（解剖学课件）结肠下区解剖.ppt

1、Unit 25 Infracolic compartment结肠下区结肠下区 LecturerLecturer：MaJianminMaJianmin Department of Anatomy,Medical college of Nanchang university一、一、The vessels of Infracolic compartment结肠下区的血管结肠下区的血管1.Superior mesenteric 肠系膜上动脉肠系膜上动脉2.Inferior mesenteric 肠系膜下动脉肠系膜下动脉1.胰十二指肠下胰十二指肠下A A2空肠空肠A3回肠回肠A4.回结肠回结肠A-阑尾阑

2、尾A6.中结肠中结肠A5.右结肠右结肠A(供应十二指肠至供应十二指肠至结肠左曲的消化道结肠左曲的消化道)动脉弓动脉弓1.Superior mesenteric A肠系膜上动脉肠系膜上动脉Small intestinal A小肠小肠AMiddle colic A中结肠中结肠ARight colic A右结肠右结肠AIleocolic A回结肠回结肠AAppendicular A阑尾阑尾A肠系膜上动脉的分支肠系膜上动脉的分支 1).左结肠左结肠A 2).乙状结肠乙状结肠A 3).直肠上直肠上 A(供应结肠左曲以供应结肠左曲以下的消化道下的消化道)2.Inferior mesenteric A肠系膜

3、下动脉肠系膜下动脉Left colic ASigmoid ASuperior rectal A肠系膜下动脉的分支肠系膜下动脉的分支二.Jejunum and ileum空、回肠空、回肠1.Position位置位置Jejunum空肠空肠 Ileum 回肠回肠 Jejunum and ileumMoreLessFat in mesenteryAggregatedSolitaryLymphatic folliclesPaler pinkDeeper redColourShort Long Vasa rectaLessGreaterVascularityFewer，smaller and less a

4、bundant villiLarger,numerous and large villiCircular foldsThinThickerW allLessGreaterDiameterLower 3/5 Upper 2/5PositionIleumJejunumCharacteristic2.Difference区别区别 Jejunum Ileum 动脉弓三三.Large intestine大肠大肠1.Composition组成组成 Rectum 直肠直肠Vermiform appendix阑尾阑尾Colon结肠结肠Cecum盲肠盲肠2.Features of cecum and colon

5、 形态Epiploic appendices肠脂垂肠脂垂Colic bands结肠带结肠带Haustra of colon结肠袋结肠袋 Ileocecal valve回盲瓣回盲瓣Orifice of vermiform appendix阑尾口阑尾口Ileocecal orifice回盲口回盲口四四.Cecum盲肠盲肠五五.Vermiform appendix 阑尾阑尾1.Position位置位置一般位于右髂窝内一般位于右髂窝内阑尾的位置2.Position of root of vermiform appendix阑尾根部的位置阑尾根部的位置McBurney点点恒定于盲肠的后内侧，是三条恒定于

6、盲肠的后内侧，是三条结肠带集中处。结肠带集中处。阑尾根部的体表投影：脐与右阑尾根部的体表投影：脐与右髂前上棘连线中、外髂前上棘连线中、外1/3交点交点。六六.Colon结肠结肠Ascending colon 15cmDescending colon20cmSigmoid colon40-50cmTransverse colon50cm七七.Hepatic portal venous system肝门肝门 V系系 1.Composition 组成组成 Hepatic portal V肝门静脉肝门静脉Splenic V脾静脉脾静脉Superior mesenteric V肠系膜上静脉肠系膜上静脉I

7、nferior mesenteric v肠系膜下静脉肠系膜下静脉2.Tributaries属支属支Inferior mesenteric v肠系膜下静脉肠系膜下静脉Cystic v胆囊静脉胆囊静脉Left gastric v胃左静脉胃左静脉Right gastric v胃右静脉胃右静脉Paraumbilical v附脐静脉附脐静脉3.Thefeatures of hepatic portal V 肝门静脉系的特点肝门静脉系的特点两端都是毛细血管两端都是毛细血管.没有功能性静脉瓣没有功能性静脉瓣.含有丰富的营养物质含有丰富的营养物质.1.At the lower end of theesopha

8、gus Hepatic portal vein left gastric vein esophageal venous plexus esophageal vein azygos vein superiorvena cava.Portal-systemic anastomoses门腔静脉吻合门腔静脉吻合肝门静脉血回流入肝受阻，逆行经食管静脉丛等回肝门静脉血回流入肝受阻，逆行经食管静脉丛等回心，静脉丛血流增多，曲张，突向食管腔，一旦食心，静脉丛血流增多，曲张，突向食管腔，一旦食管粘膜及静脉丛破裂，出血流入胃，呕出，临床称管粘膜及静脉丛破裂，出血流入胃，呕出，临床称为呕血（胃酸的作用，呕出的血为咖

9、啡色）为呕血（胃酸的作用，呕出的血为咖啡色）2.At rectal venous plexus Hepatic portal vein splenic vein inferior mesenteric vein superior rectal vein rectal venous plexus inferior rectal and anal veins internal iliac vein inferior vena cava肝门静脉血回流入肝受阻，逆行经直肠静脉肝门静脉血回流入肝受阻，逆行经直肠静脉丛等回心，静脉丛血流增多，曲张，突向直丛等回心，静脉丛血流增多，曲张，突向直肠腔，一旦直肠

10、粘膜及静脉丛破裂，流出的肠腔，一旦直肠粘膜及静脉丛破裂，流出的静脉血随大便排出，临床称为便血（为暗红静脉血随大便排出，临床称为便血（为暗红色）色）Hepatic portal veinparaumbilical veinperiumbilical venous plexusthoracoepigastric and superior epigastric vein superiorvena cavasuperficial epigastric and inferior epigastric veins inferior vena cava临床表现：腹壁临床表现：腹壁海蛇头海蛇头样外观样外观3.

11、At periumbilical venous plexusIn the retroperitoneal region,the small tributaries of the superior and inferior mesenteric veins(splemic and pancreatic veins)anastomose with the small breaches of the posterior intercostal vein,the inferior diaphragm vein,the left renal vein and testicular vein In the

12、 posterior wall of abdomen,the small tributaries of the superior,the inferior mesenteric and splenic veins anastomose with the small tributaries of the posterior intercostal veins vertebral vein and lumbar vein which communicate with vertebral venous c retroperitoneal veins 4.Portal-retroperitoneal anastomosis