1、January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,二、膈 diaphragm,外形：穹窿状 位置：封闭胸廓下口作用：为主要的呼吸肌； 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, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by
2、YP HOU and YF SONG,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23个腰椎。 止点：中心腱 薄弱区：胸肋三角腰肋三角,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,膈上有三个裂孔：,腔静脉裂孔 食管裂孔 主动脉裂孔,January, 2007,Copyright Depart. Anatomy, School of Medici
3、ne, Lanzhou University. All right reserved by YP HOU and YF SONG,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, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,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, 2007
4、,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,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。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,胸膜腔:,概念: 为脏、壁二层胸膜之间的潜在性腔隙，左、右各一，
5、内有少量浆液，可减少摩擦。 (注意与胸腔的概念区别),January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,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, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF
6、 SONG,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, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,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, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right rese
7、rved by YP HOU and YF SONG,胸腺三角 和心包三角,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,心包（抽液）穿刺术,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,胸膜下界的体表投
8、影,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,胸膜下界的体表投影,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,1. 位置胸腔内，纵隔两侧。右肺较宽短，左肺较细长。 2.形态,四、肺 lungs,Ja
9、nuary, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,左肺被斜裂分为上、下二叶。 右肺被斜裂和水平裂分为上、中、下三叶。,2. 肺的分叶,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,肺门：肺的内侧面中央凹陷的长椭圆
10、形区域。,3.肺门及肺根,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,肺根,出入肺门的血管、神经、淋巴管、支气管等结构被结缔组织包裹构成肺根。其主要结构为肺动脉、 肺静脉、支气管 。,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HO
11、U and YF SONG,肺 门 和 肺 根,Right Lung,Left Lung,V. A.B.,V. A. B.,B,V,A,B,V,A,前后:,前后:,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,肺 门 和 肺 根,Right Lung,Left Lung,上下： B.A.V.B.,上下：A. B.V.,V,B,A,B,A,V,B,*,*,January, 2007,Copyright
12、 Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,从前到后，左右肺都为： 肺静脉 肺动脉 支气管,肺根结构的排列,从上到下：左肺为: 肺动脉 支气管 肺静脉 右肺为：支气管 肺动脉 肺静脉,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,肺段支气管：为气管
13、的第三级分支。每一肺段支气管及其所属的肺组织为一个肺段。每个肺有10条肺段支气管。每个肺段略呈圆锥形，尖向肺门。,4肺段支气管和支气管肺段,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,The segments of the lungs,R Superior lobe Apical Posterior Anterior Middle lobe Lateral Medial Interior lobe
14、 Superior Medial basal Anterior basal Lateral basal Posterior basal,L Superior lobe Apicoposterior Anterior Superior lingular Inferior lingular inferior lobe Superior Medial basal Anterior basal Lateral basal Posterior basal,January, 2007,Copyright Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG,5.肺的血管、淋巴和神经,肺血管 支气管血管 淋巴 神经,
