眼科学基础知识.ppt

2019/12/13,1,第一章眼科学基础ChapteroneBasicophthalmology,2019/12/13,2,第一节眼的组织解剖anatomyofeyeball一眼球Theglobe(eyeball)正常眼球的前后径出生时约16mm.3岁时达23mm.成年时24mm.anteriorandposteriordistanceofnormaleyeballis16mminborn.Atage323mm,atadult24mm,2019/12/13,3,（一）眼球壁Eyecoat,1.外层Theoutercoat1/6角膜Cornea5/6巩膜Sclera,2019/12/13,4,（1）角膜Cornea,横径Thetransversediameter11.5-12mm垂直径Theverticaldiameter10.5-11mm,2019/12/13,5,前表面曲率半径Theradiusofconvexcurvatureinfront7.8mm后表面曲率半径Theradiusofconvexcurvatureinback6.8mm角膜厚度中央部Thecentralthickness0.5-0.55mm角膜厚度周边部Theperipherythickness1mm,2019/12/13,6,组织学分层,上皮细胞层Epithelium前弹力层Bowmansmembrane基质层Stroma后弹力层Descemetsmembrane内皮细胞层Endothelium,2019/12/13,7,2019/12/13,8,(2)巩膜Sclera组织学分层,表层巩膜Theepisclera巩膜实质层Thescleralstroma棕黑板层Thelaminafascia,2019/12/13,9,角巩膜缘Limbus前房角Anteriorchamberangle,2019/12/13,10,2中层Themiddlecoat,葡萄膜Uvea色素膜Tunicapigmentosa,2019/12/13,11,（1）虹膜Iris,分层：基质层Stroma色素上皮层Pigmentepitheliallayer瞳孔Pupil:直径2.5-4mm,2019/12/13,12,(2)睫状体Ciliarybody,睫状冠Parsplicata:前1/3睫状突Cliaryprocesses:睫状体扁平部Parsplana:后2/3锯齿缘Oraserrata:,2019/12/13,13,(3)脉络膜Choroid,组成大血管层Largevascularlayer中血管层Middlevascularlayer毛细血管层Capillarylayer,2019/12/13,14,3内层Innerlayer视网膜Retina,中心凹Fovea黄斑Maculalutea中心小凹Foveola黄斑中心凹Foveacentralis视盘Opticdisc视乳头Opticpapilla视杯、杯凹Opticcup,2019/12/13,15,视网膜分层,外层视网膜色素上皮层Retinalpigmentepithelium,RPE,2019/12/13,16,内层视网膜神经感觉层,视锥、视杆细胞层（光感受器细胞层）Coneandrodlayer外界膜Externallimitingmembrane外核层Outernuclearlayer外丛状层Outerplaxiform内核层Innernuclearlayer内丛状层Innerplexiformlayer神经节细胞层Ganglioncelllayer神经纤维层Nervefiberlayer内界膜Limitingmembrane,2019/12/13,17,2019/12/13,18,（二）眼球内容Contentsoftheeye,1.房水Aqueoushumor前房Anteriorchamber后房Posteriorchamber,2019/12/13,19,2.晶状体Lens,2019/12/13,20,3.玻璃体Vitreousbody,2019/12/13,21,2019/12/13,22,1.视路Visualpathway,光感受器双级细胞神经节细胞视乳头视神经视交叉视束外侧膝状体视放射视皮质retinalphotoreceptorbipolarcellnervousganglioncellsopticdiskopticnerveopticchasmoptictractlateralgeniculatebodyopticradiationvisualcortex.,2019/12/13,23,可编辑,2019/12/13,24,二、眼眶及附属器Orbitandaccessoryapparatus,(一)眼眶Orbit1.视神经孔和视神经管Opticforamenandcanal2.眶上裂Superiororbitalfissure3.眶下裂Inferiororbitalfissure4.眶上切迹（或孔）Thesupraorbitalnotch,2019/12/13,25,（二）眼睑Eyelids,1皮肤层Theskin2皮下组织层Subcutaneous3肌层Muscularlayer4睑板层Layerofthetarsalplate5结膜层Theconjunctivallayer,2019/12/13,26,2019/12/13,27,(三)结膜Conjunctiva,1睑结膜Palpebralconjunctiva2球结膜Bulbarconjunctiva3穹窿结膜Fornicalconjunctiva,2019/12/13,28,2019/12/13,29,(四)泪器Lacrimalapparatus,1泪腺Lacrimalgland2泪道Lacrimalpassages(1)泪小点Lacrimalpuncta(2)泪小管Lacrimalcanaliculi(3)泪囊Lacrimalsac(4)鼻泪管Nasolacrimalduct,2019/12/13,30,2019/12/13,31,(五)眼外肌Extraocularmuscles,4条直肌Rectus上直肌superiorrectimuscles下直肌inferiorrectimuscles内直肌medialrectimuscles外直肌externalrectimuscles2条斜肌Obliquemuscle上斜肌superiorobliquemuscles下斜肌Inferiorobliquemuscles,2019/12/13,32,2019/12/13,33,三、视路Visualpathway,（一）视神经Opticnerve(1)眼内段Intraocular(2)眶内段Intraorbital(3)管内段Intracanalicular(4)颅内段Intracranial（二）视交叉Opticchiasm（三）视束Optictract（四）外侧膝状体Lateralgeniculatebody（五）视放射Opticradiation（六）视皮质Visualcortex,2019/12/13,34,2.瞳孔反射路Pathwayofpapillaryreflex,光反射Lightreflex直接光反射Directreflex间接光反射Indirectreflex近反射Nearreflex,2019/12/13,35,2019/12/13,36,四、眼球的血液循环和神经分布Bloodcirculationandinnervationoftheglobe,（一）血液循环Bloodcirculation动脉Artery视网膜中央血管系统thecentralretinalvascularsystem睫状血管系统theciliaryvascularsystem,2019/12/13,37,1.视网膜中央血管系统Thecentralretinalvascularsystem视网膜中央动脉Centralretinalartery,CRA,2019/12/13,38,2.睫状血管系统theciliaryvascularsystem,(1)睫状后短动脉Shortposteriorciliaryartery(2)睫状后长动脉Longposteriorciliaryartery(3)睫状前动脉Anteriorciliaryartery,2019/12/13,39,静脉Vein,1.视网膜中央静脉CentralretinalveinCRV2.涡静脉Vortexvein3.睫状前静脉Anteriorciliarvein,2019/12/13,40,（二）神经Nerve,1睫状神经节Ciliaryganglion2鼻睫状神经Nasociliarynerve,2019/12/13,41,视路及瞳孔反射Opticpathwayandpupillaryreflex,2019/12/13,42,1瞳孔反射路Pathwayofpupillaryreflex,光反射Lightreflex直接光反射directreflex间接光反射indirectreflex近反射Nearreflex,2019/12/13,43,2.视路Visualpathway,光感受器双级细胞神经节细胞视乳头