影像解剖-Peritoneum And Peritoneal Cavity課件

PeritoneumAndPeritonealCavity

(P.94)

Departmentofthehumananatomy

attachedtotheSichuanunivers

ChenDaobang

Peritoneum—atransparent,continuousserousmembrane,tosecreteandabsorbserosity*Parietalperitoneum

Liningtheinnersurfaceoftheabdominalwall*Visceralperitoneum

coveringthevisceraintheabdominalcavity1.Peritonealcavity1).Apotentialspace2).Formedbytheparietalandvisceralperitoneum3).Containingathinfilmofserosity4).Closedinmales

Acommunicationwiththeexterior

ofthebodyinfemalesthroughthe

uterinetubes,uterus,andvagina2.

Relationshipofthevisceratotheperitoneum1)Intraperitonealorgans(腹膜內(nèi)位器官)

stomach,jejunum,ileum,caecum,vermiformappendix,spleen,etal2)Interperitonealorgans(腹膜間位器官)

liver,gallbladder,urinarybladder,uterus…3)Extraperitonealorgans(腹膜外位器官)kidney,ureter,…3Theperitonealreflection1)Omenta(1)lesseromentum*2layersfoldsofperitoneum*toextendfromtheporta

hepatistolessercurvatureofstomachandproximalpartoftheduodenum*hepatogastric

lig.andhepatoduodenal

lig.

(2)greateromentum*4foldsofperitoneum*fromgreatercurvatureofthestomach,descending,tothetransversecolon*coveringthesmallintestine*afat-apron2)Peritoneal

ligaments

oneortwofoldsoftheperitoneum,usually

fromorganstothebody-wall,orbetweentheorgans

(1)hepaticlig.*Coronarylig.*Falciform

lig.(ligamentum

teresinthefreeedge)*Leftandrighttriangularlig.*Hepatoduodenal

lig.*Hepatogastriclig.*Hepatorenal

lig.(2)lig.ofspleen*gastrosplenic

lig.*splenorenal

lig.*splenophrenic

lig.*splenocolic

lig.(3)lig.ofstomach*hepatogastric

lig.*gastrosplenic

lig.*gastrocolic

lig.3)Mesenteries

*Theyaretwolayer-foldsoftheperitoneum.

*Theyextendnormallyfrombody-walltotheorgans.

*Thereareusuallythebloodvessels,nerves,andlymphaticnodesinthemesenteries.So,theycanprotect,supportandsuspendtheorgansandsupplynutritionfortheorgans.(1)

Mesenteryofthethesmallintestine*Afan-shaped*Twolayer-foldsofperitoneum*Attachingthecoils(袢)ofjejunumandileumtoposteriorabdominalwall*Rootofthemesentery----15cm,fromtheleftsideoftheL2vertebratotherightsacroiliacjoint**Therearesuperiormesentericbloodvessels,nervesandlymphnodesintherootthemesentery**Therootofthemesenterycrossesthe

HorizontalpartoftheduodenumAbdominalaortaIVCRightpsoasmajorm.(右腰大肌)Rightureter(右輸尿管)Righttesticularvessels(右睪丸血管)(2)mesoappendix*Atriangularmesenteryofthevermiformappendix*Bloodvesselsinitsfreeedge(3)Transversemesocolon*Toconnecttransversecolontotheposteriorabdominalwall*Middlecolicbloodvessels,N.,andL.nodesinthetransversesmesocolon

*Therootofthetransversemesocoloncrossesthe

RightkidneyDescendingpartoftheduodenumHeadofthepancreasLeftkidney(4)SigmoidmesocolonToattachthesigmoidcolontothepelvicwallSigmoidbloodvessels,N.andL.nodesinthemesocolon4)OmentumbursaBetweentheposteriorwallofstomach,lesseromentumandpancreasAnteriorborder:*lesseromentum,*Peritoneumoftheposteriorwallofthestomach,*Ant.2layersofgreateromentumPosterior:Post.2layersofgreateromentum,transversecolonanditsmesenteryInferior:reflexoftheAnt.2layersandPost.2layersofthegreateromentumSuperior:peritoneumbelowtheliveranddiaphragmLeftborder:spleen,gastrosplenic

lig.,splenorenal

lig.Rightborder:omentalforamenAnterior:hepatoduodenal

lig.(freeedgeoflig.)Posterior:peritoneumcoveringtheIVCSuperior:caudatelobeoftheliverInferior:superiorpartoftheduodenumClinicimportantoftheomentalforamen:Communicatingomentumbursawiththegreaterperitonealcavity(hepatorenalrecess)*RectovesicalpouchBetweenth