Te Anatomy me te Physiology o te Ate
Ko te ate tētahi o ngā okana nui rawa atu, tino nui hoki o te tinana tangata. E mōhiotia whānuitia ana mō tana mahi ki te "whakakore paitini," engari he whānui ake ana mahi: te whakahaere i te pākia o ngā matūkai, te whakaputa i te au hei nakunaku, te penapena i ngā rahui pūngao, te whakaputa i ngā pūmua e tika ana mō te toto totoka, tae atu ki te whai wāhi ki te pūnaha ārai mate. Kia mārama ai tātou he aha te hiranga o te ate ki te oranga tonutanga, me tirotiro whānuitia te hanganga me te mahi a tēnei okana.
Te hanganga o te ate
I runga i te āhua o te tinana, kei te taha matau o runga o te kōhao puku te ate, i raro noa iho i te diaphragm. He wāhanga iti noa iho e toro atu ana ki te taha maui. I roto i ngā pakeke, ko te taumaha o te ate he 1,2–1,5 kg te toharite, koia te okana totoka nui rawa atu o te tinana. He maeneene te mata o te ate, ā, kua hipokina e te kāpūru o Glisson, he pūeru kiko honohono e āwhina ana ki te pupuri i te āhua o te okana, ā, e whakarato ana i te ara mō ngā oko toto me ngā awa au.
Kua wehea te ate ki ētahi pūrua. I runga i te āhua, ko ngā pūrua matau me ngā pūrua maui ngā wehenga matua, ko ngā pūrua kautā me ngā pūrua tapawhā kei raro. Heoi, i roto i te mahi hauora hou, ko te wehenga tino nui ko te wehenga mahi i runga i te rere o te toto me ngā awa au (te wehenga ate). E kiia ana tēnei pūnaha wehenga ko te wehenga a Couinaud, e wehea ana te ate ki ngā wāhanga e waru, ia wāhanga he toto motuhake me te rerenga au. He tino whai hua tēnei wehenga i roto i te pokanga ate, pērā i te tango i te pukupuku, nā te mea ka taea te tango i ngā wāhi motuhake me te kore e whakararu i te mahi whānui.
Ngā oko toto ate: He ahurei, he nui hoki te rere
Ko te āhua motuhake o te ate kei roto i ōna pūnaha toto e rua. Ka whiwhi te ate i te toto mai i:
1. Te uaua tomokanga ate (tata ki te 70–75% o te rere o te toto), e kawe ana i te toto whai matūkai mai i te ara nakunaku, te repe taiaki, me te whēkau.
2. Te uaua ate (tata ki te 25–30% o te rere o te toto), e kawe ana i te toto whai hāora mai i te ngākau.
Ka whakaranua te toto mai i ēnei pūtake e rua ki roto i ngā sinusoid ate, arā, ngā capillaries motuhake me ngā lumens whānui e āhei ai te whakawhiti matū pai. I muri i te haere i roto i ngā sinusoid, ka rere te toto ki roto i te uaua pokapū, kātahi ki roto i te uaua ate, ā, i te mutunga ki roto i te vena cava o raro ki te hoki ki te ngākau.
Hanganga Makariri: Ngā Lobules me ngā Pūtau Hiranga
Ko te wāhanga iti o te ate ko te pūwero ate, he āhua hexagonal tōna, ā, kei waenganui ko te uaua pokapū. Kei ngā kokonga o te pūwero ko te toru o ngā pūwero, arā, ko ngā peka o te uaua pūwero, ngā peka o te uaua ate, me ngā awa wai. E whakaata ana tēnei whakaritenga i te ariā o te "tohanga toto me te rerenga wai" o te ate: ka rere te toto mai i te toru o ngā pūwero ki te uaua pokapū, ko te awa wai ia ka rere i te taha kē atu mai i ngā hepatocytes ki ngā awa wai.
Ko ngā pūtau matua o te ate ko ngā hepatocytes, e hanga ana i ngā pereti pūtau, ā, e whai wāhi ana ki te nuinga o ngā mahi pākia. Haunga ngā hepatocytes, kei reira anō:
– Ngā pūtau Kupffer, arā, ngā macrophage ate e horomia ana ngā huakita, ngā toto whero tawhito, me ngā matūriki ke.
– Ngā pūtau stellate (Ito), e penapena ana i te huaora A; ki te whakahohehia tonutia, ka taea te whakaputa collagen me te whakaoho i te fibrosis.
– Ngā pūtau endothelial sinusoidal, he pūwero ēnei, ā, he māmā ake te whakawhiti matū i waenga i te toto me ngā hepatocytes.
Te Ate
Ko te āhua o te ate he raupapa uaua o ngā tukanga e pupuri ana i te taurite o roto o te tinana (homeostasis). Anei ētahi o ngā mahi tino nui a te ate.
1. Te Hanga me te Whakaputa Au
Ka hangaia te au e ngā pūtau ate, ā, ka haria mā roto i ngā awa au ki te awa ate. Kātahi ka rongoatia, ka whakaemihia ki roto i te pūkahukahu i mua i te tukunga ki te duodenum. Kei roto i te au ngā tote au, te bilirubin, te cholesterol, ngā phospholipid, me ngā electrolytes. Ko āna mahi matua ko:
– Ka whakapūmau i te ngako kia ngāwari ai te nakunaku e te whākōkī lipase.
– Āwhina i te mimiti o ngā huaora wairewa-ngako (A, D, E, K).
– Hei ara whakaputanga mō te bilirubin me te cholesterol.
