Материал: Атлас Ханц фениш

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Urogenital system 175

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8

27

 

 

 

3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

19

 

 

 

 

 

4

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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20

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

 

 

 

 

 

 

 

 

 

 

6

 

5

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

 

 

 

 

 

44.5

 

6

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

 

 

 

 

 

 

 

 

7

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

 

 

 

 

 

 

Pelvic floor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

 

 

 

 

 

 

from above

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

11

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

94.11

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

19

 

 

 

11

 

6

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

14

 

26

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

 

 

5

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17

1416

15

BFrontal section through the true pelvis (pelvis minor)

29

 

 

 

 

 

 

 

16

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

17

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

18

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

19

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

20

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

21

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

24

17

 

 

12

22

 

 

 

 

 

 

 

 

 

 

22

 

 

 

 

 

15

 

 

 

 

23

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

28 16

24

C Male pelvic viscera

25

176 Peritoneum

1Urogenital diaphragm. [[Diaphragm urogeni-

1 tale]]. Fibromuscular wall spread out between the right and left inferior rami of the pubis. A B E

22 Deep perineal space. Spatium perinei profundum. Space between the inferior and superior

fascia of the urogenital diaphragm. Contents: 3 Deep transversus perinei and sphincter urethrae muscles; bulbo-urethral glands; nerves and ves-

4sels for the penis. A

3M. transversus perinei profundus. Trapezoidshaped muscular plate stretched out in the pubic

5arch. I: Pudendal nerve. A B E F

4M. sphincter urethrae. Muscular fibers sur-

6rounding the membranous part of the urethra. I: Pudendal nerve. A E F

7

4 a M. compressor urethrae. Muscle fibers that ex-

tend distally from the m. sphincter urethrae to

 

 

the ramus of the ischium. F

8

4 b M. sphincter urethrovaginalis. Muscle fibers

 

that extend distally from the m. compressor

 

9

urethrae to the bulb of the vestibule. F

5 Superior fascia of urogenital diaphragm. Fascia

 

 

diaphragmatis urogenitalis superior. Fascia of the

10

deep transverse perinei muscle located on the

 

side of the ischio-anal fossa. A

 

11

6 Perineal membrane [Inferior fascia of urogeni-

tal diaphragm]. Membrana perinei [fascia dia-

 

 

phragmatis urogenitalis inferior]. Fascia on the

12

anteroinferior surface of the deep transverse per-

 

inei muscle.

 

 

7 Transverse perineal ligament. Lig. transversum

13

perinei. Thickened fusion of both fasciae of the

 

 

urogenital diaphragm at the anterior, upper mar-

14

gin of the deep transverse perinei muscle. E

8 Superficial perineal space. Spatium perinei superficiale. Space between the superficial perineal

15fascia and the inferior fascia of the urogenital diaphragm. It contains the root of the penis. A

169 M. transversus perinei superficialis. Inconstant

 

separated portion of the deep transverse perineal

17

muscle. It radiates out into the perineal body. I:

Pudendal nerve. B

 

10 M. ischiocavernosus. Muscle that arises from the

18ramus of the ischium, lies on the crus of the penis and attaches to its tunica albuginea. I: Pudendal nerve. A B

1911 M. bulbospongiosus [[m. bulbocavernosus]].

Muscle that arises from the perineal body and the

20median raphe of the corpus spongiosum, then passes lateral to them and extends to the inferior perineal membrane and the dorsum of the penis.

21In the female it follows the course of the bulb of the vestibule. I: Pudendal nerve. A B; see also

22page 225 D

12Superficial perineal fascia. Fascia perinei superficialis. Fascia forming the anteroinferior border of

23

the superficial perineal space. A

13 ISCHIOANAL FOSSA. Fossa ischioanalis. Space be-

24tween the levator ani and obturator internus muscles. It is bordered anteroinferiorly by the urogenital diaphragm. A B

2514 Fat body of ischioanal fossa. Corpus adiposum

fossae ischioanalis. A pad of fat in the ischioanal fossa.

15Pudendal [[Alcock’s]] canal. Canalis pudendalis [[Alcock]]. Splitting of obturator fascia in lateral wall of ischioanal fossa to form a tunnel for passage of the pudendal vessels and nerves. A

16Retropubic space. Spatium retropubicum [[spatium praevesicale; cavum Retzii]]. Space between the urinary bladder and the pubis filled with loose connective tissue and bounded inferiorly by the puboprostatic ligament. C

17PERITONEUM. Serous membrane that lines the peritoneal cavity.

18Abdominal cavity. [[Cavitas abdominalis]].

19Peritoneal cavity. Cavitas peritonealis. Space in abdominal cavity enclosed by peritoneum.

19 a Extraperitoneal space. Spatium extraperitoneale. Space in connective tissue with no relationship to the peritoneum.

20 Retroperitoneal space. Spatium retroperitoneale. Space between the peritoneum and the transversalis fascia.

21Extraperitoneal fascia. Fascia extraperitonealis. Connective tissue layer of varying thickness beneath the peritoneum.

22Extraperitoneal organ. Organum extraperitoneale. Organ in extraperitoneal space.

23Parietal peritoneum. Peritoneum parietale. Peritoneum of abdominal wall. D

24Tunica serosa. Serous membrane lined by smooth, simple peritoneal epithelium.

25Tela subserosa. Connective tissue layer beneath the serosa.

26Visceral peritoneum. Peritoneum viscerale. Peritoneum covering the abdominal viscera. D

27Tunica serosa. See 24.

28Tela subserosa. See 25.

29Epiploic foramen [[of Winslow]]. Foramen omentale (epiploicum). Opening into the lesser sac behind the hepatoduodenal ligament. D

30Omental bursa [[lesser sac of peritoneum]].

Bursa omentalis. A peritoneal cavity situated mainly behind the stomach. D

31Vestibule of omental bursa. Vestibulum bursae omentalis. Portion of the omental bursa situated near the caudate lobe of the liver and bounded by the gastropancreatic folds on the left. D

32Upper omental recess. Recessus superior omentalis. Upwardly directed recess between the inferior vena cava and the esophagus. D

33Lower omental recess. Recessus inferior omentalis. Lower portion of the omental bursa located between the stomach and transverse colon, or, in some cases, between the anterior and posterior layers of the greater omentum. D

34Splenic recess. Recessus splenicus (lienalis). Left portion of lower omental recess bounded by splenic ligaments. D

35Gastropancreatic folds. Plicae gastropancreaticae. Folds in the posterior wall of the lesser sac formed by the left gastric and common hepatic arteries. D

35 a Hepatopancreatic fold. Plica hepatopancreatica. Also called plica gastropancreatica dextra. Peritoneal fold that encloses the common hepatic artery.

Peritoneum 177

13

6

4

5

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

13

 

 

 

 

11

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

15

10

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

8

2

 

 

 

 

1

 

 

 

 

 

 

3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

9

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

12

 

 

 

 

 

11

 

3

10

 

 

 

 

 

 

 

 

Frontal section of male pelvis

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A

 

 

 

 

 

 

 

 

 

13

 

 

 

 

 

 

 

 

 

32

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Male perineal musculature

23

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

B

 

 

 

 

31

 

 

 

 

30

 

 

 

 

 

 

 

 

 

from below

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

34

 

 

 

 

 

 

 

29

35

26

16

C Urinary bladder, lateral view

33

 

Posterior wall

 

 

 

 

 

 

 

4

 

 

D

 

 

 

 

 

 

 

 

 

 

 

of omental bursa

 

 

 

 

 

 

 

 

 

 

 

and adjacent organs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4a

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4b

 

 

 

 

 

 

 

 

44.20

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

44.3

 

 

 

 

 

 

 

172.13

 

 

 

3

170.1

 

 

 

 

 

4

 

 

 

 

 

 

 

3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Urogenital

 

 

Female urogenital sphincter

E

 

F

 

diaphragm

 

 

 

according to Oelrich

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

 

178

Peritoneum

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1

Dorsal mesentery. [[Mesenterium dorsale 19

Splenorenal

 

(lienorenal,

phrenicosplenic)

1

 

 

 

 

 

commune]]. Embryologically original, com-

 

ligament.

Lig.

splenorenale

 

(lienorenale,

 

 

 

 

mon, dorsal suspensory ligament of the still

 

phrenicosplenicum). Peritoneal fold that ex-

2

 

 

 

undifferentiated intestinal tube.

 

 

 

 

tends from the diaphragm, kidney and pan-

 

 

2

Mesentery. Mesenterium. Dorsal

peritoneal

 

creas to the hilum of the spleen; on the right, it

3

 

 

 

fold for the fixation of the intraperitoneal small

 

is continuous with the transverse mesocolon. B

 

 

 

intestine. It transports blood vessels and

20

Hepatic ligaments. Ligg. hepatis.

 

 

 

 

 

 

nerves. B

 

 

 

 

 

21

Coronary ligament. Lig. coronarium. The line

4

 

3

Root of mesentery. Radix mesenterii. Line of

 

or reflection of the parietal peritoneum that ex-

 

 

 

 

attachment that extends from the posterior

 

tends from the diaphragmatic surface to the

5

 

 

 

wall of the abdominal cavity near the second

 

visceral peritoneum of the liver at the margin of

 

 

 

lumbar vertebra to the right iliac fossa. A

 

 

the bare area. A

 

 

 

 

 

 

 

 

4

Mesocolon. Peritoneal fold bearing vessels and

22

Falciform ligament of liver. Lig. falciforme (he-

6

 

 

 

nerves; it attaches and supplies the colon.

 

patis). Peritoneal fold from the anterior and in-

 

 

5

Transverse mesocolon. Mesocolon transver-

 

ferior sides of the liver to the anterior abdomi-

7

 

 

 

sum. Suspensory ligament of the transverse

 

nal wall. B

 

 

 

 

 

 

 

 

 

 

 

colon. A B

 

 

 

 

 

23

Right triangular ligament. Lig. triangulare

 

 

6

Mesocolon of ascending colon. Mesocolon

 

dextrum. Triangular peritoneal fold between

 

 

 

8

 

 

 

ascendens. It fuses with the posterior abdomi-

 

the right lobe of the liver and the diaphragm. It

 

 

 

 

nal wall in the 4th embryonic month.

 

 

 

forms the right end of the coronary ligament. A

 

 

 

 

 

 

 

 

7

Mesocolon of descending colon. Mesocolon

24

Left triangular ligament. Lig. triangulare sin-

9

 

 

 

descendens. It fuses with the posterior abdomi-

 

istrum. Triangular peritoneal fold between the

 

 

 

 

 

 

 

 

 

nal wall in the 4th embryonic month.

 

 

 

liver and diaphragm. It forms the left end of the

10

8

Sigmoid mesocolon. Mesocolon sigmoideum.

 

coronary ligament. A

 

 

 

 

 

 

 

 

 

Suspensory ligament of sigmoid colon. B

 

25

Hepatorenal

ligament.

Lig.

hepatorenale.

 

 

 

 

 

 

9

Mes-oappendix

[[mesenteriolum]].

Suspen-

 

Continuation

of

the

coronary

ligament at-

11

 

 

tached to the right kidney. A

 

 

 

 

 

 

sory ligament of vermiform appendix. B

 

 

 

 

 

 

10

Lesser omentum. Omentum minus. Peritoneal

26 Folds and recesses. Plicae et fossae (recessus).

12

27

Fascia retinens rostralis. Band passing upward

 

 

 

sheet extending mainly between the stomach

 

 

 

 

and liver.

 

 

 

 

 

 

at the duodenojejunal flexure, in some cases

 

 

 

 

 

 

 

 

 

 

13

11

Hepatogastric ligament. Lig. hepatogastricum.

