腹部解剖图谱

Abdominalwall2021/10/10

1AnteriorwallLayers(fromsuperficialtodeep)SkinSuperficial

fasciaAnterolateralmuscles

■

Transversalis

fascia横筋膜■

Extraperitonealfascia腹膜下筋膜

Parietal

peritoneum壁腹膜2021/10/10

2腹Superficialfascia—

i

sbelow

)fatty

layer

(MS

'

us

layer■snrpbramce'salmpererficiap(CSuuscnlioiibsmiv2021/10/10

3AnterolateralgroupObliquus

externusabsominis腹外斜肌Oblequus

enternusabdominis腹内斜肌Transversusabdominis腹横肌■

Rectus

abdominis腹直

肌Muscles

of

abdomen2021/10/104PosteriorgroupQuadiatus

lumborum

腰

s

s

major腰大肌oa肌2021/10/10

5Gen

d

t

io

r

b

e

rds:StructuresInguinal

ligament腹股沟韧带Lacunar

ligament腔隙韧带Superficial

inguinal

ring

a股opne沟edu

fi

texternusabdominisabove

pubictubercles-urulabliqnguoniaf

irnfiwdnd)awldi

Obliquusexternusabsominis腹

外

斜

肌2021/10/10

62021/10/10

7

Obliquusinternusabdominis腹

内

斜

肌Deep

to

obliquusexternus

abdominisGeneral

direction

of

2021/10/10

8fibres:upwards,forwards

and

medially

Transverselsabdominis腹

横

肌Deeptoobliquus

internus2021/10/10

9

e

he

ticcordand

testissperma提睾肌：traroundCremastInguinal

falx

腹股沟镰：arch

over

spermaticwithabdominiscord,insertedtransversesfiber

into

medialpecten

of

pubispart

of2021/10/1010in:pubic

crest

and■Has

3-4tendinousintersections

腱

划lineasemiluaris半

月

线igneriidlRectusabdominis腹

直

肌Position:

lieontoeither

ofsymphysisInsertion:xiphoidand5th-7thcostal

cartilages2021/10/1011

Similarfunctionsforabovefourpairs

ofmusclesSupportandcompresstheabdominalvisceraIncrease

intra-abdominal

pressure,aid

in

expulsiveefforts-vomiting,coughing,sneezing,defecation,urinationandchildbirth.Depress

ribs,assist

in

(theactofforce(4)expiration.

Flex,lateral

flex,and

rotate

vertebral

column2021/10/10

12

Sheathofrectusabdominis

腹直肌鞘Ant

layer

—formedbyfusionofaponeurosisofobliquusexternusa

ui

oisi

nodf

tlieq

oursleinatfe

usuriabdominisPostloFa

y

ebuyr

sisi

oo

lpi

rion

leafseuustqoobofosfuoeaprmerian

rnneuusr

sbi

omf

ti

aisn

edrsesvnabdominis

sbeilnictui

,

bhoe

et4

e

olos

stho2021/10/10

13laalyl

hrr

hemlouws

rlef

ef

rbmoradnetre

i

mr

edarcuate

lineBelowthisline

rectus

abdominis

incontactwithtransversefasciaLinea

alba

白

线

—tendinousraphebetweenrightand

left

rectifromxiphoid

to

pubic

symphysis.2021/10/10

14BoundariesInguinal

ligament■Lateral

margin

ofrectusabdominisA

horizontal

lineInguinal

region

腹

股

沟

区stretchingfromanterioriliac

spinetolaeralmargin

ofrectus

abdominis2021/10/10

15Seven-weekembryo

showing

the

testis

before

its

descent

from

the

dorsalabdominal

wallD

escent

of

testes2021/10/10

16Fetus

at28

week

the

testis

passingthrough

the

inguinal

canal2021/10/10

172021/10/10

18Position:

