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Abdominalwall2021/10/10
1AnteriorwallLayers(fromsuperficialtodeep)SkinSuperficial
fasciaAnterolateralmuscles
■
Transversalis
fascia橫筋膜■
Extraperitonealfascia腹膜下筋膜
Parietal
peritoneum壁腹膜2021/10/10
2腹Superficialfascia—
i
sbelow
)fatty
layer
(MS
'
us
layer■snrpbramce'salmpererficiap(CSuuscnlioiibsmiv2021/10/10
3AnterolateralgroupObliquus
externusabsominis腹外斜肌Oblequus
enternusabdominis腹內(nèi)斜肌Transversusabdominis腹橫肌■
Rectus
abdominis腹直
肌Muscles
of
abdomen2021/10/104PosteriorgroupQuadiatus
lumborum
腰
s
s
major腰大肌oa肌2021/10/10
5Gen
d
t
io
r
b
e
rds:StructuresInguinal
ligament腹股溝韌帶Lacunar
ligament腔隙韌帶Superficial
inguinal
ring
a股opne溝edu
fi
texternusabdominisabove
pubictubercles-urulabliqnguoniaf
irnfiwdnd)awldi
Obliquusexternusabsominis腹
外
斜
肌2021/10/10
62021/10/10
7
Obliquusinternusabdominis腹
內(nèi)
斜
肌Deep
to
obliquusexternus
abdominisGeneral
direction
of
2021/10/10
8fibres:upwards,forwards
and
medially
Transverselsabdominis腹
橫
肌Deeptoobliquus
internus2021/10/10
9
e
he
ticcordand
testissperma提睪?。簍raroundCremastInguinal
falx
腹股溝鐮:arch
over
spermaticwithabdominiscord,insertedtransversesfiber
into
medialpecten
of
pubispart
of2021/10/1010in:pubic
crest
and■Has
3-4tendinousintersections
腱
劃lineasemiluaris半
月
線igneriidlRectusabdominis腹
直
肌Position:
lieontoeither
ofsymphysisInsertion:xiphoidand5th-7thcostal
cartilages2021/10/1011
Similarfunctionsforabovefourpairs
ofmusclesSupportandcompresstheabdominalvisceraIncrease
intra-abdominal
pressure,aid
in
expulsiveefforts-vomiting,coughing,sneezing,defecation,urinationandchildbirth.Depress
ribs,assist
in
(theactofforce(4)expiration.
Flex,lateral
flex,and
rotate
vertebral
column2021/10/10
12
Sheathofrectusabdominis
腹直肌鞘Ant
layer
—formedbyfusionofaponeurosisofobliquusexternusa
ui
oisi
nodf
tlieq
oursleinatfe
usuriabdominisPostloFa
y
ebuyr
sisi
oo
lpi
rion
leafseuustqoobofosfuoeaprmerian
rnneuusr
sbi
omf
ti
aisn
edrsesvnabdominis
sbeilnictui
,
bhoe
et4
e
olos
stho2021/10/10
13laalyl
hrr
hemlouws
rlef
ef
rbmoradnetre
i
mr
edarcuate
lineBelowthisline
rectus
abdominis
incontactwithtransversefasciaLinea
alba
白
線
—tendinousraphebetweenrightand
left
rectifromxiphoid
to
pubic
symphysis.2021/10/10
14BoundariesInguinal
ligament■Lateral
margin
ofrectusabdominisA
horizontal
lineInguinal
region
腹
股
溝
區(qū)stretchingfromanterioriliac
spinetolaeralmargin
ofrectus
abdominis2021/10/10
15Seven-weekembryo
showing
the
testis
before
its
descent
from
the
dorsalabdominal
wallD
escent
of
testes2021/10/10
16Fetus
at28
week
the
testis
passingthrough
the
inguinal
canal2021/10/10
172021/10/10
18Position:
