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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(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:兩個半肝,進一步分為五個葉、六個段。,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)儲存膽汁、濃縮膽汁。呈長梨形,長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。常有膽囊動脈通過。,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?。∣ddi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)分泌部兩部分組成。◆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:位于胰實質(zhì)內(nèi),偏背側(cè),其走形與胰的長軸一致,從胰尾經(jīng)胰體走向胰頭,沿途經(jīng)過許多小葉間導(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,開口于十二指腸大乳頭?!粼谝阮^上部常可見一小管,行與胰管上方,稱副胰管,開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
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