《英文人体系统解剖》课件

TheMeningesandBloodVesselsofBrainandSpinalCord,

andtheCerebrospinalFluid山东大学医学院解剖教研室李振华TheMeningesofBrainandSpinalCordThespinalcordandbrainaresurroundedbythreemembranes,themeninges.Namedfromtheoutsideinwardtheyaretheduramater,arachnoid,andpiamater.Themeningesofspinalcord

Spinalduramater硬脊膜Spinalarachnoidmater脊髓蛛网膜Spinalpiamater

软脊膜Spinalduramater硬脊膜

CharactersAbove,attachedtocircumferenceofforamenmagnumBelow,becomesthinneratlevelofS2,investsfilumterminaletoattachatbackofcoccyxEpiduralspace

硬膜外隙Position:liesbetweenspinalduramaterandperiosteumofvertebralcanalContents:aquantityoflooseconnectivetissue,fat,lymphaticvesselsandvertebralvenousplexus,thespinalnervesoneachsidepassthroughtheepiduralspacewhichisapplicableforblockanesthesiaSubduralspace硬膜下隙Spinalarachnoidmater脊髓蛛网膜

CharactersAthin,delicate,tubularmembranlooselyinvestingspinalcordAbove,itiscontinuouswithcerebralarachnoidmaterSubarachnoidspace

蛛网膜下隙Position:liesbetweenpiaandarachnoidmaterscontainingcerebrospinalfluidTerminalcistern终池:thelargestpartofsubarachnoidspaceextendingfromterminationofspinalcordtolevelofS2,whereitisoccupiedbynervesofcaudaequina,soitisthebestsiteforalumbarpunctureLumbarspinalpuncture(spinaltap)

Spinalpiamater软脊膜AdelicatevascularmembranethatcloselyinveststhespinalcordDenticulateligament齿状韧带:consistof21pairstriangularligamentsextendingfromspinalcordoneachsidebetweenanteriorandposteriorrootsofspinalnervestospinalduramate;theseligamentshelptofixpositionofspinalcord.Filumterminale:anextensionofpiabeyondconusmedullarisTheMeningesofBrainCerebralduralmater硬脑膜Cerebralarachnoidmater脑蛛网膜Cerebralpiamater软脑膜Cerebralduralmater硬脑膜

CharactersAthickanddenseinelasticmembranethatcomposedoftwolayers,aninnerormeningealandouterorendostealItisinloosecontactwithcalvaria,andmoststronglyadherenttobaseofskullFoursepta

Cerebralfalx

大脑镰Tentoriumofcerebellum小脑幕－infrontthereisagap,thetentorialincisure幕切迹,forpassageofmidbrainCerebellarfalx

小脑镰Diaphragmasellae

鞍隔Sinusesofduramater硬脑膜窦Superiorsagittalsinus上矢状窦

Inferiorsagittalsinus

下矢状窦

Straightsinus

直窦

Confluenceofsinus

窦汇Transversesinus横窦

Sigmoidsinus乙状窦Superiorpetrosalsinuses岩上窦inferiorpetrosalsinuses岩下窦Cavernoussinus海绵窦Position:liesoneachsideofsellaturcicaRelationsofcavernoussinus:InternalcarotidarteryandabducentnerverunthroughthesinusOculomotorandtrochlearnervesandophthalmicandmaxillarydivisionsoftrigeminalnervelieinthelateralwallofthesinus

Theflowingofthebloodinduralsinus

Sup.sagittalsinus

Inf.sagittalsinus

Straightsinus

Confluenceofsinus

Transversesinus

Cavernoussinus

Sup.petrosalsinus

Inf.petrosalsinus

Internaljugularvein

SigmoidsinusCerebralarachnoidmater脑蛛网膜Characters:adelicatemembranecoveringbrainloosely,passingoversulciandenteringonlycerebrallongitudinalandtransversefissures

Arachnoidgranulations蛛网膜粒－

projectintosinusesofduramater,serveassiteswherecerebrospinalfluiddiffusesintobloodstreamSubarachnoidcisternsCerebellomedullarycistern小脑延髓池Interpeduncularcistern脚间池Pontinecistern桥池Superiorcistern上池CerebellomedullarycisternCerebralpiamater软脑膜Closelyinvestsbrainsurface,insomeareasthepiainvaginatesintoventriclestotakepartintheformationofchoroidsplexusCirculationofcerebrospinalfluid(CSF)

