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ﻥﺁ ﻱﺎﻫ ﻥﺎﻳﺮﺷ ﻭ ﺐﻠﻗ ﻪﺑ ﻲﻧﺎﺳﺭ ﻥﻮﺧ
ﻪﺧﺎﺷ ﻭ ﺎﻫ ﻥﺎﻳﺮﺷ ﻦﻳﺍ . ﺩﺮﻴﮔ ﻲﻣ ﻡﺎﺠﻧﺍ ؛ ﺪﻧﻮﺷ ﻲﻣ ﺍﺪﺟ ﻱﺩﻮﻌﺻ ﺕﺭﻮﺋ ﺁ ﻱﺍﺪﺘﺑﺍ ﺯﺍ ﻪﻛ ﭗﭼ ﻭ ﺖﺳﺍﺭ ﻱﺮﻧﻭﺮﻛ ﻦﻴﻳﺍﺮﺷ ﻖﻳﺮﻃ ﺯﺍ ﺐﻠﻗ ﻪﺑ ﻲﻧﺎﺳﺭ ﻥﻮﺧ
ﺪﻧﺍ . ﻪﺘﻓﺮﮔ ﺭﺍﺮﻗ ﺩﺭﺎﻜﻴﭘﺍ ﺮﻳﺯ ﻱﺪﻨﺒﻤﻫ ﺖﻓﺎﺑ ﻥﻭﺭﺩ ﻭ ﺐﻠﻗ ﺢﻄﺳ ﻱﻭﺭ ﺎﻫ ﻥﺁ ﻱﺎﻫ
ﺖﺳﺍﺭ ﻱﺮﻧﻭﺮﻛ ﻥﺎﻳﺮﺷ
. ﺩﺮﻴﮔ ﻲﻣ ﺭﺍﺮﻗ ﻱﺮﻧﻭﺮﻛ ﺭﺎﻴﺷ ﻲﻣﺍﺪﻗ ﺖﻤﺴﻗ ﺭﺩ ﻭ ﺩﻭﺭ ﻲﻣ ﻮﻠﺟ ﻪﺑ ﺖﺳﺍﺭ ﻚﺷﻮﮔ ﻭ ﻱﺮﻧﻮﻤﻟﻮﭘ ﻥﺎﻳﺮﺷ ﻦﻴﺑ ﻭ ﻪﺘﻓﺮﮔ ءﺎﺸﻨﻣ ﻲﻣﺍﺪﻗ ﻲﺗﺭﻮﺋﺁ ﺱﻮﻨﻴﺳ ﺯﺍ
ﻪﺧﺎﺷ ﻥﺍﻮﻨﻋ ﺖﺤﺗ ﺎﺠﻧﺁﺭﺩ ﻭ ﺩﻭﺭ ﻲﻣ ﺶﻴﭘ ﻲﻔﻠﺧ ﻲﻨﻄﺑ ﻦﻴﺑ ﺭﺎﻴﺷ ﺎﺗ ﻱﺮﻧﻭﺮﻛ ﺭﺎﻴﺷ ﻲﻔﻠﺧ ﺖﻤﺴﻗ ﺭﺩ ﻭ ﻩﺩﻮﻤﻧ ﻊﻄﻗ ﺍﺭ ﺐﻠﻗ ﻲﻧﺎﺘﺤﺗ ﺭﺎﻨﻛ ﺲﭙﺳ
- 2 ( . 16 ﻞﻜﺷ ) ﺩﻮﺷ ﻲﻣ ﻡﺎﻤﺗ [ Posterior interventricular (descending) artery] ﻲﻔﻠﺧ ﻲﻨﻄﺑ ﻦﻴﺑ
