局部解剖学（上肢）.ppt

局部解剖学regional anatomy 河北医科大学 基础课教学部 解剖组胚教研室 张边江 一、上肢概述 上肢的境界与分区 表面解剖：喙突、肩峰、肱骨大结节、肱骨外上髁、三角肌粗隆、肱骨内上髁、桡骨头、桡骨茎突、尺骨头、尺骨茎突、剑突、颈静脉切迹、胸骨角、肋弓 表面解剖 表面解剖 肘后三角 肘外侧三角 肘 畸 形 上肢动脉与神经干的投影 二、上肢浅层结构Superficial structures of upper limb 浅静脉 Superficial vein 手背静脉网（弓） Dorsal venous network(arch) 头静脉 Cephalic vein 贵要静脉 Basilic vein 肘正中静脉 Median cubital vein 皮神经 Cutaneous nerve 前臂外侧皮神经 Lateral antebrachial nerve 前臂内侧皮神经 Medial antebrachial nerve 前臂后区和肘后区浅静脉和皮神经 前臂前区和肘前区浅静脉和皮神经 臂前区和肘前区浅静脉和皮神经 三、腋 区Axillary Region 腋区的位置腋窝的概念 腋窝的一顶、一底、四壁 Axillary fossa 腋窝 The axillary fossa is a pyramid-shaped space through which major neurovascular structures pass between the thorax and upper extremity 腋窝的底：由皮肤、浅筋膜和腋筋膜构成。 Base of the axilla is formed by the skin, subcutaneous tissue and axillary fascia. 腋窝的前璧：由胸大肌、胸小肌锁骨下肌和锁胸筋膜构成。 Anterior wall of the axilla is formed by the pectoralis major, subclavius, clavipectoral fascia, pectoralis minor and suspensory ligament of axilla. 腋窝的后璧：由大圆肌、背阔肌、肩胛下肌和肩胛骨构成。 Posterior wall of the axilla is formed by the scapula , the subscapularis, the teres major and latissimus dorsi. 腋窝的后璧： 由大圆肌、背阔肌、肩胛下肌和肩胛骨构成。 Posterior wall of the axilla is formed by the scapula , the subscapularis, the teres major and latissimus dorsi. 腋窝的内侧壁：由前锯肌、上4为肋骨及肋间肌构成。 Medial wall of the axilla is formed by the thoracic wall(1st to 4th ribs and intercostal muscles)and the overlying serratus anterior. 腋窝的顶：是腋窝的上口，向上内通颈根部，由锁骨中1/3、第1肋外缘和肩胛骨上缘围成。 Apex of the axilla, the entrance from neck to axilla, lies between the 1st rib, the middle one-third of clavicle, and superior border of the scapula. 腋动脉的分段及其分支(1) Arteries of upper limb Axillary artery Continuation of subclavian artery at lateral border of first rib Becomes brachial artery at lower border of teres major Divided into three parts by overlying pectoralis minor First portion, above muscle－gives rise to thoracoacromial a. 胸肩峰动脉 Second