上腹部臟器解剖腹膜和胃new本文檔共71頁；當前第1頁；編輯于星期一\22點59分腹腔、腹膜和腹膜腔(Abdominalcavity,PeritoneumandPeritonealcavity)

基本概念：腹腔

腹膜（壁腹膜和臟腹膜）腹膜腔本文檔共71頁；當前第2頁；編輯于星期一\22點59分TheintroductionoftheperitoneumDefinition

Theperitoneumisathinserousmembranethatlinesthewallsoftheabdominalandpelviccavitiesandcovertheorganswithinthetwocavities本文檔共71頁；當前第3頁；編輯于星期一\22點59分SubdivisionsandperitonealcavityParietalperitoneum壁腹膜－linesthewallsoftheabdominalandpelviccavitiesVisceralperitoneum臟腹膜－coverstheorgansPeritonealcavity腹膜腔－thepotentialspacebetweentheparietalandviscerallayerofperitoneum.Isthereanyorgansintheperitonealcavity?Theperitonitisisverycommonforfemale!Formale,itisaclosedsac.Butforfemale,thereisacommunicationwiththeexteriorthroughtheuterinetubes,theuterus,andthevagina.本文檔共71頁；當前第4頁；編輯于星期一\22點59分FunctionSecretesalubricatingserousfluidthatcontinuouslymoistenstheassociatedorgansSupportandprotectviscusSemipermeablemembrane(Peritonealdialysis)Absorption本文檔共71頁；當前第5頁；編輯于星期一\22點59分TherelationshipbetweenvisceraandperitoneumIntraperitonealvisceraInterperitonealvisceraRetroperitonealviscera本文檔共71頁；當前第6頁；編輯于星期一\22點59分Intraperitonealviscera腹膜內位器官－visceracompletelysurroundedbyperitoneum,example,stomach,superiorpartofduodenum,jejunum,ileum,cecum,vermiformappendix,transverseandsigmoidcolons,spleenandovaryInterperitonealviscera腹膜間位器官－mostpartofviscerasurroundedbyperitoneum,example,liver,gallbladder,ascendinganddescendingcolons,upperpartofrectum,urinarybladderanduterusRetroperitonealviscera腹膜外位器官－someorganslieontheposteriorabdominalwallandarecoveredbyperitoneumontheiranteriorsurfacesonly,example,kidney,suprarenalgland,pancreas,descendingandhorizontalpartsofduodenum,middleandlowerpartsofrectum,andureter本文檔共71頁；當前第7頁；編輯于星期一\22點59分本文檔共71頁；當前第8頁；編輯于星期一\22點59分StructuresformedbyperitoneumOmentum網膜

Thefoldofperitoneumthatextendsfromtwocurvaturesofstomachtoadjacentorgans本文檔共71頁；當前第9頁；編輯于星期一\22點59分Lesseromentum

小網膜

two-layeredfoldofperitoneumwhichextendsfromportahepatistolessercurvatureofstomachandsuperiorpartofduodenum.本文檔共71頁；當前第10頁；編輯于星期一\22點59分Greateromentum

大網膜－four-layeredfoldofperitoneum,theanteriortwolayersdescendfromthegreatercurvatureofstomachandinferiorpartofduodenumandhangsdownlikeanaproninfrontofcoilsofsmallintestine,andthenturnsupwardandattachestothetransversecolon.本文檔共71頁；當前第11頁；編輯于星期一\22點59分LesseromentumGreateromentum本文檔共71頁；當前第12頁；編輯于星期一\22點59分Mesenterium系膜－two-layeredfoldofperitoneumthatattachtheabdominalorpelvicorganstotheposteriorabdominalwall.mesenterium本文檔共71頁；當前第13頁；編輯于星期一\22點59分Mesentery

腸系膜－suspendsthesmallintestinefromtheposteriorabdominalwallBroadandafan-shapedIntestinalborder－folded,5-7mlongRadixofmesentery15cmlongDirectedobliquelyfromleftsideofL2toinfrontofrightsacroiliacjoint本文檔共71頁；當前第14頁；編輯于星期一\22點59分本文檔共71頁；當前第15頁；編輯于星期一\22點59分本文檔共71頁；當前第16頁；編輯于星期一\22點59分本文檔共71頁；當前第17頁；編輯于星期一\22點59分本文檔共71頁；當前第18頁；編輯于星期一\22點59分Mesoappendix闌尾系膜Triangularmesenterium－extendsfromterminalpartofileumtoappendixAppendiculararteryrunsinfreemarginofthemesoappendix本文檔共71頁；當前第19頁；編輯于星期一\22點59分Transversemesocolon

橫結腸系膜－adoublefoldofperitoneumwhichconnectsthetransversecolontotheposteriorabdominalwallSigmoidmesocolon

