項(xiàng)背部肩胛區(qū)解剖(4ipxueshi)課件

項(xiàng)背部、肩胛區(qū)解剖

Thescapularregionandthebackvertebralregion

項(xiàng)背部、肩胛區(qū)解剖

Thescapular1(1)自枕外隆凸至尾骨尖做一縱行切口(2)自枕外隆凸沿上項(xiàng)線至乳突做一橫切口(3)自隆椎棘突向外橫向切至肩峰翻皮：沿以上切口將皮膚向外翻開(kāi)一、皮膚skin切口incisions

:⑴⑶⑵(1)自枕外隆凸至尾骨尖做一縱行切口一、皮膚skin切口in21.皮神經(jīng)cutaneousnerves頸、胸、腰神經(jīng)后支的皮支,第2頸神經(jīng)后支的皮支粗大稱為枕大神經(jīng)greateroccipitaln.,第3頸神經(jīng)后支的分支粗大稱為第三枕神經(jīng)thirdoccipitaln.2.淺血管

superficialbloodvessel肋間后動(dòng)、靜脈的后支腰動(dòng)、靜脈的后支

二、淺筋膜superficialfascia

1.皮神經(jīng)cutaneousnerves二、淺筋膜supe3三、深筋膜deepfascia項(xiàng)筋膜nuchalfascia胸腰筋膜thoracolumbarfascia上部的深筋膜較淺，下部的深筋膜較厚，呈菱形，稱胸腰筋膜，分為三層，包繞豎棘肌。前層anteriorlayer中層middlelayer后層posteriorlayer三、深筋膜deepfascia項(xiàng)筋膜nuchalfas4斜方肌Trapezius—副神經(jīng)背闊肌Latissimusdorsi—胸背N菱形肌rhomboideus

—肩胛背N肩胛提肌levatorscapulae—肩胛背N四、肌層muscularlayer①淺層superficiallayer斜方肌Trapezius

背闊肌Latissimusdorsi1.項(xiàng)背部肌themusclesoftheback肩胛提肌levatorscapulae菱形肌rhomboideus斜方肌Trapezius—副神經(jīng)四、肌層muscularl5②深層deeplayer豎脊肌erectorspinae作用：使脊柱后伸和仰頭，一側(cè)收縮使脊柱側(cè)屈。神經(jīng)支配：頸、胸、腰神經(jīng)的后支。為背肌中最長(zhǎng)、最大的肌，縱列于脊柱兩側(cè)的溝內(nèi)。包括髂肋肌iliocostalis、最長(zhǎng)肌longissimus、棘肌spinalis。髂肋肌iliocostalis最長(zhǎng)肌longissimus、棘肌spinalis②深層deeplayer作用：使脊柱后伸和仰頭，一側(cè)收縮使6①三角肌Deltoid—腋N②岡上Supraspinatus

—肩胛上N③岡下Infraspinatus

—肩胛上N④小圓肌Teresminor

—腋N⑤大圓肌Teresmajor

—肩胛下N⑥肩胛下肌Subscapularis—肩胛下N2.肩胛區(qū)肌Musclesoftheshoulder三角肌Deltoid岡上肌

Supraspinatus

岡下肌

Infraspinatus

小圓肌

Teresminor大圓肌

Teresmajor2.肩胛區(qū)肌Musclesoftheshoulder7肩胛下肌subscapularis

肩胛下肌subscapularis8肱三頭肌

Tricepsbrachii長(zhǎng)頭Longhead

外側(cè)頭Lateralhead

內(nèi)側(cè)頭medialhead

肱三頭肌Tricepsbrachii長(zhǎng)頭Longhea9五、血管blood

vessels1.肩胛上動(dòng)脈Suprascapulara.

2.肩胛背動(dòng)脈Dorsalscapulara.3.頸橫動(dòng)脈Transversecervicala.4.頸淺動(dòng)脈Superficialcervicala.

5.旋肩胛動(dòng)脈Circumflexscapulara.

