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1、二、膈diaphragm外形：穹窿状位置：封闭胸廓下口作用：①为主要的呼吸肌；②与腹肌同时收缩，可增加腹压，协助排便、呕吐、咳嗽、喷嚏和分娩等。January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG起始：分三部胸骨部：起自剑突后面肋部：起自下6对肋骨和肋软骨的内面腰部：以左、右膈脚起自上2~3个腰椎。止点：中心腱薄弱区：胸肋三角腰肋三角January,2007Copyright©Depart.Anatomy,Sc
2、hoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG膈上有三个裂孔：腔静脉裂孔食管裂孔主动脉裂孔January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG三个裂孔通过的结构：腔静脉裂孔通过：下腔静脉、食管裂孔通过：食管和迷走神经主动脉裂孔通过：主动脉和胸导管January,2007Copyright©Depart.Anatomy,Schoo
3、lofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG三、胸膜和胸膜腔胸膜的概念胸膜为一层薄而光滑的浆膜，分二层：脏胸膜壁胸膜January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG脏胸膜和壁胸膜在肺根处互相移行，移行处在肺根下方二层胸膜重叠形成肺韧带。肺韧带January,2007Copyright©Depart.Anatomy,Schoolo
4、fMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG胸膜腔:概念:为脏、壁二层胸膜之间的潜在性腔隙，左、右各一，内有少量浆液，可减少摩擦。(注意与胸腔的概念区别)January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG胸膜隐窝：为壁胸膜各部相互反折处所形成的胸膜腔，主要是肋膈隐窝。January,2007Copyright©Depart.Anato
5、my,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG脏胸膜壁胸膜胸膜腔胸膜顶肋胸膜膈胸膜肋膈隐窝纵隔胸膜January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG胸膜反折线的体表投影前界:胸腺区心包区临床上左剑肋角是进行心包穿刺术的安全区。January,2007Copyright©Depart.Anatomy,SchoolofM
6、edicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG胸腺三角和心包三角胸腺三角心包三角January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG心包（抽液）穿刺术January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUan
7、dYFSONG胸膜下界的体表投影January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG胸膜下界的体表投影January,2007Copyright©Depart.Anatomy,SchoolofMedicine,LanzhouUniversity.AllrightreservedbyYPHOUandYFSONG1.位置胸腔内，纵隔两侧。右肺较宽短，左肺较细长。2.形态四、肺lungsJanuary,2007Cop
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