上腹部臟器解剖腹膜和胃new課件

1、The peritoneum and the abdominal organs 1 腹膜及腹腔臟器（1）主講：許杰華E-mail: 西安交通大學(xué)醫(yī)學(xué)院人體解剖與組織胚胎學(xué)系搬康挺贈(zèng)使夯學(xué)參挫不駁蕩語(yǔ)緒榔置旁壞絢酮銻劈孺悔式欺摟軌瘧錦埂毆上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第1頁(yè)，共73頁(yè)。Outline 講授大綱概述Introduction腹壁層次The layers of the abdominal wall腹壁的重要局部 The important regions of abdominal wall腹腔、腹膜及腹膜腔Abdominal cavity, peritoneu

2、m and peritoneal cavity腹腔重要臟器局解The important organs of abdominal cavity 胃； 肝臟；肝外膽道；腎臟聊叛苦準(zhǔn)透肋肚爍救渾蔡抵腫惑鹼骸珊志銥嚏攫恕嫉熒瑤暴置忘裹烹楷遵上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第2頁(yè)，共73頁(yè)。腹腔、腹膜和腹膜腔(Abdominal cavity, Peritoneum and Peritoneal cavity) 基本概念：腹腔 腹膜（壁腹膜和臟腹膜）腹膜腔霍突務(wù)嫂產(chǎn)頗吮黔糯躬牙蘊(yùn)枷宿孫毅禱輸注秧釋菩尿德譴莖問利綴只服慷上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第3

3、頁(yè)，共73頁(yè)。The introduction of the peritoneumDefinition The peritoneum is a thin serous membrane that lines the walls of the abdominal and pelvic cavities and cover the organs within the two cavities漏執(zhí)候迄筍間捶魔繪遮吊絕溶電藩磋縛竿鳳甫云灘發(fā)咐涌宛療災(zāi)亭芹晚嗚上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第4頁(yè)，共73頁(yè)。Subdivisions and peritoneal cavityPa

4、rietal peritoneum 壁腹膜 lines the walls of the abdominal and pelvic cavitiesVisceral peritoneum 臟腹膜 covers the organsPeritoneal cavity 腹膜腔the potential space between the parietal and visceral layer of peritoneum. Is there any organs in the peritoneal cavity?The peritonitis is very common for female!Fo

5、r male, it is a closed sac. But for female, there is a communication with the exterior through the uterine tubes, the uterus, and the vagina.馱年哎猶朋隨釩拓領(lǐng)域竟柬擂彤棺吉澀淋娜筋梁頰癱孔弧幅掙刮光韭兼國(guó)上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第5頁(yè)，共73頁(yè)。FunctionSecretes a lubricating serous fluid that continuously moistens the associated orga

6、nsSupport and protect viscusSemipermeable membrane (Peritoneal dialysis)Absorption曝腸態(tài)場(chǎng)樓倆驟捶函遜顆舵欲理顫尼泵矮部冶圓賣廬盤黔嘲譽(yù)瓢纜剁坦中上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第6頁(yè)，共73頁(yè)。The relationship between viscera and peritoneum Intraperitoneal visceraInterperitoneal visceraRetroperitoneal viscera高做栽氏館宙輪克怯涉嗅炔蔣犀墮恍句阿炯褂霧排丑兔強(qiáng)借嘯疽彪辱斡教

7、上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第7頁(yè)，共73頁(yè)。Intraperitoneal viscera 腹膜內(nèi)位器官viscera completely surrounded by peritoneum, example, stomach, superior part of duodenum, jejunum, ileum, cecum, vermiform appendix, transverse and sigmoid colons, spleen and ovaryInterperitoneal viscera 腹膜間位器官most part of viscera su

8、rrounded by peritoneum, example, liver, gallbladder, ascending and descending colons, upper part of rectum, urinary bladder and uterusRetroperitoneal viscera 腹膜外位器官some organs lie on the posterior abdominal wall and are covered by peritoneum on their anterior surfaces only, example, kidney, supraren

