胸壁肺及胸膜膈解剖.pptx

胸壁肺及胸膜膈解剖,一.Thoracic wall,胸壁,1.,Composition,组成,Skin,皮肤,Superficial and deep fascia,浅、深筋膜,Muscles,肌,Vessels and nerves,血管和神经,1）Muscles,肌肉,Intercostales externi,肋间外肌,Intercostales interni,肋间内肌,作用：提肋助吸气,作用：降肋助呼气,Intercostales intimi,肋间最内肌,External intercostal membrfane,肋间外膜,Internal intercostal membrfane,肋间内膜,2）,Vessels and nerves,血管和神经,Posterior intercostal A,Intercostal N,Intercostal space,肋间隙,Posterior intercostal v.,Posterior intercostal a.,Intercostal n.,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，进针部位应在肋间隙的中间。,Internal thoracic artery,胸廓内动脉,descends into thorax 1.2cm lateral to edge of sternum,and ends at the sixth costal cartilage by dividing musculophrenic and superior epigastric arteries,Musculophrenic,A,肌膈动脉,superior epigastric A,腹壁上动脉,2.Pleura,胸膜,Visceral pleura,Parietal pleura,mediastinal pleura,Diaphragmatic pleura,Costal pleura,Cupula pleura,1）Partes,分部,Two pleural layers continue with each other at root of lung forming closed potential space,Contains a small amount pleural fluid,Subatmospheric pressure in it,2）Pleural cavity,胸膜腔,potential spaces of pleural cavity which lungs are not occupied in deep respiration,Costodiaphragmatic recess,肋膈隐窝,3）,Pleura recesses,胸膜隐窝,Costomediastinal recess,肋纵隔隐窝,Midclavicular lines,锁骨中线,Midaxillary lines,腋中线,Scapular line,肩胛线,The surface projection of lower border of lung and pleurae,Lower border,Midclavicular lines,Midaxillary lines,Scapular line,Lungs,6th rib,8th rib,10th rib,Pleura,8th rib,10th rib,12th rib,11th rib,3.Lung,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,Apex of lung,肺尖：,伸向颈根部，高出锁骨内侧1/3上方2.5cm,Base of lung,肺底：又称膈面,Costal surface,肋面,Mediastinal surface,纵隔面,肺呈圆锥形，有一尖、一底、两面、三缘。,纵隔面,Mediastinal surface,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,root of lung,。,肺根内结构的排列：,从前向后:上肺静脉、肺动脉、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。,Hilum of lung,肺门,From before backward:V.A.B.,From above downward:,R.B.A.V.,L.A.B.V,.,Oblipue fissure,斜裂,horizontal fissure,水平裂,Superior lobe,上叶,Middle lobe,中叶,Inferior lobe,下叶,Cardiac notch,心切迹,Each principal bronchus divides into lobar bronchi(two on the left,three on the right),each of which supplies a lobe of lung.Each lobar bronchus then divided into segmental bronchi,which supply specific segments of the lung.,Bronchial tree,主支 气管（一级支气管）肺叶支气管（二级支气管）肺段支气管（三级支气管）。,每个肺段支气管及其所属的肺组织，称为,支气管肺段,，简称,肺段Segments of lung,。,3.,Bronchial tree,支气管树,尖段,后段,前段,外侧段,内侧段,尖（上）段,内侧底段,前底段,外侧底段,后底段,尖后段,前段,上舌段,下舌段,尖（上）段,前内底段,外侧底段,后底段,上叶,中叶,下叶,上叶,下叶,外侧底段,外侧底段,Vessels OF lung,Pulmonary A,Pulmonary V,Diaphragm,Sternal part,Costal part,Lumbar part,Central tendon,Lumbocostal triangle,Sternocostal triangle,Shape,Aortic hiatus,Esophageal hiatus,Vena cava foramen,Openings in the diaphragm,T8,T10,T12,