 

together with the suspensory muscle of the

 

duodenum. See 124.10. A

 

 

 

 

 

 

 

 

Part of the lesser omentum between the

 

 

 

 

 

 

 

 

 

stomach and liver. B

 

 

 

 

28

Superior duodenal fold (duodenojejunal fold).

14

 

 

 

 

 

 

 

12

Hepatoduodenal

ligament.

Lig.

hepa-

 

Plica duodenalis superior (plica duodenoje-

 

 

 

 

toduodenale. Part of lesser omentum between

 

junalis). Peritoneal fold on the left side of the

 

 

 

 

 

15

 

 

 

the duodenum and liver. It contains the hepatic

 

duodenojejunal flexures and in front of the su-

 

 

 

 

perior duodenal recess. It contains the inferior

 

 

 

 

artery proper, bile duct and the portal vein. B

 

 

13

Hepatocolic ligament. [Lig. hepatocolicum].

 

mesenteric vein. A

 

 

 

 

 

16

29

 

 

 

 

Recessus

Superior

duodenal

 

recess.

 

 

 

Inconstant continuation of the hepatoduodenal

 

 

 

 

 

ligament toward

the right at

the

right

colic

 

duodenalis superior. Peritoneal recess behind

 

 

 

 

 

17

 

 

 

flexure or near the transverse colon. B

 

 

 

the superior duodenal fold. A

 

 

 

 

 

 

 

 

30

Inferior duodenal fold

(duodenomesocolic

 

14

Greater omentum. Omentum majus. Doubled

 

 

fold). Plica duodenalis inferior (plica duode-

 

 

 

 

peritoneal apron hanging down from the

 

18

 

 

 

 

 

 

 

 

nomesocolica). Peritoneal fold just in front of

 

 

 

stomach and transverse colon; it contains vari-

 

 

 

 

 

able amounts of fat. B

 

 

 

 

 

duodenojejunal flexure. A

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

19

15

Gastrophrenic ligament. Lig. gastrophrenicum.

31 Inferior duodenal recess. Recessus duodenalis

 

inferior. Peritoneal recess behind the inferior

 

 

 

 

Upper continuation of the phrenicosplenic and

 

 

 

 

 

 

duodenal fold. A

 

 

 

 

 

 

 

 

 

 

gastrosplenic ligaments between the stomach

 

 

 

 

 

 

 

20

 

 

 

32

 

[Plica

paraduodenalis].

 

 

 

Paraduodenal

fold.

 

 

 

and diaphragm. A B

 

 

 

 

 

16

Gastrosplenic (gastrolienal)

ligament.

Lig.

 

Peritoneal fold located on the left side of the

 

 

21

 

 

 

gastrosplenicum

(gastrolienale).

Peritoneal

 

duodenum. A

 

 

 

 

 

 

 

 

 

 

33

Paraduodenal recess. [Recessus para-

 

 

 

 

connection from the lesser curvature of the

 

 

 

 

stomach to the hilum of the spleen. B

 

 

 

duodenalis]. Peritoneal recess behind the para-

22

 

 

 

 

 

 

17

Gastrocolic ligament. Lig. gastrocolicum. Peri-

 

duodenal fold that opens toward the right. A

 

 

 

 

toneal connection between the lesser curvature

34

Retroduodenal recess. [Recessus retroduo-

23

 

 

 

of the stomach and the omental tenia of the

 

denalis]. Peritoneal recess between the aorta

 

 

 

 

transverse colon. It is attached to the gastros-

 

and the duodenum that opens toward the left.

 

 

 

 

plenic ligament. B

 

 

 

 

 

A

 

 

 

 

 

 

 

 

2418 Phrenicocolic ligament. Lig. phrenicocolicum. Peritoneal fold on the left side of the body, be-

25tween the diaphragm and the descending colon. B

Peritoneum 179

 

24

 

21

15

 

23

 

 

25

5

27

 

 

 

28

32

29

3

 

 

 

 

33

 

31

34

30

22

15

16

11

19

12

13

5

14

2

9

APosterior abdominal wall

17

18

8

BAbdominal cavity after removal of stomach, small intestine and sigmoid colon

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25