系统解剖学课件-腹膜.pptVIP

Introduction The peritoneum is a large serous membrane lining the abdominal cavity. Histologically, it is composed of an outer layer of fibrous tissue (which gives strength to the membrane) and an inner layer of mesothelial cells (which secrete a serous fluid which lubricates the surface, thus allowing free movements of viscera). The peritoneum is in the form of a closed sac which is invaginated by a number of viscera. As a result the peritoneum is divided into (1) an outer or parietal layer; (2) an inner or visceral layer; and flods of peritoneum by which the viscera are suspended. The peritoneum which is a simple cavity (before being inveaginated by viscera becomes highly complicated. * * 系统解剖学 Systematic Anatomy Peritoneum 腹 膜 腹 膜 一.概述 二.腹膜与腹盆腔脏器的关系 三.腹膜形成的结构 Peritoneum 腹 腔 (Abdominal Cavity) 脏腹膜 (Visceral Peritoneum) 壁腹膜 (Parietal Peritoneum) 腹 膜 (Peritoneum) 一.概述 腹膜腔 (Peritoneal Cavity) 网膜孔 (Omental Foramen) 大腹膜腔 小腹膜腔 即网膜囊 (Omental Bursa) 男性封闭，女性间接与外界相通 腹腔与腹膜腔的区别： 腹腔：指膈以下、骨盆上口以上，位于腹前壁和腹后壁之间的体腔。 腹膜腔：套在腹腔内，位于脏腹膜和壁腹膜之间的潜在腔隙，腔内仅含少量浆液。 脏器位于腹腔之内、位于腹膜腔之外；腹腔为脏器和腹膜腔所占据。 1.内位器官 3.外位器官 2.间位器官 二.腹膜与腹盆腔脏器的关系 根据脏器被覆腹膜程度和范围大小，可分为3类： 了解脏器与腹膜的关系，对于指导临床操作有重要意义。 膀胱穿刺 子宫经腹膜腔或外手术 试问胃、肾手术分别是否必须通过腹膜腔？ 1.网膜 (Omenta) 2.系膜 (Mesenteries) 3.韧带 (Ligament) 4.皱襞 (Folds) 隐窝 (Fossa) 三.腹膜形成的结构 壁腹膜与脏腹膜之间，或者脏腹膜之间互相折返移行，其移行部分形成许多结构： 陷凹 (Pouch) 1.网膜 (Omenta) 与胃小弯和胃大弯相连的双层腹膜皱襞，包括： 小网膜 大网膜 (Greater Omentum) (Lesser Omentum) 小网膜 (Lesser Omentum) 肝胃韧带 肝十二指肠韧带 大网膜 (Greater Omentum) 胃结肠韧带 横结肠系膜 网膜囊 (Omental Bursa ) 网膜孔 (Winslow孔) 2.系膜 (Mesenteries) 壁、脏腹膜相互延续移行，将脏器系连固定于腹盆壁的双层腹膜，其内出入有血管、神经及淋巴管和淋巴结等。 肠系膜 横结肠系膜 乙状结肠系膜 阑尾系膜 3.韧带 (Ligament) 连接腹盆壁与脏器之间或相邻脏器之间的腹膜结构。 镰状韧带 右三角韧带 冠状韧带 左三角韧带 肝裸区 肝的韧带 胃脾韧带 脾结肠韧带 膈脾韧带 脾肾韧带 脾的韧带 脐正中襞—脐尿管 脐内侧襞—脐动脉 脐外侧襞—腹壁下血管 膀胱上窝 腹股沟内侧窝 腹股沟外侧窝 4.皱襞 (Folds) 隐窝 (Fossa) 陷凹 (Pouch) 肝肾隐窝 Introduction The peritoneum is a large serous membrane lining the abdominal cavity. Histologically, it is composed of an outer layer