hernia析课件
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动物外科学--疝 PPT课件 ppt课件
可复性疝的切开线
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ppt课件
沿皮肤切口分离疝囊
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在疝囊无粘连处皱襞切开疝囊
手指伸入囊内探查肠管与囊壁的粘连情况
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ppt课件
扩大疝囊切口
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显露疝囊内容物及疝轮
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还纳肠管对疝轮作间断水平钮扣缝合
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切除疝轮缘增生的瘢痕组织
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对切成新鲜创面的疝轮作间断缝合
【治疗】保守疗法适用于疝轮较小，年龄小的动物。可用疝 带（皮带或复绷带）、强刺激剂（幼驹用赤色碘化汞软膏， 犊牛用重铬酸钾软膏）等促使局部炎性增生闭合疝口。但 强刺激剂常能使炎症扩展至疝囊壁以及其中的肠管，引起 粘连性腹膜炎。 幼龄动物可用一大于脐环的、外包纱布的小木片抵住 脐环，然后用绷带加以固定，以防移动。若同时配合疝轮 四周分点注射10%氯化钠溶液，效果更佳。
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腹股沟阴囊疝
腹股沟阴囊疝（inguinal hernia and scrotal hernia） 多见于公马和公猪，其它公畜比较少见。母猪、母犬常发 生腹股沟疝。公畜的腹股沟阴囊疝有遗传性。
后天性腹股沟阴囊疝主要是腹压增高而引起的，如公 马配种时，两前肢凌空，身体重心向后移，腹内压加大， 有时发生腹股沟阴囊疝，还可发生于装蹄时保定失误，也 是剧烈挣扎而加大腹内压力所引起。
第九讲 疝
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第一节 概述
疝又称赫尼亚 （Hernia），是家畜常 见的外科病。临床上较 常见的有腹壁疝、脐疝 和阴囊疝。
疝的组成及分类
疝由疝轮（环）、 疝囊、疝内容物构成。
图9-1 疝的模式图
1. 腹膜 2. 肌肉 3. 皮肤 4. 疝轮5. 疝囊 6. 疝内容物 7. 疝液
高二英语The-Environment课件15
马福兹曾经每天坐在这里往外看，头顶一个小小的悬挂式电扇在缓慢转动。油渍斑斑的房顶太低矮，几乎会碰到高个子的头。但他看中的正是闹市间的这个窗口，窗口内的这张小桌，小桌边的这番 安静。这里让我重温了一个区分作家优劣的界限：是小空间而大视野，还是大排场而小见识？
马福兹获诺贝尔文学奖，不仅埃及，而且整个阿拉伯世界都为之激动电视台也在不断地把他的作品改编成电视剧。而他则还是一 如既往，每天步行在街道上，走过两座桥，摸上小楼梯，坐到这张靠窗的小桌旁，叫上一杯咖啡，开始打量窗外。很少有人认出他来，这位最平民化的埃及老人。
走过一条极窄的通道，爬，一个小木梯，就见一间大约十八平方米的房间。有几张咖啡桌，靠窗边有一张，是他的位置。从窗口往外望，先看见隔壁一家皮货店高挂的皮包，伸手就可取到。往前是 一个地铁站入口，蹲着六七个擦皮鞋的人。再抬头看，则是两幢建筑物，一是希尔顿酒店，二是阿拉伯联盟总部。棋牌送18至38彩金
但是，还是有人在惦记他，仇恨的目光搜寻到了他的背影。一九九四年十月的一个黄昏，当他步行回家刚刚走过一座桥，一个歹徒扑上前去用刀刺向他的颈脖。他被路人送到医院，脱离了危险，但 由于伤及神经，右手至今不能恢复写作。
马福兹获诺贝尔文学奖，不仅埃及，而且整个阿拉伯世界都为之激动电视台也在不断地把他的作品改编成电视剧。而他则还是一 如既往，每天步行在街道上，走过两座桥，摸上小楼梯，坐到这张靠窗的小桌旁，叫上一杯咖啡，开始打量窗外。很少有人认出他来，这位最平民化的埃及老人。
走过一条极窄的通道，爬，一个小木梯，就见一间大约十八平方米的房间。有几张咖啡桌，靠窗边有一张，是他的位置。从窗口往外望，先看见隔壁一家皮货店高挂的皮包，伸手就可取到。往前是 一个地铁站入口，蹲着六七个擦皮鞋的人。再抬头看，则是两幢建筑物，一是希尔顿酒店，二是阿拉伯联盟总部。棋牌送18至38彩金
