腹膜后隙 内容： 一、肾 二、输尿管 三、血管、神经 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

概 述 腹膜后隙位置：腹后壁腹膜后方。 范围：上自膈，下至骶岬，两侧续腹膜外筋膜。向下续盆部的腹膜后间隙。 January, 2007 概 述 腹膜后隙位置：腹后壁腹膜后方。 范围：上自膈，下至骶岬，两侧续腹膜外筋膜。向下续盆部的腹膜后间隙。 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

（一）肾 kidney （一）肾的位置和毗邻 （二）肾蒂 （三）肾的血管 （四）肾的被膜 内容： January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

一、肾的位置及毗邻 肾位于脊柱两侧，腹膜后方，紧贴腹后壁的上部。 January, 2007 　 肾位于脊柱两侧，腹膜后方，紧贴腹后壁的上部。 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

左肾位置： 上端平第11胸椎下缘 下端平第2腰椎下缘 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

右肾位置： 上端平第12胸椎上缘 下端平第3腰椎上缘 第12肋跨过左肾的中部，右肾的上部。 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

肾门位置： 肾门平第一腰椎平面，距正中线约5cm。 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

肾区： 竖脊肌外侧缘与第12肋之间的部位称肾区（肋脊角）。在某些肾疾病患者，叩击或触压该区可引起疼痛。 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

肾的毗邻： 两肾后面：膈 腰大肌 腰方肌 腹横肌 两肾上端: 肾上腺 January, 2007 两肾上端: 肾上腺 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

右肾前面邻： 肝右叶 结肠右曲 十二指肠降部 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

胃 胰 空肠 结肠左曲 左肾前面邻： January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

二、肾门、肾蒂 肾门： 肾的内侧缘中部凹陷，是肾的血管、神经、淋巴管和肾盂出入肾的部位，称肾门。 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

肾蒂 renal pedicle：出入肾门的结构合称肾蒂，主要结构肾动脉、肾静脉、肾盂。右侧肾蒂较左侧短。 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

肾蒂主要结构的排列关系: 由前向后依次为： 肾静脉、肾动脉、肾盂 从上向下依次为： 肾动脉、肾静脉、肾盂 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

三、肾的被膜 纤维囊 脂肪囊 肾筋膜 肾表面包有三层被膜，由内向外为： January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

（二）输尿管 ureter 输尿管起于肾盂，终于膀胱，长约25～30cm。 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

输尿管行程分部: 分三部: 腹 盆 壁 部 部 内 部 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

输尿管腹部： 位于腹膜后方，沿腰大肌前面下降至小骨盆上口处，左右输尿管分别跨过髂血管的前面，进入盆腔移行于盆段。 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

输尿管腹部在腰大肌前面中点处与睾丸血管（男）或卵巢血管（女）相交叉（血管位于输尿管前面）。 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

腹部的血管、神经 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

动脉：腹主动脉 腹主动脉从膈的主动脉裂孔沿脊柱左前方下降，至第四腰椎平面分为左、右髂总动脉。其右侧邻下腔静脉。 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

腹主动脉的分支有： 壁 支 脏 支 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

膈下动脉 4对腰动脉 骶正中动脉 1.壁支主要有： January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

2.脏支主要有： 成对的脏支 不成对的脏支 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

（1）成对的脏支 肾上腺中动脉 肾动脉 睾丸动脉(精索内动脉) (在女性则称卵巢动脉) 有3对: January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

（2）不成对的脏支 有3支： 腹腔干 肠系膜上动脉 肠系膜下动脉 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

肾上腺的动脉 （3对） 膈下动脉发出: 肾上腺上动脉 腹主动脉发出: 肾上腺中动脉 肾动脉发出: 肾上腺下动脉 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

下腔静脉由左、右髂总静脉在第5腰椎右侧汇合而成。下腔静脉收集下肢、盆部和腹部的静脉。 静脉：下腔静脉 inferior vena cava 　　下腔静脉由左、右髂总静脉在第5腰椎右侧汇合而成。下腔静脉收集下肢、盆部和腹部的静脉。 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

下腔静脉的属支有： 壁支 脏支 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

壁支： 　膈下静脉 　４对腰静脉 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

成对脏器和肝的静脉注入下腔静脉, 不成对脏器的静脉先汇合成肝门静脉, 入肝后再经肝静脉入下腔静脉。 2. 脏支： 　　 成对脏器和肝的静脉注入下腔静脉, 不成对脏器的静脉先汇合成肝门静脉, 入肝后再经肝静脉入下腔静脉。 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

成对脏器的静脉： (1)肾静脉 (2)肾上腺静脉 (3)生殖腺静脉 3对： January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

(1)肾静脉 renal V 左侧长于右侧。 (2)肾上腺静脉 右侧注入下腔静脉, 左侧注入肾静脉。 (3)生殖腺静脉 右侧注入下腔静脉,左侧注入肾静脉。 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

肝静脉hepatic V.一般有左、中、右3条, 包埋在肝实质内, 在腔静脉沟上份（裸区）注入下腔静脉。 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG

思考题 肾的位置、毗邻；肾角、肾门、肾窦和肾蒂概念，肾血管和被膜。 肾蒂结构的排列。 输尿管分部和狭窄，左、右输尿管毗邻异同。 January, 2007 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG