腹部解剖图谱演示文稿

腹部解剖图谱演示文稿目前一页\总数八十二页\编于二十点Anteriorwall

Layers(fromsuperficialtodeep)SkinSuperficialfasciaAnterolateralmusclesTransversalisfascia腹横筋膜Extraperitonealfascia腹膜下筋膜Parietalperitoneum壁腹膜目前二页\总数八十二页\编于二十点Superficialfascia－divisionsbelowumbilicusSuperficialfattylayer(Camper’s)Membranouslayer(Scarpa’s)目前三页\总数八十二页\编于二十点

MusclesofabdomenAnterolateralgroupObliquusexternusabsominis腹外斜肌Oblequusenternusabdominis腹内斜肌Transversusabdominis腹横肌Rectusabdominis腹直肌目前四页\总数八十二页\编于二十点Posteriorgroup

Quadiatuslumborum腰方肌Psoasmajor腰大肌目前五页\总数八十二页\编于二十点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目前六页\总数八十二页\编于二十点目前七页\总数八十二页\编于二十点Obliquusinternusabdominis腹内斜肌DeeptoobliquusexternusabdominisGeneraldirectionoffibres:upwards,forwardsandmedially目前八页\总数八十二页\编于二十点Transverselsabdominis

腹横肌Deeptoobliquusinternus目前九页\总数八十二页\编于二十点Inguinalfalx腹股沟镰:archoverspermaticcord,insertedwithtransversesabdominisfiberintomedialpartofpectenofpubisCremaster提睾肌:aroundthespermaticcordandtestis目前十页\总数八十二页\编于二十点Rectusabdominis腹直肌

Position:lieontoeitherofmidlineOrigin:pubiccrestandsymphysisInsertion:xiphoidand5th-7thcostalcartilagesHas3-4tendinousintersections

腱划lineasemiluaris

半月线

目前十一页\总数八十二页\编于二十点SimilarfunctionsforabovefourpairsofmusclesSupportandcompresstheabdominalvisceraIncreaseintra-abdominalpressure,aidinexpulsiveefforts-vomiting,coughing,sneezing,defecation,urinationandchildbirth.Depressribs,assistin(theactofforce(4)expiration.Flex,lateralflex,androtatevertebralcolumn目前十二页\总数八十二页\编于二十点Sheathofrectusabdominis腹直肌鞘Antlayer－formedbyfusionofaponeurosisofobliquusexternusabdominisandanteriorleafofaponeurosisofobliquusinternusabdominisPostlayerFormedbyfusionofposterionleafofaponeurosisofobliquusinternusabdominisandaponeurosisoftransversesabdominisAbsentinabout4-5cmbelowtheumbilicus,whereaponeurosesofallthreemusclesformanteriorlayerthelowerfreebordernamedarcuatelineBelowthislinerectusabdominisincontactwithtransversefascia目前十三页\总数八十二页\编于二十点Lineaalba白线－tendinousraphebetweenrightandleftrectifromxiphoidtopubicsymphysis.目前十四页\总数八十二页\编于二十点Inguinalregion腹股沟区BoundariesInguinalligamentLateralmarginofrectusabdominisAhorizontallinestretchingfromanterioriliacspinetolaeralmarginofrectusabdominis目前十五页\总数八十二页\编于二十点DescentoftestesSeven-weekembryoshowingthetestisbeforeitsdescentfromthedorsalabdominalwall目前十六页\总数八十二页\编于二十点Fetusat28weekthetestispassingthroughtheinguinalcanal目前十七页\总数八十二页\编于二十点Newborn目前十八页\总数八十二页\编于二十点Inguinalcanal

腹股沟管Position:obliquepassage,4cmlong,located1.5cmabovemedialhalfofinguinallig.目前十九页\总数八十二页\编于二十点BoundariesAntwallAponeurosisofobliquusexternusabdominisObliquusinternusabdominis(lateralthirdofwall)目前二十页\总数八十二页\编于二十点PostwallTransversefasciaInguinalflaxmediallyRoof－archedlowerfibersofobliquusinternusandtransversuaabdominisFloor－inguinallig．目前二十一页\总数八十二页\编于二十点TwoopeningsSuperficialinguinalring腹股沟浅环Deepinguinalring腹股沟深环－defectintransversefascia1.5cmabovemidpointofinguinalligament目前二十二页\总数八十二页\编于二十点StructurespassingthroughtheinguinalcanalSpermaticcord

