腹部解剖图谱

Abdominalwall 山东大学医学院解剖教研室李振华 Anteriorwall Layers fromsuperficialtodeep SkinSuperficialfasciaAnterolateralmusclesTransversalisfascia腹横筋膜Extraperitonealfascia腹膜下筋膜Parietalperitoneum壁腹膜 Superficialfascia divisionsbelowumbilicusSuperficialfattylayer Camper s Membranouslayer Scarpa s Musclesofabdomen AnterolateralgroupObliquusexternusabsominis腹外斜肌Oblequusenternusabdominis腹内斜肌Transversusabdominis腹横肌Rectusabdominis腹直肌 PosteriorgroupQuadiatuslumborum腰方肌Psoasmajor腰大肌 Obliquusexternusabsominis腹外斜肌 Generaldirectionoffibers downward forwardandmedially rundownandinward StructuresInguinalligament腹股沟韧带Lacunarligament腔隙韧带Superficialinguinalring腹股沟浅环 triangular shapeddefectinaponeurosisofobliquusexternusabdominisabovepubictubercle Obliquusinternusabdominis腹内斜肌 DeeptoobliquusexternusabdominisGeneraldirectionoffibres upwards forwardsandmedially Transverselsabdominis腹横肌 Deeptoobliquusinternus Inguinalfalx腹股沟镰 archoverspermaticcord insertedwithtransversesabdominisfiberintomedialpartofpectenofpubisCremaster提睾肌 aroundthespermaticcordandtestis Rectusabdominis腹直肌 Position lieontoeitherofmidlineOrigin pubiccrestandsymphysisInsertion xiphoidand5th 7thcostalcartilagesHas3 4tendinousintersections腱划lineasemiluaris半月线 Similarfunctionsforabovefourpairsofmuscles SupportandcompresstheabdominalvisceraIncreaseintra abdominalpressure aidinexpulsiveefforts vomiting coughing sneezing defecation urinationandchildbirth Depressribs assistin theactofforce 4 expiration Flex lateralflex androtatevertebralcolumn Sheathofrectusabdominis腹直肌鞘 Antlayer formedbyfusionofaponeurosisofobliquusexternusabdominisandanteriorleafofaponeurosisofobliquusinternusabdominisPostlayerFormedbyfusionofposterionleafofaponeurosisofobliquusinternusabdominisandaponeurosisoftransversesabdominisAbsentinabout4 5cmbelowtheumbilicus whereaponeurosesofallthreemusclesformanteriorlayerthelowerfreebordernamedarcuatelineBelowthislinerectusabdominisincontactwithtransversefascia Lineaalba白线 tendinousraphebetweenrightandleftrectifromxiphoidtopubicsymphysis Inguinalregion腹股沟区 BoundariesInguinalligamentLateralmarginofrectusabdominisAhorizontallinestretchingfromanterioriliacspinetolaeralmarginofrectusabdominis Descentoftestes Seven weekembryoshowingthetestisbeforeitsdescentfromthedorsalabdominalwall Fetusat28weekthetestispassingthroughtheinguinalcanal Newborn Inguinalcanal腹股沟管 Position obliquepassage 4cmlong located1 5cmabovemedialhalfofinguinallig BoundariesAntwallAponeurosisofobliquusexternusabdominisObliquusinternusabdominis lateralthirdofwall PostwallTransversefasciaInguinalflaxmediallyRoof archedlowerfibersofobliquusinternusandtransversuaabdominisFloor inguinallig TwoopeningsSuperficialinguinalring腹股沟浅环Deepinguinalring腹股沟深环 defectintransversefascia1 5cmabovemidpointofinguinalligament StructurespassingthroughtheinguinalcanalSpermaticcord精索andilioinguinalnerve髂腹股沟神经inmalesRoundligamentofuterus子宫圆韧带andilioinguinalnerve髂腹股沟神经infemales InguinalTriangle ofHesselbach 腹股沟三角 BoundariesInguinalligamentinferiorlyLateralborderofrectusabdominismediallyInferiorepigastricarterylaterally Indirectinguinalheiniaanddirecetinguinalheinia Superficialvesselsandcutaneousnerves ArteriesSuperficialepigastrica Superficialiliaccircumflexa VeinsThoracoepigastricv Superficialepigastricv CutaneousnervesAnteriorandlateralcutaneousn oflowersixthoracicIliohypogastricn firstlumbnerves Deepvesselsandnerves