Blood circulation of the colon. intestinal blood loss

Blood sucking to the hood and to the club of the intestines gilki the upper brijovo artery: Aa. jejunales, ilei і ileocolica.

Verkhnya Brizhova artery , A. mesenterica superior, with a diameter of about 9 mm, ascending from the cranial aorta under the gostry cut on the edge of the I transverse ridge, 1 -2 cm lower celiac stovbur... A handful of them are seen retroperitoneally behind the chicks of the lump and spleen.

Then go from the lower edge of the zolozi, cross from the top to the bottom pars horizontalis duodeni and enter the brigi small intestine... Have moved in the breech of the small intestine, Verkhnya Brizhova artery Going from the top to the bottom from the top to the right to the right, opening the arched vigin, straightening the lumpy to the left.

here from the upper brigade artery Allow to enter the small intestine, aa. jejunales et ileales. From the side of the vigin to the right and up the hill to go up the arms for the viscid and transverse colon - a. colica media i a. colica dextra.

Verkhnya Brizhova artery end up in the right club yamtsi in your kintsevoy gilkoy - a. ileocolica. Vienna is the same for the supravodzhu artery, the right-handed person will be overwhelmed. A. ileocolica supplies blood to the endometrium of the club intestine and the cob to the cob.

The loops of the small intestine are even more collapsed, from them to pass peristalsis, as a result of which the diameter of one and the same intestine decreases, kharchovy masi also change the loops of the intestines on the protrusion. Tse, in his own heart, can lead to the destruction of the blood flow around the loops of the intestine through the squeezing of this arterial artery.

As a result, the compensatory mechanism of collateral blood circulation, Which will lead to a normal blood flow, be it a dilenka of the intestine. The whole mechanism of furrowing is as follows: the skin from the small intestine arteries on the ear from the ear (from 1 to 8 cm) extends on two heads: from the small intestine to the fall. The drooping head anastomoses from the lower back artery, and the backward one - from the lower back artery, setting the arc (arcade) of the first order.

From them distally (closer to the intestinal wall) enter new gilki, Yaki, split and conjoin oneself, make the arcades of a different order. From the rest of them come the gilts, which set up the arcades of the third and most high order. There are 3 to 5 arcades, the caliber of which changes in the world close to the intestine. Whenever you need it, it’s in the cob small intestineє Deprived of the arc of the first order, and in the world of closeness to the end of the small intestine of Budov's court arcades, the number of them grows faster.

The remaining row arterial arcades in 1-3 cm from the intestine wall, a loose, unbreakable vessel, from which to the brijovy edge of the small intestine goes into the rectum. One straight vessel supplying blood to the small intestine (Fig. 8.42). At the connection with the cym, the pockets of such vessels are 3-5 cm long, and I will more porous the blood flow on the tsiy dilyantsi.

Wounded and disarmed brigi in mezhah arcades(On the visible side of the intestine) I would like to see more severe bleeding through the large diameter of the arteries, but not to lead with these ligatures until the blood loss of the intestine is destroyed and the collateral blood loss through the artery.

arcade shy we can see the small intestine loop during the early operations on the shlunk chi stravohody. Dovgu loop is significantly easier to pull up to the organs, roztashovanim at the upper surface of the black empty, or to navigate in the middle.

However, go to mother on uvaz, to navit taka taut collateral hemlines can not help with embolism (blockage by a thrombus, which breaks down) of the upper bryzhovo artery. Most often, it is very fast until catastrophic inheritance. With an incremental sound education of the artery through the growth of an atherosclerotic plaque and the appearance of certain symptoms є a chance to help a sick person with a stent or prosthetic upper breech artery.

Primary video of the anatomy of the upper, lower Brigovian arteries and blood supply to the intestines

Blood posture of the intestine is healthy with small arterial vessels. To the right end of the intestine, go to the court from the upper Brigue artery, to the left - to the judge from the lower Bryzhovo artery (Fig. 406). Kintseviy viddil of the intestine, i.e., the rectum, with blood arteries, to go from the lower bryzhovo, internal club arteries and internal sorrow arteries.

