局部解剖学课件重点总结

局部解剖学课件重点总结 07 级临七 2 班 肖萧同学 小小兔友情制作1 脊柱区脊柱区 Muscles of Back Superficial group Trapezius 斜方肌 Latissimus dorsi 背阔肌 Levator scapulae 肩胛提肌 Rhomboideus 菱形肌 Deep group Splenius 夹肌 Erector spinae 竖脊肌 Triangle of auscultation 听诊三角听诊三角 肩胛旁三角肩胛旁三角 Boundaries Latissimus dorsi Trapezius The medial border of the scapula Inferior lumbar triangle 腰下三角腰下三角 Boundaries Lower part of the lateral margin of latissimus dorsi Posterior free border of the obliquus externus abdominis Iliac crest Superior lumbar triangle 腰上三角腰上三角 Boundaries Serratus posterior inferior Erector spinae Obliquus internus abdomins 上肢上肢 Cephalic vein 头静脉头静脉 Arises from the lateral side of the dorsal venous rete on the back of hand Winds around the lateral border of the forearm it then ascends into the cubital fossa and up the front of the arm on the lateral side of the biceps It continues up in the deltopectoral groove and then to the infraclavicular fossa where it pierces clavipectoral fascia to drain into axillary vein Basilic vein 贵要静脉贵要静脉 Arises from the medial side of the dorsal venous rete of hand Winds around the medial border of the forearm Then ascends into the cubital fossa and up the front of the arm on the medial side of the biceps to middle of the arm where it pierces the deep fascia and joins the brachial vein or axillary vein Median cubital vein 肘正中静脉肘正中静脉 Links cephalic vein and basilic vein in the cubital fossa It is a frequent site for venipuncture to remove a sample of blood or add fluid to the blood Axillary fossa 腋窝腋窝 Boundaries Apex Middle 1 3 of clavicle Lateral border of first rib Upper border of the scapula Base Skin Superficial fascia Axillary fascia 腋筋膜 cribriform fascia 筛状筋膜 The medial wall Serratus anterior Upper four ribs and intercostal spaces The lateral wall Intertubercular groove Long head and short head of biceps brachii Coracobrachialis The anterior wall Pectoralis major Pectoralis minor Subclavius Clavipectoral fascia 锁胸筋膜锁胸筋膜 The posterior wall Subscapularis 局部解剖学课件重点总结 07 级临七 2 班 肖萧同学 小小兔友情制作2 Teres major Latissimus dorsi Scapula Contents Axillary a and principal branches Axillary v and tributaries Brachial plexus and branches Axillary lymph nodes Loose connective tissue Trilateral foramen 三边孔三边孔 trilateral space 三边隙三边隙 Boundaries Superior teres minor subscapularis lateral border of scapula articular capsule of shoulder joint Inferior teres major Lateral long head of triceps brachii Structures pass through the trilateral foramen Circumflex scapular a and v Quadrilateral foramen 四边孔四边孔 quadrilateral space 四边隙四边隙 Boundaries Superior teres minor subscapularis articular capsule of shoulder joint Inferior teres major Medial long head of triceps brachii Lateral surgical neck of humerus Structures pass through the quadrilateral foramen Axillary n Posterior humeral circumflex a and v Axillary artery Begins at the at lateral border of first rib as a continuation of subclavian artery At the lower border of teres major it becomes the brachial artery Divided into three parts by overlying pectoralis minor Branches First part superior thoracic a thoracoacromial a Second part lateral thoracic a Third part subscapular a throcodorsal a circumflex scapular a anterior humeral circumflex a posterior humeral circumflex a Brachial artery 肱动脉肱动脉 Begins at the lower border of the teres major as a continuation of axillary artery Terminates opposite the neck of radius by dividing into radial and ulnar arteries Branches Deep brachial a 肱深动脉肱深动脉 Follows the radial nerve into the spinal groove of the humerus Superior ulnar collaeral a 尺侧上副动脉尺侧上副动脉 follows the