obliquepassage,4cmlong,located1.5cmInguinal

canal

腹

股

沟

管above

medial

half

of

inguinallig.2021/10/10

19BoundariesAnt

wallAponeurosis

ofobliquusexternusabdominis□

Obliquus

internusabdominis(lateralthird

of

wall)2021/10/10

20Post

wall□

Transverse

fascia□

Inguinal

flax

medially■

iboeor

fa

cbhlieqinternus

andtransversua

abdominis

Floor

—inguinal

lig.uslowers

of

—2021/10/1021FRAESuperficial

inguinalring腹股沟浅环

t

i

1.5cmligamentguinalfasciainedpoint

oftransversminovefecbe2021/10/10

22TwoopeningsDeepinguinal

ring腹股沟深环

一RECAXED口口Structurespassing

through

theinguinalcanal口

Spermaticcord精索

and

ilioinguinal

nerve骼腹股沟神经

inmales

口Round

ligament

of

uterus子宫圆韧带andilioinguinalnerve骼腹股沟神经

in

females2021/10/10

23BoundariesInguinal

ligamentinferiorly■

Lateral

borderofrectusabdominis

medially■

Inferiorepigastric

artery

laterallyInguinal

Triangle

(of

Hesselbach)腹股沟三角2021/10/10

242021/10/1025Indirectinguinalheiniaanddirecetinguinal

heiniaSuperficialvesselsandcutaneousnervesArteries□

Superficial

epigastric

a.□

Superficial

iliac

circumflex

a.■

Veins□

Thoracoepigastric

v.口

Superficial

epigastric

v.Cutaneous

nerves□

Anterior

and

lateralcutaneousn.of

lower

sixthoracic口

lliohypogastricn.(firstlumbnerves)2021/10/10Deep

vessels

and

nervesArteresSuperior

and

inferior

epigastric

arteris■

Lower

posterior

intercostal

a.■

Subcostal

a.■

Four

lumbar

a.2021/10/1027Nerveslliohypogastricn.骼腹下神经口

Pieces

obliquusinternusabdominis

2.5

cm

medial

tollioinguinal

n.骼腹股沟神经Genitofemoraln.生殖股神经Arises

from

lubar

plexus

nfo

wbalridq

o

rn

e

ld口anrvausintinntmibuiauuseanterior

superior

iliac

spine口

Pieces

aponeurosis

of

obliquuse

nb

ea

finicisiaalbion

tui

.a5ln2guperomvsouarcmext2021/10/10

28□

Runs

parallel

withiliohypogastric

n.at

a

lowerlevel□

Enters

inguinal

canal

andemergesthroughsuperficialinguinal

ringringLeft

paramedian

incisionSuprapubic

incisionSubcostal

incision

Median

or

midline

incision2021/10/1029Layer?Muscle-splitting

incisionTransverseincision山

东

大

学

医

学

院

解

剖

教

研

室李

振

华

Abdomen22021/10/10

30Continuation

of

hi

tr

i

fadoi

h

tiifront

ofT12Terminatesat

lowerncgmaorraatpaartocscuaao

Abdominalaorta

腹

主

动

脉b

rdievridoi

4in

oerrti

agegLnfyoand

left

common

iliac2021/10/10

31arteriesParietal

branchesInferiorphrenica.

膈Mediansacrala.

骶正中动脉下动脉(one

pair)■

Lumbara.

腰动脉(fourpairsofarteriesthatsupplythe

posteriorabdominalwall)2021/10/1032Visceralbranches

PaMireiddl

alartery

肾上腺中动脉□

Renalartery

肾动脉Testicular(ovarian)artery

睾丸(卵巢)动脉□rarenchespnsura2021/10/10

33Unpairedbranches□

Celiac

trunk

腹

腔

干—ashortthick

vessel

thatarisesfromthefrontoflevelofL2口Inferior

mesenteric

a.

