内脏总论

nullnull内脏学总论 内脏各系统概述第二军医大学解剖学教研室许家军提问 Answer questions提问 Answer questions肱二头肌、三角肌的英文词汇提问 Answer questions提问 Answer questions膝关节的组成、结构特点、运动方式及参与各运动的相关肌屈 肌：缝匠肌，股二头肌，半腱肌，半膜肌，腘肌 伸 肌：股四头肌 旋外肌：股二头肌 旋内肌：缝匠肌，半腱肌，半膜肌，腘肌提问 Answer questions提问 Answer questions膝关节的组成、结构特点、运动方式及参与各运动的相关肌 参与旋前，旋后，内翻，外翻的肌 旋前：旋前圆肌，旋前方肌 旋后：肱二头肌，旋后肌 内翻：胫骨前肌，胫骨后肌 外翻：腓骨长肌，腓骨短肌， 趾长伸肌（第三腓骨肌）null内脏viscera包括消化、呼吸、泌尿、生殖四个系统，这四个系统的器官总称为内脏。 内脏的概念内脏学概述 Introduction of splanchnology 内脏器官的特征 内脏器官的功能多数位于胸、腹、盆腔内，借孔道与外界相通完成物质代谢和繁殖后代null内脏的基本结构中空性器官实质性器官粘膜 粘膜下层 肌层 外膜（浆膜）分叶lobule 有门hilumhollow organparenchymatous organSplanchnologySplanchnologyViscera indicates the organs of the alimentary system, respiratory system, urinary system and genital system. These systems consist of a series of hollow and parenchymatous organs, communicating with external circumstance through some openings on the surface of the body. Most viscera are situated in the thoracic cavity, abdominal cavity and pelvic cavity. The main functions of the viscera are to fulfill the metabolism, maintain the life of the species.null胸部标志线和腹部分区第10肋髂结节腹股沟中点nullnull组成：消化管和消化腺 功能：消化食物 吸收营养 排泄食物残渣alimentary system digestive system消化系统null消化管 alimentary tract 口腔 咽 食管 胃 小肠 大肠 十二指肠 空肠 回肠盲肠 结肠 直肠 肛管上消化道下消化道null 消化腺 alimentary glands 大消化腺 肝、胰 唾液腺 小消化腺 散在于消化管管壁腮腺 下颌下腺 舌下腺null食管 esophagus位置、长度与分段 C6 ~ T11 25 cm 颈部 5 cm 胸部 18～20 cm 腹部 1 ～2 cm 狭窄部 食管起始处，距中切牙15 cm 与左主支气管相交处， 距中切牙25 cm 穿膈食管裂孔处，距中切牙40 cmnull胃 stomach 形态和分部 2口 2缘 2壁 4部 结构 4层 幽门瓣、幽门括约肌胃大弯胃小弯角切迹幽门瓣null 位置 大部位于左季肋区 小部分位于腹上区 贲门位于T11左侧 幽门位于L1右侧null消化腺肝 liver形态: 不规则楔形；前、后两缘；上(膈)、下(脏)两面；四叶　肝镰状韧带肝冠状韧带肝镰状韧带null脏面 “H”形沟　 　肝门胆囊窝 肝蒂静脉韧带null大部右季肋区和腹上区，小部左季肋区 体表投影：右肋弓下缘以上，剑突下3 cm位置null肝外胆道 组成null肝外胆道 胆囊 gallbladder位置、分部 胆囊底体表投影胆囊颈胆囊体胆囊底胆囊管肝左管肝总管胆总管组成螺旋襞null 肝总管 胆总管肝左管 肝右管肝总管 胆囊管肝总管胆总管胰 管肝胰壶腹十二指肠大乳头null左、右肝管 肝总管 胆总管 十二指肠大乳头 十二指肠胆囊管 胆汁的排泄途径 胆囊null The organs of the digestive system may be divided into two groups. The alimentary tract (digestive tube) consists of the tubular organs including the mouth, pharynx, esophagus, stomach, small intestine (duodenum, jejunum, ileum) and large intestine (caecum, vermiform appendix, colon, rectum and the anal canal). The digestive glands consist of salivary glands, liver, and pancreas.Digestive systemnull The stomach is situated between the end of the esophagus and the beginning of the small intestine. It lies in the epigastric umbilical, and left hypochondriac regions of the abdomen. The stomach presents two curvatures, greater and lesser; two surfaces, anterior and posterior; and two openings, cardiac and pyloric. The stomach is usually divided into cardiac part, fundus of stomach, body of stomach and pyloric part. The liver occupies mainly the right hypochondriac and epigastric regions of the abdominal cavity; and a small part extend to the left hypochondriac region. The liver consists of a very large right, a small left, caudate, and quadrate lobes. The porta hepatis is the point of entrance of the vessels into the liver and the emergence of the bile duct from the liver on the inferior surface of the liver. It transmits the branches of the portal vein, hepatic arteries, hepatic ducts, nerves, and lymph vessels. Digestive systemnull组成：呼吸道和肺 功能：与外界气体交换 嗅觉 发音 消化 