解破學(xué)25生殖系統(tǒng)課件

HunanUniversityofArtsandScienceHUMANANATOMY1Question:Howmanyreferencelinesinthethoraxandabdomen?Answer:morethan12referencelineswhicharelistedbelow:Medianlines:AnteriormedianlineandposteriormedianlineAxillarylines:Anterioraxillaryline,midaxillaryline,posterioraxillarylineSternallines:Lateralsternalline,parasternallineHorizontalline:Subcostalline,transtubercularlineMidclavicularline,scapularline,paravertebralline2ContentChapter5TheAlimentarySystemTheGeneralDescriptionTheAlimentaryCanal.TheDigestiveGlands.3§⒈ThebasicconstituentsofthedigestivesystemDigestivecanalAccessoryorgansThemouthThepharynxTheesophagusThestomachTheintestineTheteethThetongueThegallbladderThesalivaryglandsTheliverThepancreas消化系統(tǒng)5Stomach

Liver

IleumJejunumMajorsalivaryglands

Pharynx

Esophagus

Mouth

DuodenumRectumLargeintestinePancreas6②Absorptionofthenutrientcomponents(proteins,carbohydrates,fats,vitamins,mineralsandwater)營養(yǎng)物質(zhì)的吸收§⒉Themainfunctionsofthedigestivesystem①Ingestionoffoods攝入食物③Defecation排便:theeliminationofindigestiblesubstancesfromthebodyviatheanusintheformoffeces.7§⒈Theoralcavity口腔⑴Theoralcavityincludestwoparts:TheOralVestibule口腔前庭TheOralCavityProper固有口腔Theoralcavity口腔前庭為口腔內(nèi)牙齦、牙弓外側(cè)部的部分，外界為唇和頰，內(nèi)界為牙齦和牙齒。固有口腔上壁為硬腭和軟腭，下壁為舌、粘膜和骨骼肌，側(cè)壁為牙弓、牙齒和牙齦。9TheOralVestibule口腔前庭TheOralCavityProper固有口腔10TheOralVestibule口腔前庭11Itconstitutestheroofofthemouthandthefloorofthenasalcavity(鼻腔).⑵Thepalate(腭)Hardpalate(硬腭)：ananterior2/3partSoftpalate(軟腭):aposterior1/3partThepalate硬腭主要以骨腭為基礎(chǔ)，覆蓋黏膜而成。

軟腭由肌、肌腱和粘膜組成，后部斜向后下，稱腭帆。腭帆后緣游離，中央有向下的突起稱腭垂。

13Hardpalate(硬腭)Softpalate(軟腭)Uvula(懸雍垂)14⑶Theteeth(Dentes牙齒)TwosetsDeciduousteeth

乳牙Permanentteeth

恒牙①Twosetsfortheteeth1517ThespecialpointsforthedeciduousteethEruption萌發(fā):

startsatabout6mouthsofageandcontinuestothebeginningofthe3rdyear.Shedding脫落:

occursbetweenthe6thandthe12thyearswithreplacementbythepermanentteeth.乳牙6個(gè)月大時(shí)開始萌發(fā),3歲初出全,共20個(gè).18③ThePermanentteeth恒牙

32innumber,sixteenineachmandibularandmaxillaryarch.

中切牙

側(cè)切牙尖牙第一磨牙第二磨牙第三磨牙第一前磨牙第二前磨牙1921Thespecialpointsforthepermanentteeth

Thefirstpermanentmolar第1恒磨牙:appearsatabout6yearsofage.Thethirdmolars(wisdomteeth)第3磨牙:manypersonseruptatanytimeafterthe12yearsofageornotatall.22Comparsionbetweenthemilkteethandpermanentteeth2setsforthehumanteethmilkteeth(乳齒)permanentteeth(恒齒)Delicate(易受損的)andwillgraduallyfallout