肠系

膜

下

动

脉—

arises

fromaorta,at

the

level

of

T12□

Superior

mesenteric

a.t肠h

f膜ro

脉fa

,

st

omhefratsetarirao动nt上e系the

front

of

aorta,at

level2021/10/10

34of

L3Right

branchCystica.Rightgastric

a.Properhepatic

a.Gastroduodenala.SplemicbranchesRightgastroepiploica.Superiorpancreaticoduodenala2021/10/1035Celiactrunk

Celiactrunk2021/10/1036Middle

colic

a.Inf.pancresticodudenala.Rightcolic

a.lleocolic

a.SuperiorMesenteric

v.Superiormesenteric

a.Jejunal

and

ileal

a.2021/10/10

37Appendicular

a.Inferior

mesentericv.Inferiormesenteric

a.Left

colic

a.Sigmoid

a.Superiorrectal

a.2021/10/10

38Colic

marginalartery2021/10/10

39

Relations

ofabdominal

aortaAnteriorly

(from

above□

Pancreas□

Ascending

part

ofduodenum□

Radix

of

mesenteryPosteriorly口

Upper

four

lumbervertebraeOn

its

right□

|Inferior

vena

cavaOn

its

left□

Left

sympathetic

trunk2021/10/10

40downward)Internaliliac

vein

骼内

静

脉Parietal

tributaries:accompanywith

arteries

Visceraltributariesrectal

vein→inferior

mesenteric

v.→inferior

rectalvein→internal

iliacv.→analvein→internalpudendalv.②Vesicalvenousplexus

膀胱静脉丛→vesicalv.

③Uterinevenousplexus

子宫静脉丛→uterinev.Veinsofabdomenand①Rectal

venous

plexus直肠静脉丛2021/10/1041pelvisExternal

iliacvein骼外静脉—

accompanyCommon

iliacvein

i

al

a

j

innt,yoicnL5ieaiLcauponrnoaf

lsialindxotnetndbyernrmedntfon

o静脉io总un骼unitingeachother

toforminferiorvena

cava2021/10/10

42thearteryFormed

by

union

of

two

o

nmdoj

sitli

at

tvheinrsig

toefrior

4s～c

ds

on

the

right

side

of

oor

fe

g

vamcaraahnpeavdisamen

orta,piercn5eL

Inferiorvenacava

下

腔

静

脉

er

i

drainsuaight

atrthe

T8o

thepositinoConveys

blood

from

the

a

ytob

atriumghttheriweothelgbhrlepoah2021/10/10

43Chieftributaries■

ParietaloPaired

inferior

phrenicv.膈口

ig

t静a脉nd

left

renal

veins

左

、

口

Right

suprarenal

veinlef右t肾

l静v

i

eft

drain

into口

Right

testicular

or

ovarian

v

ra睾in丸in

l

ft)

l.

i

)nftelev(ren静o卵)ln(a腺ren上下静脉□

pairedlumbar

v.腰静脉

(four)

Visceral2021/10/10

44Hepaticveins

肝静脉：right,left

and

intermediate

Posteriorly□

|Right

crus

of

diaphragm□

Upper

four

lumber

vertebrae□

Left

sympathetic

trunk口/

Abdominal

aortaLiverH

i

o

ft

apla

rrte

duodenumRight

testicular

(or

ovarian)a.Radix

of

mesenteryoaacpnnooeRelationsofinferiorvenacavaAnteriorly

(cranially

to

caudally)口

Parietal

branches

of

abdominal

aorta2021/10/1045On

its

right□

Psoas

major□

Right

kidney口Right

suprarenal

glandOn

its

left□

□

o口口

Hepatic

portal

vein

肝

门

静

脉Generalfeaturessbeb

i

et

i

c

f

ofokonneunheyhpancreFormesuperior

mesenteric

vein

and

psl

wards

and

to

thepnueisvcendenicright,posteriortothefirst

parterstotheen

enttudenanmmourneelessuodthof

eigh

e

,flw

esevniniteorthtoTipnvalves

in

hepatic

portalsystemti

inbtl

sotdin

lot

ct

from

theramafreoosrngasDralowerendofoesophagustotheupperend

ofanal

canal,

sd,

e

adder,bileplallsgnaaeuctsancr2021/10/1046Variationandanomalies

ofhepatic

portalvein2021/10/1047Tributariesofhepaticportal

vein1.Superior

mesenteric

v.肠系膜上静脉2.Inferior

mesenteric

v.3.Splenicv.脾

静

脉4.Left

gastric

v.