精索andilioinguinalnerve髂腹股沟神经inmalesRoundligamentofuterus

子宫圆韧带andilioinguinalnerve髂腹股沟神经infemales

目前二十三页\总数八十二页\编于二十点InguinalTriangle(ofHesselbach)腹股沟三角

Boundaries

InguinalligamentinferiorlyLateralborderofrectusabdominismediallyInferiorepigastricarterylaterally目前二十四页\总数八十二页\编于二十点Indirectinguinalheiniaanddirecetinguinalheinia

目前二十五页\总数八十二页\编于二十点Superficialvesselsandcutaneousnerves

Arteries

Superficialepigastrica.Superficialiliaccircumflexa.Veins

Thoracoepigastricv.Superficialepigastricv.CutaneousnervesAnteriorandlateralcutaneousn.oflowersixthoracicIliohypogastricn.(firstlumbnerves)目前二十六页\总数八十二页\编于二十点DeepvesselsandnervesArteresSuperiorandinferiorepigastricarterisLowerposteriorintercostala.Subcostala.Fourlumbara.目前二十七页\总数八十二页\编于二十点NervesIliohypogastricn.髂腹下神经ArisesfromlubarplexusPassesforwardintheintervalbetweenobliquusinternusandtranversusabdominisPiecesobliquusinternusabdominis2.5cmmedialtoanteriorsuperioriliacspinePiecesaponeurosisofobliquusexternusabdominisabout2.5cmabovesuperficialinguinalringIlioinguinaln.髂腹股沟神经Runsparallelwithiliohypogastricn.atalowerlevelEntersinguinalcanalandemergesthroughsuperficialinguinalringGenitofemoraln.生殖股神经目前二十八页\总数八十二页\编于二十点SubcostalincisionMuscle-splittingincisionTransverseincision

MedianormidlineincisionLeftparamedianincisionLayer?Suprapubicincision目前二十九页\总数八十二页\编于二十点Abdomen2山东大学医学院解剖教研室李振华目前三十页\总数八十二页\编于二十点Abdominalaorta腹主动脉ContinuationofthoracicaortaataortichiatusofdiaphragminfrontofT12TerminatesatlowerborderofL4vertebrabydividingintorightandleftcommoniliacarteries目前三十一页\总数八十二页\编于二十点ParietalbranchesInferiorphrenica.

膈下动脉(onepair)Lumbara.

腰动脉(fourpairsofarteriesthatsupplytheposteriorabdominalwall)Mediansacrala.骶正中动脉目前三十二页\总数八十二页\编于二十点Visceralbranches

PairedbranchesMiddlesuprarenalartery肾上腺中动脉Renalartery肾动脉Testicular(ovarian)artery睾丸（卵巢）动脉目前三十三页\总数八十二页\编于二十点Unpairedbranches

Celiactrunk

腹腔干－ashortthickvesselthatarisesfromthefrontofaorta,atthelevelofT12Superiormesenterica.肠系膜上动脉－arisesfromthefrontofaorta,atthelevelofL2Inferiormesenterica.肠系膜下动脉－arisesfromthefrontofaorta,atlevelofL3目前三十四页\总数八十二页\编于二十点Leftgastrica.Commonhepatica.Splenica.Gastroduodenala.Properhepatica.Rightgastrica.LeftbranchRightbranchCystica.Shortgastrica.

Leftgastrioeploica.Rightgastroepiploica.Superiorpancreaticoduodenala.Splemicbranches

Celiactrunk

目前三十五页\总数八十二页\编于二十点Celiactrunk

目前三十六页\总数八十二页\编于二十点Superiormesenterica.

Inf.pancresticodudenala.Jejunalandileala.Ileocolica.Appendiculara.Rightcolica.Middlecolica.

SuperiorMesentericv.目前三十七页\总数八十二页\编于二十点Inferiormesenterica.Leftcolica.Sigmoida.Superiorrectala.

