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上腹部臟器解剖腹膜和胃new第一頁(yè),共七十一頁(yè)。腹腔、腹膜和腹膜腔(Abdominalcavity,PeritoneumandPeritonealcavity)
基本概念:腹腔
腹膜(壁腹膜和臟腹膜)腹膜腔第二頁(yè),共七十一頁(yè)。TheintroductionoftheperitoneumDefinition
Theperitoneumisathinserousmembranethatlinesthewallsoftheabdominalandpelviccavitiesandcovertheorganswithinthetwocavities第三頁(yè),共七十一頁(yè)。SubdivisionsandperitonealcavityParietalperitoneum壁腹膜-linesthewallsoftheabdominalandpelviccavitiesVisceralperitoneum臟腹膜-coverstheorgansPeritonealcavity腹膜腔-thepotentialspacebetweentheparietalandviscerallayerofperitoneum.Isthereanyorgansintheperitonealcavity?Theperitonitisisverycommonforfemale!Formale,itisaclosedsac.Butforfemale,thereisacommunicationwiththeexteriorthroughtheuterinetubes,theuterus,andthevagina.第四頁(yè),共七十一頁(yè)。FunctionSecretesalubricatingserousfluidthatcontinuouslymoistenstheassociatedorgansSupportandprotectviscusSemipermeablemembrane(Peritonealdialysis)Absorption第五頁(yè),共七十一頁(yè)。TherelationshipbetweenvisceraandperitoneumIntraperitonealvisceraInterperitonealvisceraRetroperitonealviscera第六頁(yè),共七十一頁(yè)。Intraperitonealviscera腹膜內(nèi)位器官-visceracompletelysurroundedbyperitoneum,example,stomach,superiorpartofduodenum,jejunum,ileum,cecum,vermiformappendix,transverseandsigmoidcolons,spleenandovaryInterperitonealviscera腹膜間位器官-mostpartofviscerasurroundedbyperitoneum,example,liver,gallbladder,ascendinganddescendingcolons,upperpartofrectum,urinarybladderanduterusRetroperitonealviscera腹膜外位器官-someorganslieontheposteriorabdominalwallandarecoveredbyperitoneumontheiranteriorsurfacesonly,example,kidney,suprarenalgland,pancreas,descendingandhorizontalpartsofduodenum,middleandlowerpartsofrectum,andureter第七頁(yè),共七十一頁(yè)。第八頁(yè),共七十一頁(yè)。StructuresformedbyperitoneumOmentum網(wǎng)膜
Thefoldofperitoneumthatextendsfromtwocurvaturesofstomachtoadjacentorgans第九頁(yè),共七十一頁(yè)。Lesseromentum
小網(wǎng)膜
two-layeredfoldofperitoneumwhichextendsfromportahepatistolessercurvatureofstomachandsuperiorpartofduodenum.第十頁(yè),共七十一頁(yè)。Greateromentum
大網(wǎng)膜-four-layeredfoldofperitoneum,theanteriortwolayersdescendfromthegreatercurvatureofstomachandinferiorpartofduodenumandhangsdownlikeanaproninfrontofcoilsofsmallintestine,andthenturnsupwardandattachestothetransversecolon.第十一頁(yè),共七十一頁(yè)。LesseromentumGreateromentum第十二頁(yè),共七十一頁(yè)。Mesenterium系膜-two-layeredfoldofperitoneumthatattachtheabdominalorpelvicorganstotheposteriorabdominalwall.mesenterium第十三頁(yè),共七十一頁(yè)。Mesentery
腸系膜-suspendsthesmallintestinefromtheposteriorabdominalwallBroadandafan-shapedIntestinalborder-folded,5-7mlongRadixofmesentery15cmlongDirectedobliquelyfromleftsideofL2toinfrontofrightsacroiliacjoint第十四頁(yè),共七十一頁(yè)。第十五頁(yè),共七十一頁(yè)。第十六頁(yè),共七十一頁(yè)。第十七頁(yè),共七十一頁(yè)。第十八頁(yè),共七十一頁(yè)。Mesoappendix闌尾系膜Triangularmesenterium-extendsfromterminalpartofileumtoappendixAppendiculararteryrunsinfreemarginofthemesoappendix第十九頁(yè),共七十一頁(yè)。Transversemesocolon
橫結(jié)腸系膜-adoublefoldofperitoneumwhichconnectsthetransversecolontotheposteriorabdominalwallSigmoidmesocolon