406. Blood circulation of the intestine.

1 - mesocolon transversum; 2 - v. mesenterica inferior; 3 - a. mesenterica inferior; 4 - a. colica sinistra; 5 - colon descendens; 6 - aa. et vv. sigmoideae; 7 - a. et v. iliaca communis; 8 - a. et v. rectalis superior; 9 - colon sigmoideum; 10 - appendix vermiformis; 11 - caecum; 12 - a. et v. ileocolica; 13 - colon ascendens; 14 - a. et v. colica dextra; 15 - a. et v. mesenterica superior; 16 - a. et v. colica media; 17 - colon transversum.

From the upper brigade artery to the area of ​​the ileocecal kut, enter the club-rim artery, a. ileocolica. Vona go from top to bottom, looking to the right, and lie behind the neck, whistling the back wall. The height of the image is raised 6-10 cm below the scene of the upper brigade artery. Near the іleocecal cut, the club-rim artery extends to the club and rim of the head. The first straight line of the upper edge of the club gut and anastomoses to a. ilei, another near the inner edge of the upper bowel. From the club and rim of the gut, a number of vessels enter the bloodstream, which blood sucks, the intestine, the gut, the gut, and lymphatic universities tsy galuzi.

The artery of the wormlike appendage, a. arrendicis vermiformis, Enter the club-rim artery. The idea of ​​the artery of a worm-like outgrowth can grow in the form of a club-rim artery on a club and a rim of a head (the most part option), for example, at the very bottom. The artery of the worm-like outgrowth can also be seen from the club or the rim, as well as from a. ilei (fig. 407). The artery of the worm-like appendage grows from the back of the worm-like appendage to the back of the worm-like appendage, then passes at the edge of the worm-like appendage and goes up to 4-5 years.

407. Options a. appendicis vermiformis.

1 - a. ileocolica; 2 - a. appendicis vermiformis; 3 - ileum; 4 - appendix vermiformis; 5 - caecum.

Go to the top of the rim rim artery rights, a. colica dextra... It is easy to grow 5-8 cm lower than the cob of the upper brijov's artery. Vaughn can also be entered by a stubby burrow with a middle rim or club-rim artery.

The rights of the rim artery extend into two heads: fall and fall. The first of them is to go to the club-rim artery, to establish an arterial arc, from which to the upper rim intestine to enter the number of heads; a friend to head to the breech of the transverse rim intestine. In the case of the rights of the rim artery during the day, in such cases, the anastomosis of the upper rim artery of the club-rim artery will work in the middle of the rim artery.

The blood supply of the transverse rim intestine is designed to be decorated with arteries: middle rim, right rim, pre-middle rim, lvoy rim arteries or gilkoy.

Middle rim artery, a. colica media, Enter from the upper brijovo artery approximately 4-8 cm below the cob. Dodatkova middle rim artery can also be seen in most of the rim arteries from the upper brigade artery.

Naybilsh often brijov's channel is formed from two dzherel: middle rim artery and upper rim artery. As the Bryzhovo channel is formed from three arteries, then in the new one it takes part in some types of law and the middle of the rim arteries, as well as the hanging artery of the left rim arteries, in those of them - the middle of the rim arteries, arteries In fig. 408 represent options for blood flow of the transverse colon.

408. Variants of blood flow of the transverse colon intestine.

1 - colon transversum; 2 - a. colica media; 3 - a. mesenterica superior; 4 - colon descendens; 5 - a. colica sinistra; 6 - a. mesenterica inferior; 7 - a. ileocolica; 8 - colon ascendens; 9 - a. colica dextra.

Reduction of the main arterial stubs in the breech of the transverse rim artery of the offensive: in the right sector the middle rim artery is often found, in the middle sector there is one middle rim artery, or the additional middle of the rim artery. Most of the concentration of arterial stovburiv spasters in the right sector of the brig, earlier in the left and even further in the middle sector.

The main arterial stovburi, straight up to the transverse rim gut, spread over two heads. The players of the first order to form arcades of a different order, from which one can find one of the third order arcades. There are few arcades. From the endless arcades to the intestine wall go straight arterial vessels, which can be alone, if only for a few minutes.

The lower rim and sigmoid colon are supplied with blood from the system of the lower bridal artery, as they enter the aorta on the edge of the III transverse ridge, 3-4 cm into the bifurcation of the aorta. The artery grows behind the parietal collar of the posterior cervical wall and at the end of 3-5 cm from the side of the rim, the sigmoid and upper rectal artery. Liva rim artery, a. colica sinistra, heading obliquely from the bottom up the hill, from the right to the left and crossing onto its own road, the livy sechovid, as well as the inner life of the judgment. It appears from both lower and lower arms, which anastomose at the mountains with the arms of the middle or secondary middle rim arteries, and below - with the arms of the sigmoid artery. Gilki lіvoї rim arterіїanastomozuyushchikh are also like themselves. From arterial arches, which are established in the course of cych anastomoses, go straight arterial vessels to the intestinal wall.

