1、January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,腹膜和腹膜腔,内容：一、腹膜腔的概念 二、腹膜形成的结构三、腹膜间隙,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,一、腹膜腔的概念,腹膜腔为壁腹膜和脏腹膜之
2、间的潜在腔隙，内有少量（100200ml）浆液。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,男性腹膜腔是密闭的，女性腹膜腔间接通外界（经输卵管腹腔口、输卵管、子宫、阴道与外界相通）。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP H
3、OU and YF SONG,二、腹膜形成的结构,网膜,系膜,韧带,皱襞,陷窝、陷凹,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,（一）网膜 omentum,与胃相连的腹膜皱襞，有：,小网膜,大网膜,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved
4、by YP HOU and YF SONG,1.小网膜 lesser omentum,为从肝门连至胃小弯和十二指肠上部的双层腹膜皱襞。又分为：,肝胃韧带,肝十二指肠韧带,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,2.大网膜 greater omentum,形似围裙覆盖在空、回肠和横结肠的前面，左缘与胃脾韧带相连续。,January, 2007,Copyright Depart. Anatomy,
5、 School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,胃结肠韧带:,自胃大弯和十二指肠上部至横结肠之间的大网膜前两层形成胃结肠韧带。内含胃网膜左、右血管、胃网膜左、右淋巴结等。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,3.网膜孔和网膜囊,网膜孔：位于小网膜游离缘后方，可容12指，经网膜
6、孔可进入胃后面的网膜囊。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,网膜孔的周界 ：,前界：肝十二指肠韧带 下界：十二指肠上部,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,后界：下腔静脉表面的腹膜
7、上界：肝尾叶,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,网膜囊 omental bursa,（又称小腹膜腔）位于小网膜和胃后壁与腹后壁的腹膜之间的一个扁窄间隙，网膜囊以外的腹膜腔称大腹膜腔。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by
8、YP HOU and YF SONG,周界 ：,上界： 肝尾叶和膈下面的腹膜。 下界： 大网膜前、后层的愈着处。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,前壁：小网膜、胃后壁的腹膜和胃结肠韧带。 后壁： 横结肠及其系膜以及覆盖胰、左肾、左肾上腺等处的腹膜。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou
9、University. All right reserved by YP HOU and YF SONG,左侧界: 脾、胃脾韧带、脾肾韧带。 右侧界：借网膜孔通腹膜腔的其余部分。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,临床意义：,网膜囊位置较深，胃后壁穿孔或某些炎症导至网膜囊内积液，早期常局限在囊内，给诊断带来一定困难。,January, 2007,Copyright Depart. Ana
10、tomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,(二)系膜 mesentery,与肠相连的双层腹膜皱襞，将肠管连于腹后壁，内有出入肠管的血管、神经及淋巴结等。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,主要的系膜有：,肠系膜 阑尾系膜 横结肠系膜 乙状结肠系膜,Janua
11、ry, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,肠系膜 mesentery：,肠系膜是将空、回肠连于腹后壁的双层腹膜结构。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,肠系膜根：长约15cm，从第二腰椎左侧至右骶髂
12、关节前方。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,（三）韧带 ligament,为腹膜反折处形成的腹膜皱襞，多数为双层。韧带对脏器起固定作用。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,(四)
13、皱襞、隐窝和陷凹,在腹膜皱襞之间形成的凹陷称隐窝，较大的隐窝称陷凹。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,1. 腹后壁的腹膜皱襞和隐窝,十二指肠上、下襞 十二指肠上、下隐窝 盲肠后隐窝 肝肾隐窝,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserve
14、d by YP HOU and YF SONG,2.盆腔的腹膜陷凹,男性：膀胱直肠陷凹 女性：膀胱子宫陷凹 子宫直肠陷凹,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,（五）腹膜间隙,1. 结肠上区的腹膜间隙 2. 结肠下区的腹膜间隙,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. Al
15、l right reserved by YP HOU and YF SONG,1.结肠上区的腹膜间隙,位于膈与横结肠及其系膜之间。又称为膈下间隙或肝周间隙。共有6个腹膜间隙。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,膈下间隙的分区：,肝上间隙： 左肝上间隙：前间隙 后间隙 右肝上间隙,January, 2007,Copyright Depart. Anatomy, School of Medi
16、cine, Lanzhou University. All right reserved by YP HOU and YF SONG,肝下间隙：右肝下间隙 （肝肾隐窝）左肝下间隙： 前间隙 后间隙 （网膜囊）,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,另还有1个腹膜外间隙 膈与肝裸区之间。,January, 2007,Copyright Depart. Anatomy, School of Me
17、dicine, Lanzhou University. All right reserved by YP HOU and YF SONG,上述7个间隙，任何一个间隙发生脓肿均称为膈下脓肿，临床上以右肝上、下脓肿较为多见。,膈下脓肿:,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,4个：左、右结肠旁沟左、右系膜窦,2. 结肠下区的腹膜间隙,January, 2007,Copyright Depart.
18、 Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,右结肠旁沟：向上通肝肾隐窝，向 下通右髂窝和盆腔。 左结肠旁沟：向下通盆腔,结肠下区腹膜间隙的通向：,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,左系膜窦：向下通盆腔 右系膜窦：几乎封闭，窦内有感染不易扩散。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,小结：,1.腹膜形成了那些结构？ 2.腹膜与腹、盆腔脏器的关系。,
