腹膜The peritoneum 海南医学院 解剖教研室 易西南

概貌General features The peritoneum is a thin serous membrane that line the inner surface of the abdominal wall and pelvic cavities and cover the organs within these cavities Parietal peritoneum 壁腹膜 －lines the inner surface the abdominal and pelvic wall Visceral peritoneum 脏腹膜 －covers the organs Peritoneal cavity 腹膜腔－the potential space between the parietal and visceral layer of peritoneum, in the mail, is a closed sac, but in the female, there is a communication with the exterior through the uterine tubes, the uterus, and the vagina

功能Function Secretes a lubricating serous fluid(润湿） Absorb（吸收） Support the visceras（支持）

脏器与腹膜的关系 腹膜内位器官Intraperitoneal viscera －viscera completely surrounded by peritoneum, example, stomach, superior part of duodenum, jejunum, ileum, cecum, vermiform appendix, transverse and sigmoid colons, spleen and ovary 腹膜间位器官Interperitoneal viscera －most part of viscera surrounded by peritoneum, example, liver, gallbladder, ascending and descending colon, upper part of rectum, urinary bladder and uterus 腹膜外(后)位器官Retroperitoneal viscera －some organs lie on the posterior abdominal wall and are covered by peritoneum on their anterior surfaces only, example, kidney, suprarenal gland, pancreas, descending and horizontal parts of duodenum, middle and lower parts of rectum, and ureter

Operation path way Intraperitoneal viscera Interperitoneal viscera Retroperitoneal viscera

腹膜形成的结构Structures which are formed by peritoneum 网膜Omentum － two-layered fold of peritoneum that extends from stomach to adjacent organs

小网膜 Lessor omentum －two-layered fold of peritoneum which extends from porta hepatis to lesser curvature of stomach and superior part of duodenum 肝胃韧带Hepatogastric ligament －extends from porta hepatis to lesser curvature of stomach 肝十二指肠韧带 Hepatoduodenal ligament Extends from porta hepatis to superior part of duodenum. Contains common bile duct胆总管, proper hepatic a肝固有动脉. and hepatic portal v门静脉.

网膜孔Omental foramen Behind the right border of hepatoduodenal ligament Superior－caudate lobe of liver Inferior－superior part of duodenum Anterior－hepatodudenal ligament Posterior－peritoneum covering the inferior vena cava

大网膜Greater omentum －four-layered fold of peritoneum

网膜囊Omental bursa 位置Position－situated behind the lesser omentum and stomach 四个壁Walls 上Superior－肝尾状叶和膈下腹膜 前Anterior－大网膜及胃后壁腹膜 下Inferior－大网膜前后两层转折处 后Posterior－大网膜后两层、横结肠及其系膜、胰及左肾前部的壁腹膜

左Left－胃脾韧带及脾肾韧带gastrosplenic ligamentand splenorenal ligament 右Right－网膜孔 omental foramen The Omental bursa (lesser sac) communicates with the greater sac through the omental foramen.

肠系膜Mesenteries － two-layered fold of peritoneum that attach part of the intestines to the posterior abdominal wall

肠系膜Mesentery －suspends the small intestine from the posterior abdominal wall Broad and a fan-shaped Consists of two peritoneal layers Intestinal border－folded, 7 m long Root of mesentery 15 cm long Directed obliquely from left side of L2 to in front of right sacroiliac joint

阑尾系膜Mesoappendix Triangular mesentery－extends from terminal part of ileum to appendix Appendicular artery runs in free margin of the mesoappendix

横结肠系膜Transverse mesocolon －a double fold of peritoneum which connects the transverse colon to the posterior abdominal wall 乙状结肠系膜Sigmoid mesocolon －inverted V-shaped, with apex located in front of left ureter and division of common iliac artery

韧带Ligaments －two-layered folds of peritoneum that attached the lesser mobile solid visera to the abdominal wall Ligaments of liver 镰状韧带Falciform ligament of liver Consists of double peritoneal layer Extends from anterior abdominal wall (umbilicus) to live Free border of ligament site of ligamentum teres

冠状韧带Coronary ligament the area between upper and lower parts of the coronary ligament is the bare area of live, this area is devoid of peritoneum and lies in contract with the diaphragm 左、右三角韧带Left and right triangular ligaments formed by right extremity of coronary ligament and left leaf of falciform ligament, respectively

肝胃韧带Hepatogastric ligament 肝十二指肠韧带Hepatoduodenal ligament 肝圆韧带 Ligamentum teres hepatis

脾的韧带Ligaments of spleen 脾肾韧带Splenorenal ligament 胃脾韧带Gastrosplenic ligament 脾肾韧带Splenorenal ligament 膈脾韧带Phrenicosplenic ligament 脾结肠韧带Splenocolic ligament

胃的韧带Ligaments of Stomach 肝胃韧带Hepatogastric ligament 胃脾韧带Gastrosplenic ligament 胃膈韧带Gastrophrenic ligament 胃结肠韧带Gastrocolic ligament 胃胰韧带Gastropancrestic ligament

返折和隐窝Folds and fossas of anterior abdominal wall 脐正中襞Medial umbilical fold －contain the remnant of urachus (median umbilical ligaments) 脐内侧襞Medial umbilical fold －contains remnants of the umbilical arteries (medial umbilical ligaments) 脐外侧襞Lateral umbilical fold －contains the inferior epigastric vessels 膀胱上窝Supravesical fossa 腹股沟内侧窝Medial inguinal fossa 腹股沟外侧窝 Lateral inguinal fossa

Pouches In male：直肠膀胱陷窝rectovesical pouch In female: 直肠子宫陷窝Rectouterine pouch: between rectum and uterus 膀胱子宫陷窝Vesicouterine pouch:between bladder and uterus

腹膜腔的分区Peritoneal cavity subdivisions The transverse colon and transverse mesocolon divides the greater sac into supracolic and infracolic compartments. 结肠上区Supracolic compartments (subphrenic space)－lies between diaphragm and transverse colon and transverse mesocolon 肝上间隙 Suprahepatic recess 左肝上 右肝上 肝下间隙 Infrahepatic recess 右肝下 左肝下：左肝下前 左肝下后（网膜囊）

结肠下区Infracolic compartments －lies below the transverse colon and transverse mesocolon 右结肠旁沟Right paracolic sulcus －lies lateral to the ascending colon. It communicates with the hepatorenal recess and the pelvic cavity. It provides a route for the spread of infection between the pelvic and the upper abdominal region. 左结肠旁沟 Left paracolic sulcus －lies lateral to the descending colon. It is separated from the area around the spleen by the phrenicocolic ligament, a fold of peritoneum that passes from the colic flexure to the diaphragm.

右肠系膜窦Right mesenteric sinus －triangular space, lies between root of mesentery, ascending colon, right 2/3 of transverse colon and transverse mesocolon 左肠系膜窦Left mesenteric sinus －lies between root of mesentery, descending colon, right 1/3 of transverse colon and transverse mesocolon, its widens below where it is continuous with the cavity of the pelvis