肌学课件：上肢肌

Myology

第三章肌学第五节上肢肌

TheMusclesoftheUpperLimb上肢带肌

Themusclesoftheshoulder臂肌

Themusclesofthearm前臂肌

Themusclesoftheforearm手肌

Themusclesofthehand一、上肢带肌

Themusclesoftheshoulder三角肌

deltoidmuscle冈上肌

supraspinousmuscle冈下肌

infraspinousmuscle小圆肌

teresminor大圆肌

teresmajor肩胛下肌

subscapularmuscle三角肌一、上肢带肌1.三角肌

DeltoidMuscle三角肌前部中部后部1.三角肌

DeltoidMuscle起点Origin：起自锁骨外1/3lateralthirdofclavicle，肩胛骨的肩峰acromion和肩胛冈spineofscapula。止点Insertion：止于肱骨的三角肌粗隆deltoidtuberosityofhumerus

。作用Action：前部肌束使臂（肩关节）屈和内旋flexesandmediallyrotatesarm;中部肌束使臂（肩关节）外展abductsarm;后部肌束使臂（肩关节）伸和外旋extendsandlaterallyrotatesarm。

冈上肌冈下肌小圆肌大圆肌一、上肢带肌一、上肢带肌大圆肌肩胛下肌上肢带肌的作用冈上肌：始动并辅助三角肌外展肩关节。Thesuprapinatusinitiatesandhelpsdeltoidtoabductarmattheshoulderjoint.冈下肌：使肱骨（肩关节）外旋。Theinfraspinatuslaterallyrotatesthehumerus.小圆肌：使肱骨（肩关节）外旋。Theteresminorlaterallyrotatesthehumerus.大圆肌：使臂（肩关节）内收和内旋。Theteresmajoradductsandmediallyrotatesarm.肩胛下肌：使臂（肩关节）内收和内旋。Thesubscapularisadductsandmediallyrotatesarm.肩

袖肩胛下肌肌腱冈上肌肌腱冈下肌肌腱小圆肌肌腱冈上肌腱撕裂伤肌腱袖

ThemusclotendinousCuff

肩胛下肌、冈上肌、冈下肌和小圆肌的肌腱分别止于肩关节的前方、上方、后方，腱纤维与关节囊纤维相交织，形成“肌腱袖”，可保持肱骨头与关节盂相接触，从而加强肩关节的稳定性。Thetendonsoffourmuscles—thesuprasipinous,infraspinous,teresminor,andsubscapularmuscles,blendtoformamusculotendinoussheatharoundtheglenohumeraljoint,calledtherotatorcuff,whichisattachedtotheunderlyingfIbrouscapsuleoftheshoulderjoint.Itprotectstheshoulderjointandgivesitstabilitybyhoidingtheheadofthehumerusintheglenoidcavity.二、臂肌

Themusclesofthearm前群

Theanteriorgroup肱二头肌bicepsbrachii喙肱肌

coracobrachialis肱肌brachialis后群

Theposteriorgroup肱三头肌

tricepsbrachii（一）臂肌前群肱二头肌喙肱肌肱肌肱肌肱二头肌腱肱二头肌腱膜(二)臂肌后群肱三头肌肱三头肌内侧头外侧头长头臂肌的作用肱二头肌：使肘关节屈，当前臂在旋前位时使前臂旋后；其长头协助屈肩关节。

Thebicepsbrachiiflexeselbowjointandsupinatesforearmwhentheforearmispronation.Itslongheadalsohelpstoflextheshoulderjoint.肱肌：使肘关节屈。Thebrachialisflexesforearminallpositions.喙肱肌：使肩关节屈和内收。Thecoracobrachialishelpstoflexandadductarmattheshoulderjoint.肱三头肌：使肘关节伸，长头可使肩关节伸和内收。Thetricepsbrachiiextendsforearm.Itslongheadcanalsoextendsandadductstheshoulderjoint.臂肌的作用

屈肩关节：肱二头肌长头、喙肱肌。伸肩关节：肱三头肌长头。内收肩关节：喙肱肌、肱三头肌长头。屈肘关节：肱二头肌、肱肌。伸肘关节：肱三头肌。前臂旋后：肱二头肌。三、前臂肌

Themusclesoftheforearm前群Theanteriorgroup分为四层共有9块肌后群Theposteriorgroup分为二层共有10块肌第一层ThefirstlayerThebrachioradialis

