大三下98790學(xué)習(xí)局解課件總結(jié)

middleofthearmwhereitpiercesthedeepfasciaandjoinsthebrachialveinoraxillaryvein

Inferior:teresLateral:longheadoftriceps

– MusclesofBackSuperficialgroup

MediancubitalveinLinkscephalicveinandbasilicveininthecubitalItisafrequentsiteforvenipuncturetoremove

Structurespassthroughthetrilateral–Circumflexscapulara.andv.Quadrilateralforamen四邊孔(quadrilateralspace四

Mediannerve

anastomosisaroundtheelbowjoint.TrapeziusLatissimusdorsiLevatorscapulaeRhomboideusDeepSpleniusErectorspinaeTriangleofauscultation聽診三角肩胛旁三LatissimusThemedialborderoftheInferiorlumbartriangleLowerpartofthelateralmarginoflatissimusdorsiPosteriorfreeborderoftheobliquusexternusabdominisIliaccrestSuperiorlumbartriangle腰上三角SerratusposteriorErectorObliquusinternusCephalicveinArisesfromthelateralsideofthedorsalvenousreteonthebackofhandWindsaroundthelateralborderoftheforearm;itthenascendsintothecubitalfossaandupthefrontofthearmonthelateralsideofthebiceps.Itcontinuesupinthedeltopectoralgrooveandthentotheinfraclavicularfossa,whereitpiercesclavipectoralfasciatodrainintoaxillaryvein.Basilicvein

ArisesfromthemedialsideofthedorsalvenousreteofhandWindsaroundthemedialborderoftheThenascendsintothecubitalfossaandupthefrontofthearmonthemedialsideofthebicepsto

sampleofbloodoraddfluidtotheAxillaryfossaMiddle1/3ofLateralborderoffirstUpperborderoftheSuperficialAxillaryfascia腋筋膜(cribriform篩狀筋膜ThemedialSerratusUpperfourribsandintercostalThelateralIntertubercularLongheadandshortheadofbicepsTheanteriorPectoralisPectoralisClavipectoralfasciaTheposteriorLatissimusAxillarya.andprincipalAxillaryv.andBrachialplexusandAxillarylymphTrilateralforamen三邊孔(trilateralspace三邊隙)

–Superior:tereslateralborderofscapula,articularcapsuleofshoulderjoint1

middleofthearmwhereitpiercesthedeepfasciaandjoinsthebrachialveinoraxillaryvein

Inferior:teresLateral:longheadoftriceps

– MusclesofBackSuperficial

MediancubitalveinLinkscephalicveinandbasilicveininthecubitalItisafrequentsiteforvenipuncturetoremove

StructurespassthroughthetrilateralCircumflexscapulara.andv.Quadrilateralforamen四邊孔(quadrilateralspace四

Mediannerve

anastomosisaroundtheelbowjoint.TrapeziusLatissimusdorsiLevatorscapulaeRhomboideusDeepSpleniusErectorspinaeTriangleofauscultation聽診三角肩胛旁三LatissimusThemedialborderoftheInferiorlumbartriangleLowerpartofthelateralmarginoflatissimusdorsiPosteriorfreeborderoftheobliquusexternusabdominisIliaccrestSuperiorlumbartriangle腰上三角SerratusposteriorErectorObliquusinternusCephalicveinArisesfromthelateralsideofthedorsalvenousreteonthebackofhandWindsaroundthelateralborderoftheforearm;itthenascendsintothecubitalfossaandupthefrontofthearmonthelateralsideofthebiceps.Itcontinuesupinthedeltopectoralgrooveandthentotheinfraclavicularfossa,whereitpiercesclavipectoralfasciatodrainintoaxillaryvein.BasilicveinArisesfromthemedialsideofthedorsalvenousreteofhandWindsaroundthemedialborderoftheThenascendsintothecubitalfossaandupthefrontofthearmonthemedialsideofthebicepsto

