肾脏的局部解剖(英)ppt课件

KidneysandAdrenalGlands,DepartmentofRegionalAnatomyandOperativeSurgery,1,Position,relationStructureBloodsupplyLymphaticdrainageInnervations,2,Position,RetroperitonealUpperpolesT12vertebraLowerpolesL3vertebraRightislowerthanleft,3,Cadaverickidneys,4,SurfaceProjectionofkidney,5,RenalAngle,Tendernessorpercussingpaincausedbykidneydiseaseislocalizedhere,6,NeighborofKidney,7,8,AnteriorSurfaceofthekidney,9,10,PosteriorSurface,11,Costodiaphragmaticrecessofthepleuralcavity,12,Renalhilum,RenalsinusandRenalpedicle,Renalhilum,Renalsinus,Renalpedicle,cortex,Renalcolumn,Renalpyramid,calyx,papilla,13,14,15,renalveinrenalarteryrenalpelvisFromabovedownwardstherenalarteryrenalveinrenalpelvis,Fromanteriortoposterior,16,Hydronephrosis,17,renalartery,T11,18,Renalartery,19,Vascularrenalsegment,Superior(apical),Anteriorsuperior(upper),Anteriorinferior(middle),Inferior(lower),posterior,20,variationofrenalartery,!,21,VariationofRenalArtery,22,Renalveins,23,24,Aorta-renalartery-segmentalartery-lobarartery-interlobarartery-arcuateartery-interlobulorartery-afferentarteriole-glomerulus(capillaries)-efferentarteriole-peritubularcapillariesandvasarecta-interlobularvein-arcuatevein-interlobarvein-renalvein-interiorvenacava,25,RenalCapsule,RenalfasciaAdiposecapsuleFibrouscapsule,26,Renalfascia,27,28,Fibrouscapsule,Adiposecapsule,Perirenalfat,Pararenalfat,29,30,31,FibrousCapsule,32,Ureter,33,Ureterisdividedinto3parts:abdominalpartpelvispartintramuralpart,34,28to34cm3narrowingsitesthepelviuretericjunctioncrossingthepelvicbrimtraversingthebladderwall,35,36,37,Horseshoekidney,38,SuprarenalGland,39,EndocrineglandT11levelRightistriangularLeftissemi-lunar,40,Relation,41,42,ArteryofAdrenalGland,43,44,45,Veinsofadrenalgland,Leftsuprarenalvein,intotheleftrenalveinRightsuprarenalvein,intotheinferiorvenacava,46,47,48,incision,Anteriortransperitonealapproach,Posteriorretroperitonealapproach,49,A55-year-oldwomanwasfoundrollingonherkitchenfloor,cryingoutfromagonizingpaininherabdomen.Thepaincameinwavesandextendedfromtherightlointothegroinandtothefrontoftherightthigh.Ananteroposteriorradiographoftheabdomenrevealedacalculusintherightureter.,CaseA,50,Whatcausesthepainwhenaureteralcalculusispresent?Whyisthepainfeltinsuchanextensivearea?Wheredoesonelookforthecourseoftheureterinaradiograph?Wherealongtheureterisacalculuslikelytobeheldup?,Question,51,AnexplorerintheAmazonjunglewasfoundaliveafterhavinglostcontactwiththeoutsideworldforsixmonths.Onphysicalexamination,hewasfoundtobeinanemaciatedcondition.Onpalpationoftheabdomen,arounded,smoothswellingappearedintherightloinattheendofinspiration.Onexpiration,theswellingmovedupwardandcouldnolongerbefelt.Whatanatomicalstructurecouldproducesuchaswelling?,CaseB,52,Anintravenouspyelogramrevealedthatapatientsleftkidneywasinitsnormalposition,buttherightkidneywassituatedinfrontoftherightsacroiliacjoint.Canyouexplainthisonembryologicalgrounds?,CaseC,53,Anexaminationofapatientrevealedthatshehadahorseshoekidney.Whatanatomicalstructurepreventsahorseshoekidneyfromascendingtoalevelabovetheumbilicus?,CaseD,54,Anintravenouspyelogramrevealedthatthecalycesandpelvisofapatientsrightkidneyweregrosslydilated(aconditionknownashydronephrosis).Whatembryologicalanomalymayberesponsibleforthiscondition?,CaseE,55,Whichcongenitalanomalyoftheureterislikelytopresentasacaseofurinaryincontinence?,CaseF,56,operationprocedureofkidneytransplant,57,nephrectomy,Foranephrectomy,thekidneycommonlyisexposedintheloin.Afteranobliqueincisionmidwaybetweenthetwelfthribandtheiliaccrest,theposteriorfreeborderoftheexternalobliqueisidentified,anddividedtorevealtheperitoneum,whichispushedforwardtorevealtherenalfasc