1、January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 腹膜后隙腹膜后隙內容：內容：一、腎一、腎二、輸尿管二、輸尿管三、血管、神經三、血管、神經January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 概概 述述 腹膜后隙位置腹膜

2、后隙位置：腹后：腹后壁腹膜后方。壁腹膜后方。范圍：范圍：上自膈，下至上自膈，下至骶岬，兩側續腹膜外骶岬，兩側續腹膜外筋膜。向下續盆部的筋膜。向下續盆部的腹膜后間隙。腹膜后間隙。January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG （一）腎（一）腎 kidney 內容：內容： （一）（一）腎的位置和腎的位置和毗鄰毗鄰（二）腎蒂（二）腎蒂（三）（三）腎的血管腎的血管（四）腎的被膜（四）腎的被膜 January,

3、2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 一、腎的位置及一、腎的位置及毗鄰毗鄰 腎位于脊柱腎位于脊柱兩側，腹膜后方，兩側，腹膜后方，緊貼腹后壁的上緊貼腹后壁的上部。部。January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 左腎位置

4、：左腎位置： 上端上端平第平第1111胸椎下緣胸椎下緣下端下端平第平第2 2腰椎下緣腰椎下緣 January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 上端上端平第平第1212胸椎上緣胸椎上緣 下端下端平第平第3 3腰椎上緣腰椎上緣 第第1212肋跨過左腎的中肋跨過左腎的中部，右腎的上部。部，右腎的上部。：January, 2007Copyright Depart. Anatomy, School of Medi

5、cine, Lanzhou University. All right reserved by YP HOU and YF SONG 腎門位置腎門位置： 腎門平第一腰腎門平第一腰椎平面，距正中線椎平面，距正中線約約5cm5cm。January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 腎區：腎區： 豎脊肌外側緣與第豎脊肌外側緣與第1212肋之間的部位稱肋之間的部位稱腎區腎區（肋脊角肋脊角）。在某些腎。在某些腎疾病

6、患者，叩擊或觸壓疾病患者，叩擊或觸壓該區可引起疼痛。該區可引起疼痛。January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 腎的毗鄰：腎的毗鄰： 兩腎后面：兩腎后面：膈膈 腰大肌腰大肌 腰方肌腰方肌 腹橫肌腹橫肌兩腎上端兩腎上端: 腎上腺腎上腺January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All r

7、ight reserved by YP HOU and YF SONG 右腎前面鄰：右腎前面鄰：肝右葉肝右葉 結腸右曲結腸右曲 十二指腸降部十二指腸降部January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 左腎前面鄰：左腎前面鄰：胃胃 胰胰 空腸空腸 結腸左曲結腸左曲January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou Univ

8、ersity. All right reserved by YP HOU and YF SONG 二、二、腎門、腎門、腎蒂腎蒂 腎門：腎門： 腎的內側腎的內側緣中部凹陷，是腎緣中部凹陷，是腎的血管、神經、淋的血管、神經、淋巴管和腎盂出入腎巴管和腎盂出入腎的部位，稱的部位，稱腎門腎門。 January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 腎蒂腎蒂 renal pedicle：出入腎門的結構合稱出入腎門的結構合

9、稱腎蒂腎蒂，主要結構，主要結構腎動腎動脈、腎靜脈、腎盂。脈、腎靜脈、腎盂。右側腎蒂較左側短。右側腎蒂較左側短。January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 由前向后依次為：由前向后依次為：腎靜脈、腎動脈、腎盂腎靜脈、腎動脈、腎盂 從上向下依次為：從上向下依次為：腎動脈、腎靜脈、腎盂腎動脈、腎靜脈、腎盂January, 2007Copyright Depart. Anatomy, School of M

10、edicine, Lanzhou University. All right reserved by YP HOU and YF SONG 三、腎的被膜三、腎的被膜 腎表面包有三層被膜，由內向外為：腎表面包有三層被膜，由內向外為：纖維囊纖維囊脂肪囊脂肪囊腎筋膜腎筋膜January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG （二）輸尿管（二）輸尿管 ureter 輸尿管起于腎盂，輸尿管起于腎盂，終于膀胱，長約終于膀