ulnar nerve Inferior ulnar collateral a 尺尺 侧下副动脉侧下副动脉 Takes part in the anastomosis around the elbow joint Median nerve 正中神经正中神经 Origin Arises from the medial and lateral cord of the brachial plexus Course Descends on the lateral side of brachial artery Halfway down the arm it crosses the brachial artery to 局部解剖学课件重点总结 07 级临七 2 班 肖萧同学 小小兔友情制作3 reach its medial side Humeromuscular tunnel 肱骨肌管肱骨肌管 Composition Formed by triceps brachii 肱三头肌肱三头肌 and groove for radial nerve of humerus 肱骨桡神经沟肱骨桡神经沟 Structures passing through the tunnel Radial nerve 桡神经桡神经 Deep brachial a and v 肱深动静脉肱深动静脉 Radial collateral a 桡侧副 动脉 Middle collateral a 中副动 脉 Cubital fossa 肘窝肘窝 Boundaries Laterally brachioradialis 肱桡肌肱桡肌 Medially pronator teres 旋前圆肌旋前圆肌 Roof skin superficial facia deep fascia and aponeurosis of biceps Floor brachialis 肱肌肱肌 supinator 旋旋 后肌后肌 and capsule of elbow joint 肘肘 关节囊关节囊 Contents biceps brachii tendon 肱二头肌腱 Medial to biceps brachii tendon Brachial a 肱动脉 divides into radial and ulnar a usually at apex of fossa Brachial v 肱静脉 Median n 正中神经 Lateral to the biceps brachii tendon Radial n 桡神经 Lateral antebrachial cutaneous n 前 臂外侧皮神经 Deep cubital lymph nodes Carpal canal 腕管腕管 Composition Formed by flexor retinaculum 屈肌支持带屈肌支持带 and carpal groove 腕骨沟腕骨沟 Structures passing through the carpal tunnel Median n 正中神经正中神经 Tendons of flexor digitorum superficialis 指浅屈肌指浅屈肌 and flexor digitorum profundus 指深屈肌指深屈肌 enclosed by common flexor synovial sheath 屈肌总腱鞘屈肌总腱鞘 Tendon of flexor pollicis longus 拇长屈肌拇长屈肌 enclosed by synovial sheath for flexor pollicis longus 拇长屈肌腱拇长屈肌腱 鞘鞘 Superficial palmar arch 掌浅弓掌浅弓 Formed by ulnar artery and superficial palmar branch of radial artery The curve of arch lies across the palm level with the distal border of fully extended thumb Gives rise to three common palmar digital arteries 指掌侧总动脉 each then divides into two proper palmar digital arteries 指掌 侧固有动脉 and one ulnar palmar artery of quinary finger 小指尺掌侧动脉 Deep palmar arch 掌深弓掌深弓 Formed by radial artery and deep palmar branch of ulnar artery The curve of arch lies across upper part of palmar at level with proximal border of extended thumb Gives rise to three palmar metacarpal arteries 掌心动脉掌心动脉 to joint the distal ends of the corresponding common palmar digital arteries Median n 正中神经正中神经 Muscular branches supply thenar except adductor pollicis first two lumbricales Cutaneus branches supply skin of thenar central part of palm palmar aspect of radial three and one half fingers including middle and distal fingers on dorsum Recurrent branch of the median nerve 正中神经返支 lies deep to the skin and deep fascia overlying the anterior margin of the thenar near the midline of the palm 局部解剖学课件重点总结 07 级临七 2 班 肖萧同学 小小兔友情制作4 Ulnar n 尺神经尺神经 Muscular branches supply hypothenar muscles interossei 3rd and 4th lumbricales and adductor pollicis Cutaneus branches supply skin of hypothenar palmar surface of ulnar one and one half fingers ulnar half of dorsum of hand posterior aspect of ulnar two and one half fingers 下肢下肢 Landmarks of lower limb Gluteal region and thigh anterior superior iliac spines anterior inferior iliac spines 髂前下棘髂前下棘 tubercle of iliac crest 髂结节髂结节 ischial tuberosity 坐骨结节坐骨结节 greater trochanter 大转子大转子 pubic tubercle 耻骨结节耻骨结节 pubic crest 耻骨嵴耻骨嵴 superior border of pubic symphysis Knee patella ligament 髌韧带髌韧带 tuberosity of tibia 胫骨粗隆胫骨粗隆 medial and lateral condyles 内外侧内外侧 髁髁 medial and lateral epicondyles 内 内 外上髁外上髁 tendon of biceps femoris 股二头肌股二头肌 腱腱 tendons of semitendinosus and semimembranosus 半腱 半膜肌腱半腱 半膜肌腱 Leg anterior border of tibia 胫骨前缘胫骨前缘 head of fibula 腓骨头腓骨头 neck of fibula 