腹膜后隙解剖ppt课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,*,腹膜后隙解剖ppt课件,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,一、概 述,腹膜后隙位置,：位于腹后壁，介于腹后壁腹膜与腹内筋膜之间。,范围：,上起膈，下至骶骨岬，两侧续于腹膜外筋膜,，,向下续于盆部的腹膜后间隙。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,主要结构：,腹膜后隙有肾、肾上腺、输尿管、腹部大血管、神经和淋巴结等重要结构。,(,胰腺、十二指肠已于结肠上区内介绍,),January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,二、肾,kidney,内容：,（一）,肾的位置和,毗邻,（二）肾门、肾窦和肾蒂,（三）,肾的血管,（四）肾的被膜,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,（一）肾的位置及,毗邻,位置：,肾位于脊柱两侧，紧贴于腹后壁。由于肝的存在，左肾略高于右肾。,左肾：上端,平第,11,胸椎下缘,下端,平第,2,腰椎下缘,右肾：上端,平第,12,胸椎上缘,下端,平第,3,腰椎上缘,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,肾的毗邻：,毗邻（相同点）：,两肾上端,:,肾上腺,两肾后面：膈,腰大肌,腰方肌,腹横肌,两肾内下方：肾盂 输尿管,两肾内后方：左右腰交感干,膈肌,腰大肌,腰方肌,腹横肌,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,毗邻（不同点）：,两肾内侧：,左肾：腹主动脉,右肾：下腔静脉,左肾前面邻：,胃 胰,空肠 结肠左曲,右肾前面邻：,肝右叶 结肠右曲,十二指肠降部,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,肾区,竖脊肌外侧缘与第,12,肋之间所夹的部位称,肾区,（,脊肋角,）,。在某些肾疾病患者，叩击或触压该区可引起疼痛。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,（二）,肾门、肾窦和,肾蒂,肾门：,肾的内侧缘中部凹陷，是肾的血管、神经、淋巴管和肾盂出入肾的部位，称,肾门,。,肾窦：,肾门深入肾实质所围成的腔隙称为肾窦。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,肾蒂,：,出入肾门的结构合称,肾蒂,，主要结构有,肾动脉、肾静脉、肾盂。,肾蒂内主要结构的排列关系,:,由前向后依次为：,肾静脉、肾动脉、肾盂,从上向下依次为：,肾动脉、肾静脉、肾盂,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,肾动脉和肾段,肾段：,每一段动脉供给的肾实质区域称为肾段，共,5,个。,（三）肾血管和肾段,上段动脉,上前段动脉,下段动脉,下前段动脉,后段动脉,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,2.,肾静脉,右肾静脉通常无肾外属支，而左肾静脉收纳左肾上腺、左睾丸（卵巢）静脉血，其属支与周围静脉有吻合，借此可建立门,-,腔静脉间的侧支循环。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,（四）肾的被膜,肾表面包有三层被膜，由内向外为：,纤维囊,脂肪囊,肾筋膜,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,三、输尿管腹部,输尿管起于肾盂，终于膀胱，全长约,25,30cm,。分为三部,:,腹部、盆部、壁内部，其中腹部长约,13-14cm,紧贴腰大肌前面向下内斜行，在腰大肌前面中点处有睾丸（卵巢）血管斜过其前方。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,右输尿管前方为十二指肠降部、升结肠血管、回结肠血管、睾丸（卵巢血管）、回肠末段。,左输尿管前方为十二指肠空肠曲、降结肠血管、斜行跨过的睾丸（卵巢血管）。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,腹主动脉沿脊柱左前方下行，至第,4,腰椎下缘平面分为左、右髂总动脉,，全长,14-15cm,，,其右侧邻下腔静脉。腹主动脉可分为脏支及壁支，其中脏支又可分为：成对的脏支 不成对的脏支,四、腹主动脉,Abdominal aorta,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,（,1,）成对的脏支,有,3,对,:,肾上腺中动脉,肾动脉,睾丸动脉,(,卵巢动脉,),January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,（,2,）不成对的脏支,有,3,支：,腹腔干,肠系膜上动脉,肠系膜下动脉,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,腹主动脉毗邻：,前方：为胰腺、十二 指肠升部、小肠系膜根,后方：为,1-4,腰椎及椎 间盘,右侧：下腔静脉,左侧：左交感干,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,五、下腔静脉,Inferior vena cava,下腔静脉由左右髂总静脉在第,5,腰椎右侧汇合而成，收集下肢、 盆部和腹部的静脉。,下腔静脉在脊柱的右前方沿腹主动脉右侧上行经肝腔静脉沟，穿膈的腔静脉孔，最后开口于右心房。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,3,对：,(1),肾静脉,左侧长于右侧,(2),肾上腺静脉,右侧注入下腔静脉,左侧注入肾静脉,。,(3),生殖腺静脉,右侧注入下腔静脉,左侧注入肾静脉,成对脏器的静脉：,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,下腔静脉毗邻：,前方：肝脏、胰头、十二指肠水平部及右睾丸（卵巢）血管和肠系膜根,后方：右膈脚、,1-4,腰椎、右交感干和腹主动脉的壁支,右侧：腰大肌、右肾和右肾上腺,左侧：腹主动脉,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,左侧睾丸静脉曲张较右侧多见，原因如下：（,1,）左侧回流流程较长（,2,）左侧睾丸静脉以直角汇入左肾静脉，压力较大（,3,）左侧前方有乙状结肠跨过，易受其压迫（,4,）左肾静脉在肠系膜上动脉与腹主动脉夹角中回流，受压时易累及左侧睾丸静脉,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,七、腰交感干（自学）,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,八、乳糜池（自学）,谢谢,