1、局部解剖学课件重点总结 07级临七2班脊柱区Muscles of BackSuperficial group Trapezius 斜方肌 Latissimus dorsi 背阔肌 Levator scapulae 肩胛提肌 Rhomboideus 菱形肌 Deep group Splenius 夹肌 Erector spinae 竖脊肌Triangle of auscultation 听诊三角(肩胛旁三角)Boundaries Latissimus dorsi Trapezius The medial border of the scapulaInferior lumbar triangle
2、腰下三角 Boundaries Lower part of the lateral margin of latissimus dorsi Posterior free border of the obliquus externus abdominis Iliac crestSuperior lumbar triangle腰上三角 Boundaries Serratus posterior inferior Erector spinae Obliquus internus abdomins上肢Cephalic vein 头静脉 Arises from the lateral side of th
3、e dorsal venous rete on the back of hand Winds around the lateral border of the forearm; it then ascends into the cubital fossa and up the front of the arm on the lateral side of the biceps. It continues up in the deltopectoral groove and then to the infraclavicular fossa, where it pierces clavipect
4、oral fascia to drain into axillary vein.Basilic vein 贵要静脉 Arises from the medial side of the dorsal venous rete of hand Winds around the medial border of the forearm Then ascends into the cubital fossa and up the front of the arm on the medial side of the biceps to middle of the arm where it pierces
5、 the deep fascia and joins the brachial vein or axillary veinMedian cubital vein 肘正中静脉 Links cephalic vein and basilic vein in the cubital fossa It is a frequent site for venipuncture to remove a sample of blood or add fluid to the bloodAxillary fossa 腋窝Boundaries Apex Middle 1/3 of clavicle Lateral
6、 border of first rib Upper border of the scapula Base Skin Superficial fascia Axillary fascia 腋筋膜(cribriform fascia 筛状筋膜) The medial wall Serratus anterior Upper four ribs and intercostal spaces The lateral wall Intertubercular groove Long head and short head of biceps brachii Coracobrachialis The a
7、nterior wall Pectoralis major Pectoralis minor Subclavius Clavipectoral fascia 锁胸筋膜 The posterior wall Subscapularis Teres major Latissimus dorsi ScapulaContents Axillary a. and principal branches Axillary v. and tributaries Brachial plexus and branches Axillary lymph nodes Loose connective tissue T
8、rilateral foramen 三边孔(trilateral space 三边隙) Boundaries Superior: teres minor subscapularis lateral border of scapula, articular capsule of shoulder joint Inferior: teres major Lateral: long head of triceps brachii Structures pass through the trilateral foramen Circumflex scapular a. and v. Quadrilat
9、eral foramen 四边孔(quadrilateral space 四边隙) Boundaries Superior: teres minor subscapularis articular capsule of shoulder joint Inferior: teres major Medial: long head of triceps brachii Lateral: surgical neck of humerus Structures pass through the quadrilateral foramen Axillary n. Posterior humeral ci
10、rcumflex a. and v.Axillary artery Begins at the at lateral border of first rib as a continuation of subclavian artery At the lower border of teres major it becomes the brachial artery. Divided into three parts by overlying pectoralis minorBranches First part superior thoracic a. thoracoacromial a. S
11、econd part lateral thoracic a. Third part subscapular a. throcodorsal a. circumflex scapular a. anterior humeral circumflex a. posterior humeral circumflex a. Brachial artery 肱动脉 Begins at the lower border of the teres major as a continuation of axillary artery Terminates opposite the neck of radius
12、 by dividing into radial and ulnar arteries Branches Deep brachial a. 肱深动脉 Follows the radial nerve into the spinal groove of the humerus Superior ulnar collaeral a. 尺侧上副动脉 follows the ulnar nerve Inferior ulnar collateral a.尺侧下副动脉 Takes part in the anastomosis around the elbow joint. Median nerve 正
13、中神经 Origin Arises from the medial and lateral cord of the brachial plexus Course Descends on the lateral side of brachial artery Halfway down the arm, it crosses the brachial artery to reach its medial sideHumeromuscular tunnel 肱骨肌管 Composition Formed by triceps brachii 肱三头肌and groove for radial ner
14、ve of humerus 肱骨桡神经沟 Structures passing through the tunnel Radial nerve 桡神经 Deep brachial a. and v. 肱深动静脉 Radial collateral a. 桡侧副 动脉 Middle collateral a. 中副动脉Cubital fossa 肘窝Boundaries Laterally: brachioradialis肱桡肌 Medially: pronator teres旋前圆肌 Roof: skin, superficial facia, deep fascia and aponeuro
15、sis of biceps Floor: brachialis 肱肌, supinator 旋后肌and capsule of elbow joint 肘关节囊Contents biceps brachii tendon 肱二头肌腱 Medial to biceps brachii tendon Brachial a. 肱动脉divides into radial and ulnar a., usually at apex of fossa Brachial v. 肱静脉 Median n. 正中神经 Lateral to the biceps brachii tendon Radial n.