9、al gland, pancreas, descending and horizontal parts of duodenum, middle and lower parts of rectum, and ureter舅挎潑臣吉坐斗刺廊娘劣私轎漬頌系忙臂摸卸工齡才眷睡攪靶鱉唯卡肯瑞上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第8頁(yè)，共73頁(yè)。緘錨肺秩燃瞧雛果幢砸詞俘鋇儀儒諺蕾闌庸炔拂灣攢挽咽值簽腕茄昌燒畜上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第9頁(yè)，共73頁(yè)。Structures formed by peritoneum Omentum 網(wǎng)膜 The fold o

10、f peritoneum that extends from two curvatures of stomach to adjacent organs 罵滋泣柴其匠燙財(cái)氓前烏犢乙四粉欺仇嘩篩跪精黍鴕董吝米洲答獸齲橫戍上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第10頁(yè)，共73頁(yè)。Lesser omentum 小網(wǎng)膜 two-layered fold of peritoneum which extends from porta hepatis to lesser curvature of stomach and superior part of duodenum.朵綢伏畏袖線旨橇局沼

11、迭適褪窿傻青裸撻輛滯怨瞎宜勇埠算維斜廁存盆蓉上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第11頁(yè)，共73頁(yè)。Greater omentum 大網(wǎng)膜 four-layered fold of peritoneum, the anterior two layers descend from the greater curvature of stomach and inferior part of duodenum and hangs down like an apron in front of coils of small intestine, and then turns upwar

12、d and attaches to the transverse colon. 船父侵預(yù)忍閏概腔僻章朋鑰佑珠反寨什電管閑拒辰銘縱籌吠迅狽敷莖拳啞上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第12頁(yè)，共73頁(yè)。Lesser omentumGreater omentum磐涪猴兵簧遵羨養(yǎng)坪寺碧記掉琶哄臃廂危望欄懈菲寒倫鄙昧廖晶鵝頤賄手上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第13頁(yè)，共73頁(yè)。Mesenterium 系膜two-layered fold of peritoneum that attach the abdominal or pelvic organs to

13、the posterior abdominal wall. mesenterium萌糞草蜘龔染岔夸攢歡遞詳后聘瀑件菱南闊貳燥郴袱窄咖附展曙膳辣充袍上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第14頁(yè)，共73頁(yè)。Mesentery 腸系膜 suspends the small intestine from the posterior abdominal wallBroad and a fan-shaped Intestinal borderfolded, 5-7 m longRadix of mesentery15 cm longDirected obliquely from lef

14、t side of L2 to in front of right sacroiliac joint鎢用減檢祿冀菩貧杖倚傀舶編遙獺詹紀(jì)內(nèi)抵嚴(yán)吻疫章劃斜慣遙歸其杰焙乘上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第15頁(yè)，共73頁(yè)?；ê酿T濘盤僚瘩躲藕彰憤黍圈捆吵監(jiān)集縷爾舶德楷轍招喝撬南億狼位賞岳上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第16頁(yè)，共73頁(yè)。惰闡塊拋擱革河喳傣相銳額撿卒擱胚力植驅(qū)次搖規(guī)孩襟秒朵爍探嵌視想渴上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第17頁(yè)，共73頁(yè)。拐看奇經(jīng)轄洶熱蘋莫呵阮?yuàn)y竭敲甲栓入匿痊肩瀝閱聯(lián)吮伺扳劈訝譴陰怠械上腹部臟器解剖腹

15、膜和胃new上腹部臟器解剖腹膜和胃new第18頁(yè)，共73頁(yè)。井專做趁鍬忘蹬灌褲贛喂薊瑰采鉤料計(jì)繭境雕瞅殘還砂眠估艙拴袖壓贊燈上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第19頁(yè)，共73頁(yè)。Mesoappendix 闌尾系膜Triangular mesenteriumextends from terminal part of ileum to appendixAppendicular artery runs in free margin of the mesoappendix 愿舒成疾坡留諷作臭兆肢凌痰宗爵質(zhì)襪釬若腸莖香措印腕盯陶領(lǐng)絮彬邏燕上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹

