1. NG TIU HA CHNH THC Bs. Trn Kim Thng

2. MC TIU: 1. Nm c cu to m hc chung ca ng tiu ha chnh thc. 2. Nhn bit c cu to m hc ca thc qun, d dy v rut. 3. Phn bit c cu to m hc ca cc on rut non, rut gi v rut tha. 3. NI DUNG: I. C IM CU TO CHUNG CA NG TIU HA CHNH THC: T thc qun n hu mn. Cu to m hc ging nhau: 4 tng - Tng nim mc. - Tng di nim mc. - Tng c. - Tng v ngoi. 4. S cu to chung ca ng tiu ha Biu m Lp m C nim Nim mc Nim mc Di nim C V ngoi Lng ng 5. 1. Tng nim mc: T trong ra ngoi, 3 lp: - Biu m: + ph thuc vo CN. - Lp m: + MLK + Cha ng tuyn. - C nim: + Gia nim mc v tng di nim + CN: vn ng. 6. 2. Tng di nim mc Gn tng nim mc vi tng c. L MLK tha cha nhiu m/m, BH ln v m ri TK di nim (RTK Meissner). Thc qun, t trng: c cha cc tuyn nhy. 7. 3. Tng c C trn: trong vng, ngoi dc (tr thc qun, hu mn l thm c vn). Gia 2 lp c c RTK Auerbach. CN: gip nho trn v a thc n xung. 8. 4. Tng v ngoi: (thanh mc) + Chnh l l tng ca PMc. + Tr TQ v 1 phn trc trng. + MLK cha MM v TK. + BM lt n. 9. II. THC QUN: Ging phn cu trc chung. 1. Nim mc: - Biu m: Lt tng khng sng ha. - Lp m: cha tuyn thc qun - v. 2. Tng di nim: - C nhiu tuyn tit nhy 3. Tng c: - 1/4 trn: c vn,1/4 k xut hin c trn. 10. S cu to ca thc qun(ct ngang) 11. S cu to ca thc qun. 12. III. D DY Chia 4 vng: tm v, y v, thn v v mn v. 13. 1. Nim mc d dy - Biu m: BM T tit nhy khng TB i. - Lp m: + cha tuyn tng ng + y v v thn v c tuyn y v. - C nim: + Lp trong, ngoi: c vng. + Lp gia: c dc. 14. BM tr n ch tit nhy khng t bo i 15. Tuyn y v: 3 loi TB + TB chnh (TB sinh men): - Tit tin pepsinogen cha hot ha. Bt mu Baz. + TB Vin: (TB Thanh): - Ln hn TB chnh, tit HCl v KCl, bt mu acid. + TB ni tit d dy - rut: - y tuyn, gia cc TB chnh. 16. TB Vin (Thnh) TB Chnh (sinh men) 17. 2. Tng di nim: - MLK. 3. Tng c: - y, thn v: thm c cho / lp trong. - Mn v: c vng rt pht trin c tht mn v. 4. Tng v ngoi: l tng ca phc mc. 18. IV. RUT NON - Di nht. - Hp thu thc n . - Gm 3 on: t trng, hng trng, hi trng. 19. c im ca rut non: - C van ngang. - T trng c tuyn Brunner/di nim. - Trn b mt van ngang c nhiu nhung mao. - Trc lin kt nhung mao c nhiu mch dng chp trung tm. - Hi trng c mng Payer. - Tuyn Lieberkun c tt c cc on rut. - T bo i tng dn. 20. 1. Nim mc: + Van ngang: - Do tng di nim i tng nim mc ln. - t trng cha c van ngang. - Hng trng c nhiu van ngang , cng v di cng thp v tha dn n gc hi - manh trng th ht. - Khng b mt i k c khi rut cng phng do cha nhiu thc n. + Nhung mao: - Do lp m i biu m ln. - BM tr n. - TB hp thu, TB i, TB ni tit ng rut. - C tt c cc on rut non. 21. Tuyn Brunner t trng 22. Van ngang Nhung mao 23. Nhung mao 24. BM tr n rut non 3 loi TB: + TB hp thu (TB mm kha): - Hnh tr, cc ngn c nhiu vi nhung mao. + TB i (TB hnh ly): - Tit nhy, xen k vi cc TB hp thu. + TB ni tit d dy - rut (h ni tit lan ta): - Ri rc BM ph v tuyn Lieberkuhn. 25. BM tr n rut non 26. Tuyn Lieberkuhn: C 4 loi TB gm: + TB hp thu (TB mm kha). + TB i (TB hnh ly). + TB ni tit d dy - rut. + TB Paneth: hnh thp, y tuyn. 27. Tuyn Lieberkunh 28. y tuyn Lieberkuhn v t bo Paneth T bo Paneth 29. V. RUT GI: + Chc nng: - Hp thu nc, to phn. - Ch tit nhy bo v nim mc. + c im: - Khng c van ngang v nhung mao. - Biu m ging rut non nhng nhiu TB i hn. - C 3 dy c dc. 30. Rut gi 31. VI. RUT THA: Cu to m hc gn ging vi rut gi. Lng hp, khng u. M bch huyt rt pht trin. Tuyn Lieberkun t v ngn, khng c 3 dy c dc 32. RUT THA (CT NGANG) 33. TI LIU THAM KHO: 1. GS. Trng nh Kit, 1994, M Hc, NXB Y hc. 2. PGS.TS.BS. Nguyn Tr Dng, TS.BS. Phan Chin Thng, 2005, M hc, NXB Y hc. 3. Liz Carlos Juunqueira, 2003, Jos Carneiro, Basic Histology, Lange Medical Books McGraw-Hill, tenth editon, United States of American. 4. Jos Carneiro, Louis C. Junqueira & John A. Long, 1971, Basic Histology, Lange Medical Books McGraw-Hill, United States of American. 34. H thng tiu ha