Pastki kovak vena

Pastki kovak vena - bu pastki va butun tanadagi kislorodsiz qonni yurakning o'ng bo'lmachasiga olib boradigan katta vena. O'ng va chap umumiy yonbosh venalarining qo'shilishi natijasida hosil bo'ladi, odatda beshinchi bel umurtqasi sohasida joylashadi^[1]. Pastki kovak vena ikki kovak venaning pastki qismi bo'lib, organizmdan kislorodsiz qonni yurakning o'ng bo'lmachasiga olib boradigan ikkita katta qon tomirdir: pastki kovak vena tananing pastki yarmidan qonni olib boradi. Yuqori kovak vena esa tananing yuqori qismidan qon olib boradi. Birgalikda kovak venalari (yurak mushaklarining o'zidan qon olib yuradigan koronar sinusga qo'shimcha ravishda) aortaning venoz qon-tomirlarini hosil qiladi. Qorin bo'shlig'ining orqasida joylashgan va umurtqa pog'onasining o'ng tomonida joylashgan katta retroperitoneal vena^[2].U yurakning pastki o'ng, orqa tomonida o'ng quloqqa kiradi.

Pastki kovak vena chap va o'ng umumiy yonbosh venalarining qo'shilishi natijasida hosil bo'ladi va to'plangan qonni yurakning o'ng bo'lmachasiga olib keladi. Shuningdek, uning toq venasi (umurtqa pog'onasining o'ng tomonida joylashgan) va orqa miya yonidagi venoz pleksuslar bilan birlashadi .

Pastki kovak vena qorin orqasidagi chap va o'ng umumiy yonbosh venalarining belning beshinchi sohasida birlashishi bilan boshlanadi.T8 - T9 darajasida kaval ochilishida ko'krak diafragmasidan o'tadi^[3]. U tushayotgan aortaning o'ng tomoniga o'tadi^[3].

Tarmoqlar

Tarmoqlarning o'ziga xos darajalari quyidagilardan iborat:

Daraja	Tomir
T8	jigar venalari, pastki frenik vena
L1	o'ng suprarenal tomir, buyrak venalari
L2	o'ng gonadal vena
L1–L5	bel tomirlari
L5	umumiy yonbosh venalari

Pastki kovak vena o'rta chiziqning o'ng tomonida joylashganligi sababli, tarmoqlarning drenajlanishi har doim ham simmetrik bo'lmaydi. O'ng tomonda gonadal venalar va buyrak usti venalari to'g'ridan-to'g'ri pastki kavak venaga oqib tushadi. Chap tomonda ular buyrak venasiga quyiladi, bu esa o'z navbatida pastki kavak venaga oqib tushadi.Aksincha, barcha bel venalari va jigar venalari odatda pastki vena kovak venaga quyiladi.

Rivojlanish

Embrionda pastki kovak vena va o'ng quloq, yevstaxiy klapan sifatida ham tanilgan pastki vena kovak klapan bilan ajralib turadi. Voyaga etgan odamda bu klapan odatda butunlay regressiyalangan yoki endokardning kichik burmasi sifatida qoladi^[4].

Variantlari

Kamdan kam hollarda pastki kovak vena hajmi va joylashuvida farq qilishi mumkin. Katta arteriyalarning transpozitsiyasida pastki kovak vena chap tomonda joylashishi mumkin.

Odamlarning 0,2% dan 0,3% gacha^[5]. pastki kovak vena buyrak venalari darajasida ko'paytirilishi mumkin ^[6].

Pastki kava vena tomirdir . Kislorodsiz qonni tananing pastki yarmidan yurakning o'ng bo'lmachasiga olib boradi.

Tananing yuqori yarmidan kislorodsiz qonni olib yuradigan qon tomir yuqori vena kavadir .