obliquepassage,4cmlong,located1.5cmInguinal
canal
腹
股
溝
管above
medial
half
of
inguinallig.2021/10/10
19BoundariesAnt
wallAponeurosis
ofobliquusexternusabdominis□
Obliquus
internusabdominis(lateralthird
of
wall)2021/10/10
20Post
wall□
Transverse
fascia□
Inguinal
flax
medially■
iboeor
fa
cbhlieqinternus
andtransversua
abdominis
Floor
—inguinal
lig.uslowers
of
—2021/10/1021FRAESuperficial
inguinalring腹股溝淺環(huán)
t
i
1.5cmligamentguinalfasciainedpoint
oftransversminovefecbe2021/10/10
22TwoopeningsDeepinguinal
ring腹股溝深環(huán)
一RECAXED口口Structurespassing
through
theinguinalcanal口
Spermaticcord精索
and
ilioinguinal
nerve骼腹股溝神經(jīng)
inmales
口Round
ligament
of
uterus子宮圓韌帶andilioinguinalnerve骼腹股溝神經(jīng)
in
females2021/10/10
23BoundariesInguinal
ligamentinferiorly■
Lateral
borderofrectusabdominis
medially■
Inferiorepigastric
artery
laterallyInguinal
Triangle
(of
Hesselbach)腹股溝三角2021/10/10
242021/10/1025Indirectinguinalheiniaanddirecetinguinal
heiniaSuperficialvesselsandcutaneousnervesArteries□
Superficial
epigastric
a.□
Superficial
iliac
circumflex
a.■
Veins□
Thoracoepigastric
v.口
Superficial
epigastric
v.Cutaneous
nerves□
Anterior
and
lateralcutaneousn.of
lower
sixthoracic口
lliohypogastricn.(firstlumbnerves)2021/10/10Deep
vessels
and
nervesArteresSuperior
and
inferior
epigastric
arteris■
Lower
posterior
intercostal
a.■
Subcostal
a.■
Four
lumbar
a.2021/10/1027Nerveslliohypogastricn.骼腹下神經(jīng)口
Pieces
obliquusinternusabdominis
2.5
cm
medial
tollioinguinal
n.骼腹股溝神經(jīng)Genitofemoraln.生殖股神經(jīng)Arises
from
lubar
plexus
nfo
wbalridq
o
rn
e
ld口anrvausintinntmibuiauuseanterior
superior
iliac
spine口
Pieces
aponeurosis
of
obliquuse
nb
ea
finicisiaalbion
tui
.a5ln2guperomvsouarcmext2021/10/10
28□
Runs
parallel
withiliohypogastric
n.at
a
lowerlevel□
Enters
inguinal
canal
andemergesthroughsuperficialinguinal
ringringLeft
paramedian
incisionSuprapubic
incisionSubcostal
incision
Median
or
midline
incision2021/10/1029Layer?Muscle-splitting
incisionTransverseincision山
東
大
學(xué)
醫(yī)
學(xué)
院
解
剖
教
研
室李
振
華
Abdomen22021/10/10
30Continuation
of
hi
tr
i
fadoi
h
tiifront
ofT12Terminatesat
lowerncgmaorraatpaartocscuaao
Abdominalaorta
腹
主
動
脈b
rdievridoi
4in
oerrti
agegLnfyoand
left
common
iliac2021/10/10
31arteriesParietal
branchesInferiorphrenica.
膈Mediansacrala.
骶正中動脈下動脈(one
pair)■
Lumbara.
腰動脈(fourpairsofarteriesthatsupplythe
posteriorabdominalwall)2021/10/1032Visceralbranches
PaMireiddl
alartery
腎上腺中動脈□
Renalartery
腎動脈Testicular(ovarian)artery
睪丸(卵巢)動脈□rarenchespnsura2021/10/10
33Unpairedbranches□
Celiac
trunk
腹
腔
干—ashortthick
vessel
thatarisesfromthefrontoflevelofL2口Inferior
mesenteric
a.