sampleofbloodoraddfluidtotheAxillaryfossa腋窩Middle1/3ofLateralborderoffirstUpperborderoftheSuperficialAxillaryfascia腋筋膜(cribriform篩狀筋膜ThemedialSerratusUpperfourribsandintercostalThelateralIntertubercularLongheadandshortheadofbicepsTheanteriorPectoralisPectoralisClavipectoralfasciaTheposteriorLatissimusAxillarya.andprincipalAxillaryv.andBrachialplexusandAxillarylymphLooseconnectivetissueTrilateralforamen三邊孔(trilateralspace三邊隙)Superior:tereslateralborderofscapula,articularcapsuleofshoulderjoint1

Superior:teresarticularcapsuleofshoulderInferior:teresMedial:longheadoftricepsLateral:surgicalneckofStructurespassthroughthequadrilateralAxillaryPosteriorhumeralcircumflexa.andv.AxillaryarteryBeginsattheatlateralborderoffirstribasacontinuationofsubclavianarteryAtthelowerborderofteresmajoritbecomesthebrachialartery.DividedintothreepartsbyoverlyingpectoralisFirstsuperiorthoracicthoracoacromialSecondlateralthoracicThirdsubscapularthrocodorsalcircumflexscapularanteriorhumeralcircumflexposteriorhumeralcircumflexBrachialarteryBeginsatthelowerborderoftheteresmajorasacontinuationofaxillaryarteryTerminatesoppositetheneckofradiusbydividingintoradialandulnararteriesDeepbrachiala.FollowstheradialnerveintothespinalgrooveofthehumerusSuperiorulnarcollaerala.尺側(cè)followstheulnarInferiorulnarcollaterala.2

ArisesfromthemedialandlateralcordofthebrachialplexusDescendsonthelateralsideofbrachialarteryHalfwaydownthearm,itcrossesthebrachialarterytoreachitsmedialsideHumeromusculartunnelFormedbytricepsbrachiiandgrooveforradialnerveofhumerus肱骨StructurespassingthroughtheRadialnerveDeepbrachiala.andv.Radialcollaterala.Middlecollaterala.Cubitalfossa肘窩Laterally:brachioradialisMedially:pronatorteresRoof:skin,superficialfacia,deepfasciaandaponeurosisofbicepsFloor:brachialis肱肌,supinatorandcapsuleofelbowjointbicepsbrachiitendonMedialtobicepsbrachiiBrachiala.肱動脈－dividesintoradialandulnara.,usuallyatapexoffossaBrachialv.Mediann.LateraltothebicepsbrachiiRadialn.Lateralantebrachialcutaneousn.前臂外DeepcubitallymphCarpalcanalComposition:Formedbyflexorretinaculum屈肌支持帶andcarpalgroove腕骨溝StructurespassingthroughthecarpalSuperior:teresarticularcapsuleofshoulderInferior:teresMedial:longheadoftricepsLateral:surgicalneckofStructurespassthroughthequadrilateralAxillaryPosteriorhumeralcircumflexa.andv.AxillaryarteryBeginsattheatlateralborderoffirstribasacontinuationofsubclavianarteryAtthelowerborderofteresmajoritbecomesthebrachialartery.DividedintothreepartsbyoverlyingpectoralisFirstsuperiorthoracicthoracoacromialSecondlateralthoracicThirdsubscapularthrocodorsalcircumflexscapularanteriorhumeralcircumflexposteriorhumeralcircumflexBrachialarteryBeginsatthelowerborderoftheteresmajorasacontinuationofaxillaryarteryTerminatesoppositetheneckofradiusbydividingintoradialandulnararteriesDeepbrachiala.FollowstheradialnerveintothespinalgrooveofthehumerusSuperiorulnarcollaerala.尺側(cè)followstheulnarInferiorulnarcollaterala.2