胃左静脉5.Right

gastric

v.胃右静脉6.Cystic

v.

胆囊静脉7.Paraumbilical

v.附

脐

静

脉2021/10/10

48肠系膜下静脉Portal-systemicanastomoses1.Atthelower

end

ofthe

oesophagusHepaticportalvein→leftgastricvein

→esophagealvenous

plexus

→esophageal

vein→azygos

vein2.At

rectal

venous

plexusHepatic

portal

vein

→splenic

vein

→inferior

mesentericinferior

vena

cava3.At

periumbilical

venous

plexusHepaticportalvein→paraumbilicalvein→periumbilicalvenousplexus→vein

→superiorrectalvein→rectalvenousplexus

→inferior

rectal

and

anal

veins

→internaliliacvein→口

thoracoepigastricandsuperiorepigastricvein→superiorvena

cava口

superficialepigastricandinferiorepigastricveins→

inferior

vena

cava2021/10/1049→superiorvenacava4.Portal-retroperitonealanastomosisB

e

v

si

p

h

hi

e

a

t

ioc

fo

u

i

u

lacfnioareolnwailmpebhlhrwofitthhanntdhssseiinnwineeetvvvecolicveins

(portal)anastomosingwithsystemic2021/10/10

50retroperitoneal

veins

The

lymphatic

drainage

ofabdomenLymphaticdrainageofabdominalwallToaxillarylymph

node

fromregionabove

umbilicusTosuperficialinguinal

lymphnodefromregion

belowumbilicusTolumbar

lymph

nodefrom2021/10/10

51postwallofabdomen

LymphaticdrainageofLumbarlymph

nodesLie

on

posterior

abdominalwall,along

the

abdominal

,sayvestes,nkaidcnaelminpcrtueoovarirs,fundus

of

uterus,ovary,and

common

iliacnodesRight

and

left

lumbar

trunksformed

byefferent

vesselPlu

r

rvl

a

d

n

to

theesraino—ympiscemai2021/10/10

52abdominalviscera腰淋巴结Celiac

lymph

nodes腹腔淋巴结—situated

around

the

celiactrunkSuperiormesenteric

lymphnode肠系膜上淋巴结—situated

around

inferiormesenteric

a.Intestinal

trunk

腹腔干celiac,superiorand

inferiorlymph

nodes—situatedaroundsuperiormesentericaInferiormesenteric

lymph

node

肠系膜下淋巴结—formed

by

efferent

vessel

of2021/10/10

53Thoracic

duct

胸

导

管Begins

infront

of

L1

as

a

dilated

sac,thelevelofT5■

At

the

roof

of

the

neck,it

turns

laterally

andlearf

sleand

descends

to

enter

thel

ecl

na

,it

brreocneci

eia

i

altrunksDrains

lymph

from

lower

limbs,pelvic

cavity,nftslhomedves

thndonianrmiveatsufoutgsuugds

anrwaruoofnseevhcisternachyli,whichformed

byjoining

of

leftand

right

lumbar

trunks

and

intestinal

trunkEnterthoraciccavity

bypassingthrough

theabdominal

cavity,left

side

of

thorax,and

leftaortic

hiatus

of

the

diaphragm

and

ascendsalong

on

the

front

of

the

vertebral

column,side

ofthe

head,neck

and

left

upper

limbbetween

thoracic

aorta

and

azygos

veinTravels

upward,veering

to

the

left

at

the2021/10/10

54Location:liesinthe

lefthypochondriac

region(between

stomach

anddiaphragm)deep

to

the9th

to

11th

rib,its

longaxis

correspondsroughlyto

the

10th

ribShape

—reddishin

colour2021/10/10

55SpleenTwo

surfacesDiaphragmatic:smooth,convexTwo

extremitiesAnterior—widerPosterior—rounderTwo

border

en

g

i

ble

i

pleen

isconsideredto