Klinik ahamiyati

Pastki kovak vena bilan bog'liq patologik muammolar ko'pincha uning spazmi bilan bog'liq (yorilishlar kam uchraydi, chunki u past bosimga ega). Tashqi bosimning odatiy manbalari kengaygan aorta ( abdominal aorta anevrizmasi ) va qorin bo'shlig'i saratoni, masalan, yo'g'on ichak saratoni, buyrak hujayrali karsinomasi va tuxumdon saratoni hisoblanadi. Pastki kovak vena birinchi navbatda o'ng tomonda joylashgan bo'lganligi sababli, behush holatda bo'lgan homilador ayollarni chap tomonga burish kerak ( tiklanish holati ), unga bosimni kamaytirish va venoz qaytishni osonlashtirish maqsadida amalga oshiriladi. Kamdan kam hollarda, defekatsiya bilan bog'liq zo'riqish pastki kovak vena orqali qon oqimining cheklanishiga olib kelishi va hushidan ketishga olib kelishi mumkin^[7].

Pastki kava venaning berkilishi kamdan-kam uchraydi va hayot uchun xavfli holat sifatida shoshilinch davolanadi. Bu chuqur tomir trombozi, pastki kovak vena filtrlari, jigar transplantatsiyasi va venaga kateter qo'yish kabi jarrohlik muolajalar bilan bog'liq^[8].

Qo'shimcha tasvirlar

Vena cava inferior
Pastki kovak venaning oldindan ko'rinishi
Pastki kovak vena filtri
Pastki kovak vena 3d ko'rinishi

Manbalar

Anatomy photo:40:13-0101 at the SUNY Downstate Medical Center - "Posterior Abdominal Wall: Tributaries to the Inferior Vena Cava"
Cross section image: pembody/body12a—Plastination Laboratory at the Medical University of Vienna

↑ Dardis, Ronan M.; Saxena, Amar; Shad, Amjad; Chitnavis, Bhupal; Gullan, Richard (2012-01-01), Quiñones-Hinojosa, Alfredo (muh.), „Chapter 154 - Disc Replacement Technologies in the Cervical and Lumbar Spine“, Schmidek and Sweet Operative Neurosurgical Techniques (Sixth Edition) (inglizcha), Philadelphia: W.B. Saunders, 1777–1788-bet, doi:10.1016/b978-1-4160-6839-6.10154-6, ISBN 978-1-4160-6839-6, qaraldi: 2020-11-22
↑ Mozes, GEZA; Gloviczki, PETER (2007-01-01), Bergan, John J. (muh.), „CHAPTER 2 - Venous Embryology and Anatomy“, The Vein Book (inglizcha), Burlington: Academic Press, 15–25-bet, doi:10.1016/b978-012369515-4/50005-3, ISBN 978-0-12-369515-4, qaraldi: 2020-11-22
↑ ^3,0 ^3,1 Blumgart, Leslie H.; Schwartz, Lawrence H.; DeMatteo, Ronald P. (2017-01-01), Jarnagin, William R. (muh.), „Chapter 2 - Surgical and radiologic anatomy of the liver, biliary tract, and pancreas“, Blumgart's Surgery of the Liver, Biliary Tract and Pancreas, 2-Volume Set (Sixth Edition) (inglizcha), Philadelphia: Elsevier, 32–59.e1-bet, doi:10.1016/b978-0-323-34062-5.00002-9, ISBN 978-0-323-34062-5, qaraldi: 2020-11-22
↑ Turhan Yavuz; Nazli, C; Kinay, O; Kutsal, A (2002). "Giant Eustachian Valve: with Echocardiographic Appearance of Divided Right Atrium". Texas Heart Institute Journal 29 (4): 336–8. PMID 12484622. PMC 140300. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=140300.
↑ Stavropoulos, S. William; Solomon, Jeffrey A. (2011-01-01), Pretorius, E. Scott; Solomon, Jeffrey A. (muh.), „Chapter 30 - Inferior Vena Cava Filters“, Radiology Secrets Plus (Third Edition) (inglizcha), Philadelphia: Mosby, 223–227-bet, doi:10.1016/b978-0-323-06794-2.00030-4, ISBN 978-0-323-06794-2, qaraldi: 2020-11-22
↑ Gray's anatomy : the anatomical basis of clinical practice, 40th Susan Standring: , London: Churchill Livingstone, 2008. ISBN 978-0-8089-2371-8.
↑ Brophy, CM; Evans, L; Sumpio, BE (1993). "Defecation syncope secondary to functional inferior vena caval obstruction during a Valsalva maneuver". Annals of Vascular Surgery 7 (4): 374–7. doi:10.1007/BF02002893. PMID 8268080. https://archive.org/details/sim_annals-of-vascular-surgery_1993-07_7_4/page/374.
↑ Geehan DM, Inferior Vena Caval Thrombosis, emedicine.com, URL: http://www.emedicine.com/med/topic2718.htm, Accessed: August 3, 2005.

