肌學(xué)總論頭頸肌軀干肌ppt課件

1、第三章第三章 肌肌 學(xué)學(xué) 全身肌由于構(gòu)造不同可分為平滑肌、心肌和骨骼肌。全身肌由于構(gòu)造不同可分為平滑肌、心肌和骨骼肌。 骨骼肌骨骼肌skeletal muscleskeletal muscle具有收縮的特性，是運(yùn)動系統(tǒng)的具有收縮的特性，是運(yùn)動系統(tǒng)的動力部分，其收縮受神經(jīng)支配，接受人的意志控制，故稱動力部分，其收縮受神經(jīng)支配，接受人的意志控制，故稱隨意肌。隨意肌。 全身有全身有600600余塊肌，占體重余塊肌，占體重40%40%。 每塊肌都是一個器官：有一定形狀、構(gòu)造，有血管、淋每塊肌都是一個器官：有一定形狀、構(gòu)造，有血管、淋巴管，受神經(jīng)支配，執(zhí)行一定功能。巴管，受神經(jīng)支配，執(zhí)行一定功能。肌學(xué)總

2、論總論總論一、骨骼肌的形狀和構(gòu)造2. classification of skeletal muscle：long muscleshort muscleflat muscleorbicular muscle1.construction of skeletal muscle ：bellytendonaponeurosis 二 肌的起止、配布、作用 1 1、起于一塊骨，止于另一塊骨跨、起于一塊骨，止于另一塊骨跨過一個或多個關(guān)節(jié)。過一個或多個關(guān)節(jié)。 2 2、起點(diǎn)定點(diǎn)、止點(diǎn)動點(diǎn)，、起點(diǎn)定點(diǎn)、止點(diǎn)動點(diǎn)，動定可互換。動定可互換。 3 3、肌在關(guān)節(jié)周圍配布的方式和多、肌在關(guān)節(jié)周圍配布的方式和多少與關(guān)節(jié)的運(yùn)動

3、類型親密相關(guān)。少與關(guān)節(jié)的運(yùn)動類型親密相關(guān)。 4 4、沿一個運(yùn)動軸周圍應(yīng)配布相對、沿一個運(yùn)動軸周圍應(yīng)配布相對 應(yīng)的兩組肌。應(yīng)的兩組肌。 三、肌的分部和命名三、肌的分部和命名分部：分部： 頭頸?。侯^肌、頸肌頭頸?。侯^肌、頸肌 軀干?。罕臣　⑿丶?、腹肌、軀干肌：背肌、胸肌、腹肌、 膈、會陰肌膈、會陰肌 四肢肌：上肢肌、下肢肌四肢肌：上肢肌、下肢肌命名：命名： 按肌的形狀、大小、位按肌的形狀、大小、位置、置、 起止或起止或 作用進(jìn)展命名。作用進(jìn)展命名。肌的輔助構(gòu)造肌的輔助構(gòu)造1、淺筋膜superficial fascia-于真皮之下，又稱皮下筋膜， 包被全身，由疏松結(jié)締組織構(gòu)成，富含脂肪。內(nèi)有淺動脈、

4、淺靜脈、皮神經(jīng)和淺淋巴管穿行。2、深筋膜deep fascia：又稱固有筋膜，致密結(jié)締組織構(gòu)成，位于淺筋膜深面，包被體壁、四肢的肌和血管神經(jīng)等。構(gòu)成肌間隔、血管神經(jīng)鞘 滑膜囊 synovial bursa：為封鎖的結(jié)締組織囊。腱鞘腱鞘 tendinous sheath:tendinous sheath:包圍在肌腱外的鞘管，包圍在肌腱外的鞘管，存在于腕、踝、手指存在于腕、踝、手指和足指處。和足指處。腱纖維鞘、腱纖維鞘、 腱滑膜鞘腱滑膜鞘 臟層臟層 壁層壁層 腱系膜腱系膜腱纖維鞘腱纖維鞘腱滑膜鞘臟層腱滑膜鞘臟層腱滑膜鞘壁層腱滑膜鞘壁層腱系膜腱系膜腱腱指骨指骨頭頭 肌肌 可分為面肌和咀嚼肌 一 面肌

