解剖学

Humananatomy山东大学医学院解剖教研室李振华BasicConceptsofAnatomyDefinition:humananatomy,theoldestsciencedealingwiththestructuresandfunctionsofbodyGrossanatomy:systematicanatomyregionalanatomyAppliedanatomyClinicalanatomy人体解剖学发展简史HippcratesHippocrates----希波克拉底（公元前460~377）古希腊名医、解剖学鼻祖。GalenGalen--------伽林（130~200）古希腊名医、解剖学家，著《医经》，对血液流动、神经分支和脑、心等器官有具体描述。Vesalius------(1514~1564)现代解剖学的奠基人，1543年出版了《人体构造》这一划时代的解剖学巨著。VesaliusHarveyHarvey------(1578~1657)解剖生理学家，发现了血液循环的原理，确定血液是在一个封闭的管道内循环。著有《血液循环论》、《动物的发生》两书。开创了动物实验研究的道路。我国人体解剖学的发展历程公元前300～200《黄帝内经》已有对人体解剖的记载。两宋时代《五脏六腑》、《存真图》描述了解剖学知识。王清任（1768～1831）编著的《医林改错》更为详细的描述了解剖学知识。1949～2003年我国解剖学工作者队伍迅速成长，编写了多套具有我国特色的解剖学教材和解剖学图谱，对我国解剖学事业的发展做出了巨大的贡献。人体解剖教学特点人体解剖学的教学包括讲授和实地解剖。主要讲授各系统的总论和各解剖操作区的重点内容。实地解剖采取分组形式，在教师指导下，按照解剖操作指导，参照图谱由学生亲自动手解剖尸体，部分内容观察标本和模型。同时，密切结合活体的观察和触摸，并适当的结合一些临床病例讨论以增强对解剖学内容的理解和记忆。教学大纲所列教学内容按要求程度的不同，分为“掌握内容”和“了解内容”两级。掌握内容为重点内容，学生必须通过反复学习与思考达到牢固掌握、熟练描述、准确指认和联系实际应用的程度。了解内容则要求学生达到一般的认识和了解。DescriptiveanatomicaltermsTheanatomicalposition:(解剖学姿势)Thebodyisupright,legstogether,anddirectedforwards.Thepalmsareturnedforward,withthethumbslaterally.Thetermsofthedirection(方位术语)superior上,inferior下anterior(ventral)前(腹侧)posterior(dorsal)后(背侧)medial内侧,lateral外侧internal内,external外superficial浅,profound深proximal近侧,distal远侧ulnar尺侧,radial桡侧tibial胫侧，fibular腓侧Anatomicalaxesandplanes（轴与面）Axis轴：Verticalaxis垂直轴Sagittalaxis矢状轴Coronalaxis冠状轴Plane面:Sagittalplane矢状面Coronalplane冠状面Horizontalplane水平面或transverseplane横切面TheLocomotorSystem运动系统运动系统由bone骨、joints关节和muscles骨骼肌组成，占成人体重60%骨起杠杆作用关节是运动的枢纽骨骼肌是动力器官功能:support支持Protection保护Locomotion运动Introductionoftheosteology骨学总论Bonesinadultare206innumber.ClassificationofboneBonesareclassifiedaccordingtotheirpositionandshapeThepositioncanbe:skull颅骨bonesoftrunk躯干骨appendicularskeleton四肢骨Typesofshapeinclude:longbone长骨shortbone短骨flatbone扁骨irregularbone不规则骨Longbones(foundinlimbs):Diaphysisorshaft骨干,whichishollow(calledmedullarycavity骨髓腔),filledwithbonemarrowTwoends－epiphysis骺articularsurface关节面,metaphysis干骺端,epiphysialcartilage骺软骨,andepiphysialline骺线Shortbones:cuboidalinshape,e.g.carpalbonesFlatbones:thin,Irregularbones:haveanyirregularormixedshape,e.g.vertebrae,pneumaticbones含气骨*Sesamoidbones籽骨:developwithintendonGeneralstructuresofbone骨的构造Bonesubstance骨质compactbone骨密质spongybone骨松质呈海绵状，由trabeculae骨小梁构成※Intheflatbonesoftheskull,thelayersofcompactbonearecalledtheouterplateandinnerplate外板和内板,whilethelayerofspongyboneiscalledthediploë板障Periosteum骨膜:OuterorfibrouslayerInnerlayerisvascularandprovidestheunderlyingbonewithnutrition.Italsocontainsosteoblasts(成骨细胞)Endosteum骨内膜isasingle-cellularosteogeniclayerliningtheinnersurfaceofbone.Bonemarrow骨髓Redmarrow红骨髓:haematopoietic造血Yellowmarrow黄骨髓:fattyChemicalcompositionandphysicalproperties化学成分和物理性质Organicmaterial有机质：主要是骨胶原纤维束和粘多糖蛋白。