胸部的局部解剖與操作人體局解剖學(xué)課件詳解

胸部的局部解剖與操作人體局解剖學(xué)課件詳解演示文稿當(dāng)前第1頁\共有131頁\編于星期四\9點優(yōu)選胸部的局部解剖與操作人體局解剖學(xué)課件當(dāng)前第2頁\共有131頁\編于星期四\9點一、概述Summarization境界Theboundary分部Theregions表面標志Thesurfacelandmark胸部標志線TheLinesoforientationontheThorax當(dāng)前第3頁\共有131頁\編于星期四\9點胸部是軀干的上部，位于頸部與腹部之間。Thethorax(chest)istheupperpartofthetrunkbetweentheneckandtheabdomen．1.Boundary當(dāng)前第4頁\共有131頁\編于星期四\9點其上界是從頸靜脈切跡沿鎖骨上緣至肩峰，然后至第七頸椎棘突的連線。1.BoundaryItsupperboundaryisformedbyalinedrawingfromthesuprasternalnotch，alongthesuperiormarginsoftheclaviclestotheacromions，andthentothespinousprocessofthe7thcervicalvertebra．當(dāng)前第5頁\共有131頁\編于星期四\9點下界為劍突、肋弓、第11肋前端、第12肋下緣和第12胸椎棘突的連線。1.BoundaryThelowerboundaryisformedbyalinedrawingfromthexiphoidprocess,costalarchs,anteriorextremityof11thribs,inferiormarginof12thribstospinousprocessof12ththoracicvertebra.當(dāng)前第6頁\共有131頁\編于星期四\9點兩外側(cè)界為三角肌的前、后緣。1.BoundaryThelateralboundaries

ofthethoraxseparatingfromtheupperlimbaretheanteriorandposteriormarginsofthedeltoid．當(dāng)前第7頁\共有131頁\編于星期四\9點Thoracicwallandcavity2.RegionThethoracicwallconsistsofskin,fascia,nerves,vessels,muscles,andbones.Thethoraciccavity,surroundedbythethoracicwall,containsthelungs,pleuraandpleuralcavityandmediastinum當(dāng)前第8頁\共有131頁\編于星期四\9點頸靜脈切跡

Thejugularnotch胸骨角Thesternalangle(ofLouis)劍突Thexiphoidprocess肋弓Thecostalmargin(costalarch)胸骨下角Theinfrasternalangle鎖骨Theclavicle肩胛骨下角Theinferiorangleofscapula乳頭Thenipple3.表面標志SurfaceLandmarks當(dāng)前第9頁\共有131頁\編于星期四\9點Thejugularnotch頸靜脈切跡當(dāng)前第10頁\共有131頁\編于星期四\9點Xiphoidprocess劍突當(dāng)前第11頁\共有131頁\編于星期四\9點Costalarch肋弓當(dāng)前第12頁\共有131頁\編于星期四\9點costalarchTheinfrasternal(subcostal)angle胸骨下角當(dāng)前第13頁\共有131頁\編于星期四\9點肩胛骨下角Theinferiorangleofscapula