乙狀結腸系膜－invertedV-shaped,withapexlocatedinfrontofleftureteranddivisionofcommoniliacartery本文檔共71頁；當前第20頁；編輯于星期一\22點59分Ligaments韌帶

Ligamentsofliver

Falciformligamentofliver鐮狀韌帶ConsistsofdoubleperitoneallayerExtendsfromanteriorabdominalwall(umbilicus)toliveFreeborderofligamenthasligamentumteres本文檔共71頁；當前第21頁；編輯于星期一\22點59分Coronaryligament冠狀韌帶－itisformedbytheperitoneumbetweenthediaphragmandtheliver.ThereareleftandrightcoronaryligamentLeftandrighttriangularligaments左、右三角韌帶－formedbytheleftandrightextremityofcoronaryligamentligament,respectively本文檔共71頁；當前第22頁；編輯于星期一\22點59分Hepatogastricligament肝胃韌帶Hepatoduodenalligament肝十二指腸韌帶ExtendsfromportahepatistosuperiorpartofduodenumContainscommonbileduct,properhepatica.andhepaticportalv.本文檔共71頁；當前第23頁；編輯于星期一\22點59分LigamentsofspleenGastrosplenicligament胃脾韌帶－adoublelayerofperitoneumthatconnectsthefundusofstomachtohilumofspleen.Inthisdoublelayerofperitoneum,therearetheshortgastricandleftgastroepiploicvesselsSplenorenalligament脾腎韌帶－extendsbetweenthehilumofspleenandanterioraspectofleftkidney.Thesplenicvesselslieswithinthisligament,aswellasthetailofpancreasPhrenicosplenicligament膈脾韌帶本文檔共71頁；當前第24頁；編輯于星期一\22點59分Ligamentsofstomach

Hepatogastricligament肝胃韌帶Gastrosplenicligament胃脾韌帶Gastrophrenicligament胃膈韌帶Gastrocolicligament胃結腸韌帶Gastropancresticligament

胃胰韌帶本文檔共71頁；當前第25頁；編輯于星期一\22點59分Folds,recessesandfossa

皺襞、隱窩和窩Superiorduodenalfoldandrecess十二指腸上襞和上隱窩Inferiorduodenalfoldandrecess十二指腸下襞和下隱窩Intersigmoidrecess

乙狀結腸間隱窩－formedbytheinvertedVattachmentofsigmoidmesocolon本文檔共71頁；當前第26頁；編輯于星期一\22點59分Hepatorenalrecess肝腎隱窩－liesbetweentherightlobeofliver,rightkidney,andrightcolicflexure,andisthelowestpartsoftheperitonealcavitywhenthesubjectissupine本文檔共71頁；當前第27頁；編輯于星期一\22點59分Medianumbilicalfold臍正中襞－containtheremnantofurachus(medianumbilicalligaments)Medialumbilicalfold

臍內側襞－containsremnantsoftheumbilicalarteries(medialumbilicalligaments)Lateralumbilicalfold臍外側襞－containstheinferiorepigastricvesselsSupravesicalfossa膀胱上窩Medialinguinalfossa腹股溝內側窩Lateralinguinalfossa腹股溝外側窩本文檔共71頁；當前第28頁；編輯于星期一\22點59分Pouches

陷窩Inmale－rectovesicalpouch直腸膀胱陷窩InfemaleRectouterinepouch(Douglas,cavity)

直腸子宮陷窩－betweenrectumanduterusVesicouterinepouch膀胱子宮陷窩－betweenbladderanduterus本文檔共71頁；當前第29頁；編輯于星期一\22點59分Omental

bursa

網膜囊Position－situatedbehindthelesseromentumandstomachWallsSuperior－peritoneumwhichcoversthecaudatelobeofliveranddiaphragmAnterior－formedbylesseromentum,peritoneumofposteriorwallofstomach,andanteriortwolayersofgreateromentumInferior－conjunctiveareaofanteriorandposteriortwolayersofgreateromentumPosterior－formedbyposteriortwolayersofgreateromentum,transversecolonandtransversemesocolon,peritoneumcoveringpancreas,leftkidneyandsuprarenalgland腹膜腔的分部Thesubdivisionoftheperitonealcavity(twosacs)本文檔共71頁；當前第30頁；編輯于星期一\22點59分Left－formedbythespleen,gastrosplenicligament胃脾韌帶

andsplenorenalligament脾腎韌帶Right－formedbyomentalforamen本文檔共71頁；當前第31頁；編輯于星期一\22點59分Omentalforamen網膜孔BehindtherightborderofhepatoduodenalligamentSuperior－caudatelobeofliverInferior－superiorpartofduodenumAnterior－hepatoduodenalligamentPosterior－peritoneumcoveringtheinferiorvenacavaTheOmentalbursa(lessersac)communicateswiththegreatersacthroughtheomentalforamen.

