同济大学：《人体解剖学 Human anatomy》课程电子教案（PPT课件）ABDOMEN Ⅳ

ABDOMEN IV liyingchd@163.com

ABDOMEN Ⅳ liyingchd@163.com

Objects Go over the stomach and the liver The arteries and ligaments of stomach and liver ·Bile circulation ·Pancreas ·Small intestine ·Large intestine Dissection 3

Objects 1 • Go over the stomach and the liver • The arteries and ligaments of stomach and liver 2 • Bile circulation • Pancreas • Small intestine • Large intestine • 3 •Dissection

Greater omentum Lesser omentum Hepatogastric ligament Hepatoduodenal ligament Gastrophrenic ligament Gastrosplenic ligament Gastrocolic ligament

Hepatogastric ligament Hepatoduodenal ligament Gastrophrenic ligament Gastrosplenic ligament Gastrocolic ligament Greater omentum & Lesser omentum

Visceral surface of liver left lobe right lobe caudate lobe quadrate lobe Caudate lobe left lobe Right lobe

Visceral surface of liver left lobe right lobe caudate lobe quadrate lobe 4 Right Quadrate lobe lobe Caudate lobe left lobe

Liver *transverse fissure--Porta hepatis 5 cm long,transversely across the "H" -Contents Right and left hepatic ducts Left and right branches of proper hepatic artery Left and right branches of hepatic portal vein Nerves and lymphatic vessels These structures are surrounded by connective tissue and is called “hepatic pedicle

Liver ★ transverse fissure -- Porta hepatis 5 cm long, transversely across the “H”, – Contents • Right and left hepatic ducts • Left and right branches of proper hepatic artery • Left and right branches of hepatic portal vein • Nerves and lymphatic vessels – These structures are surrounded by connective tissue and is called “hepatic pedicle

4 types vessels of liver Blood supply of liver: 1.proper hepatic artery(←hepatic A←celiac trunk←aorta) 2.hepatic portal vein A dual BLOOD supply:the portal vein supply for75%(dominant), The arterial supply account for 25%(lesser) Hepatic v. Sublobular vei Sublobular veins Portal triads Hepatic artery proper Hepatic portal vein ptisnand bie duct Common bile duct

• Blood supply of liver: 1. proper hepatic artery( ← hepatic A← celiac trunk ← aorta) 2. hepatic portal vein A dual BLOOD supply: the portal vein supply for75%(dominant) , The arterial supply account for 25%(lesser) 4 types vessels of liver

1.Proper hepatic artery Celiac trunk→common hepatic A→proper hepatic A>right left branches

1. Proper hepatic artery Celiac trunk → common hepatic A →proper hepatic A → right & left branches →

2.Hepatic portal vein General features the union of superior mesenteric vein SMV and splenic vein passing through the lesser omentum to the porta hepatis,divides into right and left branches Has no valves in hepatic portal system Drains blood from GI tract(capillaries) to hepatic sinusoid(capillaries):the lower end of esophagus to the upper end of anal canal,pancreas,gall bladder, bile ducts and spleen

2. Hepatic portal vein General features • the union of superior mesenteric vein SMV and splenic vein • passing through the lesser omentum to the porta hepatis, divides into right and left branches • Has no valves in hepatic portal system • Drains blood from GI tract(capillaries) to hepatic sinusoid(capillaries) : the lower end of esophagus to the upper end of anal canal, pancreas, gall bladder, bile ducts and spleen

2.Hepatic portal vein Tributaries of hepatic portal v. 1.Superior mesenteric v.SMV 2.Inferior mesenteric v.IMV 3.Splenic v. 4.Left gastricv. 5.Right gastric v. 6.Cystic v. 7.Paraumbilical v

2. Hepatic portal vein Tributaries of hepatic portal v. 1. Superior mesenteric v. SMV 2. Inferior mesenteric v. IMV 3. Splenic v. 4. Left gastric v. 5. Right gastric v. 6. Cystic v. 7. Paraumbilical v

Portal-Caval venous anastomoses 1.Site at the esophagus left gastric vein→esophageal venous plexus→ esophageal vein>hemiazygos vein superior vena cava Esophageal varices,---bleeding 2.At rectum splenic vein>inferior mesenteric vein>superior rectal vein>rectal venous plexus>inferior rectal and anal veins>internal iliac vein>inferior vena cava Hemorroid ---Hemorrage Portal hypertension

Portal- Caval venous anastomoses 1. Site at the esophagus left gastric vein → esophageal venous plexus → esophageal vein → hemiazygos vein → superior vena cava Esophageal varices,---bleeding 2. At rectum splenic vein → inferior mesenteric vein → superior rectal vein → rectal venous plexus→ inferior rectal and anal veins → internal iliac vein → inferior vena cava • Hemorroid --- Hemorrage Portal hypertension