運動系統(tǒng)解剖學培訓課件

運動系統(tǒng)解剖學BasicConceptsofAnatomy

Definition:humananatomy,theoldestsciencedealingwiththestructuresandfunctionsofbodyGrossanatomy:systematicanatomyregionalanatomy

Appliedanatomy

Clinicalanatomy2運動系統(tǒng)解剖學人體解剖學發(fā)展簡史HippcratesHippocrates----希波克拉底（公元前460~377）古希臘名醫(yī)、解剖學鼻祖。3運動系統(tǒng)解剖學GalenGalen--------伽林（130~200）古希臘名醫(yī)、解剖學家，著《醫(yī)經(jīng)》，對血液流動、神經(jīng)分支和腦、心等器官有具體描述。4運動系統(tǒng)解剖學Vesalius------(1514~1564)現(xiàn)代解剖學的奠基人，1543年出版了《人體構造》這一劃時代的解剖學巨著。Vesalius5運動系統(tǒng)解剖學HarveyHarvey------(1578~1657)解剖生理學家，發(fā)現(xiàn)了血液循環(huán)的原理，確定血液是在一個封閉的管道內循環(huán)。著有《血液循環(huán)論》、《動物的發(fā)生》兩書。開創(chuàng)了動物實驗研究的道路。6運動系統(tǒng)解剖學我國人體解剖學的發(fā)展歷程公元前300～200《黃帝內經(jīng)》已有對人體解剖的記載。兩宋時代《五臟六腑》、《存真圖》描述了解剖學知識。王清任（1768～1831）編著的《醫(yī)林改錯》更為詳細的描述了解剖學知識。1949～2003年我國解剖學工作者隊伍迅速成長，編寫了多套具有我國特色的解剖學教材和解剖學圖譜，對我國解剖學事業(yè)的發(fā)展做出了巨大的貢獻。7運動系統(tǒng)解剖學人體解剖教學特點人體解剖學的教學包括講授和實地解剖。主要講授各系統(tǒng)的總論和各解剖操作區(qū)的重點內容。實地解剖采取分組形式，在教師指導下，按照解剖操作指導，參照圖譜由學生親自動手解剖尸體，部分內容觀察標本和模型。同時，密切結合活體的觀察和觸摸，并適當?shù)慕Y合一些臨床病例討論以增強對解剖學內容的理解和記憶。教學大綱所列教學內容按要求程度的不同，分為“掌握內容”和“了解內容”兩級。掌握內容為重點內容，學生必須通過反復學習與思考達到牢固掌握、熟練描述、準確指認和聯(lián)系實際應用的程度。了解內容則要求學生達到一般的認識和了解。8運動系統(tǒng)解剖學

DescriptiveanatomicaltermsTheanatomicalposition:

(解剖學姿勢)

Thebodyisupright,legstogether,anddirectedforwards.Thepalmsareturnedforward,withthethumbslaterally.9運動系統(tǒng)解剖學Thetermsofthedirection

(方位術語)superior上,inferior下anterior(ventral)前(腹側)posterior(dorsal)后(背側)medial內側,lateral外側internal內,external外superficial淺,profound深proximal近側,distal遠側ulnar尺側,radial橈側tibial脛側，fibular腓側10運動系統(tǒng)解剖學

Anatomicalaxes

andplanes（軸與面）Axis軸：Verticalaxis垂直軸Sagittalaxis

矢狀軸Coronalaxis冠狀軸Plane面:Sagittalplane矢狀面Coronalplane冠狀面Horizontalplane

水平面或transverseplane橫切面11運動系統(tǒng)解剖學TheLocomotorSystem

運動系統(tǒng)

