局部解剖学：肺与纵膈.ppt

,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,Chengchun Chen Dept of Anatomy WZMC,*,局部解剖学,jiepou,断层影像解剖,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,1,胸 部,Thorax,肺与纵膈,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,2,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,3,1.,切开胸壁,肋骨钳,小心！,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,4,打开胸壁,观察胸壁内面,Endothoracic fascia,胸内筋膜,Internal thoracic a.&v.,胸廓内动脉和静脉,Parasternal ln.,胸骨旁淋巴结,Intercostal space&intercostal avn,胸内筋膜,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,5,Intercostal space,Posterior intercostal v.,Posterior intercostal a.,Intercostal n.,胸腔穿刺,Middle point,Easy injury the vessel&n,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,6,一、胸膜,胸膜的配布,二、胸膜腔,1,、,肋膈隐窝,2,、肋纵隔隐窝,胸膜和胸膜腔,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,7,胸腔积液,(,液体在胸膜腔,),气胸,(,气体在胸膜腔,),血胸,(,血液在胸膜腔,),胸膜腔,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,8,Pleural recesses,Costodiaphragmatic recesse(G),Costomediastinal recess(R),2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,9,一、位置和体表投影,锁骨中线 腋中线 肩胛线,肺下界,6,肋,8,肋,10,肋,胸膜下界,8,肋,10,肋,11,肋,二、结构,（一）肺叶与段：左,2,右,3,肺,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,10,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,11,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,12,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,13,（四）肺门和,肺根,肺根结构的排列关系,支气管,肺动脉,肺静脉,肺动脉,支气管,肺静脉,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,14,胸 部,-,纵隔,Thorax-mediastinum,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,15,基本内容,1,.,掌握主动脉弓及其三大分支,2,.,掌握心包窦的位置,3,.,掌握食管,胸部,、胸主动脉,、,胸导管的毗邻关系及其临床意义,4.,膈神经和迷走神经的走行和分布,关键结构,1.,食管上下三角,2.,动脉导管三角,临床连接,1.,纵膈淋巴结地图（,ATS-MAP),2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,16,纵 隔,一、概述,(,一,),境界与位置,纵隔,(,mediastinum,):,概念,纵隔胸膜,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,17,(,二,),分区,(divided),1.,四分法,2.,三分法,上纵隔,后,纵隔,前纵隔,中纵隔,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,18,(,三,),侧面观,1.,左侧面观,(left),A,食管上三角,B,食管下三角,C,左肺门,左膈神经,左心包膈动静脉,左迷走神经,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,19,2.,右侧面观,(right),以右肺根为中心,奇静脉和奇静脉弓,食管,右膈,N,、迷走,N,和交感干,奇静脉弓,右胸交感干,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,20,二、上纵隔,（,superior,m,ediastinum,）,上纵隔,的器官和结构由前向后可分为,三层,：,前层：,有胸腺，左、右头臂,V,和上腔,V,；,中层：,有主,A,弓及其三大分支、膈,N,和迷走,N,；,后层：,有气管、食管和胸导管等。,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,21,（一）胸腺,胸腺区,（二）上腔静脉及其属支,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,22,（三）,主动脉弓及其分支,1,.位置,主动脉弓自右向左,三大分支,2.,毗邻,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,23,3.,动脉韧带,动脉导管三角,动脉导管三角,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,24,（四）气管胸部和主支气管,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,25,三、下纵隔（,inferior mediastimum,）,分为：前纵隔,中纵隔,后纵隔,（一）前纵隔,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,26,（二）中纵隔,1,、心包,(pericardium),（,1,）位置和毗邻,（,2,）心包腔,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,27,心包窦的位置、意义,心包横窦,心包斜窦,心包前下窦,2.,心,(,自学）,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,28,（三）,后纵隔,(,posterior mediastinum,),内容,食管、奇,V,系、,胸主,A,、胸导管、,胸交感干、迷走,N,和内脏大小,V,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,29,奇静脉、半奇静脉,和副半奇静脉,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,30,胸导管,（,throacic duct,）,（,1,）,行程,（,2,）,意义：胸导管,上下不同部位损伤，,引起不同侧的乳糜胸。,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,31,胸交感干,(trunk),位置,2025/5/16 周五,Chengchun Chen Dept of Anatomy WZMC,32,WenZhou Medical College,sectional Anatomy,Thanks!,chengchun-chenn,Department of Anatomy,