《运动解剖学》肌学.ppt

肌学Myology,第一部分头肌TheMusclesofHead,头肌包括面肌和咀嚼肌,1、颅顶肌额腹枕腹帽状腱膜2、眼轮匝肌3、口周围肌颊肌口轮匝肌,面肌Thefacialmuscles,咀嚼肌Themasticatorymuscles,1、咬肌2、颞肌3、翼内肌4、翼外肌,第二部分颈肌TheMusclesofNeck,颈肌可分为颈浅肌和颈外侧肌、颈前肌、颈深肌三群,颈浅肌thesuperficialgroup,颈阔肌Theplatysma,为一皮肌起自胸大肌和三角肌表面的筋膜，向上止于口角作用：拉口角向下，并使颈部皮肤出现皱褶,胸锁乳突肌Thesternocleidomastoid,起自胸骨柄前面和锁骨的胸骨端，止于颞骨的乳突作用：一侧肌收缩使头向同侧倾斜，脸转向对侧；两侧收缩可使头后仰,颈前肌theanteriorgroup,1.舌骨上肌群二腹肌下颌舌骨肌茎突舌骨肌颏舌骨肌,2.舌骨下肌群theinfrahyoidmuscles胸骨舌骨肌肩胛舌骨肌胸骨甲状肌甲状舌肌肌,颈深肌thedeepcervicalmuscles,1.外侧群lateralgroup前斜角肌scalenusanterior中斜角肌scalenusmedius后斜角肌scalenusposterior,斜角肌间隙Scalenefissure:前、中斜角肌与第1肋之间的空隙有锁骨下动脉和臂丛通过,2.内侧群medialgroup,第三部分躯干肌TheMusclesofTrunk,背肌胸肌膈腹肌,一、背肌TheMusclesofBack,1、斜方肌Trapezius位于项部和背上部浅层起自上项线、枕外隆凸、项韧带、第7颈椎和全部胸椎棘突止于锁骨的外侧1/3、肩峰、肩胛冈作用：使肩胛骨向脊柱靠拢，上部肌束可上提肩胛骨，下部肌束使肩胛骨下降。如果肩胛骨固定，一侧肌收缩使颈向内侧屈、脸转向对侧，两侧同时收缩可使头后仰。瘫痪：“塌肩”,（一）背浅肌,2、背阔肌Latissimusdorsi为全身最大的扁肌位于背的下半部及胸的后外侧起自下6个胸椎棘突、全部腰椎棘突、骶正中嵴及髂嵴后部止于肱骨小结节嵴作用：使肱肌内收、旋内和后伸,竖脊肌erectorspinae也称骶棘肌为背肌中最长、最大的肌起自骶骨背面和髂嵴后部，沿途止于椎骨和肋骨，向上可到达颞骨乳突作用：使脊柱后伸和仰头，一侧收缩使脊柱侧屈,3、肩胛提肌levatorscapulae位于项部两侧、斜方肌的深面起自第6、7颈椎横突止于肩胛骨上角作用：上提肩胛骨，并使肩胛骨下角转向内。,4、菱形肌rhomboideus位于斜方肌的深面起自第6、7颈椎和第1-4胸椎棘突止于肩胛骨的内侧缘作用：牵引肩胛骨向内上并向脊柱靠拢,位于脊柱两侧，分为长肌和短肌长肌位置表浅，主要有竖脊肌和夹肌短肌较多，有枕下肌、棘间肌、横突间肌、肋提肌等。,（一）背深肌,二、胸肌TheMusclesofThorax,（一）胸上肢肌,1、胸大肌起自锁骨内侧半、胸骨和第1-6肋软骨,止于肱骨大结节嵴.,作用：使肩关节内收、旋内和前屈adductsandmediallyrotatesarm,2、胸小肌起自第3-5肋骨止于肩胛骨的喙突。作用：拉肩胛骨向前下方,3、前锯肌Serratusanterior起自上8个或9个肋骨止于肩胛骨内侧缘和下角作用：拉肩胛骨向前和紧贴胸廓损伤：“翼状肩”,肋间外肌:助呼吸肋间内肌：参与呼气肋间最内肌胸横肌,（二）胸固有肌,三、膈Diaphragm,分部：胸骨部：起自剑突后面肋部：起自下6对肋骨和肋软骨腰部：以左、右两个膈脚起自上2-3个腰椎各部肌纤维向中央移行于中心腱,裂孔：主动脉裂孔T12有主动脉和胸导管通过食管裂孔T10有食管和迷走神经通过腔静脉孔T8有下腔静脉通过,胸肋三角腰肋三角腰疝,作用:膈为主要的呼吸肌，与腹肌同时收缩，则能增加腹压，协助排便、呕吐、咳嗽、喷嚏及分娩等活动,四、腹肌TheMusclesofAbdomen,前外侧群,后群,（一）前外侧群,腹外斜肌浅层，以8个肌齿起自下8个肋骨的外面止于髂嵴前部和腹股沟韧带，移行为腹股沟韧带。,结构：腹股沟韧带inguinalligament腔隙韧带（陷窝韧带）lacunarligament耻骨梳韧带pectinealligament腹股沟管浅（皮下）环superficialinguinalring,腹内斜肌obliquusinternusabdominis起自胸腰筋膜、髂嵴和腹股沟韧带外侧1/2。后部肌束止于下位3个肋骨。