ReplacethemilkteethWillnotbereplacedbythenewteethiflostSmallerandwhiterthanthepermanentteeth23基本結(jié)構(gòu)附屬結(jié)構(gòu)⑤ThestructureofatoothEnamel

(釉質(zhì))Dentine(牙質(zhì))Cement(牙骨質(zhì))Pulpcavity(髓腔)Periodontalmembrane(牙周膜)Jawbone(腭骨)Gingiva(牙齦)Toothstructure25Enamel(琺瑯質(zhì))▲Enamel(琺瑯質(zhì))theoutermost,non-living,hardlayermainlymadeofcalciumphosphate(磷酸鈣)andasmallamountoforganicmatterprotectsthetooth26Pulpcavity(髓腔)▲Pulpcavity(髓腔)theinnermostpartcontainslivingcells,bloodvesselsandnerves29Periodontalmembrane&Jawbone▲Periodontalmembrane

(牙周膜)▲Jawbone(牙槽骨)30牙整體結(jié)構(gòu)示意圖31⑶Thetongue舌①TwopartsTonguebody:anterior2/3Tongueroot:posterior1/3TonguepartsThemuscularorganisdividedintotwopartsbythev-shapedterminalsulcus(界溝).bodyroot32②Theforamencecumofthetongue

舌盲孔Attheapexofterminalsulcusthereisasmallmedianpit

(洞),calledtheforamencecumoftongue

舌盲孔.舌盲孔舌盲孔為甲狀舌管朝向咽的開口部的殘存結(jié)構(gòu)。

33③Thepapillaeofthetongue舌乳頭Filiformpapillae

絲狀乳頭

Fungiformpapillae

菌狀乳頭

Foliatepapillae

葉狀乳頭Vallatepapillae

輪廓乳頭菌狀乳頭、葉狀乳頭、

輪廓乳頭以及會(huì)厭等處的粘膜上皮內(nèi)，均含有味蕾，為味覺感受器。PapillaetypesThereare4typesofthepapillaeonthetongue.34Filiformpapillae

Fungiformpapillae

FoliatepapillaeVallatepapillae35Thepapillaeofthetongueview36Thepapillaeofthetongueview37▲Massesofsub-mucosallymphoid(淋巴的)tissueontherootofthetongue.舌扁桃體由許多淋巴組織構(gòu)成的許多大小不等的突起組成。④Thelingualtonsil舌扁桃體38⑷ThesalivaryglandsMajorsalivaryglandsMinorsalivaryglandsParotidglandSubmandibularglandSublingualglandTonguegland舌腺Lipgland唇腺Cheekgland頰腺Palatinegland腭腺Thesalivaryglandscanbedividedintotwogroupsaccordingtotheirsizes:39Majorsalivaryglandsview40§⒉ThePharynx咽⑴ThegeneralfeaturesAfibromuscular(纖維肌肉質(zhì)的)tube,partofthedigestiveandrespiratorysystems.ExtendsfromthebaseoftheskulltothelowerborderoftheC6level.Threesegmentsaredividedforthepharynx.41ThreesegmentsNasopharynx鼻咽部Oropharynx口咽部Laryngopharynx喉咽部⑵Threesegments鼻咽部上達(dá)顱底，下至腭帆后緣平面續(xù)口咽部。喉咽部上起自會(huì)厭上緣平面，下至第6頸椎體下緣平面與食管相續(xù)?？谘什课挥陔穹缶壟c會(huì)厭平面之間，向前經(jīng)咽峽與口腔相通。4243§⒊TheEsophagus食管⑴GeneralfeaturesAmusculartubeabout25cmlongThreeconstrictions(狹窄)fortheesophagus.(注：為食道癌好發(fā)部位)PassingthroughthediaphragmatleveloftheT10vertebraandentersthestomachafter1~2cmConnectingthepharynxatleveloftheC6vertebra44⑵Threeconstrictions三個(gè)狹窄ThreeconstrictionsCommencementWherecrossedbytheleftbronchusWherepassthroughthediaphragm

第一狹窄處Atitsbeginning:liesatlevelofC6,isthenarrowestpartoftheesophagus.

