解剖篇2-1內(nèi)臟系統(tǒng)消化呼吸生理學(xué)

上 解剖學(xué)（humananatomy）下 生理（humanDigestiveDigestive第一化管Sec.1Gastrointestinal第二節(jié)Sec.2Digestive第三腹膜Sec.3消化管Gastrointestinal組成：口腔 上、下消化道upper&lowerdigestive內(nèi)臟的一般結(jié)構(gòu) eralstructureof中 ：管壁3-4Holloworganshavewallswith3-4實 ：被膜、小葉、Solidorganshaveenvelope,lobeand粘膜Mucous：上皮、固有層（結(jié)締組織）、粘膜肌層（平滑?。〦pithelium,laminapropria,muscularis功能Function：保護(hù)、吸收 protection,粘膜下層Submucosa（結(jié)締組織connective肌層Muscularlayer（平滑肌Smoothmuscle—內(nèi)環(huán)circular、外縱outerlongitudinal功能：消化管蠕動、推送食物Functions:agitationandperistalsis,pushing外膜Adventitia（纖維膜fibrousmembranes、漿膜serosa）功能： 漿液、減少摩擦Functions:serousfluid,reduce腹上區(qū)，左季肋 胸部標(biāo)志Surface前正中線，Anteriormedianline鎖骨中線，Midclavicularline胸骨線，Sternalline胸骨旁線Parasternal腋前線，Anterioraxillary腋中線，Midaxillary腋后線，Posterioraxillary肩胛線Scapular后正中線Posterior二、口腔（唇、腭、牙、舌、唾液腺Lips,palate,teeth,tongue,salivary三、咽（三部nasopharynx,oropharynx,laryngopharynx）四、食管Esophagus（三狹窄constrictedinthree五、胃stomach（分四部cardia,fundus,body,pylorus六、小腸 intestine（分三段duodenum,jejunum,七、大腸 intestine（分四部分cecum,colon,rectum,epityphlon上消化道：口腔到十二指腸。UpperDigestiveTract:Oralto下消化道：空腸以下的部分。LowerDigestiveTract:Theportionbelowthejejunum.二、口分部：口 、固有口Has2sections:vestibuleandthe （一）口腔壁Oral口唇Lips：上唇Upper下唇Lower頰cheek：皮膚

口裂、人oralRenzhong二、（一）口腔Oral3.腭硬腭(前2/3Hard分隔鼻、口Itformsapartitionbetweenthenasalpassagesandthe軟腭(后1/3)、Soft皺襞plica：腭舌弓palatoglossalarch腭咽弓palatopharyngealarch腭扁桃體Palatinetonsil咽峽Isthmusofthe腭舌弓、腭垂、舌根組成，是口腔通向咽搶的門Constitutedbypalataltonguearch,uvulaandrootofIsthegatewaytothepharynxofthe二、口（二）口腔內(nèi)和口腔旁組TissuesofIntraoral&牙 位于上、下頜牙槽Inthedentalalveolusof二、口腔（二）口腔內(nèi)和口腔旁牙（形態(tài)和構(gòu)造Teeth(morphologyand牙的形牙冠、牙根、牙 crown,rootand牙的構(gòu)牙質(zhì)、牙釉質(zhì)牙骨質(zhì)、牙腔、牙Dentin,enamel,cementum, ,牙周組織Periodontal牙周膜、牙槽骨、牙齦Periodontalmembrane,alveolarbone,

二、口腔（二）口腔內(nèi)和口腔旁組

1.牙（牙的數(shù)目和排列amount& 出牙：人的一生中有兩組牙發(fā)生：乳牙、恒Humanhavetwosetsofteeth:deciduous&permanent 數(shù)目與名稱Amount& 20（羅馬數(shù)字表示UseRoman（6月始出begins ofsix 中、側(cè)切牙；尖牙；第一、二磨 Centralincisors:6–12 Lateralincisors:9–16 premolars:13–19 Canineteeth:16–23 Secondpremolars:22–33 恒牙Permanent 28-32個 數(shù)useArabicdigit）（6歲始begins ofsixyr. 第一、二、三磨牙（恒牙、智齒 Centralincisor,Lateralincisor,Canine,1stpremolar,2nd二、（二）口腔內(nèi)和口腔旁組

1.牙（牙的數(shù)目和排列amount&arrangement 牙式：II

I

32

12 II

I

32

12

R.R.