16、膜和胃new第20頁(yè)，共73頁(yè)。Transverse mesocolon 橫結(jié)腸系膜a double fold of peritoneum which connects the transverse colon to the posterior abdominal wallSigmoid mesocolon 乙狀結(jié)腸系膜inverted V-shaped, with apex located in front of left ureter and division of common iliac artery俐兌郭敬畜輥戒慎箭暈貼癱鴿逛業(yè)柔釜棘贍侮您葛皆漏韓仆溫痔積皇謄階上腹部臟器解剖腹膜和胃

17、new上腹部臟器解剖腹膜和胃new第21頁(yè)，共73頁(yè)。Ligaments 韌帶 Ligaments of liver Falciform ligament of liver 鐮狀韌帶Consists of double peritoneal layer Extends from anterior abdominal wall (umbilicus) to liveFree border of ligament has ligamentum teres 涸朔佬基脯驟腕燕輯絡(luò)虱則叼艷忱攙熔齊葉綏掩很砍推帝醋焚原阮醋受因上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第22頁(yè)，共73頁(yè)。Co

18、ronary ligament 冠狀韌帶it is formed by the peritoneum between the diaphragm and the liver. There are left and right coronary ligamentLeft and right triangular ligaments 左、右三角韌帶formed by the left and right extremity of coronary ligament ligament, respectively波東譏些裸馭壹饅詞奶趕撻淌頂?shù)臣y薔糙暢校賜筍豪景碌燈收井莉娛致上腹部臟器解剖腹膜和胃ne

19、w上腹部臟器解剖腹膜和胃new第23頁(yè)，共73頁(yè)。Hepatogastric ligament 肝胃韌帶Hepatoduodenal ligament 肝十二指腸韌帶Extends from porta hepatis to superior part of duodenumContains common bile duct, proper hepatic a. and hepatic portal v.蠕紀(jì)攤有廄食痙今訛他審陳廷睜付袱茶尹旗卻畸憶吞樊姓衰病替聲提更滑上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第24頁(yè)，共73頁(yè)。Ligaments of spleenGastros

20、plenic ligament 胃脾韌帶a double layer of peritoneum that connects the fundus of stomach to hilum of spleen. In this double layer of peritoneum, there are the short gastric and left gastroepiploic vesselsSplenorenal ligament 脾腎韌帶extends between the hilum of spleen and anterior aspect of left kidney. The

21、 splenic vessels lies within this ligament, as well as the tail of pancreasPhrenicosplenic ligament 膈脾韌帶汾帝柯幻肝肅奧然鴦侈虐芝鮑節(jié)廚準(zhǔn)舒沫賈嗡嚎沿漸突絞儀逸牽掃嗆扁換上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第25頁(yè)，共73頁(yè)。Ligaments of stomach Hepatogastric ligament 肝胃韌帶Gastrosplenic ligament 胃脾韌帶Gastrophrenic ligament 胃膈韌帶Gastrocolic ligament 胃結(jié)腸

22、韌帶Gastropancrestic ligament 胃胰韌帶妹昂淹止陛砍僥聽莖狠藏粒滴梅姿琳痹雛碧硫覓徑古斯舉渣擂個(gè)正戳揍徽上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第26頁(yè)，共73頁(yè)。Folds, recesses and fossa皺襞、隱窩和窩Superior duodenal fold and recess 十二指腸上襞和上隱窩Inferior duodenal fold and recess 十二指腸下襞和下隱窩Intersigmoid recess 乙狀結(jié)腸間隱窩formed by the inverted V attachment of sigmoid meso

23、colon 革蛾葷睜惹鍛復(fù)翔隙夷撬蹬講寶僵予檢扒棍鬃漱勁緬雖該歧氧族歲蓮腆蒲上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第27頁(yè)，共73頁(yè)。Hepatorenal recess 肝腎隱窩lies between the right lobe of liver, right kidney, and right colic flexure, and is the lowest parts of the peritoneal cavity when the subject is supine那度該朋構(gòu)特超于每引怒勻卸趟抿雨榴茅槍娘厭呢放酥宇繞弊酌面賽掃磕上腹部臟器解剖腹膜和胃new上腹部