ArisesfromthemedialandlateralcordofthebrachialDescendsonthelateralsideofbrachialarteryHalfwaydownthearm,itcrossesthebrachialarterytoreachitsmedialsideHumeromusculartunnelFormedbytricepsbrachiiandgrooveforradialnerveofhumerus肱骨StructurespassingthroughtheRadialnerveDeepbrachiala.andv.Radialcollaterala.Middlecollaterala.Cubitalfossa肘窩BoundariesLaterallybrachioradialisMedially:pronatorteresRoof:skin,superficialfacia,deepfasciaandaponeurosisofbicepsFloor:brachialis肱肌,supinatorandcapsuleofelbowjointbicepsbrachiitendonMedialtobicepsbrachiiBrachiala.肱動脈－dividesintoradialandulnarausuallyatapexofBrachialv.Mediann.LateraltothebicepsbrachiiRadialn.Lateralantebrachialcutaneousn.前臂DeepcubitallymphCarpalcanalComposition:Formedbyflexorretinaculum屈肌支持帶andcarpalgroove腕骨溝StructurespassingthroughthecarpalMediann.

andone-halffingers,ulnarhalfof

–Arisesfromthelateralpartofthe

AgapinthedeepfasicaTendonsofflexordigitorumsuperficialis指淺屈肌andflexordigitorumprofundus指深enclosedbycommonflexorsynovialsheath屈肌總腱鞘Tendonofflexorpollicislongus拇長屈肌enclosedbysynovialsheathforflexorpollicislongusSuperficialpalmararchFormedbyulnararteryandsuperficialpalmarbranchofradialarteryThecurveofarchliesacrossthepalm,levelwiththedistalborderoffullyextendedthumbGivesrisetothreecommonpalmardigitalarteries(eachthendividesintotwoproperpalmardigitalarteries指掌側(cè)固有動脈)andoneulnarpalmararteryofquinaryfinger小指尺掌側(cè)DeeppalmararchFormedbyradialarteryanddeeppalmarbranchofulnararteryThecurveofarchliesacrossupperpartofpalmaratlevelwithproximalborderofextendedthumbGivesrisetothreepalmarmetacarpalarteries掌心動脈tojointthedistalendsofthecorrespondingcommonpalmardigitalarteriesMediann.Muscularbranches:supplythenarexceptadductorpollicis,firsttwoCutaneusbranches:supplyskinofthenar,centralpartofpalm,palmaraspectofradialthreeandone-halffingers,includingmiddleanddistalfingersonRecurrentbranchofthemedian–liesdeeptotheskinanddeepfasciaoverlyingtheanteriormarginofthethenarnearthemidlineofthepalmUlnarn.Muscularbranchessupplyhypothenarmuscles,interossei,3rdand4thlumbricalesandadductorpollicisCutaneusbranchessupplyskinofhypothenar,palmarsurfaceofulnarone

ofhand,posterioraspectofulnartwoandone-halffingersLandmarksoflowerGlutealregionandanteriorsuperioriliacspinesanteriorinferioriliacspines髂前下棘tubercleofiliaccrestischialtuberositygreatertrochanterpubictuberclepubiccrestsuperiorborderofpubicpatellaligamenttuberosityoftibiamedialandlateralcondylesmedialandlateralepicondyles內(nèi)、外上tendonofbicepsfemoris semimembranosus半腱、半膜肌腱anteriorborderoftibiaheadoffibulaneckoffibulaAnkleandmedialandlateralmalleoluscalcanealtuberositytuberosityofnavicularbonetuberosityoffifthmetatarsalbone第五SuperficialGreatsaphenousveinDrainsthemedialendofdorsalvenousarchoffootandpassesupwarddirectlyinfrontofthemedialmalleolus.Thenascendsincompanywiththesaphenousn.inthesuperficialfasciaoverthemedialsideoftheSmallsaphenousv.3