ﻭ ﻡﻮﻟﻮﺒﻳﺪﻧﺎﻔﻨﻳﺍ ﻭ ﺪﺷﺎﺑ ﻲﻣ ﺖﺳﺍﺭ ﻦﻄﺑ ﻡﻮﻟﻮﺒﻳﺪﻧﺎﻔﻨﻳﺍ ﻱﻮﻠﺟ ﺭﺩ ﻪﻛ ،ﺖﺳﺍ ( Right conus artery ) ﺖﺳﺍﺭ ِﻲ ﻃﻭﺮﺨﻣ ِﻥﺎﻳﺮﺷ ،ﻥﺁ ﻪﺧﺎﺷ ﻦﻴﻟﻭﺍ
ﻭ ﻱﺰﻴﻠﻫﺩ ﻱﺎﻫ ﻪﺧﺎﺷ ،ﺖﺳﺍﺭ ﻚﺷﻮﮔ ﻭ ﻱﺩﻮﻌﺻ ﺕﺭﻮﺋﺁ ﻦﻴﺑ ﺯﺍ ﺭﻮﺒﻋ ﻦﻤﺿ ، ﺖﺳﺍﺭ ﻱﺮﻧﻭﺮﻛ ﻥﺎﻳﺮﺷ . ﺪﻳﺎﻤﻧ ﻲﻣ ﻲﻧﺎﺳﺭ ﻥﻮﺧ ﺍﺭ ﻥﺁ ﺭﻭﺎﺠﻣ ﻱﺎﻫ ﺶﺨﺑ
. ﺪﻨﻳﺎﻤﻧ ﻲﻣ ﻲﻧﺎﺳﺭ ﻥﻮﺧ ( ﺍﺭ ﻝﺎﻳﺮﺗﺍﻮﻨﻴﺳ ) ﻱﺰﻴﻠﻫﺩ - ﻲﺳﻮﻨﻴ ﺳ ﻩﺮﮔ ، ﻱﺰﻴﻠﻫﺩ ﻱﺎﻫ ﻪﺧﺎﺷ ؛ ﺩﻮﺷ ﻲﻣ ﺍﺪﺟ ﻥﺁ ﺯﺍ ﺖﺳﺍﺭ ﻲﻣﺍﺪﻗ ﻲﻨﻄﺑ
ﻲﻣ ﺍﺪﺟ ﺖﺳﺍﺭ ﻱﺮﻧﻭﺮﻛ ﻥﺎﻳﺮﺷ ﺯﺍ ﺖﺸﭘ ﻑﺮﻃ ﻪﺑ ﺭﻮﺒﻋ ﻦﻤﺿ ، ﺐﻠﻗ ﻲﻨﻴﻳﺎﭘ ﻪ ﻴﺷﺎﺣ ﺭﺩ ( Right marginal branch ) ﺖﺳﺍﺭ ﻝﺎﻨﻳژﺭﺎﻣ ﻥﺎﻳﺮﺷ
ﻩﻭﻼﻋ ، ﻲﻔﻠﺧ ِﻲ ﻨﻄﺑ ﻦﻴﺑ ﻥﺎﻳﺮﺷ . ﺩﻭﺭ ﻣ ﻲ ﺐﻠﻗ ﺱ ﺭ ﺃ ﻑﺮﻃ ﺑ ﻪ ﺐﻠﻗ ﻲﻧﺎﺘﺤﺗ ﻩ ﺭﺎﻨﻛ ﻱﻭﺭ ﻪﻛ ﻩﺩﻮﺑ ﻲﻣﺍﺪﻗ ﻲﻨﻄﺑ ﻱﺎﻫ ﻪﺧﺎﺷ ﻪﻣﺍﺩﺍ ﺭﺩ ﻥﺎﻳﺮﺷ ﻦﻳﺍ . ﺩﻮﺷ
ﻲﻨﻄﺑ ﻦﻴﺑ ﻩ ﺭﺍﻮﻳﺩ ِﻲﻔﻠﺧ ﺖﻤﺴﻗ ﻪﺑ ﻪﻛ ﺩﻮﺷ ﻲﻣ ﺐﻌﺸﻨﻣ ﻥﺁ ﺯﺍ ﺰﻴﻧ (Septal) ﻱﺍ ﻩﺭﺍﻮﻳﺩ ﻱﺎﻫ ﻪﺧﺎﺷ ، ﺖﺳﺍﺭ ﻭ ﭗﭼ ﻦﻄﺑ ﻲﻧﺎﺘﺤﺗ ﺢﻄﺳ ﻪﻳﺬﻐﺗ ﺮﺑ
