系统解剖学教学课件：introduction and muscles of trunk,head and neck

Myology

肌学

全身肌由于构造不同可分为

smoothm.平滑肌

cardiacm.心肌

skeletonm.骨骼肌

skeletalmuscle具有收缩的特性，是运动系统的动力部分，其收缩受神经支配，接受人的意志控制，故称voluntarym.随意肌。全身有600余块肌，占体重40%。每块肌都是一个器官：有一定形态、构造，有血管、淋巴管，受神经支配，执行一定功能。Section1.

Introduction

总论Ⅰ.Shapeandstructureofthemuscle

肌的形态和构造longm.长肌

shortm.短肌

flatm.扁(阔)肌

orbicularm.轮匝肌1.Classification

M.ofhead

头肌

M.ofneck

颈肌

M.oftrunk

躯干肌

M.oflimbs四肢肌

1.ClassificationAcordingthepositionofthemusclesmaybedividedintom.ofback背肌

m.ofthorax胸肌

m.ofabdomen腹肌

diaphragm膈腱划腱膜二腹肌2.Structure

musclebelly

肌腹

tendon

肌腱：

aponeurosis腱膜Ⅱ.

Originandinsertion

肌的起、止

1、起于一块骨，止于另一块骨,跨过一个或多个关节。

2、Origin起点（定点）、insertion止点（动点），起止点可互换。

3、肌在关节周围配布的方式和多少与关节的运动类型密切相关。沿一个运动轴周围一般配布相对应的两组肌。

agonist原动肌、

synergist协同肌、

antagonist拮抗肌

fixator固定肌、

Ⅲ.

Nameofmuscles

肌的命名Locationofthemuscle.Shapeofthemuscle.SizeofthemuscleDirectionofmuscleⅠ)

fascia筋膜1、

superficialfascia

浅筋膜

位于真皮之下，又称皮下筋膜，包被全身，由疏松结缔组织构成，富含脂肪。内有浅动脉、浅静脉、皮神经和浅淋巴管穿行。

Ⅳ.Accessorystructure

辅助结构2、deepfascia深筋膜：又称固有筋膜，致密结缔组织构成，位于浅筋膜深面，包被体壁、四肢的肌和血管神经等。形成肌间隔、血管神经鞘Ⅱ）

synovialbursa

滑膜囊：为封闭的结缔组织囊，位于肌腱与骨面接触处。

fibrouslayer

纤维层、

Synoviallayer

滑膜层或

synovialsheathoftendon

腱滑膜鞘Ⅲ）Tendinoussheath

腱鞘

:包围在肌腱外的鞘管，存在于腕、踝、手指和足指处。Viscerasllayer脏层Parietallayer壁层腱系膜Section2

Themusclesofhead

andneck

头肌和颈肌Ⅰ.

Themusclesofhead

头肌一、Musclesofhead

Facialmuscles

面肌:includEpicranius颅顶肌

(oroccipitofrontalis)枕额肌

Frontalbelly额腹

Occipitalbelly枕腹

Galeaaponeurotica帽状腱膜Orbicularisoculi眼轮匝肌Buccinator颊肌Orbicularisoris口轮匝肌Nasalis鼻肌FrontalbellyofoccitofrontalisorbicularisoculiOrbicularisoris口轮匝肌Levatorangulioris提口角肌Levatorlabiisuperioris提上唇肌Depressorlabiiinferioris降下唇肌Depressorangulioris降口角肌

（二）

masticatorymuscles咀嚼肌

masseter

咬肌

：

Origin－inferiorborderandmedialsurfaceofzygomaticarch

Insertion－lateralsurfaceoframusofmandibleandangleofmandible

temporalis颞肌

：

Origin－temporalfossa

Insertion－coronoidprocessofmandibleaction：

masseter,temporalis---elevatesmandible—closethemouth

（二）

masticatorymuscles咀嚼肌

action：

medialpterygoid---elevatesmandible—closethemouthlateralpterygoid

：pulltheheadofmandibleforwards---openthemouthmedialpterygoid翼内肌

：

lateralpterygoid翼外肌

：Ⅱ.

