腹壁及上腹部解剖

3. The cutaneous nerves； (皮神经)
➢ 肌肉(The muscles of abdominal wall)
腹外斜肌腱膜的形成物
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inguinal ligament 腹股沟韧带 lacunar ligament 腔隙韧带 pectineal ligament 耻骨梳韧带 reflected ligament 返转韧带 iliopubic arch 髂耻弓
➢Inguinal canal 腹股沟管
定义和位置: 位于腹股沟 韧带内侧半 上方的肌肉 筋膜间隙, 3~4cm in length
结构--- 腹股沟管由四壁两口构成:
➢ 四壁:上、下、前、后。
➢ 两口（two openings）： 浅环（皮下环）；深环（腹环）
内容: 腹股沟管内男女性分别通过的结构是精索和子 宫圆韧带
Section 2.腹壁层次(The layers of Anterolateral Abdominal Wall)
❖ Skin 皮肤 ❖ Superficial fascia 浅筋膜 ❖ Anterolateral muscles肌肉 ❖ Transversalis fascia
腹横筋膜
❖ Extraperitoneal fascia 腹膜下筋膜
Left gastrioeploic a. Right gastroepiploic a.
Superior pancreaticoduodenal a.
Venous drainage
Lymph nodes and lymph drainage of stomach
Nerve of stomach
Left branch
Right branch
Cystic a. Right gastric a. Proper hepatic a. Gastroduodenal a.
Common hepatic a.
Left gastric a. Short gastric a.
Splenic a.
Splemic branches
abdominal wall ❖ 腹腔、腹膜及腹膜腔Abdominal cavity,
peritoneum and peritoneal cavity ❖ 腹腔重要脏器局解The important organs of
abdominal cavity 胃； 肝脏；肝外胆道；肾脏
Section 1概述Intromphatics ❖ 神经支配Nerve
Features and divisions
Position and Relationship of stomach
Relationship of stomach
Liver
Diaphragmatic area
Suprarenal area Renal area
The Clinical Significance of Inguinal canal Inguinal triangle
--------Oblique inguinal hernia (腹股沟斜疝) ------ Direct inguinal hernia (腹股沟直疝)
不同类型疝疝囊突出部位
➢ Contents: spermatic cord and ilioinguinal nerve in male; round ligament of uterus and ilioinguinal nerve in female
➢Inguinal triangle (Hesselbach
triangle)腹股沟三角
❖ 位置（Position）: 位于胸部和
盆部之间。
❖ 境界 （Boundaries of abdomen）
上界— 即胸部的下界； 下界—耻骨联合上缘起始向两
侧经耻骨嵴、耻骨结节 后沿腹股沟经髂前上棘、 髂嵴及髂后上棘达第5
腰椎棘突。
❖ 结构（Construction） :
abdominal wall abdominal cavity visceral organs ❖ 分区（Divisions）:
右 季 肋 区
右 腰 区
右髂区
左
腹上区
季 肋
区
左
脐区
腰
区
腹下区
左髂区
Free area
Pancreatic area Colic area
Anterior view
Posterior iew
Celiac trunk and blood supply of stomach
Celiac trunk and blood supply of stomach
Celiac trunk and its branches
腹股沟管知识点总结
➢ Definition and Position--- above medial part of inguinal ligament, 3~4cm in length
➢ Structure--- four walls and two openings * four walls---anteriorly — aponeurosis of OEA, enforced by OIA laterally posteriorly — transversalis fascia, enforced by inguinal falx superiorly — the arch edge of the OIA and TA inferiorly — the inguinal ligament * two openings superficial inguinal ring（腹股沟管浅环或皮下环） --- formed by aponeurosis of OEA deep inguinal ring（腹股沟管深环或腹环） --- formed by transversalis fascia
❖ Parietal peritoneum 壁腹膜
➢ 浅层结构:
1. There is two layers under the umbilicus；脐下浅筋膜 分两层:脂肪层(Camper);膜 性层(Scarpa)
2. The Superficial blood vessels and its clinical significance; (浅血管及其 临床意义)
The Anatomy of Abdomen(腹部解剖）
主讲：许杰华
E-mail: xujiehua@
西安交通大学医学院
人体解剖与组织胚胎学系
Outline 讲授大纲
❖ 概述Introduction ❖ 腹壁层次The layers of the abdominal wall ❖ 腹壁的重要局部 The important regions of
腹 壁 深 层 的 血 管 和 神 经
问题
question?
How many layers are there in each part of abdominal wall?
(腹部不同区域 的层次有何不 同?)
Section 3. 重要局部
腹股沟区Inguinal Region
❖ Inguinal canal(腹股沟管) ❖ Inguinal triangle腹股沟三角
4 parts 9 parts
epigastric region 腹上区 umbilical area 脐区 hypogastric region 腹下区 left and right hypochondriac regions 左、右季肋区 left and right lateral (lumbar) regions左、右外侧区或腰区 left and right iliac (inguinal) regions左、右髂区或腹股沟区
❖ 体表标志 Surface Marker
xiphoid process剑突 costal arch 肋弓 iliac crest 髂嵴 pubic symphysis 耻骨联合 pubic tubercle 耻骨结节 superior anterior iliac spine 髂前上棘 umbilicus 脐 linea alba 白线 semilunar line 半月线 inguinal ligament 腹股沟韧带
❖ 位置: 位于腹股 沟区的内 侧部的三 角形区域
❖ 境界
内侧界 — lateral border of rectus abdominis 外侧界 — inferior epigastric a. 下界 — medial part of inguinal ligament
➢腹股沟管和腹股沟三角的临床意义
腹股沟 直疝
腹股沟 斜疝
股疝
疝囊（腹膜） 腹股沟斜疝
疝囊（腹膜） 腹股沟直疝
➢ 问题（Question）？
❖What are the differences between direct and indirect inguinal hernias （腹股沟直疝和斜疝有何不同，如何 辨别二者）?
➢Section 4. 腹腔、腹膜和腹 膜腔(Abdominal cavity, Peritoneum and Peritoneal cavity)
什么是腹腔？ 什么是腹膜？
什么是壁腹膜和脏腹膜？ 什么是腹膜腔？
腹膜腔的分部： 结肠上区 结肠下区 腹膜后间隙
➢胃的局解（Anatomy of stomach）
❖ 形态和分部Features and divisions ❖ 位置和毗邻Position and relationship ❖ 血供和淋巴Blood vessels and