正常人體解剖學(xué)：第三章 呼吸系統(tǒng)

第三章呼吸系統(tǒng)概述一、呼吸系統(tǒng)的組成ReferencelinesofthoraxAnteriormedianlineMidclavicularlineParasternallineAnterioraxillarylinePostaxillarylineMidaxillarylineScapularlinePosteriormedianlineFunctionalAnatomyoftheRespiratorySystemRespiratoryorgansNose,nasalcavity,andparanasalsinusesPharynx,larynx,andtracheaBronchiandsmallerbranchesLungsandalveoliOrgansoftheRespiratorySystemCompositionRespiratorytractNosePharynxupperrespiratorytractLarynxTrachealowerrespiratorytractBronchiLungs-pairedorgansofrespirationFunction:supplythebodywithoxygenandtogetridofexcesscarbondioxideresultingfromcellmetabolism.呼吸道鼻咽喉肺上呼吸道下呼吸道氣管支氣管

主支氣管肺內(nèi)支氣管一、呼吸系統(tǒng)的組成O2(外界)

CO2↓

↑肺呼吸：肺泡毛細(xì)血管

血液循環(huán)↓↑細(xì)胞呼吸：組織細(xì)胞毛細(xì)血管

全身各細(xì)胞

二、呼吸系統(tǒng)的主要功能呼吸道——運(yùn)輸氣體肺——?dú)怏w交換TheNoseProvidesanairwayforrespirationMoistensandwarmsairFiltersinhaledairResonatingchamberforspeechHousesolfactoryreceptorsTheNoseSizevariationduetodifferencesinnasalcartilagesSkinisthin–containsmanysebaceousglands第一節(jié)肺外呼吸道一、鼻

(一)外鼻(二)鼻腔1、鼻前庭2、固有鼻腔(1)內(nèi)側(cè)壁：即鼻中隔，以骨性鼻中隔和鼻中隔軟骨為基礎(chǔ)。(2)外側(cè)壁

上鼻甲

上鼻道

中鼻甲

中鼻道

下鼻甲

下鼻道MucousmembraneofnoseOlfactoryregion嗅區(qū):locateduppernasalcavity,abovesuperior，nasalconchae，containsolfactorycellsRespiratoryregion呼吸區(qū):itsfunctionistowarm,moisten,andcleantheinspiredair嗅區(qū)——上鼻甲及其相對(duì)應(yīng)的鼻中隔表面。呼吸區(qū)——嗅區(qū)以外的部分。鼻腔粘膜的分區(qū)：(三)鼻旁竇開(kāi)口于上鼻甲上方的：蝶竇開(kāi)口于上鼻道的：篩竇后組開(kāi)口于中鼻道的：額竇、上頜竇、篩竇前組和中組TheParanasalSinusesFrontalsinusEthmoidalsinusesSphenoidsinusMaxillarysinusPharynx咽TheLarynxThreefunctionsVoiceproductionProvidesanopenairwayRoutesairandfoodintotheproperchannelsAnatomyoftheLarynxFigure21.5a,b前角喉結(jié)㈡喉的構(gòu)造

1、喉軟骨(1)甲狀軟骨：最大二、喉㈠喉的位置：頸前部正中皮下，喉咽的前方。（2）環(huán)狀軟骨：位于甲狀軟骨下方，呈環(huán)形；環(huán)狀軟骨弓，環(huán)狀軟骨板。（3）會(huì)厭軟骨（4）杓狀軟骨：成對(duì)，位于環(huán)狀軟骨板上方。⑴關(guān)節(jié)連結(jié)：環(huán)杓關(guān)節(jié)、環(huán)甲關(guān)節(jié)⑵韌帶或膜連結(jié)：

甲狀舌骨膜(甲舌膜)彈性圓錐(環(huán)甲膜)上緣——聲韌帶

杓會(huì)厭膜(方形膜)上緣——杓會(huì)厭韌帶下緣——前庭韌帶(又稱室韌帶)2、喉軟骨的連結(jié)喉軟骨的連結(jié)喉軟骨的連結(jié)喉軟骨的連結(jié)喉軟骨的連結(jié)3、喉肌(1)控制聲門裂大小的??；(2)調(diào)節(jié)聲帶緊張度的?。?3)開(kāi)大和關(guān)閉喉口的肌。StructurefeaturesTwopairsofshelflikefolds:Vestibularfolds前庭襞Vocalfolds聲襞TwofissuresRimavestibulithe前庭裂Fissureofglottis聲門裂Intermembranouspart膜間部anterior3/5,betweenvocal-foldsIntercartilagrnouspart軟骨間部posterior2/5,betweenarytenoidscartilagesThreepartsLaryngealvestibule

