系统解剖学英文教学课件：Splanchnology1

SplanchnologySplanchnologyIntroductionsDigestivesystemRespiratorysystemUrinarysystemReproductivesystemMostofthevisceraorganslieinthethorax,abdominalorpelviccavitiesThequadrantsystemdividestheabdomenbymeansofthetransumbilicalplaneandthemedianplane.Theregionalsystemdividestheabdomenbasedontherightandleftmidclavicularlines,thesubcostalplaneandthetranstubercularplane.AbdominalregionsThequadrantsystemdividestheabdomenbymeansofthetransumbilicalplaneandthemedianplane.Theregionalsystemdividestheabdomenbasedontherightandleftmidclavicularlines,thesubcostalplaneandthetranstubercularplane.AbdominalregionsReferencelinesAlimentarysystemDigestivetubesMouthPharynxEsophagusStomachSmallintestineLargeintestineDigestiveglandsMajorsalivaryglandsLiverpancreasAlimentarysystem–oralcavityoralcavity:oralvestibuleoralcavityproperBoundariesOralcavityCheeksPapillaoftheparotidductOppositetothe2ndmolarLipsPhiltrumNasolabialsulcusFrenulumoflipsHardpalate:

anterior2/3,formedbythemaxillaandpalatineboneSoftpalate:

posterior1/3PalatinevelumUvulaPalatoglossalarchPalatopharyngealarchIsthmusoffauces咽峡Palateisformedbyposteriorborderofpalatinevelum,bothsideofpalatoglossalarches,androotoftongue.a,bDeciduous(milk)andpermanentdentitions(bothupperjaw)Eruptionofdeciduousteethstartsatabout6mouthofageandcontinuestobeginningof3rdyear,Sheddingofthedeciduousteethoccursbetween6thand12thyearswithreplacementbypermanentteethFirstpermanentmolarappearsatabout6yearsold.Thirdmolars(wisdomteeth)－manyeruptatanytimeafter12yearsoldornotatall.TeethTwosets:DeciduousteethPermanentteethTeethTeethThirdmolars(wisdomteeth)－manyeruptatanytimeafter12yearsoldornotatallTeethaDeciduousdentition:

incisors(blue),

canines(yellow),

deciduousmolars(violet)bPermanentdentition:

incisors(blue),

canines(yellow),

premolars(green),

molars(violet);the3rdmolars(wisdomteeth)notyeteruptedTeeth123456781234567812345678123456786右上第一恒磨牙TeethPermanentteethVIVIIIIIIIIIIIIIVVVIVIIIIIIIIIIIIIVVIV左上第一乳磨牙TeethDeciduousteethTeethEachtoothconsistsof3parts:

CrownNeckRootDentalcavity－containsconnectivetissue,bloodvesselsandnerves,andiscontinuouswiththeperiodontaltissuethroughtherootcanalandapicalforamen.TeethCalcifiedtissuesDentine－isayellowishwhitetissuethatformsthebulkoftooth.Enamel

－isahead,brittlewhitetissuethatcoversthecrownofthetoothCement

－isanunusualformofbonethatcoverstherootofthetoothTeethPeriodontaltissuePeriodontalmembraneAlveolarboneGingiva

Alimentarysystem–oralcavity1.oralcavity:oralvestibule,orallips,cheeks,gums,teeth,oralfissure,oralcavityproper,tongue,orallips,vermilionborder,labialfrenulum,cheeks,palate:hardpalate,softpalate,uvula,palatoglossalarch,isthmusoffauces,palatopharyngealarch,tonsillarfossa,palatinetonsils,supratonsillarfossa,tosillarcryptsTongueBodyoftongue－ant2/3，Rootoftongue－post1/3dividedtwopartsbyv-shapedterminalsulcus

TongueMucosaofTonguePapillaeoftongueFiliformpapillaeFungiformpapillaeFoliatepapillaeVallatepapillaeLingualtonsil

massesofsubmucosallymphoidtissueontherootoftongueLocationofvarioustastesensationsonthetongue.

TongueTongueInferiorsurfaceoftongue

Frenulumoftongue

－amidlinefoldofmucousmembraneconnectingtonguetofloorofmouthSublingualcaruncle

－smallelevationSublingualfoldTongueMusclesoftongue

IntrinsicmusclesoftongueInvolvedinchangingshapeoftongueIncludelongitudinal,transverseandverticalmusclesoftongueTongueTongueExtrinsicmusclesoftongue

GenioglossusAction:actingtogether,theywoulddrawthetongueforwardanddownward(depressesandprotrudestongue);actingalone,itdrawsapexofthetonguetotheoppositeside.HyoglossusStyloglossusInvolvedinchangingthepositionofthetongueParotidglandParotidgland

Superficialpart:triangularinshape,liesbelowandinfrontoftheexternalacousticmeatus,andpartiallycoversthemasseter.Deeppart:liesdeeptomedialpterygoid.Parotidduct:

arisesfrontanteriorborderofgland,runsoverthemasseterafinger’sbreadthbelowthezygomaticarchtopiercethebuccinatorandopensintothemouthcavity,oppositetheuppersecondmolartoothParotidglandSubmandibularglandPosition:liesinsubmandibulartriangle,betweenanteriorandposteriorbelliesofdigastricDuct

