局部解刨学胸部.pptxVIP

局部解刨学胸部第1页/共56页 2023/5/29 12:21:522The Bony ThoraxSternumManubrium, Body (Gladiolus), Xiphoid ProcessRibs7 True Ribs5 False RibsClavicleScapulaVertebraeCervicle,Thoracic, Lumbar, Sacral (Sacrum), Coccygeal (Coccyx)第2页/共56页 2023/5/29 12:21:523The Sternum (Composed of fused sternebrae)ManubriumJugular (sternal) notchArticulation with rib #1 2Clavicular Articular facetsSternal Angle – 2nd ribBody (Gladiolus)Articulates w/ribs 2-7Xiphosternal jointXiphoid processCartilage-calcifies thru timePartial attachment of many musclesPg 178第3页/共56页 2023/5/29 12:21:524Typical Rib ArticulationDorsal (P) Attachment Thoracic VertebraeHead of Rib ? 2 Demifacets Superior demifacet Inferior demifacet of vertebra above itIntervertebral disc Tubercle of Rib ? Transverse Costal Facete.g. Rib #4 articulates with Superior Demifacet and Transverse Costal Facet of T4 Inferior demifacet of T3Ventral (A) Attachment to SternumVia costal cartilagePg 180第4页/共56页 2023/5/29 12:21:525Intervertebral DiscsAnnulus FibrosusOuter collar of concentric rings Outer rings = ligamentsInner rings = fibrocartilageSupportive/StructuralNucleus PulposusInner disc, cushiony padRemnants of notocordShock AbsorberIntervertebral discsPg 171第5页/共56页 2023/5/29 12:21:526Anterior Surface of ThoraxPalpate the followingSternum (3 parts)Jugular notchSternal Angle (= 2nd rib)ClavicleCostal margin Infrasternal angleXiphosternal jointMidclavicular LineMidaxillary Line第6页/共56页 2023/5/29 12:21:527一、胸前外侧壁解剖程序 (一)尸位 (二)摸认体表标志 (三)翻开浅部结构 (四)解剖肋间隙．1．肋间肌2．肋间后动、静脉和肋间神经． (五)打开胸前壁1．断离锁骨2．切断肋间肌3．剪断肋骨4．切断胸锁乳突肌与舌骨下肌的起点5．掀开胸前壁6．切断膈的前部起点 (六)剖查胸前壁内面的结构1．胸内筋膜和胸横肌 2．胸廓内动、静脉和胸骨旁淋巴结第7页/共56页 2023/5/29 12:21:528（一） 胸前外侧壁 1．尸位：取仰卧位。 2．摸认体表标志：颈静脉切迹、胸骨角、剑突、肋、肋间隙、肋弓、胸骨下角、剑肋角。 3．解剖胸壁结构：胸前外侧壁浅部结构已在上肢解剖时剖查，现逐层翻开皮片、筋膜、胸大肌、胸小肌、复查肋间神经前皮支和外侧皮支穿出部位，清理胸大、小肌在胸壁上的附着部分，将前踞肌自起点剥离，连同支配该肌的胸长神经一起翻向外侧，并观察其与腹外斜肌肌齿的交错。　 第8页/共56页 2023/5/29 12:21:529第9页/共56页 2023/5/29 12:21:5210第10页/共56页 2023/5/29 12:21:5211Mammary GlandPg 726第11页/共56页 2023/5/29 12:21:5212第12页/共56页 2