當(dāng)前第14頁\共有131頁\編于星期四\9點

劍肋角當(dāng)前第15頁\共有131頁\編于星期四\9點經(jīng)劍肋角的心包（液）穿刺術(shù)當(dāng)前第16頁\共有131頁\編于星期四\9點InferiorfossaofclavicleClavicleGreatersupraclavicularfossaLessersupraclavicularfossa當(dāng)前第17頁\共有131頁\編于星期四\9點Nipple當(dāng)前第18頁\共有131頁\編于星期四\9點Sternalangle(ofLouis)胸骨角當(dāng)前第19頁\共有131頁\編于星期四\9點胸骨角ThesternalAngle(ofLouis)Thesternalanglemarksthefollowingitems當(dāng)前第20頁\共有131頁\編于星期四\9點①Thelowerborderofthe4ththoracicvertebra①向后平對第4胸椎下緣；當(dāng)前第21頁\共有131頁\編于星期四\9點②Thelevelwherethetracheadividesintotherightandleftprincipal(main)bronchi.②氣管分為左、右主支氣管的水平，即氣管杈水平；當(dāng)前第22頁\共有131頁\編于星期四\9點③Thesecondconstrictionoftheesophagus③平左主支氣管與食管交叉處，即食管的第2狹窄處；當(dāng)前第23頁\共有131頁\編于星期四\9點④Theoriginandendoftheaorticarch④平主動脈弓的起、止處；當(dāng)前第24頁\共有131頁\編于星期四\9點⑤Theligamentumarteriosumjoinstheleftpulmonaryarterytotheaorticarch⑤動脈韌帶連與左肺動脈與主動脈弓之處；當(dāng)前第25頁\共有131頁\編于星期四\9點⑥Theazygosveinentersthesuperiorvenacava⑥奇靜脈匯入上腔靜脈處；當(dāng)前第26頁\共有131頁\編于星期四\9點⑦Theboundarylinebetweenthesuperiorandinferiormediastina⑦上、下縱隔的分界線；當(dāng)前第27頁\共有131頁\編于星期四\9點4.TheLinesofOrientationontheThorax(1)Theanteriormedianline前正中線(2)Thesternalline胸骨線(3)Themidclavicularline鎖骨中線(4)Theparasternalline胸骨旁線(5)Theanterioraxillaryline腋前線(6)Themidaxillaryline腋中線(7)Theposterioraxiltaryline腋后線(8)Thescapularline肩胛線(9)Theposteriormedianline后正中線胸部標志線當(dāng)前第28頁\共有131頁\編于星期四\9點TheLinesofOrientationontheThorax當(dāng)前第29頁\共有131頁\編于星期四\9點TheLinesofOrientationontheThoraxparasternallinesternalline當(dāng)前第30頁\共有131頁\編于星期四\9點TheLinesofOrientationontheThorax當(dāng)前第31頁\共有131頁\編于星期四\9點TheLinesofOrientationontheThorax當(dāng)前第32頁\共有131頁\編于星期四\9點

ThethoracicwallmaybedividedintoThesuperficialstructuresThedeepstructures胸壁可分為淺層結(jié)構(gòu)和深層結(jié)構(gòu)。二、胸壁TheThoracicWall當(dāng)前第33頁\共有131頁\編于星期四\9點（一）TheSuperficialStructuresTheskin皮膚Thesuperficialfascia淺筋膜Thesuperficialbloodvessels淺血管Thecutaneousnerves皮神經(jīng)Thesuperficiallymphaticvessels淺淋巴管Thebreast乳房當(dāng)前第34頁\共有131頁\編于星期四\9點深筋膜deepfascia胸壁淺層肌superiormusclesofthoracicwall肋及肋間隙ribsandintercostalspace胸內(nèi)筋膜internalthoracicfascia（二）TheDeepStructures當(dāng)前第35頁\共有131頁\編于星期四\9點1.深筋膜deepfasciaClavipectoralfasciaSuspensoryligamentofaxilla當(dāng)前第36頁\共有131頁\編于星期四\9點鎖胸筋膜及其穿行結(jié)構(gòu)Clavipectoralfasciaispiercedbythecephalicvein頭靜脈,lymphaticvessels淋巴管,thoracoacromialarteryandvein胸肩峰動、靜脈,lateralpectoralnerve胸外側(cè)神經(jīng).“二進二出”當(dāng)前第37頁\共有131頁\編于星期四\9點Thepectoralismajor胸大肌Thesubclavius鎖骨下肌Thepectoralisminor胸小肌Theserratusanterior前鋸肌Theobliquusexternusabdominis腹外斜肌Thetrapezius斜方肌Therhomboids菱形肌Thelatissimusdorsi背闊肌Thetransversusthoracis胸橫肌Therectusabdominis腹直肌Theintercostalmuscles肋間肌2.Themuscles

當(dāng)前第38頁\共有131頁\編于星期四\9點當(dāng)前第39頁\共有131頁\編于星期四\9點當(dāng)前第40頁\共有131頁\編于星期四\9點當(dāng)前第41頁\共有131頁\編于星期四\9點當(dāng)前第42頁\共有131頁\編于星期四\9點當(dāng)前第43頁\共有131頁\編于星期四\9點Theintercostalmuscles肋間肌Nerves神經(jīng)Vessels血管(theintercostalvessels肋間血管,theinternalthoracicvessels胸廓內(nèi)血管)3.TheintercostalSpaces當(dāng)前第44頁\共有131頁\編于星期四\9點（1）Theintercostalmuscles

①Theexternalintercostalmuscleandmembrane②Theinternalintercostalmuscleandmembrane③Theinnermostintercostalmuscle肋間外膜肋間外肌肋間內(nèi)肌肋間最內(nèi)肌肋間內(nèi)膜當(dāng)前第45頁\共有131頁\編于星期四\9點（2）ThecourseandRelationshipoftheintercostalNerveandVessels