Opensontosublingualcaruncle

SublingualglandPosition:situatedbeneaththemucousmembraneofthefloorofmouthDuctsMajorsublingualduct－opensontothesublingualcaruncleMinorsublingualducts－openontothesublingualfoldGeneralfeaturesA–fibromusculartube,partofdigestiveandrespiratorysystensExtendsfrombaseofskulltotheinferiorborderofcricoidcartilage(lowerborderofC6leavel)Pharynx胃内部结构十二指肠悬韧带

Suspensoryligamentofduodenum：

由十二指肠悬肌和十二指肠空肠襞共同构成，又称Treitz韧带，是确定空肠起始的重要标志。DuodenumIleumandjejunumSuperiormesentericarteryandarterialarcadesEnterectomyCecum&Vermiformappendix26%28%24%8%6%FIGURE1A.Thepsoassign.Painonpassiveextensionoftherightthigh.Patientliesonleftside.Examinerextendspatient'srightthighwhileapplyingcounterresistancetotherighthip(asterisk).FIGURE1B.Anatomicbasisforthepsoassign:inflamedappendixisinaretroperitoneallocationincontactwiththepsoasmuscle,whichisstretchedbythismaneuver.FIGURE2A.Theobturatorsign.Painonpassiveinternalrotationoftheflexedthigh.Examinermoveslowerleglaterallywhileapplyingresistancetothelateralsideoftheknee(asterisk)resultingininternalrotationofthefemur.FIGURE2B.Anatomicbasisfortheobturatorsign:inflamedappendixinthepelvisisincontactwiththeobturatorinternusmuscle,whichisstretchedbythismaneuver.PelvicappendixRetroperitoneal

retrocecalappendixMcburney’spoint&ColicbandsHowtoidentifytheappendixduringsurgery?AppendectomyandResectionofMeckel'sDiverticulumAppendectomy/v_show/id_XMTQ2Njk3MzIw.htmlSigmoidmesocolonandmesentryofsmallintestine,interioroftransversecolonCrohn’sdiseaseAppendicitisIndirectinquinalherniaInternalhemorrhoidsexternalhemorrhoidsCarcinomaIntusstceptionCarcinomaTheliverTheliveristhelargestvisceralorganinthebodyandisprimarilyintherighthypochondriumandepigastricregion,extendingintothelefthypochondrium(orintherightupperquadrant,extendingintotheleftupperquadrant).Surfacesoftheliverinclude:adiaphragmaticsurfaceintheanterior,superior,andposteriordirections;avisceralsurfaceintheinferiordirection.

Thediaphragmaticsurfaceoftheliver,thediaphragmaticsurfaceoftheliverisdividedintorightandleftareasbythefalciformligament.

Incontrasttothesmoothdiaphragmaticsurface,thevisceralsurfacebearsmultiplefissuresandimpressionsfromcontactwithotherorgans.Twosagittalfissures,linkedcentrallybythetransverseportahepatis,formtheletterHonthevisceralsurface.

Theportahepatisservesasthepointofentryintotheliverforthehepaticarteriesandtheportalvein,andtheexitpointforthehepaticducts.

Therightsagittalfissureisthecontinuousgrooveformedanteriorlybythefossaforthegallbladderandposteriorlybythegrooveforthevenacava;

theleftsagittalfissureisthecontinuousgrooveformedanteriorlybythefissurefortheligamentumteresorroundligament,andposteriorlybythefissurefortheligamentumvenosum.

theleftsagittalfissureisthecontinuousgrooveformedanteriorlybythefissurefortheligamentumteresorroundligament,andposteriorlybythefissurefortheligamentumvenosum.

LobesofLiver

Falciformligament“H”fissureTheliverliesmainlyintherightupperquadrantoftheabdomenwhereitishiddenandprotectedbythethoraciccageanddiaphragm.Thenormalliverliesdeeptoribs5-10ontherightsideandcrossesthemidlinetowardtheleftnipple.Consequently,theliveroccupiesmostoftherighthypochondrium,theupperepigastrium,andextendsintothelefthypochondrium.Theliverislocatedmoreinferiorlywhenoneiserectbecauseofgravity.Itssharpinferiorborderfollowstherightcostalmargin.

SurfaceAnatomyoftheLiverWhenapersoninthesupinepositionisaskedtoinspiredeeply,thelivermaybepalpatedbecauseoftheinferiormovementofthediaphragmandliver.Onemethodofpalpatingtheliveristoplacethelefthandposteriorlybehindthelowerribcage.Then,puttherighthandontheperson'srightupperquadrant,lateraltotherectusabdominisandinferiortothecostalmargin.Thepersonisaskedtotakeadeepbreathastheexaminerpressesposterosuperiorlywiththerighthandandpullsanteriorlywiththelefthand(BickleyandSzilagyi,2003).SurfaceAnatomyoftheLiverSegmentsofLiver

Thegallbladderisapear-shapedsaclyingonthevisceralsurfaceoftherightlobeoftheliverinafossabetweentherightandquadratelobes.Ithas:aroundedend(fundusofgallbladder),whichmayprojectfromtheinferiorborderoftheliver,amajorpartinthefossa(bodyofgallbladder),whichmaybeagainstthetransversecolonandthesuperiorpartoftheduodenum;anarrowpart(neckofgallbladder)withmucosalfoldsformingthespiralfold.