腸系
膜
下
動
脈—
arises
fromaorta,at
the
level
of
T12□
Superior
mesenteric
a.t腸h
f膜ro
脈fa
,
st
omhefratsetarirao動nt上e系the
front
of
aorta,at
level2021/10/10
34of
L3Right
branchCystica.Rightgastric
a.Properhepatic
a.Gastroduodenala.SplemicbranchesRightgastroepiploica.Superiorpancreaticoduodenala2021/10/1035Celiactrunk
Celiactrunk2021/10/1036Middle
colic
a.Inf.pancresticodudenala.Rightcolic
a.lleocolic
a.SuperiorMesenteric
v.Superiormesenteric
a.Jejunal
and
ileal
a.2021/10/10
37Appendicular
a.Inferior
mesentericv.Inferiormesenteric
a.Left
colic
a.Sigmoid
a.Superiorrectal
a.2021/10/10
38Colic
marginalartery2021/10/10
39
Relations
ofabdominal
aortaAnteriorly
(from
above□
Pancreas□
Ascending
part
ofduodenum□
Radix
of
mesenteryPosteriorly口
Upper
four
lumbervertebraeOn
its
right□
|Inferior
vena
cavaOn
its
left□
Left
sympathetic
trunk2021/10/10
40downward)Internaliliac
vein
骼內(nèi)
靜
脈Parietal
tributaries:accompanywith
arteries
Visceraltributariesrectal
vein→inferior
mesenteric
v.→inferior
rectalvein→internal
iliacv.→analvein→internalpudendalv.②Vesicalvenousplexus
膀胱靜脈叢→vesicalv.
③Uterinevenousplexus
子宮靜脈叢→uterinev.Veinsofabdomenand①Rectal
venous
plexus直腸靜脈叢2021/10/1041pelvisExternal
iliacvein骼外靜脈—
accompanyCommon
iliacvein
i
al
a
j
innt,yoicnL5ieaiLcauponrnoaf
lsialindxotnetndbyernrmedntfon
o靜脈io總un骼unitingeachother
toforminferiorvena
cava2021/10/10
42thearteryFormed
by
union
of
two
o
nmdoj
sitli
at
tvheinrsig
toefrior
4s~c
ds
on
the
right
side
of
oor
fe
g
vamcaraahnpeavdisamen
orta,piercn5eL
Inferiorvenacava
下
腔
靜
脈
er
i
drainsuaight
atrthe
T8o
thepositinoConveys
blood
from
the
a
ytob
atriumghttheriweothelgbhrlepoah2021/10/10
43Chieftributaries■
ParietaloPaired
inferior
phrenicv.膈口
ig
t靜a脈nd
left
renal
veins
左
、
口
Right
suprarenal
veinlef右t腎
l靜v
i
eft
drain
into口
Right
testicular
or
ovarian
v
ra睪in丸in
l
ft)
l.
i
)nftelev(ren靜o卵)ln(a腺ren上下靜脈□
pairedlumbar
v.腰靜脈
(four)
Visceral2021/10/10
44Hepaticveins
肝靜脈:right,left
and
intermediate
Posteriorly□
|Right
crus
of
diaphragm□
Upper
four
lumber
vertebrae□
Left
sympathetic
trunk口/
Abdominal
aortaLiverH
i
o
ft
apla
rrte
duodenumRight
testicular
(or
ovarian)a.Radix
of
mesenteryoaacpnnooeRelationsofinferiorvenacavaAnteriorly
(cranially
to
caudally)口
Parietal
branches
of
abdominal
aorta2021/10/1045On
its
right□
Psoas
major□
Right
kidney口Right
suprarenal
glandOn
its
left□
□
o口口
Hepatic
portal
vein
肝
門
靜
脈Generalfeaturessbeb
i
et
i
c
f
ofokonneunheyhpancreFormesuperior
mesenteric
vein
and
psl
wards
and
to
thepnueisvcendenicright,posteriortothefirst
parterstotheen
enttudenanmmourneelessuodthof
eigh
e
,flw
esevniniteorthtoTipnvalves
in
hepatic
portalsystemti
inbtl
sotdin
lot
ct
from
theramafreoosrngasDralowerendofoesophagustotheupperend
ofanal
canal,
sd,
e
adder,bileplallsgnaaeuctsancr2021/10/1046Variationandanomalies
ofhepatic
portalvein2021/10/1047Tributariesofhepaticportal
vein1.Superior
mesenteric
v.腸系膜上靜脈2.Inferior
mesenteric
v.3.Splenicv.脾
靜
脈4.Left
gastric
v.