5、 facial muscles 又稱 表情?。褐饕植加诿娌苛芽字車?，呈環(huán)狀和放射狀分布。大體可分為四群： 顱頂肌 epicranius：枕額?。赫砀埂㈩~腹 、帽狀腱膜 眼輪匝肌 orbicularis oculi：使瞼裂閉合 口周圍肌 orbicularis oris：口輪匝肌、提上唇肌 提口角肌、降下唇肌、降口角肌、 頰肌 鼻肌 nasalis 頰肌頰肌Facial muscles 面肌面肌 咀咀 嚼嚼 肌肌masticatory musclesmasticatory muscles Masseter Masseter 咬肌咬肌 OriginOrigininferior border in

6、ferior border and medial surface of and medial surface of zygomatic archzygomatic arch InsertionInsertionlateral lateral surface of ramus of surface of ramus of mandible and angle of mandible and angle of mandiblemandible ActionActionelevates elevates mandiblemandible Temporalis Temporalis 顳肌顳肌 Orig

7、inOrigintemporal fossatemporal fossa InsertionInsertioncoronoid coronoid process of mandibleprocess of mandible ActionActionelevates and elevates and retracts mandibleretracts mandible翼外肌翼外肌Lateral pterygoid收縮時拉下頜關(guān)節(jié)的關(guān)節(jié)盤連同下頜頭向前收縮時拉下頜關(guān)節(jié)的關(guān)節(jié)盤連同下頜頭向前至關(guān)節(jié)結(jié)節(jié)的下方，作張口運(yùn)動。至關(guān)節(jié)結(jié)節(jié)的下方，作張口運(yùn)動。一側(cè)作用時使下頜移向?qū)?cè)一側(cè)作用時使下頜移向?qū)?cè)翼

8、內(nèi)肌翼內(nèi)肌Medial pterygoid收縮時上提下頜骨，并使其向前運(yùn)動。收縮時上提下頜骨，并使其向前運(yùn)動。一側(cè)作用時使下頜移向?qū)?cè)一側(cè)作用時使下頜移向?qū)?cè)The muscles of neck頸肌頸肌一、頸淺層肌和頸外側(cè)肌一、頸淺層肌和頸外側(cè)肌1. Platysma 頸闊肌，菲薄的皮肌，起自胸大肌和三角肌的筋頸闊肌，菲薄的皮肌，起自胸大肌和三角肌的筋膜，向內(nèi)上止于口角?？衫诮窍蛳隆Ｄ?，向內(nèi)上止于口角。可拉口角向下。 2. Sternocleidomastoid 胸胸鎖乳突肌鎖乳突肌origin: Anterior surface of manubrium and sternal end

9、of clavicalinsertion: Mastoid process of temporal boneActon: one side acting alone, draws head toward the same side, and turn face to opposite side; both sides together, draw head directly backward頸前肌1.舌骨上肌群舌骨上肌群 Suprahyoid muscles Digastric 二腹肌二腹肌Mylohyoid 下頜舌骨肌下頜舌骨肌Stylohyoid 莖突舌骨肌莖突舌骨肌Geniohyoid

10、頦舌骨肌頦舌骨肌 作用：當(dāng)舌骨固定時，拉下頜骨向下而張口吞咽時，下頜骨固定，上提舌骨。 2.舌骨下肌群舌骨下肌群Infrahyoid muscleSternohyoid 胸骨舌骨肌胸骨舌骨肌Thyrohyoid 甲狀舌骨肌甲狀舌骨肌Sternothyroid 胸骨甲狀肌胸骨甲狀肌Omohyoid 肩胛舌骨肌肩胛舌骨肌-下降舌骨和喉下降舌骨和喉.頸前肌Muscles of the neck頸深肌群頸深肌群Deep group位于脊柱頸部兩側(cè)和前方。位于脊柱頸部兩側(cè)和前方。LateralScalenus anterior 前斜角肌前斜角肌Scalenus medius 中斜角肌中斜角肌Scalen

11、us posterior 后斜角肌后斜角肌Medial longus capitis 頭長肌頭長肌 longus colli 頸長肌頸長肌 一側(cè)肌收縮一側(cè)肌收縮,使頸側(cè)屈使頸側(cè)屈;兩側(cè)兩側(cè)肌同時收縮可上提第肌同時收縮可上提第1、2肋肋助吸氣助吸氣. Scalene fissure 斜角肌間隙斜角肌間隙 Boundaries first rib scalenus anterior and medius Structures passing through scalene fissure brachial plexus 臂叢臂叢 subclavian a. 鎖骨下動脈鎖骨下動脈Muscles of