運動系統(tǒng)由bone骨、joints關節(jié)和muscles骨骼肌組成，占成人體重60%骨起杠桿作用關節(jié)是運動的樞紐骨骼肌是動力器官功能:

support支持Protection保護Locomotion運動

12運動系統(tǒng)解剖學Introductionoftheosteology骨學總論

Bonesinadultare206innumber.Classificationofbone

Bonesareclassifiedaccordingtotheirpositionandshape

Thepositioncanbe:skull顱骨bonesoftrunk軀干骨appendicularskeleton四肢骨Typesofshapeinclude:

longbone長骨shortbone短骨flatbone扁骨

irregularbone不規(guī)則骨

13運動系統(tǒng)解剖學

Longbones(foundinlimbs):Diaphysisorshaft骨干,whichishollow(calledmedullarycavity骨髓腔),filledwithbonemarrowTwoends－epiphysis骺articularsurface關節(jié)面,metaphysis干骺端,epiphysialcartilage骺軟骨,andepiphysialline骺線Shortbones:cuboidalinshape,e.g.carpalbones14運動系統(tǒng)解剖學Flatbones:thin,Irregularbones:haveanyirregularormixedshape,e.g.vertebrae,pneumaticbones含氣骨*Sesamoidbones籽骨:developwithintendon15運動系統(tǒng)解剖學Generalstructuresofbone骨的構造Bonesubstance骨質compactbone

骨密質spongybone

骨松質

呈海綿狀，由trabeculae骨小梁構成※Intheflatbonesoftheskull,thelayersofcompactbonearecalledtheouterplateandinnerplate外板和內板,whilethelayerofspongyboneiscalledthediplo?板障

16運動系統(tǒng)解剖學Periosteum骨膜:

OuterorfibrouslayerInnerlayerisvascularandprovidestheunderlyingbonewithnutrition.Italsocontainsosteoblasts(成骨細胞)Endosteum骨內膜

isasingle-cellularosteogeniclayerliningtheinnersurfaceofbone.Bonemarrow骨髓Redmarrow紅骨髓:haematopoietic造血Yellowmarrow黃骨髓:fatty17運動系統(tǒng)解剖學

Chemicalcompositionandphysicalproperties化學成分和物理性質Organicmaterial有機質：主要是骨膠原纖維束和粘多糖蛋白。構成支架，賦予骨的彈性和韌性。

Inorganicsalts無機質：主要是堿性磷酸鈣。賦予骨硬度和脆性

OrganicmaterialInorganicsaltsChildren11Adult37Old1418運動系統(tǒng)解剖學Bonesoftrunk軀干骨

Composition:vertebrae,sacrum,coccyx,sternumandribs

Vertebrae椎骨Thereare33vertebraeinchildren,arrangedasfollows:Cervicalvertebrae頸椎C.7Thoracicvertebrae

胸椎T.12Lumbarvertebrae

腰椎L.5Sacralvertebrae

骶椎S.5sacrum骶骨Coccygealvertebrae

尾椎Co.3~4coccyx尾骨19運動系統(tǒng)解剖學GeneralfeaturesofvertebraeVertebralbody椎體Vertebralarch椎弓pedicleofvertebralarch椎弓根:sup.andinf.Vertebralnotch

椎上、下切跡

laminaofvertebralarch椎弓板process(7):spinousprocess棘突transverseprocess橫突sup.andinf.articularprocesses上、下關節(jié)突Vertebralforamen椎孔

Vertebralcanal椎管Intervertebralforamen椎間孔20運動系統(tǒng)解剖學RegionalvariationsofvertebraeCervicalvertebraeVertebraeBody:smallVertebralforamen:largerandtriangularSpinousprocesses:shortandbifidinC3toC5,longinC6,andlongerinC7Transverseprocesses:shortandbifid,transverseforamen橫突孔Articularprocesses:horizontal21運動系統(tǒng)解剖學Atlas寰椎(C1)Bodyandspinousprocessabsent,consistsofanteriorandposteriorarches,andtwolateralmassesGrooveforvertebralartery椎動脈溝22運動系統(tǒng)解剖學Axis樞椎(C2):distinguishedbydens齒突whicharticulateswithdentalfoveaofanteriorarchofatlas23運動系統(tǒng)解剖學Carotidtubercle:頸動脈結節(jié):anteriortubercleoftransverseprocessofC6Vertebraprominens

