系统解剖 英文版 消化腺. Alimentary System

Alimentaryglands消化腺

Liver肝

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ShapePyramidTwosurfacesDiaphragmaticsurface膈面Visceralsurface脏面FourbordersAnteriorborderPosteriorborderLeftborderRightborderLiver肝

Diaphragmaticsurface

膈面ConvexandsmoothDividedintorightandleftlobes

byfalciformlig.ofliver镰状韧带coronarylig.

ofliver冠状韧带Barearea裸区：PosteriorlyLiver肝

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Visceralsurface

脏面HasaH-shapedfissuresandgroovesFourlobes:

LeftlobeRightlobeQuadratelobecaudatelobeLiver肝

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Leftlimbof“H”

Anteriorpartfissureforligamentumtereshepatis肝圆韧带裂ligamentumtereshepatis

肝圆韧带(Vestigeofumbilicalvein

脐静脉)Posteriorpart

fissureforligamentumvenosum静脉韧带裂ligamentumvenosum静脉韧带

(VestigeofDuctusvenosus静脉导管)Liver肝★

Rightlimbof“H”

Anteriorpartfossaforgallbladder胆囊窝PosteriorpartSulcusforvenacava腔静脉沟Secondaryportaofliver第二肝门Liver肝★

Cross-barof“H”---Portahepatis

肝门★

ashortbutdeepfissure,about5cmlong,extendingtransverselyacrosstheundersurfaceoftheliver,representedbythehorizontallineofthe“H”,ContentsRightandlefthepaticductsLeftandrightbranchesofproperhepaticarteryLeftandrightbranchesofhepaticportalveinNervesandlymphaticvesselsThesestructuresaresurroundedbyconnectivetissue

andcalledhepaticpedicle肝蒂Liver肝Anterior(inferior)border–thinandsharpNotchforgallbladder胆囊切迹Notchforligamentumtereshepatis肝圆韧带切迹Posteriorborder–roundLeftborder–thinandsharpRightborder–roundLiver肝★

PositionMostofliverliesintherighthypochondriacregionandepigastricregionlesspartextendsintothelefthypochondriacregionLiver肝★SurfaceprojectionUpperborderontherightmidclavicularlineitextendsthelevelof5thribLowerborderNormally,therightlobeextendsjustbeneaththecostalmargin,itdoesn’tdownbeyondthecostalmarginOntheanteriormedianlineitslowerbordercrossesapointabout3~5cmbelowthexiphoidprocessInchildren,theliverbeinglargerinproportiontothebodythanintheadultstage,itextendsbelowthecostalarchwithinin2cmLiver肝Thesegmentsoftheliver

肝段Thesegmentationoftheliver,basesupontheprincipaldivisionsoftheproperhepaticarteryandaccompanyinghepaticductsandhepaticportalvein－Glissonsystem.Thehepaticveins,howeverdonotfollowthesamepatternandvary:theirmaintributariestendtorunratherintersegmental.按外形分：肝左叶、肝右叶、方叶、尾状叶（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★ExtrahepaticBiliaryApparatus★Consistsof

Gallbladder胆囊Leftandrighthepaticducts肝左、右管Commonhepaticduct肝总管Commonbileduct胆总管★Gallbladder

胆囊★Position

Liesinfossaforgallbladderonvisceralsurfaceofliver★FourpartsFundusofgallbladder

胆囊底Surfaceprojection:atthejunctionofrightmidclavicularlineandrightcostalarchBodyofgallbladder

胆囊体Neckofgallbladder

胆囊颈Cysticduct胆囊管Function:storesandconcentratebile★

BiliaryductsystemLeftandright

hepaticducts肝左、右管uniteoutsideoflivertoformcommonhepaticductcommonhepaticduct

肝总管Cysticductjoinscommonhepaticducttoformcommonbileduct

胆总管★BiliaryductsystemHepatopancreaticampulla

肝胰壶腹(ampullaofVater)Commonbileductandpancreaticductrunobliquelythroughthewallofthedescendingpartofduodenumwherethetwoductsusuallyunitetoformthe

hepatopancreaticampulla

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