venousarchofAscendsbehindlateralmalleolusandthenrunsupthemidlineofthebackofthelegPiercesthedeepfasciaandentersthepoplitealv.DrainsthelateralsideofthefootandankleandthebackofthelegStructurespassingthroughsuprapiriformforamen(fromlateraltomedialside)Superiorglutealn.Superiorgluteala.Superiorglutealv.臀上靜脈Structurespassingthroughinfrapiriformforamen(fromlateraltomedialside)Sciaticn.Posteriorfemoralcutaneousn.股后皮神Inferiorglutealn.Inferiorgluteala.,v.Internalpudendalv.,a.Pudendaln.Structurespassingthroughsmallsciaticforamen(fromlateraltomedialside)Internalpudendalv.,a.Pudendaln.SuperficialinguinallymphSuperiorLiesjustdistaltotheinguinalReceivelymphvesselsfromanteriorabdominalwallbelowumbilicus,glutealregion,perinealregion,externalgenitalorgansInferiorLiesverticalalongtheterminalgreatsaphenousv.Receivesallsuperficiallymphvesselsoflowerlimb,exceptforthosefromtheposterolateralpartofcalfEfferentvesselsdrainintothedeepinguinalln.orexternaliliacln.FascialataIliotibialtractlaterallythedeepfasciaformsathickbandfromtheiliactubercletothelateralcondyleoftibialSaphenoushiatus4

liesabout4cmbelowandlateraltothepubictubercle.Thefalciformmarginisthelowerlateralborderoftheopeningwhichliesanteriortothefemoralvessels.Filledwithlooseconnectivetissuecalledthecribriformfascia篩筋膜LacunamusculorumAnteriorly:lateralportionofinguinalligamentPosterolaterally:Medially:iliopectinalIliopsoasfemoraln.lateralfemoralcutaneousn.股外LacunavasorumAnteriorly:medialportionofinguinalligamentPosteriorly:fasciaofpecteineusandpectinealligamentMedially:lacunaLaterally:iliopectinalFemoralsheathFemorala.andv.Femoralbranchofn.LymphaticFemoraltriangleSuperiorly(base):inguinalligament腹股溝韌帶Laterally:medialborderofsartorius縫匠肌內(nèi)側(cè)緣Medially:medialborderofadductorlongus長收肌內(nèi)側(cè)Apex:continuouswithadductorcanal收肌管Anteriorwall:fascialataPosteriorwall:consistsofiliopsoas髂腰肌,pectineus恥骨肌andadductorlongusMediann.

andone-halffingers,ulnarhalfof

–Arisesfromthelateralpartofthe ?AgapinthedeepfasicaTendonsofflexordigitorumsuperficialis指淺屈肌andflexordigitorumprofundus指深enclosedbycommonflexorsynovialsheath屈肌總腱鞘Tendonofflexorpollicislongus拇長屈肌enclosedbysynovialsheathforflexorpollicislongusSuperficialpalmararchFormedbyulnararteryandsuperficialpalmarbranchofradialarteryThecurveofarchliesacrossthepalm,levelwiththedistalborderoffullyextendedthumbGivesrisetothreecommonpalmardigitalarteries指掌側(cè)總動脈(eachthendividesintotwoproperpalmardigitalarteries指掌側(cè)固有動脈)andoneulnarpalmararteryofquinaryfinger小指尺掌側(cè)DeeppalmararchFormedbyradialarteryanddeeppalmarbranchofulnararteryThecurveofarchliesacrossupperpartofpalmaratlevelwithproximalborderofextendedthumbGivesrisetothreepalmarmetacarpalarteries掌心動脈tojointthedistalendsofthecorrespondingcommonpalmardigitalarteriesMediann.Muscularbranches:supplythenarexceptadductorpollicis,firsttwoCutaneusbranches:supplyskinofthenar,centralpartofpalm,palmaraspectofradialthreeandone-halffingers,includingmiddleanddistalfingersondorsumRecurrentbranchofthemedian–liesdeeptotheskinanddeepfasciaoverlyingtheanteriormarginofthethenarnearthemidlineoftheUlnarn.Muscularbranchessupply

