影像解剖- 19The Anterior And Lateral Abdominal Wall課件

TheAnteriorAndLateralAbdominalWall(P.80)DepartmentofthehumananatomyattachedtotheSichuanuniversity

Chendaobang1.Subdivisionshypogastric季肋區(qū)腹股溝區(qū)1.TheregionsofabdomenSubcostalplaneIliactubercularplaneMidclavicularplanes1)epigastricregion2)leftandrighthypochondriacregions3)umbilicalregion4)leftandrightlumbarregions5)hypogastricregion6)leftandrightinguinalregions2Thelayersofanteriorlateralabdominalwall1)skin2)superficialfascia(1)Camper’sfasciabelowthelevelofumbilicus

Scarpa’sfascia(2)superficialbloodvessels,cutaneousnervesandlymphaticvesselsSuperficialepigastricarterySuperficialcircumflexiliacarterySuperficialveinsandumbilicalvenousplexus(network)Lymphaticvessels:abovetheleveloftheumbilicalaxillaryL.nodes,belowthelevelofumbilicalsuperficialinguinalL.nodes3)Themusclesofanteriorandlateralabdominalwall(1)rectusabdominis*position*tendinousintersection*rectussheath*Itisformedbytheaponeurosisesofthe3flatmuscles,*Itissituatedthelateralsidesofmidline,and*Itconsistsofananteriorlayerandposteriorlayer

anteriorlayer

aponeurosisofexternalobliqueandsuperficiallaminaofinternalobliquefusedwithtendinousintersection

posteriorlayer

deeplaminaofaponeurosisofinternalobliqueandtransversusabdominisabout4cmbelowtheumbilicus,thelayerisdeficientandformsafreelowermargin,calledarcuateline(lineasemicircularis).Belowtheline,theposteriorsurfaceoftherectusabdominiscontactsdirectlywiththetransversalisfascia.缺如Contentsintherectussheath

ThesheathislodgedwithRectusabdominisSuperiorepigastricbloodvesselsInferiorepigastricbloodvesselsLower5pairsofintercostalsandapairofsubcostalbloodvesselsandnervesPyramidalmuscle腹壁上血管*Thelineaalbaisformedbythefusionoftheleftandrightrectussheathes,inthemedianlineoftheabdominalwall.(2)3flatmusclesExternalobliqueInternalobliqueTransversusabdominis腹外斜肌腹橫肌ExternalObliqueSuperficialflatm.FiberspassinginferomediallyBelowthejointinglinebetweentheumbilicusandanteriorsuperior

iliacspine,them.iscontinuedastheaponeurosisMainstructuresformedbytheaponeurosis*rectussheath(腹直肌鞘)*lineaalba(白線)*inguinalligament(腹股溝韌帶)attachedtotheanteriorsuperioriliacspineandthepubictubercle.

*superficialring:

*Reflectedinguinallig.(反轉(zhuǎn)韌帶)*Lacunar

lig.(腔隙韌帶)*Pubicpectineal

lig.(恥骨梳韌帶)*Externalspermaticfascia(精索外筋膜)InternalObliquem.Intermediateflatm.ThefiberspassingsuperomediallyMainstructuresoutofthem.ArchingfibersCremasterm.Inguinalfalx/conjoinedtendonRectussheathLineaalba提睪肌腹股溝鐮/聯(lián)合腱弓狀下緣TransversusabdominisThedeepestoneofthe3flatabdominalM.ItsfibersrunmoreorlesshorizontallyMainstructuresformedoutofthem.(ditto)Thestructurebetweentheinternalobliquem.andtransversusabdominis(1)lower5pairsofintercostalsand1pairof

subcostalbloodvesselsandnerves(2)4pairsoflumbararteries(3)iliohypogastricnerveandilioinguinalnerve4)ThetransversalisfasciaToliestothedeeptothetransversusabdominis,posteriorlayeroftherectussheathandrectusabdominis(belowthearcuateline)Toformdeepinguinalringand

internalspermaticfascia5)Theextraperitonealfat

Tobelongtofat6)TheparietalperitoneumBriefSummarythelayersoftheabdominalwall1)skin2)superficialfascia(Camper’sandScarpa’s)3)externaloblique

4)internaloblique

5)transversusabdominis

6)transversalisfascia

7)extraperitonealfat

8)parietalperitoneumAbdominalincisionsInguinalCanal

itliesabovethemedialhalfoftheinguinallig.(1).BordersSuperiorwall:ArchingfibersInferiorwall:inguinallig.

lacunarlig.Anteriorwall:externalobliqueaponeurosis;

originfibersoftheinternalobliquePosteriorWall:transversalisfascia,conjointtendon/inguinalfalxSuperficialinguinalring:formedbytheexternalobliqueaponeurosis*Laterosuperiortothepubictubercle*Atriangularaperture—latercrusandmedialcrus,andintercruralfibersDeepinguinalring:formedbythetransversalisfascia*Locatedjustsuperiortothemidpointoftheinguinallig.*Tolieatthelateraltotheinferiorepigastricartery(2)Contentspassingthroughtheinguinalcanal*spermaticcordandilioinguinalnerveinmale*roundlig.oftheuterusandilioinguinalnerveinfemale

(3)Clinicimportant—indirecthernia子宮髂腹股溝n.Inguinaltriangle(1)Borders:Inferiorepigastrica.—lateralborderLateralborderoftherectusabdominis–medialMedialhalfpartoftheinguinallig.—inferior(2)Clinical:directhernia

Thescrotum陰囊Thescrotumisacutaneoussacandliesbetweentherootofpenis(陰莖)andperineum(會(huì)陰).Itconsistsoftheskinandsuperficial

fascia(knownasdartos

肉膜)Thelayersofthescrotumcut(1)skin(2)dartos(3)externalspermaticfascia(4)cremasteris(5)internalspermaticfascia(6)extraperitonealfat(7)tunicavaginalis(睪丸鞘膜)Contents:testis,epididymis睪丸附睪TestesLocation:inthescrotumFunction:toproducesperms

andmalehormones精曲小管2-4條精直小管睪丸網(wǎng)睪丸輸出管附睪管精子Epididymis

附睪Dividedintohead,bodyandtailTobecontinuousasductus

defferensFunction:storingsperms輸精管SpermaticcordFrom

deepinguinalring,throughtheinguinalcanal,totheposteriorborderofthetestis精索ThemainconstituentsofthespermaticcordDuct