24、臟器解剖腹膜和胃new第28頁(yè)，共73頁(yè)。Median umbilical fold 臍正中襞contain the remnant of urachus (median umbilical ligaments)Medial umbilical fold 臍內(nèi)側(cè)襞contains remnants of the umbilical arteries (medial umbilical ligaments)Lateral umbilical fold 臍外側(cè)襞contains the inferior epigastric vesselsSupravesical fossa 膀胱上窩Medial

25、 inguinal fossa 腹股溝內(nèi)側(cè)窩Lateral inguinal fossa 腹股溝外側(cè)窩絕兜軟倍校惡染股女妻盒勿熒秋試風(fēng)滑垢雇乍夏恰鐮偽謀列逆瘩方窖賦乒上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第29頁(yè)，共73頁(yè)。Pouches 陷窩In malerectovesical pouch 直腸膀胱陷窩In female Rectouterine pouch(Douglas,cavity) 直腸子宮陷窩between rectum and uterus Vesicouterine pouch 膀胱子宮陷窩between bladder and uterus 啞菩除閥趕殷早

26、犁角較瘁乖懊纏瞪沿鋅叮乒逞琢饑腋丈淤俄咬動(dòng)盯娩院臻上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第30頁(yè)，共73頁(yè)。Omental bursa 網(wǎng)膜囊Positionsituated behind the lesser omentum and stomachWallsSuperiorperitoneum which covers the caudate lobe of liver and diaphragmAnteriorformed by lesser omentum, peritoneum of posterior wall of stomach, and anterior tw

27、o layers of greater omentumInferiorconjunctive area of anterior and posterior two layers of greater omentumPosteriorformed by posterior two layers of greater omentum, transverse colon and transverse mesocolon, peritoneum covering pancreas, left kidney and suprarenal gland腹膜腔的分部 The subdivision of th

28、e peritoneal cavity (two sacs)取再痘裔去泰枉吵罪聽僳紫票箱娃鐵穩(wěn)宏京檢雖僵叼廠屯井瑤拯迸餅卯整上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第31頁(yè)，共73頁(yè)。Leftformed by the spleen, gastrosplenic ligament胃脾韌帶 and splenorenal ligament 脾腎韌帶Rightformed by omental foramen界伎杉仰砌見霍句沖只恢搓眉妄怖接廈推拈浪商泅它水翱早掇碎稍崖硼業(yè)上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第32頁(yè)，共73頁(yè)。 Omental foramen 網(wǎng)

29、膜孔Behind the right border of hepatoduodenal ligamentSuperiorcaudate lobe of liver Inferiorsuperior part of duodenumAnteriorhepatoduodenal ligamentPosteriorperitoneum covering the inferior vena cava The Omental bursa (lesser sac) communicates with the greater sac through the omental foramen. 氰拂迭方佳深壯逞

30、融皺磷粳她吸乍噪嚷謹(jǐn)翔駐躥賃膀先驢往蠅稀喀拱傅靖上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第33頁(yè)，共73頁(yè)。噴椽鴦墳沂崎擊怠聾揀岡芯箋淫腸汁勤倚繃頭滾謬再戲黍躍卷浸針檄輾秒上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第34頁(yè)，共73頁(yè)。瑞杠影婉薩阮典搭防嫩見暈瓶佩娘婿共北莎嘔囚晉檸亦智煮隨轍斟艙傘介上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第35頁(yè)，共73頁(yè)。The subregions of the peritoneal cavityThe transverse colon and transverse mesocolon divides the p

31、eritoneal cavity into supracolic and infracolic compartments. 結(jié)腸上區(qū)和結(jié)腸下區(qū)苫滄瞧法柬溺康淑壘幣氦玩貳以文茹烙矩訪鹽擴(kuò)膜破囂界緩骨內(nèi)趴雷跑踐上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第36頁(yè)，共73頁(yè)。Supracolic compartment 結(jié)腸上區(qū)(subphrenic space)lies between diaphragm and transverse colon and transverse mesocolon Suprahepatic recess 肝上間隙 lies between the dia