Musclesofneck

颈肌（一）颈浅层肌和颈外侧肌

Sternocleidomastoid

胸锁乳突肌Platysma

颈阔肌Origins:

manubriumandmedial1/3ofclavicleInsertion:mastoidprocessoftemporalbone;Actions:actingalone,theheadisinclinedipsilateralandthefaceisrotatedtooppositeside;actingtogether,theyextendthehead.（二）颈前肌1、suprahyoidmuscles

舌骨上肌群

Mylohyoid下颌舌骨肌Stylohyoid茎突舌骨肌Geniohyoid颏舌骨肌Action:elevate(raise)hyoidboneanddepressmandible.Anteriorbelly前腹Posteriorbelly后腹digastric二腹肌（二）颈前肌sternohyoid胸骨舌骨肌

omohyoid肩胛舌骨肌

sternothyroid胸骨甲状肌

Thyrohyoid甲状舌骨肌Action:depresshyoidorlarynx2、infrahyoidmuscles

舌骨下肌群可分为内、外两群

1、lateralgoup

scalenusanterior前斜角肌scalenusmedius中斜角肌scalenusposterior后斜角肌

2、medialgroup：

longuscolli颈长肌

longuscapitis头长肌scalenefissure

斜角肌间隙：

itisboundedbythescalenusanteriorandmediusandfirstrib

，itcontainsthesubclavianaandbrachialplexus.（三）Thedeepcervicalm.

颈深部肌

section3

Themusclesoftrunk

躯干肌Ⅰ.Themusclesofback

背肌

（1）Trapezius

斜方肌alarge,triangularm.lyingonthebackoftheneckandthorax;Origin:externaloccipitalprotuberance,superiornuchalline,ligamentumnuchae,thespinousprocessesof7thcervicalvertebraeandallthoracicvertebrae;trapezius1、superficialgroupInsertion:lateral1/3ofclavicle,acromionandspineofscapula.

（1）Trapezius

斜方肌trapezius1、superficialgroupAction：

raises,descends,androtatesthescapulaandextendsthehead.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，一侧肌收缩使颈向同侧屈、脸转向对侧，两侧同时收缩可使头后仰。

（2）LatissimusDorsi

背阔肌Itisalargestandtriangularm.lyingthebackandlateralwallofthorax;Origins:

thespinousprocessesoflower6thoracicvertebraeandalllumbarvertebrae;Insertion:insertedintotheflooroftheintertubercularsulcusAction:Extend,adduct，androtatetheshoulderjointmedially当上肢上举被固定时，可引体向上。Latissimusdorsi背阔肌1、superficialgroupLevatorscapulaeRhomboideus（3）levatorscapulae

肩胛提肌origin：thetransverseprocessesoftheupper4cervicalvertebrae;insertion：superiorangleofscapula.Action：raisethescapula.（4）rhomboideus

菱形肌Liesdeeptothetrapezius，可拉肩胛骨向脊柱靠拢。1、superficialgroup2、Thedeepgroup

position：Itliesinthevertebralgrooveoneachsideofvertebralspines;Action：extendthespinalcolumnandhead使脊柱后伸和仰头。Splenius

夹肌

position：位于斜方肌深面，Action：单侧收缩，可使头转向同侧，

两侧收缩使头后伸。ErectorSpinae

竖脊肌3.Thoracolumbarfacia：胸腰筋膜指在竖脊肌周围的筋膜，可分为三层：Superficiallayer：竖脊肌后面；Middlelayer

：分隔竖脊肌和腰方肌；Deeplayer：覆盖在腰方肌前面Ⅱ.Themusclesofthorax

胸肌

1.

ExtrinsicmusclesPectoralismajorPectoralisminorSerratusanteriorPectoralismajor

胸大肌Origin:medialhalfofclavicle,sternum,1th-6thcostalcartilages.Insertion:crestofgreatertubercleofhumerus.Action:flexes,adductsandrotatesarmmedially;armfixed,elevatestrunk;elevatesribs1-6,aiddinginforcedinspiration.Pectoralisminor胸小肌

DeeptothepectoralismajorOrigin:3rd-5thribsInsertion:coracoidprocessofscapulaAction:Drawthescapulaforwardsanddownwards,whenthescapulaisfixedithelpstheinspiration(byelevationtheribs)Serratusanterior

前锯肌ItoverliesthelaeralwallofthoraxOrigin:externalsurfacesoftheupper8~9ribsInsertion:medialborderofscapulaAction:holdsthescapulaagainstthechestwall；Pullsthescapulaforwardsinthrowingandpushing.Intercostalesexterni

