解剖学胸壁肺及胸膜膈解剖课件

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1、Unit19Thoracicwall、pleura、lung、diaphragm胸壁、肺、胸膜、纵隔一.Thoracicwall胸壁1.Composition组成△Skin皮肤△Superficialanddeepfascia浅、深筋膜△Muscles肌△Vesselsandnerves血管和神经1）Muscles肌肉Intercostalesexterni肋间外肌Intercostalesinterni肋间内肌作用：提肋助吸气作用：降肋助呼气Intercostalesintimi肋间最内肌Externalintercostalmembrfane肋间外膜In

2、ternalintercostalmembrfane肋间内膜2）Vesselsandnerves血管和神经PosteriorintercostalAIntercostalNIntercostalspace肋间隙Posteriorintercostalv.Posteriorintercostala.Intercostaln.肋间后动脉、肋间后静脉和肋间神经三者的位置关系:在肋间隙后部：位于肋间隙中间，三者的上、下的排列次序不定。在肋沟内，自上而下依次为：肋间后静脉、肋间后动脉、肋间神经。.胸膜腔穿刺部位:在肋间隙后部，进针部位应在下位肋的上缘。在肋间隙前部，进

3、针部位应在肋间隙的中间。Internalthoracicartery胸廓内动脉－descendsintothorax1.2cmlateraltoedgeofsternum,andendsatthesixthcostalcartilagebydividingmusculophrenicandsuperiorepigastricarteriesMusculophrenicA肌膈动脉superiorepigastricA腹壁上动脉2.Pleura胸膜VisceralpleuraParietalpleuramediastinalpleuraDiaphragmatic

4、pleuraCostalpleuraCupulapleura1）Partes分部△TwopleurallayerscontinuewitheachotheratrootoflungformingclosedpotentialspaceContainsasmallamountpleuralfluidSubatmosphericpressureinit2）Pleuralcavity胸膜腔△potentialspacesofpleuralcavitywhichlungsarenotoccupiedindeeprespirationCostodiaphragmati

5、crecess肋膈隐窝3）Pleurarecesses胸膜隐窝Costomediastinalrecess肋纵隔隐窝Midclavicularlines锁骨中线Midaxillarylines腋中线Scapularline肩胛线ThesurfaceprojectionoflowerborderoflungandpleuraeLowerborderMidclavicularlinesMidaxillarylinesScapularlineLungs6thrib8thrib10thribPleura8thrib10thrib12thrib11thrib3.Lun

6、g肺1）Postion位置肺位于胸腔内，纵隔两侧，因心位置偏左，故左肺狭长，右肺略宽短2）Features形态Apexoflung肺尖：伸向颈根部，高出锁骨内侧1/3上方2.5cmBaseoflung肺底：又称膈面Costalsurface肋面Mediastinalsurface纵隔面肺呈圆锥形，有一尖、一底、两面、三缘 。纵隔面Mediastinalsurface中部有长圆形凹陷叫肺门，有支气管、肺动脉、肺静脉、支气管动脉、支气管静脉、神经和淋巴管出入。出入肺门的结构被结缔组织包绕，构成肺根rootoflung。肺根内结构的排列：从前向后:上肺静脉、肺动脉

7、、主支气管。从上向下:左肺根：肺动脉、左主支气管、上肺静脉、下肺静脉。右肺根：上叶支气管、肺动脉、主支气管、上肺静脉、下肺静脉。Hilumoflung肺门Frombeforebackward:V.A.B.Fromabovedownward:R.－B.A.V.L.－A.B.V.Oblipuefissure斜裂horizontalfissure水平裂Superiorlobe上叶Middlelobe中叶Inferiorlobe下叶Cardiacnotch心切迹Eachprincipalbronchusdividesintolobarbronchi(twoonthe

8、left,threeontheright),each