腹壁解剖及操作.pptxVIP

局部解剖学（十四）;主要内容 Main Content;一、境界与分区Boundary and Region;1. 腹部的境界;2. (固有)腹腔的境界;3A. 腹部的分区;3B. 腹部的分区;二、表 面 解 剖The Surface Anatomy;;;3.体表投影;三、腹 前 外 侧 壁The Anterolateral Abdominal Wall;;（一）浅 层 结 构The superficial structures;;2. Superficial fascia：主要由脂肪和疏松结缔组织组成。;深层称为Scarpa` fascia，是富有弹性纤维的膜性层，在中线附于白线，向下在腹股沟下方约一横指处，紧附于股部的深筋膜，在耻骨结节之间，越过耻骨联合向下至会阴，与会阴浅筋膜（Colles筋膜）相延续。;浅 筋膜;2. Superficial fascia;;;（二）深层结构 The Deep Structures;1. 肌层 The Muscular layer;（1）腹外斜肌 external oblique muscle;;;（2）腹内斜肌及其腱膜 internal oblique muscle aponeurosis ：参与构成腹直肌鞘前、后层，结合腱 和提睾肌。;Transversus abdominis, aponeurosis;;;腹直肌鞘;;☆ 腹直肌鞘 Rectus sheath;2.血管、淋巴及神经Vessels, Lymph and Nerve;(1)动脉;;(2)静脉;(3)神经;3.腹横筋膜;腹横筋膜 Transverse fascia;腹股沟深环deep inguinal ring 窝间韧带 interfoveolar ligament;腹前壁内面的皱襞及凹窝;5. 腹前壁手术常用切口;Subcostal incision;;四、腹 股 沟 区The Inguinal Region;（一）境界 Boundary;4. 髂腹下神经 Iliohypogastric n. 和髂腹股沟神经 ilioinguinal n. 5. 腹内斜肌 Obliquus internus abdominis 6. 腹横肌 Transversus abdominis;7. 腹横筋膜 Transverse fascia 8. 腹膜外筋膜 Extraperitoneal fascia 9. 腹璧下动脉Inferior epigastric a. and 旋髂深动脉 deep circumflex iliac a. 10.璧腹膜 Parietal peritoneum;（三）腹股沟管The inguinal canal;（三）腹股沟管 Inguinal Canal;;;The deep ( internal ) inguinal ring, entrance to inguinal canal , is an outpouching of the transversalis fascia approximately 1.25cm superior to the middle of the inguinal ligament and lateral to the inferior epigastric vessels. ;;;Indirect Hernia;睾丸下降过程;卵巢下降过程;睾丸下降过程 descending process of the testis;; 先天性腹股沟斜疝 A congenital indirect inguinal hernia;精索的被膜与腹前外侧壁层次的关系;;解剖与观察Dissection and Observation;;;;;;;;;;;;;;;;;;;The End