本文檔共71頁；當前第32頁；編輯于星期一\22點59分本文檔共71頁；當前第33頁；編輯于星期一\22點59分本文檔共71頁；當前第34頁；編輯于星期一\22點59分ThesubregionsoftheperitonealcavityThetransversecolonandtransversemesocolondividestheperitonealcavityintosupracolicandinfracoliccompartments.結腸上區和結腸下區本文檔共71頁；當前第35頁；編輯于星期一\22點59分Supracoliccompartment

結腸上區(subphrenicspace)－liesbetweendiaphragmandtransversecolonandtransversemesocolonSuprahepaticrecess肝上間隙

liesbetweenthediaphragmandlive－thefalciformligamentdividesitintorightandleftsuprahepaticrecesses本文檔共71頁；當前第36頁；編輯于星期一\22點59分Leftsuprahepaticspace

左肝上間隙leftanteriorsuprahepaticspaceleftposteriorsuprahepaticspaceRightsuprahepaticspace

右肝上間隙Subphrenicextraperitonealspace膈下腹膜外間隙

(correspondingtothebareareaofliver)本文檔共71頁；當前第37頁；編輯于星期一\22點59分Infrahepaticspace肝下間隙

liesbetweentheliveandtransversecolonandtransversemesocolon－theligamentumtereshepaticdividesitintorightandleftinfrahepaticspacesRightinfrahepaticspace右肝下間隙(hepatorenalrecess)Leftinfrahepaticspaces左肝下間隙

leftanteriorinfrahepaticspaceleftposteriorinfrahepaticspace本文檔共71頁；當前第38頁；編輯于星期一\22點59分Infracoliccompartment

結腸下區

－liesbelowthetransversecolonandtransversemesocolonRightparacolicsulcus(gutter)右結腸旁溝－lieslateraltotheascendingcolon.Itcommunicateswiththehepatorenalrecessandthepelviccavity.Itprovidesarouteforthespreadofinfectionbetweenthepelvicandtheupperabdominalregion.Leftparacolicsulcus(gutter)左結腸旁溝－lieslateraltothedescendingcolon.Itisseparatedfromtheareaaroundthespleenbythephrenicocolicligament,afoldofperitoneumthatpassesfromthecolicflexuretothediaphragm.本文檔共71頁；當前第39頁；編輯于星期一\22點59分Rightmesentericsinus

右腸系膜竇－triangularspace,liesbetweenrootof

mesentery,ascendingcolon,right2/3oftransversecolonandtransversemesocolonLeftmesentericsinus

左腸系膜竇－liesbetweenrootof

mesentery,descendingcolon,left1/3oftransversecolonandtransversemesocolon,itswidensbelowwhereitiscontinuouswiththecavityofthepelvis本文檔共71頁；當前第40頁；編輯于星期一\22點59分Theorgansoftheabdominalcavity

腹腔臟器：Supracoliccompartment

結腸上區

Infracoliccompartment

結腸下區

Extraperitonealspace腹膜后間隙本文檔共71頁；當前第41頁；編輯于星期一\22點59分本文檔共71頁；當前第42頁；編輯于星期一\22點59分結腸上區臟器解剖胃的局解肝臟的局解肝外膽道的局解本文檔共71頁；當前第43頁；編輯于星期一\22點59分胃的局解（Anatomyof

stomach）形態和分部Featuresanddivisions位置和毗鄰Positionandrelationship胃的網膜和韌帶OmentumandLigaments血供和淋巴Bloodvesselsandlymphatics神經支配Nerve本文檔共71頁；當前第44頁；編輯于星期一\22點59分Featuresanddivisions本文檔共71頁；當前第45頁；編輯于星期一\22點59分

Positionand

Relationshipofstomach１．位置中度充盈時，大部分位于左季肋區，小部分位于腹上區。

賁門在第11胸椎左側，幽門在第1腰椎右側。2.毗鄰?：本文檔共71頁；當前第46頁；編輯于星期一\22點59分

Positionand

Relationshipofstomach本文檔共71頁；當前第47頁；編輯于星期一\22點59分

Positionand

Relationshipofstomach本文檔共71頁；當前第48頁；編輯于星期一\22點59分１．位置中度充盈時，大部分位于左季肋區（3/4)，小部分位于腹上區(1/4)。

賁門在第11胸椎左側，幽門在第1腰椎右側。2.

毗鄰：胃前壁右側份鄰接肝左葉,左側份上部鄰接膈，下部接觸腹前壁。胃后壁隔網膜囊與胃床(胰、左腎上腺、左腎、脾、橫結腸及系膜)相鄰。

Positionand

Relationshipofstomach本文檔共71頁；當前第49頁；編輯于星期一\22點59分OmentumandLigaments網膜：大網膜，小網膜

韌帶：肝胃韌帶、胃膈韌帶、胃脾韌帶、胃結腸韌帶、胃胰韌帶。本文檔共71頁；當前第50頁；編輯于星期一\22點59分Bloods