【医学课件大全】the liver (hepar)

Section 7Section 7 The Liver (Hepar) The Liver (Hepar) Systematic Anatomy1Dept of Anatomy, Medical College, Qingdao University The Liver (Hepar) The Liver (Hepar) A. Location Right hypochondriac region (右季肋区) & epigastric region (腹上 区) B. Weight M: 1.2 1.5 kg F : 1.0 1.3 kg Systematic Anatomy2Dept of Anatomy, Medical College, Qingdao University The Liver The Liver (Hepar)(Hepar) C. External feature 1. Diaphragmatic surface (膈面) 1) right lobe (右叶) 2) left lobe (左叶) 3) bare area (裸区) sulcus for vena cava (腔静脉沟) Systematic Anatomy3Dept of Anatomy, Medical College, Qingdao University TheThe Liver (Hepar)Liver (Hepar) 2. Visceral surface (脏面) 1) right lobe (右叶) a. fossa for gallbladder (胆囊窝) b. renal impression (肾压迹) c. colic impression (结肠压迹结肠压迹) 2) left lobe (左叶) gastric impression (胃压迹) 3) quadrate lobe (方叶) 4) caudate lobe (尾状叶) 5) porta hepatis (肝门) Systematic Anatomy4Dept of Anatomy, Medical College, Qingdao University TheThe Liver (Hepar)Liver (Hepar) D. Internal Structure hepatic lobules (肝小叶) E. Functions 1. Bile secretion (分泌胆 汁) 8001000 ml/d, pH 7.6 -8.6 (bile salts 胆盐 & bile pigments 胆色素) 2. Detoxification (解毒): NHNH 3 3 & urea 3. Phagocytosis (吞噬): by Kupffer cells. Systematic Anatomy5Dept of Anatomy, Medical College, Qingdao University TheThe Liver (Hepar)Liver (Hepar) 4. Hematopoiesis (造血 ): in embryo 5. Coagulation (凝血) 6. Storage of glycogen (糖原) & vitamins hepatitis 肝炎 cirrhosis 肝硬化 liver cancer 肝癌 Systematic Anatomy6Dept of Anatomy, Medical College, Qingdao University TheThe Liver (Hepar)Liver (Hepar) F. Liver Segments (肝段) G. Hepatic fissures (肝裂) 1. middle hepatic fissure 2. interlobular fissures 3. Intersegmental fissures AS MS MI AI LS LI PS PI PI PS AI MI LI LS CL Liver Segments Systematic Anatomy7Dept of Anatomy, Medical College, Qingdao University TheThe Liver (Hepar)Liver (Hepar) Variations in form of liver (肝形态变异) Diaphragmatic grooves “Saddlelike” liverSmall left lobe “Tonguelike” liver Atrophy of left lobe Deep renal impression Systematic Anatomy8Dept of Anatomy, Medical College, Qingdao University B. The Gallbladder andB. The Gallbladder and biliary ducts biliary ducts 1. Gallbladder (胆囊 ) 1) fundus (底) 2) body (体): stores and concentrates bile (储存,浓缩胆汁) 3) neck (颈) 4) cystic duct (胆囊管 ) Murfys sign cholecystitis 胆囊炎 gall-stone 胆囊石病 Systematic Anatomy9Dept of Anatomy, Medical College, Qingdao University The Gallbladder andThe Gallbladder and biliary ducts biliary ducts 2. Biliary ducts (胆道) 1) right hepatic duct (肝右管) 2) left hepatic duct (肝左管)管管 3) common hepatic duct (肝总) 4) common bile duct (胆总管) 5) hepatopancreatic (Vaters) ampulla (肝胰壶腹) biliary ascariasis 胆道蛔虫病 obstructive jaundice 阻塞性黄疸 Systematic Anatomy10Dept of Anatomy, Medical College, Qingdao University The Gallbladder andThe Gallbladder and biliary ducts biliary ducts Accessory hepatic ducts (副肝管) Variations in Cystic & hepatic ducts (胆囊管和肝管变异) Systematic Anatomy11Dept of Anatomy, Medical College, Qingdao University Section 8Section 8 The Pancreas The Pancreas A. Divisions 1. Head (头): uncinate process (钩突) carcinoma of head of pancreas 胰头癌 2. Neck (颈) 3. Body (体) 4. Tail (尾) acute pancreatitis 急性胰腺炎 adenocarcinoma of pancreas 胰腺腺癌 Systematic Anatomy12Dept of Anatomy, Medical College, Qingdao University Pancreas in situ (原位胰) The PancreasThe Pancreas Systematic Anatomy13Dept of Anatomy, Medical College, Qingdao University Variations in Pancreatic Ducts (胰管变异) The PancreasThe Pancreas Systematic Anatomy14Dept of Anatomy, Medical College, Qingdao University B. Structure 1. Main pancreatic duct (主胰管) 2. Accessory pancreatic duct (副胰管) The PancreasThe Pancreas Systematic Anatomy15Dept of Anatomy, Medical College, Qingdao University 3. Sphincter of pancreatic duct (胰管括约肌 ) 4. Hepatopancreatic (Vaters) ampulla (肝胰壶腹) 5. Sphincter of common bile duct (Oddis sphincter) (胆总管括约肌) The PancreasThe Pancreas Systematic Anatomy16Dept of Anatomy, Medical College, Qingdao University C. Function 1. Exocrine function (外分泌): Secretes pancreatic juice (胰液) 1200 1500ml/d, pH 7.1-8.2 digestive enzymes (消化酶): trypsin (胰蛋 白酶), carboxypeptidase (羧肽酶), am