系统解剖学教学课件：胸部的肌肉

胸部Thethorax南京大学医学院人体解剖教研室Thethorax-conceptualoverview1、境界与分区

Boundariesanddivisions上界：颈静脉切迹、胸锁关节、锁骨上缘、肩峰和第7颈椎棘突的连线下界：剑突、肋弓、第11肋前缘、第12肋下缘和胸12棘突的连线胸腔：通过膈肌与腹腔来分界

胸廓上口胸廓下口

骨性胸廓胸壁肌性装置左右肺与胸膜胸腔心包与大血管纵隔其它分区纵膈的划分肋间肌Theintercostalmuscles1、肋间外肌（intercostalexterni）—肋间外膜（externalintercostalmembrane）肋软骨2、肋间内肌（intercostalinterni）—肋间内膜（internalintercostalmembrane）肋角3、肋间最内肌（intercostalintimi）4、胸横肌（transversusthoracism.）助呼气Intercostalesexterni

肋间外肌Origin:lowerborderofribInsertion:upperborderofribbeloworiginexternalintercostalsmembrane肋间外膜.Action:elevateribsaddinginforcedinspiration2.IntrinsicmusclesOrigin:upperborderofrib；Insertion:lowerborderofribaboveoriginReplacedposteriorlybyinternalintercostalsmembrane.Action:depressribsforforcedexpirationIntercostalesinterni

肋间内肌(1)

Positionanddivision:

dome-shapedbetweenthoraxandabdomen,consistsof

Centraltendon中心腱

muscularpart

肌部

Ⅲ.Diaphragm

膈Sternalpart:Costal

part:Lumbar

part:

arisesbyleftandrightcrus

fromupper2-3lumbarvertebrae

Insertion:

centraltendon(2)Openingsofdiaphragm①

Aortichiatus主动脉裂孔atthelevelof12ththoracicvertebra,the

thoracicaortaandthoracicductpassthroughit②Esophagealhiatus食管裂孔atthelevelof10ththoracicvertebra,

the

esophagusandvagusn.passthroughtit③Venacavalforamen腔静脉孔

atthelevelof8ththoracicvertebra,

inferiorvenacavathroughitT8T10T12inferiorvenacavaesophagusthoracicaorta(3)Action

Contraction:thedomemovingdownward,increasesthevolumeofthoraciccavitywhichresultsininspiration.Relaxation:thedomereturnstotheformerposition,reducesthevolumeofthethoraciccavity,resultinginexpiration.

(2)Weak

areas:triangularspaceswithoutmusculartissue

Lumbocostal

triangle腰肋三角

betweencostalandlumbarparts.

Sternocostal

triangle胸肋三角:betweencostalandsternalparts.膈Thediaphragm（1）1、positionandshape穹隆状、分隔胸、腹腔，最高点达第5肋间。2、divisions中心腱centraltenddon、左、右膈脚

crus起自上2-3个腰椎体、有内、外侧弓状韧带，分成腰、肋、胸三部，三部之间缺乏肌纤维，为膈的薄弱区，形成胸肋三角sternocostaltriangle和腰肋三角lumbocostaltriangle。膈Thediaphragm（2）3、裂孔foramen腔静脉裂孔venacavalf.平第8胸椎,有下腔静脉和右膈神经通过.食管裂孔esophagealhiatus平第10胸椎,有食管、左、右迷走神经干vagaln.和胃左动脉的食管支通过。主动脉裂孔aortichiatus平第12胸椎，有主动脉、胸导管、奇静脉、半奇静脉通过4、血管、淋巴和神经Thebloodvessela、thelymphaticdrainageandnerves血供：心包膈动脉、肌膈动脉、膈上、下动脉和下位肋间后动脉淋巴：注入膈上、下淋巴结神经：膈神经phrenicnerve、副膈神经accessoryphrenicnerve出现率为48%。膈Thediaphragm（3）呼吸运动运动方式胸式呼吸—肋间肌的舒缩