ﺯﺍ ﻲﻜﻳ ،ﺪﺷ ﺮﻛﺫ ﻻ ﺎﺑ ﺭﺩ ﻪﻛ ﻥﺎﻨﭽﻤﻫ . ﺪﻫﺩ ﻲﻣ ﻥﻮﺧ ﻲﻨﻄﺑ ﻱﺰﻴﻠﻫﺩ ﻩﺮﮔ ﻪﺑ ﺹﺎﺨﺷﺍ ﺪﺻﺭﺩ 80 ﺭﺩ ﻱﺍ ﻩﺭﺍﻮﻳﺩ ﻪﺧﺎﺷ ﻦﻴﻟﻭﺍ . ﺪﻨﻜﻴﻣ ﻲﻧﺎﺳﺭ ﻥﻮﺧ
. ﺪﻨﻛ ﻲﻣ ﻲﻧﺎﺳﺭ ﻥﻮﺧ ﻩﺮﮔ ﻦﻳﺍ ﻪﺑ ﺹﺎﺨﺷﺍ ﺪﺻﺭﺩ 65 ﺭﺩ ﻪﻛ ﺖﺳﺍ ﻝﺎﻳﺮﺗﺍﻮﻨﻴﺳ ﻱﺍ ﻩﺮﮔ ﻥﺎﻳﺮﺷ ﺖﺳﺍﺭ ﻱﺮﻧﻭﺮﻛ ﻥﺎﻳﺮﺷ ﻱﺰﻴﻠﻫﺩ ﻱﺎﻫ ﻪﺧﺎﺷ
ﻚﻳ ﻭ ﭗﭼ ﻦﻄﺑ ﻭ ﺰﻴﻠﻫﺩ ﺯﺍ ﻲﻳﺎﻫ ﺶﺨﺑ ،ﻲﻨﻄﺑ - ﻱﺰﻴﻠﻫﺩ ﻭ ﻝﺎﻳﺮﺗﺍﻮﻨﻴﺳ ﻱﺎﻫ ﻩﺮﮔ ،ﺖﺳﺍﺭ ﻦﻄﺑ ﻭ ﺰﻴﻠﻫﺩ ﻩﺪﻤﻋ ﺖﻤﺴﻗ ﺖﺳﺍﺭ ﺮﻧﻭﺮﻛ ﻥﺎﻳﺮﺷ ﻞﻛ ﺭﺩ
. ﺪﻳﺎﻤﻧ ﻲﻣ ﻲﻧﺎﺳﺭ ﻥﻮﺧ ﺍﺭ ﻲﻨﻄﺑ ﻦﻴﺑ ﺍﻮ ﺭ ﻩ ﻳﺩ ﻲﻔﻠﺧ ﻡﻮﺳ
ﭗﭼ ﻱﺮﻧﻭﺮﻛ ﻥﺎﻳﺮﺷ
ﺱﻮﻨﻴﺳ ﺯﺍ ﻥﺁ ﻲﻠﺻﺍ . ﻨﺗ ﻪ ﺪﻫﺩ ﻲﻣ ﻥﻮﺧ ﺩﺭﺎﻛﻮﻴﻣ ﺯﺍ ﻱﺮﺘﺸﻴﺑ ﻢﺠﺣ ﻪﺑ ﻭ ﺩﺭﺍﺩ ﺖﺳﺍﺭ ﻱﺮﻧﻭﺮﻛ ﻥﺎﻳﺮﺷ ﻪﺑ ﺖﺒﺴﻧ ﻱﺮﺘﺸﻴﺑ ﺮﻄﻗ ﭗﭼ ﻱﺮﻧﻭﺮﻛ ﻥﺎﻳﺮﺷ
ﻪﺧﺎﺷ ﻭﺩ ﻪﺑ ﺎﺠﻨﻳﺍ ﻭ ﺭﺩ ﺪﺳﺮﺑ ﻱﺮﻧﻭﺮﻛ ﺭﺎﻴﺷ ﻪ ﺑ ﺎﺗ ﺩﻭﺭ ﻲﻣ ﻮﻠﺟ ﻪﺑ ﭗﭼ ﻚﺷﻮﮔ ﻭ ﻡﻮﻟﻮﺒﻳﺪﻧﺎﻔﻨ ﺍ ﻳ ﻦﻴﺑ ﻪﻠﺻﺎﻓ ﺭﺩ ﻭ ﺩﻮﺷ ﻲﻣ ﻉﻭﺮﺷ ﭗﭼ ﻲﻔﻠﺧ ﻱﺮﻧﻭﺮﻛ