构成支架，赋予骨的弹性和韧性。Inorganicsalts无机质：主要是碱性磷酸钙。赋予骨硬度和脆性OrganicmaterialInorganicsaltsChildren11Adult37Old14Bonesoftrunk躯干骨Composition:vertebrae,sacrum,coccyx,sternumandribsVertebrae椎骨Thereare33vertebraeinchildren,arrangedasfollows:Cervicalvertebrae颈椎C.7Thoracicvertebrae胸椎T.12Lumbarvertebrae腰椎L.5Sacralvertebrae骶椎S.5sacrum骶骨Coccygealvertebrae尾椎Co.3~4coccyx尾骨GeneralfeaturesofvertebraeVertebralbody椎体Vertebralarch椎弓pedicleofvertebralarch椎弓根:sup.andinf.Vertebralnotch椎上、下切迹laminaofvertebralarch椎弓板process(7):spinousprocess棘突transverseprocess横突sup.andinf.articularprocesses上、下关节突Vertebralforamen椎孔Vertebralcanal椎管Intervertebralforamen椎间孔RegionalvariationsofvertebraeCervicalvertebraeVertebraeBody:smallVertebralforamen:largerandtriangularSpinousprocesses:shortandbifidinC3toC5,longinC6,andlongerinC7Transverseprocesses:shortandbifid,transverseforamen横突孔Articularprocesses:horizontalAtypicalvertebeaeAtlas寰椎(C1)Bodyandspinousprocessabsent,consistsofanteriorandposteriorarches,andtwolateralmassesGrooveforvertebralartery椎动脉沟Axis枢椎(C2):distinguishedbydens齿突whicharticulateswithdentalfoveaofanteriorarchofatlasCarotidtubercle:颈动脉结节:anteriortubercleoftransverseprocessofC6Vertebraprominens隆椎(C7):containslongandnon-bifidspinousprocess,itisvisiblewithneckflexed,usedasclinicallandmarkincountingcervicalandthoracicspinousprocessesThoracicvertebraeVertebraeBody：heart-shape,superiorandinferiorcostalfovea上、下肋凹Vertebralforamen：smaller,rounderSpinousprocesses：long,pointobliquelydownwardTransverseprocesses：transversecostalfovea横突肋凹Articularprocesses:coronalLumbarvertebraeVertebraeBody：larger,kidney-shapeVertebralforamen:largerandtriangularSpinousprocesses:projectshorizontallyTransverseprocesses:longArticularprocesses:sagittalSacrumAnteriorsurface:promontory岬,anteriorsacralforamina骶前孔(fourpairs)Posteriorsurface:mediansacralcrest骶正中嵴,posteriorsacralforamina(fourpairs),sacralhiatus骶管裂孔，sacralcornu骶角Lateralpart:auricularsurface耳状面,sacraltuberosity骶粗隆Transsacral(epidural)anasthesiaCornuapalpationSacralhiatusSternumManubriumsterni胸骨柄:jugularnotch颈静脉切迹,clavicularnotch锁切迹Bodyofsternum胸骨体Xiphoidprocess★Sternalangle胸骨角:thejunctionofmanubriumandbody,whichcon