但是，还是有人在惦记他，仇恨的目光搜寻到了他的背影。一九九四年十月的一个黄昏，当他步行回家刚刚走过一座桥，一个歹徒扑上前去用刀刺向他的颈脖。他被路人送到医院，脱离了危险，但 由于伤及神经，右手至今不能恢复写作。
人教版生物必修一《细胞的癌变》经典ppt课堂课件
糖蛋白
人教版生物必修一6.4《细胞的癌变》 经典教 学课件 (共41 张PPT)
癌细胞的主要特征：
分裂次数
无限增殖
形态结构
发生显著变化
表面物质
人教版生物必修一6.4《细胞的癌变》 经典教 学课件 (共41 张PPT)
发生变化，糖蛋白等物质减少，癌 细胞间的黏着性降低，易分散和转 移
人教版生物必修一6.4《细胞的癌变》 经典教 学课件 (共41 张PPT) 人教版生物必修一6.4《细胞的癌变》 经典教 学课件 (共41 张PPT)
•
5.根据诗歌内容，课文中配有相应的插图， 形象地 描绘了 三种植 物传播 种子的 方法， 同时告 诉小读 者植物 传播种 子的方 法有很 多，仔 细观察 就能得 到更多 的知识 。
•
6本课的突出特点是拟人手法的运用， 把植物 和种子 分别当 作“妈 妈”和 “孩子 ”来写 。“妈 妈孩子 ”这样 的关联 ，易触 动儿童 的情感 世界， 易激发 想象、 引发思 考，读 起来亲 切、有 趣，易 于调动 小读者 的阅读 兴趣。
人教版生物必修一6.4《细胞的癌变》 经典教 学课件 (共41 张PPT)
人教版生物必修一6.4《细胞的癌变》 经典教 学课件 (共41 张PPT) 人教版生物必修一6.4《细胞的癌变》 经典教 学课件 (共41 张PPT)
人教版生物必修一6.4《细胞的癌变》 经典教 学课件 (共41 张PPT) 人教版生物必修一6.4《细胞的癌变》 经典教 学课件 (共41 张PPT)
人教版生物必修一6.4《细胞的癌变》 经典教 学课件 (共41 张PPT)
抑基抑基主癌因癌因要阻止细致胞突癌的变因子不正常增殖。抑基癌因抑基癌因
正常表达
不表达
hernia分析课件共50页文档
The mouth, The neck and The body of the
sac.
Composition of a hernia
2. The covering:
Coverings are derived from the layers of abdominal wall through which the sac pass
Strangulated: the arterial blood supply to the contents of .3 the sac is compromised, in such a hernia unless surgical relief is undertaken the contents of the sac will become gangrenous.
Composition of a hernia
1. The sac 2. The covering of
the sac 3. The content of the
sac
Composition of a hernia
1. The sac :
It is a diverticulum of peritoneum and is made up of three parts :
3. Contents:
can be Omentum = omentocle Intestine = enterocele Portion of circumference of intestine = Richter’s hernia Portion of the bladder Ovary(with or without oviduct) Meckel’s diverteculum =Littre’s hernia
sac.
Composition of a hernia
2. The covering:
Coverings are derived from the layers of abdominal wall through which the sac pass
Strangulated: the arterial blood supply to the contents of .3 the sac is compromised, in such a hernia unless surgical relief is undertaken the contents of the sac will become gangrenous.