ﻥﺎﻳﺮﺷ " ﻭ Anterior interventricular (descending) branch " ﻲﻟﻭﺰﻧ ﻱﺮﻧﻭﺮﻛ ﻪ ﺧﺎﺷ ﺎﻳ ﻭ ﻲﻣﺍﺪﻗ ﻲﻨﻄﺑ ﻦﻴﺑ ﻥﺎﻳﺮﺷ ﻱﺎﻫ ﻡﺎﻧ ﺑ ﻪ ﻲﻳﺎﻬﺘﻧﺍ
ﻭ ﺩﺮﻴﮔ ﻲﻣ ﺭﺍﺮﻗ ﻲ ﻣﺍﺪﻗ ﻲﻨﻄﺑ ﻦﻴﺑ ﺭﺎﻴﺷ ، ﺭﺩ ﻲﻣﺍﺪﻗ ﻲﻨﻄﺑ ﻦﻴﺑ ﻥﺎﻳﺮﺷ . ﺩﻮﺷ ﻲﻣ ﻢﻴﺴﻘﺗ (Circumflex branch) ﺲﻜﻠﻔﻣﻮﻛﺮﻴﺳ ﺎﻳ ﻲﺸﺧﺮﭼ
ﻩﺭﺍﻮﻳﺩ ﺯﺍ ﻱﺮﺘﺸﻴﺑ ﺖﻤﺴﻗ ،ﻱﺍ ﻩﺭﺍﻮﻳﺩ ﻱﺎﻫ ﻪﺧﺎﺷ . ﺩﻮﺷ ﻲﻣ ﺐﻌﺸﻨﻣ ﻥﺁ ﺯﺍ ﻱﺍ ﻩﺭﺍﻮﻳﺩ ﻱﺎﻫ ﻪﺧﺎﺷ ﻭ ﻲﻧﺎﻳﺮﺷ ﻁﻭﺮﺨﻣ ،ﭗﭼ ﻦﻄﺑ ﻲﻣﺍﺪﻗ ﻱﺎﻬﻧﺎﻳﺮﺷ
( . 16 ﻞﻜﺷ ) ﺪﻳﺎﻤﻧ ﻲﻣ ﻲﻧﺎﺳﺮﻧﻮﺧ ﺭ ﺍ ﻲﻨﻄﺑ ﻦﻴﺑ ﻩﺭﺍﻮﻳﺩ ﻲﻣﺍﺪﻗ ﻡﻮﺳ ﻭﺩ ﺩﻭﺪﺣ ﻲﻨﻌﻳ
ﺖﺤﺗ ﻭ ﺪﻨﺷﺎﺑ ﻲﻣ ﺮﺘﮔﺭﺰﺑ ﻪﻴﻘﺑ ﺯﺍ ﻪﻛ ﺩﻮﺷ ﻲﻣ ﻩﺪﻳﺩ ﭗﭼ ﻦﻄﺑ ﻲﻣﺍﺪﻗ ﺢﻄﺳ ﺭﺩ ﻞﻳﺎ ﻣ ﺭﻮﻃ ﺑ ﻪ ﻲﻣﺍﺪﻗ ﻲﻨﻄﺑ ﻦﻴﺑ ﻱﺎﻫ ﻪﺧﺎﺷ ﺯﺍ ﻪﺧﺎﺷ ﻭﺩ ﺎﻳ ﻚﻳ
