腹膜后隙ppt课件

腹膜后隙 内容： 一、肾 二、输尿管 三、血管、神经 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 概 述 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 腹膜后隙位置：腹后 壁腹膜后方。 范围：上自膈，下至 骶岬，两侧续腹膜外 筋膜。向下续盆部的 腹膜后间隙。 （一）肾 kidney 内容： （一）肾的位置和毗邻 （二）肾蒂 （三）肾的血管 （四）肾的被膜 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 一、肾的位置及毗邻 肾位于脊柱 两侧，腹膜后方 ，紧贴腹后壁的 上部。 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 左肾位置： 上端平第11胸椎下缘 下端平第2腰椎下缘 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 上端平第12胸椎上缘 下端平第3腰椎上缘 第12肋跨过左肾的中 部，右肾的上部。 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 右肾位置右肾位置： 肾门位置： 肾门平第一腰 椎平面，距正中线 约5cm。 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 肾区： 竖脊肌外侧缘与第 12肋之间的部位称肾区 （肋脊角）。在某些肾 疾病患者，叩击或触压 该区可引起疼痛。 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 肾的毗邻： 两肾后面：膈 腰大肌 腰方肌 腹横肌 两肾上端: 肾上腺 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 右肾前面邻： 肝右叶 结肠右曲 十二指肠降部 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 左肾前面邻： 胃 胰 空肠 结肠左曲 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 二、肾门、肾蒂 肾门： 肾的内侧 缘中部凹陷，是肾 的血管、神经、淋 巴管和肾盂出入肾 的部位，称肾门。 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 肾蒂 renal pedicle： 出入肾门的结构合称 肾蒂，主要结构肾动 脉、肾静脉、肾盂。 右侧肾蒂较左侧短。 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 由前向后依次为： 肾静脉、肾动脉、肾盂 从上向下依次为： 肾动脉、肾静脉、肾盂 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 肾蒂主要结构的排列关系肾蒂主要结构的排列关系: : 三、肾的被膜 肾表面包有三层被膜，由内向外为： January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 纤维囊 脂肪囊 肾筋膜 （二）输尿管 ureter 输尿管起于肾盂 ，终于膀胱，长约 2530cm。 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 输尿管行程分部: 分三部: January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 腹 部 盆 部 壁 内 部 输尿管腹部 ： 位于腹膜后方， 沿腰大肌前面下降至 小骨盆上口处，左右 输尿管分别跨过髂血 管的前面，进入盆腔 移行于盆段。 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 输尿管腹部在 腰大肌前面中点处 与睾丸血管（男） 或卵巢血管（女） 相交叉（血管位于 输尿管前面）。 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 腹部的血管、神经 腹主动脉从膈的 主动脉裂孔沿脊柱 左前方下降，至第 四腰椎平面分为左 、右髂总动脉。其 右侧邻下腔静脉。 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 动脉：腹主动脉 腹主动脉的分支有： January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 壁 支 脏 支 1.壁支主要有： 膈下动脉 4对腰动脉 骶正中动脉 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 2.脏支主要有： 成对的脏支 不成对的脏支 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG （1）成对的脏支 有3对: 肾上腺中动脉 肾动脉 睾丸动脉(精索内动脉) (在女性则称卵巢动脉) January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG （2）不成对的脏支 有3支： 腹腔干 肠系膜上动脉 肠系膜下动脉 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 膈下动脉发出: 肾上腺上动脉 腹主动脉发出: 肾上腺中动脉 肾动脉发出: 肾上腺下动脉 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 肾上腺的动脉 （3对） January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 静脉：下腔静脉 inferior vena cava 下腔静脉由 左、右髂总静脉 在第5腰椎右侧汇 合而成。下腔静 脉收集下肢、盆 部和腹部的静脉 。 下腔静脉的属支有： January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 壁支 脏支 1.壁支： 膈下静脉 对腰静脉 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 2. 脏支： 成对脏器和肝的静 脉注入下腔静脉, 不成 对脏器的静脉先汇合成 肝门静脉, 入肝后再经 肝静脉入下腔静脉。 January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 3对： (1)肾静脉 (2)肾上腺静脉 (3)(3)生殖腺静脉 成对脏器的静脉： January, 2007 Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG (1)肾静脉 renal V 左侧长于右侧。 (2)肾上腺静脉 右侧注入下腔静脉, 左侧注入肾静脉。 (3)(3)生殖腺静脉 右侧注入下腔静脉,左侧注入肾静脉。 肝静脉hepatic V.一般有左、中、 右3条, 包埋在肝实质内, 在腔静脉沟 上份（裸区）注入下腔静脉。 January, 2007 Copyrigh