6.旋肱前動(dòng)脈Anteriorcircumflexhumerala7.旋肱后動(dòng)脈Posteriorcircumflexhumerala.五、血管bloodvessels1.肩胛上動(dòng)脈Supras10肩胛上動(dòng)脈Suprascapulara.

旋肱后動(dòng)脈Posteriorcircumflexhumerala.旋肩胛動(dòng)脈Circumflexscapulara.

肩胛背動(dòng)脈Dorsalscapulara.肩胛上動(dòng)脈Suprascapulara.旋肱后動(dòng)脈Pos11肩胛上動(dòng)脈Suprascapulara.頸橫動(dòng)脈transversecervicala.肩胛背動(dòng)脈dosalscapulaa.頸淺動(dòng)脈superficialcervicala.

甲狀頸干

thyrocervicaltrunk肩胛上動(dòng)脈Suprascapulara.頸橫動(dòng)脈tran12六、神經(jīng)nerves

1.肩胛上神經(jīng)suprascapularn.2.肩胛背神經(jīng)dosalscapulan.3.腋神經(jīng)axillaryn.4.副神經(jīng)accessoryn.肩胛背神經(jīng)dosalscapulan.肩胛上神經(jīng)suprascapularn.腋神經(jīng)Axillaryn.六、神經(jīng)nerves1.肩胛上神經(jīng)suprascapul131.三邊孔Triangularforamen上superior：小圓肌Teresminor下inferior：大圓肌Teresmajor外lateral：肱三頭肌長(zhǎng)頭Longheadofthetriceps內(nèi)容Contents

：旋肩胛血管circumflexscapulara.旋肩胛動(dòng)、靜脈Circumflexscapulara、v.

七、局部結(jié)構(gòu)

regionalstructure

1.三邊孔Triangularforamen上superi14

2.四邊孔Quadrangularforamen上Superior

:小圓肌Teresminor下inferior：大圓肌Teresmajor內(nèi)Medial：肱三頭肌長(zhǎng)頭Longheadofthetriceps外Lateral：肱骨Humerus通過(guò)內(nèi)容：腋神經(jīng)、旋肱后血管AxillarynervePosteriercircumflexhumerala.v.腋神經(jīng)Axillaryn

、旋肱后血管Posteriorcircumflexhumerala.v.2.四邊孔Quadrangularforamen上Sup153.聽(tīng)診三角triangleofauscultation:上Superior：斜方肌外下緣lateralmarginof

Trapezius下Inferior：肩胛骨脊柱緣vertebralmarginiofscapula外Lateral：背闊肌上緣superiormarginoflatissimusdorsi聽(tīng)診三角triangleogauscultation3.聽(tīng)診三角triangleofauscultation16

項(xiàng)背部、肩胛區(qū)解剖

Thescapularregionandthebackvertebralregion

項(xiàng)背部、肩胛區(qū)解剖

Thescapular17(1)自枕外隆凸至尾骨尖做一縱行切口(2)自枕外隆凸沿上項(xiàng)線至乳突做一橫切口(3)自隆椎棘突向外橫向切至肩峰翻皮：沿以上切口將皮膚向外翻開(kāi)一、皮膚skin切口incisions

:⑴⑶⑵(1)自枕外隆凸至尾骨尖做一縱行切口一、皮膚skin切口in181.皮神經(jīng)cutaneousnerves頸、胸、腰神經(jīng)后支的皮支,第2頸神經(jīng)后支的皮支粗大稱為枕大神經(jīng)greateroccipitaln.,第3頸神經(jīng)后支的分支粗大稱為第三枕神經(jīng)thirdoccipitaln.2.淺血管

superficialbloodvessel肋間后動(dòng)、靜脈的后支腰動(dòng)、靜脈的后支

二、淺筋膜superficialfascia

1.皮神經(jīng)cutaneousnerves二、淺筋膜supe19三、深筋膜deepfascia項(xiàng)筋膜nuchalfascia胸腰筋膜thoracolumbarfascia上部的深筋膜較淺，下部的深筋膜較厚，呈菱形，稱胸腰筋膜，分為三層，包繞豎棘肌。前層anteriorlayer中層middlelayer后層posteriorlayer三、深筋膜deepfascia項(xiàng)筋膜nuchalfas20斜方肌Trapezius—副神經(jīng)背闊肌Latissimusdorsi—胸背N菱形肌rhomboideus