lumbricalesandadductorpollicis–Cutaneusbranchessupplyskinofhypothenar,palmarsurfaceofulnarone

ofhand,posterioraspectofulnartwoandone-halffingersLandmarksoflowerGlutealregionandanteriorsuperioriliacspinesanteriorinferioriliacspines髂前下棘tubercleofiliaccrestischialtuberositygreatertrochanterpubictuberclepubiccrestsuperiorborderofpubicpatellaligamenttuberosityoftibiamedialandlateralcondylesmedialandlateralepicondyles內(nèi)、外上tendonofbicepsfemoris semimembranosus半腱、半膜肌腱anteriorborderoftibiaheadoffibulaneckoffibulaAnkleandmedialandlateralmalleoluscalcanealtuberositytuberosityofnavicularbonetuberosityoffifthmetatarsalbone第五SuperficialGreatsaphenousveinDrainsthemedialendofdorsalvenousarchoffootandpassesupwarddirectlyinfrontofthemedialmalleolus.

Thenascendsincompanywiththehesuperficialfasciaoverthemedialsideoftheleg.Smallsaphenousv.3肌fromlateraltomedialContents：fromlateraltoFemoraln.

SemitendinosusSemimembranosusBicepsfemoris

顴弓zygomatic耳屏髁突condylar

PosteriorOccipitala.v.Greateroccipitaln.FemoralsheathFemorala.Femoralv.FemoralcanalDeepinguinallymphnodes腹股溝深淋巴結(jié)FattytissueFemoralcanalFemoralringAnteriorly:inguinalMedially:lacunalig.Posteriorly:pecteneallig.恥骨Laterally:femoralv.Superior:coveredbyfemoralseptum股環(huán)隔AdductorcanalAnteriorwall:adductorlamina大收肌腱板andsartorius縫匠肌Lateralwall:vastusmedialis股Posteomedialwall:adductorlongus長收肌andadductormagmus大收肌Saphenousn.Femorala.andfemoralv.股動、lymphaticvesselsandlooseconnectivetissueSciaticnerveArisesfromthesacralLeavespelvisthroughinfrapiriformforamentoenterglutealregionRunsinferiorlylaterallydeeptogluteusPassingmidwaybetweenthegreatertrochanteroffemurandischialtuberositytobackofthighLyingdeeptolongheadofbicepsNormallydividedintotibialandcommonperonealnervesjustabovepoplitealfossa

HipandkneejointsPoplitealfossaSuperolaterally:Bicepsfemoris肌Superomedially:semitendinosusandsemimembranosus半腱肌和半膜肌Inferiorly:lateralandmedialheadsofgastrocnemius腓腸肌內(nèi)、外側(cè)頭Roof:deeppoplitealsurfaceoftheposteriorcapsuleofthekneefasciacoveringTibialnerveCommonperonealnerve腓總神PoplitealveinanditsPoplitealarteryanditsPopliteallymphnodesMalleolarcanalFormedbymedialsurfaceofcalcaneus,flexorretinaculumandmedialmalleolusStructurespassingthroughthemalleolarTibialisposteriorFlexordigitirumlongusPosteriortibiala.vandn.脛后動脈、靜Tibialn.Flexorhallucis 眉弓superciliary眶上切跡supraorbital眶下孔infraorbital頦孔mental翼點5

乳突mastoid前囟點人字點枕外隆突externaloccipitalParotidductArisesfrontanteriorborderofLies15cmbelowandparalleltozygomaticarchPassesforwardovermasseter,piercesthebuccinatorandoralmucosatoopenoppositeseconduppermolartoothStructuresverticalpassingthroughtheparotidExternalcarotida.Superficialtemporala.Superficialtemporalv.RetromandibularveinAuriculotemporaln.耳顳神經(jīng)StructurestransversalpassingthroughtheparotidMaxillarya&v.Transversefaciala&v.Branchesoffacialn.ThestructuresfromsuperficialtoBranchesoffacialnerveRetromandibularveinExternalcarotida. 頸外動脈andAuriculotemporaln.耳顳神經(jīng)LayersoffrontoparietooccipitalConsistsoffiveThesuperficial3layerarecloselyknittogether,calledscalp頭皮SkinthickandhairbearingandcontainsnumeroussebaceousglandsThesuperficialfasciaDenseconnectivetissuethatbindstheskintotheunderlyingepicranialaponeurosisThevasculatureofthescalprunsprimarilyinthislayer.Itisrichandwidelyanastomosis.Woundsofthescalpbleedprofuselybutheala.v.andn.insuperficialAnteriorSupratrochleara.vn.滑車上動、靜脈和Supraorbitala.v.n.眶上動、靜脈和6

