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1、Human anatomy 山东大学医学院山东大学医学院 解剖教研室解剖教研室 李振华李振华Basic Concepts of Anatomy nDefinition:human anatomy,the oldest science dealing with the structures and functions of bodyqGross anatomy:nsystematic anatomy nregional anatomyq Applied anatomyq Clinical anatomy人体解剖学发展简史人体解剖学发展简史HippcratesHippocrates-希波克拉底希波
2、克拉底（公元前（公元前460377）古）古希腊名医、解剖学鼻祖。希腊名医、解剖学鼻祖。GalenGalen-伽林伽林（130200）古希腊名医、解剖学家，著医经，对血液流动、神经分支和脑、心等器官有具体描述。Vesalius-(15141564)现代解剖学的现代解剖学的奠基人，奠基人，1543年出版了年出版了人体构造人体构造这这一划时代的解剖学巨著。一划时代的解剖学巨著。VesaliusHarveyHarvey-(15781657)解剖生理学家，发现了血液循解剖生理学家，发现了血液循环的原理，确定血液是在一个环的原理，确定血液是在一个封闭的管道内循环。著有封闭的管道内循环。著有血血液循环论液循
3、环论、动物的发生动物的发生两书。开创了动物实验研究的两书。开创了动物实验研究的道路。道路。我国人体解剖学的发展历程我国人体解剖学的发展历程n公元前300200黄帝内经已有对人体解剖的记载。n两宋时代五脏六腑、存真图描述了解剖学知识。n王清任（17681831）编著的医林改错更为详细的描述了解剖学知识。n19492003年我国解剖学工作者队伍迅速成长，编写了多套具有我国特色的解剖学教材和解剖学图谱，对我国解剖学事业的发展做出了巨大的贡献。人体解剖教学特点人体解剖教学特点n人体解剖学的教学包括讲授和实地解剖。主要讲授各人体解剖学的教学包括讲授和实地解剖。主要讲授各系统的总论和各解剖操作区的重点内容
4、。实地解剖采系统的总论和各解剖操作区的重点内容。实地解剖采取分组形式，在教师指导下，按照解剖操作指导，参取分组形式，在教师指导下，按照解剖操作指导，参照图谱由学生亲自动手解剖尸体，部分内容观察标本照图谱由学生亲自动手解剖尸体，部分内容观察标本和模型。同时，密切结合活体的观察和触摸，并适当和模型。同时，密切结合活体的观察和触摸，并适当的结合一些临床病例讨论以增强对解剖学内容的理解的结合一些临床病例讨论以增强对解剖学内容的理解和记忆。和记忆。n教学大纲所列教学内容按要求程度的不同，分为教学大纲所列教学内容按要求程度的不同，分为“掌掌握内容握内容”和和“了解内容了解内容”两级。掌握内容为重点内容，两
5、级。掌握内容为重点内容，学生必须通过反复学习与思考达到牢固掌握、熟练描学生必须通过反复学习与思考达到牢固掌握、熟练描述、准确指认和联系实际应用的程度。了解内容则要述、准确指认和联系实际应用的程度。了解内容则要求学生达到一般的认识和了解。求学生达到一般的认识和了解。Descriptive anatomical termsnThe anatomical position:(解剖学姿势解剖学姿势)The body is upright,legs together,and directed forwards.The palms are turned forward,with the thumbs la
6、terally.The terms of the direction (方位术语方位术语)nsuperior 上上,inferior 下下nanterior(ventral)前前(腹侧腹侧)posterior(dorsal)后后(背侧背侧)nmedial 内侧内侧,lateral 外侧外侧ninternal 内内,external 外外nsuperficial 浅浅,profound 深深nproximal 近侧近侧,distal 远侧远侧nulnar 尺侧尺侧,radial 桡侧桡侧ntibial 胫侧胫侧，fibular 腓侧腓侧 Anatomical axes and planes（轴与
7、面）轴与面）nAxis 轴：轴：qVertical axis 垂直轴垂直轴qSagittal axis 矢状轴矢状轴qCoronal axis 冠状轴冠状轴nPlane面面:qSagittal plane 矢状面矢状面qCoronal plane 冠状面冠状面qHorizontal plane 水平面水平面 或transverse plane 横切面横切面The Locomotor System 运动系统运动系统n运动系统由运动系统由bone 骨骨、joints关节关节和和muscles 骨骼肌骨骼肌组成，占成人组成，占成人体重体重60%q骨起杠杆作用骨起杠杆作用q关节是运动的枢纽关节是运动的
8、枢纽q骨骼肌是动力器官骨骼肌是动力器官n功能功能:q support 支持支持qProtection 保护保护qLocomotion 运动运动 Introduction of the osteology 骨学总论骨学总论nBones in adult are 206 in number.nClassification of bone Bones are classified according to their position and shape nThe position can be:qskull 颅骨qbones of trunk 躯干骨qappendicular skeleton 四