Cerebrospinalfluidisaclearcolorlessfluid,whichactsasatransportmediumfornutrientsandvasterproductsandprovidesaprotectivefluidcushionforthecentralnervoussystem.Production:producedbythechoroidsplexuseswithinthelateral,thirdandfourthventriclesCirculationofcerebrospinalfluidCSFdrainsfromlateralventricleinterventricularforaminathirdventriclemesencephalicaqueductfourthventriclemedianandtwolateralaperturessubarachnoidspacearachnoidgranulationssuperiorsagittalsinusveinBloodvesselsofbrainandspinalcordArteriesofbrain

TwosourcesInternalcarotidartery:suppliesanterior2/3ofcerebralhemisphereandpartsofdiencephalonVertebralartery:suppliespostterior1/3ofcerebralhemisphereandpartsofdiencephalon,brainstemandcerebellumInternalcarotidartery颈内动脉Anteriorcerebralartery大脑前动脉

Middlecerebralartery大脑中动脉

Anteriorchoroidalartery脉络丛前动脉Posteriorcommunicatingartery后交通动脉Anteriorcerebralartery大脑前动脉JoinedthefellowoftheoppositesidebytheanteriorcommunicatingarteryCorticalbranches:supplyallmedialsurfaceofthecerebralcortexasfarbackastheparietooccipitalsulcusandsuperiorborderofthesuprolateralsurfaceofthecerebralhemisphereCentralbranches:supplycaudatenucleus,anteriorpartoflentiformnucleusandanteriorlimbofinternalcapsuleMiddlecerebralartery大脑中动脉Corticalbranches:supplymostofsuperolateralsurfaceofcerebralhemisphereandinsularlobeCentralbranches:supplylentiformandcaudatenuclei,genuandposteriorlimbofinternalcapsule(lenticulostriateartery)Anteriorchoroidalartery脉络丛前动脉:passesbackward,entersinferiorhornoflateralventricle,andendsinchoroidplexus.Itsupplieslateralgeniculatebody,posteriorlimbofinternalcapsule,middle3/5ofcruscerebri,andglobuspallidusPosteriorcommunicatingartery后交通动脉:runsbackwardtojoinposteriorcerebralarteryVertebralartery椎动脉CranialbrancheAnteriorandposteriorspinalarteries脊髓前、后动脉Posteriorinferiorcerebellarartery小脑下后动脉BranchesofbasilararteryAnteriorinferiorcerebralartery小脑下前动脉Labyrinthineartery迷路动脉Pontinearteries脑桥动脉Superiorcerebellarartery小脑上动脉Posteriorcerebralartery

大脑后动脉

PosteriorcerebralarteryCorticalbranches:supplymedialandinferiorsurfacesoftemporallobeandoccipitallobeCentralbranches:supplydorsalthalamus,medialandlateralgeniculatebodies,hypothalamusandsubthalamusCerebralarterialcircle(circleofWillis)Formation:formedbyanteriorcommunicatingartery,bothanteriorcerebralarteries,internalcarotidarteries,posteriorcommunicatingarteries,andposteriorcerebralarteriesPosition:liesonsellaturcicaaroundopticchiasma,tubercinereumandmamillarybodiesBlockage

AreaofoxygendeprivesbrainThrombusPlaqueSubarachnoidhemorrhageMicroaneurysmLenticulostriatearteriesIntracerebralhemorhageArteriovenousmalformationVeinsofbrainSuperficialcerebralveinsDrainbloodfromcortexandsubcorticalmedullarysubstanceandemptyintoadjacentsinusesofduramaterVeinsofbrainDeepcerebralveins:draindeeperpartsofhemispheres,basalnuclei,internalcapsule,diencephalonandchoroidplexus,ultimatelyformgreatcerebralveinwhichenterstraightsinusBloodvesselsofspinalcordArteriesofspinalcordTwosources

AnteriorandposteriorspinalarteriesBranchesofsegmentalarteries:radiculararteriesofposteriorintercostalsarter