胃左靜脈5.Right
gastric
v.胃右靜脈6.Cystic
v.
膽囊靜脈7.Paraumbilical
v.附
臍
靜
脈2021/10/10
48腸系膜下靜脈Portal-systemicanastomoses1.Atthelower
end
ofthe
oesophagusHepaticportalvein→leftgastricvein
→esophagealvenous
plexus
→esophageal
vein→azygos
vein2.At
rectal
venous
plexusHepatic
portal
vein
→splenic
vein
→inferior
mesentericinferior
vena
cava3.At
periumbilical
venous
plexusHepaticportalvein→paraumbilicalvein→periumbilicalvenousplexus→vein
→superiorrectalvein→rectalvenousplexus
→inferior
rectal
and
anal
veins
→internaliliacvein→口
thoracoepigastricandsuperiorepigastricvein→superiorvena
cava口
superficialepigastricandinferiorepigastricveins→
inferior
vena
cava2021/10/1049→superiorvenacava4.Portal-retroperitonealanastomosisB
e
v
si
p
h
hi
e
a
t
ioc
fo
u
i
u
lacfnioareolnwailmpebhlhrwofitthhanntdhssseiinnwineeetvvvecolicveins
(portal)anastomosingwithsystemic2021/10/10
50retroperitoneal
veins
The
lymphatic
drainage
ofabdomenLymphaticdrainageofabdominalwallToaxillarylymph
node
fromregionabove
umbilicusTosuperficialinguinal
lymphnodefromregion
belowumbilicusTolumbar
lymph
nodefrom2021/10/10
51postwallofabdomen
LymphaticdrainageofLumbarlymph
nodesLie
on
posterior
abdominalwall,along
the
abdominal
,sayvestes,nkaidcnaelminpcrtueoovarirs,fundus
of
uterus,ovary,and
common
iliacnodesRight
and
left
lumbar
trunksformed
byefferent
vesselPlu
r
rvl
a
d
n
to
theesraino—ympiscemai2021/10/10
52abdominalviscera腰淋巴結(jié)Celiac
lymph
nodes腹腔淋巴結(jié)—situated
around
the
celiactrunkSuperiormesenteric
lymphnode腸系膜上淋巴結(jié)—situated
around
inferiormesenteric
a.Intestinal
trunk
腹腔干celiac,superiorand
inferiorlymph
nodes—situatedaroundsuperiormesentericaInferiormesenteric
lymph
node
腸系膜下淋巴結(jié)—formed
by
efferent
vessel
of2021/10/10
53Thoracic
duct
胸
導(dǎo)
管Begins
infront
of
L1
as
a
dilated
sac,thelevelofT5■
At
the
roof
of
the
neck,it
turns
laterally
andlearf
sleand
descends
to
enter
thel
ecl
na
,it
brreocneci
eia
i
altrunksDrains
lymph
from
lower
limbs,pelvic
cavity,nftslhomedves
thndonianrmiveatsufoutgsuugds
anrwaruoofnseevhcisternachyli,whichformed
byjoining
of
leftand
right
lumbar
trunks
and
intestinal
trunkEnterthoraciccavity
bypassingthrough
theabdominal
cavity,left
side
of
thorax,and
leftaortic
hiatus
of
the
diaphragm
and
ascendsalong
on
the
front
of
the
vertebral
column,side
ofthe
head,neck
and
left
upper
limbbetween
thoracic
aorta
and
azygos
veinTravels
upward,veering
to
the
left
at
the2021/10/10
54Location:liesinthe
lefthypochondriac
region(between
stomach
anddiaphragm)deep
to
the9th
to
11th
rib,its
longaxis
correspondsroughlyto
the
10th
ribShape
—reddishin
colour2021/10/10
55SpleenTwo
surfacesDiaphragmatic:smooth,convexTwo
extremitiesAnterior—widerPosterior—rounderTwo
border
en
g
i
ble
i
pleen
isconsideredto
beFormationoflymphocytesand
monocytesr:einedthun:ortantonsor—rimponctiInferFu■■a,paatio切oaltp脾npht
isonnotcllyrknlse;ar3as2-laesisrvhanorehriwhwSuhpice■
ait
obcl
toodsi
eoll
cdt
eprliaat,
particles
andeletsinertnasfcshhwPDestroyingeffeteorabnormalred
blood
cellsVisceral:concave,hilum
of
spleen2021/10/10
56■
Making
antibodiesRalationshipsofspleenDiaphragmatic
Visceralsurface□
Anteriorly—fundus
ofstomach□
r
dly□
Inferiorly—tailof
pancreas
and
left
colic
flexureysuprarenaleftnekid—laniordeglanPost2021/10/10
57surface—diaphragmLumbarplexus腰叢Formation:formed
byofT12and
L4■
Position:lieswithinanterior
rami
of
L1-L3,a
partof
anterior
ramisubstance
of
psoas2021/10/10
58Nervers
of
abdomenmajorBranches■
lliohypogastricn.