11、胱，長約252530cm30cm。January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 輸尿管行程分部輸尿管行程分部: : 分三部分三部: : 腹腹部部盆盆部部壁壁內內部部January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

12、 位于腹膜后方，位于腹膜后方，沿腰大肌前面下降至沿腰大肌前面下降至小骨盆上口處，左右小骨盆上口處，左右輸尿管分別跨過髂血輸尿管分別跨過髂血管的前面，進入盆腔管的前面，進入盆腔移行于盆段。移行于盆段。輸尿管腹部：輸尿管腹部：January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 輸尿管腹部在輸尿管腹部在腰大肌前面中點處腰大肌前面中點處與睪丸血管（男）與睪丸血管（男）或卵巢血管（女）或卵巢血管（女）相交叉（血管位于

13、相交叉（血管位于輸尿管前面）。輸尿管前面）。January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 腹部的血管、神經腹部的血管、神經January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 腹主動脈從膈的腹主動脈從膈的主動脈裂孔沿

14、脊柱左主動脈裂孔沿脊柱左前方下降，至第四腰前方下降，至第四腰椎平面分為左、右髂椎平面分為左、右髂總動脈。其右側鄰下總動脈。其右側鄰下腔靜脈。腔靜脈。動脈：動脈：腹主動脈腹主動脈January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 腹主動脈的腹主動脈的分支分支有有： 壁壁 支支臟臟 支支January, 2007Copyright Depart. Anatomy, School of Medicine, Lan

15、zhou University. All right reserved by YP HOU and YF SONG 1.壁支壁支主要有：主要有： 膈下動脈膈下動脈 4對腰動脈對腰動脈 骶正中動脈骶正中動脈January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 2.臟支臟支主要有：主要有： 成對的臟支成對的臟支 不成對的臟支不成對的臟支January, 2007Copyright Depart. Anatomy,

16、 School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG （1）成對的臟支）成對的臟支 有有3對對: 腎上腺中動脈腎上腺中動脈 腎動脈腎動脈 睪丸動脈睪丸動脈(精索內動脈精索內動脈) (在在女性則稱女性則稱卵巢動脈卵巢動脈)January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG （2）不成對的臟支）不成對的

17、臟支 有有3支：支： 腹腔干腹腔干 腸系膜上動脈腸系膜上動脈 腸系膜下動脈腸系膜下動脈January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 膈下動脈膈下動脈發出發出: 腎上腺上動脈腎上腺上動脈 腹主動脈腹主動脈發出發出: 腎上腺中動脈腎上腺中動脈 腎動脈腎動脈發出發出: 腎上腺下動脈腎上腺下動脈腎上腺的動脈腎上腺的動脈 （3對）對）January, 2007Copyright Depart. Anatomy,

18、 School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 靜脈：靜脈：下腔靜脈下腔靜脈inferior vena cava 下腔靜脈由下腔靜脈由左、右髂總靜脈左、右髂總靜脈在第在第5腰椎右側匯腰椎右側匯合而成。下腔靜合而成。下腔靜脈收集下肢、盆脈收集下肢、盆部和腹部的靜脈。部和腹部的靜脈。January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by

19、YP HOU and YF SONG 壁支壁支臟支臟支下腔靜脈的屬支有下腔靜脈的屬支有：January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 1. 壁支：壁支：膈下靜脈膈下靜脈 對腰靜脈對腰靜脈 January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU

20、 and YF SONG 2. 臟支：臟支： 成對臟器成對臟器和和肝肝的靜的靜脈注入下腔靜脈脈注入下腔靜脈, 不成不成對臟器的靜脈先匯合成對臟器的靜脈先匯合成肝門靜脈肝門靜脈, 入肝后再經入肝后再經肝靜脈入下腔靜脈。肝靜脈入下腔靜脈。January, 2007Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG 3對：對：(1)腎靜脈腎靜脈 (2)腎上腺靜脈腎上腺靜脈 生殖腺靜脈生殖腺靜脈成對臟器的靜脈：成對臟器的靜脈：January, 2007Copyright Depart.