12、 trunk 軀干肌軀干肌 Muscles of back背肌 Muscles of thorax胸肌 Diaphragm膈 Muscles of abdomen腹肌 muscles of perineum會陰肌The Muscles of Back 淺層淺層Superficial group 斜方肌斜方肌Trapezius 肩胛提肌肩胛提肌Levator scapulae 菱形肌菱形肌 Rhomboideus 背闊肌背闊肌Latissimus dorsi 深層深層 deep group Erector spinae 豎脊肌豎脊肌 Splenius 夾肌夾肌The Muscles of Bac

13、kDeep group Splenius 夾肌夾肌Erector spinae 豎脊肌豎脊肌Position: fills the vertebral groove on each side of the spine Action: both sides together extends vertebral column and head. acting along, flex the vertebral column laterally.Major Muscles of Back Trapezius 斜方肌斜方肌 Origin: superior nuchal line, external

14、occipital protuberance, ligamentum nuchae and spinous processes of seventh cervical and all thoracic vertebrae Insertion: lateral third of clavicle, acromion, and spine of scapular Acton: draw the scapula toward vertebral column. supper fibers elevate scapula, lower fibers depress scapula; if scapul

15、a is fixed, one side acting along, draws head toward the same side, and turn face to opposite side; both sides together, draw head directly backward Major Muscles of BackLatissimus dorsi 背闊肌背闊肌Origin: Spinous processes of lower six thoracic and all lumbar vertebraeMedian sacral crestPosterior part o

16、f iliac crestInsertion: crest of lesser tubercleAction: trunk fixed, extends, adducts and medially rotates arm; arm fixed, elevates trunkThoracolumbar Fascia 胸腰筋膜胸腰筋膜Posterior layerMiddle layerAnterior layer指在豎脊肌周圍的筋膜，在腰部可分為三層：后層：豎脊肌后面；中層：分隔豎脊肌 和腰方?。簧顚樱焊采w在腰方 肌前面Muscles of thoraxMuscles connecting th

17、e upper limb to the thoracic wallPectoralis major 胸大肌胸大肌 Pectoralis minor 胸小肌胸小肌 Serratus anterior 前鋸肌前鋸肌 Major muscles of thoraxPectoralis Major 胸大肌胸大肌Origin: medial half of clavicle, sternum, upper six costal cartilages.Insertion: crest of greater tubercleAction: adducts the arm and rotates it med

18、ially; the clavicular fibers also flex the arm; with the arm above the head, raise the body as in climbing The muscles of thoraxExtrinsic musclesPectoralis major Pectoralis minorSerratus anteriorIntrinsic musclesIntercostales externi 肋間肋間外肌外肌Intercostales interni 肋間肋間內(nèi)肌內(nèi)肌Intercostales intimi 肋間最肋間最內(nèi)

19、肌內(nèi)肌Transversus thoracis 胸橫胸橫肌肌 Major muscles of thoraxIntercostales externi 肋間外肌肋間外肌Origin: inferior border of rib aboveInsertion: superior border of rib belowReplaced anteriorly by external intercostals membrane Action: raise ribs adding in forced inspiration Major muscles of thoraxIntercostales in

20、terni 肋間內(nèi)肌肋間內(nèi)肌Origin: superior border of rib belowInsertion: inferior border of rib above Replaced posteriorly by internal intercostals membrane.Action: depress ribs for forced expiration Intercostales intimi 肋間最內(nèi)肌 Diaphragm 膈Shape and positiondome-shaped between thorax and abdomenconsists of a peri

21、pheral muscular part and a central tendonOriginSternal part: arising from xiphoid processCostal part: arising from lower six and costal cartilagesLumbar part: arising by two crura from upper 2-3 lumbar vertebrae, medial and lateral arcuate ligamentsInsertion: central tendon Diaphragm 膈Weak areas: Lu

22、mbocostal triangle Sternocostal triangleOpenings in the diaphragmAortic hiatus自動脈裂孔自動脈裂孔lies anterior to the body of the 12th thoracic vertebra between the crura. It transmits the aorta, thoracic ductEsophageal hiatus 食管裂孔食管裂孔for esophagus and vagus nerves at level of T10. Vena cava foramen 腔靜脈孔腔靜脈孔

23、for inferior vena cava, through central tendon at T8 levelT8T10T12Action:Contraction: the dome moving downward, increases the volume of thoracic cavity which results in inspiration, at the same time the intra-abdominal pressure is increased assists in defecation排便排便, vomiting嘔吐嘔吐or child birth.Relax

