影像解剖-The supracolic compartment課件

Thesupracoliccompartment

(P98-106,113)

Thesupracoliccompartmentlies

betweenthe

diaphragm

and

transversecolonandits

mesocolon.Itcontains

theabdominalpart

oftheesophagus,stomach,duodenum,liver,spleen,pancreas,extrahepaticbiliary

apparatus,andbloodvessels,nerves,andlymphnodes.Stomach(1)LocationGreaterpartinthelefthypochondriacLesserpartintheepigastricregionCardiac–lefttoT11Pyloric—righttoL1Fundus–supraposteriortothecardiacapexseparateddiaphragmrelations:

itisadjacent

anteriorlyto—theleftlobeofliver,diaphragm,anteriorabdominalwallPosteriorlyto--*beingseparatedbytheomentalbursafrompancreas,spleen,leftsuprarenalgland,leftkidney,transversecolonanditsmesocolon**Abovestructuresarecalledas“stomachbed”(2)

Morphology(features)anddivisionsLessercurvature(concaveborder)AngularnotchGreatercurvature(convexborder)CardiacnotchCardiacorificePyloricorificeAnteriorandposteriorwallPyloricsphincter

(thickenedSM)Pyloricvalve(mucosacoveringthepyloricsphincter)Gastriccanal幽門(mén)括約肌胃道/胃管/胃路

DivisionsCardiacpartFundusofstomachBodyofstomachPyloricpart

Pyloricantrum

幽門(mén)竇

Pyloriccanal幽門(mén)管Intermedialgroove(3)LigamentsofstomachHepatogastriclig.

Leftandrightgastric

aa.and

ant.andpost.

gastricbranchesofvagus

helig.Gastrospleniclig.

shortgastricaa.,heligGastrophreniclig.Gastrocoliclig.

leftandrightgastroomental

helig(4)VesselsandnervesofstomachLeftgastrica.fromceliactrunkRperhepatica.Leftgastroomentala.fromsplenica.Rightgastroomentala.fromgastroduodenala.Shortgastrica.fromsplenica.Sometimes,posteriorgastricartery

**Thegastricveinsparallelthearteriesinthepositionandcourse**Thenervesofthestomach:parasympatheticfromanteriorandposteriorvagaltrunks“crow’sfoot”

鴉爪

sympatheticfibers前干:肝支胃前支后干:腹腔支胃后支ThelymphnodesofstomachDuodenum

*tobelongtothe

oneofthesmall

intestine

*tobea“c”-shaped,

*tocoursesaround

theheadofpancreas

Divisions:Superiorpart:duodenumcap—first2cm,tohaveperitoneum,innersurfacesmoothUlcer—潰瘍Descendingpart:Longitudinalfoldofduodenum

Majorduodenalpapilla-------

hepatopancreatic

ampulla

openedHorizontalpart:Ascendingpart:*Duodenojejunalflexure

*Suspensory

lig.ofduodenum---Treitz

lig.Sup.flexureInf.flexureSpleen

1)location:InthelefthypochondriacregionLongaxisisalongthelineofthe10thrib.Superiorandinferiorendsareatthelevelof9thand11thribsrespectively.2)relation:DiaphragmaticsurfaceisrelatedtothediaphragmVisceralsurface–stomach,leftkidney,leftcolicflexureandtailofthepancreas2)Feature(morphology)Twosurface—Diaphragmaticandvisceralsurfaces**SplenichilumTwoextremities—AnteriorandposteriorTwoborders—Superiorandinferior**Splenicnotch3)Thebloodvessels*Splenicartery:

-fromceliacartery

-alongthesuperiorborderofthepancreas

-tothesplenichilum

-branches--

pancreaticbranchesshortgastricaa.leftgastroomentala

splenicbranches*Splenicvein–thetributaryoftheportalvein4)ligamentsGastrospleniclig.Splenorenallig.5)Functions

totakepartinimmunoreactions

tostoreblood

todestroytheoldredbloodcellstoproducethebloodinthefetalCeliactrunk(T12)

theceliaca.isoneof3unpairedvisceralbranchesfromabdominalaorta(1)leftgastrica.(2)commonhepatica.Ⅰ.ProperhepaticarteryRightgastrica.Cystica.Leftandrightbranchesofthehepatica.Ⅱ.

Gastroduodenala.Rightgastroomentala.Superior

pancreaticoduodenala.(3)Splenicartery

givesoff

*pancreaticbranches

*shortgastricaa.

*leftgastroomentala.

*splenicbranches1.Toobservethepositionandrelationshipofstomach;featureanddivisionofstomach2.Toexaminetheduodenojejunalflexureandsuspensory

lig.3.Todissecttheceliaca.anditsbr.tonotice:*courseofaa.*whichlig.thearteriesarein?*tocutthegastrocolic

lig.andtoturnthe