脑和脊髓的被膜血管.ppt

脑和脊髓的被膜与血管脑脊液循环TheMeningesandBloodVesselsofBrainandSpinalCord,theCerebrospinalFluid,脑和脊髓的被膜TheMeningesofBrainandSpinalCord,硬膜duramater蛛网膜arachnoid软膜piamater,脊髓的被膜Themeningesofspinalcord硬脊膜spinalduramater脊髓蛛网膜spinalarachnoidmater软脊膜spinalpiamater,1、硬脊膜spinalduramater枕骨大孔边缘-S2水平。硬膜外隙Epiduralspace位置内容物特点临床意义：硬膜外麻醉Subduralspace硬膜下隙,脊髓,硬脊膜,脊神经根,硬膜外隙,2、脊髓蛛网膜Spinalarachnoidmater特点：缺乏血管和神经与脑蛛网膜相延续Subarachnoidspace蛛网膜下隙Terminalcistern终池：脊髓下端S2水平内含马尾和终丝腰穿,蛛网膜下隙,终池,Lumbarspinalpuncture,3、Spinalpiamater软脊膜,特点：血管丰富，深入沟裂Filumterminale终丝Denticulateligament齿状韧带:,齿状韧带,脑的被膜TheMeningesofBrain,Cerebralduralmater硬脑膜Cerebralarachnoidmater脑蛛网膜Cerebralpiamater软脑膜,硬脑膜cerebralduralmater,1、特点坚韧、无弹性两层合成与颅盖骨连接疏松与颅底骨结合紧密,2、形成结构：1）四个隔幕Cerebralfalx大脑镰Tentoriumofcerebellum小脑幕Cerebellarfalx小脑镰Diaphragmasellae鞍隔,2）Sinusesofduramater硬脑膜窦窦壁无平滑肌、内衬内皮、无瓣膜、Superiorsagittalsinus上矢状窦Inferiorsagittalsinus下矢状窦Straightsinus直窦Confluenceofsinus窦汇,Transversesinus横窦Sigmoidsinus乙状窦Superiorpetrosalsinuses岩上窦inferiorpetrosalsinuses岩下窦,Cavernoussinus海绵窦位置：蝶鞍两侧通过结构：颈内动脉动眼神经滑车神经眼神经上颌神经展神经与周围静脉的交通：,蝶窦,颈内动脉,Theflowingofthebloodinduralsinus硬脑膜窦的血液流注,Sup.sagittalsinus上矢状窦,Inf.sagittalsinus下矢状窦,Straightsinus直窦,Confluenceofsinus窦汇,Transversesinus横窦,Cavernoussinus海绵窦,Sup.petrosalsinus岩上窦,Inf.petrosalsinus岩下窦,Internaljugularvein颈内静脉,Sigmoidsinus乙状窦,脑蛛网膜cerebralarachnoidmater,特点：缺乏血管和神经、跨越沟裂（除外大脑纵裂和大脑横裂）Subarachnoidspace蛛网膜下隙,Subarachnoidcisterns蛛网膜下池小脑延髓池脚间池桥池交叉池四叠体上池,A,B,C,D,E,Cerebellomedullarycistern,Arachnoidgranulations蛛网膜粒,上矢状窦,硬脑膜,脑蛛网膜,软脑膜,蛛网膜粒,大脑镰,软脑膜cerebralpiamater,特点：富血管神经、深入沟裂脉络组织：在脑室的一定部位，软脑膜及其血管与室管膜上皮共同形成。脉络丛Choroidplexus,脑脊液循环Circulationofcerebrospinalfluid(CSF),Circulationofcerebrospinalfluid,CSFdrainsfromlateralventricle侧脑室的脑脊液,interventricularforamina室间孔,thirdventricle第三脑室,mesencephalicaqueduct中脑水管,fourthventricle第四脑室,medianandtwolateralapertures第四脑室正中孔和外侧孔,subarachnoidspace蛛网膜下隙,arachnoidgranulations蛛网膜粒,superiorsagittalsinus上矢状窦,Vein静脉,脑和脊髓的血管Bloodvesselsofbrainandspinalcord,脑的动脉,脑的动脉的来源：Internalcarotidartery颈内动脉供应：端脑前2/3、部分间脑Vertebralartery椎动脉供应：端脑后1/3、部分间脑、脑干、小脑分支类型：皮质支、中央支,颈内动脉,椎动脉,颈内动脉internalcarotidartery,行径颈部、岩部、海绵窦部、前床突上部虹吸部分支大脑前动脉大脑中动脉脉络丛前动脉后交通动脉,大脑前动脉Anteriorcerebral皮质支中央支,大脑中动脉Middlecerebralartery皮质支:中央支:,大脑中动脉,豆纹动脉,脉络丛前动脉Anteriorchoroidalartery:后交通动脉Posteriorcommunicatingartery,颈内动脉,脉络丛前动脉,后交通动脉,椎动脉Vertebralartery脊髓前、后动脉小脑下后动脉基底动脉basilarartery小脑下前动脉迷路动脉脑桥动脉小脑上动脉大脑后动脉,大脑后动脉PosteriorcerebralarteryCorticalbranches皮质支:Centralbranches中央支:,大脑后动脉,大脑前动脉,Cerebralarterialcircle(circleofWillis)大脑动脉环,Veinsofbrain脑的静脉,Superficialcerebralveins大脑浅静脉Drainbloodfromcortexandsubcorticalmedullarysubstanceandemptyintoadjacentsinusesofduramater,脑的静脉无静脉瓣，不与动脉伴行，分浅、深组。,Deepcerebralveins大脑静脉深组draindeeperpartsofhemispheres,basalnuclei,internalcapsule,diencephalonandchoroidplexus,ultimatelyformgreatcerebralvein大脑大静脉whichenterstraightsinus,Bloodvesselsofspinalc