當(dāng)前第46頁\共有131頁\編于星期四\9點Anteriorandposteriorintercostalartery胸廓內(nèi)動脈胸主動脈肋間后動脈肋間前動脈當(dāng)前第47頁\共有131頁\編于星期四\9點

在達肋角之前，肋間血管和神經(jīng)位于肋間隙中部，彼此排列關(guān)系不恒定；然后行于肋溝內(nèi)、肋間內(nèi)肌與肋間最內(nèi)肌之間。Beforereachingtothecostalangle,theintercostalnerveandvesselsruninthemiddleoftheintercostalspaceandtheirarrangementisinconstant;Thentheyliebetweentheinnermostandinternalintercostalmuscles.當(dāng)前第48頁\共有131頁\編于星期四\9點Inthecostalgrooveoftherib,thearrangementfromupdownwardsisthevein,arteryandnerve.肋間血管和神經(jīng)循肋溝前行，在肋角前方，三者排列順序自上而下為靜脈、動脈、神經(jīng)。當(dāng)前第49頁\共有131頁\編于星期四\9點胸廓內(nèi)動脈:腹壁上動脈、肌膈動脈、肋間前動脈當(dāng)前第50頁\共有131頁\編于星期四\9點當(dāng)前第51頁\共有131頁\編于星期四\9點4.胸內(nèi)筋膜Internalthoracicfascia當(dāng)前第52頁\共有131頁\編于星期四\9點氣胸pneumothorax水胸hydrothorax血胸hemothorax乳糜胸chylothorax當(dāng)前第53頁\共有131頁\編于星期四\9點①在肋角內(nèi)側(cè)：②在肋角之前：行胸膜腔穿刺術(shù)（抽液）在何部位進行？不宜穿刺；可在肋間隙的中部或肋上緣稍上方進針。當(dāng)前第54頁\共有131頁\編于星期四\9點臨床行胸膜腔穿刺術(shù)（抽液）常選在肩胛線或腋后線、第7或8肋間隙中部或肋上緣稍上方進針。當(dāng)前第55頁\共有131頁\編于星期四\9點施行胸膜腔穿刺術(shù)需經(jīng)過哪些層次？

①Skin皮膚②superficialfascia淺筋膜③deepfascia深筋膜④superficialmusclesofthethoracicwall胸壁肌⑤ribandintercostalmuscles肋間?、辝ndothoracicfascia胸內(nèi)筋膜

⑦parietalpleura.壁胸膜當(dāng)前第56頁\共有131頁\編于星期四\9點當(dāng)前第57頁\共有131頁\編于星期四\9點臟胸膜

visceral(orpulmonary)pleura壁胸膜

Theparietalpleuracanbesubdividedinto:肋胸膜

costalpleura膈胸膜diaphragmaticpleura胸膜頂

cupulaofpleura縱隔胸膜

Themediastinalpleura胸膜腔pleuralcavity,胸膜隱窩pleuralrecess肺韌帶pulmonaryligament三、PleuraandPleuralCavity當(dāng)前第58頁\共有131頁\編于星期四\9點臟胸膜壁胸膜胸膜腔胸膜頂肋胸膜膈胸膜肋膈隱窩縱隔胸膜當(dāng)前第59頁\共有131頁\編于星期四\9點肋縱隔隱窩costomediastinalrecess肺韌帶pulmonaryligament當(dāng)前第60頁\共有131頁\編于星期四\9點pulmonaryligament肺韌帶當(dāng)前第61頁\共有131頁\編于星期四\9點在胸骨角水平以上或第4肋軟骨水平以下。兩側(cè)胸膜前界之間距離較大，分別稱為胸膜上間區(qū)（胸腺區(qū)）和胸膜下間區(qū)（心包區(qū)）。Abovethesternalangleandbelowthelevelofthe4thcostalcartilage,thedistancebetweentwopleuralreflectionsislarger.Thesetwointervalsarecalledthesuperiorintermediateregion(triangleofthymus)andtheinferiorintermediateregion(triangleofpericardium)ofpleurarespectively.ThePleuralReflections當(dāng)前第62頁\共有131頁\編于星期四\9點胸膜前界的體表投影TriangleofThymus胸腺三角triangleofpericardium心包三角當(dāng)前第63頁\共有131頁\編于星期四\9點胸腺三角和心包三角當(dāng)前第64頁\共有131頁\編于星期四\9點心包（抽液）穿刺術(shù)當(dāng)前第65頁\共有131頁\編于星期四\9點胸膜下界的體表投影當(dāng)前第66頁\共有131頁\編于星期四\9點胸膜下界的體表投影當(dāng)前第67頁\共有131頁\編于星期四\9點肺根：為出入肺門的主支氣管、肺動脈、肺靜脈、支氣管動脈和靜脈、肺叢以及淋巴管等結(jié)構(gòu)的總稱，表面包以胸膜。Therootoflungisformedbytheprincipalbronchus,thepulmonaryartery,thepulmonaryveins,thebronchialarteriesandveins,thepulmonaryplexusesofnervesandthelymphaticvessels.Thesestructuresareheldtogetherbymediastinalconnectivetissueandsurroundedbythepleura.四、TheLungs當(dāng)前第68頁\共有131頁\編于星期四\9點肺門和肺根RightLungLeftLungV.A.B.V.A.B.③①②③①②前→后:前→后:當(dāng)前第69頁\共有131頁\編于星期四\9點肺門和肺根RightLungLeftLung上→下：B.A.V.B.上→下：A.V.B.③①②④①②③**當(dāng)前第70頁\共有131頁\編于星期四\9點Thechiefstructurescomposingtherootofeachlungarearrangedinasimilarmanner.肺根內(nèi)主要結(jié)構(gòu)的排列fromfrontbackwardsonbothsides:thesuperiorpulmonaryveininfront,thepulmonaryarteryinthemiddleandthebronchuswiththebronchialvesselsonitsposterioraspectbehind.由前→后為上肺靜脈、肺動脈、主支氣管。

