上腹部臟器解剖腹膜和胃new

上腹部臟器解剖腹膜和胃new現(xiàn)在是1頁\一共有71頁\編輯于星期三腹腔、腹膜和腹膜腔(Abdominalcavity,PeritoneumandPeritonealcavity)

基本概念：腹腔

腹膜（壁腹膜和臟腹膜）腹膜腔現(xiàn)在是2頁\一共有71頁\編輯于星期三TheintroductionoftheperitoneumDefinition

Theperitoneumisathinserousmembranethatlinesthewallsoftheabdominalandpelviccavitiesandcovertheorganswithinthetwocavities現(xiàn)在是3頁\一共有71頁\編輯于星期三SubdivisionsandperitonealcavityParietalperitoneum壁腹膜－linesthewallsoftheabdominalandpelviccavitiesVisceralperitoneum臟腹膜－coverstheorgansPeritonealcavity腹膜腔－thepotentialspacebetweentheparietalandviscerallayerofperitoneum.Isthereanyorgansintheperitonealcavity?Theperitonitisisverycommonforfemale!Formale,itisaclosedsac.Butforfemale,thereisacommunicationwiththeexteriorthroughtheuterinetubes,theuterus,andthevagina.現(xiàn)在是4頁\一共有71頁\編輯于星期三FunctionSecretesalubricatingserousfluidthatcontinuouslymoistenstheassociatedorgansSupportandprotectviscusSemipermeablemembrane(Peritonealdialysis)Absorption現(xiàn)在是5頁\一共有71頁\編輯于星期三TherelationshipbetweenvisceraandperitoneumIntraperitonealvisceraInterperitonealvisceraRetroperitonealviscera現(xiàn)在是6頁\一共有71頁\編輯于星期三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現(xiàn)在是7頁\一共有71頁\編輯于星期三現(xiàn)在是8頁\一共有71頁\編輯于星期三StructuresformedbyperitoneumOmentum網(wǎng)膜

Thefoldofperitoneumthatextendsfromtwocurvaturesofstomachtoadjacentorgans現(xiàn)在是9頁\一共有71頁\編輯于星期三Lesseromentum

小網(wǎng)膜

two-layeredfoldofperitoneumwhichextendsfromportahepatistolessercurvatureofstomachandsuperiorpartofduodenum.現(xiàn)在是10頁\一共有71頁\編輯于星期三Greateromentum

大網(wǎng)膜－four-layeredfoldofperitoneum,theanteriortwolayersdescendfromthegreatercurvatureofstomachandinferiorpartofduodenumandhangsdownlikeanaproninfrontofcoilsofsmallintestine,andthenturnsupwardandattachestothetransversecolon.現(xiàn)在是11頁\一共有71頁\編輯于星期三LesseromentumGreateromentum現(xiàn)在是12頁\一共有71頁\編輯于星期三Mesenterium系膜－two-layeredfoldofperitoneumthatattachtheabdominalorpelvicorganstotheposteriorabdominalwall.mesenterium現(xiàn)在是13頁\一共有71頁\編輯于星期三Mesentery

腸系膜－suspendsthesmallintestinefromtheposteriorabdominalwallBroadandafan-shapedIntestinalborder－folded,5-7mlongRadixofmesentery15cmlongDirectedobliquelyfromleftsideofL2toinfrontofrightsacroiliacjoint現(xiàn)在是14頁\一共有71頁\編輯于星期三現(xiàn)在是15頁\一共有71頁\編輯于星期三現(xiàn)在是16頁\一共有71頁\編輯于星期三現(xiàn)在是17頁\一共有71頁\編輯于星期三現(xiàn)在是18頁\一共有71頁\編輯于星期三Mesoappendix闌尾系膜Triangularmesenterium－extendsfromterminalpartofileumtoappendixAppendiculararteryrunsinfreemarginofthemesoappendix現(xiàn)在是19頁\一共有71頁\編輯于星期三Transversemesocolon

橫結(jié)腸系膜－adoublefoldofperitoneumwhichconnectsthetransversecolontotheposteriorabdominalwallSigmoidmesocolon

乙狀結(jié)腸系膜－invertedV-shaped,withapexlocatedinfrontofleftureteranddivisionofcommoniliacartery現(xiàn)在是20頁\一共有71頁\編輯于星期三Ligaments韌帶

Ligamentsofliver

Falciformligamentofliver鐮狀韌帶ConsistsofdoubleperitoneallayerExtendsfromanteriorabdominalwall(umbilicus)toliveFreeborderofligamenthasligamentumteres現(xiàn)在是21頁\一共有71頁\編輯于星期三Coronaryligament冠狀韌帶－itisformedbytheperitoneumbetweenthediaphragmandtheliver.ThereareleftandrightcoronaryligamentLeftandrighttriangularligaments左、右三角韌帶－formedbytheleftandrightextremityofcoronaryligamentligament,respectively現(xiàn)在是22頁\一共有71頁\編輯于星期三Hepatogastricligament肝胃韌帶Hepatoduodenalligament肝十二指腸韌帶ExtendsfromportahepatistosuperiorpartofduodenumContainscommonbileduct,properhepatica.andhepaticportalv.現(xiàn)在是23頁\一共有71頁\編輯于星期三LigamentsofspleenGastrosplenicligament胃脾韌帶－adoublelayerofperitoneumthatconnectsthefundusofstomachtohilumofspleen.Inthisdoublelayerofperitoneum,therearetheshortgastricandleftgastroepiploicvesselsSplenorenalligament脾腎韌帶－extendsbetweenthehilumofspleenandanterioraspectofleftkidney.Thesplenicvesselslieswithinthisligament,aswellasthetailofpancreasPhrenicosplenicligament膈脾韌帶現(xiàn)在是24頁\一共有71頁\編輯于星期三Ligamentsofstomach