9、肢骨nTypes of shape include:qlong bone 长骨长骨qshort bone 短骨短骨qflat bone 扁骨扁骨 qirregular bone不规则骨不规则骨 n Long bones(found in limbs):qDiaphysis or shaft 骨干骨干,which is hollow(called medullary cavity 骨髓腔骨髓腔),filled with bone marrowqTwo endsepiphysis 骺骺 articular surface 关节面关节面,metaphysis干骺端干骺端,epiphysial car
10、tilage 骺软骨骺软骨,and epiphysial line 骺线骺线nShort bones:cuboidal in shape,e.g.carpal bonesnFlat bones:thin,nIrregular bones:have any irregular or mixed shape,e.g.vertebrae,pneumatic bones含气骨*Sesamoid bones籽骨:develop within tendonGeneral structures of bone骨的构造骨的构造nBone substance 骨质骨质qcompact bone 骨密质骨密质qs
11、pongy bone 骨松质骨松质 呈海绵状，由trabeculae骨小梁构成In the flat bones of the skull,the layers of compact bone are called the outer plate and inner plate外板和和内板,while the layer of spongy bone is called the diplo 板障板障 nPeriosteum 骨膜骨膜:qOuter or fibrous layer qInner layer is vascular and provides the underlying bone
12、 with nutrition.It also contains osteoblasts(成骨细胞)Endosteum骨内膜 is a single-cellular osteogenic layer lining the inner surface of bone.nBone marrow 骨髓骨髓qRed marrow 红骨髓红骨髓:haematopoietic 造血qYellow marrow黄骨髓黄骨髓:fatty Chemical composition and physical properties化学成分和物理性质nOrganic material有机质有机质：主要是骨胶原纤维束
13、和粘多糖蛋白。构成支架，赋予骨的弹性和韧性。n Inorganic salts无机质无机质：主要是碱性磷酸钙。赋予骨硬度和脆性 Organic materialInorganic saltsChildren 1 1Adult 3 7Old 1 4Bones of trunk 躯干骨躯干骨nComposition:vertebrae,sacrum,coccyx,sternum and ribs Vertebrae 椎骨椎骨nThere are 33 vertebrae in children,arranged as follows:nCervical vertebrae 颈椎颈椎 C.7nTho
14、racic vertebrae 胸椎胸椎 T.12nLumbar vertebrae 腰椎腰椎 L.5nSacral vertebrae 骶椎骶椎 S.5 sacrum 骶骨骶骨nCoccygeal vertebrae 尾椎尾椎 Co.34 coccyx尾骨尾骨General features of vertebraenVertebral body 椎体椎体nVertebral arch 椎弓椎弓qpedicle of vertebral arch 椎弓根椎弓根:sup.and inf.Vertebral notch 椎上、下切迹椎上、下切迹 qlamina of vertebral arch
15、 椎弓板椎弓板nprocess(7):qspinous process 棘突棘突qtransverse process 横突横突qsup.and inf.articular processes 上、下关节突上、下关节突nVertebral foramen 椎孔椎孔 nVertebral canal 椎管椎管nIntervertebral foramen 椎间孔椎间孔Regional variations of vertebraeCervical vertebraenVertebrae Body:small nVertebral foramen:larger and triangularnSpi
16、nous processes:short and bifid in C3 to C5,long in C6,and longer in C7nTransverse processes:short and bifid,transverse foramen横突孔横突孔nArticular processes:horizontal Atypical vertebeaenAtlas寰椎寰椎(C1)qBody and spinous process absent,consists of anterior and posterior arches,and two lateral massesqGroove
17、 for vertebral artery 椎动脉沟椎动脉沟nAxis枢椎枢椎(C2):distinguished by dens齿突齿突 which articulates with dental fovea of anterior arch of atlasnCarotid tubercle:颈动脉颈动脉结节结节:anterior tubercle of transverse process of C6nVertebra prominens 隆椎隆椎(C7):contains long and non-bifid spinous process,it is visible with nec