ﺍﺪﺟ ﭗﭼ ﺮﻧﻭﺮﻛ ﻥﺎﻳﺮﺷ ﻲﻠﺻﺍ ﻪﻨﺗ ﺯﺍ ﻴ ًﺎﻤ ﻘﺘﺴﻣ ﻪﺧﺎﺷ ﻦﻳﺍ ﺩﺍﺮﻓﺍ ﺯﺍ ﻲﻀﻌﺑ ﺭﺩ . ﺩﻮﺷ ﻲﻣ ﻩﺪﻴﻣﺎﻧ (Left diagonal artery) ﭗﭼ ﻝﺎﻧﻮﮔﺎﻳﺩ ﻥﺎﻳﺮﺷ ﻥﺍﻮﻨﻋ
. ﺩﻮﺷ ﻲﻣ
ﻑﺮﻃ ﻭ ﺭﺩ ﺪﺳﺮﺑ ﻱﺮﻧﻭﺮﻛ ﺭﺎﻴﺷ ﻲﻔﻠﺧ ﺖﻤﺴﻗ ﺎﺗ ﻪﺑ ﺪﻧﺯ ﻲﻣ ﺭﻭﺩ ﺍﺭ ﺐﻠﻗ ﭗﭼ ﺭﺎﻨﻛ ﻭ ﺩﻭﺭ ﻲﻣ ﭗﭼ ﻑﺮﻃ ﻪﺑ ﻱﺮﻧﻭﺮﻛ ﺭﺎﻴﺷ ﺭﺩ ﺲﻜﻠﻔﻣﻮﻛﺮﻴﺳ ﻥﺎﻳﺮﺷ
ﺯﺍ : ﺪﻨﺗﺭﺎﺒﻋ ﻥﺁ ﻱﺎﻫ ﻪﺧﺎﺷ . ﺩﻮﺷ ﻲﻣ ﻡﺎﻤﺗ ﻲﺒﻠﻗ ﺐﻴﻠﺻ ﭗﭼ
ﻲﻔﻠﺧ ﻭ ﻲﻣﺍﺪﻗ ﻱﺰﻴﻠﻫﺩ ﻱﺎﻫ ﻪﺧﺎﺷ ﻲﻔﻠﺧ ﻭ ﻲﻣﺍﺪﻗ ﻲﻨﻄﺑ ﻱﺎﻬﻧﺎﻳﺮﺷ ،ﺪﻨﻛ ﻲﻣ ﺮﻴﺴﻣ ﻲﻃ ﺐﻠﻗ ﭗﭼ ﺭﺎﻨﻛ ﻱﻭﺭ ﻪﻛ ﭗﭼ ﻝﺎﻨﻳژﺭﺎﻣ ﻥﺎﻳﺮﺷ 1 .
ﺭﺩ ﺩﺭﺍﻮﻣ % 20 ﺭﺩ ﻲﻨﻄﺑ ﻱﺰﻴﻠﻫﺩ ﻩﺮﮔ ﻥﺎﻳﺮﺷ ﻭ ﺩﻮﺷ ﻲﻣ ﺍ ﺪﺟ ﺲﻜﻠﻔﻣﻮﻛﺮﻴﺳ ﻥﺎﻳﺮﺷﺯﺍ ﺹﺎﺨﺷﺍ % 35 ﺭﺩ ﻝﺎﻳﺮﺗﺁﻮﻨﻴﺳ ﻩﺮﮔ ﻥﺎﻳﺮﺷ 2 .
. ﺩﻮﺷ ﻲﻣ ﺍﺪﺟ ﺲﻜﻠﻔﻣﻮﻛﺮﻴﺳ ﻥﺎﻳﺮﺷ ﺯﺍ ﻲﺒﻠﻗ ِﺐﻴﻠﺻ ِﻲﻜﻳﺩﺰﻧ
ﻥﻮﺧ ﺍﺭ ﻥﺁ ﺕﺎﺑﺎﻌﺸﻧﺍ ﻭ ﻲﻨﻄﺑ - ﻱﺰﻴﻠﻫﺩ ﺕﺎﺠﺘﺳﺩ ﻦﻴﻨﭽﻤﻫ ﻭ ﻲﻨﻄﺑ ﻦﻴﺑ ﻩ ﺭﺍﻮﻳﺩ ﻭ ﭗﭼ ﺰﻴﻠﻫﺩ ، ﻦﻄﺑ ﻩﺪﻤﻋ ﺖﻤﺴﻗ ﭗﭼ ﺮﻧﻭﺮﻛ ﻥﺎﻳﺮﺷ 3 .
. ﺪﻳﺎﻤﻧ ﻲﻣ ﻲﻧﺎﺳﺭ
19