第二狹窄處Whereitiscrossedbytheleftmainbronchus:liesatlevelofintervertebraldiscbetweenT4andT5.第三狹窄處Whereitpassesthroughtheesophagealhiatus(裂孔)ofdiaphragm:40cmfromincisors(切牙),atlevelofT1045Threeconstrictions三個(gè)狹窄◎◎◎Commencement:liesatlevelofC6,isthenarrowestpartoftheesophagus.Wherecrossedbytheleftbronchus:liesatlevelofintervertebraldiscbetweenT4andT5.Wherepassthroughthediaphragm:40cmfromincisors(切牙),

atlevelofT1046§⒋TheStomach胃⒈ThestomachshapeTwosurface

▲AnteriorandposteriorTwocurvatures(彎曲)▲Lessercurvature胃小彎

▲Greatercurvature胃大彎Twoopenings(開口)▲Cardia賁門▲Pylorus幽門47臨床上將幽門部稱為胃竇,此部和胃小彎附近是潰瘍和癌癥的好發(fā)部位.⒉Fourpartsforthestomach

Cardiacpart賁門部Fundusofstomach胃底Bodyofstomach胃體Pyloricpart幽門部Pyloricantrum幽門竇Pyloriccanal幽門管Stomachparts

48Pyloricpart幽門部Fundus胃底Body胃體Cardiacpart

賁門部Pyloricantrum

幽門竇Pyloriccanal

幽門管49⒊Thestructureofthestomachwall

Stomachwall胃壁有四層,粘膜呈桔紅色,胃空虛時(shí)形成許多皺壁,充盈時(shí)變平。Itconsistsofthefourusuallayers.Mucosa粘膜層Submucosa粘膜下層Muscularis肌肉層Serosa漿膜層50粘膜層粘膜下層肌肉層漿膜層5152About5-7mlong,Itcanbedividedintothreeparts.§⒌

TheSmallIntestine小腸小腸組成▲⒈GeneralfeaturesDuodenum十二指腸Jejunum空腸Ileum回腸duodenum[.dju?'d?n?m][.dju(?)?u'd??n?m]

十二指腸5354▲⒉Thewallstructureofthesmallintestine腸壁結(jié)構(gòu)仍為4層。特點(diǎn)：小腸管壁有環(huán)形皺襞，粘膜有許多絨毛分布,增加吸收面積。55▲⒊

Duodenum十二指腸Duodenumcanbedividedintofourparts.Superiorpart上部Descendingpart降部Horizontalpart

水平部Ascendingpart

升部十二指腸分部十二指腸圍成C字形,包繞胰頭.降部中段后內(nèi)側(cè)壁上有一縱行皺襞,稱十二指腸縱襞,其下端形成十二指腸大乳頭,為肝胰壺腹的開口處。56CharacteristicJejunum空腸Ileum回腸PositionUpper2/5Lower3/5DiameterGreaterLessWallThickerThinCircularfolds環(huán)狀皺襞Larger,numerousandlargevilli高而密,絨毛大Fewer，smallerandlessabundantvilliVascularity血管供應(yīng)GreaterLessColourDeeperredPalerpink粉紅色Lymphaticfollicles淋巴濾泡Solitary分散單獨(dú)存在Aggregated集合存在Fatinmesentery腸系膜脂肪Less腸系膜脂肪少M(fèi)ore腸系膜脂肪多▲⒋Jejunumandileum空腸和回腸57Jejunumandileum

Jejunumileum58§⒍

TheLargeIntestine大腸Approximately1.5mlong,Fiveparts:

Cecum盲腸Vermiformappendix闌尾Colon結(jié)腸Rectum直腸Analcanal肛管大腸分部59▲⑴TheremarkablefeaturesforltheargeIntestine