18、k flexed,used as clinical landmark in counting cervical and thoracic spinous processesThoracic vertebrae nVertebrae Body：heart-shape,superior and inferior costal fovea 上、下肋凹上、下肋凹nVertebral foramen：smaller,rounder nSpinous processes：long,point obliquely downward nTransverse processes：transverse costa
19、l fovea 横突肋凹横突肋凹 nArticular processes:coronal Lumbar vertebrae nVertebrae Body：larger,kidney-shape nVertebral foramen:larger and triangular nSpinous processes:projects horizontally nTransverse processes:long nArticular processes:sagittal Sacrum nAnterior surface:promontory岬岬,anterior sacral foramina
20、 骶前孔骶前孔(four pairs)nPosterior surface:median sacral crest 骶正中嵴骶正中嵴,posterior sacral foramina(four pairs),sacral hiatus骶管裂孔骶管裂孔，sacral cornu 骶角骶角nLateral part:auricular surface耳状面耳状面,sacral tuberosity骶粗隆骶粗隆Transsacral(epidural)anasthesiaCornua palpationSacral hiatusSternum nManubrium sterni 胸骨柄胸骨柄:ju
21、gular notch 颈静脉切迹颈静脉切迹,clavicular notch 锁切迹锁切迹nBody of sternum 胸骨体胸骨体 nXiphoid process Sternal angle 胸骨角胸骨角:the junction of manubrium and body,which connects 2nd costal cartilage laterally,and lies opposite lower border of T4 posteriorly Sternal angle 胸骨角胸骨角 which connects 2nd costal cartilage later
22、ally,and lies opposite lower border of T4 posteriorlyRibs肋肋:12 pairnGeneral featuresqRibs 17 called true ribs真肋真肋qRibs 810 called false ribs 假肋假肋qRibs 1112 called floating ribs 浮肋浮肋 Characteristics of“typical”ribnPosterior end:costal head 肋头肋头,costal neck肋颈肋颈,costal tubercle肋肋结节结节 nShaft:costal angl
23、e肋角肋角,costal groove 肋沟肋沟nAnterior endAtypical ribnFirst rib:tubercle for scalenus anterior前斜角肌结节前斜角肌结节,sulcus for subclavian artery and vein 锁骨下锁骨下动、静脉沟动、静脉沟n11th and 12th ribs lack costal necks,tubercles and anglesThe Bones of Limbs山东大学医学院山东大学医学院 解剖教研室解剖教研室李振华李振华Bones of upper limbsComposition:nSho
24、uld girdle 上肢带骨上肢带骨clavicle锁骨锁骨，scapula肩胛骨肩胛骨nBones of free upper limb 自由上肢骨自由上肢骨qHumerus肱骨肱骨 in armqRadius桡骨桡骨 and ulna尺骨尺骨 in forearmqCarpal腕骨腕骨,metacarpals掌骨掌骨 and phalanges指骨指骨 in hand Clavicle 锁骨锁骨n“S”shaped,medial 2/3 convex forward and lateral 1/3 convex backwardnSternal end胸骨端胸骨端 medially an
25、d acromial end肩峰端肩峰端 laterally Scapula 肩胛骨肩胛骨nThree bordersqSuperior:coracoid process 喙突喙突,scapular notch 肩胛切迹qLateral(axillary)border腋缘腋缘qMedial(vertebral)border脊柱缘脊柱缘nThree anglesqSuperior:opposite to the 2nd rib qInferior:opposite to the 7th rib or 7th intercostals spaceqLateral:glenoid cavity关节盂
