影像解剖-ant.regon of arm,elbow fossa and ant.region of forearm 課件

Anteriorregionsof

thearmandforearm

(P.306-318)

DepartmentofthehumananatomyattachedtotheSichuanUniversity

ChenDaobang

Mpartmentofarm1).bicepsbrachiiorigin:longhead—supraglenoidshort

head—coracoidprocessInsertinginto:tuberosityofradiusfunction:flexeselbowjointandshoulderjoint,supinateforearm2).coracobrachialis3).brachialisabovethe3musclesaresuppliedbymusculocutaneousn.2.Mpartmentofforearm1).superficiallayer:

brachioradialis

(radialN)

pronator

teres(pronatesforearm)旋前圓肌

flexorcarpi

radialis

palmaris

longusflexorcarpi

ulnaris(ulnarN)2).intermedial

layerflexordigitorum

superficialis

指淺屈肌肱橈肌掌長肌橈側(cè)腕屈肌3).deeplayer:flexorpollicis

longusflexordigitorum

profundus

(ulnarhalfpart—ulnar

n.;radial–mediann.)

pronator

quadratusFunctionsabovethemuscels:

*flexelbowjoint,wristjoint,

metacarpo-phalangeal

joints,….

*pronateforearm指深屈肌旋前方肌拇長屈肌Mainvesselsandnervesinthearm1.Brachialartery

deepbrachiala.2.Medialn.3.Ulnarn.4.Radialn.5.Musculocutaneousn.

Cubital

fossa

肘窩1.Itisbounded

laterally

bybrachioradialis

mediallybypronator

teres

superiorlybyalinebetweenthemedialandlateralepicondyleofhumerus

posteriorlybybrachialisandsupinator,anteriorlyby:deepfasciaandaponeurosisofbicepsbrachii

Cubitalfossa2.Contentsinthefossa

#tendonofbicepsbrachii

#brachiala.,v.,and

mediann.

#radialn.*thebrachiala.isdividedintoulnaa.andradiala.,attheleveloftheneckofradius*mediann.liesinthemedialtothebrachiala.andpiercesthepronator

teres,thenitdescendsbetweentheflexordigitorum

superfisialis

andflexordigitorum

profundus.Vpartmentoftheforearm1.Radialvesselsandsuperficialbr.ofradialn.bundle

橈血管神經(jīng)束

descendbetweenthebrachioradialisandflexorcarpi

radialis.

Theradiala.coursesaroundthestyloidofradiusandreachestothedorsumofhand.2.Ulnara.,v.,and

n.bundle*A.passesthroughthedeeptothepronator

teres.*N.piercestheflexorcarpi

ulnaris*Then,ulnar

a.,v.,andn.descendbetweentheflexor

digitorum

superficialisandflexorcarpi

ulnaris,andthey(a.v.,n.)reachtothepalm,throughthelateraltothepisiformbone.Supply:Injury:“clawhand”3mediann.Piercespronator

teresDescendesbetweentheflexor

digitorum

superficialisandprofundusAtwrist：betweenthetendonsofpalmaris

longusandflexorcarpi

radialis;

throughthedeeptotheflexorretinaculum

(throughthecarpalcanal腕管)supply:injury：tointerfere障礙/abatewithpronationofforearmandflexionofwrist“ape-like”erosseousvesselsandn.N-arisesfrommediann.A-arisesfromcommoninterosseous

a.(br.oftheulnara.)

carpalcanal腕管1.Itisformedbytheflexorretinaculumandgrooveofthecarpalbones2.Thestructurespassingthroughthecarpalcanal

1)tendonsoftheflexordigitorum

superficialis

2)tendonsofflexordigitorum

profundus

3)tendonofflexorpollicis

longus

4)mediannervecommonflexorsynovialsheathflexorpollicis

longussynovialsheathUlnarsacRadialsac(bursa)(3肌)9腱2囊1神經(jīng)palmLayers:1)Skincallus(胼胝)2)Superficialfascia3)Palmaraponeurosistriangle-shaped,connectingwithtendonofpalmaris

longus掌腱膜palm4)Vesselsandnerves*superficial

palmar

arch:superficialpalmar

br.ofradiala.unitswithterminalbr.ofulnara..Sometimeitisacontinuationoftheulnara.Thearchgivesoff3commonpalmardigitala.*terminalbr.ofmediann.---thenarbr.(recurrentbr.)

*superficialbrofulnarn.血管神經(jīng)層指掌側(cè)總動脈魚際支(返支)palm5)Tendon-muscelslayer腱肌層

(1)tendonsoftheflexordigitorum

superficialis

(2)tendonsofflexordigitorum

profundus

(3)tendonofflexorpollicis

longusandtheirsynovialsheath

(4)4lumbricals

蚓狀肌6)Fascialspaces

midpalmar

space(medial),掌中隙

thenarspace(lateral)魚際隙7)Deeppalmararchitisformedbytheanastomosisofterminalofradiala.withdeeppalmarbr.oftheulnara.

givingoff3

palmarmetacarpalaa.掌心動脈8)Interosseousm.andmetacarpalbones(9腱2囊4肌)

Themusclesinthehandmedialgroup---hyp