肘部解剖

TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity肘关节的解剖TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity主要内容•肘关节的体表标志•骨性结构•关节•神经的支配范围2TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity体表标志肱骨内上髁、肱骨外上髁尺骨鹰嘴肱二头肌腱肘后内侧沟3TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity4TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity5TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity骨性结构6TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity7TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity8TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity9TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity10TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity11TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity关节的基本构造•1、关节面2、关节囊由纤维结缔组织构成的囊，附着于关节的周围，并与骨膜融合连续，包围关节腔。纤维膜-----厚且坚韧•滑膜----薄而柔软12TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity13TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity14TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity15TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity16TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity关节的辅助结构•1、韧带•2、关节盘和关节唇•尺神经走行于肱骨内上髁后下方的尺神经沟，然后向前穿过尺侧腕屈肌的起点，行向前臂的前内侧17TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity18TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity19TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity20TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity21TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity正中神经支配•正中神经的主干在前臂发支支配除肱桡肌、尺侧腕屈肌和指深屈肌尺侧半的所有前臂屈肌和旋前肌。•正中神经在手的分布：运动纤维支配第1、2蚓状肌和鱼际肌（拇收肌除外）；感觉纤维则分布与桡侧半个手掌、桡侧三个半手指掌面皮肤及其中节呵远节指背皮肤。22TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity23TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity24TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity桡神经的分布•桡神经在臂部发出较多的分支，其中肌支主要分布与肱三头肌、肘肌、肱桡肌和桡侧腕长伸肌。•关节支分布于肘关节•皮支总共三支：分布于臂后区的皮肤；臂下外侧部的皮肤，前臂后面的皮肤。•手部的分布：手部桡侧半皮肤和桡侧三个半手指近指节背面的皮肤25TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity26TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity27TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity28TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity尺神经•尺神经在臂部不发出分支，于前臂上部发肌支支配尺侧腕屈肌和指深屈肌尺侧半。•手部分布：分布于手背尺侧半和小指、环指及中指尺侧半背面皮肤。浅支分布于小鱼际表面的皮肤、小指掌面皮肤。深支分布于小鱼际肌、拇收肌、骨间掌侧肌、骨间背侧肌及第3、4蚓状肌29TheDiagnosticsInstitute,SchoolofMedicine,ShandongUniversity30