Infracolic Compartments

Transcription

1 模块 8- 局部解剖学 Infracolic Compartments JING LI Ph.D Department of Human Anatomy School of Medicine, Zhejiang University June

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3 Jejunum and ileum 空肠和回肠

4 Jejunum and ileum 空肠和回肠

5 Jejunum and ileum Characteristic Jejunum 空肠 Ileum 回肠 Position Upper 2/5 Lower 3/5 Diameter Greater Less Wall Thicker Thin Circular folds Larger, numerous Fewer,smaller 环状襞 Vascularity Greater Less Color Deeper red Paler pink Lymphatic follicles 淋巴滤泡 Solitary Aggregated

6 Vermiform appendix 阑尾

7 Vermiform appendix 阑尾 Mac Burney' point 麦氏点 Surface marking of the base is at the so-called McBurney s point which is at junction of lateral and middle thirds of line joining right anterior superior iliac spine and umbilicus Lanz 点

8 Vermiform appendix 阑尾

9 Superior mesenteric a. 肠系膜上动脉 Middle colic a. Superior Mesenteric v. Inf. pancresticodudenal a. Right colic a. Ileocolic a. Superior mesenteric a. Jejunal and ileal a. Appendicular a.

10 Inferior mesenteric a. 肠系膜下动脉 Inferior mesenteric a. Left colic a. Sigmoid a. Superior rectal a.

11 Hepatic portal vein 肝门静脉 General features Formed behind the neck of pancreas by the union of superior mesenteric vein and splenic vein Ascends upwards and to the right, posterior to the first part of duodenum and then enters the lesser omentum to the porta hepatis, where it divides into right and left branches There are no functioning valves in hepatic portal system Drains blood from gastrointestinal tract from the lower end of esophagus to the upper end of anal canal, pancreas, gall bladder, bile ducts and spleen

12 Hepatic portal vein 肝门静脉 Tributaries of hepatic portal vein 门静脉的属支 1. Superior mesenteric v. 肠系膜上静脉 2. Inferior mesenteric v. 肠系膜下静脉 3. Splenic v. 脾静脉 4. Left gastric v. 胃左静脉 5. Right gastric v. 胃右静脉 6. Cystic v. 胆囊静脉 7. Paraumbilical v. 附脐静脉

13 Hepatic portal vein 肝门静脉

14 Hepatic portal vein 肝门静脉 Variation and anomalies of hepatic portal vein

15 Retroperitoneal Space

16 The boundary The retroperitoneal space lies between the parietal peritoneum and the endoabdominal fascia ( 腹内筋膜 ) of the posterior abdominal wall. Superior diaphragm Retroperitoneal Space Inferior--- sacral promontory and pelvic inlet Communication superiorly--- continuous with the posterior mediastinum inferiorly --- continuous with pelvic retroperitoneal space.

17 Main contents: Ⅰ. Kidney 肾 Ⅱ. Ureter 输尿管 Ⅲ. Pancreas 胰腺 Ⅳ. Duodenum 十二指肠 Ⅴ. Blood vessels Ⅵ. Lymph nodes Ⅶ. Nerves

18 Kidney 肾 1. Position and relation 2. Coverings of the kidney ( 肾的被膜 ) 3. Renal hilum, sinus and pedicle ( 肾门 肾窦和肾蒂 ) 4. Blood vessels and renal segments ( 肾段 ) 5. Lymphatics 6. Nerves 7. Renal capusule

19 1. Position and relations

20 1. Position and relations

21 1. Position and relations anterior: left: stomach, spleen, pancreas, left colic flexure right: liver, descending part of duodenum, right colic flexure superior: suprarenal gland

22 1. Position and relations posterior: iliohypogastric nerve ( 髂腹下神经 ) ilioinguinal nerve ( 髂腹股沟神经 ) quadratus lumborum ( 腰方肌 ) psoas major transverse abdominis 12th rib subcostal nerve diaphragm

23 1. Position and relations medial: renal pelvis, lumbar sympathetic trunk ( 腰交感神经干 ) left:abdominal aorta right: inferior vena cava

24 2. Coverings of the kidney ( 肾的被膜 ) fibrous capsule 纤维囊 maintains its shape and forms a barrier that can inhibit the spread of infection from surrounding regions fatty renal capsule renal fascia

25 2. Coverings of the kidney ( 肾的被膜 ) fibrous capsule 纤维囊 fatty renal capsule 脂肪囊 : cushion and hold the kidney in place renal fascia

26 2. Coverings of the kidney ( 肾的被膜 ) fibrous capsule 纤维囊 fatty renal capsule 脂肪囊 renal fascia 肾筋膜 : fix the kidney

27 3. Renal hilum, sinus and pedicle renal hilum ( 肾门 )-L1 where vessels, ureters, and nerves enter and leave the kidneys renal pelvis ( 肾盂 ) renal pedicle ( 肾蒂 ) anterior-posterior: renal v., renal a., renal pelvis superior-inferior: renal a., renal v., renal pelvis

28 3. Renal hilum, sinus and pedicle Renal sinus 肾窦 : is a cavity within the Renal hilum Contents: minor and major calices ( 肾大 小盏 ), renal pelvis 肾盂, renal artery and its branches, renal vein and its tributaries, nerves and lymphatics, etc.

29 4. Blood vessels and renal segments

30 Renal arteries and segments

31 Differentiation ( 变异 )

32 5. Renal nerves

33 Ureter 输尿管

34 Ureter Each ureter is about 25 cm long, cm, and carries urine from the renal pelvis to the urinary bladder via peristaltic waves.

35 Relations of Ureter left ureter: flexura duodenojejunalis Testicular/ovarian vessels Left colic vessels right ureter: Descending part of duodenum Testicular/ovarian vessels right colic vessels Ileocolic vessels End part of ileum

36 Abdominal part Ureter Three segments pelvic part intramural part superior stricture 起始部 Three constriction middle stricture 跨越小骨盆入口髂血管处 inferior stricture 斜穿膀胱壁处

37 Suprarenal vessels

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