腹部解剖圖譜

Abdominalwall

2021/10/101Anteriorwall

Layers(fromsuperficialtodeep)SkinSuperficialfasciaAnterolateralmusclesTransversalisfascia腹橫筋膜Extraperitonealfascia腹膜下筋膜Parietalperitoneum壁腹膜2021/10/102Superficialfascia－divisionsbelowumbilicusSuperficialfattylayer(Camper’s)Membranouslayer(Scarpa’s)2021/10/103

MusclesofabdomenAnterolateralgroupObliquusexternusabsominis腹外斜肌Oblequusenternusabdominis腹內斜肌Transversusabdominis腹橫肌Rectusabdominis腹直肌2021/10/104Posteriorgroup

Quadiatuslumborum腰方肌Psoasmajor腰大肌2021/10/105Obliquusexternusabsominis腹外斜肌Generaldirectionoffibers:downward,forwardandmedially(rundownandinward)StructuresInguinalligament

腹股溝韌帶Lacunarligament

腔隙韌帶Superficialinguinalring

腹股溝淺環(huán)－triangular-shapeddefectinaponeurosisofobliquusexternusabdominisabovepubictubercle2021/10/1062021/10/107Obliquusinternusabdominis腹內斜肌DeeptoobliquusexternusabdominisGeneraldirectionoffibres:upwards,forwardsandmedially2021/10/108Transverselsabdominis

腹橫肌Deeptoobliquusinternus2021/10/109Inguinalfalx腹股溝鐮:archoverspermaticcord,insertedwithtransversesabdominisfiberintomedialpartofpectenofpubisCremaster提睪肌:aroundthespermaticcordandtestis2021/10/1010Rectusabdominis腹直肌

Position:lieontoeitherofmidlineOrigin:pubiccrestandsymphysisInsertion:xiphoidand5th-7thcostalcartilagesHas3-4tendinousintersections

腱劃lineasemiluaris

半月線

2021/10/1011SimilarfunctionsforabovefourpairsofmusclesSupportandcompresstheabdominalvisceraIncreaseintra-abdominalpressure,aidinexpulsiveefforts-vomiting,coughing,sneezing,defecation,urinationandchildbirth.Depressribs,assistin(theactofforce(4)expiration.Flex,lateralflex,androtatevertebralcolumn2021/10/1012Sheathofrectusabdominis腹直肌鞘Antlayer－formedbyfusionofaponeurosisofobliquusexternusabdominisandanteriorleafofaponeurosisofobliquusinternusabdominisPostlayerFormedbyfusionofposterionleafofaponeurosisofobliquusinternusabdominisandaponeurosisoftransversesabdominisAbsentinabout4-5cmbelowtheumbilicus,whereaponeurosesofallthreemusclesformanteriorlayerthelowerfreebordernamedarcuatelineBelowthislinerectusabdominisincontactwithtransversefascia2021/10/1013Lineaalba白線－tendinousraphebetweenrightandleftrectifromxiphoidtopubicsymphysis.2021/10/1014Inguinalregion腹股溝區(qū)BoundariesInguinalligamentLateralmarginofrectusabdominisAhorizontallinestretchingfromanterioriliacspinetolaeralmarginofrectusabdominis2021/10/1015DescentoftestesSeven-weekembryoshowingthetestisbeforeitsdescentfromthedorsalabdominalwall2021/10/1016Fetusat28weekthetestispassingthroughtheinguinalcanal2021/10/1017Newborn2021/10/1018Inguinalcanal

腹股溝管Position:obliquepassage,4cmlong,located1.5cmabovemedialhalfofinguinallig.2021/10/1019BoundariesAntwallAponeurosisofobliquusexternusabdominisObliquusinternusabdominis(lateralthirdofwall)2021/10/1020PostwallTransversefasciaInguinalflaxmediallyRoof－archedlowerfibersofobliquusinternusandtransversuaabdominisFloor－inguinallig．2021/10/1021TwoopeningsSuperficialinguinalring腹股溝淺環(huán)Deepinguinalring腹股溝深環(huán)－defectintransversefascia1.5cmabovemidpointofinguinalligament2021/10/1022StructurespassingthroughtheinguinalcanalSpermaticcord

