局部解剖学-结肠上区课件

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,*,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,局 部 解 剖 学,Topographical Anatomy,Department of Anatomy,Jilin University,石岫昆 Xiukun Shi 2019.02.08,Section 4 Peritoneum and Peritoneal Cavity,I.Introduction,1.,Peritoneum is a serous membrane which lines abdominopelvic cavity,and can be likened to a slack balloon into which organs are invaginated.,Parietal peritoneum,lines abdominal and part of pelvic walls,while,Visceral peritoneum,covers viscera.,Peritoneal cavity,is potential space between parietal and visceral layer of peritoneum.In male,is a closed sac;but in female,there is a communication with,outside,through uterine tubes,uterus,and vagina.,A film of fluid lubricates surfaces of peritoneum and facilitates free movement of viscera,one against another or against abdominal or pelvic walls.,2.,The most important,functions,of peritoneum,are,Absorption,Secretion,and,Supporting viscera.,Peritoneum has capacity of absorption.Soluble substances and water are probably absorbed directly into blood.Peritoneum in subphrenic region has a greater absorptive capacity than other regions.,After abdominal or,pelvic operations,it has been customary to put patient in Fowlers position,so that any inflammatory intraperitoneal effusion will gravitate into pelvis.,Fowlers position,Peritoneum,may secrete a lubricating serous fluid that continuously moistens associated organs to minimize friction and,to resist infection.,Under certain pathological conditions,potential space of peritoneal cavity may form an actual space containing several liters of fluid.,Ascites,is an accumulation of serous fluid in peritoneal cavity(hydroperitoneum).,The peritoneum surrounds and supports viscera in a number of different ways,which may be characterised as follows:mesentery,ligament,omentum,and so on.,Treatment of Renal Failure,Continuous Ambulatory Peritoneal Dialysis,3.,Based on covering of peritoneum,viscera in abdominal and pelvic cavities can be divided into three kinds:,Intraperitoneal viscera,viscera are almost completely invested by peritoneum and more mobile than,other viscera,such as spleen,stomach,small intestine,transverse colon and sigmoid colon,etc.,Intraperitoneal viscera,Interperitoneal viscera,viscera are covered by peritoneum on their three aspects,such as gall-bladder,liver,ascending colon,uterus and urinary bladder.,Retroperitoneal viscera,viscera are covered by peritoneum only on their one aspect,such as pancreas,ureter,kidney and suprarenal gland.,Interperitoneal viscera,Retroperitoneal viscera,II.Main Contents,I)Structures which are formed by peritoneum,1.Omenta,are folds of peritoneum between stomach and other abdominal viscera.There are two omenta,lesser and greater.,(1),Lessor omentum,two-layered fold of peritoneum which extends from porta hepatis to lesser curvature of stomach and superior part of duodenum.,The portion of lesser omentum extending between the liver and stomach is named,Hepatogastric ligament,.,Hepatoduodenal ligament,extends from porta hepatis to superior part of duodenum.Close to its right free margin the two layers of lesser omentum enclose proper hepatic artery(left anterior),hepatic portal,vein(posterior)and common bile duct(right anterior).,(2),Greater omentum,consists of a double sheet,folded on itself so that it is made up of four layers.,Anterior,two layers descend from,greater curvature of stomach and superior part of,duodenum and,pass,downwards,like an apron in front of coils of small intestine,for a variable distance,and then turns upward,themselves as far as to,attach,anterosuperior aspect of transverse colon.,The,part,between greater curvature of stomach and transverse colon is referred to as gastrocolic ligament.,If an infection occurs in intestine,plasma cells in greater omentum combat infection and help prevent it from spreading to peritoneum.,(3),Omental bursa,(lesser sac),lies behind stomach and lesser omentum.,Its superior wall,is,peritoneum which covers the caudate lobe of liver and diaphragm;,Inferior wall,is transverse colon and its mesocolon;,Anterior wall,is formed by lesser omentum,posterior wall of stomach and gastrocolic ligament;,Posterior wall,is formed by peritoneum covering diaphragm,pancreas,left kidney and suprarenal gland;,Left,wall,is bounded by spleen,gastrosplenic ligament and splenorenal ligament;,On the right,omental bursa communicates with greater sac through omental foramen.,(4),Omental foramen,(Winslow,s foramen),lies behind free edge of hepatoduodenal lig.and it can admit two fingers.It is a channel between omental bursa and greater sac.,Its anterior wall is formed by,hepatodudenal lig.,;,Peritoneum covering inferior vena cava,lies its behind;,Caudate lobe of liver,forms its roof;,Superior part of duodenum,is its inferior wall.,2.,Mesenteries or mesocolons,are,two-layered fold of peritoneum that attach part of intestines to posterior abdominal wall.,(1)mesentery(of small intestine)