隆椎(C7):containslongandnon-bifidspinousprocess,itisvisiblewithneckflexed,usedasclinicallandmarkincountingcervicalandthoracicspinousprocesses24運動系統(tǒng)解剖學Thoracicvertebrae

VertebraeBody：

heart-shape,superiorandinferiorcostalfovea上、下肋凹Vertebralforamen：

smaller,rounder

Spinousprocesses：

long,pointobliquelydownward

Transverseprocesses：transversecostalfovea橫突肋凹

Articularprocesses:coronal

25運動系統(tǒng)解剖學VertebraeBody：larger,kidney-shapeVertebralforamen:largerandtriangularSpinousprocesses:projectshorizontallyTransverseprocesses:longArticularprocesses:sagittal26運動系統(tǒng)解剖學Sacrum

Anteriorsurface:

promontory岬,anteriorsacralforamina

骶前孔(fourpairs)

Posteriorsurface:

mediansacralcrest骶正中嵴,posteriorsacralforamina(fourpairs),sacralhiatus骶管裂孔，sacral

cornu骶角Lateralpart:

auricularsurface耳狀面,sacraltuberosity骶粗隆27運動系統(tǒng)解剖學Transsacral(epidural)anasthesiaCornuapalpationSacralhiatus28運動系統(tǒng)解剖學Sternum

Manubriumsterni胸骨柄:jugularnotch頸靜脈切跡,clavicularnotch鎖切跡Bodyofsternum胸骨體

Xiphoidprocess★Sternalangle胸骨角:

thejunctionofmanubriumandbody,whichconnects2ndcostalcartilagelaterally,andliesoppositelowerborderofT4posteriorly29運動系統(tǒng)解剖學★Sternalangle胸骨角

whichconnects2ndcostalcartilagelaterally,andliesoppositelowerborderofT4posteriorly30運動系統(tǒng)解剖學Ribs肋:12pairGeneralfeaturesRibs1~7calledtrueribs真肋Ribs8~10calledfalseribs

假肋Ribs11~12calledfloatingribs

浮肋31運動系統(tǒng)解剖學

Characteristicsof“typical”ribPosteriorend:costalhead肋頭,costalneck肋頸,costaltubercle肋結節(jié)

Shaft:costalangle肋角,costalgroove肋溝Anteriorend32運動系統(tǒng)解剖學AtypicalribFirstrib:tubercleforscalenusanterior前斜角肌結節(jié),sulcusforsubclavianarteryandvein鎖骨下動、靜脈溝11thand12thribslackcostalnecks,tuberclesandangles33運動系統(tǒng)解剖學TheBonesofLimbs

山東大學醫(yī)學院解剖教研室李振華34運動系統(tǒng)解剖學Bonesofupperlimbs

Composition:Shouldgirdle上肢帶骨clavicle鎖骨，scapula肩胛骨Bonesoffreeupperlimb自由上肢骨Humerus肱骨inarmRadius橈骨andulna尺骨inforearmCarpal腕骨,metacarpals掌骨andphalanges指骨inhand35運動系統(tǒng)解剖學

Clavicle鎖骨“S”shaped,medial2/3convexforwardandlateral1/3convexbackwardSternalend胸骨端mediallyandacromialend肩峰端laterally36運動系統(tǒng)解剖學Scapula

肩胛骨ThreebordersSuperior:coracoidprocess喙突,scapularnotch肩胛切跡Lateral(axillary)border腋緣Medial(vertebral)border脊柱緣ThreeanglesSuperior:oppositetothe2ndribInferior:oppositetothe7thribor7thintercostalsspaceLateral:glenoidcavity關節(jié)盂,

supra-andinfraglenoidtubercles盂上、下結節(jié)TwosurfacesAnteriorsurfaceconcave:subscapularfossa肩胛下窩Posteriorsurface:supra-andinfraspinousfossae岡上、下窩,

