眼科学基础-(双语)ppt课件

02.05.2020,.,1,第一章眼科学基础ChapteroneBasicophthalmology,02.05.2020,.,2,第一节眼的组织解剖Anatomyofeyeball,02.05.2020,.,3,眼球：眼球壁、眼球内容物,02.05.2020,.,4,一眼球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,02.05.2020,.,5,（一）眼球壁Eyecoat,1.外层Theoutercoat1/6角膜Cornea5/6巩膜Sclera,02.05.2020,.,6,（1）角膜Cornea,横径Thetransversediameter11.5-12mm垂直径Theverticaldiameter10.5-11mm,02.05.2020,.,7,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,02.05.2020,.,8,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,02.05.2020,.,9,02.05.2020,.,10,02.05.2020,.,11,(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,02.05.2020,.,12,角巩膜缘Limbus,角膜前弹力层止端与后弹力层止端的平面，宽1.5-2.0mm角膜和巩膜的移行区前房角、房水引流系统所在地许多内眼手术切口的标志,02.05.2020,.,13,02.05.2020,.,14,前房角Anteriorchamberangle,周边角膜与虹膜根部的连接处前房角内结构：Schwalbe线小梁网和Schlemm管巩膜突睫状带虹膜根部,02.05.2020,.,15,02.05.2020,.,16,2中层Themiddlecoat,葡萄膜Uvea色素膜Tunicapigmentosa,02.05.2020,.,17,（1）虹膜Iris,分层：基质层Stroma色素上皮层Pigmentepitheliallayer瞳孔Pupil:直径2.5-4mm,02.05.2020,.,18,02.05.2020,.,19,02.05.2020,.,20,(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:,02.05.2020,.,21,(3)脉络膜Choroid,组成大血管层Largevascularlayer中血管层Middlevascularlayer毛细血管层Capillarylayer,02.05.2020,.,22,3内层Innerlayer视网膜Retina,02.05.2020,.,23,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,02.05.2020,.,24,02.05.2020,.,25,02.05.2020,.,26,视网膜分层,外层视网膜色素上皮层Retinalpigmentepithelium,RPE,02.05.2020,.,27,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ExternallimitingmembraneOLM外核层OuternuclearlayerONL外丛状层OuterplaxiformOPL内核层InnernuclearlayerINL内丛状层InnerplexiformlayerIPL神经节细胞层GanglioncelllayerGCL神经纤维层NervefiberlayerNFL内界膜LimitingmembraneILM,02.05.2020,.,28,02.05.2020,.,29,（二）眼球内容Contentsoftheeye,房水晶状体玻璃体,02.05.2020,.,30,02.05.2020,.,31,1.房水Aqueoushumor透明液体总量占眼容积4%前房0.2ml后房0.06ml,02.05.2020,.,32,前房Anteriorchamber角膜后面、虹膜、瞳孔区、晶状体前面中央深度：2.5-3mm后房Posteriorchamber虹膜后面、睫状体内侧、晶状体悬韧带前面、晶状体前侧面,02.05.2020,.,33,2.晶状体Lens,晶状体囊晶状体纤维（核、皮质）,02.05.2020,.,34,02.05.2020,.,35,3.玻璃体Vitreousbody,透明的胶质体占眼球的4/5、4.5ml,02.05.2020,.,36,02.05.2020,.,37,二、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,02.05.2020,.,38,（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,02.05.2020,.,39,02.05.2020,.,40,眼睑的血供动脉浅部动脉血管丛（颈外动脉的面动脉支）深部动脉血管丛（颈内动脉的眼动脉分支）静脉浅部静脉回流到颈内、颈外静脉深部静脉回流到海绵窦感觉三叉神经第1、2支,02.05.2020,.,41,(三)结膜Conjunctiva,1睑结膜Palpebralconjunctiva2穹窿结膜Fornicalconjunctiva3球结膜Bulbarconjunctiva,02.05.2020,.,42,02.05.2020,.,43,结膜内腺体杯状细胞：分泌粘液Krause腺：分泌浆液Wolfring腺：分泌浆液,02.05.2020,.,44,结膜血管眼睑动脉弓：睑结膜、穹窿结膜、角膜缘4mm外球结膜结膜充血睫状前动脉：角膜缘周围球结膜睫状充血结膜感觉第V脑神经,02.05.2020,.,45,(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,02.05.2020,.,46,02.05.2020,.,47,02.05.2020,.,48,(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,02.05.2020,.,49,02.05.2020,.,50,02.05.2020,.,51,三、视路Visualpathway,（一）视神经Opticnerve(1)眼内段Intraocular1mm(2)眶内段Intraorbital25-30mm(3)管内段Intracanalicular6-10mm(4)颅内段Intracranial10mm（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,02.05.2020,.,52,02.05.2020,.,53,四、眼部的血管和神经分布,02.05.2020,.,54,（一）眼球的血液循环Bloodcirculation动脉Artery视网膜中央血管系统thecentralretinalvascularsystem睫状血管系统theciliaryvascularsystem,02.05.2020,.,55,1.视网膜中央血管系统Thecentralretinalvascularsystem视网膜中央动脉Centralretinalartery,CRA,02.05.2020,.,56,2.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,02.05.2020,.,57,02.05.2020,.,58,眼部血管,1.颈内A眼A：视网膜中央A(CRV)：视网膜内层泪腺A：泪腺、外直肌睑外侧A（睑动脉弓）睫状后短A：脉络膜、视网膜外层睫状后长A：虹膜、睫状体、前部脉络膜肌A支：眼外肌睫状前A：虹膜睫状体、角膜缘血管、结膜前A眶上A：上睑、眉部皮肤鼻梁A：泪腺等,02.05.2020,.,59,2.颈外A：面A内呲A：内呲、泪囊、下睑内侧皮肤颞浅A：上下睑外侧皮肤、眼轮匝肌眶下A：下睑内侧、泪囊、下斜肌,02.05.2020,.,60,静脉Vein,1.视网膜中央静脉CentralretinalveinCRV2.涡静脉Vortexvein3.睫状前静脉Anteriorciliarvein,02.05.2020,.,61,眼球静脉1.视网膜中央静脉(centralretinalvein,CRV)眼上V海绵窦2.涡V(vortexvein)：脉络膜、部分虹膜睫状体上下V海绵窦3.睫状前V(anteriorciliaryvein):虹膜、睫状体眼上下V海绵窦面V、翼腭V丛颈外V,02.05.2020,.,62,（二）神经Nerve,神经第II脑神经（视N）视神经第III脑神经（动眼N）眼内肌、提上睑肌、眼外肌第IV脑神经（滑车N）上斜肌第V脑神经（三叉N）眼部感觉第VI脑神经（外展N）外直肌第VII脑神经（面N）眼轮匝肌,02.05.2020,.,63,1睫状神经节Ciliaryganglion2鼻睫状神经Nasociliarynerve,02.05.2020,.,64,睫状神经节(ciliaryganglion)长根：感觉根短根：运动根交感根：眼血管的舒缩鼻睫状神经(nasociliarynerve)：眼部感觉睫状长神经(longciliarynerve)：角膜感觉、睫状肌、瞳孔开大肌睫状短神经(shortciliarynerve)：虹膜睫状体、角膜、巩膜感觉、血管舒缩,02.05.2020,.,65,第二节眼生理生化及代谢,02.05.2020,.,66,泪膜,眼前表面的一层液体：眼球前泪膜、角膜前泪膜结构：表面脂质层睑板腺分泌中间水液层泪腺、副泪腺分泌底部粘蛋白层结膜杯状细胞分泌生理作用：润滑眼球表面、防止角结膜干燥、保持角膜光学特性、供给角膜氧气、抵御异物,02.05.2020,.,67,02.05.2020,.,68,角膜,结构排列规则透明性富含感觉神经感觉敏锐无血管营养来自房水、泪膜、角膜血管网,02.05.2020,.,69,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,02.05.2020,.,70,近反射,传入：与视路伴行至视皮质传出：枕叶-中脑束中脑E-W核、动眼神经的内直肌核随动眼神经到达瞳孔括约肌、睫状肌、内直肌,02.05.2020,.,71,瞳孔光反射(lightreflex),传入：视觉纤维伴行视交叉视束外侧膝状体前离开四叠体上丘臂中脑顶盖前区顶盖前核交换神经元E-W核（同、异侧）传出：动眼神经入眶睫状神经节交换神经元瞳孔括约肌,02.05.2020,.,72,房水循环途径,睫状体后房瞳孔前房角小梁网Schlemm管集