精索

andilioinguinalnerve髂腹股溝神經

inmalesRoundligamentofuterus

子宮圓韌帶andilioinguinalnerve髂腹股溝神經

infemales

2021/10/1023InguinalTriangle(ofHesselbach)腹股溝三角

Boundaries

InguinalligamentinferiorlyLateralborderofrectusabdominismediallyInferiorepigastricarterylaterally2021/10/1024Indirectinguinalheiniaanddirecetinguinalheinia

2021/10/1025Superficialvesselsandcutaneousnerves

Arteries

Superficialepigastrica.Superficialiliaccircumflexa.Veins

Thoracoepigastricv.Superficialepigastricv.CutaneousnervesAnteriorandlateralcutaneousn.oflowersixthoracicIliohypogastricn.(firstlumbnerves)2021/10/1026DeepvesselsandnervesArteresSuperiorandinferiorepigastricarterisLowerposteriorintercostala.Subcostala.Fourlumbara.2021/10/1027NervesIliohypogastricn.髂腹下神經ArisesfromlubarplexusPassesforwardintheintervalbetweenobliquusinternusandtranversusabdominisPiecesobliquusinternusabdominis2.5cmmedialtoanteriorsuperioriliacspinePiecesaponeurosisofobliquusexternusabdominisabout2.5cmabovesuperficialinguinalringIlioinguinaln.髂腹股溝神經Runsparallelwithiliohypogastricn.atalowerlevelEntersinguinalcanalandemergesthroughsuperficialinguinalringGenitofemoraln.生殖股神經2021/10/1028SubcostalincisionMuscle-splittingincisionTransverseincision

MedianormidlineincisionLeftparamedianincisionLayer?Suprapubicincision2021/10/1029Abdomen2山東大學醫(yī)學院解剖教研室李振華2021/10/1030Abdominalaorta腹主動脈ContinuationofthoracicaortaataortichiatusofdiaphragminfrontofT12TerminatesatlowerborderofL4vertebrabydividingintorightandleftcommoniliacarteries2021/10/1031ParietalbranchesInferiorphrenica.

膈下動脈(onepair)Lumbara.

腰動脈(fourpairsofarteriesthatsupplytheposteriorabdominalwall)Mediansacrala.骶正中動脈2021/10/1032Visceralbranches

PairedbranchesMiddlesuprarenalartery腎上腺中動脈Renalartery腎動脈Testicular(ovarian)artery睪丸（卵巢）動脈2021/10/1033Unpairedbranches

Celiactrunk

腹腔干－ashortthickvesselthatarisesfromthefrontofaorta,atthelevelofT12Superiormesenterica.腸系膜上動脈－arisesfromthefrontofaorta,atthelevelofL2Inferiormesenterica.腸系膜下動脈－arisesfromthefrontofaorta,atlevelofL32021/10/1034Leftgastrica.Commonhepatica.Splenica.Gastroduodenala.Properhepatica.Rightgastrica.LeftbranchRightbranchCystica.Shortgastrica.

Leftgastrioeploica.Rightgastroepiploica.Superiorpancreaticoduodenala.Splemicbranches

Celiactrunk

2021/10/1035Celiactrunk

2021/10/1036Superiormesenterica.

Inf.pancresticodudenala.Jejunalandileala.Ileocolica.Appendiculara.Rightcolica.Middlecolica.

SuperiorMesentericv.2021/10/1037Inferiormesenterica.Leftcolica.Sigmoida.Superiorrectala.

Inferiormesentericv.2021/10/1038Colicmarginalartery2021/10/1039RelationsofabdominalaortaAnteriorly(fromabovedownward)PancreasAscendingpartofduodenumRadixofmesenteryPosteriorlyUpperfourlumbervertebraeOnitsrightInferiorvenacavaOnitsleftLeftsympathetictrunk2021/10/1040VeinsofabdomenandpelvisInternaliliacvein髂內靜脈Parietaltributaries:accompanywitharteriesVisceraltributaries

→superiorrectalvein→inferiormesentericv.①Rectalvenousplexus →inferiorrectalvein→internaliliacv.

