腹部解剖图谱ppt课件

腹部解剖图谱,Abdominalwall,腹部解剖图谱,Anteriorwall,Layers(fromsuperficialtodeep)SkinSuperficialfasciaAnterolateralmusclesTransversalisfascia腹横筋膜Extraperitonealfascia腹膜下筋膜Parietalperitoneum壁腹膜,腹部解剖图谱,SuperficialfasciadivisionsbelowumbilicusSuperficialfattylayer(Campers)Membranouslayer(Scarpas),腹部解剖图谱,Musclesofabdomen,AnterolateralgroupObliquusexternusabsominis腹外斜肌Oblequusenternusabdominis腹内斜肌Transversusabdominis腹横肌Rectusabdominis腹直肌,腹部解剖图谱,PosteriorgroupQuadiatuslumborum腰方肌Psoasmajor腰大肌,腹部解剖图谱,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,腹部解剖图谱,腹部解剖图谱,Obliquusinternusabdominis腹内斜肌,DeeptoobliquusexternusabdominisGeneraldirectionoffibres:upwards,forwardsandmedially,腹部解剖图谱,Transverselsabdominis腹横肌,Deeptoobliquusinternus,腹部解剖图谱,Inguinalfalx腹股沟镰:archoverspermaticcord,insertedwithtransversesabdominisfiberintomedialpartofpectenofpubisCremaster提睾肌:aroundthespermaticcordandtestis,腹部解剖图谱,Rectusabdominis腹直肌,Position:lieontoeitherofmidlineOrigin:pubiccrestandsymphysisInsertion:xiphoidand5th-7thcostalcartilagesHas3-4tendinousintersections腱划lineasemiluaris半月线,腹部解剖图谱,Similarfunctionsforabovefourpairsofmuscles,SupportandcompresstheabdominalvisceraIncreaseintra-abdominalpressure,aidinexpulsiveefforts-vomiting,coughing,sneezing,defecation,urinationandchildbirth.Depressribs,assistin(theactofforce(4)expiration.Flex,lateralflex,androtatevertebralcolumn,腹部解剖图谱,Sheathofrectusabdominis腹直肌鞘,AntlayerformedbyfusionofaponeurosisofobliquusexternusabdominisandanteriorleafofaponeurosisofobliquusinternusabdominisPostlayerFormedbyfusionofposterionleafofaponeurosisofobliquusinternusabdominisandaponeurosisoftransversesabdominisAbsentinabout4-5cmbelowtheumbilicus,whereaponeurosesofallthreemusclesformanteriorlayerthelowerfreebordernamedarcuatelineBelowthislinerectusabdominisincontactwithtransversefascia,腹部解剖图谱,Lineaalba白线tendinousraphebetweenrightandleftrectifromxiphoidtopubicsymphysis.,腹部解剖图谱,Inguinalregion腹股沟区,BoundariesInguinalligamentLateralmarginofrectusabdominisAhorizontallinestretchingfromanterioriliacspinetolaeralmarginofrectusabdominis,腹部解剖图谱,Descentoftestes,Seven-weekembryoshowingthetestisbeforeitsdescentfromthedorsalabdominalwall,腹部解剖图谱,Fetusat28weekthetestispassingthroughtheinguinalcanal,腹部解剖图谱,Newborn,腹部解剖图谱,Inguinalcanal腹股沟管,Position:obliquepassage,4cmlong,located1.5cmabovemedialhalfofinguinallig.,腹部解剖图谱,BoundariesAntwallAponeurosisofobliquusexternusabdominisObliquusinternusabdominis(lateralthirdofwall),腹部解剖图谱,PostwallTransversefasciaInguinalflaxmediallyRoofarchedlowerfibersofobliquusinternusandtransversuaabdominisFlooringuinallig,腹部解剖图谱,TwoopeningsSuperficialinguinalring腹股沟浅环Deepinguinalring腹股沟深环defectintransversefascia1.5cmabovemidpointofinguinalligament,腹部解剖图谱,StructurespassingthroughtheinguinalcanalSpermaticcord精索andilioinguinalnerve髂腹股沟神经inmalesRoundligamentofuterus子宫圆韧带andilioinguinalnerve髂腹股沟神经infemales,腹部解剖图谱,InguinalTriangle(ofHesselbach)腹股沟三角,BoundariesInguinalligamentinferiorlyLateralborderofrectusabdominismediallyInferiorepigastricarterylaterally,腹部解剖图谱,Indirectinguinalheiniaanddirecetinguinalheinia,腹部解剖图谱,Superficialvesselsandcutaneousnerves,ArteriesSuperficialepigastrica.Superficialiliaccircumflexa.VeinsThoracoepigastricv.Superficialepigastricv.CutaneousnervesAnteriorandlateralcutaneousn.oflowersixthoracicIliohypogastricn.