Sigmoid artery, aa. sigmoideae, Enter from the lower brijovaya artery (most often) or from both rim and upper rectal arteries (Fig. 409). The number of them varies from one to the next. Straight up to the sigmoid intestine, the stench anastomose between itself, setting up arcades, from which you go straight to the intestinal wall.

409. Variant blood circulation in the sigmoid colon.

1 - a. mesenterica inferior; 2 - a. colica sinistra; 3 - aa. sigmoideae; 4 - colon sigmoideum; 5 - a. rectalis superior.

Upper rectal artery, a. rectalis superior, Є direct progressions of the lower brijovo artery. Straight downwards, you will see the cobbled view of the outward club artery and into the maliy pelvis.

On the back surface of the rectum, there are two or three pins extending to the intestine wall. Cycles anastomose between themselves, as well as between middle and lower rectal arteries.

Middle rectal artery, a. rectalis media, Enter from the inner club or the inner sorority artery. Vona pass along the upper surface m. levator ani and place in the lower part of the rectum ampoule.

Lower straight artery, a. rectalis inferior, Enter from the internal sorority artery in the sidnichny-rectal pit. Vona supplies the anal canal and the outward sphincter of the rectum. In fig. 410 is a diagram of rectal blood circulation.

410. Diagram of rectal blood circulation.

1 - aorta abdominalis; 2 - a. mesenterica inferior; 3 - a. colica sinistra; 4 - aa. sigmoideae; 5 - a. rectalis superior; 6 - a. sacralis media; 7 - a. iliaca communis; 8 - a. iliaca externa; 9 - a. iliaca interna; 10 - a. umbilicalis; 11 - a. glutaea superior; 12 - a. obturatoria; 13 - a. sacralis lateralis; 14 - a. glutaea inferior; 15 - a. Tectalis media; 16 - a. pudenda interna; 17 - a. rectalis inferior.

The arteries, which live the rectum, may have a number of anastomoses, so the ligation of the limbs does not lead to the blood circulation.

Lead the intestines up to the system of the upper and lower brijovy veins. Moreover, as a rule, the skin arterial stovbur, which is located up to the intestine, and also the arterial stovbur is superimposed on the same veins. Only in rare cases of venous storms go through the same arteries.

From the right flank of the intestine to the blood, go along v. ileocolica, v. colica dextra, v. colica media, which flow into the upper Brigovian vein.

From the intestine, as well as from the endometrium of the small intestine and the cob to the side of the intestine, the roof is shown along the club-rim vein. Rights of the rim vein take shelter from the viscid rim intestine. Vaughn can fall into the upper brijovyh vein independently or with a stubbore with a club-rim or middle rim veins.

The appearance of blood from the transverse colon is brought into the system of the upper and lower Brigovian veins. In the upper Brigovian veins, the middle of the rim and dodatkov rim veins flow; in the lower Brijovy vein, Vienna is heading, yak supervoduzhu vshіdnu gіlku lіvoї rim artery.

From the lower rim and sigmoid intestine from the blood, it grows along the left rim and sigmoid veins.

Lower Brijov Vienna, v. mesenterica inferior, who pretends to be the way of zlittya v. colica sinistra, vv. sigmoideae et v. rectalis superior spinal stop... From the breech of the transverse rim intestine, it grows into the plica duodenojejunalis, then from the side of the breech zone, and most often flows into the upper Brijovian vein, flowing into the splenic vein or into the cout of the vein.

The venous line of the rectum is composed of three gossips: submucosal, subfascial and pediatric. The submucosal gossip grows out of the mucous membrane of the intestine on the basis of the columnae anales. During the day of the mucus gossip, they pierce the mucous membrane of the intestine and get rid of the subfascial gossip, as it grows on the mucous membrane of the rectum. The upper and middle rectal veins, v. rectalis superior et vv. rectales mediae. Persha supravodzhu with the same artery and flowing into the lower Brigovian vein; others are located at the inner club vein. Pidshkirne venous gossip grows near the anal opening and the last sphinkter; the lower rectal veins, vv. rectales inferiores, form into vv. pudendae internae.