spineofscapula肩胛岡,acromion肩峰37運動系統(tǒng)解剖學

Humerus

肱骨Upperend:headofhumerus肱骨頭,anatomicalneck解剖頸,greaterandlessertubercles大、小結節(jié),crestsofgreaterandlessertubercle,大、小結節(jié)嵴，intertuberculargroove結節(jié)間溝,surgicalneck外科頸Shaft:deltoidtuberosity三角肌粗隆onlateralsurface,andagrooveforradialnerve橈神經(jīng)溝onposteriorsurfaceLowerend:lateralandmedialepicondyles內、外上髁,capitulum肱骨小頭,trochlea肱骨滑車,coranoidfossa冠突窩andradialfossa橈窩(anteriorly)andolecranonfossa鷹嘴窩(posteriorly),andsulcusforulnarnerve尺神經(jīng)溝38運動系統(tǒng)解剖學RadiusUpperend:headofradius橈骨頭,neckofradius橈骨頸,radialtuberosity橈骨粗隆,andarticularcircumference環(huán)狀關節(jié)面Shaft：interosseousborder骨間緣Lowerend:styloidprocess

莖突laterally,ulnarnotch尺切跡medially,andcarpalarticularsurface腕關節(jié)面inferiorly39運動系統(tǒng)解剖學Fractureofthedistalendpftheradius

40運動系統(tǒng)解剖學UlnarUpperend:olecranon鷹嘴

coronoidprocess

冠突

trochlearnotch滑車切跡

radialnotch

橈切跡ulnartubersity尺骨粗隆

Lowerendstyloidprocess尺骨莖突headofulna尺骨頭41運動系統(tǒng)解剖學Carpalbones腕骨Proximalrow―(lateraltomedial)scaphoid手舟骨,lunate月骨,triquetral三角骨

andpisiform豌豆骨Distalrow―(lateraltomedial)trapezium大多角骨,trapezoid小多角骨,capitate頭狀骨

andhamate鉤骨Metacarpalbones掌骨NumberedonetofivefromthumbtolittlefingerStructureofeach―base(proximally),shaft,andhead(distally)Phalangesoffingers指骨Consistof14―twoforfirstdigit(thumb)andthreeforeachofotherfourdigitsStructureofeach―base(proximally),shaft,andtrochleaofphalanx(distally),tuberosityofdistalphalanx遠節(jié)指骨粗隆42運動系統(tǒng)解剖學BonesofLowerLimb

Composition:

Pelvicgirdle:hipbone髖骨Bonesoffreelowerlimb:Femur股骨inthigh(patella髕骨)Tibia脛骨andfibula腓骨inlegTarsals跗骨,metatarsals跖骨,phalangesoftoes趾骨infoot43運動系統(tǒng)解剖學Hipbone

Consistingofthreefusedbones,ilium,ischium,pubisIlium髂骨Bodyofilium髂骨體

toformsuperior2/5ofacetabulum髖臼Alaofilium髂骨翼:iliaccrest髂嵴,anteriorsuperior

iliacspine髂前上棘，anteriorinferioriliacspine髂前下棘,tubercleofiliaccrest髂結節(jié),posteriorsuperior

iliacspine髂后上棘，posteriorinferioriliacspine髂后下棘,greatersciaticnotch坐骨大切跡,glutealsurface臀面，iliacfossa髂窩,arcuateline弓狀線,auricularsurface耳狀面,iliactuberosity髂粗隆,44運動系統(tǒng)解剖學Ischium坐骨Bodyofischium坐骨體―toformposteriorandinferior2/5ofacetabulum,ischialspine坐骨棘,lessersciaticnotch坐骨小切跡Ramusofischium坐骨支,ischialtuberosity坐骨結節(jié)Pubis恥骨Bodyofpubis恥骨體―toformanteriorandinferior1/5ofacetabulum,iliopubiceminence髂恥隆起Superiorramusofpubis恥骨上支:pectenofpubis恥骨梳,pubictubercle恥骨結節(jié),pubiccrest恥骨嵴,symphysialsurface恥骨聯(lián)合面Inferiorramusofpubis恥骨下支:obturatorforamen閉孔Acetabulum髖臼―formedbybodiesofischium,iliumandpubisLunatesurface月狀面,acetabularfossa髖臼窩,acetabularnotch髖臼切跡45運動系統(tǒng)解剖學