Inferiormesentericv.目前三十八页\总数八十二页\编于二十点Colicmarginalartery目前三十九页\总数八十二页\编于二十点RelationsofabdominalaortaAnteriorly(fromabovedownward)PancreasAscendingpartofduodenumRadixofmesenteryPosteriorlyUpperfourlumbervertebraeOnitsrightInferiorvenacavaOnitsleftLeftsympathetictrunk目前四十页\总数八十二页\编于二十点VeinsofabdomenandpelvisInternaliliacvein髂内静脉Parietaltributaries:accompanywitharteriesVisceraltributaries

→superiorrectalvein→inferiormesentericv.①Rectalvenousplexus →inferiorrectalvein→internaliliacv.

直肠静脉丛 →analvein→internalpudendalv.②Vesicalvenousplexus膀胱静脉丛→vesicalv.③Uterinevenousplexus子宫静脉丛→uterinev.目前四十一页\总数八十二页\编于二十点

Externaliliacvein

髂外静脉–accompanythearteryCommoniliacvein

髂总静脉–formedbyunionofinternalandexternaliliacveinsinfrontofsacroiliacjoint,enduponL4~L5byunitingeachothertoforminferiorvenacava目前四十二页\总数八十二页\编于二十点Inferiorvenacava

下腔静脉FormedbyunionoftwocommoniliacveinsanteriortoandjusttotherightofL4~L5Ascendsontherightsideofaorta,piercesvenacavaforamenofdiaphragmoppositetheT8anddrainsintotherightatriumConveysbloodfromthewholebodybelowthediaphragmtotherightatrium目前四十三页\总数八十二页\编于二十点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目前四十四页\总数八十二页\编于二十点RelationsofinferiorvenacavaAnteriorly(craniallytocaudally)LiverHeadofpancreasHorizontalpartofduodenumRighttesticular(orovarian)a.RadixofmesenteryPosteriorlyRightcrusofdiaphragmUpperfourlumbervertebraeLeftsympathetictrunkParietalbranchesofabdominalaortaOnitsrightPsoasmajorRightkidneyRightsuprarenalglandOnitsleftAbdominalaorta目前四十五页\总数八十二页\编于二十点Hepaticportalvein肝门静脉

GeneralfeaturesFormedbehindtheneckofpancreasbytheunionofsuperiormesentericveinandsplenicveinAscendsupwardsandtotheright,posteriortothefirstpartofduodenumandthenentersthelesseromentumtotheportahepatis,whereitdividesintorightandleftbranchesTherearenofunctioningvalvesinhepaticportalsystemDrainsbloodfromgastrointestinaltractfromthelowerendofoesophagustotheupperendofanalcanal,pancreas,gallbladder,bileductsandspleen目前四十六页\总数八十二页\编于二十点Variationandanomaliesofhepaticportalvein目前四十七页\总数八十二页\编于二十点Tributariesofhepaticportalvein

1.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.附脐静脉目前四十八页\总数八十二页\编于二十点Portal-systemicanastomoses1.Atthelowerendoftheoesophagus

Hepaticportalvein→leftgastricvein→esophagealvenousplexus→esophagealvein→azygosvein→superiorvenacava2.Atrectalvenousplexus

Hepaticportalvein→splenicvein→inferiormesentericvein→superiorrectalvein→rectalvenousplexus→inferiorrectalandanalveins→internaliliacvein→inferiorvenacava3.AtperiumbilicalvenousplexusHepaticportalvein→paraumbilicalvein→periumbilicalvenousplexus→thoracoepigastricandsuperiorepigastricvein→superiorvenacavasuperficialepigastricandinferiorepigastricveins→inferiorvenacava目前四十九页\总数八十二页\编于二十点4.Portal-retroperitonealanastomosis

