acute jugular vein thrombosis kufanele kuqinisekiswe ngokushesha okukhulu:

• ngesithombe sezokwelapha: I-MRI, isithwebuli esinomkhiqizo ohlukile noma i-ultrasound;
• ngokuhlolwa kwelabhorethri: lokhu kufanele kufake phakathi ama-D-dimers njengezimpawu ezingacacisi kodwa ezibucayi kakhulu ze-thrombosis, kanye nezimpawu zokuvuvukala njenge-CRP nama-leukocyte. Ukwengeza, amasiko egazi kufanele enziwe ukuze kutholwe izifo ezingase zibe khona futhi ukwazi ukwelapha ngokwanele ngokushesha nangokufanele.

Ngaphezu kokwelashwa okungaguquki, i-thrombosis enjalo ye-venous ye-jugular veins idinga ukusesha okungaguquki kwesimo esingaphansi. Ngakho-ke kuyadingeka ukuqhubeka ikakhulukazi ekufuneni isimila esibi, esingaba imbangela ye-paraneoplastic thrombosis (okungukuthi ekhiqizwa ngenxa yomdlavuza).

Ekuqaleni kwamashumi amabili^e leminyaka, waphefumula edolobheni Lyon i umoya ongasoleki ukuthi wabeletha ke kakhulu intuthuko, ukuhlinzwa semithambo. Amavulandlela amane amagama kaJaboulay, uCarrel, uVillard kanye noLeriche ngakho bazihlukanisa kulo mkhakha, beqhutshwa umfutho wenqubekelaphambili ... Indlela yabo yokuhlola yayithembisa, okungenzeka ikhiqize izinto ezimangalisayo ezifana nokuxhunyelelwa kwemithambo noma ngisho nokufakelwa 'izitho zomzimba. Udokotela ohlinzayo uMathieu Jaboulay (1860-1913) wayengumhlwanyeli wangempela wemibono: ngakho-ke wakha eLyon izisekelo zokuhlinzwa ngemithambo, ngesikhathi okwakungakenziwa mzamo ngaso. Ngokuqhamile wasungula inqubo ye-end-to-end arterial anastomosis (ukuxhumana okusungulwe ngokuhlinzwa phakathi kwemikhumbi emibili), eyashicilelwa ngo-1896.

UMathieu Jaboulay ubebone nezicelo eziningi ezingaba khona ze-arteriovenous anastomosis. Ephakamisa ukuthumela igazi le-arterialized ebuchosheni ngaphandle kwe-carotid-jugular anastomosis, uhlongoze uCarrel noMorel ukuthi benze ucwaningo lokuhlola, ezinjeni, ekupheleni kwe-anastomosis yokuphela kwe-jugular kanye ne-carotid eyinhloko. Imiphumela yalolu cwaningo yashicilelwa ngo-1902 kumagazini I-Lyon Medical. Nakhu okuvezwe nguMathieu Jaboulay: “Yimina engicele uMnu. Carrel ukuthi ahlaziye umthambo we-carotid kanye nomthambo we-jugular enjeni. Bengifuna ukwazi ukuthi yini enganikeza lo msebenzi ngokuhlolwa ngaphambi kokuwusebenzisa kubantu, ngoba ngangicabanga ukuthi ungasiza ezimeni zokuchelela komthambo ongenele ngenxa ye-thrombosis ethambisa, noma ngokubopha ukukhula kokuzalwa.".

UCarrel uthole umphumela omuhle ezinjeni: “Emasontweni amathathu ngemuva kokuhlinzwa, umthambo oyindilinga wawushaya ngaphansi kwesikhumba futhi usebenza njengomthambo.Kodwa, ngerekhodi, uJaboulay akazange azame ukuhlinza okunjalo kubantu.

Ukuphetha, sizokhumbula futhi ukuthi izingathekiso ezinhle kwesinye isikhathi zisetshenziswe ngabanye ababhali abazungeze le jugular. Ngeke sehluleke ukucaphuna, ngokwesibonelo, uBarrès othi, kweyakhe notebooks, ebhala: “I-Ruhr yi-jugular vein yaseJalimane“… Izinkondlo nesayensi kuhlangene ngezinye izikhathi futhi kwakha ama-nuggets amahle.