Femur

股骨Upperend:femoralhead股骨頭,foveaoffemoralhead股骨頭凹,neckoffemur股骨頸,greater

trochanter大轉子，lessertrochanter小轉子,

intertrochantericline轉子間線,intertrochantericcrest轉子間嵴Shaft:lineaaspera粗線,glutealtuberosity臀肌粗隆,pectinealline恥骨肌線，poplitealsurface腘面

Lowerend:medialandlateralcondyles內、外側髁，medialandlateral

epicondyles內、外上髁,adductortubercle收肌結節(jié)，

intercondylarfossa髁間窩,patellarsurface髕面46運動系統(tǒng)解剖學Fractureofthefemoralneck47運動系統(tǒng)解剖學Tibia

脛骨Upperend:medialandlateralcondyles內、外側髁,intercondylareminence髁間隆起,fibulararticularsurface腓關節(jié)面,tuberosityoftibia脛骨粗隆

Shaft:interosseousborder骨間緣,solealline比目魚肌線Lowerend:fibularnotch腓切跡,medialmalleolus內踝48運動系統(tǒng)解剖學

Fibula

腓骨Upperend:fibular

head腓骨頭,neckoffibula腓骨頸Shaft:interosseousborder骨間緣Lowerend:lateralmalleolus外踝Patella髕骨triangularsesamoidbone49運動系統(tǒng)解剖學Tarsalbones

跗骨ConsistofsevenshortbonesarrangedinthreerowPosteriorrow―talus距骨,calcaneus跟骨Intermediaterow―navicularbone足舟骨Anteriorrow―medial,intermediate,andlateralcuneiforms內側、中間和外側楔骨,cuboidbone骰骨50運動系統(tǒng)解剖學

Metatarsalbones跖骨Consistoffiveelongatedbones,numberedonetofivemedialtolateralStructureofeach―base(proximally),shaft,andhead(distally)ineachPhalangesoftoes趾骨Consistof14―twoforfirsttoe(hallux)andthreeforeachofotherfourtoes※Surfacelandmarks:

trochleaoftalus距骨滑車,calcanealtuberosity跟骨結節(jié),tuberosityofnavicularbone舟骨粗隆,andtuberosityoffifthmetatarsalbone第五跖骨粗隆51運動系統(tǒng)解剖學Skull顱山東大學醫(yī)學院解剖教研室李振華52運動系統(tǒng)解剖學Theskulliscomposedof23bones,whichmaybedividedintothecerebralcraniumandfacialcranium

Cerebralcranium

腦顱(8)―larger,upperandposteriorpart,containsandprotectsthebrainSinglebones:includefrontalbone額骨,ethmoidbone篩骨,sphenoidbone蝶骨,occipitalbone

枕骨Pairedbones:includetemporalbone顳骨parietalbone頂骨

53運動系統(tǒng)解剖學Bonesoffacialcranium

面顱(15)―smaller,lower,andanteriorpart,containsbonesthatsurroundedtheeye,noseandmouthSinglebones:include

mandible下頜骨,vomer

犁骨hyoidbone舌骨Pairedbones:includemaxilla上頜骨,nasalbone鼻骨,

lacrimalbone淚骨,palatinebone腭骨,zygomaticbone顴骨,inferiornasalconcha下鼻甲54運動系統(tǒng)解剖學FrontalboneZygomaticboneNasalboneMaxilla

