腹膜&泌尿系统

  • Peritoneum 腹膜
    • 基础介绍
      • Gr. Stretched round
      • 定义 - Serous membrane浆膜 that stretches around/lines the abdominal cavity
      • 作用 - Makes serous fluid
      • 组织构成 - Made of mesothelium tissue 间皮//一种上皮组织
      • parietal peritoneum 壁腹膜
        • lines the wall of the abdominal cavity
      • visceral peritoneum 脏腹膜
        • covers the organs in the abdominal cavity
      • 图
      • Space in between is peritoneal cavity腹膜腔, which contains lubricating fluid.
      • The GI tract pushes in the peritoneum. 消化道是向内推入腹膜中的
      • Peritoneum contains large folds大型皱襞, that bind the organs to one another and to the walls of the abdominal cavity.
      • Major peritoneal folds
        • The greater omentum 大网膜
        • The lesser omentum 小网膜
        • The mesentery 肠系膜
        • The mesocolon 结肠系膜
    • peritoneal cavity 腹膜腔
      • space between the parietal and visceral peritoneum
      • contains serous fluid
      • 病-Ascites腹水肿
        • accumulation of several liters of fluid
    • greater omentum 大网膜
      • attaches the stomach and transverse colon
      • 4 layers
      • 图
    • lesser omentum 小网膜
      • attaches to the stomach, duodenum and liver
      • lesser omentum = Hepatogastric ligament + Hepatoduodenal ligament
      • 图
    • mesentery 肠系膜
      • portion of peritoneum//红色部分
      • attaches small intestine (jejunum and ileum) to posterior abdominal wall
      • double layers
      • Blood vessels and nerves go through the double layers of the mesentery to supply the abdominal organs
      • 连在小肠后面//大网膜提溜起来,小肠扒拉开
    • mesocolon 结肠系膜
      • Two separate peritoneum
        • transverse mesocolon (transverse colon )
        • sigmoid mesocolon (sigmoid colon)
      • bind the transverse colon and sigmoid colon to the posterior abdominal wall
    • 器官根据与腹膜相对位置的分类
      • Intraperitoneal viscera 腹膜内位器官
        • Stomach
        • Duodenum (1st part)
        • Jejunum and ileum
        • Cecum
        • Appendix
        • Transverse colon
        • Sigmoid colon
        • Upper rectum
        • Liver Pancreas (only the tail)
        • Spleen
      • Mesoperitoneal viscera 腹膜间位器官
        • Ascending and descending colon
        • Middle rectum
        • Gallbladder
      • Retroperitoneal viscera 腹膜外位器官
        • Esophagus
        • Duodenum (2nd-4th parts)
        • Pancreas (head, neck and body)
        • Kidneys
        • Ureters
        • Urinary bladder
      • 图
  • Urinary System
    • 构成
      • Kidneys 肾
      • Ureters 输尿管
      • Urinary bladder 膀胱
      • Urethra 尿道
      • 图
    • kidney
      • Location
        • Right kidney is slightly lower than the left because the liver occupies considerable space on the right side superior to the kidney
        • Kidneys are retroperitoneal, along side the vertebral column
        • locate between the levels of T12 and L2/L3
        • partially protected by ribs 11 and 12
      • External Anatomy of the Kidneys
        • Near the center of the concave border is the renal hilum肾蒂
        • Entry & Exit for
          • Renal pelvis 肾盂
          • Renal A
          • Renal V
          • lymphatic vessels
          • nerves
        • Suprarenal gland 肾上腺
      • Three layers of tissue surround each kidney
        • deep layer - the renal capsule 纤维囊
          • a smooth, transparent sheet of dense connective tissue
          • gives kidney its distinctive shape
        • middle layer - the adipose capsule 脂肪囊
          • a mass of fatty tissue
          • protects the kidney
        • superficial layer - the renal fascia 肾筋膜
          • a thin layer of dense connective tissue
          • anchors the kidney to the surroundings
        • 竖着劈开,最左边的是肋骨
      • Internal Anatomy of the Kidneys
        • a superficial, light red region called renal cortex 肾皮质
        • a deep, darker reddish-brown inner region called renal medulla 肾髓质
        • renal columns 肾柱,皮质向髓质延伸的部分，填充在肾锥体之间的空隙中
        • medulla made of 10-18 renal pyramids 肾锥体
        • apex (tip) of the renal pyramid called renal papilla 肾乳头
        • 图
        • 尿液汇集
          • 希腊语calyces = cups, singular calyx
          • 1-3 papillary ducts → 1 minor calyx
          • 2-3 minor calyces → 1 major calyx
          • renal pelvis肾盂 is a single large cavity
          • The hilum expands into a cavity within the kidney called the renal sinus
          • Adipose tissue脂肪组织 helps stabilize the position of these structures in the renal sinus.
