系统解剖 英文版 消化腺. Alimentary System课件

1、Alimentary glands 消化腺Liver 肝 Shape PyramidTwo surfacesDiaphragmatic surface 膈面Visceral surface 脏面Four bordersAnterior borderPosterior borderLeft borderRight border Liver 肝Diaphragmatic surface 膈面Convex and smoothDivided into right and left lobes by falciform lig. of liver 镰状韧带coronary lig. of liver冠

2、状韧带Bare area 裸区：PosteriorlyLiver 肝 Visceral surface 脏面Has a H-shaped fissures and groovesFour lobes: Left lobeRight lobeQuadrate lobecaudate lobeLiver 肝 Left limb of “H” Anterior partfissure for ligamentum teres hepatis 肝圆韧带裂ligamentum teres hepatis 肝圆韧带(Vestige of umbilical vein 脐静脉)Posterior part

3、fissure for ligamentum venosum 静脉韧带裂ligamentum venosum 静脉韧带 (Vestige of Ductus venosus静脉导管)Liver 肝 Cross-bar of “H”-Porta hepatis 肝门 a short but deep fissure, about 5 cm long, extending transversely across the under surface of the liver, represented by the horizontal line of the “H” , ContentsRight

4、and left hepatic ductsLeft and right branches of proper hepatic artery Left and right branches of hepatic portal veinNerves and lymphatic vesselsThese structures are surrounded by connective tissue and called hepatic pedicle 肝蒂Liver 肝Anterior (inferior) border thin and sharpNotch for gallbladder 胆囊切

5、迹Notch for ligamentum teres hepatis 肝圆韧带切迹Posterior border round Left border thin and sharpRight border round Liver 肝 Surface projectionUpper borderon the right midclavicular line it extends the level of 5th ribLower borderNormally, the right lobe extends just beneath the costal margin, it doesnt do

6、wn beyond the costal marginOn the anterior median line its lower border crosses a point about 35cm below the xiphoid process In children, the liver being larger in proportion to the body than in the adult stage, it extends below the costal arch within in 2cmLiver 肝The segments of the liver 肝段The seg

7、mentation of the liver, bases upon the principal divisions of the proper hepatic artery and accompanying hepatic ducts and hepatic portal veinGlisson system.The hepatic veins, however do not follow the same pattern and vary: their main tributaries tend to run rather intersegmental.按外形分：肝左叶、肝右叶、方叶、尾状

8、叶（不完全符合肝内胆道系统的配布）Glisson系统：将肝分两个半肝，进一步分5叶，6个段左外叶、左内叶、右前叶、右后叶、尾状叶左外叶上段、左外叶下段、右后叶上段、右后叶下段、尾状叶左段、尾状叶右段左外叶左内叶右前叶右后叶尾状叶上段下段上段上段上段下段下段下段左外叶左段右段右前叶左内叶 Gallbladder 胆囊 Position Lies in fossa for gallbladder on visceral surface of liver Four partsFundus of gallbladder 胆囊底Surface projection: at the junction of

9、 right midclavicular line and right costal arch Body of gallbladder 胆囊体Neck of gallbladder 胆囊颈Cystic duct 胆囊管Function: stores and concentrate bile Biliary duct systemLeft and right hepatic ducts肝左、右管 unite outside of liver to form common hepatic duct common hepatic duct 肝总管Cystic duct joins common h

10、epatic duct to form common bile duct 胆总管Bile is secreted by the liver cells Common hepatic ductWhen fat enters small intestine, gallbladder contracts, sphincter of hepatopancreatic ampulla relaxCommon bile ductMajor duodenal papillaBiliary ductuliRight and left hepatic ductsCystic ductGallbladder (s

11、tore, concentrate)Duodenal cavity Extrahepatic Biliary ApparatusMagnetic resonance cholangiopancreatogram. Pancreas 胰Shape A soft yellowish lobulated gland PositionLies in epigastric and left hypochondriac regions, behind the peritoneum on the posterior abdominal wall, roughly at the level of of L1L

12、2Surface projectionUpper border: about 10 cm above umbilicusLower border: about 5 cm above umbilicus Pancreas 胰 Four partsHead-Lies within the cancavity of the C-shaped curvatune of duodenum.Uncinate process钩突 A projection to the left from the lower part of the head behind the superior mesenteric ve

13、ssels.Neck-narrow part, overlies the superior mesenteric vessels and beginning of the portal veinBody-triangular in cross section, passes upward ang to the left across the midlineTail-extends to the hilum of spleen in the splenorenal ligamentPancreas 胰Pancreatic ductMain Pancreatic ductBegins at tail and throughout gland Joins common bile duct before enter