大腸的三個(gè)鑒別性特征Colicbands結(jié)腸帶Haustraofcolon結(jié)腸袋Epiploicappendices

腸脂垂ColicbandsHaustraofcolon

Epiploicappendices60▲⑵Vermiformappendix闌尾Blindworm-liketube,6～8cmlong,about0.5cmindiameter.盲腸表面的3條結(jié)腸帶均集中到闌尾根部,手術(shù)中依據(jù)這一特點(diǎn)來尋找闌尾.Thebaseattheappendix(闌尾)liesatthepointofconvergenceofthreecolicbands(usedasaguidetofindtheappendixduringoperation).61Surfacemarkingofthebaseisattheso-calledMcBurney’spointwhichisatthejunctionofthelateralandmiddlethirdsoflinejoiningrightanteriorsuperioriliacspineandumbilicus.▲ThesurfacemarkingforthebaseofVermiformappendix闌尾根部體表投影點(diǎn)闌尾根部的體表投影點(diǎn),通常以右髂前上棘與臍的連線的中、外1/3交點(diǎn)處為代表，該點(diǎn)被稱為McBurney點(diǎn).62Ascendingcolon升結(jié)腸Transversecolon橫結(jié)腸Descendingcolon降結(jié)腸Sigmoidcolon乙狀結(jié)腸▲⑶Colon

結(jié)腸結(jié)腸分部升結(jié)腸和降結(jié)腸無系膜,乙狀結(jié)腸是惡性腫瘤的多發(fā)部位.6364▲⑷Rectumandanalcanal

直腸與肛管直腸是大腸位于骨盆腔下部的一段,全長(zhǎng)10-14cm。肛管為直腸的肛門部，長(zhǎng)3-4cm。65直腸有兩個(gè)彎曲和三個(gè)直腸橫襞。肛管內(nèi)有縱行皺襞，形成6-10條肛柱，肛柱的末端形成肛竇?！蹦c與肛管的特點(diǎn)直腸橫襞肛柱肛竇66▲Theformationofthehemorroids肛痔的形成▲直腸與肛道粘膜及粘膜下層內(nèi)有豐富的靜脈叢，容易發(fā)生瘀血而靜脈曲張，形成痔。67Theliver肝Thegallbladder膽囊Thepancreas胰Section3TheDigestiveGlands68§⒈TheLiver

肝Theliveristhelargestsingleglandinthebodyandperformsmanyvitalfunctions.69▲ThelivershapeTherearetwosurfacesforliver.▲⑴TheshapeandlocationoftheliverDiaphragmaticsurface膈面Visceralsurface

臟面Thelivershape肝上面臌隆,對(duì)向隔故稱膈面；肝下面凹凸不平,鄰接一些腹腔器官,稱為臟面70★Diaphragmaticsurface膈面RightandleftlobesdividedbythefalciformligamentConvexandsmooth表面凸起且光滑.71★Visceralsurface臟面HasaH-shapedfissuresandgroovesanddividedintofourlobes.Leftlobe左葉Rightlobe右葉Quadratelobe方葉Caudatelobe尾狀葉臟面分葉72方葉尾狀葉左葉右葉73▲Theliverlocation肝大部分位于右季肋區(qū)和腹上區(qū)，小部分達(dá)左季肋區(qū)。肝前面大部分被肋所掩蓋，僅有一小部分露出劍突之外，下緣不超過肋骨下緣。Righthypochondriacregion(右季肋區(qū))

Epigastricregion(上腹部區(qū))Lefthypochondriacregion(左季肋區(qū))LargeportionSmallportion右季上腹左季74lobule[‘lɑbjul][’l?bju?l]小葉hexagonal[hεks‘?g?nl][hek’s?g?nl]六角形的▲⑵Thestructureoftheliver①Hexagonal-shapedliverlobulesarethestructuralandfunctionalunitsoftheliver.75②Theliverlobulesaremainlycomposedofhepatocytes