L.L.二、口（二）口腔內(nèi)和口腔旁組Tongue功能Function：咀嚼吞Chewingandswallowing輔助發(fā)AuxiliaryV-shaped前2/3Anterior2/3tongueisapex(alsonamed后1/3舌Posterior1/3is舌系帶、舌下阜Frenumlinguae,sublingualcaruncle,sublingual二、口腔（二）口腔內(nèi)和口腔旁組舌

消化管舌粘膜Lingualmucousmembrane（ Lingualpapillae （味蕾tastebud） （味蕾tastebud舌扁桃體：淋巴lingualtonsil:舌肌Lingualmuscles（骨骼肌skeletal舌內(nèi)肌、舌外?。焊淖兩嗟男螒B(tài)與位TheintrinsicmusclesacttochangetheshapeofTheextrinsicmusclesacttochangethepositionofthetongue.二、口腔（二）口腔內(nèi)和大唾液腺M(fèi)ajorsalivary腮腺Parotid位置：耳廓Location:belowandinfrontofeachear 導(dǎo)管：穿過頰肌開口平對上頜第2磨牙的頰粘膜ParotidThroughthecheekmuscle,openingattheparotidpapilla,whichliesacrossthesecondsuperiormolar下頜下腺Submandibular位置：下頜骨體內(nèi)

Lieininnersideof舌下腺Submandibular位置：舌下襞的深Lieindeepsurfaceofsublingual

共同開口于舌（一）咽的位置和形態(tài)Locationand位置：顱底→第6頸椎下緣

三、咽 Location:extendsfromtheskullbasetolowerborderofthecricoid(aroundthe6thcervical形態(tài)：上寬下窄，前后略扁漏斗形肌性管道其內(nèi)腔稱咽腔Morphology:infundibuliformtube,lookslikeaninvertedtrapezia,slightlyflatonanteriorandposterior.Theofthepharynxnamed咽腔位于1-6頸椎前方 isinfrontof1st-cervical三、口腔（二）咽的分部與結(jié)構(gòu)咽的分鼻咽部：借鼻后孔→通鼻口咽部：借咽峽 喉咽部借喉口→通喉腔

Communicates Communicatesthroughthechoanaewiththenasal Onitslateralwallisthepharyngealopeningoftheauditorycommunicateswithmiddle Pharyngealrecess:Significantinthatitmaybeinvolvedincertainandneckcancers,notablyNasopharyngeal四、食管（一）食管的位置位置：上端第6頸椎體Upperstarfrominferiorborderof6thcervicalvertebra’s下端第11胸椎Thelowerendliesattheliftsideof11ththoracic接續(xù)：上接咽，下接胃Fromthepharynxtothe分部：頸部、胸部、Neck,chest,穿膈：食管裂孔Esophageal四、食（二）食管的狹第一個狹窄：食管起始（與咽接續(xù)第三個狹窄：膈的食管裂孔處距中切牙約0c。癌的好發(fā)TheTheesophagushas3particularstructurescompresstheAtthestartoftheesophagus,wherethelaryngopharynxjoinstheesophagus,behindthecricoidcartilage.About15cmfromtheincisors.Whereitiscrossedonthefrontbytheaorticarchandtheleftmainbronchus.About25cmfromtheTheesophagealhiatuswhereitpassesthroughdiaphragm.About40cmfromtheThoseareThosearepredilectionsitesofesophagealcancerandretainedforeignbodies.五、胃stomach（一）胃的形形態(tài)：勾型二壁：前、后壁Anterior/Posterior二緣：大、小彎二口：出 分部：四部分4胃底Fundus、胃體幽門部Pylorus、賁門部胃潰瘍易發(fā)：胃小彎幽門部Predilectionsitesofgastriculcer:curvature&（二）胃的位WhenmediumfillingMost:LefthypochondriacFractional:epigastricregionCardia:Leftsideof11th幽門：第1腰椎右Pylorus:Rightsideof1st幽門瓣pyloric幽門括約肌Pyloric幽門螺桿菌Helicobacter）了胃壁的組織結(jié)構(gòu)（4）了粘膜胃底頸粘液細(xì)胞：粘