腓骨颈腓骨颈 Ankle and foot medial and lateral malleolus 内 内 外侧踝外侧踝 calcaneal tuberosity 跟骨结节跟骨结节 tuberosity of navicular bone 舟骨粗舟骨粗 隆隆 tuberosity of fifth metatarsal bone 第五跖骨粗隆第五跖骨粗隆 Superficial veins Great saphenous vein 大隐静脉大隐静脉 Drains the medial end of dorsal venous arch of foot and passes upward directly in front of the medial malleolus Then ascends in company with the saphenous n in the superficial fascia over the medial side of the leg Small saphenous v 小隐静脉小隐静脉 Arises from the lateral part of the dorsal venous arch of foot Ascends behind lateral malleolus and then runs up the midline of the back of the leg Pierces the deep fascia and enters the popliteal v Drains the lateral side of the foot and ankle and the back of the leg Structures passing through suprapiriform foramen from lateral to medial side Superior gluteal n 臀上神经 Superior gluteal a 臀上动脉 Superior gluteal v 臀上静脉 Structures passing through infrapiriform foramen from lateral to medial side Sciatic n 坐骨神经 Posterior femoral cutaneous n 股后 皮神经 Inferior gluteal n 臀下神经 Inferior gluteal a v 臀下动 静脉 Internal pudendal v a 阴部内动 静脉 Pudendal n 阴部神经 Structures passing through small sciatic foramen from lateral to medial side Internal pudendal v a 阴部内动 静脉 Pudendal n 阴部神经 Superficial inguinal lymph nodes 局部解剖学课件重点总结 07 级临七 2 班 肖萧同学 小小兔友情制作5 Superior group Lies just distal to the inguinal ligament Receive lymph vessels from anterior abdominal wall below umbilicus gluteal region perineal region external genital organs Inferior group Lies vertical along the terminal great saphenous v Receives all superficial lymph vessels of lower limb except for those from the posterolateral part of calf Efferent vessels drain into the deep inguinal ln or external iliac ln Fascia lata 阔筋膜阔筋膜 Iliotibial tract 髂胫束髂胫束 laterally the deep fascia forms a thick band from the iliac tubercle to the lateral condyle of tibial Saphenous hiatus 隐静脉裂孔隐静脉裂孔 A gap in the deep fasica which lies about 4 cm below and lateral to the pubic tubercle The falciform margin 镰状缘镰状缘 is the lower lateral border of the opening which lies anterior to the femoral vessels Filled with loose connective tissue called the cribriform fascia 筛筋膜筛筋膜 Lacuna musculorum 肌腔隙肌腔隙 Boundaries Anteriorly lateral portion of inguinal ligament Posterolaterally ilium Medially iliopectinal arch Contents Iliopsoas 髂腰肌 femoral n 股神经 lateral femoral cutaneous n 股外侧皮神经 Lacuna vasorum 血管腔隙血管腔隙 Boundaries Anteriorly medial portion of inguinal ligament Posteriorly fascia of pecteineus and pectineal ligament Medially lacuna ligament Laterally iliopectinal arch Contents Femoral sheath 股鞘 Femoral a and v 股动 静 脉 Femoral branch of genitofemoral n 生殖股神 经股支 Lymphatic vessels Femoral triangle 股三角股三角 Boundaries Superiorly base inguinal ligament 腹股沟韧带 Laterally medial border of sartorius 缝匠肌内侧缘 Medially medial border of adductor longus 长收肌 内侧缘 Apex continuous with adductor canal 收肌管 Anterior wall fascia lata 阔 筋膜 Posterior wall consists of iliopsoas 髂腰肌 pectineus 耻骨肌 and adductor longus 长收肌 from lateral to medial side Contents from lateral to medial Femoral n 股神经 Femoral sheath 股鞘 Femoral a 股动脉 Femoral v 股静脉 Femoral canal 股管 Deep inguinal 局部解剖学课件重点总结 07 级临七 2 班 肖萧同学 小小兔友情制作6 lymph nodes 腹股 沟深淋巴结 Fatty tissue 脂肪组 织 Femoral canal 股管股管 Femoral ring 股环 Anteriorly inguinal ligament Medially lacuna lig 腔隙 韧带 Posteriorly pecteneal lig 耻骨梳韧带 Laterally femoral v 股静 脉 Superior covered by femoral septum 股环隔 Adductor canal 收肌管收肌管 Boundies Anterior wall adductor lamina 大收肌腱板大收肌腱板 and sartorius 缝匠肌缝匠肌 Lateral wall vastus medialis 股内侧肌股内侧肌 Posteomedial wall adductor longus 长收肌长收肌 and adductor