(肝實(shí)質(zhì)細(xì)胞)76③Hepatocytes’functions(肝實(shí)質(zhì)細(xì)胞的功能)Productionofbile產(chǎn)生膽汁肝細(xì)胞分泌膽汁，有助于脂肪的消化和吸收。Processingbloodbornenutrients處理血源性營養(yǎng)物質(zhì)肝細(xì)胞將過多的血糖轉(zhuǎn)化為肝糖元，將血液中的氨基酸轉(zhuǎn)變成蛋白質(zhì)加以貯存。

Storageoffat-solublevitamins儲(chǔ)存脂溶性維生素Detoxification解毒肝細(xì)胞將氨基酸在代謝過程中產(chǎn)生的有毒的氨轉(zhuǎn)變?yōu)闊o毒的尿素。肝血竇內(nèi)的枯否氏細(xì)胞(Kupffercell)有強(qiáng)的吞噬能力。77Gallbladder

膽囊

Leftandrighthepaticducts

左、右肝管Commonhepaticduct肝總管Cysticduct

膽囊管Commonbileduct

膽總管肝外膽道系統(tǒng)肝外膽道系統(tǒng)主要包括：膽囊、肝總管和膽總管。肝左右葉的左右肝管出肝門后匯合成肝總管，肝總管與膽囊管匯合成膽總管。膽總管長(zhǎng)約6～8cm，開口于十二指腸降部。§⒉Theextrahepaticbiliaryapparatus

肝外膽道系統(tǒng)7879▲⑴TheGallbladder

膽囊PositionLiesinthefossa(窩)forthegallbladderonthevisceralsurfaceoftheliver.80▲Function:storesandconcentratethebile

Fundus膽囊底Body膽囊體Neck膽囊頸Cysticduct膽囊管膽囊分部CysticductNeckFundusBody▲TheGallbladderparts81BileissecretedbythelivercellsCommonhepaticductCommonbileductMajorduodenalpapilla十二指腸大乳頭Biliaryductuli膽小管RightandlefthepaticductsCysticductGallbladder(store,concentrate)肝臟分泌膽汁流經(jīng)路線脂肪進(jìn)入小腸引起膽囊收縮，肝胰壺腹括約肌釋放82Bilesalts(膽鹽

)Bilepigments(膽色素

)Cholesterol(膽固醇

)Neutralfats(中性脂

)Phospholipids(磷脂)Electrolytes(電解質(zhì))▲②ThecompositionofthebileCompositionofthebile83①Ayellow-green,alkaline

(堿性的)

solution▲Specialpointsforthebile②Bilesaltsarecholesterol(膽固醇

)derivativesthat:Emulsify(使乳化)fatFacilitatefatandcholesterolabsorptionHelpsolubilize(溶解)cholesterol③Thechiefbilepigmentisbilirubin(膽紅素),

awasteproductoftheheme(血紅素).84Acidic,fattychyme(酸性脂質(zhì)食糜)▲③TheregulationofthebilereleaseTheduodenumreleaseCholecystokinin(縮膽囊肽)andsecretin(促胰液素)intobloodBilesaltsandsecretintransportedinbloodstimulatethelivertoproducebileVagal(迷走神經(jīng)的)stimulationcausesweakcontractionsofthegallbladderCholecystokinin(縮膽囊肽)

ThegallbladdertocontractThegallbladderThebileenterstheduodenumhepatopancreatic(肝胰的)sphinctertorelax85Enteroendocrinecell:腸內(nèi)分泌細(xì)胞Vagal:迷走神經(jīng)的Cholecystokinin:縮膽囊肽Secretin:促胰液素Hepatopancreatic:肝胰的Theregulationofthebilerelease86§⒊ThePancreas

胰▲TheShape

Asoftyellowishlobulatedgland.▲PositionLiesbehindtheperitoneum(腹膜)onthe