[:1-1] Dardis, Ronan M.; Saxena, Amar; Shad, Amjad; Chitnavis, Bhupal; Gullan, Richard (2012-01-01), Quiñones-Hinojosa, Alfredo (muh.), „Chapter 154 - Disc Replacement Technologies in the Cervical and Lumbar Spine“, Schmidek and Sweet Operative Neurosurgical Techniques (Sixth Edition) (inglizcha), Philadelphia: W.B. Saunders, 1777–1788-bet, doi:10.1016/b978-1-4160-6839-6.10154-6, ISBN 978-1-4160-6839-6, qaraldi: 2020-11-22

[:0-2] Mozes, GEZA; Gloviczki, PETER (2007-01-01), Bergan, John J. (muh.), „CHAPTER 2 - Venous Embryology and Anatomy“, The Vein Book (inglizcha), Burlington: Academic Press, 15–25-bet, doi:10.1016/b978-012369515-4/50005-3, ISBN 978-0-12-369515-4, qaraldi: 2020-11-22

[:2-3] 3,0 ^3,1 Blumgart, Leslie H.; Schwartz, Lawrence H.; DeMatteo, Ronald P. (2017-01-01), Jarnagin, William R. (muh.), „Chapter 2 - Surgical and radiologic anatomy of the liver, biliary tract, and pancreas“, Blumgart's Surgery of the Liver, Biliary Tract and Pancreas, 2-Volume Set (Sixth Edition) (inglizcha), Philadelphia: Elsevier, 32–59.e1-bet, doi:10.1016/b978-0-323-34062-5.00002-9, ISBN 978-0-323-34062-5, qaraldi: 2020-11-22

[4] Turhan Yavuz; Nazli, C; Kinay, O; Kutsal, A (2002). "Giant Eustachian Valve: with Echocardiographic Appearance of Divided Right Atrium". Texas Heart Institute Journal 29 (4): 336–8. PMID 12484622. PMC 140300. //www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pmcentrez&artid=140300.

[5] Stavropoulos, S. William; Solomon, Jeffrey A. (2011-01-01), Pretorius, E. Scott; Solomon, Jeffrey A. (muh.), „Chapter 30 - Inferior Vena Cava Filters“, Radiology Secrets Plus (Third Edition) (inglizcha), Philadelphia: Mosby, 223–227-bet, doi:10.1016/b978-0-323-06794-2.00030-4, ISBN 978-0-323-06794-2, qaraldi: 2020-11-22

[GRAYS40TH-6] Gray's anatomy : the anatomical basis of clinical practice, 40th Susan Standring: , London: Churchill Livingstone, 2008. ISBN 978-0-8089-2371-8.

[7] Brophy, CM; Evans, L; Sumpio, BE (1993). "Defecation syncope secondary to functional inferior vena caval obstruction during a Valsalva maneuver". Annals of Vascular Surgery 7 (4): 374–7. doi:10.1007/BF02002893. PMID 8268080. https://archive.org/details/sim_annals-of-vascular-surgery_1993-07_7_4/page/374.

[8] Geehan DM, Inferior Vena Caval Thrombosis, emedicine.com, URL: http://www.emedicine.com/med/topic2718.htm, Accessed: August 3, 2005.

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]