—肩胛背N肩胛提肌levatorscapulae—肩胛背N四、肌層muscularlayer①淺層superficiallayer斜方肌Trapezius

背闊肌Latissimusdorsi1.項(xiàng)背部肌themusclesoftheback肩胛提肌levatorscapulae菱形肌rhomboideus斜方肌Trapezius—副神經(jīng)四、肌層muscularl21②深層deeplayer豎脊肌erectorspinae作用：使脊柱后伸和仰頭，一側(cè)收縮使脊柱側(cè)屈。神經(jīng)支配：頸、胸、腰神經(jīng)的后支。為背肌中最長(zhǎng)、最大的肌，縱列于脊柱兩側(cè)的溝內(nèi)。包括髂肋肌iliocostalis、最長(zhǎng)肌longissimus、棘肌spinalis。髂肋肌iliocostalis最長(zhǎng)肌longissimus、棘肌spinalis②深層deeplayer作用：使脊柱后伸和仰頭，一側(cè)收縮使22①三角肌Deltoid—腋N②岡上Supraspinatus

—肩胛上N③岡下Infraspinatus

—肩胛上N④小圓肌Teresminor

—腋N⑤大圓肌Teresmajor

—肩胛下N⑥肩胛下肌Subscapularis—肩胛下N2.肩胛區(qū)肌Musclesoftheshoulder三角肌Deltoid岡上肌

Supraspinatus

岡下肌

Infraspinatus

小圓肌

Teresminor大圓肌

Teresmajor2.肩胛區(qū)肌Musclesoftheshoulder23肩胛下肌subscapularis

肩胛下肌subscapularis24肱三頭肌

Tricepsbrachii長(zhǎng)頭Longhead

外側(cè)頭Lateralhead

內(nèi)側(cè)頭medialhead

肱三頭肌Tricepsbrachii長(zhǎng)頭Longhea25五、血管blood

vessels1.肩胛上動(dòng)脈Suprascapulara.

2.肩胛背動(dòng)脈Dorsalscapulara.3.頸橫動(dòng)脈Transversecervicala.4.頸淺動(dòng)脈Superficialcervicala.

5.旋肩胛動(dòng)脈Circumflexscapulara.

6.旋肱前動(dòng)脈Anteriorcircumflexhumerala7.旋肱后動(dòng)脈Posteriorcircumflexhumerala.五、血管bloodvessels1.肩胛上動(dòng)脈Supras26肩胛上動(dòng)脈Suprascapulara.

旋肱后動(dòng)脈Posteriorcircumflexhumerala.旋肩胛動(dòng)脈Circumflexscapulara.

肩胛背動(dòng)脈Dorsalscapulara.肩胛上動(dòng)脈Suprascapulara.旋肱后動(dòng)脈Pos27肩胛上動(dòng)脈Suprascapulara.頸橫動(dòng)脈transversecervicala.肩胛背動(dòng)脈dosalscapulaa.頸淺動(dòng)脈superficialcervicala.

甲狀頸干

thyrocervicaltrunk肩胛上動(dòng)脈Suprascapulara.頸橫動(dòng)脈tran28六、神經(jīng)nerves

1.肩胛上神經(jīng)suprascapularn.2.肩胛背神經(jīng)dosalscapulan.3.腋神經(jīng)axillaryn.4.副神經(jīng)accessoryn.肩胛背神經(jīng)dosalscapulan.肩胛上神經(jīng)suprascapularn.腋神經(jīng)Axillaryn.六、神經(jīng)nerves1.肩胛上神經(jīng)suprascapul291.三邊孔Triangularforamen上superior：小圓肌Teresminor下inferior：大圓肌Teresmajor外lateral：肱三頭肌長(zhǎng)頭Longheadofthetriceps內(nèi)容Contents

：旋肩胛血管circumflexscapulara.旋肩