,结构：腹股沟镰或联合腱inguinalfalxconjointtendon提睾肌,腹横肌transversusabdominis起自下6个肋软骨内面、胸腰筋膜、髂嵴和腹股沟韧带外侧1/3,腹直肌rectusabdomen起自耻骨联合和耻骨嵴，止于胸骨剑突和第5-7肋软骨前面腱划tendinousintersection,前鞘：腹外斜肌腱膜，腹内斜肌腱膜前层,腹直肌鞘,后鞘：腹内斜肌后层，腹横肌腱膜，在脐下3横指以下后鞘中断形成弓状线白线：位于腹壁正中线，坚韧而少血管。,腹股沟管：在腹前外侧壁的下部，在腹股沟韧带内侧半的上方，有两口，长约4.5cm。走形男性精索和女性子宫圆韧带。,腹股沟三角：由腹直肌外侧缘、腹股沟韧带和腹壁下动脉未成三角区。腹壁下区薄弱区，腹股沟疝。,（二）后群,腰大肌起自腰椎体侧面和横突，止于股骨小转子作用：使髋关节屈和旋外,腰方肌位于腹后壁，在脊柱两侧起自髂嵴后部，止于第12肋和第1-4腰椎横突作用：下降和固定第12肋，并使脊柱侧屈,第四部分四肢肌TheMusclesofLimbs,上肢肌,上肢肌分为上肢带肌、臂肌、前臂肌和手肌,一、上肢带肌TheMusclesofShoulder,三角肌Deltoid冈上肌supraspinatus冈下肌Infraspinatus小圆肌Teresminor大圆肌Teresmajor肩胛下肌subscapularis,三角肌Deltoid冈上肌supraspinatus冈下肌Infraspinatus小圆肌Teresminor大圆肌Teresmajor肩胛下肌subscapularis,lateral1/3oftheclavicle,acromionandspineofscapuladeltoidtuberosityabducts,flexes&extendsarm,三角肌deltoid,大圆肌Teresmajor,dorsalsurfaceneartheinferiorangleofscapulacrestoflessertubercleadducts,extends&mediallyrotates,肩胛下肌subscapularis,Thesubscapularfossalessertubercleadducts&mediallyrotates,肌腱袖,二、臂肌,肱二头肌Bicepsbrachii喙肱肌Coracobrachialis肱肌Brachialis,（一）前群Theanteriorgroup,肱二头肌Bicepsbrachii,theshortheadarisesfromthecoracoidprocess,thelongheadfromthesupraglenoidtubercleradialtuberosityflexesshoulderandelbow&supinateshand,喙肱肌Coracobrachialisflexesandadducts肱肌Brachialisflexes,肱三头肌Tricepsbrachiilongheadarisesscapulamedial&lateralheadsfromhumerusinsertsonulnaextendselbowlongheadextend&adductshoulderjoints,（二）后群Theposteriorgroup,三边孔和四边孔,第一层Thefirstlayer：肱桡肌Brachioradialis旋前圆肌Pronatorteres桡侧腕屈肌Flexorcarpiradialis掌长肌Palmarislongus尺侧腕屈肌Flexorcarpiulnaris,三、前臂肌,（一）前群Theanteriorgroup,第二层Thesecondlayer：指浅屈肌Flexordigitorumsuperficialis,第三层Thethirdlayer指深屈肌Flexordigitorumprofundus拇长屈肌Flexorpollicislongus,第四层The4thlayer旋前方肌Pronatorquadratus,前臂前群桡向尺肱桡旋前桡腕屈掌长指浅尺屈腕拇长指深深方居,肘窝,浅深屈指肌腱止点,腕管,浅层Thesuperficiallayer,（一）后群Theposteriorgroup,桡侧腕长伸肌Extensorcarpiradialislongus桡侧腕短伸肌Extensorcarpiradialisbrevis指伸肌Extensordigitorum小指伸肌Extensordigitorumminimi尺侧腕伸肌Extensorcarpiulnaris,桡侧腕长伸肌Extensorcarpiradialislongus桡侧腕短伸肌Extensorcarpiradialisbrevis指伸肌Extensordigitorum小指伸肌Extensordigitorumminimi尺侧腕伸肌Extensorcarpiulnaris,深层Thedeeplayer旋后肌supinator拇长展肌actorpollicislongus拇短伸肌extensorpollicisbrevis拇长伸肌extensorpollicislongus示指伸肌extensorindicis,桡侧腕长与腕短指伸小指尺伸腕深层旋后拇长展拇短拇长示指完,Cross-SectionThroughForearm,IfIamlookingdownontothissectionisitfromrightorleftarm?,（一）外侧群1、拇短展肌abductorpllicsbrevis2、拇短屈肌flexorpollicisbrevis,三、手肌,3、拇对掌肌opponenspollicis4、拇收肌adductorpollicis,Musclesofhand,（一）内侧群1、小指展肌abductordigitiminimi2、小指短屈肌flexordigitiminimibrevis3、小指对掌肌opponensdigitiminimi,（一）中间群1、蚓状肌lumbricales2、骨间掌侧肌palmarinterossei3、骨间背侧肌dorsalinterossei,Musclesofhand,蚓状肌,骨间掌侧肌,骨间背侧肌,下肢肌可分为髋肌大腿肌小腿肌足肌,下肢肌,一、髋肌,（一）前群1、髂腰肌iliposoas2、腰小肌psoasminor3、阔筋膜张肌tensorfasciaelatae,Iliopsoas髂腰肌composedoftwomuscles,psoasmajor腰大肌andiliacus髂肌psoasmajorarisesfromthetransverseprocessesandvertebralbodiesoflumbarvertebraIliacusarisesfromtheiliacfossaInsertsintothelessertrochanterflexesandlaterallyrotatesTensorfasciaelatae阔筋膜张肌,臀大肌Gluteusmaximus臀中肌Gluteusmedius臀小肌Gluteusminimus梨状肌Piriformis闭孔内肌Obturatorinternus股方肌Quadratusfemoris闭孔外肌Obturatorexternus,（一）后群Theposteriorgroup,臀大肌Gluteusmaximus臀中肌Gluteusmedius臀小肌Gluteusminimus梨状肌Piriformis闭孔内肌Obturatorinternus股方肌Quadratusfemoris闭孔外肌Obturatorexternus,dorsalportionoftheiliacalaandthedorsalsurfaceofsacrumtheiliotibialtractandtheglutealtuberosityExtendsandlaterallyrotates,臀大肌Gluteusmaximus,thefrontsurfaceofthesacrumthegreatertrochanterLaterallyrotates,梨状肌Piriformis,梨状肌上孔梨状肌下孔,大腿肌分为前群、后群和内侧群。前群缝匠肌sartorius股四头肌quadricepsfemoris,二、大腿肌,缝匠肌SartoriusfromtheanteriorsuperioriliacspinethemedialsurfaceoftheupperpartoftheshaftoftibiaFlexesthehipandknee,股四头肌Quadricepsfemorishas4heads股直肌Rectusfemorisarisesfromtheanteriorinferioriliacspine3headsarisefromfemurTibialtuberosityallacttoextendtheknee.Rectusfemorisalsoflexesthethigh,耻骨肌pectineus长收肌adductorlongus短收肌adductorbrevis股薄肌gracilis大收肌adductormagnus,内侧群,股三角和收肌管,股二头肌bicepsfemorisT