肋间外肌Origin:lowerborderofribInsertion:upperborderofribbeloworiginexternalintercostalsmembrane肋间外膜.Action:elevateribsaddinginforcedinspiration2.IntrinsicmusclesOrigin:upperborderofrib；Insertion:lowerborderofribaboveoriginReplacedposteriorlybyinternalintercostalsmembrane.Action:depressribsforforcedexpirationIntercostalesinterni

肋间内肌(1)

Positionanddivision:

dome-shapedbetweenthoraxandabdomen,consistsof

Centraltendon中心腱

muscularpart

肌部

Ⅲ.Diaphragm

膈Sternalpart:Costal

part:Lumbar

part:

arisesbyleftandrightcrus

fromupper2-3lumbarvertebrae

Insertion:

centraltendon(2)Openingsofdiaphragm①

Aortichiatus主动脉裂孔atthelevelof12ththoracicvertebra,the

thoracicaortaandthoracicductpassthroughit②Esophagealhiatus食管裂孔atthelevelof10ththoracicvertebra,

the

esophagusandvagusn.passthroughtit③Venacavalforamen腔静脉孔

atthelevelof8ththoracicvertebra,

inferiorvenacavathroughitT8T10T12inferiorvenacavaesophagusthoracicaorta(3)Action

Contraction:thedomemovingdownward,increasesthevolumeofthoraciccavitywhichresultsininspiration.Relaxation:thedomereturnstotheformerposition,reducesthevolumeofthethoraciccavity,resultinginexpiration.

(2)Weak

areas:triangularspaceswithoutmusculartissue

Lumbocostal

triangle腰肋三角

betweencostalandlumbarparts.

Sternocostal

triangle胸肋三角:betweencostalandsternalparts.

MusclesofabdomenAnterolateralgroupObliquusexternusabdominis腹外斜肌Obliquusinternusabdominis腹内斜肌Transversusabdominis腹横肌Rectusabdominis

腹直肌Obliquusexternusabdominis

腹外斜肌Origin:Arisesfromthelower8ribs,andthemuscularfibersrunobliquelyfromthesuperolatealtotheinferomedial,theanteriorpartofthem.changegraduallyintoaponeurosis,whichpassovertherectusAbdominis;

insertion:Lineaalba白线.Obliquusexternusabsominis

腹外斜肌Structuresformedby

aponeurosisofthism.include：Inguinalligament

腹股沟韧带Superficialinguinalring

腹股沟浅环－triangular-shapedhiatusabovepubictubercleLacunarligament

腔隙韧带SuperficialinguinalringLacunarligamentObliquusinternusabdominis

腹内斜肌Origin:thoracolumbarfascia胸腰筋膜,

iliaccrestandthelateralhalfoftheingunallig.Insertion:Lineaalba白线Themuscularfibersrunupwardsandforwards,andbecometheaponeurosisclosethelateralborderoftherectusabdominis.Itsaponeurosisdividedintotwolayerstoinclosetherectusabdominis.Transverselsabdominis

腹横肌Origin:itarisesfromthecostalcartilagesofthelower6ribs，thethoracolumbarfascia,theiliaccrest

andthelateral1/3oftheingunallig.,isthedeepestoneofthethreeflatabdominalm.Insertion:Lineaalba白线

Themuscularfibersruntransversly,andpassdeeptorectusabdominis.Inguinalfalx(conjoinedtendon)腹股沟镰or联合腱:isacommonaponeurosisjoinedbyobliquusinternusabdominis腹内斜肌

andtransverseabdominis腹横肌,itturnsdownwardstoinsertthepubiccrestandpectenpubis耻骨梳.Cremaster提睾肌:aroundthespermaticcordandtestisTransverselsabdominis

腹横肌TheSheathofrectusabdominis

腹直肌鞘Anteriorlayer－formedbythe

aponeurosisofobliquusexternusabdominis

；

anteriorleafofaponeurosisofobliquusinternusabdominisPosteriorlayer：formedbyposterionleafofaponeurosisofobliquusinternusabdominis

；

aponeurosisoftransversesabdominisTheSheathofrectusabdominis

腹直肌鞘arcuateline

弓状线或semicircularline

半环线

atabout4-5cmbelowtheumbilicus脐,thelowerfreeborderoftheposteriorlayeroftheshethpresentarcuated.

Belowthislinetherectusabdominisincontactwithtransversefasciadirectly.Lineaalba

白线－tendinousrap