16、 桡神经 Lateral antebrachial cutaneous n. 前臂外侧皮神经 Deep cubital lymph nodes Carpal canal 腕管 Composition: Formed by flexor retinaculum 屈肌支持带 and carpal groove 腕骨沟 Structures passing through the carpal tunnel Median n. 正中神经 Tendons of flexor digitorum superficialis 指浅屈肌and flexor digitorum profundus 指深屈肌e
17、nclosed by common flexor synovial sheath 屈肌总腱鞘 Tendon of flexor pollicis longus 拇长屈肌enclosed by synovial sheath for flexor pollicis longus 拇长屈肌腱鞘Superficial palmar arch 掌浅弓 Formed by ulnar artery and superficial palmar branch of radial artery The curve of arch lies across the palm, level with the di
18、stal border of fully extended thumb Gives rise to three common palmar digital arteries 指掌侧总动脉 (each then divides into two proper palmar digital arteries 指掌侧固有动脉) and one ulnar palmar artery of quinary finger 小指尺掌侧动脉Deep palmar arch 掌深弓 Formed by radial artery and deep palmar branch of ulnar artery T
19、he curve of arch lies across upper part of palmar at level with proximal border of extended thumb Gives rise to three palmar metacarpal arteries 掌心动脉 to joint the distal ends of the corresponding common palmar digital arteriesMedian n. 正中神经 Muscular branches: supply thenar except adductor pollicis,
20、first two lumbricales Cutaneus branches: supply skin of thenar, central part of palm, palmar aspect of radial three and one-half fingers, including middle and distal fingers on dorsum Recurrent branch of the median nerve正中神经返支 lies deep to the skin and deep fascia overlying the anterior margin of th
21、e thenar near the midline of the palmUlnar n. 尺神经 Muscular branches supply hypothenar muscles, interossei, 3rd and 4th lumbricales and adductor pollicis Cutaneus branches supply skin of hypothenar, palmar surface of ulnar one and one-half fingers, ulnar half of dorsum of hand, posterior aspect of ul
22、nar two and one-half fingers 下肢Landmarks of lower limb Gluteal region and thigh anterior superior iliac spines anterior inferior iliac spines 髂前下棘 tubercle of iliac crest 髂结节 ischial tuberosity 坐骨结节 greater trochanter 大转子 pubic tubercle 耻骨结节 pubic crest 耻骨嵴 superior border of pubic symphysis Knee pa
23、tella ligament 髌韧带 tuberosity of tibia 胫骨粗隆 medial and lateral condyles 内外侧髁 medial and lateral epicondyles 内、外上髁 tendon of biceps femoris 股二头肌腱 tendons of semitendinosus and semimembranosus 半腱、半膜肌腱 Leg anterior border of tibia 胫骨前缘 head of fibula 腓骨头 neck of fibula 腓骨颈 Ankle and foot medial and lat
24、eral malleolus 内、外侧踝 calcaneal tuberosity 跟骨结节 tuberosity of navicular bone 舟骨粗隆 tuberosity of fifth metatarsal bone 第五跖骨粗隆Superficial veins: Great saphenous vein 大隐静脉 Drains the medial end of dorsal venous arch of foot and passes upward directly in front of the medial malleolus. Then ascends in com
25、pany with the saphenous n. in the superficial fascia over the medial side of the leg. Small saphenous v. 小隐静脉 Arises from the lateral part of the dorsal venous arch of foot Ascends behind lateral malleolus and then runs up the midline of the back of the leg Pierces the deep fascia and enters the pop
