胸腔及其脏器.ppt

January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,胸腔及其脏器,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,起始：分三部胸骨部：起自剑突后面肋部：起自下6对肋骨和肋软骨的内面腰部：以左、右膈脚起自上23个腰椎。止点：中心腱薄弱区：胸肋三角腰肋三角,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,膈上有三个裂孔：,腔静脉裂孔食管裂孔主动脉裂孔,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,三个裂孔通过的结构：,腔静脉裂孔通过：下腔静脉、食管裂孔通过：食管和迷走神经主动脉裂孔通过：主动脉和胸导管,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,三、胸膜和胸膜腔,胸膜的概念胸膜为一层薄而光滑的浆膜，分二层：,脏胸膜,壁胸膜,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,脏胸膜和壁胸膜在肺根处互相移行，移行处在肺根下方二层胸膜重叠形成肺韧带。,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,胸膜腔:,概念:为脏、壁二层胸膜之间的潜在性腔隙，左、右各一，内有少量浆液，可减少摩擦。(注意与胸腔的概念区别),January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,胸膜隐窝：,为壁胸膜各部相互反折处所形成的胸膜腔，主要是肋膈隐窝。,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,脏胸膜,壁胸膜,胸膜腔,胸膜顶,肋胸膜,膈胸膜,肋膈隐窝,纵隔胸膜,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,胸膜反折线的体表投影,前界:胸腺区心包区临床上左剑肋角是进行心包穿刺术的安全区。,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,胸腺三角和心包三角,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,心包（抽液）穿刺术,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,胸膜下界的体表投影,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,胸膜下界的体表投影,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,1.位置胸腔内，纵隔两侧。右肺较宽短，左肺较细长。2.形态,四、肺lungs,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,左肺被斜裂分为上、下二叶。右肺被斜裂和水平裂分为上、中、下三叶。,2.肺的分叶,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,肺门：肺的内侧面中央凹陷的长椭圆形区域。,3.肺门及肺根,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,肺根,出入肺门的血管、神经、淋巴管、支气管等结构被结缔组织包裹构成肺根。其主要结构为肺动脉、肺静脉、支气管。,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,肺门和肺根,RightLung,LeftLung,V.A.B.,V.A.B.,B,V,A,B,V,A,前后:,前后:,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,肺门和肺根,RightLung,LeftLung,上下：B.A.V.B.,上下：A.B.V.,V,B,A,B,A,V,B,*,*,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,从前到后，左右肺都为：肺静脉肺动脉支气管,肺根结构的排列,从上到下：左肺为:肺动脉支气管肺静脉右肺为：支气管肺动脉肺静脉,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,肺段支气管：为气管的第三级分支。每一肺段支气管及其所属的肺组织为一个肺段。每个肺有10条肺段支气管。每个肺段略呈圆锥形，尖向肺门。,4肺段支气管和支气管肺段,January,2007,CopyrightDepart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG,Thesegmentsofthelungs,RSuperiorlobeApicalPosteriorAnteriorMiddlelobeLateralMedialInteriorlobeSuperiorMedialbasalAnteriorbasalLateralbasalPosteriorbasal,LSuperiorlobeApicoposteriorAnteriorSuperiorlingularInferiorlingularinferiorlobeSuper