ArteresSuperiorandinferiorepigastricarterisLowerposteriorintercostala Subcostala Fourlumbara NervesIliohypogastricn 髂腹下神经ArisesfromlubarplexusPassesforwardintheintervalbetweenobliquusinternusandtranversusabdominisPiecesobliquusinternusabdominis2 5cmmedialtoanteriorsuperioriliacspinePiecesaponeurosisofobliquusexternusabdominisabout2 5cmabovesuperficialinguinalringIlioinguinaln 髂腹股沟神经Runsparallelwithiliohypogastricn atalowerlevelEntersinguinalcanalandemergesthroughsuperficialinguinalringGenitofemoraln 生殖股神经 Layer Abdomen2 山东大学医学院解剖教研室李振华 Abdominalaorta腹主动脉 ContinuationofthoracicaortaataortichiatusofdiaphragminfrontofT12TerminatesatlowerborderofL4vertebrabydividingintorightandleftcommoniliacarteries ParietalbranchesInferiorphrenica 膈下动脉 onepair Lumbara 腰动脉 fourpairsofarteriesthatsupplytheposteriorabdominalwall Mediansacrala 骶正中动脉 VisceralbranchesPairedbranchesMiddlesuprarenalartery肾上腺中动脉Renalartery肾动脉Testicular ovarian artery睾丸 卵巢 动脉 UnpairedbranchesCeliactrunk腹腔干 ashortthickvesselthatarisesfromthefrontofaorta atthelevelofT12Superiormesenterica 肠系膜上动脉 arisesfromthefrontofaorta atthelevelofL2Inferiormesenterica 肠系膜下动脉 arisesfromthefrontofaorta atlevelofL3 Celiactrunk Celiactrunk Colicmarginalartery RelationsofabdominalaortaAnteriorly fromabovedownward PancreasAscendingpartofduodenumRadixofmesenteryPosteriorlyUpperfourlumbervertebraeOnitsrightInferiorvenacavaOnitsleftLeftsympathetictrunk Veinsofabdomenandpelvis Internaliliacvein髂内静脉Parietaltributaries accompanywitharteriesVisceraltributaries superiorrectalvein inferiormesentericv Rectalvenousplexus inferiorrectalvein internaliliacv 直肠静脉丛 analvein internalpudendalv Vesicalvenousplexus膀胱静脉丛 vesicalv Uterinevenousplexus子宫静脉丛 uterinev Externaliliacvein髂外静脉 accompanythearteryCommoniliacvein髂总静脉 formedbyunionofinternalandexternaliliacveinsinfrontofsacroiliacjoint enduponL4 L5byunitingeachothertoforminferiorvenacava Inferiorvenacava下腔静脉 FormedbyunionoftwocommoniliacveinsanteriortoandjusttotherightofL4 L5Ascendsontherightsideofaorta piercesvenacavaforamenofdiaphragmoppositetheT8anddrainsintotherightatriumConveysbloodfromthewholebodybelowthediaphragmtotherightatrium ChieftributariesParietalPairedinferiorphrenicv 膈下静脉pairedlumbarv 腰静脉 four VisceralRightandleftrenalveins左 右肾静脉Rightsuprarenalvein右肾上腺静脉 leftdrainintoleftrenalvein Righttesticularorovarianv右睾丸 卵巢 静脉 leftdrainintoleftrenalvein Hepaticveins肝静脉 right leftandintermediate RelationsofinferiorvenacavaAnteriorly craniallytocaudally LiverHeadofpancreasHorizontalpartofduodenumRighttesticular orovarian a RadixofmesenteryPosteriorlyRightcrusofdiaphragmUpperfourlumbervertebraeLeftsympathetictrunkParietalbranchesofabdominalaortaOnitsrightPsoasmajorRightkidneyRightsuprarenalglandOnitsleftAbdominalaorta Hepaticportalvein肝门静脉 GeneralfeaturesFormedbehindtheneckofpancreasbytheunionofsuperiormesentericveinandsplenicveinAscendsupwardsandtotheright posteriortothefirstpartofduodenumandthenentersthelesseromentumtotheportahepatis whereitdividesintorightandleftbranchesTherearenofunctioningvalvesinhepaticportalsystemDrainsbloodfromgastrointestinaltractfromthelowerendofoesophagustotheupperendofanalcanal pancreas gallbladder bileductsandspleen Variationandanomaliesofhepaticportalvein Tributariesofhepaticportalvein1 Superiormesentericv 肠系膜上静脉2 Inferiormesentericv 肠系膜下静脉3 Splenicv 脾静脉4 Leftgastricv 胃左静脉5 Rightgastricv 胃右静脉6 Cysticv 胆囊静脉7 Paraumbilicalv 附脐静脉 Portal