I-diaphragm iyimisipha ebalulekile emishini yokuphefumula.

I-diaphragm iyimisipha ekhuthazayo etholakala ngaphansi kwamaphaphu. Ihlukanisa isifuba esifubeni nesisu esiswini. Ngokuma kwedome, kumakwe ngemizi emibili ngakwesokunene nangakwesobunxele. Azilingani, idome le-diaphragmatic elifanele livame ukuphakama ngo-1 kuya ku-2 cm kunedome lesobunxele.

I-diaphragm yakhiwe nge-tendon emaphakathi, isikhungo se-tendon se-diaphragm noma isikhungo se-phrenic. Ezingxenyeni, imicu yemisipha ixhuma ezingeni le-sternum, izimbambo nama-vertebrae.

Inemidwebo yemvelo evumela ukudlula kwezitho noma izitsha kusuka komgodi kuya komunye. Lokhu kunjalo, isibonelo, nge-esophageal, aortic noma inferior vena cava orifices. Ayigcini inzwa ye-phrenic ebangela ukuthi ifinyelele.

I-diaphragm iyisicubu esiyinhloko sokuphefumula. Ihlanganiswe nemisipha ye-intercostal, iqinisekisa imishini yokuphefumula ngokushintsha ukunyakaza kokuphefumlelwa nokuphelelwa yisikhathi.

Ngokuphefumulelwa, isivumelwano se-diaphragm kanye nemisipha ye-intercostal. Njengoba izinkontileka, i-diaphragm yehlisa futhi iqonde. Ngaphansi kwesenzo semisipha ye-intercostal, izimbambo ziyakhuphuka eziphakamisa ubambo lwezintambo bese ziqhubekisela phambili i-sternum. I-thorax bese inyuka ngosayizi, kuyehla ingcindezi yayo yangaphakathi edala ukuthi kushayelwe umoya wangaphandle. Umphumela: umoya ungena emaphashini.

Imvamisa yokusikwa kwesifafazi ichaza izinga lokuphefumula.

Ngokuphefumula, umsipha we-diaphragm kanye ne-intercostal uyakhululeka, okwenza izimbambo zehle njengoba i-diaphragm ibuyela endaweni yayo yasekuqaleni. Kancane kancane, ubambo lwezintambo luyehla, ivolumu yalo iyancipha okwandisa ukucindezela kwayo kwangaphakathi. Ngenxa yalokho, amaphaphu ahoxisa futhi kuphuma umoya kuwo.

AmaHiccups : ichaza ukulandelana kokuphambana okungazibandakanyi nokuphindaphindwayo kwe-diaphragm okuhambisana nokuvalwa kwe-glottis futhi imvamisa ukusikwa kwemisipha ye-intercostal. Le reflex ivela ngokuzumayo nangokungalawuleki. Iphumela ochungechungeni lwezimpawu ze-sonic "hics". Singakwazi ukuhlukanisa okuthiwa ama-hiccups anobungozi ahlala isikhathi esingaphezu kwemizuzwana noma imizuzu embalwa, kanye nama-hiccups angapheli, ayivelakancane kakhulu, angahlala kusuka emahoreni amaningana kuya ezinsukwini ezimbalwa futhi okuthinta kakhulu abantu abaneminyaka engaphezu kwengu-50 ubudala.

Ukuqhekeka kwangemva kwenhlekelele : Ukuqhekeka kwesifo okwenzeka kulandela ukuhlukumezeka kwesifuba, noma amanxeba ezinhlamvu noma izikhali ezifakiwe. Ukuqhekeka kuvame ukwenzeka ezingeni ledome lakwesobunxele, idome lesokudla lifihlwe kancane yisibindi.

I-hernia ye-Transdiaphragmatic : ukukhuphuka kwesitho esiswini (isisu, isibindi, amathumbu) nge-orifice ku-diaphragm. I-hernia ingaba yinto yokuzalwa, umgodi lapho isitho esithuthelayo sidlula khona kungukuvela okungalungile kusukela ekuzalweni. Ingatholwa futhi, umgodi ungumphumela womthelela ngesikhathi sengozi yomgwaqo ngokwesibonelo; kulokhu sikhuluma ngokwenzakaliswa kwesichazamazwi. Kuyisimo esingajwayelekile esithinta cishe eyodwa ezinganeni ezingama-4000.