(firstlumbnerves),腹部解剖图谱,Deepvesselsandnerves,ArteresSuperiorandinferiorepigastricarterisLowerposteriorintercostala.Subcostala.Fourlumbara.,腹部解剖图谱,NervesIliohypogastricn.髂腹下神经ArisesfromlubarplexusPassesforwardintheintervalbetweenobliquusinternusandtranversusabdominisPiecesobliquusinternusabdominis2.5cmmedialtoanteriorsuperioriliacspinePiecesaponeurosisofobliquusexternusabdominisabout2.5cmabovesuperficialinguinalringIlioinguinaln.髂腹股沟神经Runsparallelwithiliohypogastricn.atalowerlevelEntersinguinalcanalandemergesthroughsuperficialinguinalringGenitofemoraln.生殖股神经,腹部解剖图谱,Layer?,腹部解剖图谱,Abdomen2,山东大学医学院解剖教研室李振华,腹部解剖图谱,Abdominalaorta腹主动脉,ContinuationofthoracicaortaataortichiatusofdiaphragminfrontofT12TerminatesatlowerborderofL4vertebrabydividingintorightandleftcommoniliacarteries,腹部解剖图谱,ParietalbranchesInferiorphrenica.膈下动脉(onepair)Lumbara.腰动脉(fourpairsofarteriesthatsupplytheposteriorabdominalwall)Mediansacrala.骶正中动脉,腹部解剖图谱,VisceralbranchesPairedbranchesMiddlesuprarenalartery肾上腺中动脉Renalartery肾动脉Testicular(ovarian)artery睾丸（卵巢）动脉,腹部解剖图谱,UnpairedbranchesCeliactrunk腹腔干ashortthickvesselthatarisesfromthefrontofaorta,atthelevelofT12Superiormesenterica.肠系膜上动脉arisesfromthefrontofaorta,atthelevelofL2Inferiormesenterica.肠系膜下动脉arisesfromthefrontofaorta,atlevelofL3,腹部解剖图谱,Celiactrunk,腹部解剖图谱,Celiactrunk,腹部解剖图谱,腹部解剖图谱,腹部解剖图谱,Colicmarginalartery,腹部解剖图谱,RelationsofabdominalaortaAnteriorly(fromabovedownward)PancreasAscendingpartofduodenumRadixofmesenteryPosteriorlyUpperfourlumbervertebraeOnitsrightInferiorvenacavaOnitsleftLeftsympathetictrunk,腹部解剖图谱,Veinsofabdomenandpelvis,Internaliliacvein髂内静脉Parietaltributaries:accompanywitharteriesVisceraltributariessuperiorrectalveininferiormesentericv.Rectalvenousplexusinferiorrectalveininternaliliacv.直肠静脉丛analveininternalpudendalv.Vesicalvenousplexus膀胱静脉丛vesicalv.Uterinevenousplexus子宫静脉丛uterinev.,腹部解剖图谱,Externaliliacvein髂外静脉accompanythearteryCommoniliacvein髂总静脉formedbyunionofinternalandexternaliliacveinsinfrontofsacroiliacjoint,enduponL4L5byunitingeachothertoforminferiorvenacava,腹部解剖图谱,Inferiorvenacava下腔静脉,FormedbyunionoftwocommoniliacveinsanteriortoandjusttotherightofL4L5Ascendsontherightsideofaorta,piercesvenacavaforamenofdiaphragmoppositetheT8anddrainsintotherightatriumConveysbloodfromthewholebodybelowthediaphragmtotherightatrium,腹部解剖图谱,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,腹部解剖图谱,RelationsofinferiorvenacavaAnteriorly(craniallytocaudally)LiverHeadofpancreasHorizontalpartofduodenumRighttesticular(orovarian)a.RadixofmesenteryPosteriorlyRightcrusofdiaphragmUpperfourlumbervertebraeLeftsympathetictrunkParietalbranchesofabdominalaortaOnitsrightPsoasmajorRightkidneyRightsuprarenalglandOnitsleftAbdominalaorta,腹部解剖图谱,Hepaticportalvein肝门静脉,GeneralfeaturesFormedbehindtheneckofpancreasbytheunionofsuperiormesentericveinandsplenicveinAscendsupwardsandtotheright,posteriortothefirstpartofduodenumandthenentersthelesseromentumtotheportahepatis,whereitdividesintorightandleftbranchesTherearenofunctioningvalvesinhepaticportalsystemDrainsbloodfromgastrointestinaltractfromthelowerendofoesophagustotheupperendofanalcanal,pancreas,gallbladder,bileductsandspleen,腹部解剖图谱,Variationandanomaliesofhepaticportalvein,腹部解剖图谱,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,腹部解