Visiting the intestine may cause a connection with the veins, so that it can be brought to the system of the lower empty vein (portacaval anastomoses). The cyst anastomosis is promoted in the cells of the extra-urethral space between the edges of the veins mesoperitoneally in the intestine: v. ileocolica, v. colica dextra, v. colica sinistra, and by the veins, which can be carried to the system of the lower empty vein: vv. lumbales, vv. testiculares, vv. ovaricae, vv. renales і ін. Especially developed anastomoses in the rectal area, through the venous gossip, there is a connection between the upper rectal veins and the middle and lower rectal veins.

Portacaval anastomoses are performed with maneuvers, according to some type of roofs from the portal vein system in case of liver cirrhosis or in case of thrombosis of the portal vein. In some cases, the presence of portacaval anastomoses in ignition processes in the area of ​​\ u200b \ u200bthe intestine, if promptly on the intestines, there may be a viscid thrombosis of the sudin, which can be carried to the system of the lower empty vein.

Intestinal blood circulation is healthy by the upper and lower Brigs arteries. The upper brisket artery extends from the cranial aorta on the level of the XII thoracic ridge to the III transverse ridge and from the side to the middle zone, twelve-fingered intestines, Thin and right half of the intestine. Anastasia-Mozir, an instinctual head, is surrounded by himself, creating arcades, from which one comes straight from the court, from where the thin head goes to the serozonyms of the sheaths. Tsі gіlki penetrate into the pidlizovy ball, de validate the gossip of judgment. Venous judges from the slime ball set up venous gossip, from which roofs are seen in the mesenteric vein. Half of the intestine will cut off the shelter from the lower Brigate artery, yaka anastomoses with the collaterals of the internal club artery and through the left rim of the artery from the arch of Rilan. From the blood from the left half of the intestine, go through the lower breech vein into the portal vein. The intestines in normal minds will take close to 20% of the heart wikidu, or 25% of the blood. The mucous sheath to wind in the minds of the physiological calm will take away 38% of the blood flow to the intestines. Intestine innervations go from celiac, upper and lower breeches gossip.

E. Kokhan, I. Zavarina

23084 0

Tovsty intestines with the blood of the upper and lower Brigs arteries. Zone of water supply of basins of both arteries in distal view the transverse colon is located between the middle and posterior portions of the primary intestine. The options for the distribution of the main arterial stoves are usually not large. More beautifully, go sudin, go to go transverse intestine... Tsim is assimilated by natural anatomical superimposition of the sudins (Fig. 1 A and B).

In normi judges, the intestines are anastomosed along the edge of the breech. The middle breeches are both peripheral and central anastomoses (Fig. 2). A thin peripheral artery is most clearly visible in the serpentine camp, which is called the marginal artery (Drummond artery, which in 1913 described the central and peripheral anastomoses). The central anastomoses are used for pathological camps, if there is a sound, or close to the education of the upper or lower brijovaya artery. Vinikak gradієnt vise between two vasodenal zones veda to the expansion of the erect central anastomoses, often velmi-valued. Tsi sudini bouly were called the vivid arteries of the brigades (the arcades of Riolan, which described them in the 17th century).

The options for the upper bryzhovo artery, especially for the ear, do not put a special strain on the tactics of the operation of the resection of the intestinal tract. Vinyatk becomes rіdkіsnі vipadki, if the upper and lower brijovy arteries may have a cob. The knowledge of the distribution of the brigades' arteries will assist the surgeon in the mobilization and rosetting of the brigades to start the process of finding the main vessels.

All three types of heads of the upper brijovaya artery - middle rims, rim rights and club-rims (Fig. 3) - may be the same more important... The middle rim artery shores the cob from the front wall of the upper brigade artery, immediately after the start of the sprout. Up to the intestines, the middle artery goes through the sheets of the transverse breech. Approximately 2/3 of the arteries are made of independent vessels, and in the third of the arteries there is a cob from the right rim artery. The rights of the rim artery only in four vipadkiv can be independently cob from the Upper Brigade artery and more often than not in the middle rim arteries and club-rim arteries.