粘膜下肌織膜

幽幽門括約肌、幽門外膜Thestomachwallsconsistofanoutermucosa,andinnersubmucosa,muscularlayer,andserosa.OuterFundusglandsecretesgastricPrimarycells:pepsinogenParietalcells:hydrochloricacidNeckmucuscells:mucusInnerMuscularPyloricsphincter,pyloricSmall六、Small下→盲腸cecum回腸（一）十二指腸長約25cm1-3腰椎Theduodenumisaabout25C-shapedstructuresurroundingpancreas,altituderangeis1st-3rdlumbarvertebra.分部上部superiorpart（十二指腸duodenal降部descendingpart（十二指腸majorduodenalpapilla） hepatopancreaticampulla）水平部horizontalpart升部ascending（二）空腸Jejunum、回腸Ileum（占2/5、積擴(kuò)大600倍superficialareaextend600times，面積達(dá)功能：吸收功能為Absorbingisthemain粘膜

小腸管壁結(jié)構(gòu)了皺襞、絨毛、微絨Pilca,villi,乳糜管小腸液、食糜變Secretintestinalfluidandthe毛細(xì)血管吸Capillary粘膜下層Inner肌層Muscular外膜起自Start：回腸末端Endof終于 長度Length：約Absorbwater,mineralsalt,emptying分段盲腸、闌尾、結(jié)腸、直腸Cecum,appendix,colon,rectumc（一）盲腸、闌尾Cecum, 回盲瓣Ileocecalvalve：回盲口Ileocecalorifice 內(nèi)Rightiliacfossa 闌尾Appendix：6-8cm, 位置：右髂窩內(nèi)iliac 根部位置固Fixedbythe（一）盲腸、闌闌尾根部的體表投影點 麥?zhǔn)螹cBurney’spointisthepositionwithintheabdomencorrespondspointofappendixrootonthehumansurface.右髂前上棘與臍連線的LocationofMcBurney’spoint:locatedtwothirdsthedistancefromtheumbilicustotherightanteriorsuperioriliacspine.（二）結(jié)腸、直腸 Colon,rectum 結(jié)腸升結(jié)腸AscendingcolonTransversecolonDescendingcolon乙狀結(jié)腸Sigmoidcolon三個特征性結(jié)3signature結(jié)腸帶band、結(jié)腸袋haustra、腸脂epiploicappendages七、大腸（二）結(jié)腸、直腸 消化直腸rectum：位于盆腔Locatedinthe上端Upper：平第3骶椎S3下端Lower：盆隔處續(xù)Terminatesattheleveloftheanorectal 、側(cè)面Side：骶曲 （二） 長度：3-上端：盆隔處與直腸connectswiththerectuminpelvic下端：開口Openingat內(nèi)括約 外括約肌 ine:Alinewhichdividesmucosa,nervesystem,arteryand痔：內(nèi)痔、外Internalhemorrhoids,external的組成 Smalldigestivegland消化管壁內(nèi)wallofthedigestive 物→管腔口腔粘膜腺、胃腺、腸腺Oralmucosalgland,stomachgland,intestinal GreatDigestive（唾液腺、肝、胰Salivarygland,liver,pancreas）被膜、小葉envelope,lobule腺實質(zhì)（腺泡、導(dǎo)管）Glandularsubstance(acinar,腺間質(zhì)（結(jié)締組織）Glandularstroma(connective一、 重量weight：約 最大的腺體Theglandinthehuman 功能 參與代謝、激素與藥物轉(zhuǎn)化和解Participateinmetabolism,conversionofhormonesanddrug, 膽汁、促進(jìn)脂肪消化和吸收Secretbile,promotefatdigestionand 吞噬防御功能、胚胎時期造血Phagocytosis&defense.Fetalblood（一）形態(tài)與位置Morphologyand1.形態(tài)：兩面：上、下面Superior/兩緣：前、后緣Anterior/兩葉：左、右left/right上面：鐮狀韌帶（分左右葉）Superior:Falciformligamentofliver,divideleft/rightlobe.下面：肝門（門靜脈Inferior:Portahepatic(Portal肝的形態(tài)MorphologyofThevisceralsurfaceoftheliverhasanH-ThevisceralsurfaceoftheliverhasanH-shapedgroupofdeepfissuresandfossae. Rightlongitudinalgroove:gallbladder LeftLeftgroove:ligamentumteres TransverseTransversechannel:hepatic 大部分位于 右季肋區(qū)和腹上 小部分位于 左季肋 Most:Righthypochondriac&epigastricregion Fractional:Left其體表投影如下右鎖骨中左鎖骨中上平第５平胸劍結(jié)合平第５肋間下右肋弓下劍突下MarkingofliveronMarkingofliveronhumanRightMiddleLeftmid-Upwardasfarasthe5thcostalAtthelevelofthejunctionbetweenthesternumandthexiphoidprocessUpwardasfaras5thintercostalReachthe7thribatthesideofthe3cmbelowthe（三）肝的組織結(jié)構(gòu) 了肝小葉：是肝結(jié)構(gòu)與功能的基本單位Lobules:Thebasicunitofliver’structureand組成 靜脈、肝索、肝血竇、膽小Construction:Centralvein,hepaticcords,hepatic bilePortalarea:hepaticlobulebileduct,hepaticartery,hepaticportal膽囊功能 濃縮膽汁Storedandconcentrated位置：膽囊窩Gallbladder分部膽囊底、膽囊體、膽囊頸、膽囊管→小Fundus,body,neckandBilewillbereleasedthroughbileductintothesmallintestine.