喉前庭ExtendsfromtheapertureoflarynxtotherimavestibuliTubercleofepiglottis會(huì)厭結(jié)節(jié)Intermedialcavityoflarynx喉中間腔ExtendsfromtheleveloftherimavestibulitothelevelofthefissureofglottisVentricleoflarynx

喉室asmallrecessbetweenvestibularandvocalfoldsoneachsideInfraglotticcavity

聲門下腔extendsfromthelevelofthevocalfoldstothelowerborderofthecricoidcartilageMovementsoftheVocalFolds㈢喉腔1、兩對(duì)粘膜皺襞：上方——前庭襞(室襞)，呈淺紅色下方——聲襞，呈白色2、裂隙：

前庭裂

聲門裂：兩側(cè)聲襞及杓狀軟骨之間的裂隙。膜間部—前3／5軟骨間部—后2／53、喉腔的分部：⑴喉前庭⑵喉中間腔⑶聲門下腔TheTracheaDescendsintothemediastinumDividesintotwomainbronchiC-shapedcartilageringskeepairwayopenTheTrachea三、氣管位置：頸前部正中及胸骨柄后方。形態(tài)結(jié)構(gòu)：圓筒形，后壁略平，由14—16個(gè)氣管軟骨連成，氣管軟骨成“C”形。四、主支氣管：由氣管杈到肺門。

左主支氣管：較長(zhǎng)、細(xì)、水平；

右主支氣管：較短、粗、陡直。BronchiintheConductingZoneTheLungsPosition:locatedinthethoraciccavitybybothsidesofmediastinumGeneralfeaturesCone-shaped,therightlungisshorterandbroader,theleftoneislongerandnarrowerApexoflung－rises2～3cmabovethemedialthirdofclavicleintoneckBase－concave,relatedtodiaphragm,alsocalleddiaphragmaticsurfaceCostalsurface－large,convex,relatedtothoracicwallMedialsurface－concave,relatedtomediastinumandvertebraeHilumoflung

肺門：areaonmedialsurfacewherestructuresinrootenterorleavelungRootoflung肺根ContentsPrincipalbronchusPulmonaryarteryandveinNervesandlymphaticsSurroundedbyconnectivetissueOrderofstructuresintherootoflungFrombeforebackward:V.A.B.Fromabovedownward:R.－B.A.V.L.－A.B.V.BordersPosterior－bluntInferior－sharpAnterior－sharpcardiacnotch心切跡

lingualinleftlung左肺小舌LobesandFissureRightlungTwofissures:horizontalobliqueThreelobes:superiormiddleinferiorLeftlungOnefissure:obliqueTwolobes:superiorinferior第二節(jié)肺一、肺的位置胸腔內(nèi)，縱隔的兩側(cè)二、肺的形態(tài)近似圓錐形，有一尖、一底、兩面、三緣。肺尖：鈍圓，可高出鎖骨內(nèi)側(cè)端上方2-3cm。肺底(膈面)前緣：銳利

心切跡(左肺)后緣：鈍圓下緣：銳利外側(cè)面(肋面)內(nèi)側(cè)面(縱隔面)：

肺門

肺門——肺內(nèi)側(cè)面中央凹陷處，有主支氣管、肺動(dòng)脈、肺靜脈、神經(jīng)和淋巴管通過(guò)。

肺根——出入肺門諸結(jié)構(gòu)被結(jié)締組織和胸膜包繞成束。肺的分葉：

右肺：3葉(上中下)

左肺：2葉(上下)水平裂斜裂斜裂水平裂ThePleuraGeneralfeaturesSerousmembranesformingclosedsacsTwolayersVisceralpleura－adherestolung,continuouswithparietalpleuraatrootoflungParietalpleura－linesthethoraciccavity

Twopleurallayerscontinuewitheachotheratrootoflungformingclosedpotentialspace－pleuralcavity

胸膜腔ContainsasmallamountpleuralfluidSubatmosphericpressureinitNamedpartsofparietalpleuraCupulaofpleura胸膜頂

－extendsupintotheneck,overtheapexoflung,2～3cmabovethemedialthirdofclavicleCostalpleura肋胸膜

－linestheinnersurfaceofthewallofthechestMediastinalpleura縱隔胸膜LinesmediastinumPulmonaryligament肺韌帶

－redundantpleuraatrootoflung,whichextendsdownward,allowsmovementofstructuresformingrootoflungDiaphragmaticpleura膈胸膜－Linesdiaphragm

Pleurarecesses胸膜隱窩－potentialspacesofpleuralcavitywhichlungsarenotoccupiedinquietrespirationCostodiaphragmaticrecesse肋膈隱窩－aretheslit-likeintervalsbetweencostalanddiaphragmaticpleuraeoneachside,thelowestpointofpleuralcavityCostomediastinalrecess肋縱隔隱窩－ontheleftsidebetweenthemediastinalpleuralandcostalpleuraThesurfaceprojectionoflowerborderoflun