systemicanastomoses1 AtthelowerendoftheoesophagusHepaticportalvein leftgastricvein esophagealvenousplexus esophagealvein azygosvein superiorvenacava2 AtrectalvenousplexusHepaticportalvein splenicvein inferiormesentericvein superiorrectalvein rectalvenousplexus inferiorrectalandanalveins internaliliacvein inferiorvenacava3 AtperiumbilicalvenousplexusHepaticportalvein paraumbilicalvein periumbilicalvenousplexus thoracoepigastricandsuperiorepigastricvein superiorvenacavasuperficialepigastricandinferiorepigastricveins inferiorvenacava 4 Portal retroperitonealanastomosisBetweentheretroperitonealbranchesofthecolicveinsandthelumbarveins pancreaticoduodenalveinswiththerenalveinsandthesubcapsularveinsoftheliverwiththephrenicveinstwigsofcolicveins portal anastomosingwithsystemicretroperitonealveins Thelymphaticdrainageofabdomen LymphaticdrainageofabdominalwallToaxillarylymphnodefromregionaboveumbilicusTosuperficialinguinallymphnodefromregionbelowumbilicusTolumbarlymphnodefrompostwallofabdomen LymphaticdrainageofabdominalvisceraLumbarlymphnodes腰淋巴结Lieonposteriorabdominalwall alongtheabdominalaortaandinferiorvenacavaReceivelymphfromkidneys suprarenalglands testes ovarirs fundusofuterus ovary andcommoniliacnodesRightandleftlumbartrunksformedbyefferentvesselPairedviscera draintothelumbarlymphnodes Celiaclymphnodes腹腔淋巴结 situatedaroundtheceliactrunkSuperiormesentericlymphnode肠系膜上淋巴结 situatedaroundsuperiormesenterica Inferiormesentericlymphnode肠系膜下淋巴结 situatedaroundinferiormesenterica Intestinaltrunk腹腔干 formedbyefferentvesselofceliac superiorandinferiorlymphnodes Thoracicduct胸导管BeginsinfrontofL1asadilatedsac thecisternachyli whichformedbyjoiningofleftandrightlumbartrunksandintestinaltrunkEnterthoraciccavitybypassingthroughtheaortichiatusofthediaphragmandascendsalongonthefrontofthevertebralcolumn betweenthoracicaortaandazygosveinTravelsupward veeringtotheleftatthelevelofT5Attheroofoftheneck itturnslaterallyandarchesforwardsanddescendstoentertheleftvenousangleJustbeforetermination itreceivestheleftjugular subclavianandbronchomediastinaltrunksDrainslymphfromlowerlimbs pelviccavity abdominalcavity leftsideofthorax andleftsideofthehead neckandleftupperlimb Spleen脾 Location liesinthelefthypochondriacregion betweenstomachanddiaphragm deeptothe9thto11thrib itslongaxiscorrespondsroughlytothe10thribShape reddishincolour TwosurfacesDiaphragmatic smooth convexVisceral concave hilumofspleenTwoextremitiesAnterior widerPosterior rounderTwoborderSuperior has2 3splenicnotch脾切迹 whichserveasalandmarkonpalpationwhenitisenlarge normallyitisnotpalpableInferior rounderFunctions thespleenisconsideredtobeimportantin FormationoflymphocytesandmonocytePhagocytosisofbacteria inertparticlesandwhitebloodcellsandplateletsDestroyingeffeteorabnormalredbloodcellsMakingantibodies RalationshipsofspleenDiaphragmaticsurface diaphragmVisceralsurfaceAnteriorly fundusofstomachPosteriorly leftsuprarenalglandandkidneyInferiorly tailofpancreasandleftcolicflexure Nerversofabdomen Lumbarplexus腰丛Formation formedbyanteriorramiofL1 L3 apartofanteriorramiofT12andL4Position lieswithinsubstanceofpsoasmajor BranchesIliohypogastricn 髂腹下神经SupplieslowerpartofanteriorabdominalwallIlioinguinaln 髂腹股沟神经PassesthroughinguinalcanaltosupplyskinofthegroinandscrotumLateralfemoralcutaneous股外侧皮神经Femoraln 股神经Obturatorn 闭孔神经Genitofemoraln 生殖股神经 Lumbarsympathetictrunk腰交感干 