骼腹下神經(jīng)Lateralfemoralcutaneous股外側(cè)皮神經(jīng)■
Femoral
n.
股
神
經(jīng)■
Obturator
n.
閉孔神經(jīng)Genitofemoral
n.生殖股神經(jīng)Supplieslower
part
ofanteriorabdominalwallllioinguinal
n.骼腹股溝神經(jīng)Passesthroughinguinall
olyt
in
of
themkusscrppantogroincana2021/10/1059Made
up
of
paired
chainswithfourtofive
lumbarPasses
inferiorly
behind
eormin
i
cb
ejsosi
il
gatnodnsneyvsaoniliaomm
Lumbar
sympathetic
trunk
腰
交
感
干ganglia
anterolateral
tovertebral
column
a
i
theaasvanndmeaogaphrersdiaEntcontinuation
of
hethoracicform
unpaired
ganglionimpar,anterior
to
sacrum2021/10/1060part山
東
大
學(xué)
醫(yī)
學(xué)
院
解
剖
教
研
室
李振華
Abdomen32021/10/10
61
RelationshipsofabdominalvisceraFirst
layer—live,gallbladder,stomachSecond
layer—duodenum,pancreas,spleenThird
layer—suprarenal
gland,kidney,ureter,inferior
vena
cava,abdominal
aorta,nerves2021/10/10
62and
lymphatics■
Anterior:□
Live(right
part)□
Pancreas□
Left
suprarenal
gland□
Left
kidney□
SpleenTransverse
colon
andtransvers
mesoclonRelationshipsof
thestomach□
Diaphragm(left
upper
part)□
i
a
dominal
wall
(leftt)braporrrloweAnte■
Posterior—separatedbyperitonumoflessersacfromthe
following(“stumach-bed”)2021/10/1063Left
and
rightgastricarteries
arise
fromceliac
trunk
andArteries
of
stomachproperhepatic
artery,repectively.These
twovessels
run
in
lesseromentumalong
lessercurvature
,andanastomoseend.end-to-2021/10/1064Rightandleftgastroepiploicduo
a
r
dt
lenic
h
i
ry,ent
and2021/10/10ligamh
thecggastrosplenicoursethrourtes,aesplenicic
arterfres
ogastbrancShortpeshnmaolfneeisdargastroarteriesartery,repectively.These
twovesselspass
intothe
greatertpu
to
theandllelreargreater
curvaomentum,runsupplythefundusofstomach.Posteriorgastricartery
(72%)arisefromthesplenicartery,
p
ent
andmeahgtlihnicugrerohthgastrocoursesupplytheposteriorwall
ofanastomoseend-to-end.fundus
of
stomach.65VenousdrainageRight
and
left
gastric
veins
empty
directly
into
hepatic
portal
vein.■
Leftgastroepiploicandshortgastric
veins
drain
into
hepatic
portal■
|
tv
l
i
.
join
either
superior
mesenteric
vein.nnoic
venic
veipi
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