fromabovedownwardsonthetwosides:ontherightside,theirarrangementissuperiorlobarbronchus,pulmonaryartery,middleandinferiorlobarbronchus,andpulmonaryvein.ontheleftside,theyarethepulmonaryartery,thebronchus,andthelowermoststructurethepulmonaryvein.自上→下：左側(cè)為肺動脈、主支氣管、上肺靜脈；右側(cè)為上葉支氣管，肺動脈、下葉支氣管、肺上靜脈。左、右肺下靜脈位置最低，在肺手術(shù)中切斷肺韌帶時應(yīng)加以保護。

當(dāng)前第71頁\共有131頁\編于星期四\9點TheRelationshipsoftheRootoftheLungs當(dāng)前第72頁\共有131頁\編于星期四\9點當(dāng)前第73頁\共有131頁\編于星期四\9點奇靜脈弓(自后→前)肺韌帶右迷走神經(jīng)奇靜脈上腔靜脈右膈神經(jīng)心包膈血管部分心包右心房右肺根的毗鄰當(dāng)前第74頁\共有131頁\編于星期四\9點左肺根的毗鄰主動脈弓(自前→后)肺韌帶左迷走神經(jīng)胸主動脈左膈神經(jīng)心包膈血管當(dāng)前第75頁\共有131頁\編于星期四\9點五、縱隔Mediastinum縱隔的概念、境界、分區(qū)縱隔的左、右側(cè)面上縱隔當(dāng)前第76頁\共有131頁\編于星期四\9點1.概念與境界當(dāng)前第77頁\共有131頁\編于星期四\9點SuperiormediastinumInferiormediastinum1.境界與分區(qū)