2. Te Pūnaha Whakaora Warowaihā: Te Pupuri i ngā Taumata Huka Toto
Ko te ate te kaiwhakaū i te huka toto. Ina teitei te taumata huka i muri i te kai, ka rongoa te ate i te huka i roto i te ahua o te glycogen (glycogenesis). Ina heke te taumata huka, ka pakaru te ate i te glycogen hei huka (glycogenolysis). Mena ka pau ngā toa glycogen, ka whakaputa te ate i te huka hou mai i ngā waikawa amino, te lactate, te glycerol rānei mā te gluconeogenesis. Mā tēnei tikanga ka mau tonu te tuku pūngao ki te roro me ētahi atu kiko.
3. Te Pūnaha Ngako: Cholesterol me ngā Lipoprotein
Ko te ate te pokapū o te pākia o te ngako. Ko tēnei okana:
– Ka hanga i te cholesterol me ngā phospholipid.
– Ka hanga i ngā lipoproteins (hei tauira, VLDL) hei kawe i te ngako i roto i te toto.
– Whakawaikura i ngā waikawa ngako hei pūtake pūngao.
– Ka huri i ngā warowaihā me ngā pūmua nui rawa hei triglycerides hei penapena.
Mā te kore taurite o tēnei tukanga ka puta te kohikohinga ngako i roto i te ate (steatosis), ka taea ai te mumura me te kino atu mēnā ka haere tonu.
4. Te Pūmua Pūmua: Te Pūmua me ngā Tauwehenga Taupoki
Ka hangaia e te ate ngā momo pūmua plasma nui, tae atu ki:
– Ko te albumin, e pupuri ana i te pēhanga osmotic o te toto me te kawe i ngā momo matū (ngā homoni, ngā rongoā, ngā waikawa ngako).
– Ngā take toto totoka (hei tauira, fibrinogen, prothrombin, ngā take VII, IX, X).
– Ngā pūmua kawe pērā i te transferrin me te ceruloplasmin.
Haunga te hanga, ka whakahaere anō hoki te ate i te pākia o te waikawa amino. Ko te haukini paitini, he hua o te pakaru o te waikawa amino, ka hurihia hei urea mā te huringa urea, kātahi ka tukuna mā roto i ngā whatukuhu.
5. Te Whakakore i ngā Paitini me te Whakawhitinga Koiora o ngā Tarukino
Ko tētahi o ngā mahi tino rongonui a te ate ko te huri i ngā matū kino ki ngā āhua e ngāwari ake ai te puta atu. Ka tutukihia tēnei tukanga mā roto i ngā whākōkī, inā koa te pūnaha cytochrome P450, e whakapūmau ana i ngā raau taero, te waipiro, me ngā paitini. Ko te whakakorenga paitini e puta ana i ngā wāhanga e rua:
– Wāhanga Tuatahi: te waikura, te whakaiti, te waikura rānei, e whakarerekē ana i te hanganga o te matū.
– Wāhanga II: te hononga (hei tauira ki te glucuronide, ki te sulfate rānei), ka wairewa ake te matū ki te wai kia ngāwari ai te puta i roto i te au, i te mimi rānei.
Nō reira, mā te ngoikore o te mahi a te ate ka roa ake te noho o ngā rongoā ki roto i te tinana, ā, ka nui ake te mōrearea o ngā pānga taha.
6. Te Rokiroki i ngā Matū Hira
Ko te mahi a te ate hei putunga rahui:
– Ko te glycogen hei pūngao rahui.
– Ngā huaora: A, D, E, K, me te huaora B12.
– Ngā kohuke: inā koa te rino (i roto i te āhua o te ferritin) me te parahi.
Mā ēnei rahui ka kaha ake te tinana ki te ātete ki ngā wā kore kai, ki ngā āhuatanga rānei o te ahotea pākia o te tinana.
7. Te Mahi Ārai Mate me te Tātari Toto
Mā roto i ngā pūtau Kupffer, ka tātarihia e te ate te toto mai i te ara kai, he nui ngā huakita me ngā endotoxins. He mea nui tēnei tikanga nā te mea ko ngā whekau te pūtake nui o ngā moroiti me ngā matū ke. Nō reira, ka mahi te ate hei "wāhi tirotiro" i mua i te urunga o te toto ki te tohanga pūnaha.
Te Whakaurunga o te Anatomy me te Physiology: He aha te Hanganga e Tautoko ana i te Mahi
Mā te hanganga pūwero o ngā sinusoid ka taea e ngā hepatocytes te whiwhi matūkai, rongoā, me ngā paitini mai i te toto. Ko te rere o te toto e ahu mai ana i te uaua portal te take e haere tuatahi ai tetahi mea e mimitihia ana mai i ngā whekau mā te ate (te pānga tuatahi-haere), ka pā ki te whai huatanga o ngā rongoā ā-waha. I taua wā, ko te pūnaha awa au, e rere ana i te taha ke atu i te rere o te toto, ka whakarite kia taea te kohikohi me te whakaputa i ngā hua para pēnei i te bilirubin.
Te Katinga
He okana maha-mahi te ate, he āhua motuhake tōna hanganga hei tautoko i ōna mahi whānui. Mai i ngā hanganga nui pēnei i ngā lobes me ngā wāhanga ki ngā waeine moroiti pēnei i ngā lobules me ngā sinusoids, ka whai wāhi katoa ki te kaha o te ate ki te whakahaere i te pākia o te tinana, te whakaputa au, te penapena i ngā matū nui, me te tango paitini. Ehara i te mea he mea nui anake te mārama ki te hanganga me te āhua o te ate mō te ao hauora, engari ka āwhina hoki i te marea ki te mōhio ko te pupuri i te hauora o te ate—mā te kai taurite, te korikori tinana, te karo i te waipiro nui, me te whakamahi tika i ngā rongoā—he haumitanga nui ki te hauora whānui.