Betweentheretroperitonealbranchesofthecolicveinsandthelumbarveins,pancreaticoduodenalveinswiththerenalveinsandthesubcapsularveinsoftheliverwiththephrenicveinstwigsofcolicveins(portal)anastomosingwithsystemicretroperitonealveins目前五十页\总数八十二页\编于二十点ThelymphaticdrainageofabdomenLymphaticdrainageofabdominalwallToaxillarylymphnodefromregionaboveumbilicusTosuperficialinguinallymphnodefromregionbelowumbilicusTolumbarlymphnodefrompostwallofabdomen目前五十一页\总数八十二页\编于二十点LymphaticdrainageofabdominalvisceraLumbarlymphnodes腰淋巴结Lieonposteriorabdominalwall,alongtheabdominalaortaandinferiorvenacavaReceivelymphfromkidneys,suprarenalglands,testes,ovarirs,fundusofuterus,ovary,andcommoniliacnodesRightandleftlumbartrunksformedbyefferentvesselPairedviscera－draintothelumbarlymphnodes目前五十二页\总数八十二页\编于二十点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目前五十三页\总数八十二页\编于二十点Thoracicduct胸导管BeginsinfrontofL1asadilatedsac,thecisternachyli,whichformedbyjoiningofleftandrightlumbartrunksandintestinaltrunkEnterthoraciccavitybypassingthroughtheaortichiatusofthediaphragmandascendsalongonthefrontofthevertebralcolumn,betweenthoracicaortaandazygosveinTravelsupward,veeringtotheleftatthelevelofT5Attheroofoftheneck,itturnslaterallyandarchesforwardsanddescendstoentertheleftvenousangleJustbeforetermination,itreceivestheleftjugular,subclavianandbronchomediastinaltrunksDrainslymphfromlowerlimbs,pelviccavity,abdominalcavity,leftsideofthorax,andleftsideofthehead,neckandleftupperlimb目前五十四页\总数八十二页\编于二十点Spleen脾Location:liesinthelefthypochondriacregion(betweenstomachanddiaphragm)deeptothe9thto11thrib,itslongaxiscorrespondsroughlytothe10thribShape－reddishincolour目前五十五页\总数八十二页\编于二十点TwosurfacesDiaphragmatic:smooth,convexVisceral:concave,hilumofspleenTwoextremities

Anterior－widerPosterior－rounderTwoborder

Superior－has2-3splenicnotch脾切迹,whichserveasalandmarkonpalpationwhenitisenlarge;normallyitisnotpalpableInferior－rounderFunctions:thespleenisconsideredtobeimportantin:FormationoflymphocytesandmonocytePhagocytosisofbacteria,inertparticlesandwhitebloodcellsandplateletsDestroyingeffeteorabnormalredbloodcellsMakingantibodies目前五十六页\总数八十二页\编于二十点RalationshipsofspleenDiaphragmaticsurface－diaphragmVisceralsurfaceAnteriorly－fundusofstomachPosteriorly－leftsuprarenalglandandkidneyInferiorly－tailofpancreasandleftcolicflexure目前五十七页\总数八十二页\编于二十点NerversofabdomenLumbarplexus腰丛Formation:formedbyanteriorramiofL1-L3,apartofanteriorramiofT12andL4Position:lieswithinsubstanceofpsoasmajor目前五十八页\总数八十二页\编于二十点BranchesIliohypogastricn.髂腹下神经SupplieslowerpartofanteriorabdominalwallIlioinguinaln.髂腹股沟神经PassesthroughinguinalcanaltosupplyskinofthegroinandscrotumLateralfemoralcutaneous股外侧皮神经Femoraln.股神经Obturator

n.

闭孔神经Genitofemoraln.生殖股神经目前五十九页\总数八十二页\编于二十点Lumbarsympathetictrunk腰交感干MadeupofpairedchainswithfourtofivelumbargangliaanterolateraltovertebralcolumnEntersabdomenviathediaphragmandasacontinuationofhethoracicpartPassesinferiorlybehindcommoniliacvesselsandterminationsbyjoiningtoformunpairedganglionimpar,anteriortosacrum目前六十页\总数八十二页\编于二十点Abdomen3山东大学医学院解剖教研室李振华目前六十一页\总数八十二页\编于二十点Relationshipsofabdominalviscera

Firstlayer－live,gallbladder,stomachSecondlayer－duodenum,pancreas,spleenThirdlayer－suprarenalgland,kidney,ureter,inferiorvenacava,abdominalaorta,nervesandlymphatics目前六十二页\总数八十二页\编于二十点