magmus 大收肌大收肌 Contents Saphenous n 隐神经隐神经 Femoral a and femoral v 股动 静脉股动 静脉 lymphatic vessels and loose connective tissue Sciatic nerve 坐骨神经坐骨神经 Course Arises from the sacral plexus Leaves pelvis through infrapiriform foramen to enter gluteal region Runs inferiorly laterally deep to gluteus maximus Passing midway between the greater trochanter of femur and ischial tuberosity to back of thigh Lying deep to long head of biceps femoris Normally divided into tibial and common peroneal nerves just above popliteal fossa Innervates Semitendinosus 半腱肌半腱肌 Semimembranosus 半膜肌半膜肌 Biceps femoris 股二头肌股二头肌 Hip and knee joints 髋关节和膝关髋关节和膝关 节节 Popliteal fossa Boundaries Superolaterally Biceps femoris 股股 二头肌二头肌 Superomedially semitendinosus and semimembranosus 半腱肌和半半腱肌和半 膜肌膜肌 Inferiorly lateral and medial heads of gastrocnemius 腓肠肌内 外侧腓肠肌内 外侧 头头 Roof deep fascia Floor popliteal surface of the femur posterior capsule of the knee joint fascia covering popliteus Contents Nerves Tibial nerve 胫神经胫神经 Common peroneal nerve 腓腓 总神经总神经 Popliteal vein and its tributaries 腘静脉及属支腘静脉及属支 Popliteal artery and its branches 腘动脉及分支腘动脉及分支 Popliteal lymph nodes 腘淋巴结腘淋巴结 Malleolar canal 踝管踝管 Boundaries Formed by medial surface of calcaneus flexor retinaculum and medial malleolus Structures passing through the malleolar canal Tibialis posterior 胫骨后肌 Flexor digitirum longus 趾长屈肌 局部解剖学课件重点总结 07 级临七 2 班 肖萧同学 小小兔友情制作7 Posterior tibial a v and n 胫后动脉 静脉 Tibial n 胫神经 Flexor hallucis longus 长屈肌 头部头部 眉弓 superciliary arch 眶上切迹 supraorbital notch 眶下孔 infraorbital foramen 颏孔 mental foramen 翼点 pterion 颧弓 zygomatic arch 耳屏 tragus 髁突 condylar process 乳突 mastoid process 前囟点 bregma 人字点 lambda 枕外隆突 external occipital protuberance Parotid duct 腮腺管腮腺管 Arises front anterior border of gland Lies 1 5 cm below and parallel to zygomatic arch Passes forward over masseter pierces the buccinator and oral mucosa to open opposite second upper molar tooth Structures vertical passing through the parotid gland External carotid a 颈外动脉 Superficial temporal a 颞浅动脉 Superficial temporal v 颞浅静脉 Retromandibular vein 下颌后静脉 Auriculotemporal n 耳颞神经 Structures transversal passing through the parotid gland Maxillary a extends from base of skull downward into the superior mediastinum continuous with anterior longitudinal lig and endothoracic fascia Covers subclavian vessels and roots of brachial plexus Extends into upper limb as axillary sheath Carotid triangle 颈动脉三角颈动脉三角 Boundaries Anterior border of sternocleidomastoid Superior belly of omohyoid Posterior belly of digastic Covered by skin superficial fascia platysma and investing fascia Deep prevertebral fascia Medial lateral wall of pharynx Contents Common carotid a and its branches Internal jugular v and its tributaries Hypoglossal n with its descending branches 局部解剖学课件重点总结 07 级临七 2 班 肖萧同学 小小兔友情制作9 Vagus nerve Accessory nerve Deep cervical lymph nodes Muscular triangle 肌三角肌三角 Bounded by midline of the neck superior belly of the omohyoid and anterior border of the sternocleidomastoid Covered by skin superficial fascia platysma anterior jugular v and investing fascia Deep prevertebral fascia Thyroid gland 甲状腺甲状腺 Shape and position H shape Left and right lobes lie on either side of inferior part of larynx and superior part of trachea extend from middle of thyroid cartilage to level of sixth trachea cartilage Isthmus overlies 2nd to 4th tracheal cartilage Pyramidal lobe some times arises from isthmus Coverings of the thyroid gland False capsule a sheath of pretracheal fascia which is attached to arch of cricoid and thyroid cartilages to form the suspensory ligament of