膽囊底的體表SurfaceMarkingofbile右腹直肌外側(cè)緣與右肋弓相交處深Thefundusofthegallbladderapproachesthesurfacebehindtheanteriorendofthe9thrightcostalcartilageclosetothelateralmarginoftherectusabdominis.輸膽管道Transportductsof左右肝管、肝總管膽囊管、膽總管Left/righthepaticduct,Commonhepaticduct,CysticCommonbile左、右肝內(nèi)的毛細(xì)膽管Bilecapillariesofleft&rightlobes.→逐匯合肝左、右肝管Toleft/righthepatic→匯合肝總管。ToCommonhepatic肝總管+膽囊管→膽總管膽總管+胰管→肝 ?。└?→十二指 頭major二、胰（二）位置腹后壁第1-2腰椎水Liesinfrontofthe1st- lumbar前面有腹膜覆 coverstheanterior（一）形分部:頭、體、尾Head,body,頭：十二指腸環(huán)抱Occupiesthecurveofthe尾：脾門Splenic胰管：Pancreiatic開口于十二指 頭Openingatmajorduodenal（一）腮（一）腮（二）下頜下腺（三）舌下腺三、唾液腺（前面已述）Majorsalivaryglads腹膜 ：漿膜--臟層、壁Serosa---viscerallayer,parietal腹膜腔:臟層與壁層之Thepotentialspacebetweenthesetwolayersthe：完全封閉囊與外界不Male: y Female:communicatewiththroughfallopiantubes,uterus&腹膜 Secretsperitonealfluidforlubricating.Supportstheabdominalorgansandservesasconduitfortheirbloodvessels,lymphvessels,and作業(yè)題消化管 由哪 組成人一生牙有幾套（名稱、數(shù)量、出齊時間 的組成？咽分為哪幾部分、各通向什么腔食管有哪3個生理性狹窄胃分幾部分？上、下兩口的名稱和接續(xù) 名稱小腸分幾段？大腸分幾部分闌尾壓痛點、膽囊壓痛點在肝的位置、膽囊的形態(tài)、輸膽管道的組成胰腺分部？胰管與膽總管匯合后的名稱、開口解釋名詞：咽峽、十二指 頭、恒牙、腹膜WhichorgansconstitutedigestivetubeanddigestiveHowmanysetsofteethdothehumanhave? tyWhataretheconstitutionsoflingualpapilla?Howmanysectionsareinpharynx?AndwhatcavitieswilltheyWhatis“constrictedinthreeHowmanysectionsarethereinstomach?Whatarethenameoftheopening,loweropeningandtheircorrelativeHowmanysectionsarethereinlargeintestineandsmallWhereareMcBurney'spoint(tendernesspointofappendicopathy)tendernesspointofgallbladderWhereisthelocationoftheliver?Whatisthemorphologyofgallbladder?WhatareconstitutionsthetransportductsofWhatarethepancreas’sections?Whatisthenameoftissuecombinepancreaticductandcommonbileduct?AndwherewillitExplainthefollowingIsthmusoftheMajorduodenalPermanentRespiratory一、（一）外鼻：鼻根、鼻背、鼻尖翼、Externalnose:nasion,nasaldorsum,apexnasi,alanasi,nostril ：鼻中隔nasalseptum、鼻腔 nasalvestibule、固有鼻腔nasal 固有鼻腔：內(nèi)側(cè)壁medialwall-鼻中隔（ Easybleedingarea外側(cè)壁lateralwall-上、中、下鼻甲turbinate（鼻道第一一、鼻（二）鼻 固有鼻腔 外側(cè)壁-上、中、下鼻甲鼻粘膜Nasalmucosa 部respiration呼吸部Smell嗅部一、（三）鼻旁額竇Frontalsinus：開口于中鼻opensintomiddlenasal上頜竇Maxillarysinus：開口于中鼻道opensintomiddlenasal篩竇Ethmoidalsinus：前組和中組開口于中鼻道posterior&middlegroupareopenintomiddlenasalmeatus.后組開口上鼻道。group(sometimestheanteriorsinus)drainsintothesuperiornasal蝶竇：開口于蝶篩隱Sphenoidsinus:Openssphenoethmoidal三、喉LarynxRespiratoryandarticulatory位位于頸前部正中，上端第４、５頸椎之間，下端平第頸椎下緣Locatedwithintheanterioraspecttheneck,upperboardisonthesamelevelofC4-5cervicalvertebra;lowerboardisonthesamelevelofC6cervicalvertebra’slowerlimit. 喉軟骨cartilagines甲狀軟骨喉valveofaditus環(huán)狀軟骨cricoid