Composition of a hernia
1. The sac 2. The covering of
the sac 3. The content of the
sac
Composition of a hernia
1. The sac :
It is a diverticulum of peritoneum and is made up of three parts :
3. Contents:
can be Omentum = omentocle Intestine = enterocele Portion of circumference of intestine = Richter’s hernia Portion of the bladder Ovary(with or without oviduct) Meckel’s diverteculum =Littre’s hernia
Hernia PPT
In the adult it is approximately 4 cm in length Is located 2-4 cm cephalad to the inguinal ligament A canal extends between the internal (deep inguinal) ring and the external (superficial inguinal) ring opening The inguinal canal contains either the spermatic cord or the round ligament of the uterus
Pathological anatomy
composed of: covering tissue: skin, subcutanous tissue hernial sac: protrusion of peritonum, neck of the sac: is narrow where the sac emerges from the abdomen body of the sac hernial contents: small intestine, major omentum
Size and location of the hernia Degree of adipose tissue
Anatomic Considerations
The surgeon must also be aware of the precise location of the:
Femoral nerve Genitofemoral nerve Lateral femoral cutaneous nerves
Pathological anatomy
composed of: covering tissue: skin, subcutanous tissue hernial sac: protrusion of peritonum, neck of the sac: is narrow where the sac emerges from the abdomen body of the sac hernial contents: small intestine, major omentum
Size and location of the hernia Degree of adipose tissue
Anatomic Considerations
The surgeon must also be aware of the precise location of the:
Femoral nerve Genitofemoral nerve Lateral femoral cutaneous nerves
hernia分析课件-PPT资料50页
hernia
Signs and Symptoms
- A lump disappears, reappears, and enlarges on
straining and discomfort.
Physical Signs:
Reduced. + ve cough impulse.
Investigation:
Inguinal hernia
There are two types of inguinal hernia:
Direct inguinal hernia
Indirect inguinal hernia
Differences between direct
and indirect hernias
3. Contents:
can be Omentum = omentocle Intestine = enterocele Portion of circumference of intestine = Richter’s hernia Portion of the bladder Ovary(with or without oviduct) Meckel’s diverteculum =Littre’s hernia
Congenital abnormality. Acquired :
• Traumatic • Diseases
Varieties
A hernia at any site may be:
1. Reducible This is the one which the contents of the sac reduced
• vas deferens,
Signs and Symptoms
- A lump disappears, reappears, and enlarges on
straining and discomfort.
Physical Signs:
Reduced. + ve cough impulse.
Investigation:
Inguinal hernia
There are two types of inguinal hernia:
Direct inguinal hernia
Indirect inguinal hernia
Differences between direct
and indirect hernias
3. Contents:
can be Omentum = omentocle Intestine = enterocele Portion of circumference of intestine = Richter’s hernia Portion of the bladder Ovary(with or without oviduct) Meckel’s diverteculum =Littre’s hernia
Congenital abnormality. Acquired :
• Traumatic • Diseases
Varieties
A hernia at any site may be:
1. Reducible This is the one which the contents of the sac reduced
• vas deferens,
2023年AEVEL课程生物课件Inheritance
20 of 45
© Boardworks Ltd 2009
Sex determination
Sex in mammals is determined by two chromosomes, known as the sex chromosomes or heterosomes.
The X chromosome is larger and contains about 2000 genes, whereas the Y chromosome contains fewer than 100.
Phenotype blood group A blood group B blood group O blood group AB
A and B are codominant and O is recessive to both.
7 of 45
© Boardworks Ltd 2009
Genetics terminology
For example, flower colour in snapdragons Antirrhinum majus. CR = red flowers CW = white flowers
Genotype
CRCR
homozygous
CRCW
heterozygous
CWCW
homozygous
Phenotype red flowers pink flowers white flowers
Pedigree diagrams show how alleles, like the one for CF, have been inherited through families.
hernia析课件
internal oblique on lateral one third
Posterior:
fascia transversalis conjoint tendonon in medial one
third
Roof:
arching fibers of internal oblique ,and
Inguinal hernia
There are two types of inguinal hernia:
Direct inguinal hernia
Indirect inguinal hernia
Differences between direct
and indirect hernias
Inguinal hernia
Signs & symptoms:
Bulge that enlarges when stand or strain, but often asymptomatic.