26、关节盂,supra-and infraglenoid tubercles 盂上、下结节nTwo surfacesqAnterior surface concave:subscapular fossa肩胛下窝肩胛下窝qPosterior surface:supra-and infraspinous fossae冈上、下窝冈上、下窝,spine of scapula 肩胛冈肩胛冈,acromion 肩肩峰峰 Humerus 肱骨肱骨nUpper end:head of humerus肱骨头肱骨头,anatomical neck解剖颈解剖颈,greater and lesser tubercles大
27、、小结节大、小结节,crests of greater and lesser tubercle,大、小结节大、小结节嵴嵴，intertubercular groove结节间沟结节间沟,surgical neck外科颈外科颈nShaft:deltoid tuberosity三角肌粗隆三角肌粗隆on lateral surface,and a groove for radial nerve桡神经沟桡神经沟 on posterior surfacenLower end:lateral and medial epicondyles内、外上髁内、外上髁,capitulum 肱骨肱骨小头小头,trochl
28、ea 肱骨滑车肱骨滑车,coranoid fossa 冠突窝冠突窝and radial fossa 桡窝桡窝(anteriorly)and olecranon fossa鹰嘴鹰嘴窝窝(posteriorly),and sulcus for ulnar nerve 尺神经沟尺神经沟RadiusnUpper end:head of radius桡骨头桡骨头,neck of radius桡骨颈桡骨颈,radial tuberosity 桡骨粗隆桡骨粗隆,and articular circumference环状关节面nShaft：interosseous border骨间骨间缘缘nLower end
29、:styloid process 茎突茎突laterally,ulnar notch尺切迹尺切迹 medially,and carpal articular surface腕关节面腕关节面 inferiorlyFracture of the distal end pf the radius UlnarnUpper end:olecranon鹰嘴鹰嘴 coronoid process 冠突冠突 trochlear notch滑车切迹滑车切迹 radial notch 桡切迹桡切迹 ulnar tubersity尺骨粗隆尺骨粗隆 nLower end styloid process 尺骨茎突尺骨茎
30、突 head of ulna 尺骨头尺骨头Carpal bones 腕骨腕骨nProximal row (lateral to medial)scaphoid手舟骨手舟骨,lunate月骨月骨,triquetral三角骨三角骨 and pisiform豌豆骨豌豆骨nDistal row (lateral to medial)trapezium大大多角骨多角骨,trapezoid小多角骨小多角骨,capitate头状骨头状骨 and hamate钩骨钩骨Metacarpal bones掌骨掌骨nNumbered one to five from thumb to little fingernSt
31、ructure of eachbase(proximally),shaft,and head(distally)Phalanges of fingers 指骨指骨nConsist of 14 two for first digit(thumb)and three for each of other four digitsnStructure of each base(proximally),shaft,and trochlea of phalanx(distally),tuberosity of distal phalanx远节指骨粗隆远节指骨粗隆Bones of Lower LimbComp
32、osition:nPelvic girdle:hip bone髋骨髋骨nBones of free lower limb:qFemur股骨股骨 in thigh(patella髌髌骨骨)qTibia胫骨胫骨 and fibula腓骨腓骨 in leg qTarsals跗骨跗骨,metatarsals跖骨跖骨,phalanges of toes趾骨趾骨 in footHip bone Consisting of three fused bones,ilium,ischium,pubisnIlium髂骨髂骨qBody of ilium 髂骨体髂骨体 to form superior 2/5 of
33、acetabulum髋臼髋臼qAla of ilium 髂骨翼髂骨翼:iliac crest 髂嵴髂嵴,anterior superior iliac spine 髂前上棘髂前上棘，anterior inferior iliac spine 髂前下棘髂前下棘,tubercle of iliac crest髂结节髂结节,posterior superior iliac spine 髂后上棘髂后上棘，posterior inferior iliac spine 髂后下棘髂后下棘,greater sciatic notch 坐骨大切迹坐骨大切迹,gluteal surface 臀面臀面，iliac