肱桡肌Thepronator

teres

旋前圆肌Theflexorcarpi

radialis

桡侧腕屈肌Thepalmaris

longus

掌长肌Theflexorcarpi

lnaris

尺侧腕屈肌（一）前臂肌前群①②③④⑤指浅屈肌Theflexordigitorum

superficialis第二层

Thesecondlayer（一）前臂肌前群第三层Thethirdlayer第四层Thefourthlayer

Thepronator

quaduratus

旋前方肌

Theflexorpollicis

longus

拇长屈肌

Theflexordigitorum

profunds

指深屈肌

（一）前臂肌前群（一）前臂肌前群前臂肌前群的作用屈肘关节：肱桡肌、旋前圆肌、桡侧腕屈肌和指浅屈肌。屈腕关节：桡侧腕屈肌、掌长肌、尺侧腕屈肌、指浅屈肌、拇长屈肌和指深屈肌。外展腕关节：桡侧腕屈肌。内收腕关节：尺侧腕屈肌。前臂旋前：旋前圆肌、旋前方肌。屈拇指腕掌关节和指骨间关节：拇长屈肌。屈第2~5指腕掌关节及近侧指骨间关节：指浅屈肌和指深屈肌。屈远侧指骨间关节：指深屈肌。1.浅层

Thesuperficiallayer①Extensorcarpi

radialis

longus

桡侧腕长伸肌②Extensorcarpi

radialis

brevis

桡侧腕长短肌③Extensordigitorum

指伸肌④Extensordigiti

minimi

小指伸肌⑤Extensorcarpi

ulnaris

尺侧腕伸肌（二）前臂肌后群①②③④⑤肘肌2.深层Thedeeplayer①Supinator

旋后肌②Abductorpollicis

longus

拇长展肌③Extensorpollicis

brevis

拇短伸肌④Extensorpollicis

longus

拇长伸肌⑤

Extensorindicis

示指伸肌①②③④⑤（二）前臂肌后群肘肌体表标志Thesurfacelandmark拇长伸肌腱拇短伸肌腱拇长展肌腱指伸肌腱解剖鼻烟壶前臂肌后群的作用伸肘关节：指伸肌、肘肌。伸腕关节：桡侧腕长伸肌、桡侧腕短伸肌、指伸肌、尺侧腕伸肌。外展腕关节：桡侧腕长、短伸肌。内收腕关节：尺侧腕伸肌。前臂旋后：旋后肌。伸拇指腕掌关节：拇长、短伸肌。外展拇指腕掌关节：拇长展肌。伸拇指指骨间关节：拇长伸肌。伸第2~5指腕掌关节及指骨间关节：指伸肌、食指伸肌和小指伸肌。四、手（固有）肌

Theintrinsicmuscleofthehand外侧群Thelateralgroup（鱼际肌群thenarmuscles）

拇短展肌abductorpollicis

brevis拇短屈肌flexorpollicis

brevis拇对掌肌opponens

pollicis拇收肌adductorpollicis内侧群Themedialgroup（小鱼际肌群hypothenarm.）

小指展肌abductordigiti

minimi小指短屈肌flexordigiti

minimi

brevis小指对掌肌opponens

digiti

minimi中间群Theintermediategroup蚓状肌

lumbricalmuscles骨间肌interosseousmuscles手固有肌的内、外侧群拇短展肌拇短屈肌拇对掌肌拇收肌小指展肌小指短屈肌小指对掌肌鱼际肌群的作用屈拇指腕掌关节：拇短屈肌内收拇指腕掌关节：拇收肌外展拇指腕掌关节：拇短展肌拇指对掌：拇对掌肌小鱼际肌群的作用屈小指：小指短屈肌外展小指：小指展肌小指对掌：小指对掌肌第1~4蚓状肌

lumbricalmuscles（三）中间群蚓状肌的起点、止点和作用

Origin，insertionandactionofthelumbricalmuscles蚓状肌的作用蚓状肌

lumbricales屈掌指关节伸指骨间关节Flexthemetacarpophalangealjointsandextendtheinterphalangealjoints.骨间肌Thepalmar

interossei第1~4骨间背侧肌第1~3骨间掌侧肌骨间肌止点和作用

Originandactionoftheinterossei骨间肌的作用骨间肌Theinterossei屈掌指关节伸指骨间关节