腹膜和腹膜腔解剖

腹膜和腹膜腔内容：一、腹膜腔的概念二、腹膜形成的结构三、腹膜间隙

January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

一、腹膜腔的概念

腹膜腔为壁腹膜和脏腹膜之间的潜在腔隙，内有少量（100~200ml）浆液。

January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

男性腹膜腔是密闭的，女性腹膜腔间接通外界（经输卵管腹腔口、输卵管、子宫、阴道与外界相通）。January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

二、腹膜形成的结构网膜系膜韧带皱襞陷窝、陷凹January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

（一）网膜omentum

与胃相连的腹膜皱襞，有：小网膜大网膜January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

1.小网膜lesseromentum为从肝门连至胃小弯和十二指肠上部的双层腹膜皱襞。又分为：肝胃韧带肝十二指肠韧带January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

肝胃韧带：

内含胃左、右血管、胃左、右淋巴结和神经等。January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

肝十二指肠韧带：内有出入肝门的三个重要管道，即：右前方的胆总管、左前方的肝固有动脉和两者后方的肝门静脉。January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

2.大网膜greateromentum

形似围裙覆盖在空、回肠和横结肠的前面，左缘与胃脾韧带相连续。January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

胃结肠韧带:

自胃大弯和十二指肠上部至横结肠之间的大网膜前两层形成胃结肠韧带。内含胃网膜左、右血管、胃网膜左、右淋巴结等。

January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

3.网膜孔和网膜囊网膜孔：

位于小网膜游离缘后方，可容1~2指，经网膜孔可进入胃后面的网膜囊。January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

网膜孔的周界：

前界：

肝十二指肠韧带

下界：

十二指肠上部January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

后界：下腔静脉表面的腹膜上界：

肝尾叶January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

网膜囊omentalbursa（又称小腹膜腔）位于小网膜和胃后壁与腹后壁的腹膜之间的一个扁窄间隙，网膜囊以外的腹膜腔称大腹膜腔。January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

周界：上界：肝尾叶和膈下面的腹膜。下界：大网膜前、后层的愈着处。January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

前壁：

小网膜、胃后壁的腹膜和胃结肠韧带。后壁：

横结肠及其系膜以及覆盖胰、左肾、左肾上腺等处的腹膜。January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

左侧界:脾、胃脾韧带、脾肾韧带。右侧界：借网膜孔通腹膜腔的其余部分。January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

临床意义：

网膜囊位置较深，胃后壁穿孔或某些炎症导至网膜囊内积液，早期常局限在囊内，给诊断带来一定困难。January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

(二)系膜mesentery

与肠相连的双层腹膜皱襞，将肠管连于腹后壁，内有出入肠管的血管、神经及淋巴结等。January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

主要的系膜有：

肠系膜阑尾系膜横结肠系膜乙状结肠系膜January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

肠系膜mesentery：肠系膜是将空、回肠连于腹后壁的双层腹膜结构。January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

肠系膜根：长约15cm，从第二腰椎左侧至右骶髂关节前方。January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

（三）韧带ligament

为腹膜反折处形成的腹膜皱襞，多数为双层。韧带对脏器起固定作用。January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

(四)皱襞、隐窝和陷凹

在腹膜皱襞之间形成的凹陷称隐窝，较大的隐窝称陷凹。January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG

1.腹后壁的腹膜皱襞和隐窝十二指肠上、下襞十二指肠上、下隐窝盲肠后隐窝肝肾隐窝January,2007Copyright©Depart.Anatomy,SchoolofMedicine,