34、fossa 髂窝髂窝,arcuate line弓状线弓状线,auricular surface 耳状面耳状面,iliac tuberosity 髂髂粗隆粗隆,nIschium 坐骨坐骨qBody of ischium 坐骨体坐骨体to form posterior and inferior 2/5 of acetabulum,ischial spine坐骨棘坐骨棘,lesser sciatic notch 坐骨小切迹坐骨小切迹qRamus of ischium 坐骨支坐骨支,ischial tuberosity 坐骨结节坐骨结节nPubis 耻骨耻骨qBody of pubis 耻骨体耻骨体t
35、o form anterior and inferior 1/5 of acetabulum,iliopubic eminence 髂耻隆起髂耻隆起qSuperior ramus of pubis 耻骨上支耻骨上支:pecten of pubis 耻骨梳耻骨梳,pubic tubercle 耻骨结节耻骨结节,pubic crest 耻骨嵴耻骨嵴,symphysial surface耻耻骨联合面骨联合面qInferior ramus of pubis耻骨下支耻骨下支:obturator foramen 闭孔闭孔nAcetabulum 髋臼髋臼formed by bodies of ischium
36、,ilium and pubis Lunate surface月状面月状面,acetabular fossa髋臼窝髋臼窝,acetabular notch髋臼切髋臼切迹迹 Femur 股骨股骨nUpper end:femoral head股骨头股骨头,fovea of femoral head 股骨头凹,neck of femur 股骨颈股骨颈,greater trochanter 大转大转子子，lesser trochanter 小转子小转子,intertrochanteric line 转子间线转子间线,intertrochanteric crest 转子间嵴转子间嵴nShaft:line
37、a aspera 粗线粗线,gluteal tuberosity 臀肌粗隆臀肌粗隆,pectineal line耻骨耻骨肌线肌线，popliteal surface 腘面腘面 nLower end:medial and lateral condyles内、外侧髁内、外侧髁，medial and lateral epicondyles内、外上髁内、外上髁,adductor tubercle 收肌结节收肌结节，intercondylar fossa髁间窝髁间窝,patellar surface髌面Fracture of the femoral neckTibia 胫骨胫骨nUpper end:me
38、dial and lateral condyles 内、外侧髁内、外侧髁,intercondylar eminence 髁髁间隆起间隆起,fibular articular surface 腓关节面,tuberosity of tibia胫骨粗隆胫骨粗隆 nShaft:interosseous border 骨间缘骨间缘,soleal line 比目鱼肌比目鱼肌线线nLower end:fibular notch腓切腓切迹迹,medial malleolus 内踝内踝 Fibula 腓骨nUpper end:fibular head 腓骨头腓骨头,neck of fibula 腓骨颈nShaf
39、t:interosseous border骨间缘骨间缘nLower end:lateral malleolus 外踝外踝Patella 髌骨髌骨ntriangular sesamoid boneTarsal bones 跗骨跗骨Consist of seven short bones arranged in three rownPosterior row talus 距骨距骨,calcaneus 跟骨跟骨nIntermediate row navicular bone 足舟骨足舟骨nAnterior row medial,intermediate,and lateral cuneiforms
40、内侧、中间和外侧楔骨内侧、中间和外侧楔骨,cuboid bone 骰骨骰骨 Metatarsal bones 跖骨跖骨nConsist of five elongated bones,numbered one to five medial to lateralnStructure of each base(proximally),shaft,and head(distally)in eachPhalanges of toes 趾骨趾骨nConsist of 14two for first toe(hallux)and three for each of other four toesSurfa
41、ce landmarks:trochlea of talus距骨滑车距骨滑车,calcaneal tuberosity 跟骨结节跟骨结节,tuberosity of navicular bone 舟骨粗隆舟骨粗隆,and tuberosity of fifth metatarsal bone第五跖骨粗隆第五跖骨粗隆Skull颅颅山东大学医学院解剖教研室山东大学医学院解剖教研室李振华李振华The skull is composed of 23 bones,which may be divided into the cerebral cranium and facial cranium nCere
42、bral cranium 脑颅脑颅(8)larger,upper and posterior part,contains and protects the brainqSingle bones:include frontal bone 额骨额骨,ethmoid bone 筛骨筛骨,sphenoid bone 蝶骨蝶骨,occipital bone 枕骨枕骨qPaired bones:include temporal bone 颞骨颞骨 parietal bone 顶骨顶骨 nBones of facial cranium 面颅面颅(15)smaller,lower,and anterior p