RelationshipsofthestomachAnterior:Live(rightpart)Diaphragm(leftupperpart)Anteriorabdominalwall(leftlowerpart)Posterior－separatedbyperitonumoflessersacfromthefollowing(“stumach-bed”)PancreasLeftsuprarenalglandLeftkidneySpleenTransversecolonandtransversmesoclon目前六十三页\总数八十二页\编于二十点ArteriesofstomachLeftandrightgastricarteriesarisefromceliactrunkandproperhepaticartery,repectively.Thesetwovesselsruninlesseromentumalonglessercurvature,andanastomoseend-to-end.目前六十四页\总数八十二页\编于二十点Rightandleft

gastroepiploicarteriesarisefromthegastroduodenalandsplenicartery,repectively.Thesetwovesselspassintothegreateromentum,runparalleltothegreatercurvature,andanastomoseend-to-end.Shortgastricarteries,branchesofsplenicartery,coursethroughthegastrosplenicligamentandsupplythefundusofstomach.Posteriorgastricartery(72%)arisefromthesplenicartery,coursethroughthegastrophrenicligamentandsupplytheposteriorwalloffundusofstomach.目前六十五页\总数八十二页\编于二十点VenousdrainageRightandleftgastricveinsemptydirectlyintohepaticportalvein.Leftgastroepiploicandshortgastricveinsdrainintohepaticportalveinviathesplenicvein.Rightgastroepiploicveinjoineithersuperiormesentericvein.目前六十六页\总数八十二页\编于二十点LymphaticsofstomachRightandleftgastricln.liealongthesamevesselsandfinallytotheceliacln.Rightandleftgastroomentalln.liealongthesamevessels,theformerdrainintosubpyloricln.,thelatterdrainintosplinicln.Supra-andsubpyloricln.receivelymphaticsfrompyloricpartandfinallytotheceliacln.Splenicln.receivelymphaticsfromfundusandleftthirdofstomach,andfinallytotheceliacln.目前六十七页\总数八十二页\编于二十点NervesupplyParasympatheticinnervationbyanterior(left)andposterior(right)vagaltrunksTheanteriortrunkdividesintoanteriorgastricandhepaticbranchesTheposteriortrunkdividesintoposteriorgastricandceliacbranchesTheanteriorandposteriorgastricbranchesdescendontheanteriorandposteriorsurfacesofthestomachasaruleabout1to2cmfromthelessercurvatureandparalleltoitinthelesseromentumasfarasthrpyloricantrumtofanoutintobranchescalled“crow’sfoot”tosupplythepyloricpartSympatheticinnervationMainlyfromceliacgangliaAffentandeffentfibersderivesfromthoracicsegments(T5－L1目前六十八页\总数八十二页\编于二十点TheduodenumRelationshipsofsuperiorpart

AnteriorlyQuadratelobeofliveGallbladderPosteriorlyCommombileductGastroduodenala.Hepaticportalv.InferiorvenacavaSuperioelyOmentalforamenInferiorlyHeadofpancreas目前六十九页\总数八十二页\编于二十点RelationshipsofdescendingpartAnteriorlyLiveTransversecolonandmesocolonLoopsofsmallintestinePosteriorlyRightrenalhilumandureterRightrenalvesselsMediallyHeadofpancreasCommonbileductandpancreaticductLaterallyRightcolicflexure目前七十页\总数八十二页\编于二十点RelationshipsofhorizontalpartSuperiorlyHeadofpancreasInferiorlyLoopsofsmallintestineAnteriorlyRadixofmesenterySuperiormesenterica.andv.PosteriorlyRightureterInferiorvenacavaAbdominalaorta目前七十一页\总数八十二页\编于二十点RelationshipsofascendingpartRightHeadofpancreasandabdominalaortaLeftLeftkidneyandureter目前七十二页\总数八十二页\编于二十点RelationshipsofliverDiaphragmaticsurface－separatedbydiaphragmfromthefollowingRightcostodiaphramaticrecessandlungCardiacbaseVisceralsurfaceLeftlobeisrelatedtothestomachandabdominalpartofesophagusRightlobeisrelatedtotherightcolicflexureanteroly,gallbladderandsuperiorduodenalflexuremedially,rightkidney,superarenalglandposteriorly目前七十三页\总数八十二页\编于二十点BloodsupplyArteriesSuperiorpancreaticoduodenala.Inferiorpancreaticoduodenala.Veins－followarteries,drainingdirectlyintosuperiormesentericandhepaticportalveins