乙狀結(jié)腸系膜-invertedV-shaped,withapexlocatedinfrontofleftureteranddivisionofcommoniliacartery第二十頁(yè),共七十一頁(yè)。Ligaments韌帶
Ligamentsofliver
Falciformligamentofliver鐮狀韌帶ConsistsofdoubleperitoneallayerExtendsfromanteriorabdominalwall(umbilicus)toliveFreeborderofligamenthasligamentumteres第二十一頁(yè),共七十一頁(yè)。Coronaryligament冠狀韌帶-itisformedbytheperitoneumbetweenthediaphragmandtheliver.ThereareleftandrightcoronaryligamentLeftandrighttriangularligaments左、右三角韌帶-formedbytheleftandrightextremityofcoronaryligamentligament,respectively第二十二頁(yè),共七十一頁(yè)。Hepatogastricligament肝胃韌帶Hepatoduodenalligament肝十二指腸韌帶ExtendsfromportahepatistosuperiorpartofduodenumContainscommonbileduct,properhepatica.andhepaticportalv.第二十三頁(yè),共七十一頁(yè)。LigamentsofspleenGastrosplenicligament胃脾韌帶-adoublelayerofperitoneumthatconnectsthefundusofstomachtohilumofspleen.Inthisdoublelayerofperitoneum,therearetheshortgastricandleftgastroepiploicvesselsSplenorenalligament脾腎韌帶-extendsbetweenthehilumofspleenandanterioraspectofleftkidney.Thesplenicvesselslieswithinthisligament,aswellasthetailofpancreasPhrenicosplenicligament膈脾韌帶第二十四頁(yè),共七十一頁(yè)。Ligamentsofstomach
Hepatogastricligament肝胃韌帶Gastrosplenicligament胃脾韌帶Gastrophrenicligament胃膈韌帶Gastrocolicligament胃結(jié)腸韌帶Gastropancresticligament
胃胰韌帶第二十五頁(yè),共七十一頁(yè)。Folds,recessesandfossa
皺襞、隱窩和窩Superiorduodenalfoldandrecess十二指腸上襞和上隱窩Inferiorduodenalfoldandrecess十二指腸下襞和下隱窩Intersigmoidrecess
乙狀結(jié)腸間隱窩-formedbytheinvertedVattachmentofsigmoidmesocolon第二十六頁(yè),共七十一頁(yè)。Hepatorenalrecess肝腎隱窩-liesbetweentherightlobeofliver,rightkidney,andrightcolicflexure,andisthelowestpartsoftheperitonealcavitywhenthesubjectissupine第二十七頁(yè),共七十一頁(yè)。Medianumbilicalfold臍正中襞-containtheremnantofurachus(medianumbilicalligaments)Medialumbilicalfold
臍內(nèi)側(cè)襞-containsremnantsoftheumbilicalarteries(medialumbilicalligaments)Lateralumbilicalfold臍外側(cè)襞-containstheinferiorepigastricvesselsSupravesicalfossa膀胱上窩Medialinguinalfossa腹股溝內(nèi)側(cè)窩Lateralinguinalfossa腹股溝外側(cè)窩第二十八頁(yè),共七十一頁(yè)。Pouches
陷窩Inmale-rectovesicalpouch直腸膀胱陷窩InfemaleRectouterinepouch(Douglas,cavity)
直腸子宮陷窩-betweenrectumanduterusVesicouterinepouch膀胱子宮陷窩-betweenbladderanduterus第二十九頁(yè),共七十一頁(yè)。Omental
bursa
網(wǎng)膜囊Position-situatedbehindthelesseromentumandstomachWallsSuperior-peritoneumwhichcoversthecaudatelobeofliveranddiaphragmAnterior-formedbylesseromentum,peritoneumofposteriorwallofstomach,andanteriortwolayersofgreateromentumInferior-conjunctiveareaofanteriorandposteriortwolayersofgreateromentumPosterior-formedbyposteriortwolayersofgreateromentum,transversecolonandtransversemesocolon,peritoneumcoveringpancreas,leftkidneyandsuprarenalgland腹膜腔的分部Thesubdivisionoftheperitonealcavity(twosacs)第三十頁(yè),共七十一頁(yè)。Left-formedbythespleen,gastrosplenicligament胃脾韌帶
andsplenorenalligament脾腎韌帶Right-formedbyomentalforamen第三十一頁(yè),共七十一頁(yè)。Omentalforamen網(wǎng)膜孔BehindtherightborderofhepatoduodenalligamentSuperior-caudatelobeofliverInferior-superiorpartofduodenumAnterior-h(huán)epatoduodenalligamentPosterior-peritoneumcoveringtheinferiorvenacavaTheOmentalbursa(lessersac)communicateswiththegreatersacthroughtheomentalforamen.