Epicranialaponeurosisandoccipitofrontalis帽狀I(lǐng)tisinterposedbetweenthefrontalisandoccipitalisportionsoftheoccipitofrontalisThesemusclesplacetheaponeurosisundertensionsothatdeeptransverselacerationsofthescalpgapewidelySubaponeuroticlooseconnectivetissue(space)腱膜Containsarichnetworkofdeeparteriesandveins.Therefore,thislayerhasbeencalledthe“dangerousarea”.Infectionmayspreadtothesubstanceofthebones,tovenouschannelswithinthecranialcavity,ortothebrain.PericraniumFusesfirmlywithboneatthesuturesandwiththeperiosteumoftheadjacentbone,thuslimitingthesubperiostealspace.HypophysisandhypiphysealfossaShapeandPea-sizedorgan,attachedbyinfundibulumtohypothalamus,liesinhypophysialfossaConsistsoftwoAnterior－tuberculumPosterior－dorsumAnterolateraly－opticAbove－diaphragmsellae,opticchiasmaandopticnerveLaterally－cavernousBelow－sphenoidCavernoussinusPosition:liesoneachsideofsellaTraversingthecavernousinternalcarotidarteryabducentnerveTraversingthelateralwallofthecavernousoculomotornervetrochlearnervevenousarchofAscendsbehindlateralmalleolusandrunsupthemidlineofthebackofthe Piercesthedeepfasciaandentersthepoplitealv.DrainsthelateralsideofthefootandankleandthebackofthelegStructurespassingthroughsuprapiriformforamen(fromlateraltomedialside)Superiorglutealn.Superiorgluteala.Superiorglutealv.臀上靜脈Structurespassingthroughinfrapiriformforamen(fromlateraltomedialside)Sciaticn.Posteriorfemoralcutaneousn.股后皮神Inferiorglutealn.Inferiorglutealav.Internalpudendalva.Pudendaln.Structurespassingthroughsmallsciaticforamen(fromlateraltomedialside)Internalpudendalva.Pudendaln.SuperficialinguinallymphSuperiorLiesjustdistaltotheinguinalReceivelymphvesselsfromanteriorabdominalwallbelowumbilicus,glutealregion,perinealregion,externalgenitalorgansInferiorLiesverticalalongtheterminalgreatsaphenousv.Receivesallsuperficiallymphvesselsoflowerlimb,exceptforthosefromtheposterolateralpartofcalfEfferentvesselsdrainintothedeepinguinalln.orexternaliliacln.FascialataIliotibialtractlaterallythedeepfasciaformsathickbandfromtheiliactubercleto

lateralcondyleofSaphenoushiatus

liesabout4cmbelowandlateraltothepubictubercle.Thefalciformmarginisthelowerlateralborderoftheopening,whichliesanteriortothefemoralvessels.Filledwithlooseconnectivetissuecalledthecribriformfascia篩筋膜LacunamusculorumAnteriorly:lateralportionofinguinalligamentPosterolaterally:Medially:iliopectinalIliopsoasfemoraln.lateralfemoralcutaneousn.股LacunavasorumAnteriorly:medialportionofinguinalligamentPosteriorly:fasciaofpecteineusandpectinealMedially:lacunaLaterally:iliopectinalFemoralsheathFemorala.andv.Femoralbranchofn.LymphaticFemoraltriangleSuperiorly(base):inguinalligament腹股溝韌帶Laterally:medialborderofsartorius縫匠肌內(nèi)側(cè)緣Medially:medialborderofadductorlongus長收肌內(nèi)側(cè)Apex:continuouswithadductorcanal收肌管Anteriorwall:fascialata