剖图谱,Portal-systemicanastomoses1.AtthelowerendoftheoesophagusHepaticportalveinleftgastricveinesophagealvenousplexusesophagealveinazygosveinsuperiorvenacava2.AtrectalvenousplexusHepaticportalveinsplenicveininferiormesentericveinsuperiorrectalveinrectalvenousplexusinferiorrectalandanalveinsinternaliliacveininferiorvenacava3.AtperiumbilicalvenousplexusHepaticportalveinparaumbilicalveinperiumbilicalvenousplexusthoracoepigastricandsuperiorepigastricveinsuperiorvenacavasuperficialepigastricandinferiorepigastricveinsinferiorvenacava,腹部解剖图谱,4.Portal-retroperitonealanastomosisBetweentheretroperitonealbranchesofthecolicveinsandthelumbarveins,pancreaticoduodenalveinswiththerenalveinsandthesubcapsularveinsoftheliverwiththephrenicveinstwigsofcolicveins(portal)anastomosingwithsystemicretroperitonealveins,腹部解剖图谱,Thelymphaticdrainageofabdomen,LymphaticdrainageofabdominalwallToaxillarylymphnodefromregionaboveumbilicusTosuperficialinguinallymphnodefromregionbelowumbilicusTolumbarlymphnodefrompostwallofabdomen,腹部解剖图谱,LymphaticdrainageofabdominalvisceraLumbarlymphnodes腰淋巴结Lieonposteriorabdominalwall,alongtheabdominalaortaandinferiorvenacavaReceivelymphfromkidneys,suprarenalglands,testes,ovarirs,fundusofuterus,ovary,andcommoniliacnodesRightandleftlumbartrunksformedbyefferentvesselPairedvisceradraintothelumbarlymphnodes,腹部解剖图谱,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,腹部解剖图谱,Thoracicduct胸导管BeginsinfrontofL1asadilatedsac,thecisternachyli,whichformedbyjoiningofleftandrightlumbartrunksandintestinaltrunkEnterthoraciccavitybypassingthroughtheaortichiatusofthediaphragmandascendsalongonthefrontofthevertebralcolumn,betweenthoracicaortaandazygosveinTravelsupward,veeringtotheleftatthelevelofT5Attheroofoftheneck,itturnslaterallyandarchesforwardsanddescendstoentertheleftvenousangleJustbeforetermination,itreceivestheleftjugular,subclavianandbronchomediastinaltrunksDrainslymphfromlowerlimbs,pelviccavity,abdominalcavity,leftsideofthorax,andleftsideofthehead,neckandleftupperlimb,腹部解剖图谱,Spleen脾,Location:liesinthelefthypochondriacregion(betweenstomachanddiaphragm)deeptothe9thto11thrib,itslongaxiscorrespondsroughlytothe10thribShapereddishincolour,腹部解剖图谱,TwosurfacesDiaphragmatic:smooth,convexVisceral:concave,hilumofspleenTwoextremitiesAnteriorwiderPosteriorrounderTwoborderSuperiorhas2-3splenicnotch脾切迹,whichserveasalandmarkonpalpationwhenitisenlarge;normallyitisnotpalpableInferiorrounderFunctions:thespleenisconsideredtobeimportantin:FormationoflymphocytesandmonocytePhagocytosisofbacteria,inertparticlesandwhitebloodcellsandplateletsDestroyingeffeteorabnormalredbloodcellsMakingantibodies,腹部解剖图谱,RalationshipsofspleenDiaphragmaticsurfacediaphragmVisceralsurfaceAnteriorlyfundusofstomachPosteriorlyleftsuprarenalglandandkidneyInferiorlytailofpancreasandleftcolicflexure,腹部解剖图谱,Nerversofabdomen,Lumbarplexus腰丛Formation:formedbyanteriorramiofL1-L3,apartofanteriorramiofT12andL4Position:lieswithinsubstanceofpsoasmajor,腹部解剖图谱,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,腹部解剖图谱,Lumbarsympathetictrunk腰交感干,MadeupofpairedchainswithfourtofivelumbargangliaanterolateraltovertebralcolumnEntersabdomenviathediaphragmandasacontinuationofhethoracicpartPassesinferiorlybehindcommoniliacvesselsandterminationsbyjoiningtoformunpairedganglionimpar,anteriortosacrum,腹部解剖图谱,Abdomen3,山东大学医学院解剖教研室李振华,腹部解剖图谱,Relationshipsofabdominalviscera,Firstlayerlive,gallbladder,stomachSecondlayerduodenum,pancreas,spleenThirdlayersuprarenalgland,kidney,ureter,inferiorvenacava,abdominalaorta,nervesandlymphatics,腹部解剖图谱,Relationshipsofthestomach,Anterior:Live(rightpart)Diaphragm(leftupperpart)Anteriorabdominalwall(leftlowerpart)Posteriorseparatedbyperitonumoflessersacfromthefollowing(“stumach-bed”)PancreasLeftsuprarenalglandLeftkidneySpleenTransversecolonandtransversmesoclon,腹部解剖图谱,Arteriesofstomach,Leftandrightgastricarteriesarisefromceliactrunkandproperhepaticartery,repectively.Thesetwovesselsruninlesseromentumalonglessercurvature,andanastomoseend-to-end.,腹部解剖图谱,Rightandleftgastroepiploicarteriesarisefromthegastroduodenalandsplenicartery,repectively.Thesetwovesselspassintothegreateromentum,runparalleltothegreatercurvature,andanastomoseend-to-end.Shortgastricarteries,branchesofsplenicartery,coursethroughthegastrosplenicligamentandsupplythefundusofstomach.Posteriorgastricartery(72%)arisefromthesplenicartery,coursethroughthegastrophrenicligamentandsupplytheposteriorwalloffundusofstomach.,腹部解剖图谱,VenousdrainageRightandleftgastricveinsemptydirectlyintohepaticportalvein.Leftgastroepiploicandshortgastricveinsdrainintohepaticportalveinviathesplenicvein.Rightgastroepiploicveinjoineithersuperiormesentericvein.,腹部解剖图谱,LymphaticsofstomachRightandleftgastricln.liealongthesamevesselsandfinallytotheceliacln.Rightandleftgastroomentalln.liealongthesamevessels,theformerdrainintosubpyloricln.,thelatterdrainintosplinicln.Supra-andsubpyloricln.receivelymphaticsfrompyloricpartandfinallytotheceliacln.Splenicln.receivelymphaticsfromfundusandleftthirdofstomach,andfinallytotheceliacln.,腹部解剖图谱,NervesupplyParasympatheticinnervationbyanterior(left)andposterior(right)vagaltrunksTheanteriortrunkdividesintoanteriorgastricandhepaticbranchesTheposteriortrunkdividesintoposteriorgastricandceliacbranchesTheanteriorandposteriorgastricbranchesdescendontheanteriorandposteriorsurfacesofthestomachasaruleabout1to2cmfromthelessercurvatureandparalleltoitinthelesseromentumasfarasthrpyloricantrumtofanoutintobranchescalled“crowsfoot”tosupplythepyloricpartSympatheticinnervationMainlyfromceliacgangliaAffentandeffentfibersderivesfromthoracicsegments(T5L1,腹部解剖图谱,Theduodenum,RelationshipsofsuperiorpartAnteriorlyQuadratelobeofliveGallbladderPosteriorlyCommombileductGastroduodenala.Hepaticportalv.InferiorvenacavaSuperioelyOmentalforamenInferiorlyHeadofpancreas,腹部解剖图谱,RelationshipsofdescendingpartAnteriorlyLiveTransversecolonandmesocolonLoopsofsmallintestinePosteriorlyRightrenalhilumandureterRightrenalvesselsMediallyHeadofpancreasCommonbileductandpancreaticductLaterallyRightcolicflexure,腹部解剖图谱,RelationshipsofhorizontalpartSuperiorlyHeadofpancreasInferiorlyLoopsofsmallintestineAnteriorlyRadixofmesenterySuperiormesenterica.andv.PosteriorlyRightureterInferiorvenacavaAbdominalaorta,腹部解剖图谱,RelationshipsofascendingpartRightHeadofpancreasandabdominalaortaLeftLeftkidneyandureter,腹部解剖图谱,Relationshipsofliver,DiaphragmaticsurfaceseparatedbydiaphragmfromthefollowingRightcostodiaphramaticrecessandlungCardiacbaseVisceralsurfaceLeftlobeisrelatedtothestomachandabdominalpartofesophagusRightlobeisrelatedtotherightcolicflexureanteroly,gallbladde