腹膜后隙解剖

1、January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,腹膜后隙,內(nèi)容：一、腎二、輸尿管三、血管、神經(jīng),January, 2007,Copyright© Depart. Anatomy, School of Medicine

2、, Lanzhou University. All right reserved by YP HOU and YF SONG,概 述,腹膜后隙位置：腹后壁腹膜后方。范圍：上自膈，下至骶岬，兩側(cè)續(xù)腹膜外筋膜。向下續(xù)盆部的腹膜后間隙。,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reser

3、ved by YP HOU and YF SONG,（一）腎 kidney,內(nèi)容： （一）腎的位置和毗鄰（二）腎蒂（三）腎的血管（四）腎的被膜,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,一、腎的位置及毗鄰,腎位于脊柱兩

4、側(cè)，腹膜后方，緊貼腹后壁的上部。,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,左腎位置：,上端平第11胸椎下緣下端平第2腰椎下緣,January, 2007,Copyright© Depart. Anatomy, S

5、chool of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,上端平第12胸椎上緣 下端平第3腰椎上緣 第12肋跨過(guò)左腎的中部，右腎的上部。,右腎位置：,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All

6、 right reserved by YP HOU and YF SONG,腎門(mén)位置：,腎門(mén)平第一腰椎平面，距正中線約5cm。,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,腎區(qū)：,豎脊肌外側(cè)緣與第12肋之間的部位稱(chēng)腎區(qū)（肋脊角）

7、。在某些腎疾病患者，叩擊或觸壓該區(qū)可引起疼痛。,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,腎的毗鄰：,兩腎后面：膈 腰大肌 腰方肌

8、 腹橫肌兩腎上端: 腎上腺,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,右腎前面鄰：肝右葉 結(jié)腸右曲 十二指腸降部,January, 2007,Copyright© Depa

9、rt. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,左腎前面鄰：胃 胰 空腸 結(jié)腸左曲,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right re

10、served by YP HOU and YF SONG,二、腎門(mén)、腎蒂,腎門(mén)： 腎的內(nèi)側(cè)緣中部凹陷，是腎的血管、神經(jīng)、淋巴管和腎盂出入腎的部位，稱(chēng)腎門(mén)。,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,腎蒂 renal pedic

11、le：出入腎門(mén)的結(jié)構(gòu)合稱(chēng)腎蒂，主要結(jié)構(gòu)腎動(dòng)脈、腎靜脈、腎盂。右側(cè)腎蒂較左側(cè)短。,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,由前向后依次為：腎靜脈、腎動(dòng)脈、腎盂 從上向下依次為：腎動(dòng)脈、腎靜脈、腎盂,腎蒂主要結(jié)構(gòu)的排列關(guān)系

12、:,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,三、腎的被膜,腎表面包有三層被膜，由內(nèi)向外為：,纖維囊脂肪囊腎筋膜,January, 2007,Copyright© Depart. Anatomy, School

13、of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,（二）輸尿管 ureter,輸尿管起于腎盂，終于膀胱，長(zhǎng)約25～30cm。,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by

14、 YP HOU and YF SONG,輸尿管行程分部:,分三部:,腹部,盆部,壁內(nèi)部,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,位于腹膜后方，沿腰大肌前面下降至小骨盆上口處，左右輸尿管分別跨過(guò)髂血管的前面，進(jìn)入盆腔移

15、行于盆段。,輸尿管腹部：,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,輸尿管腹部在腰大肌前面中點(diǎn)處與睪丸血管（男）或卵巢血管（女）相交叉（血管位于輸尿管前面）。,January, 2007,Copyright© Dep

16、art. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,腹部的血管、神經(jīng),January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU

17、and YF SONG,腹主動(dòng)脈從膈的主動(dòng)脈裂孔沿脊柱左前方下降，至第四腰椎平面分為左、右髂總動(dòng)脈。其右側(cè)鄰下腔靜脈。,動(dòng)脈：腹主動(dòng)脈,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,腹主動(dòng)脈的分支有：,壁 支,臟 支,Januar

18、y, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,1.壁支主要有： 膈下動(dòng)脈 4對(duì)腰動(dòng)脈 骶正中動(dòng)脈,January, 2007,Copyright© Depart. Anatomy, School of Medici

19、ne, Lanzhou University. All right reserved by YP HOU and YF SONG,2.臟支主要有： 成對(duì)的臟支 不成對(duì)的臟支,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

20、,（1）成對(duì)的臟支,有3對(duì): 腎上腺中動(dòng)脈 腎動(dòng)脈 睪丸動(dòng)脈(精索內(nèi)動(dòng)脈) (在女性則稱(chēng)卵巢動(dòng)脈),January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,（2）不成對(duì)的臟支,有3支： 腹

21、腔干 腸系膜上動(dòng)脈 腸系膜下動(dòng)脈,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,膈下動(dòng)脈發(fā)出: 腎上腺上動(dòng)脈 腹主動(dòng)脈發(fā)出: 腎上腺中動(dòng)脈 腎動(dòng)脈發(fā)出: 腎

22、上腺下動(dòng)脈,腎上腺的動(dòng)脈 （3對(duì)）,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,靜脈：下腔靜脈inferior vena cava,下腔靜脈由左、右髂總靜脈在第5腰椎右側(cè)匯合而成。下腔靜脈收集下肢、盆部和腹部的靜脈。,Jan

23、uary, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,壁支,臟支,下腔靜脈的屬支有：,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou Univ

24、ersity. All right reserved by YP HOU and YF SONG,壁支：　膈下靜脈 ?。磳?duì)腰靜脈,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,2. 臟支：　　 成對(duì)臟器和肝的靜脈注入下腔

25、靜脈, 不成對(duì)臟器的靜脈先匯合成肝門(mén)靜脈, 入肝后再經(jīng)肝靜脈入下腔靜脈。,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,3對(duì)：(1)腎靜脈 (2)腎上腺靜脈 (3)生殖腺靜脈,成對(duì)臟器的靜脈：,January, 2007,

26、Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,(1)腎靜脈 renal V 左側(cè)長(zhǎng)于右側(cè)。(2)腎上腺靜脈 右側(cè)注入下腔靜脈, 左側(cè)注入腎靜脈。(3)生殖腺靜脈,右側(cè)注入下腔靜脈,左側(cè)注入腎靜脈。,January, 200

27、7,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,肝靜脈hepatic V.一般有左、中、右3條, 包埋在肝實(shí)質(zhì)內(nèi), 在腔靜脈溝上份（裸區(qū)）注入下腔靜脈。,January, 2007,Copyright© Depart. Anatomy, Scho