13% of vipadkіv have the rights of the rim artery during the day. Yak і middle rim, club-rim artery є by an independent vessel in 2/3 vipadks, and in the third vypadkov there is a cob from the right rim artery. Pislya vidhozhennya gilok to slips and thin intestines, club-rim artery end at the vyglyadi of the appendicular artery, as seen in the glib, to the end of the small intestine and the reach of the brisket of the appendix.

The lower artery of the lower artery is seen from the rim artery, the artery of the sigmoid colon, which ends at the upper artery of the rectum (Fig. 4). Liva rim arteries can be supplied with blood for the zone, as if you want to live in the upper bryzhovo artery, or navpaki, - the zone can be supplied with blood from the basin of the rest arteries. The main blood loss of the rectum is the upper artery. There are two nozzles, which go along the back surface of the intestine, and the throat, go down along the front and back surfaces.

Gilks ​​of the upper rectal arteries of the middle rectal arteries, which come from the internal club arteries (only one middle rectal artery). Less significant for blood posture may be the lower rectal arteries, but to take the cob from the sorrow arteries. Gilki of the upper bridal vein, where they take shelter from the viscous and transverse viddiliv of the colon, pass the handguard with the gaps of the upper bridal artery (Fig. 5). The blood from both sides of the intestinal tract goes into the lower Brigovian vein, which passes through to the base of the breech of the transverse colon intestine directly from the same artery. Most often, the vein flows into the splenic vein in the lower pidshlunkovaya zalozi. One day you can fall into the upper brijovy vein, or a little bit of evil of the upper brijovy and spleen veins. The development of lymphatic vessels of the intestinal tract is visible in the course of the arteries.

The appendix with the blood of the endocytic gullet of the club-rim artery, as it goes to the breech of the growth behind the endometrium of the small intestine (Fig. 6). Kintseva dilyanka small intestineє Edinim, like on the protivo-fringe edge of the fat pad ("pivnyachi comb"), the service officer is an organizer for the jokes of the appendix. The growth of the growth grows in the middle of the evil three tenies. More often than not in half of the tumors, the appendix grows behind the mucous membrane. If the gut is too attached, then the sprout just lies behind it, and when it’s full of it, it’s empty. Well, the intestine is fixed, - the sprout grows behind her, ale retroperitoneally.

Wind G.J.

Applied laparoscopic anatomy: cherevna empty i maliy pelvis

First, talk about the development of sickness and surgery, take an important look at the anatomical peculiarities of the most important cystic health, as you can say, the share of people. If you go out of the way of the TBS, it is negative to think about biomechanics not only nig, but all locomotives, but it is not easy to bring them to invalidity.

The suglobs are holed up for sinews, the stench is correctly called "suglobovy bags."

Tazostegnovy suglob is the most effective member in organism. It is set up with two articulating cysts - a quilted cyst and a swivel basin of the pelvis. The head of the stegovyetsya in a bowl-like, bogged down pelvic brush, de von it is easy to collapse in different strains. The staff of such interconnection of two key elements will take care of:

• zignannya and razginannya;
• presentation and introduction;
• the wrapping is quilted.

Tilna part.

The surface of the interconnecting cysts is covered with a special elastic ball, we call the hyaline cartilage. The special spring allows the heads to go smoothly and without any problems. physical activity... In addition, the cartilage has the function of stabilization of the hip joint and shock absorption of the skin debris.

The design of the slope is placed in a small case - a sloped capsule. In the middle of the capsule, the synovial membrane is seated, for the production of specific ridine. Vona replace cartilage suglobovyh k_stok, Zvolozhuє i zbagachuє live rhymes I will adapt the structure of the cartilage in excellent condition.

The names of the capsule of the protruding supra-angular group of staghorn and pelvic oysters, zavdyaki yakim, vlasne, suglob і are brought into rukh. In addition, the most effective way to understand the difference is that it is more flexible, but it does not allow for overmixing the stegna, more physiological norms.

On the hip joint the seizure is the main part of it, so it is easy to get injured and sick up to high wear when unpleasant factors are diagnosed. Tsim and explain the fact that the disease is wider. It’s a pity that many children go to death until they die on the low term of arthrosis, since the functional possibilities have irreversibly been exhausted.

When negative manifestations break down the synthesis of synovial birth. Vona produce in catastrophically low quantities, change in the warehouse. In such a rank, the cartilage tissue is constantly inadequate for grubbing, it becomes anxious. The cartilage step by step consumes the colishness and elasticity, it grows and changes in the liabilities, so that the unworthy people can go on and on.