腹部血管解剖-2

腹部血管解剖易西南腹部的血管腹主动脉下腔静脉腹腔干肠系膜上动脉肠系膜下动脉肾上腺动脉肾动脉肝门静脉肝的血管胰及十二指肠的血管脾的血管胃的血管肾上腺的血管Abdominalaorta腹主动脉ContinuationofthoracicaortaataortichiatusofdiaphragminfrontofT12TerminatesatlowerborderofL4vertebrabydividingintorightandleftcommoniliacarteriesLeftrenalarterycrossanteriortoit.Abdominalaorta（二）RelationsofabdominalaortaAnteriorly(fromabovedownward)PancreasAscendingpartofduodenumRadixofmesenteryPosteriorly

UpperfourlumbervertebraeOnitsrightInferiorvenacavaOnitsleftLeftsympathetictrunkAbdominalaorta（三）ParietalbranchesInferiorphrenica.

膈下动脉(onepair)Lumbara.

腰动脉(fourpairsofarteriesthatsupplytheposteriorabdominalwall)Mediansacrala.骶正中动脉Abdominalaorta（四）Visceralbranches

Pairedbranches

Middlesuprarenalartery肾上腺中动脉Renalartery肾动脉Testicular(ovarian)artery睾丸（卵巢）动脉VisceralbranchesUnpairedbranches

Celiactrunk

腹腔干－ashortthickvesselthatarisesfromthefrontofaorta,atthelevelofT12Superiormesenterica.肠系膜上动脉－arisesfromthefrontofaorta,atthelevelofL1Inferiormesenterica.肠系膜下动脉－arisesfromthefrontofaorta,atlevelofL3Abdominalaorta（五）肝总a腰a骶中a脾a肾a肠系膜上a肠系膜下aAbdominalaortaDSA影像（一）

主干及主要分支Celiactrunk

（一）Leftgastrica.Commonhepatica.Splenica.Gastroduodenala.Properhepatica.Rightgastrica.LeftbranchRightbranchCystica.Shortgastrica.

Leftgastrioeploica.Rightgastroepiploica.Superiorpancreaticoduodenala.Splemicbranches

Celiactrunk

（二）Celiactrunk（三）

CeliactrunkDSA影像（一）CeliactrunkDSA影像（二）Superiormesenterica.

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

SuperiorMesentericv.Superiormesenterica.

（一）主干跨十二指肠前、跨中线行向右下方ColicmarginalarterySuperiormesenterica.

（二）Superiormesenterica.DSA影像（一）胰十二指肠前动脉弓胃网膜右a胰十二指肠上后动脉弓Superiormesenterica.

（二）胰十二指肠前动脉弓Inferiormesenterica.（一）Leftcolica.Sigmoida.Superiorrectala.

起自Ｌ３左侧，行向左髂窝Inferiormesenterica.Inferiormesenterica.（二）Inferiormesenterica.DSA影像Abdominalaorticimaging（一）

abdominalrenalarteriesCeliactrunkSplenica.CommonHepatica.Superiormesenterica.

inferiormesenterica.

Superiorrectala.

Leftcolica.Rightcolica.Abnormalabdominalaorta（二）

abdominalaneurysm

Superiormesenterica.

Inferiorsuprarenal.aTesticulara.Superiormesenterica.

Inf.pancresticodudenala.Splenica.Inferiorphrenica.Rightcolica.sup.pancresticodudenala.Hepatica.肝的动脉Commonhepatica.肝总动脉起源、行程、分支、变异肝固有动脉肝左动脉肝中动脉（65％）右肝动脉肝动脉在肝内分支由肝固有A发出的肝右A仅占70-80%，10%发自肝总A，20%来源于肠系膜上A。肝动脉起源变异迷走肝动脉和副肝动脉迷走替代动脉：作为左右A之一而存在迷走副肝动脉：作为附加支而出现肝动脉的变异肝左动脉变异肝左动脉分支变异AbdominalhepaticarteryAbdominalhepaticartery肝右动脉起源变异起源于肠系膜上a的肝右动脉起源于腹主a的肝右动脉肝右动脉起源变异肝外动脉侧支循环Cysticartery胆囊动脉SplenicarteryStomacharteryPancreaticArtery后面观肠系膜上胰十二指肠下腹腔干胰十二指肠上前胰大胰背胰十二指肠上后胰横动脉胃十二指肠动脉：胰十二指肠前上A、胰十二指肠后A、上胰十二指肠中A肠系膜A：胰十二指肠下A脾A胰支：胰背A、胰横A、胰大A、分界A、胰尾A肝A分出的小支十二指肠的动脉Renalartery肾动脉起源及行程肾动脉的变异肾段动脉

上后下上前下前肾外动脉侧支循环Renalsegmentalarteries肾被膜动脉2.肾静脉renalvein左肾静脉高于右肾静脉左肾静脉跨过主动脉前方VeinsofabdomenandpelvisInternaliliacvein髂内静脉Parietaltributaries:accompanywitharteriesVisceraltributaries

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

直肠静脉丛

→analvein→internal

pudendalv.②Vesicalvenousplexus膀胱静脉丛→vesicalv.③Uterinevenousplexus子宫静脉丛→uterinev.

Externaliliacvein

髂外静脉–accompanythearteryCommoniliacvein

髂总静脉–formedbyunionofinternalandexternaliliacveinsinfrontofsacroiliacjoint,enduponL4~L5byunitingeachothertoforminferiorvenacavaInferiorvenacava

下腔静脉FormedbyunionoftwocommoniliacveinsanteriortoandjusttotherightofL4~L5Ascendsontherightsideofaorta,piercesvenacavaforamenofdiaphragmoppositetheT8anddrainsintotherightatriumConveysbloodfromthewholebodybelowthediaphragmtotherightatriumAbnormalinferiorvenacavaChieftributariesofinferiorvenacava

ParietalPairedinferiorphrenicv.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,leftandintermediateRelationsofinferiorvenacavaAnteriorly(craniallytocaudally)LiverHeadofpancreasHorizontalpartofduodenumRighttesticular(orovarian)a.RadixofmesenteryPosteriorly

RightcrusofdiaphragmUpperfourlumbervertebraeLeftsympathetictrunkParietalbranchesofabdominalaortaOnitsrightPsoasmajorRightkidneyRightsuprarenalglandOnitsleftAbdominalaortaHepaticportalvein肝门静脉

GeneralfeaturesFormedbehindtheneckofpancreasbytheunionofsuperiormesentericveinandsplenicveinAscendsupwardsandtotheright,posteriortothefirstpartofduodenumandthenentersthelesseromentumtotheporta

hepatis,whereitdividesintorightandleftbranchesTherearenofunctioningvalvesinhepaticportalsystemDrainsbloodfromgastrointestinaltractfromthelowerendofoesophagustotheupperendofanalcanal,pancreas,gallbladder,bileductsa