In general direct hernias produce fewer symptoms than indirect hernias and are less likely to complicate.
Inguinal hernia
Risk factors:
( increases intra-abdominal pressure )
Chronic cough. Constipation. Pregnancy. Straining at micturation. Severe muscular effort (lifting heavy
transversus abdominis
Posterior:
fascia transversalis conjoint tendonon in medial one
third
Roof:
arching fibers of internal oblique ,and
Inguinal hernia
There are two types of inguinal hernia:
Direct inguinal hernia
Indirect inguinal hernia
Differences between direct
and indirect hernias
Inguinal hernia
Signs & symptoms:
Bulge that enlarges when stand or strain, but often asymptomatic.
In general direct hernias produce fewer symptoms than indirect hernias and are less likely to complicate.
Inguinal hernia
Risk factors:
( increases intra-abdominal pressure )
Chronic cough. Constipation. Pregnancy. Straining at micturation. Severe muscular effort (lifting heavy
transversus abdominis
高一英语必修2-Module1课件2
粉一红的天空中，曲曲折折的漂着许多条石绿色*的浮云，星便在那后面忽明忽灭的[目夹]眼。天边的血红的云彩里有一个光芒四射的太?，如流动的金球包在荒古的熔岩中；那一边，却是一个生铁 一般的冷而且白的月亮。然而伊并不理会谁是下去，和谁是上来。
地上都嫩绿了，便是不很换叶的松柏也显得格外的娇一嫩。
桃红和青白色*的斗大的杂花，在眼前还分明，到远处可就成为斑斓的烟霭了。 “唉唉，我从来没有这样的无聊过！”伊想着，猛然间站立起来了，擎上那非常圆满而精力洋溢的臂膊，向天打一个欠伸，天空便突然失了色*，化为神异的肉红，暂时再也辨不出伊所在的处所。 伊在这肉红色*的天地间走到海边，全身的曲线都消融在淡玫瑰似的光海里，直到身中央才浓成一段纯白。波涛都惊异，起伏得很有秩序了，然而浪花溅在伊身上。这纯白的影子在海水里动摇，仿 佛全体都正在四面八方的迸散。但伊自己并没有见，只是不由的跪下一足，伸手掬起带水的软泥来，同时又一揉一捏几回，便有一个和女娲（2）忽然醒来了。 伊（3）似乎是从梦中惊醒的，然而已经记不清做了什么梦；只是很懊恼，觉得有什么不足，又觉得有什么太多了。煽动的和风，暖暾的将伊的气力吹得弥漫在宇宙里。pt网站怎么注册 伊一揉一一一揉一自己的眼睛。
地上都嫩绿了，便是不很换叶的松柏也显得格外的娇一嫩。
桃红和青白色*的斗大的杂花，在眼前还分明，到远处可就成为斑斓的烟霭了。 “唉唉，我从来没有这样的无聊过！”伊想着，猛然间站立起来了，擎上那非常圆满而精力洋溢的臂膊，向天打一个欠伸，天空便突然失了色*，化为神异的肉红，暂时再也辨不出伊所在的处所。 伊在这肉红色*的天地间走到海边，全身的曲线都消融在淡玫瑰似的光海里，直到身中央才浓成一段纯白。波涛都惊异，起伏得很有秩序了，然而浪花溅在伊身上。这纯白的影子在海水里动摇，仿 佛全体都正在四面八方的迸散。但伊自己并没有见，只是不由的跪下一足，伸手掬起带水的软泥来，同时又一揉一捏几回，便有一个和女娲（2）忽然醒来了。 伊（3）似乎是从梦中惊醒的，然而已经记不清做了什么梦；只是很懊恼，觉得有什么不足，又觉得有什么太多了。煽动的和风，暖暾的将伊的气力吹得弥漫在宇宙里。pt网站怎么注册 伊一揉一一一揉一自己的眼睛。
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hernia
Signs and Symptoms
- A lump disappears, reappears, and enlarges on
straining and discomfort.