直腸靜脈叢 →analvein→internalpudendalv.②Vesicalvenousplexus膀胱靜脈叢→vesicalv.③Uterinevenousplexus子宮靜脈叢→uterinev.2021/10/1041

Externaliliacvein

髂外靜脈–accompanythearteryCommoniliacvein

髂總靜脈–formedbyunionofinternalandexternaliliacveinsinfrontofsacroiliacjoint,enduponL4~L5byunitingeachothertoforminferiorvenacava2021/10/1042Inferiorvenacava

下腔靜脈FormedbyunionoftwocommoniliacveinsanteriortoandjusttotherightofL4~L5Ascendsontherightsideofaorta,piercesvenacavaforamenofdiaphragmoppositetheT8anddrainsintotherightatriumConveysbloodfromthewholebodybelowthediaphragmtotherightatrium2021/10/1043ChieftributariesParietalPairedinferiorphrenicv.膈下靜脈pairedlumbarv.腰靜脈

(four)VisceralRightandleftrenalveins左、右腎靜脈Rightsuprarenalvein右腎上腺靜脈(leftdrainintoleftrenalvein) Righttesticularorovarianv右睪丸（卵巢）靜脈.(leftdrainintoleftrenalvein) Hepaticveins肝靜脈:right,leftandintermediate2021/10/1044RelationsofinferiorvenacavaAnteriorly(craniallytocaudally)LiverHeadofpancreasHorizontalpartofduodenumRighttesticular(orovarian)a.RadixofmesenteryPosteriorlyRightcrusofdiaphragmUpperfourlumbervertebraeLeftsympathetictrunkParietalbranchesofabdominalaortaOnitsrightPsoasmajorRightkidneyRightsuprarenalglandOnitsleftAbdominalaorta2021/10/1045Hepaticportalvein肝門靜脈

GeneralfeaturesFormedbehindtheneckofpancreasbytheunionofsuperiormesentericveinandsplenicveinAscendsupwardsandtotheright,posteriortothefirstpartofduodenumandthenentersthelesseromentumtotheportahepatis,whereitdividesintorightandleftbranchesTherearenofunctioningvalvesinhepaticportalsystemDrainsbloodfromgastrointestinaltractfromthelowerendofoesophagustotheupperendofanalcanal,pancreas,gallbladder,bileductsandspleen2021/10/1046Variationandanomaliesofhepaticportalvein2021/10/1047Tributariesofhepaticportalvein

1.Superiormesentericv.腸系膜上靜脈2.Inferiormesentericv.腸系膜下靜脈3.Splenicv.脾靜脈4.Leftgastricv.胃左靜脈5.Rightgastricv.胃右靜脈6.Cysticv.膽囊靜脈7.Paraumbilicalv.附臍靜脈2021/10/1048Portal-systemicanastomoses1.Atthelowerendoftheoesophagus

Hepaticportalvein→leftgastricvein→esophagealvenousplexus→esophagealvein→azygosvein→superiorvenacava2.Atrectalvenousplexus

Hepaticportalvein→splenicvein→inferiormesentericvein→superiorrectalvein→rectalvenousplexus→inferiorrectalandanalveins→internaliliacvein→inferiorvenacava3.AtperiumbilicalvenousplexusHepaticportalvein→paraumbilicalvein→periumbilicalvenousplexus→thoracoepigastricandsuperiorepigastricvein→superiorvenacavasuperficialepigastricandinferiorepigastricveins→inferiorvenacava2021/10/10494.Portal-retroperitonealanastomosis