24、ation: the dome returns to the former position, reduces the volume to the thoracic cavity, resulting in expiration. 四、腹肌Muscles of abdomenAnterolateral groupObliquus externus abdominis 腹外斜肌腹外斜肌Oblequus enternus abdominis腹內(nèi)斜肌腹內(nèi)斜肌Transversus abdominis腹腹橫肌橫肌Rectus abdominis 腹直肌腹直肌腹外斜肌腹外斜肌腹內(nèi)斜肌腹內(nèi)斜肌Poster

25、ior group Quadratus lumborum 腰方肌腰方肌Psoas major 腰大肌腰大肌髂肌iliacusObliquus externus abdominis 腹外斜肌腹外斜肌General direction of fibers: downward, forwardStructuresInguinal ligament 腹股溝韌帶腹股溝韌帶Lacunar ligament 腔隙韌帶腔隙韌帶pectineal ligament恥骨梳韌帶恥骨梳韌帶Superficial inguinal ring 腹股溝管腹股溝管淺環(huán)淺環(huán) triangular-shaped defect缺損

26、缺損in aponeurosis of obliquus externus abdominis above pubic tubercleObliquus internus abdominis 腹內(nèi)斜肌腹內(nèi)斜肌Position:deep to obliquus externus abdominisGeneral direction of fibres: upwards, forwards Transversus abdominis 腹橫肌腹橫肌Position:deep to obliquus internus General direction of fibres:run more or le

27、ss horizontally.腹外斜肌腹外斜肌腹內(nèi)斜肌腹內(nèi)斜肌腹橫肌腹橫肌腹橫肌腹橫肌腹內(nèi)斜肌腹內(nèi)斜肌腹直肌腹直肌 Inguinal falx 腹股溝鐮腹股溝鐮: arch over spermatic cord, inserted with transverses abdominis fiber into medial part of pecten of pubis Cremaster 提睪肌提睪肌: around the spermatic cord精索精索and testis睪丸睪丸腹股溝鐮腹股溝鐮Rectus abdominis 腹直肌腹直肌 Position: lie on to

28、either of midline Origin: pubic crest and symphysis Insertion: xiphoid and 5th-7th costal cartilages Has 3-4 tendinous intersections 腱劃腱劃 Similar functions for above four pairs of muscles 1.Support and compress the abdominal viscera 2.Increase intra-abdominal pressure, aid in vomiting嘔吐, coughing, s

29、neezing, defecation排便, urination排尿and childbirth. 3.Depress ribs, assist in (the act of force(4)expiration. 4.Flex, lateral flex, and rotate vertebral column.Sheath of rectus abdominis 腹直肌鞘腹直肌鞘Ant layerformed by fusion of aponeurosis of obliquus externus abdominis and anterior leaf of aponeurosis of

30、 obliquus internus abdominisPost layerFormed by fusion of posterion leaf of aponeurosis of obliquus internus abdominis and aponeurosis of transverses abdominisAbsent in about 4-5cm below the umbilicus, where aponeuroses of all three muscles form anterior layer the lower free border named arcuate lin

31、eBelow this line rectus abdominis in contact with transverse fasciaLinea alba 白線白線tendinous raphe縫縫between right and left recti from xiphoid to pubic symphysis.Inguinal canal 腹股溝管腹股溝管Position: oblique passage, 4cm long, located 1.5cm above medial half of inguinal lig.BoundariesAnterior wallAponeuros

32、is of obliquus externus abdominisObliquus internus abdominis (lateral third of wall) Posterior wall Transverse fascia Inguinal falx medially Superior wallarched lower fibers of obliquus internus and transversua abdominis inferior wallinguinal lig Two openings Superficial inguinal ring 腹股溝管淺環(huán)腹股溝管淺環(huán) D

33、eep inguinal ring 腹腹股溝管深環(huán)股溝管深環(huán) defect in transverse fascia 1.5cm above midpoint of inguinal ligamentStructures passing through the inguinal canal Spermatic cord 精索精索 and ilioinguinal nerve髂腹股溝神經(jīng)髂腹股溝神經(jīng) in males Round ligament of uterus 子宮圓韌帶子宮圓韌帶and ilioinguinal nerve髂腹股溝神經(jīng)髂腹股溝神經(jīng) in females Inguinal Triangle (of Hesselbach) 腹股溝三角腹股溝三角 Boundaries Inguinal ligament inferiorlyLateral border of rectus abdominis medially Inferior epigastr