Hepatogastricligament肝胃韌帶Gastrosplenicligament胃脾韌帶Gastrophrenicligament胃膈韌帶Gastrocolicligament胃結(jié)腸韌帶Gastropancresticligament

胃胰韌帶現(xiàn)在是25頁\一共有71頁\編輯于星期三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現(xiàn)在是26頁\一共有71頁\編輯于星期三Hepatorenalrecess肝腎隱窩－liesbetweentherightlobeofliver,rightkidney,andrightcolicflexure,andisthelowestpartsoftheperitonealcavitywhenthesubjectissupine現(xiàn)在是27頁\一共有71頁\編輯于星期三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)窩現(xiàn)在是28頁\一共有71頁\編輯于星期三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現(xiàn)在是29頁\一共有71頁\編輯于星期三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)現(xiàn)在是30頁\一共有71頁\編輯于星期三Left－formedbythespleen,gastrosplenicligament胃脾韌帶

andsplenorenalligament脾腎韌帶Right－formedbyomentalforamen現(xiàn)在是31頁\一共有71頁\編輯于星期三Omentalforamen網(wǎng)膜孔BehindtherightborderofhepatoduodenalligamentSuperior－caudatelobeofliverInferior－superiorpartofduodenumAnterior－h(huán)epatoduodenalligamentPosterior－peritoneumcoveringtheinferiorvenacavaTheOmentalbursa(lessersac)communicateswiththegreatersacthroughtheomentalforamen.

現(xiàn)在是32頁\一共有71頁\編輯于星期三現(xiàn)在是33頁\一共有71頁\編輯于星期三現(xiàn)在是34頁\一共有71頁\編輯于星期三ThesubregionsoftheperitonealcavityThetransversecolonandtransversemesocolondividestheperitonealcavityintosupracolicandinfracoliccompartments.結(jié)腸上區(qū)和結(jié)腸下區(qū)現(xiàn)在是35頁\一共有71頁\編輯于星期三Supracoliccompartment

結(jié)腸上區(qū)(subphrenicspace)－liesbetweendiaphragmandtransversecolonandtransversemesocolonSuprahepaticrecess肝上間隙

liesbetweenthediaphragmandlive－thefalciformligamentdividesitintorightandleftsuprahepaticrecesses現(xiàn)在是36頁\一共有71頁\編輯于星期三Leftsuprahepaticspace

左肝上間隙leftanteriorsuprahepaticspaceleftposteriorsuprahepaticspaceRightsuprahepaticspace

右肝上間隙Subphrenicextraperitonealspace膈下腹膜外間隙

(correspondingtothebareareaofliver)現(xiàn)在是37頁\一共有71頁\編輯于星期三Infrahepaticspace肝下間隙

liesbetweentheliveandtransversecolonandtransversemesocolon－theligamentumtereshepaticdividesitintorightandleftinfrahepaticspacesRightinfrahepaticspace右肝下間隙(hepatorenalrecess)Leftinfrahepaticspaces左肝下間隙

leftanteriorinfrahepaticspaceleftposteriorinfrahepaticspace現(xiàn)在是38頁\一共有71頁\編輯于星期三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.現(xiàn)在是39頁\一共有71頁\編輯于星期三Rightmesentericsinus

右腸系膜竇－triangularspace,liesbetweenrootof

mesentery,ascendingcolon,right2/3oftransversecolonandtransversemesocolonLeftmesentericsinus

左腸系膜竇－liesbetweenrootof

mesentery,descendingcolon,left1/3oftransversecolonandtransversemesocolon,itswidensbelowwhereitiscontinuouswiththecavityofthepelvis現(xiàn)在是40頁\一共有71頁\編輯于星期三Theorgansoftheabdominalcavity

腹腔臟器：Supracoliccompartment

結(jié)腸上區(qū)

Infracoliccompartment

結(jié)腸下區(qū)

Extraperitonealspace腹膜后間隙現(xiàn)在是41頁\一共有71頁\編輯于星期三現(xiàn)在是42頁\一共有71頁\編輯于星期三結(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現(xiàn)在是43頁\一共有71頁\編輯于星期三胃的局解（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現(xiàn)在是44頁\一共有71頁\編輯于星期三Featuresanddivisions現(xiàn)在是45頁\一共有71頁\編輯于星期三

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?：現(xiàn)在是46頁\一共有71頁\編輯于星期三

Positionand

Relationshipofstomach現(xiàn)在是47頁\一共有71頁\編輯于星期三

Positionand

Relationshipofstomach現(xiàn)在是48頁\一共有71頁\編輯于星期三１．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)份上部鄰接膈，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。

Positionand

Relationshipofstomach現(xiàn)在是49頁\一共有71頁\編輯于