Betweentheretroperitonealbranchesofthecolicveinsandthelumbarveins,pancreaticoduodenalveinswiththerenalveinsandthesubcapsularveinsoftheliverwiththephrenicveinstwigsofcolicveins(portal)anastomosingwithsystemicretroperitonealveins2021/10/1050ThelymphaticdrainageofabdomenLymphaticdrainageofabdominalwallToaxillarylymphnodefromregionaboveumbilicusTosuperficialinguinallymphnodefromregionbelowumbilicusTolumbarlymphnodefrompostwallofabdomen2021/10/1051LymphaticdrainageofabdominalvisceraLumbarlymphnodes腰淋巴結Lieonposteriorabdominalwall,alongtheabdominalaortaandinferiorvenacavaReceivelymphfromkidneys,suprarenalglands,testes,ovarirs,fundusofuterus,ovary,andcommoniliacnodesRightandleftlumbartrunksformedbyefferentvesselPairedviscera－draintothelumbarlymphnodes2021/10/1052Celiaclymphnodes腹腔淋巴結－situatedaroundtheceliactrunkSuperiormesentericlymphnode腸系膜上淋巴結－situatedaroundsuperiormesenterica.Inferiormesentericlymphnode腸系膜下淋巴結－situatedaroundinferiormesenterica.Intestinaltrunk腹腔干－formedbyefferentvesselofceliac,superiorandinferiorlymphnodes2021/10/1053Thoracicduct胸導管BeginsinfrontofL1asadilatedsac,thecisternachyli,whichformedbyjoiningofleftandrightlumbartrunksandintestinaltrunkEnterthoraciccavitybypassingthroughtheaortichiatusofthediaphragmandascendsalongonthefrontofthevertebralcolumn,betweenthoracicaortaandazygosveinTravelsupward,veeringtotheleftatthelevelofT5Attheroofoftheneck,itturnslaterallyandarchesforwardsanddescendstoentertheleftvenousangleJustbeforetermination,itreceivestheleftjugular,subclavianandbronchomediastinaltrunksDrainslymphfromlowerlimbs,pelviccavity,abdominalcavity,leftsideofthorax,andleftsideofthehead,neckandleftupperlimb2021/10/1054Spleen脾Location:liesinthelefthypochondriacregion(betweenstomachanddiaphragm)deeptothe9thto11thrib,itslongaxiscorrespondsroughlytothe10thribShape－reddishincolour2021/10/1055TwosurfacesDiaphragmatic:smooth,convexVisceral:concave,hilumofspleenTwoextremities

Anterior－widerPosterior－rounderTwoborder

Superior－h(huán)as2-3splenicnotch脾切跡,whichserveasalandmarkonpalpationwhenitisenlarge;normallyitisnotpalpableInferior－rounderFunctions:thespleenisconsideredtobeimportantin:FormationoflymphocytesandmonocytePhagocytosisofbacteria,inertparticlesandwhitebloodcellsandplateletsDestroyingeffeteorabnormalredbloodcellsMakingantibodies2021/10/1056RalationshipsofspleenDiaphragmaticsurface－diaphragmVisceralsurfaceAnteriorly－fundusofstomachPosteriorly－leftsuprarenalglandandkidneyInferiorly－tailofpancreasandleftcolicflexure2021/10/1057NerversofabdomenLumbarplexus腰叢Formation:formedbyanteriorramiofL1-L3,apartofanteriorramiofT12andL4Position:lieswithinsubstanceofpsoasmajor2021/10/1058BranchesIliohypogastricn.髂腹下神經SupplieslowerpartofanteriorabdominalwallIlioinguinaln.髂腹股溝神經PassesthroughinguinalcanaltosupplyskinofthegroinandscrotumLateralfemoralcutaneous股外側皮神經Femoraln.股神經Obturator

n.

閉孔神經Genitofemoraln.生殖股神經2021/10/1059Lumbarsympathetictrunk腰交感干MadeupofpairedchainswithfourtofivelumbargangliaanterolateraltovertebralcolumnEntersabdomenviathediaphragmandasacontinuationofhethoracicpartPassesinferiorlybehindcommoniliacvesselsandterminationsbyjoiningtoformunpairedganglionimpar,anteriortosacrum2021/10/1060Abdomen3山東大學醫(yī)學院解剖教研室李振華2021/10/1061Relationshipsofabdominalviscera

Firstlayer－live,gallbladder,stomachSecondlayer－duodenum,pancreas,spleenThirdlayer－suprarenalgland,kidney,ureter,inferiorvenacava,abdominalaorta,nervesandlymphatics2021/10/1062