43、art,contains bones that surrounded the eye,nose and mouthqSingle bones:include mandible下颌骨下颌骨,vomer 犁骨犁骨 hyoid bone舌骨舌骨qPaired bones:include maxilla 上颌骨上颌骨,nasal bone 鼻骨鼻骨,lacrimal bone 泪骨泪骨,palatine bone 腭骨腭骨,zygomatic bone 颧骨颧骨,inferior nasal concha 下鼻甲下鼻甲Frontal boneZygomatic boneNasal boneMaxill
44、a MandibleSphenoid bone parietal bone Temporal boneOccipital bone面颅上颌为中心，上鼻泪，下下颌，面颅上颌为中心，上鼻泪，下下颌，外颧内甲后犁腭，舌骨颈前单落脚外颧内甲后犁腭，舌骨颈前单落脚。Mandible下颌骨下颌骨nBody of mandible qSuperior border:alveolar arch 牙槽弓 qInferior border:base of mandible下颌底qOuter surface:mental protuberance 颏隆凸,mental foramen 颏孔颏孔qInner surf
45、ace:mental spine颏棘,digastric fossa二腹肌窝nRamus:has two vertical processes separated by mandibular notch下颌切迹qCoronoid process 冠突qCondylar process 髁突髁突nhead of mandible 下颌头下颌头 nneck of mandible 下颌颈下颌颈qMandibular foramen 下颌孔下颌孔，mandibular lingula下颌小舌qAngle of mandible下颌角下颌角qMasseteric tuberocity 咬肌粗隆咬肌粗隆
46、The skull as a whole 颅的整体观颅的整体观Skull viewed from above(superior view)nBones:frontal额,paired parietal顶,occipital枕nSutures:qcoronal冠状缝冠状缝,qsagittal 矢状缝矢状缝,qlambdoid人字缝人字缝nparietal tuber 顶结节，parietal foramen顶孔Internal surface of the calvaria nsulcus for superior sagittal sinus上矢状窦沟上矢状窦沟ngranular foveol
47、a 颗粒小凹颗粒小凹 narterial grooves 动脉沟Skull viewed from behind nexternal occipital protuberance 枕外隆凸枕外隆凸nsuperior nuchal line上项线Internal view of base of skull 颅底内面观颅底内面观Base of skull forms three fossae nAnterior cranial fossa 颅前窝颅前窝nMeddle cranial fossa 颅中窝颅中窝nPosterior cranial fossa 颅后窝颅后窝Anterior crania
48、l fossa 颅前窝颅前窝nFormed by orbital part of frontal bone,cribriform plate of ethmoid,and lesser wings of sphenoidnStructures:qfrontal crest额嵴额嵴 qforamen cecum 盲孔盲孔 qcrista galli 鸡冠鸡冠 qcribriform plate 筛板筛板 qcribriform foramina 筛孔筛孔Meddle cranial fossa 颅中窝颅中窝nFormed by the body and greater wings of sphe
49、noid,petrous part of temporalnStructures:qbody of sphenoid bone 蝶骨体蝶骨体 qhypophysial fossa 垂体窝垂体窝 qoptic canal 视神经管视神经管 qanterior clinoid process 前床突前床突 qtuberculum sellae 鞍结节鞍结节 qdorsum sellae 鞍背 qposterior clinoid process 后床突后床突 qsella turcica 蝶鞍蝶鞍 Meddle cranial fossa 颅中窝颅中窝qcarotid sulcus 颈动脉沟颈动脉
50、沟 qsuperior orbital fissure 眶上裂眶上裂qforamen rotundum 圆孔圆孔 qforamen ovale 卵圆孔卵圆孔 qforamen spinosum 棘孔棘孔qsulcus for middle meningeal artery 脑膜中动脉沟脑膜中动脉沟qforamen lacerum 破裂孔破裂孔 qinternal opening of carotid canal 颈脉管内口颈脉管内口qtrigeminal impression 三叉神经压迹三叉神经压迹qtegmen tympani 鼓室盖鼓室盖 Posterior cranial fossa