beFormationoflymphocytesand

monocytesr:einedthun:ortantonsor—rimponctiInferFu■■a，paatio切oaltp脾npht

isonnotcllyrknlse;ar3as2-laesisrvhanorehriwhwSuhpice■

ait

obcl

toodsi

eoll

cdt

eprliaat,

particles

andeletsinertnasfcshhwPDestroyingeffeteorabnormalred

blood

cellsVisceral:concave,hilum

of

spleen2021/10/10

56■

Making

antibodiesRalationshipsofspleenDiaphragmatic

Visceralsurface□

Anteriorly—fundus

ofstomach□

r

dly□

Inferiorly—tailof

pancreas

and

left

colic

flexureysuprarenaleftnekid—laniordeglanPost2021/10/10

57surface—diaphragmLumbarplexus腰丛Formation:formed

byofT12and

L4■

Position:lieswithinanterior

rami

of

L1-L3,a

partof

anterior

ramisubstance

of

psoas2021/10/10

58Nervers

of

abdomenmajorBranches■

lliohypogastricn.

骼腹下神经Lateralfemoralcutaneous股外侧皮神经■

Femoral

n.

股

神

经■

Obturator

n.

闭孔神经Genitofemoral

n.生殖股神经Supplieslower

part

ofanteriorabdominalwallllioinguinal

n.骼腹股沟神经Passesthroughinguinall

olyt

in

of

themkusscrppantogroincana2021/10/1059Made

up

of

paired

chainswithfourtofive

lumbarPasses

inferiorly

behind

eormin

i

cb

ejsosi

il

gatnodnsneyvsaoniliaomm

Lumbar

sympathetic

trunk

腰

交

感

干ganglia

anterolateral

tovertebral

column

a

i

theaasvanndmeaogaphrersdiaEntcontinuation

of

hethoracicform

unpaired

ganglionimpar,anterior

to

sacrum2021/10/1060part山

东

大

学

医

学

院

解

剖

教

研

室

李振华

Abdomen32021/10/10

61

RelationshipsofabdominalvisceraFirst

layer—live,gallbladder,stomachSecond

layer—duodenum,pancreas,spleenThird

layer—suprarenal

gland,kidney,ureter,inferior

vena

cava,abdominal

aorta,nerves2021/10/10

62and

lymphatics■

Anterior:□

Live(right

part)□

Pancreas□

Left

suprarenal

gland□

Left

kidney□

SpleenTransverse

colon

andtransvers

mesoclonRelationshipsof

thestomach□

Diaphragm(left

upper

part)□

i

a

dominal

wall

(leftt)braporrrloweAnte■

Posterior—separatedbyperitonumoflessersacfromthe

following(“stumach-bed”)2021/10/1063Left

and

rightgastricarteries

arise

fromceliac

trunk

andArteries

of

stomachproperhepatic

artery,repectively.These

twovessels

run

in

lesseromentumalong

lessercurvature

,andanastomoseend.end-to-2021/10/1064Rightandleftgastroepiploicduo

a

r

dt

lenic

h

i

ry,ent

and2021/10/10ligamh

thecggastrosplenicoursethrourtes,aesplenicic

arterfres

ogastbrancShortpeshnmaolfneeisdargastroarteriesartery,repectively.These

twovesselspass

intothe

greatertpu

to

theandllelreargreater

curvaomentum,runsupplythefundusofstomach.Posteriorgastricartery

(72%)arisefromthesplenicartery,

p

ent

andmeahgtlihnicugrerohthgastrocoursesupplytheposteriorwall

ofanastomoseend-to-end.fundus

of

stomach.65VenousdrainageRight

and

left

gastric

veins

empty

directly

into

hepatic

portal

vein.■

Leftgastroepiploicandshortgastric

veins

drain

into

hepatic

portal■

|

tv

l

i

.

join

either

superior

mesenteric

vein.nnoic

venic

veipi