Posteriorwall:consistsofiliopsoas髂腰肌,pectineus恥骨肌andadductorlongusophthalmicnervemaxillarynerve

investingDeep－prevertebral

–Recurrentlaryngeal

enteringtheTheinferiorthyroida.iscloselyrelatedtoLandmarksoftheHyoidboneThyroidcartilageCricoidcartilageCatotidtubercleSternocleidomastoidSuprasternalfossaGreatersupraclaviclarfossaCervicalfasciaSuperficiallayerofcervicalfascia頸筋膜淺層(investingfascia封套筋膜Enclosestrapezius,sternocleidomastoid,posteriorbellyofdigastricandparotidandsubmandibularAttachedtobonylandmarksofupperandlowerboundariesofneckandzygomaticarchoffacePretracheallayerLiesdeeptotheinfrahyoidEnclosesvisceraofneck:pharynx,larynx,trachea,esophagus,thyroidglandandparathyroidglandsCompletelysurroundsthyroidgland,formingasheathforit,andbindtheglandtolarynxtoformsuspensoryligamentofthyroidgland甲狀腺懸Extendsfromarchofcricoidcartilage,thyroidcartilageandhyoidbonetofibrouspericardiumofsuperiormediastinumPrevertebrallayerLiesanteriortobodiesofcervicalvertebraeandprevertebralmuscles;extendsfrombaseofskulldownwardintothesuperiormediastinum,continuouswithanteriorlongitudinallig.andendothoracicfasciaCoverssubclavianvesselsandrootsofbrachialExtendsintoupperlimbasaxillary★CarotidtriangleAnteriorborderofSuperiorbellyofPosteriorbellyofCoveredbyskin,superficialfascia,platysma

Medial－lateralwallofCommoncarotida.anditsInternaljugularv.anditsHypoglossaln.withitsdescendingAccessoryDeepcervicallymphMusculartriangleBoundedbymidlineoftheneck,superiorbellyoftheomohyoidandanteriorborderoftheCoveredbyskin,superficialfascia,platysma,anteriorjugularv.,andinvestingfasciaDeep－prevertebralThyroidglandShapeandH-Leftandrightlobes:lieoneithersideofinferiorpartoflarynxandsuperiorpartoftrachea,extendfrommiddleofthyroidcartilagetolevelofsixthtracheacartilageIsthmus:overlies2ndto4thtrachealPyramidallobe:sometimesarisesfromCoveringsofthethyroidFalsecapsule:asheathofpretrachealfasciawhichisattachedtoarchofcricoidandthyroidcartilagestoformthesuspensoryligamentofthyroidgland,hence,thethyroidglandmoveswithlarynxduringswallowingandoscillatesduringspeakingTruecapsule:fibrousSpacebetweensheathandcapsuleofthyroidgland:therearelooseconnectivetissue,vessels,nervesandparathyroidglandsRelationsofthethyroidsuperficialinvestingInfrahyoidmusclesandpretrachealLarynxandPharynxand7