26、liteal v. Drains the lateral side of the foot and ankle and the back of the legStructures passing through suprapiriform foramen (from lateral to medial side) Superior gluteal n. 臀上神经 Superior gluteal a. 臀上动脉 Superior gluteal v. 臀上静脉Structures passing through infrapiriform foramen (from lateral to me
27、dial side) Sciatic n. 坐骨神经 Posterior femoral cutaneous n. 股后皮神经 Inferior gluteal n. 臀下神经 Inferior gluteal a., v. 臀下动、静脉 Internal pudendal v., a.阴部内动、静脉 Pudendal n. 阴部神经Structures passing through small sciatic foramen (from lateral to medial side) Internal pudendal v., a.阴部内动、静脉 Pudendal n. 阴部神经Super
28、ficial inguinal lymph nodes Superior group: Lies just distal to the inguinal ligament Receive lymph vessels from anterior abdominal wall below umbilicus, gluteal region, perineal region, external genital organs Inferior group: Lies vertical along the terminal great saphenous v. Receives all superfic
29、ial lymph vessels of lower limb, except for those from the posterolateral part of calf Efferent vessels drain into the deep inguinal ln. or external iliac ln.Fascia lata 阔筋膜 Iliotibial tract 髂胫束 laterally the deep fascia forms a thick band from the iliac tubercle to the lateral condyle of tibial Sap
30、henous hiatus 隐静脉裂孔 A gap in the deep fasica which lies about 4 cm below and lateral to the pubic tubercle. The falciform margin 镰状缘 is the lower lateral border of the opening, which lies anterior to the femoral vessels. Filled with loose connective tissue called the cribriform fascia 筛筋膜Lacuna musc
31、ulorum 肌腔隙 Boundaries: Anteriorly: lateral portion of inguinal ligament Posterolaterally: ilium Medially: iliopectinal arch Contents: Iliopsoas 髂腰肌 femoral n. 股神经 lateral femoral cutaneous n. 股外侧皮神经 Lacuna vasorum 血管腔隙 Boundaries: Anteriorly: medial portion of inguinal ligament Posteriorly: fascia o
32、f pecteineus and pectineal ligament Medially: lacuna ligament Laterally: iliopectinal arch Contents: Femoral sheath 股鞘 Femoral a. and v. 股动、静脉 Femoral branch of genitofemoral n. 生殖股神经股支 Lymphatic vesselsFemoral triangle 股三角 Boundaries Superiorly (base) : inguinal ligament 腹股沟韧带 Laterally: medial bor
33、der of sartorius 缝匠肌内侧缘 Medially: medial border of adductor longus 长收肌内侧缘 Apex: continuous with adductor canal 收肌管 Anterior wall: fascia lata 阔筋膜 Posterior wall: consists of iliopsoas 髂腰肌, pectineus 耻骨肌 and adductor longus 长收肌 from lateral to medial side Contents：from lateral to medial Femoral n. 股神
34、经 Femoral sheath 股鞘 Femoral a. 股动脉 Femoral v. 股静脉 Femoral canal 股管 Deep inguinal lymph nodes 腹股沟深淋巴结 Fatty tissue 脂肪组织Femoral canal 股管 Femoral ring 股环 Anteriorly:inguinal ligament Medially: lacuna lig. 腔隙韧带 Posteriorly: pecteneal lig. 耻骨梳韧带 Laterally: femoral v. 股静脉 Superior: covered by femoral sept
35、um 股环隔Adductor canal 收肌管 Boundies Anterior wall: adductor lamina大收肌腱板 and sartorius 缝匠肌 Lateral wall: vastus medialis 股内侧肌 Posteomedial wall: adductor longus 长收肌 and adductor magmus 大收肌 Contents Saphenous n. 隐神经 Femoral a. and femoral v. 股动、静脉 lymphatic vessels and loose connective tissueSciatic ner