MadeupofpairedchainswithfourtofivelumbargangliaanterolateraltovertebralcolumnEntersabdomenviathediaphragmandasacontinuationofhethoracicpartPassesinferiorlybehindcommoniliacvesselsandterminationsbyjoiningtoformunpairedganglionimpar anteriortosacrum Abdomen3 山东大学医学院解剖教研室李振华 Relationshipsofabdominalviscera Firstlayer live gallbladder stomachSecondlayer duodenum pancreas spleenThirdlayer suprarenalgland kidney ureter inferiorvenacava abdominalaorta nervesandlymphatics Relationshipsofthestomach Anterior Live rightpart Diaphragm leftupperpart Anteriorabdominalwall leftlowerpart Posterior separatedbyperitonumoflessersacfromthefollowing stumach bed PancreasLeftsuprarenalglandLeftkidneySpleenTransversecolonandtransversmesoclon Arteriesofstomach Leftandrightgastricarteriesarisefromceliactrunkandproperhepaticartery repectively Thesetwovesselsruninlesseromentumalonglessercurvature andanastomoseend to end Rightandleftgastroepiploicarteriesarisefromthegastroduodenalandsplenicartery repectively Thesetwovesselspassintothegreateromentum runparalleltothegreatercurvature andanastomoseend to end Shortgastricarteries branchesofsplenicartery coursethroughthegastrosplenicligamentandsupplythefundusofstomach Posteriorgastricartery 72 arisefromthesplenicartery coursethroughthegastrophrenicligamentandsupplytheposteriorwalloffundusofstomach VenousdrainageRightandleftgastricveinsemptydirectlyintohepaticportalvein Leftgastroepiploicandshortgastricveinsdrainintohepaticportalveinviathesplenicvein Rightgastroepiploicveinjoineithersuperiormesentericvein LymphaticsofstomachRightandleftgastricln liealongthesamevesselsandfinallytotheceliacln Rightandleftgastroomentalln liealongthesamevessels theformerdrainintosubpyloricln thelatterdrainintosplinicln Supra andsubpyloricln receivelymphaticsfrompyloricpartandfinallytotheceliacln Splenicln receivelymphaticsfromfundusandleftthirdofstomach andfinallytotheceliacln NervesupplyParasympatheticinnervationbyanterior left andposterior right vagaltrunksTheanteriortrunkdividesintoanteriorgastricandhepaticbranchesTheposteriortrunkdividesintoposteriorgastricandceliacbranchesTheanteriorandposteriorgastricbranchesdescendontheanteriorandposteriorsurfacesofthestomachasaruleabout1to2cmfromthelessercurvatureandparalleltoitinthelesseromentumasfarasthrpyloricantrumtofanoutintobranchescalled crow sfoot tosupplythepyloricpartSympatheticinnervationMainlyfromceliacgangliaAffentandeffentfibersderivesfromthoracicsegments T5 L1 Theduodenum RelationshipsofsuperiorpartAnteriorlyQuadratelobeofliveGallbladderPosteriorlyCommombileductGastroduodenala Hepaticportalv InferiorvenacavaSuperioelyOmentalforamenInferiorlyHeadofpancreas RelationshipsofdescendingpartAnteriorlyLiveTransversecolonandmesocolonLoopsofsmallintestinePosteriorlyRightrenalhilumandureterRightrenalvesselsMediallyHeadofpancreasCommonbileductandpancreaticductLaterallyRightcolicflexure RelationshipsofhorizontalpartSuperiorlyHeadofpancreasInferiorlyLoopsofsmallintestineAnteriorlyRadixofmesenterySuperiormesenterica andv PosteriorlyRightureterInferiorvenacavaAbdominalaorta RelationshipsofascendingpartRightHeadofpancreasandabdominalaortaLeftLeftkidneyandureter Relationshipsofliver Diaphragmaticsurface separatedbydiaphragmfromthefollowingRightcostodiaphramaticrecessandlungCardiacbaseVisceralsurfaceLeftlobeisrelatedtothestomachandabdominalpartofesophagusRightlobeisrelatedtotherightcolicflexureanteroly gallbladderandsuperiorduodenalfl