腹膜后隙,內(nèi)容：一、腎二、輸尿管三、血管、神經(jīng),January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,概 述,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,腹膜后隙位置：腹后壁腹膜后方。范圍：上自膈，下至骶岬，兩側(cè)續(xù)腹膜外筋膜。向下續(xù)盆部的腹膜后間隙。,（一）腎 kidney,內(nèi)容： （一）腎的位置和毗鄰（二）腎蒂（三）腎的血管（四）腎的被膜,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,一、腎的位置及毗鄰,腎位于脊柱兩側(cè)，腹膜后方，緊貼腹后壁的上部。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,左腎位置：,上端平第11胸椎下緣下端平第2腰椎下緣,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,上端平第12胸椎上緣 下端平第3腰椎上緣 第12肋跨過左腎的中部，右腎的上部。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,右腎位置：,腎門位置：,腎門平第一腰椎平面，距正中線約5cm。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,腎區(qū)：,豎脊肌外側(cè)緣與第12肋之間的部位稱腎區(qū)（肋脊角）。在某些腎疾病患者，叩擊或觸壓該區(qū)可引起疼痛。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,腎的毗鄰：,兩腎后面：膈 腰大肌 腰方肌 腹橫肌兩腎上端: 腎上腺,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,右腎前面鄰：肝右葉 結(jié)腸右曲 十二指腸降部,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,左腎前面鄰：胃 胰 空腸 結(jié)腸左曲,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,二、腎門、腎蒂,腎門： 腎的內(nèi)側(cè)緣中部凹陷，是腎的血管、神經(jīng)、淋巴管和腎盂出入腎的部位，稱腎門。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,腎蒂 renal pedicle：出入腎門的結(jié)構(gòu)合稱腎蒂，主要結(jié)構(gòu)腎動脈、腎靜脈、腎盂。右側(cè)腎蒂較左側(cè)短。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,由前向后依次為：腎靜脈、腎動脈、腎盂 從上向下依次為：腎動脈、腎靜脈、腎盂,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,腎蒂主要結(jié)構(gòu)的排列關(guān)系:,三、腎的被膜,腎表面包有三層被膜，由內(nèi)向外為：,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,纖維囊脂肪囊腎筋膜,（二）輸尿管 ureter,輸尿管起于腎盂，終于膀胱，長約2530cm。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,輸尿管行程分部:,分三部:,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,腹部,盆部,壁內(nèi)部,輸尿管腹部：,位于腹膜后方，沿腰大肌前面下降至小骨盆上口處，左右輸尿管分別跨過髂血管的前面，進(jìn)入盆腔移行于盆段。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,輸尿管腹部在腰大肌前面中點(diǎn)處與睪丸血管（男）或卵巢血管（女）相交叉（血管位于輸尿管前面）。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,腹部的血管、神經(jīng),腹主動脈從膈的主動脈裂孔沿脊柱左前方下降，至第四腰椎平面分為左、右髂總動脈。其右側(cè)鄰下腔靜脈。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,動脈：腹主動脈,腹主動脈的分支有：,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,壁 支,臟 支,1.壁支主要有： 膈下動脈 4對腰動脈 骶正中動脈,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,2.臟支主要有： 成對的臟支 不成對的臟支,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,（1）成對的臟支,有3對: 腎上腺中動脈 腎動脈 睪丸動脈(精索內(nèi)動脈) (在女性則稱卵巢動脈),January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,（2）不成對的臟支,有3支： 腹腔干 腸系膜上動脈 腸系膜下動脈,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,膈下動脈發(fā)出: 腎上腺上動脈 腹主動脈發(fā)出: 腎上腺中動脈 腎動脈發(fā)出: 腎上腺下動脈,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,腎上腺的動脈 （3對）,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,靜脈：下腔靜脈inferior vena cava,下腔靜脈由左、右髂總靜脈在第5腰椎右側(cè)匯合而成。下腔靜脈收集下肢、盆部和腹部的靜脈。,下腔靜脈的屬支有：,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,壁支,臟支,壁支：膈下靜脈 對腰靜脈,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,2. 臟支： 成對臟器和肝的靜脈注入下腔靜脈, 不成對臟器的靜脈先匯合成肝門靜脈, 入肝后再經(jīng)肝靜脈入下腔靜脈。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,3對：(1)腎靜脈 (2)腎上腺靜脈 (3)生殖腺靜脈,成對臟器的靜脈：,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,(1)腎靜脈 renal V 左側(cè)長于右側(cè)。(2)腎上腺靜脈 右側(cè)注入下腔靜脈, 左側(cè)注入腎靜脈。(3)生殖腺靜脈,右側(cè)注入下腔靜脈,左側(cè)注入腎靜脈。,肝靜脈hepatic V.一般有左、中、右3條, 包埋在肝實(shí)質(zhì)內(nèi), 在腔靜脈溝上份（裸區(qū)）注入下腔靜脈。,January, 2007,Copyright