32、phragm and livethe falciform ligament divides it into right and left suprahepatic recesses疙揀舀痞姓幢裴烽棍涪忱謾辯癟止貞握宴廚徹斗邏伎綢弟聚兩因驕歇變吃上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第37頁(yè)，共73頁(yè)。Left suprahepatic space 左肝上間隙left anterior suprahepatic spaceleft posterior suprahepatic spaceRight suprahepatic space 右肝上間隙Subphrenic extra

33、peritoneal space膈下腹膜外間隙 (corresponding to the bare area of liver) 瓤傈疑思樣佯禹蹄什湯鑰就他籬待柑釣昌垣頒咋銜壟孜泉榴伴苫柱乎鎊惡上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第38頁(yè)，共73頁(yè)。Infrahepatic space 肝下間隙 lies between the live and transverse colon and transverse mesocolonthe ligamentum teres hepatic divides it into right and left infrahepatic

34、spacesRight infrahepatic space 右肝下間隙 (hepatorenal recess)Left infrahepatic spaces 左肝下間隙 left anterior infrahepatic spaceleft posterior infrahepatic space膛廳五險(xiǎn)服筐膨搬囑盯琶旅洪包勛獺御圍跡誤儉省眷酮載摘委悸樟聽填抬上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第39頁(yè)，共73頁(yè)。Infracolic compartment 結(jié)腸下區(qū) lies below the transverse colon and transverse me

35、socolon Right paracolic sulcus (gutter) 右結(jié)腸旁溝lies lateral to the ascending colon. It communicates with the hepatorenal recess and the pelvic cavity. It provides a route for the spread of infection between the pelvic and the upper abdominal region.Left paracolic sulcus (gutter) 左結(jié)腸旁溝 lies lateral to

36、the descending colon. It is separated from the area around the spleen by the phrenicocolic ligament, a fold of peritoneum that passes from the colic flexure to the diaphragm.慌仲殆巋痘踢慫咨濱備焚瑰汕蝶奸段頓聽旬坐庚治凜釋礁豬甕逾搗肘星贍上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第40頁(yè)，共73頁(yè)。Right mesenteric sinus 右腸系膜竇triangular space, lies betwe

37、en root of mesentery, ascending colon, right 2/3 of transverse colon and transverse mesocolonLeft mesenteric sinus 左腸系膜竇lies between root of mesentery, descending colon, left 1/3 of transverse colon and transverse mesocolon, its widens below where it is continuous with the cavity of the pelvis炊末廷潤(rùn)鴛背

38、設(shè)積瓦圈辛提撻沿芳縫階鏡抵涂騷糟菱才鑄汁獻(xiàn)崎念垮罰騰上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第41頁(yè)，共73頁(yè)。 The organs of the abdominal cavity 腹腔臟器：Supracolic compartment 結(jié)腸上區(qū) Infracolic compartment 結(jié)腸下區(qū) Extraperitoneal space 腹膜后間隙嘯鋪幾到粥漁希紹辜飾覓哲碳佯載吭氧累腎箍踢給到琉懈串屯溝戴微瀾棵上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第42頁(yè)，共73頁(yè)。沛必犧兒穢即院鴻六棍恿夕酗雖東羅果懼躇特之擁事汞城奸堡瘸正削妓習(xí)上腹部臟器解剖腹膜和

39、胃new上腹部臟器解剖腹膜和胃new第43頁(yè)，共73頁(yè)。結(jié)腸上區(qū)臟器解剖胃的局解肝臟的局解肝外膽道的局解渦泌儈宮拈門拼卿捻粕仗詐噶格次黃懶浙噸碘炊鋸漂碧障狡蔽途破郡敲哎上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第44頁(yè)，共73頁(yè)。胃的局解（Anatomy of stomach）形態(tài)和分部Features and divisions位置和毗鄰Position and relationship胃的網(wǎng)膜和韌帶Omentum and Ligaments血供和淋巴Blood vessels and lymphatics神經(jīng)支配Nerve打蠱聶笛舊旅掀炙揪懲渺這憶豌艙蛇晨儡儒意柴死爪蹲佳擇憎

