《局部解剖学》英文课件：The pectoral region and axillary region （2015）

1、Regional Anatomy,Ling Shucai,（Systematic Anatomy） 系统解剖学, Locomotor system Digestive system Respiratory system Urinary system Genital system Circulatory system Sensory system Nervous system Endocrine system,运动系统 消化系统 呼吸系统 泌尿系统 生殖系统 循环系统 感觉系统 神经系统 内分泌系统,（Regional Anatomy） 局部解剖学, Head Neck Thorax Abdom

2、en Pelvis Limbs Back Vertebral region,头部 颈部 胸部 腹部 盆部 四肢 背部 脊柱区,The pectoral region and axillary region,Regional anatomy of upper limb,Ling Shucai,. The pectoral region,1. Surface anatomy 表面解剖 2. The superficial structures 浅层结构 Superficial veins 浅静脉 Superficial lymph vessels 浅淋巴管 Cutaneous nerves 皮神经

3、 3. The deep structures 深层结构 The deep fascia 深筋膜 The muscles 肌肉 The vessels 血管 The nerves 神经 4. Regional anatomy 局部解剖 The breast (mamma) 乳房 The clavipectoral fascia 锁胸筋膜,Main contents,1. Surface anatomy,剑 肋 角,Skin incisions,2. The superficial structures,The cutaneous nerves皮神经 The superficial blood

4、vessels 浅血管 The superficial lymphatic vessels 浅淋巴管 The breast 乳房,Superficial Structures,3. The deep structures,The muscles of thorax,Extrinsic muscles Pectoralis major 胸大肌 Pectoralis minor 胸小肌 Serratus anterior 前锯肌 Intrinsic muscles Intercostales externi 肋间外肌 Intercostales interni 肋间内肌 Intercostales

5、 intimi 肋间最内肌,4. Regional anatomy,Mamma 乳房,Position Lie in superficial fascia over the pectorals major and pectoral fascia Extend from 3rd to 7th ribs vertically, and from parasternal line to midaxillary line transversally,Structures contains skin, mammary glands and adipose tissue Each brest has ab

6、out 1520 lobes of mammary gland Each lobe radiates out from the nipple and has a lactiferous duct 输乳管 which opens separately on the summit of the nipple and possesses a dilated lactiferous sinuses 输乳管窦 just prior to its termination,Suspensory ligaments of breast 乳房悬韧带(coopers ligaments ) strands of

7、connective tissue runs between skin and deep fascia and serve to support the mammary glands,The deep faxcia which extends between subclavius, coracoid process and pectoralis minor muscles The structures pass through the clavipectoral faxcia Cephalic v. Thoracoacromial a. Lateral pectoral n.,Clavipec

8、toral fascia 锁胸筋膜,锁胸筋膜及其穿行结构,Clavipectoral fascia,Suspensory ligament of axilla,锁胸筋膜及其穿行结构,is pierced by the cephalic vein 头静脉, lymphatic vessels淋巴管,thoracoacromial artery and vein 胸肩峰动、静脉, lateral pectoral nerve胸外侧神经. “二进二出”,Clavipectoral fascia,. The axillary region,Boundaries of the axilla Conten

9、ts of the axilla Regional anatomy,Main contents,Axillary fossa 腋窝一尖一底四个壁,The axillary fossa is a pyramid-shaped space through which major neurovascular structures pass between the thorax and upper extremity,1. Boundaries of the axilla,The apex is a triangular space limited by the first rib, the scap

10、ula, and the middle third of clavicle. The baseskin and fascia of the axillary fossa,Boundaries of the axilla,The anterior wall Pectoralis major, pectoralis minor and subclavius muscles Clavipectoral fascia 锁胸筋膜,The broad medial wallserratus anterior，intercostal muscles and upper four ribs The narro

11、w lateral wallcoracobrachialis, biceps brachii and intertubercular groove,The posterior wall subscapularis 肩胛下肌, teres major 大圆肌 latissimus dorsi 背阔肌, scapula 肩胛骨,Boundaries of the axilla,Apex Base：axillary fascia 腋筋膜 Anterior wall：pectoralis major and pectoralis minor 胸大、小肌 subclavius muscles 锁骨下肌

12、clavipectoral fascia 锁胸筋膜 Posterior wall：subscapularis肩胛下肌, teres major大圆肌 latissimus dorsi背阔肌, scapula 肩胛骨 Medial wall： serratus anterior 前锯肌， intercostal muscles 肋间内肌 and upper four ribs Lateral wall： coracobrachialis 喙肱肌, biceps brachii 肱二头肌 intertubercular groove 结节间沟,2. Contents of the axilla,A

13、xillary artery Axillary vein Infraclavicular part of brachial plexus Axillary sheath Axillary lymph nodes,Axillary artery Continuation of subclavian artery at lateral border of first rib Becomes brachial artery at lower border of teres major Divided into three parts by overlying pectoralis minor tho

14、racoacromial a. 胸肩峰动脉 lateral thoracic a. 胸外侧动脉 subscapular a. 肩胛下动脉, throcodorsal a. 胸背动脉 and circumflex scapular a. 旋肩胛动脉 anterior and posterior humeral circumflex a. 旋肱前、后动脉;,Axillary artery were divided into three parts:,Brachial plexus 臂丛,Formation: （根、干、股、束） Five roots: formed by anterior rami

15、 of C5-C8 and T1 spinal nerves, roots C5C7give rise to long thoracic n. 胸长神经 Three trunks Six divisions Three cords: below clavicle, divisions form three cords that surround the second portion of axillary a.,Main branches Lateral cord Musculocutaneous n. 肌皮神经 Lateral root to median n. 正中神经外侧根 Medial

16、 cord Medial root to median n. 正中神经内侧根 Ulnar n. 尺神经 Medial brachial cutaneous n. 臂内侧皮神经 Medial antebrachial cutaneous n. 前臂内侧皮神经,Posterior cord radial n. 桡神经 axillary n. 腋神经 thoracodorsal n. 胸背神经,Musculocutaneous 肌皮神经,Median nerve 正中神经 Distribution Injury: ape-like hand 猿掌,Ulnar nerve 尺神经 Distributi

17、on Injury: clawhand 爪形手,Radial nerve 桡神经 Distribution: Injury: Wristdrop 垂腕,Axillary nerve Distribution: Injury: result in deltoid and teres minor paralysis,Axillary lymph nodes arranged in five groups Lateral lymph nodes 外侧淋巴结 Pectoral lymph nodes 胸肌淋巴结 Subscapular lymph node 肩胛下淋巴结 Efferents above

18、 three groups pass to central lymph node 中央淋巴结,Central lymph node 中央淋巴结 Apical lymph node 尖淋巴结,3. Regional anatomy,Trilateral and quadrilateral foramina 三边孔和四边孔 Axillary sheath 腋鞘 Lymph vessels and node of mammary gland,Trilateral and quadrilateral foramina 三边孔和四边孔 posterior humeral circumflex a. and axillary n. pass through the