36、ve 坐骨神经 Course Arises from the sacral plexus Leaves pelvis through infrapiriform foramen to enter gluteal region Runs inferiorly laterally deep to gluteus maximus Passing midway between the greater trochanter of femur and ischial tuberosity to back of thigh Lying deep to long head of biceps femoris,
37、 Normally divided into tibial and common peroneal nerves just above popliteal fossa Innervates Semitendinosus 半腱肌 Semimembranosus 半膜肌 Biceps femoris 股二头肌 Hip and knee joints 髋关节和膝关节Popliteal fossaBoundaries: Superolaterally: Biceps femoris 股二头肌 Superomedially: semitendinosus and semimembranosus 半腱肌和
38、半膜肌 Inferiorly: lateral and medial heads of gastrocnemius 腓肠肌内、外侧头 Roof: deep fascia Floor: popliteal surface of the femur posterior capsule of the knee joint fascia covering popliteus Contents Nerves Tibial nerve 胫神经 Common peroneal nerve 腓总神经 Popliteal vein and its tributaries 腘静脉及属支 Popliteal art
39、ery and its branches 腘动脉及分支 Popliteal lymph nodes 腘淋巴结Malleolar canal 踝管 Boundaries Formed by medial surface of calcaneus, flexor retinaculum and medial malleolus Structures passing through the malleolar canal Tibialis posterior 胫骨后肌 Flexor digitirum longus 趾长屈肌 Posterior tibial a. v. and n. 胫后动脉、静脉
40、 Tibial n. 胫神经 Flexor hallucis longus 长屈肌头部 眉弓 superciliary arch 眶上切迹 supraorbital notch 眶下孔 infraorbital foramen 颏孔 mental foramen 翼点 pterion 颧弓 zygomatic arch 耳屏 tragus 髁突 condylar process 乳突 mastoid process 前囟点 bregma 人字点 lambda 枕外隆突 external occipital protuberanceParotid duct 腮腺管 Arises front an
41、terior border of gland Lies 1.5 cm below and parallel to zygomatic arch Passes forward over masseter, pierces the buccinator and oral mucosa to open opposite second upper molar toothStructures vertical passing through the parotid gland External carotid a. 颈外动脉 Superficial temporal a. 颞浅动脉 Superficia
42、l temporal v. 颞浅静脉 Retromandibular vein 下颌后静脉 Auriculotemporal n. 耳颞神经Structures transversal passing through the parotid gland Maxillary a. & v. 上颌动、静脉 Transverse facial a. & v. 面横动、静脉 Branches of facial n. 面神经的分支The structures from superficial to deep Branches of facial nerve 面神经的分支 Retromandibular
43、 vein 下颌后静脉 External carotid a. 颈外动脉 and Auriculotemporal n. 耳颞神经Layers of frontoparietooccipital region Consists of five layers The superficial 3 layer are closely knit together, called scalp 头皮1. Skin 皮肤 thick and hair bearing and contains numerous sebaceous glands 皮厚、腺多、血运丰富2. The superficial fas
44、cia 浅筋膜 Dense connective tissue that binds the skin to the underlying epicranial aponeurosis The vasculature of the scalp runs primarily in this layer. It is rich and widely anastomosis. Wounds of the scalp bleed profusely but heal well. a. v. and n. in superficial fascia Anterior group Supratrochle
45、ar a. v. n. 滑车上动、静脉和神经 Supraorbital a. v. n. 眶上动、静脉和神经 Posterior group Occipital a. v. 枕动、静脉 Greater occipital n. 枕大神经3. Epicranial aponeurosis and occipitofrontalis 帽状腱膜和枕额肌 It is interposed between the frontalis and occipitalis portions of the occipitofrontalis muscle. These muscles place the aponeurosis under tension so
