泌尿系统课件.ppt

泌尿系统课件泌尿系统课件 2 2Composition and Functionn肾肾(kidney)forms urine.n输尿管输尿管(ureter)conducts urine from Kidneys to bladder.n膀胱膀胱(bladder)receives and stores urine.n尿道尿道(urethra)conducts urine from bladder to exterior of body.3 3肾肾Kidney1.肾的形态肾的形态n成对、蚕豆形、红褐色成对、蚕豆形、红褐色成对、蚕豆形、红褐色成对、蚕豆形、红褐色n上端宽薄、下端窄厚上端宽薄、下端窄厚上端宽薄、下端窄厚上端宽薄、下端窄厚n前面圆钝、后面扁平前面圆钝、后面扁平前面圆钝、后面扁平前面圆钝、后面扁平n外侧缘凸隆、内侧缘中外侧缘凸隆、内侧缘中外侧缘凸隆、内侧缘中外侧缘凸隆、内侧缘中部凹陷部凹陷部凹陷部凹陷 4 4n内侧缘中部凹陷内侧缘中部凹陷内侧缘中部凹陷内侧缘中部凹陷n肾门肾门肾门肾门(Renal hilum)(Renal hilum)a vertical slit a vertical slit on the medial border of kidney.on the medial border of kidney.uu肾蒂肾蒂肾蒂肾蒂(Renal pedicle)(Renal pedicle)the the structures which enter and leave structures which enter and leave the renal hilum is calledthe renal hilum is called.including including the renal the renal v vein,renal ein,renal a artery,renal rtery,renal p pelvis,lymphatic vessels and elvis,lymphatic vessels and nerves.nerves.uu肾蒂的结构顺序肾蒂的结构顺序肾蒂的结构顺序肾蒂的结构顺序 A AP:V.A.P.P:V.A.P.S S I:A.V.P.I:A.V.P.5 5uu肾窦肾窦肾窦肾窦(Renal sinus)(Renal sinus)which is the renal hilum which is the renal hilum leads into a space within the leads into a space within the kidney.kidney.is occupied by the renal is occupied by the renal vessels and branchesvessels and branches、minor renal calicesminor renal calices、major major renal calicesrenal calices、renal pelvis renal pelvis and some adipose tissue.and some adipose tissue.6 62.肾的构造肾的构造n肾皮质肾皮质肾皮质肾皮质(Renal cortex)(Renal cortex)红褐色、富含血管、细小颗粒（肾小体）红褐色、富含血管、细小颗粒（肾小体）红褐色、富含血管、细小颗粒（肾小体）红褐色、富含血管、细小颗粒（肾小体）肾柱肾柱肾柱肾柱(renal columns)renal columns)n肾髓质肾髓质肾髓质肾髓质(Renal medulla)(Renal medulla)色淡、小的管道色淡、小的管道色淡、小的管道色淡、小的管道 肾锥体肾锥体肾锥体肾锥体(Renal pyramids):15-20Renal pyramids):15-20 肾乳头肾乳头肾乳头肾乳头(Renal papilla)Renal papilla)乳头孔乳头孔乳头孔乳头孔n肾小盏肾小盏肾小盏肾小盏(Minor renal calices)(Minor renal calices):7-87-8n肾大盏肾大盏肾大盏肾大盏(Major real calices(Major real calices):):2-32-3n肾盂肾盂肾盂肾盂(Renal pelvis)(Renal pelvis)前后扁平、漏斗状前后扁平、漏斗状前后扁平、漏斗状前后扁平、漏斗状 7 73.肾的位置肾的位置n腹腔后上部，脊柱两旁，腹腔后上部，脊柱两旁，腹腔后上部，脊柱两旁，腹腔后上部，脊柱两旁，是腹膜外位器官；是腹膜外位器官；是腹膜外位器官；是腹膜外位器官；n左高右低左高右低左高右低左高右低,八字形八字形八字形八字形u左肾：T12L3椎体上缘u右肾：T12L3椎体下缘u第十二肋斜过左肾后面中部、右肾后面上部n 肾门：肾门：平对L1椎体，距正中 线约5cmn 肾区：肾区：竖脊肌外侧缘与第12 肋的夹角部位 8 8uuLeft kidneyLeft kidney lies at the level lies at the level from the lower border of T11 to from the lower border of T11 to L2;the 12th rib is behind its L2;the 12th rib is behind its middle part of the post surface.middle part of the post surface.uuRight kidneyRight kidney lies slightly lower lies slightly lower than the left kidney,at the level than the left kidney,at the level from the lower border of T12 to from the lower border of T12 to L3;the 12th rib is behind its L3;the 12th rib is behind its upper part of the post surface.upper part of the post surface.uuRenal hilumRenal hilum at the level of L1,at the level of L1,is about 5cm from the posterior is about 5cm from the posterior median line.median line.uuRenal regionRenal regionthe area the area between 12th rib and the lateral between 12th rib and the lateral margin of erector spinae.margin of erector spinae.9 9 10104.