Ukuphakama kwedome e-diaphragmatic : i-dome yangakwesokudla imvamisa ukuphakama okungu-1 kuya ku-2 cm kunedome lakwesobunxele. Kukhona "ukuphakama kwedome elungile" lapho ibanga lidlula u-2 cm ukusuka kudome lwesobunxele. Leli banga lihlolwe kwi-X-ray yesifuba ethathwe ngogqozi olujulile. Sikhuluma "ngokuphakama kwedome elingakwesobunxele" uma liphakeme kunesokudla noma limane lisezingeni elifanayo. Kungakhombisa ukugula okwedlulele ngokwe-diaphragmatic (ukuphazamiseka komoya noma embolism ye-pulmonary) noma i-diaphragmatic pathology (izilonda ezihlukumezayo zesibindi se-phrenic noma i-hemiplegia) (5).

Izicubu : zivame kakhulu. Ngokuvamile, lezi izicubu ezinobungozi (i-lipomas, i-angio ne-neurofibromas, i-fibrocytomas). Ezingxenyeni ezibulalayo (ama-sarcomas nama-fibrosarcomas), kuvame ukuba nenkinga ne-pleural effusion.

Izifo ze-neurological : Noma yikuphi ukulimala esakhiweni esiphakathi kobuchopho ne-diaphragm kungaba nemiphumela ekusebenzeni kwayo (6).

Isibonelo, i-Guillain-Barré syndrome (i-7) yisifo sokuvuvukala komzimba esihlasela uhlelo lwezinzwa, ngamanye amagama izinzwa. Sizibonakalisa ngobuthakathaka bemisipha obungafika ekukhubazekeni. Endabeni yesiyaluyalu, kuthinteka imizwa ye-phrenic futhi kuvela ukuphazamiseka kokuphefumula. Ngaphansi kokwelashwa, iningi labantu abathintekile (75%) libuyisela amandla abo ngokomzimba.

I-Amyotrophic lateral sclerosis, noma isifo sikaCharcot, yisifo se-neurodegenerative esibonakala ngokukhubazeka kwemisipha okuqhubekayo ngenxa yokwehla kwama-motor neurons athumela ama-oda wokunyakaza kwemisipha. Njengoba lesi sifo siqhubeka, singathinta imisipha edingekayo ekuphefumuleni. Ngemuva kweminyaka emi-3 kuye kwengu-5, isifo sikaCharcot singadala ukwehluleka kokuphefumula okungaholela ekufeni.

Ama-hiccups kuphela angaba isihloko sezinyathelo ezimbalwa. Kunzima ukuvimbela ukubukeka kwayo okungahleliwe, kepha singazama ukunciphisa izingozi ngokugwema ukudla ngokushesha okukhulu, kanye nogwayi oweqile, utshwala noma iziphuzo ezinekhabhoni, izimo ezicindezelayo noma ushintsho olungazelelwe lokushisa.

I-diaphragm kunzima ukuyifundisisa nge-imaging (8). I-Ultrasound, i-CT kanye / noma i-MRI imvamisa ingezwa kwi-radiography ejwayelekile yokuqinisekisa nokucwengisisa ukuxilongwa kwezifo.

I-Radiography: inqubo yezithombe yezokwelapha esebenzisa ama-X-ray. Lokhu kuhlolwa akunabuhlungu. I-diaphragm ayibonakali ngqo kwi-x-ray yesifuba, kodwa ukuma kwayo kungabonakala ngomugqa ophawula isikhombimsebenzisi sesibindi samaphaphu ngakwesokudla, iphaphu-isisu-ubende ngakwesobunxele (5).

I-Ultrasound: inqubo yezithombe yezokwelapha esuselwa ekusetshenzisweni kwe-ultrasound, amaza omsindo angazwakali, enza kube lula "ukubona ngeso lengqondo" ingaphakathi lomzimba.

I-MRI (imaging resonance imaging): ukuhlolwa kwezokwelapha ngenhloso yokuxilonga okwenziwa kusetshenziswa idivaysi enkulu eyindilinga lapho kukhiqizwa khona amandla kazibuthe namagagasi omsakazo ukukhiqiza izithombe eziqonde kakhulu, ku-2D noma ku-3D, zezitho zomzimba noma izitho zangaphakathi (lapha isithombe).

Iskena: inqubo yokuhlola yokuxilonga equkethe ukudala izithombe ezihlukanisayo zengxenye ethile yomzimba, kusetshenziswa umsebe we-X-ray. Igama elithi "isithwebuli" empeleni yigama ledivayisi, kepha besivame ukusetshenziselwa ukubhekisa ekuhlolweni (i-computed tomography noma i-CT scan).

Ku-anatomy yomuntu, igama elithi diaphragm lisetshenziselwa ukubhekisela ku-iris yeso. Iris ilawula inani lokukhanya elingena esweni. Lo msebenzi ufanelekile ukuthi uqhathaniswe ne-diaphragm yekhamera.