胸腔及其脏器

1、january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 二、膈二、膈 diaphragm 外形：穹窿状外形：穹窿状位置：封闭胸廓下口位置：封闭胸廓下口作用：作用：为主要的呼吸肌；为主要的呼吸肌； 与腹肌同时收缩，与腹肌同时收缩，可增加腹压，协助排便、可增加腹压，协助排便、呕吐、咳嗽、喷嚏和分娩呕吐、咳嗽、喷嚏和分娩等。等。 january, 2007copyright depart. anatomy, scho

2、ol of medicine, lanzhou university. all right reserved by yp hou and yf song 起始：起始： 分三部分三部 胸骨部：起自剑突后面胸骨部：起自剑突后面 肋部：起自下肋部：起自下6对肋骨对肋骨 和肋软骨的内面和肋软骨的内面 腰部：以左、右膈脚起腰部：以左、右膈脚起 自上自上23个腰椎。个腰椎。止点止点：中心腱中心腱薄弱区：胸肋三角薄弱区：胸肋三角 腰肋三角腰肋三角january, 2007copyright depart. anatomy, school of medicine, lanzhou university. al

3、l right reserved by yp hou and yf song 膈上有三个裂孔：膈上有三个裂孔：腔静脉裂腔静脉裂孔孔食管裂孔食管裂孔主动脉裂主动脉裂孔孔january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 三个裂孔通过的结构：三个裂孔通过的结构：腔静脉裂孔通过：腔静脉裂孔通过： 下腔静脉、下腔静脉、食管裂孔通过：食管裂孔通过： 食管和迷走神经食管和迷走神经主动脉裂孔通过：主动脉裂孔通过： 主动脉

4、和胸导管主动脉和胸导管january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 三、胸膜和胸膜腔三、胸膜和胸膜腔1.胸膜的概念胸膜的概念 胸膜为一层薄而光滑胸膜为一层薄而光滑的浆膜，的浆膜，分分二层：二层：脏脏胸膜胸膜壁壁胸膜胸膜january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right res

5、erved by yp hou and yf song 脏胸膜和壁脏胸膜和壁胸膜在肺根处互胸膜在肺根处互相移行，移行处相移行，移行处在肺根下方二层在肺根下方二层胸膜重叠形成肺胸膜重叠形成肺韧带。韧带。肺韧带肺韧带january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 胸膜腔胸膜腔: 概念概念: 为脏、壁二层为脏、壁二层胸膜之间的潜在性胸膜之间的潜在性腔隙，左、右各一，腔隙，左、右各一，内有少量浆液，可内有少量浆

6、液，可减少摩擦。减少摩擦。(注意与胸腔的概念区注意与胸腔的概念区别别) january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 胸膜隐窝：胸膜隐窝： 为壁胸膜各为壁胸膜各部部 相互反折处所相互反折处所形成的胸膜腔，形成的胸膜腔，主要是主要是肋膈隐窝。肋膈隐窝。january, 2007copyright depart. anatomy, school of medicine, lanzhou universit

7、y. all right reserved by yp hou and yf song 脏胸膜脏胸膜壁胸膜壁胸膜胸膜腔胸膜腔胸膜顶胸膜顶肋胸膜肋胸膜膈胸膜膈胸膜肋膈隐窝肋膈隐窝纵隔胸膜纵隔胸膜january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 胸膜反折线胸膜反折线的体表投影的体表投影前界前界: 胸腺区胸腺区 心包区心包区 临床上左临床上左剑肋角是进行剑肋角是进行心包穿刺术的心包穿刺术的安全区。安全区。jan

8、uary, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 胸胸腺腺三三角角和和心心包包三三角角胸腺三角胸腺三角心包三角心包三角january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 心包（抽液）穿刺术心包（抽液）穿刺术january,

9、2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 胸胸膜膜下下界界的的体体表表投投影影january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 胸胸膜膜下下界界的的体体表表投投影影january, 2007copyright depart.

10、anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 1. 位置位置 胸腔内，纵胸腔内，纵隔两侧。隔两侧。 右肺较宽短，右肺较宽短，左肺较细长。左肺较细长。2.形态形态 lungs january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 左肺被斜裂分为左肺被斜裂分为上、下二叶上、下二叶。

11、 右肺被斜裂和水右肺被斜裂和水平裂分为上、中、平裂分为上、中、下三叶。下三叶。2.2. january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 肺门：肺的内肺门：肺的内侧面中央凹侧面中央凹陷的长椭圆陷的长椭圆形区域。形区域。 3.肺门及肺门及肺根肺根 january, 2007copyright depart. anatomy, school of medicine, lanzhou university. a

12、ll right reserved by yp hou and yf song 肺根肺根 出入肺门的血出入肺门的血管、神经、淋巴管、管、神经、淋巴管、支气管等结构被结支气管等结构被结缔组织包裹构成肺缔组织包裹构成肺根。其主要结构为根。其主要结构为肺动脉、肺动脉、 肺静脉、肺静脉、支气管支气管 。january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 肺肺 门门 和和 肺肺 根根right lungleft lu

13、ngv. a.b.v. a. b.bvabva前后:前后:january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 肺肺 门门 和和 肺肺 根根right lungleft lung上下： b.a.v.b.上下：a. b.v.vbabavb*january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all rig

14、ht reserved by yp hou and yf song 从前到后，左从前到后，左右肺都为：右肺都为： 肺静脉肺静脉 肺动脉肺动脉 支气管支气管 从上到下：从上到下： 左肺为左肺为: 肺动脉肺动脉 支气管支气管 肺静脉肺静脉 右肺为：支气管右肺为：支气管 肺动脉肺动脉 肺静脉肺静脉january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 肺段支气管：肺段支气管： 为气管的第三为气管的第三级分支。每一肺级

15、分支。每一肺段支气管及其所段支气管及其所属的肺组织为一属的肺组织为一个肺段。个肺段。 每个肺有每个肺有10条肺段条肺段支气管。每个肺支气管。每个肺段略呈圆锥形，段略呈圆锥形，尖向肺门。尖向肺门。4 4肺段支气管和支气管肺段肺段支气管和支气管肺段january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song the segments of the lungsr superior lobe apical posterior anterior middle lobe lateral medial interior lobe superior medial basal anterior basal lateral basal posterior basall superior lobe apicoposterior anterior superior lingular inferior lingular i