杓狀軟骨arytenoid喉肌Laryngeal聲韌帶vocal聲帶肌vocalis喉腔內(nèi)粘膜 聲帶vocal三、襞plicarima聲襞vocal聲門裂fissureof發(fā)音、Pronunciation,breath/hold四、氣管主支氣管Trachea,mainThetracheaissurroundedbyringshyalinecartilage;theseringspleteandC-shaped,exceptfor ring,calledthecricoidcartilage;Connectinglarynxandlung;thegapscoverbyconnectivetissueandsmoothmusle.（一）上平環(huán)狀軟左、右主支氣管，分杈處稱為氣管杈Thetracheabeginslevelwiththecricoidcartilageandthelowerlimitisfoundatthelevelofthe4ththoracicvertebra(sternalangle).Dividedintoleftandrightmainbronchus,thedividedpointcalledthebifurcationoftrachea.四、氣管主支氣（二）Compareleft&rightmain管徑長與氣細(xì)、管徑長與氣細(xì)、傾粗、較垂管徑和長度andlength

與氣管中線線的Anglewiththetracheamidlineextensionline左主支氣管Leftmain

細(xì)、長Thin,

傾斜

右主支氣管Rightmain

粗、短Thick,

較垂直

一、肺的位位于胸腔內(nèi)、縱膈兩Locatedinthechest,bothsidesofthe二、形態(tài)和結(jié)Coniform,leftlungisnarrowerandlongerthanrightlung.1apex,1base,3surfaces,3Coniform,l