Carotidsheathwithcommoncarotida.,internaljugularv.,andvagusn.CervicalsympatheticArteriesofthethyroidSuperiorthyroida.BranchofexternalcarotidRunssuperficialandparalleltotheexternalbranchofsuperiorlaryngealn.toreachtheupperpoleofthyroidglandGivesoffsuperiorlaryngeala.incompanywithinternalbranchofsuperiorlaryngealn.InferiorthyroidarteryBranchofthyrocervicaltrunkofsubclaviana.Turnsmediallyanddownward,reachestheposteriorborderofthethyroidgland,whereitiscloselyrelatedtotherecurrentlaryngealn.SuppliesinferiorpoleofthyroidArteriathyroideaimaMayarise(4%)fromthea.oraorticSuperiorlaryngealn.Internalbranch內(nèi)支：whichpiercesthyrohyoidmembranetoinnervatesmucousmembraneoflarynxabovefissureofglottisExternalbranch外支：isfinen.,whichdescendsincompanywiththesuperiorthyroida.andsuppliescricothyroidRecurrentlaryngealnervesAscendintracheo-esophagealPassdeeptothelobeofthethyroidglandandcomeintocloserelationshipwiththeinferiorthyroida.CrosseitherinfrontoforbehindtheNervesenterlarynxposteriortocricothyroidjoint,thenerveisnowcalledinferiorlaryngealnerve喉Innervations:laryngealmucosabelowfissureofglottis,alllaryngeallaryngealmusclesexceptRelationshipofarteriestothelaryngealThesuperiorthyroida.iscloselyrelatednearitsorigintothesuperiorlaryngealn.Sectionofthenervewouldanaesthetisethelaryngealmucosaandabolishthecoughreflex,soincreasingtheriskoffoodoraforeignbody8

recurrentlaryngealn.asitenterstheSectionofthenervewouldresultinparalysisofmusclesthatmovethevocalcordsonthatside.ParathyroidglandTwosuperiorparathyroidglands:lieatjunctionofsuperiorandmiddlethirdofposteriorborderofthyroidglandTwoinferiorparathyroidglands:lieneartheinferiorthyroidartery,closetotheinferiorpolesofthyroidglandRelationsofcervicalpartofSuperficialInvestingSuprasternalspaceandjugularInfrahyoidmusclesandpretrachealIsthmusofthyroidgland(infrontofthe2ndto4thtrachealcartilage)Inferiorthyroidv.andunpairedthyroidvenousplexusArteriathyroidima(ifThymus,leftbrachiocephalicv.andaorticarchinchildlobesofthethyroidgland(downasfarasthesixthring)R.&L.recurrentlaryngealCervicalsympatheticCarotidCarotidsheathFormedbycomponentsofallthreelayersofdeepcervicalfasciaContainscommonandinternalcarotidarteries,internaljugularvein,andvagusnerveLandmarksofJugularnotchcorrespondsThe2ththoracicvertebrainmale,the3ththoracicvertebrainfemale肌fromlateraltomedialContents：fromlateraltoFemoraln.

SemitendinosusSemimembranosusBicepsfemoris

zygomatic耳屏condylar

PosteriorOccipitala.v.Greateroccipitaln.FemoralsheathFemorala.Femoralv.FemoralcanalDeepinguinallymphnodesFattytissueFemoralcanalFemoralringAnteriorly:inguinalMedially:lacunalig.Posteriorly:pecteneallig.恥骨Laterally:femoralv.Superior:coveredbyfemoralseptum股環(huán)隔AdductorcanalAnteriorwall:adductorlamina大收肌腱板andsartorius縫匠肌Lateralwall:vastusmedialis股Posteomedialwall:adductorlongus長收肌andadductormagmus大收肌Saphenousn.Femorala.andfemoralv.股動、lymphaticvesselsandlooseconnectivetissueSciaticnerveArisesfromthesacralLeavespelvisthroughinfrapiriformforamentoenterglutealregionRunsinferiorlylaterallydeeptogluteusPassingmidwaybetweenthegreatertrochanteroffemurandischialtuberositytobackofthigh

LyingdeeptolongheadofbicepsNormallydividedintotibialandcommonperonealnervesjustabovepoplitealfossa

HipandkneejointsPoplitealfossaSuperolaterally:Bicepsfemoris股二頭Superomedially:semitendinosusandsemimembranosus半腱肌和半膜肌Inferiorly:lateralandmedialheadsofgastrocnemius腓腸肌內(nèi)、外側(cè)頭Roof:deeppoplitealsurfaceofth