          • 图
      • Functions of the Kidneys
        • Filter blood Kidneys filter 150 L of blood a day
        • If 5L blood in body that means Entire volume of blood is filtered 30 times a day
        • 病-Peritoneal dialysis for chronic kidney disease慢性肾脏病的腹膜透析
          • uses a catheter to introduce fluid into the peritoneal cavity
          • wastes in the capillaries of the peritoneum pass out of the bloodstream and into the fluid
          • fluid (with wastes) removed by catheter
          • 将透析液注入腹腔，利用腹膜毛细血管与透析液之间的渗透/扩散作用净化血液
          • 图
        • 病-Hemodialysis透析
          • filters blood through an artificial porous membrane
          • returns the dialyzed blood to the patient’s body
          • 图
    • Ureter
      • about 25 cm long
      • retroperitoneal position
      • 3部分
        • Abdominal part 腹部
          • extends from the renal pelvis to the iliac A 髂qia动脉
        • Pelvic part 盆部
          • After crossing the pelvic brim骨盆缘, the ureter enters the pelvic cavity towards the bladder.
        • Intramural part 输尿管壁内部
          • short segment that passes through the wall of the urinary bladder
          • 1.5 cm
      • The ureter has 3 constrictions
        • Junction where the renal pelvis connects the ureter
        • Point where the ureter crosses the iliac A (either the right or left) 髂动脉
        • Junction where the ureter enters the urinary bladder
        • 这三处位置容易出现renal stone
    • Urinary Bladder
      • In the pelvic cavity
      • a muscular “bag” servers as a reservoir for the urine
      • holds up to 800 mL of urine
      • 位置
        • In males, it is directly anterior to the rectum
        • In females, it is anterior to the vagina and inferior to the uterus
      • Internal anatomy of the urinary bladder
        • Trigone
          • In the floor of the urinary bladder
          • Two corners - ureteral openings
          • Third corner - opening into urethra 尿道内口
          • Mucosa is firmly bound to the muscularis - smooth appearance
          • Sensitive to expansion
        • Muscularis consists of three layers of smooth muscle
          • inner longitudinal fibers
          • middle circular fibers - form an internal urethral sphincter 尿道内括约肌
          • outer longitudinal fibers
        • external urethral sphincter尿道外括约肌 - composed of skeletal muscle
        • 图//女性
    • Urethra
      • 女性
        • length of 4cm
      • 男性
        • length of 20 cm
        • 3部分
          • prostatic urethra 前列腺部
            • passes through the prostate
          • membranous urethra/intermediate urethra 膜部
            • passes through the deep muscles of the perineum 会阴尿道外括约肌
          • spongy urethra 海绵体部
            • passes through the penis
          • 图
        • Urethral sphincters
          • Internal sphincter
            • smooth-muscle involuntary sphincter at the neck of the bladder
          • External sphincter
            • skeletal muscle voluntary sphincter surrounding the membranous urethra
      • males vs. females
        • The urethra is 5 times longer in males
        • The urethra is divided into 3 segments in males, but is only 1 short tube in females
        • The urethra is a common duct for the urinary and reproductive systems in males.
        • These two systems are separate in female.