肾的被膜肾的被膜n纤维囊纤维囊纤维囊纤维囊(Fibrous capsule)(Fibrous capsule)a strong fibrous capsule which a strong fibrous capsule which strips easily from a normal kidney strips easily from a normal kidney surface but adheres firmly to an surface but adheres firmly to an organ that has been inflamed.organ that has been inflamed.n脂肪囊脂肪囊脂肪囊脂肪囊(Adipose capsule)(Adipose capsule)a thick adipose connective tissue a thick adipose connective tissue capsule,surrounds the fibrous capsule,surrounds the fibrous capsule.It acts as a shock absorber capsule.It acts as a shock absorber to protect the kidney from jolting and to protect the kidney from jolting and jarring.jarring.n肾筋膜肾筋膜肾筋膜肾筋膜(Renal fascia)(Renal fascia)on outside,surrounds both the on outside,surrounds both the kidney and suprarenal gland,holding kidney and suprarenal gland,holding these organs in place.these organs in place.11115.肾的毗邻关系肾的毗邻关系n上面上面上面上面superarenal glandsuperarenal glandn后面后面后面后面uuThree musclesThree muscles膈膈膈膈 (pleural cavity)(pleural cavity)腰大肌腰大肌腰大肌腰大肌 腰方肌腰方肌腰方肌腰方肌uuThree nervesThree nerves肋下神经肋下神经肋下神经肋下神经髂腹下神经髂腹下神经髂腹下神经髂腹下神经 髂腹股沟神经髂腹股沟神经髂腹股沟神经髂腹股沟神经n内面内面内面内面uuLeft kidneyLeft kidney腹主动脉腹主动脉腹主动脉腹主动脉uuRight kidneyRight kidney下腔静脉下腔静脉下腔静脉下腔静脉 1212n前面前面前面前面uuLeft kidneyLeft kidneyStomach(superior)Stomach(superior)Pancreas(middle)Pancreas(middle)Jejunum and left colic Jejunum and left colic flexure(inferiorly)flexure(inferiorly)uuRight kidneyRight kidneyRight lobe of liver Right lobe of liver(superior)(superior)Right colic flexure Right colic flexure(inferior)(inferior)Descending part of Descending part of duodenum(medially)duodenum(medially)1313输尿管输尿管Ureters1.一般形态一般形态nMuscular tube,about Muscular tube,about 25cm long25cm longn三部三部三部三部uu腹部腹部腹部腹部descend on the descend on the psoas major behind the psoas major behind the peritoneum.peritoneum.uu盆部盆部盆部盆部in females,passes in females,passes 2cm lateral to the neck of 2cm lateral to the neck of uterus and lies below the uterus and lies below the uterine artery.uterine artery.uu壁内部壁内部壁内部壁内部passes obliquely passes obliquely through the bladder wall through the bladder wall for 2cm long.for 2cm long.1414n三个狭窄三个狭窄三个狭窄三个狭窄uu肾盂与输尿管移行处肾盂与输尿管移行处uu越过骨盆上口处越过骨盆上口处uu输尿管壁内部输尿管壁内部n临床意义临床意义临床意义临床意义 结石滞留的好发部位结石滞留的好发部位 1515膀胱膀胱Bladder1.一般形态一般形态nPyramidal in shape when Pyramidal in shape when emptyemptyn四部四部四部四部uu 膀胱尖膀胱尖膀胱尖膀胱尖uu 膀胱体膀胱体膀胱体膀胱体uu 膀胱底膀胱底膀胱底膀胱底uu 膀胱颈膀胱颈膀胱颈膀胱颈 16162.位置位置n盆腔前部，耻骨联合后方；盆腔前部，耻骨联合后方；盆腔前部，耻骨联合后方；盆腔前部，耻骨联合后方；为腹膜间位器官为腹膜间位器官为腹膜间位器官为腹膜间位器官n随着尿液充盈而变化随着尿液充盈而变化随着尿液充盈而变化随着尿液充盈而变化n对穿刺的意义对穿刺的意义对穿刺的意义对穿刺的意义3.内面结构内面结构n膀胱三角膀胱三角膀胱三角膀胱三角Trigone of bladder Trigone of bladder uu三点三点三点三点uu结构特点结构特点结构特点结构特点uu临床意义临床意义临床意义临床意义 n 输尿管间襞输尿管间襞Interureteric fold 1717尿道尿道Urethra1.女性尿道女性尿道n 短、直、粗，开口于阴道短、直、粗，开口于阴道短、直、粗，开口于阴道短、直、粗，开口于阴道前庭前庭前庭前庭n 临床意义临床意义临床意义临床意义 18182.男性尿道男性尿道男性尿道男性尿道n分部分部分部分部u 前列腺部前列腺部u 膜部膜部u 海绵体部海绵体部n 狭窄狭窄u 尿道内口尿道内口u 膜部膜部u 尿道外口尿道外口n 狭窄狭窄n 扩大扩大u 尿道内口尿道内口u 膜部膜部u 尿道外口尿道外口u 耻骨下弯耻骨下弯u 耻骨前弯耻骨前弯