肝管和膽總管

1、January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,消化系統(tǒng) Alimentary system,蘭州大學(xué)基礎(chǔ)醫(yī)學(xué)院人體解剖學(xué)教研室,January, 2007,Copyright© Depart. Anatomy, Sc

2、hool of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,第七節(jié) 肝,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,肝是人體中

3、最大的腺體，也是體內(nèi)最大的消化腺。長(zhǎng)（左右徑）×寬（上下徑）×厚（前后徑）約為258mm×152mm×58mm。肝的功能：◆參與蛋白質(zhì)、脂類、糖類和維生素等物質(zhì)的 合成、轉(zhuǎn)化與分解； ◆參與激素、藥物等物質(zhì)的轉(zhuǎn)化和解毒； ◆具有分泌膽汁，吞噬、防御以及在胚胎時(shí)期 造血等功能。,January, 2007,Copyright© Depart. Anatomy, Schoo

4、l of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,一、肝的形態(tài)二、肝的位置及毗鄰三、肝的分葉與分段四、肝外膽道系統(tǒng),January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by

5、 YP HOU and YF SONG,一、肝的形態(tài),呈不規(guī)則的楔形，分為上、下兩面，前、后、左、右四緣。肝的兩面：◆肝上面，又稱膈面。后部沒(méi)有腹膜被覆的部分稱裸區(qū)；◆肝下面，又叫臟面。將肝分為肝左葉、肝右葉、方葉和尾狀葉。臟面中部有呈“H”形的三條溝。,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. A

6、ll right reserved by YP HOU and YF SONG,肝的四緣： 前緣是肝的臟面與膈面的分界線，薄而銳利,膽囊 底常在此處露出； 后緣鈍圓，朝向脊柱； 右緣是肝右葉的右下緣，亦鈍圓； 左緣是肝左葉的左緣，薄而銳利。,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzh

7、ou University. All right reserved by YP HOU and YF SONG,,肝 的 形 態(tài),January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,肝 的 形 態(tài),,January, 2007,Copy

8、right© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,大部分：右季肋區(qū) 腹上區(qū) 小部分；左季區(qū),二、肝的位置及毗鄰,,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou

9、 University. All right reserved by YP HOU and YF SONG,按照肝臟外形分為：肝左葉、肝右葉、方葉和尾狀葉；肝內(nèi)有四套管道，形成兩個(gè)系統(tǒng)：Glisson系統(tǒng)和肝靜脈系統(tǒng)。按照Glisson系統(tǒng)將肝分為：兩個(gè)半肝，進(jìn)一步分為五個(gè)葉、六個(gè)段。,三、肝的分葉與分段,January, 2007,Copyright© Depart. Anatomy, School of Medicin

10、e, Lanzhou University. All right reserved by YP HOU and YF SONG,肝,左半肝右半肝,左內(nèi)葉左外葉右前葉右后葉尾狀葉,上段下段,上段下段,上段下段,,,,,,,,,,,,,,,,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University.

11、 All right reserved by YP HOU and YF SONG,肝的分葉與分段,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,肝的分葉與分段,,January, 2007,Copyright© Dep

12、art. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,是指行出于肝門之外的膽道系統(tǒng)，包括膽囊、輸膽管道（包括肝左管、肝右管、肝總管和膽總管）。與肝內(nèi)膽道一起將肝分泌的膽汁輸送到十二指腸腔。,四、肝外膽道系統(tǒng),January, 2007,Copyright© Depart. Anatomy,

13、School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,（一）膽 囊,◆膽囊 (gall bladder)儲(chǔ)存膽汁、濃縮膽汁。呈長(zhǎng)梨形，長(zhǎng)8-12cm,寬3-5cm,容量40-60ml。分底、體、頸、管四部分。 ◆Calot三角：也稱膽囊三角,指膽囊管、肝總管和肝的臟面圍成的三角形區(qū)域。常有膽囊動(dòng)脈通過(guò)。,January, 200

14、7,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserve

15、d by YP HOU and YF SONG,（二）肝管和膽總管,肝總管長(zhǎng)約3cm,下行于肝十二指腸韌帶內(nèi)，并在韌帶內(nèi)與膽囊管以銳角匯合成膽總管。,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,（三）膽總管,膽總管長(zhǎng)約4-8cm

16、，直徑0.6-0.8cm，由肝總管 和膽囊管匯合而成。,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,膽 總 管,肝胰壺腹十二指腸乳頭肝胰壺腹括約肌（Oddi括約?。?,January, 2007,Copyright&#

17、169; Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,第八節(jié) 胰,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by Y

18、P HOU and YF SONG,胰(pancreas)是人體的第二大腺，由外分泌部和內(nèi)分泌部?jī)刹糠纸M成。◆外分泌部分泌胰液，內(nèi)含多種消化酶，分解消化蛋白質(zhì)、脂類；◆內(nèi)分泌部即胰島，主要分泌胰島素和胰高血糖素，調(diào)節(jié)血糖濃度。,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserve

19、d by YP HOU and YF SONG,（一）胰的位置與毗鄰,胰位于腹上區(qū)和左季肋區(qū)，平對(duì)第1、2腰椎體。上緣平臍上10cm,下緣約在臍上5cm。,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,（二）胰的分部,胰可分為頭、

20、體、尾三部，各部間無(wú)明顯界限。頭部在腹中線右側(cè)，體、尾部在腹中線左側(cè)。,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,◆胰管：位于胰實(shí)質(zhì)內(nèi)，偏背側(cè)，其走形與胰的長(zhǎng)軸一致，從胰尾經(jīng)胰體走向胰頭，沿途經(jīng)過(guò)許多小葉間導(dǎo)管，最后于十二指腸

21、降部的壁內(nèi)與膽總管匯合成肝胰壺腹，開(kāi)口于十二指腸大乳頭?！粼谝阮^上部常可見(jiàn)一小管，行與胰管上方，稱副胰管，開(kāi)口于十二指腸小乳頭。,January, 2007,Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,思 考 題,1.食物在消化管中是如何被消化吸收和排出