MandibleSphenoidbone

parietalbone

TemporalboneOccipitalbone55運動系統(tǒng)解剖學面顱上頜為中心，上鼻淚，下下頜，

外顴內甲后犁腭，舌骨頸前單落腳。56運動系統(tǒng)解剖學Theskullasawhole顱的整體觀Skullviewedfromabove(superiorview)Bones:frontal額,pairedparietal頂,occipital枕Sutures:coronal冠狀縫,sagittal矢狀縫,lambdoid人字縫parietaltuber頂結節(jié)，

parietalforamen頂孔Internalsurfaceofthecalvaria

sulcusforsuperiorsagittalsinus上矢狀竇溝granularfoveola顆粒小凹arterialgrooves動脈溝Skullviewedfrombehind

externaloccipitalprotuberance枕外隆凸superiornuchalline上項線58運動系統(tǒng)解剖學Internalviewofbaseofskull

顱底內面觀BaseofskullformsthreefossaeAnteriorcranialfossa

顱前窩Meddlecranialfossa

顱中窩Posteriorcranialfossa顱后窩59運動系統(tǒng)解剖學Anteriorcranialfossa顱前窩Formedbyorbitalpartoffrontalbone,cribriformplateofethmoid,andlesserwingsofsphenoidStructures:frontalcrest額嵴

foramencecum

盲孔

cristagalli雞冠

cribriformplate篩板

cribriformforamina

篩孔60運動系統(tǒng)解剖學Meddlecranialfossa

顱中窩Formedbythebodyandgreaterwingsofsphenoid,petrouspartoftemporalStructures:bodyofsphenoidbone

蝶骨體

hypophysialfossa垂體窩

opticcanal視神經(jīng)管anteriorclinoidprocess

前床突

tuberculumsellae鞍結節(jié)

dorsumsellae鞍背

posteriorclinoidprocess

后床突

sellaturcica蝶鞍

61運動系統(tǒng)解剖學Meddlecranialfossa

顱中窩carotidsulcus頸動脈溝

superiororbitalfissure眶上裂foramenrotundum圓孔

foramenovale卵圓孔

foramenspinosum棘孔sulcusformiddlemeningealartery腦膜中動脈溝foramenlacerum破裂孔

internalopeningofcarotidcanal頸脈管內口trigeminalimpression三叉神經(jīng)壓跡tegmentympani鼓室蓋

62運動系統(tǒng)解剖學Posteriorcranialfossa

顱后窩FormedbyoccipitalandthepetrouspartoftemporalStructures:foramenmagnum枕骨大孔

clivus斜坡

internalopeningofhypoglossalcanal舌下神經(jīng)管內口

internaloccipitalprotuberance

枕內隆凸internaloccipital

crest枕內嵴

sulcusfortransversesinus橫竇溝

sulcusforsigmoidsinus乙狀竇溝

jugularforamen頸靜脈孔

internalacousticpore內耳門internalacousticmeatus內耳道63運動系統(tǒng)解剖學Skullseenfrombelow(inferiorview)alveolararch牙槽弓bonypalate骨腭medianpalatinesuture腭正中縫incisiveforamina切牙孔incisivecanal切牙管greaterpalatineforamen腭大孔posteriornasalapertures鼻后孔pterygoidprocess翼突occipitalcondyle枕髁externalopeningofhypoglossalcanal舌下神經(jīng)管外口externalopeningofcarotidcanal頸動脈管外口styloidprocess莖突stylomastoidforamen

莖乳孔mandibularfossa下頜窩articulartubercle

關節(jié)結節(jié)64運動系統(tǒng)解剖學

Lateralviewoftheskull

顱側面觀externalacousticpore外耳門

mastoidprocess乳突

zygomaticarch顴弓

temporalfossa顳窩

pterion翼點pterygomaxillaryfissure翼上頜裂pterygopalatinefossa翼腭窩

sphenopalatineforamen蝶腭孔

65運動系統(tǒng)解剖學Skullviewedfromthefront(anteriorview)

顱的前面觀Frontalregion:frontalsquama額鱗

frontaltuber額結節(jié)superciliaryarch眉弓

glabella

眉間66運動系統(tǒng)解剖學Orbit眶pyramid