RelationshipsofthestomachAnterior:Live(rightpart)Diaphragm(leftupperpart)Anteriorabdominalwall(leftlowerpart)Posterior－separatedbyperitonumoflessersacfromthefollowing(“stumach-bed”)PancreasLeftsuprarenalglandLeftkidneySpleenTransversecolonandtransversmesoclon2021/10/1063ArteriesofstomachLeftandrightgastricarteriesarisefromceliactrunkandproperhepaticartery,repectively.Thesetwovesselsruninlesseromentumalonglessercurvature,andanastomoseend-to-end.2021/10/1064Rightandleft

gastroepiploicarteriesarisefromthegastroduodenalandsplenicartery,repectively.Thesetwovesselspassintothegreateromentum,runparalleltothegreatercurvature,andanastomoseend-to-end.Shortgastricarteries,branchesofsplenicartery,coursethroughthegastrosplenicligamentandsupplythefundusofstomach.Posteriorgastricartery(72%)arisefromthesplenicartery,coursethroughthegastrophrenicligamentandsupplytheposteriorwalloffundusofstomach.2021/10/1065VenousdrainageRightandleftgastricveinsemptydirectlyintohepaticportalvein.Leftgastroepiploicandshortgastricveinsdrainintohepaticportalveinviathesplenicvein.Rightgastroepiploicveinjoineithersuperiormesentericvein.2021/10/1066LymphaticsofstomachRightandleftgastricln.liealongthesamevesselsandfinallytotheceliacln.Rightandleftgastroomentalln.liealongthesamevessels,theformerdrainintosubpyloricln.,thelatterdrainintosplinicln.Supra-andsubpyloricln.receivelymphaticsfrompyloricpartandfinallytotheceliacln.Splenicln.receivelymphaticsfromfundusandleftthirdofstomach,andfinallytotheceliacln.2021/10/1067NervesupplyParasympatheticinnervationbyanterior(left)andposterior(right)vagaltrunksTheanteriortrunkdividesintoanteriorgastricandhepaticbranchesTheposteriortrunkdividesintoposteriorgastricandceliacbranchesTheanteriorandposteriorgastricbranchesdescendontheanteriorandposteriorsurfacesofthestomachasaruleabout1to2cmfromthelessercurvatureandparalleltoitinthelesseromentumasfarasthrpyloricantrumtofanoutintobranchescalled“crow’sfoot”tosupplythepyloricpartSympatheticinnervationMainlyfromceliacgangliaAffentandeffentfibersderivesfromthoracicsegments(T5－L12021/10/1068TheduodenumRelationshipsofsuperiorpart

AnteriorlyQuadratelobeofliveGallbladderPosteriorlyCommombileductGastroduodenala.Hepaticportalv.InferiorvenacavaSuperioelyOmentalforamenInferiorlyHeadofpancreas2021/10/1069RelationshipsofdescendingpartAnteriorlyLiveTransversecolonandmesocolonLoopsofsmallintestinePosteriorlyRightrenalhilumandureterRightrenalvesselsMediallyHeadofpancreasCommonbileductandpancreaticductLaterallyRightcolicflexure2021/10/1070RelationshipsofhorizontalpartSuperiorlyHeadofpancreasInferiorlyLoopsofsmallintestineAnteriorlyRadixofmesenterySuperiormesenterica.andv.PosteriorlyRightureterInferiorvenacavaAbdominalaorta2021/10/1071RelationshipsofascendingpartRightHeadofpancreasandabdominalaortaLeftLeftkidneyandureter2021/10/1072RelationshipsofliverDiaphragmaticsurface－separatedbydiaphragmfromthefollowingRightcostodiaphramaticrecessandlungCardiacbaseVisceralsurfaceLeftlobeisrelatedtothestomachandabdominalpartofesophagusRightlobeisrelatedtotherightcolicflexureanteroly,gallbladderandsuperiorduodenalflexuremedially,rightkidney,superarenalglandposteriorly2021/10/1073BloodsupplyArteriesSuperiorpancreaticoduodenala.Inferiorpancreaticoduodenala.Veins－followarteries,drainingdirectlyintosuperiormesentericandhepaticportalveins2021/10/1074DivisionsandrelationsofcommonbileductSupraduodenalsegment

Descend