anteriormediastinummiddlemediastinumposteriormediastinum當(dāng)前第78頁\共有131頁\編于星期四\9點縱隔概念：縱隔是左、右縱隔胸膜之間所有器官、結(jié)構(gòu)和結(jié)締組織的總稱，包括心、心包、出入心的大血管、胸腺和神經(jīng)、淋巴等。境界：縱隔的左、右側(cè)界為左、右縱隔胸膜，下界為膈，上界為胸廓下口，前界為胸骨，后界為脊柱胸段。分區(qū)（四分法）：以胸骨角平面為界分為上、下縱隔；下縱隔又以心包的前、后壁為界分為前、中、后縱隔。當(dāng)前第79頁\共有131頁\編于星期四\9點2.縱隔左側(cè)面①左肺根及其毗鄰②食管上三角③食管下三角食管上三角構(gòu)成：由左鎖骨下動脈、主動脈弓和脊柱圍成；內(nèi)容：有食管上份和胸導(dǎo)管。當(dāng)前第80頁\共有131頁\編于星期四\9點2.縱隔左側(cè)面①左肺根及其毗鄰②食管上三角③食管下三角食管下三角構(gòu)成：由心包、胸主動脈和膈圍成；內(nèi)容：有食管下份。當(dāng)前第81頁\共有131頁\編于星期四\9點2.縱隔右側(cè)面①右肺根及其毗鄰②食管與右縱隔胸膜的關(guān)系當(dāng)前第82頁\共有131頁\編于星期四\9點Themainorgansfromanteriorposteriorlyarethethymus,胸腺leftandrightbrachiocephaticveins,左右頭臂靜脈superiorvenacava,上腔靜脈leftandrightphrenicandvagusnerves,左右膈神經(jīng)和迷走神經(jīng)aortaarchanditsthreebranches,主動脈弓及其三大分支trachea,氣管esophagus,食管leftrecurrentlaryngealnerve左喉返神經(jīng)thoracicduct,胸導(dǎo)管3.TheSuperiorMediastinum當(dāng)前第83頁\共有131頁\編于星期四\9點Thethymusliesposteriortothemanubriumofthesternumandextendsintotheanteriormediastinum,anteriortothepericardium.胸腺位于胸骨柄后方，延伸至前縱隔、心包的前方。Thethymusislocatedinthelowerpartoftheneckandtheanteriorpartofthesuperiormediastinum.胸腺位于頸的下部和上縱隔的前部。Afterpubertythethymusundergoesgradualinvolutionandislargelyreplacedbyfat.青春后胸腺逐漸萎縮，大部分被脂肪組織代替。Thethymusconsistsoftwounequallaterallobes.

胸腺由左、右兩葉構(gòu)成。1stlayerTheThymus

當(dāng)前第84頁\共有131頁\編于星期四\9點左頭臂靜脈leftbrachiocephalicvein從左向右行，跨過主動脈弓三大分支的起始部。頭臂靜脈brachiocephalicveins是由頸內(nèi)靜脈和鎖骨下靜脈在胸鎖關(guān)節(jié)后方匯合而成。Thebrachiocephalicveins1stlayer當(dāng)前第85頁\共有131頁\編于星期四\9點上腔靜脈superiorpartofthesuperiorvenacava由左、右頭臂靜脈在第1胸肋軟骨結(jié)合處的下緣匯合而成。TheSuperiorPartofSVC1stlayer當(dāng)前第86頁\共有131頁\編于星期四\9點2ndlayer主動脈弓archofaorta在第2胸肋關(guān)節(jié)處續(xù)于升主動脈，然后從右前行向左后，在第4胸椎體下緣處移行為胸主動脈。TheArchoftheAorta當(dāng)前第87頁\共有131頁\編于星期四\9點2ndlayer主動脈弓凸側(cè)從右向左發(fā)出分支為：TheBranchesoftheArchoftheAortabrachiocephalictrunkleftcommoncarotida.leftsubclaviana.當(dāng)前第88頁\共有131頁\編于星期四\9點2ndlayer主動脈弓的凹側(cè)發(fā)出支氣管動脈bronchialarteries和食管動脈esophagealarteries。TheBranchesoftheArchoftheAorta當(dāng)前第89頁\共有131頁\編于星期四\9點2ndlayerTheArterialLigament動脈韌帶arterialligament是胎兒期動脈導(dǎo)管arterialduct在出生后閉鎖形成的結(jié)締組織索，連于主動脈弓與左肺動脈的起始部。當(dāng)前第90頁\共有131頁\編于星期四\9點2ndlayerTheTriangleofArterialDuct動脈導(dǎo)管三角

triangleofarterialduct

是由左膈神經(jīng)、左迷走神經(jīng)和左肺動脈圍成，內(nèi)有動脈韌帶、左喉返神經(jīng)和心淺叢，是手術(shù)中尋找動脈導(dǎo)管的標志。當(dāng)前第91頁\共有131頁\編于星期四\9點Itisthearterialductinfetallife,butitclosestoformtheligamentafterbirth.Itconnectstheoriginoftheleftpulmonaryarterywiththeinferiorsurfaceoftheendofaorticarch.Theunclosedarterialductmaybefoundinthetriangleofarterialductwhichisencircledbytheleftpulmonaryarteryinferiorly,leftphrenicnerveanteriorlyandleftvagusnerveposteriorly.Theleftrecurrentlaryngealnerveisoftenusedasalandmarktofindtheductinoperation,becauseitisincontactwiththearterialductposteriorly.TheArterialLigament當(dāng)前第92頁\共有131頁\編于星期四\9點3rdlayer氣管主支氣管食管胸導(dǎo)管Trachea,principalbronchus,EsophagusandThoracicDuct

