Transcript Document

腹膜The peritoneum
海南医学院 解剖教研室
易西南
概貌General features
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The peritoneum is a thin serous
membrane that line the inner surface of
the abdominal wall and pelvic cavities and
cover the organs within these cavities
Parietal peritoneum 壁腹膜
－lines the inner surface the abdominal
and pelvic wall
Visceral peritoneum 脏腹膜
－covers the organs
Peritoneal cavity 腹膜腔－the potential
space between the parietal and visceral
layer of peritoneum, in the mail, is a closed
sac, but in the female, there is a
communication with the exterior through
the uterine tubes, the uterus, and the
vagina
功能Function
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Secretes a lubricating
serous fluid(润湿）
Absorb（吸收）
Support the visceras（支持）
脏器与腹膜的关系
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腹膜内位器官Intraperitoneal viscera －viscera completely
surrounded by peritoneum, example, stomach, superior
part of duodenum, jejunum, ileum, cecum, vermiform
appendix, transverse and sigmoid colons, spleen and ovary
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腹膜间位器官Interperitoneal viscera －most part of
viscera surrounded by peritoneum, example, liver,
gallbladder, ascending and descending colon, upper part of
rectum, urinary bladder and uterus
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腹膜外(后)位器官Retroperitoneal viscera －some organs
lie on the posterior abdominal wall and are covered by
peritoneum on their anterior surfaces only, example, kidney,
suprarenal gland, pancreas, descending and horizontal parts
of duodenum, middle and lower parts of rectum, and ureter
Operation path way
Intraperitoneal viscera
Interperitoneal viscera
Retroperitoneal viscera
腹膜形成的结构Structures which are formed by peritoneum
网膜Omentum － two-layered fold of peritoneum that
extends from stomach to adjacent organs
小网膜 Lessor omentum －
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two-layered fold of peritoneum
which extends from porta hepatis to
lesser curvature of stomach and
superior part of duodenum
肝胃韧带Hepatogastric ligament
－extends from porta hepatis to lesser
curvature of stomach
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肝十二指肠韧带 Hepatoduodenal
ligament
Extends from porta hepatis to
superior part of duodenum.
Contains common bile duct胆总管,
proper hepatic a肝固有动脉. and
hepatic portal v门静脉.
网膜孔Omental foramen
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Behind the right border of
hepatoduodenal ligament
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Superior－caudate lobe of liver
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Inferior－superior part of
duodenum
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Anterior－hepatodudenal ligament
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Posterior－peritoneum covering
the inferior vena cava
大网膜Greater omentum
－four-layered fold of peritoneum
网膜囊Omental bursa
位置Position－situated behind the
lesser omentum and stomach
四个壁Walls
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上Superior－肝尾状叶和膈下腹膜
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前Anterior－大网膜及胃后壁腹膜
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下Inferior－大网膜前后两层转折处
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后Posterior－大网膜后两层、横结肠及其
系膜、胰及左肾前部的壁腹膜
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左Left－胃脾韧带及脾肾韧带
gastrosplenic ligamentand
splenorenal ligament
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右Right－网膜孔
omental foramen
The Omental bursa (lesser sac)
communicates with the greater
sac through the omental
foramen.
肠系膜Mesenteries －
two-layered fold of peritoneum that
attach part of the intestines to the
posterior abdominal wall
肠系膜Mesentery －
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suspends the small
intestine from the posterior
abdominal wall
Broad and a fan-shaped
Consists of two peritoneal
layers
Intestinal border－folded, 7
m long
Root of mesentery
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15 cm long
Directed obliquely from
left side of L2 to in front
of right sacroiliac joint
阑尾系膜Mesoappendix
 Triangular mesentery－
extends from terminal part
of ileum to appendix
 Appendicular artery runs
in free margin of the
mesoappendix
横结肠系膜Transverse mesocolon
－a double fold of peritoneum
which connects the transverse
colon to the posterior abdominal
wall
乙状结肠系膜Sigmoid mesocolon
－inverted V-shaped, with apex
located in front of left ureter and
division of common iliac artery
韧带Ligaments －two-layered
folds of peritoneum that attached
the lesser mobile solid visera to
the abdominal wall
Ligaments of liver
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镰状韧带Falciform ligament of liver
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Consists of double peritoneal
layer
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Extends from anterior
abdominal wall (umbilicus) to
live
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Free border of ligament site of
ligamentum teres
冠状韧带Coronary ligament
the area between upper and
lower parts of the coronary
ligament is the bare area of
live, this area is devoid of
peritoneum and lies in
contract with the diaphragm
左、右三角韧带Left and
right triangular ligaments
formed by right extremity of
coronary ligament and left
leaf of falciform ligament,
respectively
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肝胃韧带Hepatogastric
ligament
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肝十二指肠韧带
Hepatoduodenal ligament
肝圆韧带
Ligamentum teres hepatis
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脾的韧带Ligaments of spleen
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胃脾韧带Gastrosplenic ligament
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脾肾韧带Splenorenal ligament
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膈脾韧带Phrenicosplenic ligament
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脾结肠韧带Splenocolic ligament
胃的韧带Ligaments of Stomach
 肝胃韧带Hepatogastric ligament
 胃脾韧带Gastrosplenic ligament
 胃膈韧带Gastrophrenic ligament
 胃结肠韧带Gastrocolic ligament
 胃胰韧带Gastropancrestic ligament
返折和隐窝Folds and fossas of anterior abdominal wall
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脐正中襞Medial umbilical fold
－contain the remnant of
urachus (median umbilical
ligaments)
脐内侧襞Medial umbilical fold
－contains remnants of the
umbilical arteries (medial
umbilical ligaments)
脐外侧襞Lateral umbilical
fold －contains the inferior
epigastric vessels
膀胱上窝Supravesical fossa
腹股沟内侧窝Medial inguinal
fossa
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腹股沟外侧窝
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Lateral inguinal fossa
Pouches
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In male：直肠膀胱陷窝rectovesical pouch
In female:
 直肠子宫陷窝Rectouterine pouch:
between rectum and uterus
 膀胱子宫陷窝Vesicouterine
pouch:between bladder and uterus
腹膜腔的分区Peritoneal cavity subdivisions
The transverse colon and transverse mesocolon divides
the greater sac into supracolic and infracolic
compartments.
结肠上区Supracolic compartments (subphrenic
space)－lies between diaphragm and transverse
colon and transverse mesocolon
肝上间隙
Suprahepatic recess
左肝上
右肝上
肝下间隙
Infrahepatic recess
右肝下
左肝下：左肝下前
左肝下后（网膜囊）
结肠下区Infracolic compartments
－lies below the transverse colon and
transverse mesocolon
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右结肠旁沟Right paracolic sulcus －lies
lateral to the ascending colon. It
communicates with the hepatorenal
recess and the pelvic cavity. It provides a
route for the spread of infection between
the pelvic and the upper abdominal region.
左结肠旁沟 Left paracolic sulcus －lies
lateral to the descending colon. It is
separated from the area around the
spleen by the phrenicocolic ligament, a
fold of peritoneum that passes from the
colic flexure to the diaphragm.
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右肠系膜窦Right mesenteric sinus
－triangular space, lies between root
of mesentery, ascending colon, right
2/3 of transverse colon and
transverse mesocolon
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左肠系膜窦Left mesenteric sinus
－lies between root of mesentery,
descending colon, right 1/3 of
transverse colon and transverse
mesocolon, its widens below where
it is continuous with the cavity of the
pelvis