Physical Signs:
Reduced. + ve cough impulse.
Investigation:
internal oblique on lateral one third
Posterior:
fascia transversalis conjoint tendonon in medial one
third
Roof:
arching fibers of internal oblique ,and
reducible hernia imparts an expansile impulse on coughing.
2. Irreducible This one whose contents cannot be returned to the peritoneal cavity either because there are: adhesions between the sac and contents, or because of the narrow neck of the sac.
1. The sac 2. The covering of
the sac 3. The content of the
sac
Composition of a hernia
1. The sac :
It is a diverticulum of peritoneum and is made up of three parts :
On examination: Palpable defect or swelling may be present . Indirect Hernia usually bulge at Internal Inguinal Ring. Direct Hernia usually bulge at External Inguinal Ring.
to the inferior epigastric artery.
2. Content:
• Direct: Retroperitoneal fat. less commonly, peritoneal sac
containing bowel .
• Indirect: Sac of peritoneum coming through internal ring,
3. Contents:
can be Omentum = omentocle Intestine = enterocele Portion of circumference of intestine = Richter’s hernia Portion of the bladder Ovary(with or without oviduct) Meckel’s diverteculum =Littre’s hernia
through which omentum or bowel can enter.
3. Etiology:
The mouth, The neck and The body of the
sac.
Composition of a hernia
2. The covering:
Coverings are derived from the layers of abdominal wall through which the sac pass
Etiology
Hernias occur at sites of weakness in the wall This weakness may be :
Normal (physiological) weakness, related to the anatomical causes.
Congenital abnormality. Acquired :
• Traumatic • Diseases
Varieties
A hernia at any site may be:
1. Reducible This is the one which the contents of the sac reduced
spontaneously or can be pushed back manually. A
• autonomic nerves, • processus vaginalis.
• Ilio inguinal nerve
Female:
Round ligament of the uterus, genital branch of genitofemoral nerve, lymphatics, sympathetic plexus.
1. Origin and coarse:
• Direct: Develops in the area of Hasselbach's triangle. The
origin is medially to the inferior epigastric vessels.
• Indirect: Develops at the internal ring. The origin is lateral
Classification
A. External hernia B. Internal hernia
Classification continue…
A. External hernia
Common hernia
inguinal Femoral Umbilical incisional
Inguinal hernia
Risk factors:
( increases intra-abdominal pressure )
Chronic cough. Constipation. Pregnancy. Straining at micturation. Severe muscular effort (lifting heavy
Varieties
Irreducible hernia can be :
1. Incarcerated: there are adhesions between the sac and the contents, but there is no obstruction or interference with blood supply. the hernia simply will not reduce
2. Obstructed: a hollow viscus is trapped within the sac and obstruction occurs. The blood supply remains intact. This is a common cause of small bowel obstruction.
HERNIAS
Dr David Swar General Surgery Qilu Hospital Shandong University
Definition
A hernia is the protrusion of an organ through its containing wall.
Composition of a hernia
transversus abdominis
Floor (inferior):
inguinal ligament, and lacunar ligamen at the medial
end
Inguinal hernia
Inguinal Canal Contents:
Male:
Spermatic cord structures:源自Inguinal hernia
Signs & symptoms:
Bulge that enlarges when stand or strain, but often asymptomatic.
In general direct hernias produce fewer symptoms than indirect hernias and are less likely to complicate.
• vas deferens,
• testicular artery
• testicular veins (pampiniform plexus),
• genital branch of genitofemoral nerve,
• artery of the vas deference,
• lymphatics,
Inguinal hernia
Epidemiology:
Male : Female
• by 9 to 1 ratio
young adults mostly have indirect inguinal hernia.
As age of patient increases, the incidence of direct hernias increases .
Strangulated: the arterial blood supply to the contents of .3 the sac is compromised, in such a hernia unless surgical relief is undertaken the contents of the sac will become gangrenous.