thyroid gland hence the thyroid gland moves with larynx during swallowing and oscillates during speaking True capsule fibrous capsule Space between sheath and capsule of thyroid gland there are loose connective tissue vessels nerves and parathyroid glands Relations of the thyroid gland Anteriorly Skin superficial fascia investing fascia Infrahyoid muscles and pretracheal fascia Posteromedially Larynx and trachea Pharynx and esophagus Recurrent laryngeal nerve Posterolaterally Carotid sheath with common carotid a internal jugular v and vagus n Cervical sympathetic trunk Arteries of the thyroid gland Superior thyroid a 甲状腺上动脉 Branch of external carotid a Runs superficial and parallel to the external branch of superior laryngeal n to reach the upper pole of thyroid gland Gives off superior laryngeal a in company with internal branch of superior laryngeal n Inferior thyroid artery 甲状腺下动脉 Branch of thyrocervical trunk of subclavian a Turns medially and downward reaches the posterior border of the thyroid gland where it is closely related to the recurrent laryngeal n Supplies inferior pole of thyroid gland Arteria thyroidea ima 甲状腺最下动脉 May arise 4 from the brachiocephalic a or aortic arch Superior laryngeal n 喉上神经喉上神经 Internal branch 内支 which pierces thyrohyoid membrane to innervates mucous membrane of larynx above fissure of glottis External branch 外支 is fine n which descends in company with the superior thyroid a and supplies cricothyroid Recurrent laryngeal nerves 喉返神经喉返神经 Ascend in tracheo esophageal groove Pass deep to the lobe of the thyroid gland and come into close relationship with the inferior thyroid a Cross either in front of or behind the artery Nerves enter larynx posterior to cricothyroid joint the nerve is now called inferior laryngeal nerve 喉下神经 Innervations laryngeal mucosa below fissure of glottis all laryngeal laryngeal muscles 局部解剖学课件重点总结 07 级临七 2 班 肖萧同学 小小兔友情制作10 except cricothyroid Relationship of arteries to the laryngeal nerves The superior thyroid a is closely related near its origin to the superior laryngeal n Section of the nerve would anaesthetise the laryngeal mucosa and abolish the cough reflex so increasing the risk of food or a foreign body entering the trachea The inferior thyroid a is closely related to the recurrent laryngeal n as it enters the gland Section of the nerve would result in paralysis of muscles that move the vocal cords on that side Parathyroid gland 甲状旁腺甲状旁腺 Position Two superior parathyroid glands lie at junction of superior and middle third of posterior border of thyroid gland Two inferior parathyroid glands lie near the inferior thyroid artery close to the inferior poles of thyroid gland Relations of cervical part of trachea Anteriorly Skin Superficial fascia Investing fascia Suprasternal space and jugular arch Infrahyoid muscles and pretracheal fascia Isthmus of thyroid gland in front of the 2nd to 4th tracheal cartilage Inferior thyroid v and unpaired thyroid venous plexus Arteria thyroid ima if present Thymus left brachiocephalic v and aortic arch in child Superolaterally lobes of the thyroid gland down as far as the sixth ring Posteriorly Esophagus R on the anterior median line its lower border crosses a point about 3 5cm below the xiphoid process In children the liver being larger in proportion to the body than in the adult stage it extends below the costal arch within in 2 cm Relationships Diaphragmatic surface Separated by diaphragm from the following Right costodiaphramatic recess and lung Diaphragmatic surface of heart Visceral surface Left lobe is related to the stomach and abdomi