002胸壁.ppt

局部解剖学;Summarization 概述 Thoracic wall 胸壁 Breast 乳房 Axillary Region 腋区;一、概述 Summarization;胸部是躯干的上部，位于颈部与腹部之间。 The thorax (chest) is the upper part of the trunk between the neck and the abdomen．;;;颈静脉切迹 The jugular notch 胸骨角The sternal angle (of Louis) 剑突The xiphoid process 肋弓The costal margin (costal arch) 胸骨下角The infrasternal angle 锁骨 The clavicle 肩胛骨下角The inferior angle of scapula 乳头The nipple;The jugular notch;Xiphoid process;Costal arch;costal arch;;;经剑肋角的心包（液）穿刺术; ;;Sternal angle (of Louis);胸 骨 角 The sternal Angle (of Louis);①The lower border of the 4th thoracic vertebra;②The level where the trachea divides into the right and left principal (main) bronchi. ;③ The second constriction of the esophagus ;④ The origin and end of the aortic arch;⑤The ligamentum arteriosum joins the left pulmonary artery to the aortic arch;⑥The azygos vein enters the superior vena cava;⑦ The boundary line between the superior and inferior mediastina;;The Lines of Orientation on the Thorax;The Lines of Orientation on the Thorax;The Lines of Orientation on the Thorax;The Lines of Orientation on the Thorax; ;（一）The Superficial Structures;深筋膜 deep fascia 胸壁浅层肌 superior muscles of thoracic wall 肋及肋间隙 ribs and intercostal space 胸内筋膜 internal thoracic fascia ;1. 深 筋 膜 deep fascia;锁胸筋膜及其穿行结构;The pectoralis major 胸大肌 The subclavius 锁骨下肌 The pectoralis minor 胸小肌 The serratus anterior 前锯肌 The obliquus externus abdominis 腹外斜肌 The trapezius 斜方肌 The rhomboids 菱形肌 The latissimus dorsi 背阔肌 The transversus thoracis 胸横肌 The rectus abdominis 腹直肌 The intercostal muscles 肋间肌;;;;;;The intercostal muscles 肋间肌 Nerves 神经 Vessels 血管(the intercostal vessels 肋间血管, the internal thoracic vessels 胸廓内血管);（1）The intercostal muscles ;;Anterior and posterior intercostal artery; 在达肋角之前，肋间血管和神经位于肋间隙中部，彼此排列关系不恒定；然后行于肋沟内、肋间内肌与肋间最内肌之间。;;;;4. 胸内筋膜;;①在肋角内侧： ②在肋角之前：;;施行胸膜腔穿刺术需经过哪些层次？ ;;三、乳房;;;;乳房的血管;乳房的淋巴引流;四、腋 区Axillary Region;腋区的位置腋窝的概念;腋窝的一顶、一底、四壁;;;;腋窝的四壁Four