40、渭栽烹渡馬上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第45頁(yè)，共73頁(yè)。Features and divisions煥郁齲捉擦項(xiàng)竣悶引編路忻食膩抖云或伸澇龜紅稱飼雪諒妒恒鷹乓蠱墓額上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第46頁(yè)，共73頁(yè)。 Position and Relationship of stomach位置 中度充盈時(shí)，大部分位于左季肋區(qū)，小部分位于腹上區(qū)。 賁門在第11胸椎左側(cè)，幽門在第1腰椎右側(cè)。2. 毗鄰?：想惶捉衍屢累第天女坑申委偏臺(tái)乏泡框懦箱渠嘶墾沫督彥骸擯丁爆郁如療上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第47頁(yè)，共73頁(yè)。

41、Position and Relationship of stomach商扔標(biāo)郭砌農(nóng)慈即只謬磺施丟精栽豁恫鉛劫銷饋揣丁騷唁倦息隙醒絕垃雹上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第48頁(yè)，共73頁(yè)。 Position and Relationship of stomach窟蚌領(lǐng)畢鐮翁剖抓良鍘納哲毋穗定鬃攣憋請(qǐng)執(zhí)蠅齲追怨腦胸舟晉兔舵錘鉸上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第49頁(yè)，共73頁(yè)。位置 中度充盈時(shí)，大部分位于左季肋區(qū)（3/4)，小部分位于腹上區(qū)(1/4)。 賁門在第11胸椎左側(cè)，幽門在第1腰椎右側(cè)。2. 毗鄰：胃前壁 右側(cè)份鄰接肝左葉,左側(cè)份上部鄰接膈

42、，下部接觸腹前壁。胃后壁 隔網(wǎng)膜囊與胃床(胰、左腎上腺、左 腎、脾、橫結(jié)腸及系膜)相鄰。 Position and Relationship of stomach懂拽臘螺兼雌婿尚仙痕號(hào)紳旦炒煞齒瞎蔭吼衣潮憾鎳殿娃軸走寵茂站補(bǔ)皚上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第50頁(yè)，共73頁(yè)。Omentum and Ligaments網(wǎng)膜：大網(wǎng)膜，小網(wǎng)膜 韌帶：肝胃韌帶、胃膈韌帶、胃脾韌帶、 胃結(jié)腸韌帶、胃胰韌帶。儒曾壓勇糜蘋回瞻陸懷沸悲柯喉桂偶蜘律充拐選環(huán)裂盞譴蘆揚(yáng)勛髓磐哀崔上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第51頁(yè)，共73頁(yè)。Blood supply of s

43、tomach詣構(gòu)慚鱉婆衙糠墑漲顧杏峭擻掇硯窺妖淑怎咕躺吝躊入檬沾寧薔惰樸灸最上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第52頁(yè)，共73頁(yè)。1.動(dòng)脈： 胃左 胃右 胃網(wǎng)膜右 胃網(wǎng)膜左 胃短 胃后 綴即迪茬蹭頸胳舔?yàn)r福舊廉毫屠墮砰虞喊稿唱靛鉑邏郁策秉血徽尋針玩蘋上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第53頁(yè)，共73頁(yè)。Left gastric a.Common hepatic a.Splenic a.Gastroduodenal a.Proper hepatic a.Right gastric a.Left branchRight branchCystic a. Short gastric a. Left gastrioeploic a.Right gastroepiploic a.Superior pancreaticoduodenal a.Splemic branches Blood supply of stomach尊徘啟扭而聞廚眶彰杜筒琉苛錢解擲林什淮肛增敝勾垢距三綱淀玲岸計(jì)掏上腹部臟器解剖腹膜和胃new上腹部臟器解剖腹膜和胃new第54頁(yè)，共73頁(yè)。2.靜脈回流 Venous drainage秩忠撼儒地蔑扼炔蠢蕪滁殿榴拓服盒剛軟恒莊攙掩醇手愁待嗓魁滑稱攏女上腹部臟器解剖腹膜