第三十二頁(yè),共七十一頁(yè)。第三十三頁(yè),共七十一頁(yè)。第三十四頁(yè),共七十一頁(yè)。ThesubregionsoftheperitonealcavityThetransversecolonandtransversemesocolondividestheperitonealcavityintosupracolicandinfracoliccompartments.結(jié)腸上區(qū)和結(jié)腸下區(qū)第三十五頁(yè),共七十一頁(yè)。Supracoliccompartment
結(jié)腸上區(qū)(subphrenicspace)-liesbetweendiaphragmandtransversecolonandtransversemesocolonSuprahepaticrecess肝上間隙
liesbetweenthediaphragmandlive-thefalciformligamentdividesitintorightandleftsuprahepaticrecesses第三十六頁(yè),共七十一頁(yè)。Leftsuprahepaticspace
左肝上間隙leftanteriorsuprahepaticspaceleftposteriorsuprahepaticspaceRightsuprahepaticspace
右肝上間隙Subphrenicextraperitonealspace膈下腹膜外間隙
(correspondingtothebareareaofliver)第三十七頁(yè),共七十一頁(yè)。Infrahepaticspace肝下間隙
liesbetweentheliveandtransversecolonandtransversemesocolon-theligamentumtereshepaticdividesitintorightandleftinfrahepaticspacesRightinfrahepaticspace右肝下間隙(hepatorenalrecess)Leftinfrahepaticspaces左肝下間隙
leftanteriorinfrahepaticspaceleftposteriorinfrahepaticspace第三十八頁(yè),共七十一頁(yè)。Infracoliccompartment
結(jié)腸下區(qū)
-liesbelowthetransversecolonandtransversemesocolonRightparacolicsulcus(gutter)右結(jié)腸旁溝-lieslateraltotheascendingcolon.Itcommunicateswiththehepatorenalrecessandthepelviccavity.Itprovidesarouteforthespreadofinfectionbetweenthepelvicandtheupperabdominalregion.Leftparacolicsulcus(gutter)左結(jié)腸旁溝-lieslateraltothedescendingcolon.Itisseparatedfromtheareaaroundthespleenbythephrenicocolicligament,afoldofperitoneumthatpassesfromthecolicflexuretothediaphragm.第三十九頁(yè),共七十一頁(yè)。Rightmesentericsinus
右腸系膜竇-triangularspace,liesbetweenrootof
mesentery,ascendingcolon,right2/3oftransversecolonandtransversemesocolonLeftmesentericsinus
左腸系膜竇-liesbetweenrootof
mesentery,descendingcolon,left1/3oftransversecolonandtransversemesocolon,itswidensbelowwhereitiscontinuouswiththecavityofthepelvis第四十頁(yè),共七十一頁(yè)。Theorgansoftheabdominalcavity
腹腔臟器:Supracoliccompartment
結(jié)腸上區(qū)
Infracoliccompartment
結(jié)腸下區(qū)
Extraperitonealspace腹膜后間隙第四十一頁(yè),共七十一頁(yè)。第四十二頁(yè),共七十一頁(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第四十三頁(yè),共七十一頁(yè)。胃的局解(Anatomyof
stomach)形態(tài)和分部Featuresanddivisions位置和毗鄰Positionandrelationship胃的網(wǎng)膜和韌帶OmentumandLigaments血供和淋巴Bloodvesselsandlymphatics神經(jīng)支配Nerve第四十四頁(yè),共七十一頁(yè)。Featuresanddivisions第四十五頁(yè),共七十一頁(yè)。
Positionand
Relationshipofstomach1.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?:第四十六頁(yè),共七十一頁(yè)。
Positionand
Relationshipofstomach第四十七頁(yè),共七十一頁(yè)。
Positionand
Relationshipofstomach第四十八頁(yè),共七十一頁(yè)。1.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
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