Inguinal hernia
There are two types of inguinal hernia:
Signs and Symptoms
- A lump disappears, reappears, and enlarges on
straining and discomfort.
Physical Signs:
Reduced. + ve cough impulse.
Investigation:
internal oblique on lateral one third
Posterior:
fascia transversalis conjoint tendonon in medial one
third
Roof:
arching fibers of internal oblique ,and
reducible hernia imparts an expansile impulse on coughing.
2. Irreducible This one whose contents cannot be returned to the peritoneal cavity either because there are: adhesions between the sac and contents, or because of the narrow neck of the sac.
1. The sac 2. The covering of
the sac 3. The content of the
sac
Composition of a hernia
1. The sac :
It is a diverticulum of peritoneum and is made up of three parts :
On examination: Palpable defect or swelling may be present . Indirect Hernia usually bulge at Internal Inguinal Ring. Direct Hernia usually bulge at External Inguinal Ring.
to the inferior epigastric artery.
2. Content:
• Direct: Retroperitoneal fat. less commonly, peritoneal sac
containing bowel .
• Indirect: Sac of peritoneum coming through internal ring,
3. Contents:
can be Omentum = omentocle Intestine = enterocele Portion of circumference of intestine = Richter’s hernia Portion of the bladder Ovary(with or without oviduct) Meckel’s diverteculum =Littre’s hernia
through which omentum or bowel can enter.
3. Etiology:
The mouth, The neck and The body of the
sac.
Composition of a hernia
2. The covering:
Coverings are derived from the layers of abdominal wall through which the sac pass
Etiology
Hernias occur at sites of weakness in the wall This weakness may be :
Normal (physiological) weakness, related to the anatomical causes.
Congenital abnormality. Acquired :
• Traumatic • Diseases
Varieties
A hernia at any site may be:
1. Reducible This is the one which the contents of the sac reduced
spontaneously or can be pushed back manually. A
• autonomic nerves, • processus vaginalis.
• Ilio inguinal nerve
Female:
Round ligament of the uterus, genital branch of genitofemoral nerve, lymphatics, sympathetic plexus.
1. Origin and coarse:
• Direct: Develops in the area of Hasselbach's triangle. The
origin is medially to the inferior epigastric vessels.
• Indirect: Develops at the internal ring. The origin is lateral
Classification
A. External hernia B. Internal hernia
Classification continue…
A. External hernia
Common hernia
inguinal Femoral Umbilical incisional
Inguinal hernia
Risk factors:
( increases intra-abdominal pressure )
Chronic cough. Constipation. Pregnancy. Straining at micturation. Severe muscular effort (lifting heavy
Varieties
Irreducible hernia can be :
1. Incarcerated: there are adhesions between the sac and the contents, but there is no obstruction or interference with blood supply. the hernia simply will not reduce
2. Obstructed: a hollow viscus is trapped within the sac and obstruction occurs. The blood supply remains intact. This is a common cause of small bowel obstruction.
HERNIAS
Dr David Swar General Surgery Qilu Hospital Shandong University
Definition
A hernia is the protrusion of an organ through its containing wall.
Composition of a hernia
transversus abdominis
Floor (inferior):
inguinal ligament, and lacunar ligamen at the medial
end
Inguinal hernia
Inguinal Canal Contents:
Male:
Spermatic cord structures:源自Inguinal hernia
Signs & symptoms:
Bulge that enlarges when stand or strain, but often asymptomatic.
In general direct hernias produce fewer symptoms than indirect hernias and are less likely to complicate.
• vas deferens,
• testicular artery
• testicular veins (pampiniform plexus),
• genital branch of genitofemoral nerve,
• artery of the vas deference,
• lymphatics,
Inguinal hernia
Epidemiology:
Male : Female
• by 9 to 1 ratio
young adults mostly have indirect inguinal hernia.
As age of patient increases, the incidence of direct hernias increases .
Strangulated: the arterial blood supply to the contents of .3 the sac is compromised, in such a hernia unless surgical relief is undertaken the contents of the sac will become gangrenous.
Inguinal hernia
There are two types of inguinal hernia: