腹盆部局解总结.ppt

以腹壁下动脉为标志。脏器经腹壁下动脉的外侧（深环）突出者为斜疝。脏器经腹壁下动脉的内侧（直疝三角）突出者为直疝。 The inguinal canal 腹股沟管 The inguinal canal is about 4.5cm long intermuscular slit lying above the medial half of the inguinal ligament. It transmits the spermatic cord精索 in the male and the round ligament of the uterus子宫圆韧带 in the female. The four walls of the inguinal canal 四壁 the anterior wall---- aponeurosis of the external oblique abdominis ,laterally by muscle fibers of the internal oblique abdominis the posterior wall---- transverse fascia, medially reinforced by the conjoint tendon The superior wall----the arching fibers of the internal oblique abdominis and the transversus abdominis The inferior wall----the inguinal ligament Two rings: the deep inguinal ring; the superficial inguinal ring Contents: the spermatic cord ( round ligament of uterus in female) and the ilioinguinal nerve The layers of lateral abdominal wall 腹外侧壁层次(from superficial to deep) 1.skin 2.superficial fascia 3.deep fascia 4.external oblique muscle（aponeurosis） 5.internal oblique muscle 6.transversus abdominis 7.transvers fascia （腹横筋膜） 8.extraperitoneal tissue （腹膜外筋膜，腹膜外组织，腹膜外脂肪） 9.parietal peritoneum （壁腹膜） 腹壁切口层次 incision layers of abdominal wall 前正中切口： 皮肤、浅筋膜、深筋膜、腹白线、腹横筋膜、腹膜外筋膜、壁腹膜。 旁正中切口：在前正中线旁开1～2cm 皮肤、浅筋膜、深筋膜、腹直肌鞘前层、腹直肌(游离其内侧缘后拉向外侧，不切开该肌)、腹直肌鞘后层、腹横筋膜、腹膜外筋膜、壁腹膜。 阑尾切口（麦氏点切口）（脐与右髂前上棘连线中、外1/3交点并与此线垂直的斜切口 ）： 皮肤、浅筋膜、深筋膜、腹外斜肌腱膜、腹内斜肌和腹横肌、腹横筋膜、腹膜外筋膜、壁腹膜 The gall-bladder triangle 胆囊三角（Calot 三角) Formed by the cystic duct胆囊管, the common hepatic duct肝总管, the inferior surface of the liver肝下面 Content: the cystic artery The Coverings of Kidneys 肾被膜 From inner to outer, they are the fibrous capsule纤维囊 (firm, strong), the adipose capsule脂肪囊, the renal fascia肾筋膜. The relations of the structures within the renal pedicle: ( ★ ★ ★) From front backward: renal vein, artery, renal pelvis From upper downward: renal artery, vein, renal pelvis The pedicle of kidney 肾蒂 The arteries of suprarenal gland 肾上腺动