Thoracicduct當(dāng)前第93頁\共有131頁\編于星期四\9點TheRelationshipsoftheAorticArch在主動脈弓的左前方是：左膈神經(jīng)和左迷走神經(jīng)在主動脈弓的后方是:氣管、食管、左喉返神經(jīng)、胸導(dǎo)管和心深叢。

當(dāng)前第94頁\共有131頁\編于星期四\9點主動脈弓上方：有頭臂干、左頸總動脈和左鎖骨下動脈.TheRelationshipsoftheAorticArch主動脈弓下方：有肺動脈干分叉、左主支氣管動脈韌帶、左喉返神經(jīng)和心淺叢.當(dāng)前第95頁\共有131頁\編于星期四\9點主動脈弓前方：有胸腺thymus(3)and左左頭臂靜脈leftbrachiocephalicvein(2).TheRelationshipsoftheAorticArch當(dāng)前第96頁\共有131頁\編于星期四\9點TheRelationshipsoftheAorticArchSuperiorly,thebrachiocephalictrunk,theleftcommoncarotidandtheleftsubclavianarteries.

Anteriorly,thymusandtheleftbrachiocephalicvein.Theanteriorandleftsurfacesofthearch:theleftphrenicandleftvagusnerves.Therightsurfaceofthearch:thesuperiorvenacava.Posteriortothearch:thetrachea,esophagus,leftrecurrentlaryngealnerve,thoracicductanddeepcardiacplexus.Theinferiorsurfaceofthearch:thebifurcationofpulmonarytrunk,leftprincipalbronchus,arterialligament,leftrecurrentlaryngealnerveandthesuperficialcardiacplexus.當(dāng)前第97頁\共有131頁\編于星期四\9點解剖與觀察

DissectionandObservation當(dāng)前第98頁\共有131頁\編于星期四\9點斷離胸鎖關(guān)節(jié)：鋸斷或用刀離斷胸鎖關(guān)節(jié)，注意保護深部結(jié)構(gòu)。當(dāng)前第99頁\共有131頁\編于星期四\9點解剖肋間肌

Dissecttheintercostalmuscle

肋間外肌externalintercostalmuscles當(dāng)前第100頁\共有131頁\編于星期四\9點肋間外膜Externalintercostalmembranes解剖與觀察當(dāng)前第101頁\共有131頁\編于星期四\9點肋間內(nèi)肌internalintercostalmuscles解剖與觀察當(dāng)前第102頁\共有131頁\編于星期四\9點肋間神經(jīng)intercostalnerve肋間最內(nèi)肌Innermostintercostalmuscles解剖與觀察當(dāng)前第103頁\共有131頁\編于星期四\9點Cutthroughthe2ndto10thribsatthethemidaxillaryline.翻開胸前壁Reflecttheanteriorchestwalldownwardsbyseparatingtheribsfromtheparietalpleuraandthepericardium.

當(dāng)前第104頁\共有131頁\編于星期四\9點胸前壁內(nèi)面觀胸橫肌Transversethoracicmuscle胸廓內(nèi)動、靜脈Internalthoracicarteryandvein腹壁上動脈superiorepigastricartery肌膈動脈musculophrenicartery解剖與觀察當(dāng)前第105頁\共有131頁\編于星期四\9點thecostalpleura.

肋胸膜觀察當(dāng)前第106頁\共有131頁\編于星期四\9點Thetwopleuralcavitiesareseparatecompartmentsandnotcontinuouswitheachother.

左右胸膜腔是互不相通的各自獨立的腔隙。觀察當(dāng)前第107頁\共有131頁\編于星期四\9點Observethecostomediastinalrecess.

觀察肋縱隔竇。觀察當(dāng)前第108頁\共有131頁\編于星期四\9點Observethecostodiaphragmaticrecess.

觀察肋膈隱窩。觀察當(dāng)前第109頁\共有131頁\編于星期四\9點Cutthroughtherootofleftlungfromabovedownwardsclosetothehilumoflung.切肺取肺當(dāng)前第110頁\共有131頁\編于星期四\9點Observethecostalpleura.

觀察肋胸膜觀察當(dāng)前第111頁\共有131頁\編于星期四\9點Observethediaphragmaticpleura.

觀察膈胸膜觀察當(dāng)前第112頁\共有131頁\編于星期四\9點Observethecostomediastinalpleura.

觀察肋縱隔胸膜。觀察當(dāng)前第113頁\共有131頁\編于星期四\9點Observethecostodiaphragmaticrecess.

觀察肋膈隱窩。觀察