呼吸系统 respiratory systemnull呼吸道 respiratory tract 鼻nose 咽pharynx 喉larynx 气管trachea 支气管bronchus 肺 lung 气体交换的场所上呼吸道下呼吸道null位置肺 lung胸腔内, 纵隔两侧 右肺粗短 左肺狭长分叶左肺：上、下叶 右肺：上、中、下叶斜裂水平裂null 形态：圆锥形肺尖：锁骨内侧1/3段上方2～３cm 肺底（膈面） 两面 三缘肋面 内侧面（纵隔面）前缘 左肺心切迹 后缘 下缘null肺门 hilum of lung肺根 root of lungnull肺内支气管和支气管肺段气管 左、右主支气管 肺叶支气管 肺段支气管 支气管肺段(10)AVCO2O2肺泡pulmonary segmentnullPulmonary vessels, seen in a dorsal view of the heart and lungs. The lungs have been pulled away from the median line, and a part of the right lung has been cut away to display the air-ducts and bloodvessels nullRespiratory system The organs of the respiratory system may be divided into a conducting division and a respiratory division. The conducting division consists of the nose, pharynx, larynx, trachea, bronchi, bronchioles, and terminal bronchioles. The respiratory division is composed of the respiratory bronchiolis, alveolar ducts, and alveolar sacs. nullRespiratory system The lungs are situated one on each side within the thorax, and separated from each other by the heart and other contents of the mediastinum. Each lung is conical and has an apex, a base, three surfaces and three borders. Near the center of the mediastinal surface, there is a depression called the hilum of lung. The structures entering and emerging the hilum is called the root of lung, which consists of the principal bronchi, pulmonary artery and veins, nerves, bronchial vessels, lymphatic vessels and lymph nodes. The term visceral ( pulmonary ) pleura are given to the membrane on the lung surface itself. These membranes are serous membranes and produce a watery fluid that lubricates the lung and chest surfaces, allowing them to slide easily over one another as the lungs expand and deflate.null组成 肾、输尿管、 膀胱、尿道 功能 产尿、排尿泌尿系统 urinary systemnull形态: 蚕豆状肾 kidney上、下端 前、后面 内、外侧缘 肾门 renal hilun 肾蒂 renal pedicle 肾窦 renal sinus前面观null构造肾皮质renal cortex：肾柱 肾髓质renal medulla：肾锥体(15~20) 输尿管肾乳头肾小盏(7~8)肾大盏(2~3)肾盂nullScheme of renal tubule and its vascular supply null位置 position左肾： 上端平第12胸椎上缘 下端平第3腰椎上缘右肾比左肾低半个椎体脊柱两旁， 紧贴腹后壁上部null被膜: 固定肾 纤维囊 脂肪囊 肾筋膜由内向外fibrous capsulefat renal capsulerenal fascianull输尿管 ureter肾盂与输尿管移行处 与髂血管交叉处 壁内段狭窄部nullUrinary system The urinary organs comprise the kidneys, which secrete the urine, the ureters, which convey urine to the urinary bladder, where it is for a time retained; and the urethra, through which it is discharged from the body. null Urinary system The kidneys lie on the posterior abdominal wall, one on each side of the vertebral column, and are surrounded by a mass of fat and loose areolar tissue (fibrous capsule, fatty renal capsule and renal fascia). The kidneys are a pair of bean-shaped, reddish-brown organs. Each kidney has a medial and a lateral border and an anterior and a posterior surface, a superior extremity and an inferior extremity. The lateral border is convex. On medial border of the kidney there is a vertical slit, the renal hilum, which transmits the renal vessels, nerves and a part of pelvis. A coronal section of the kidney shows two distinct regions ( renal cortex and renal medulla ) and major cavity. The renal medulla is composed of 15 to 20 renal pyramids.null男性生殖系统 male genital system组成生殖腺 输送管道 附属腺 外生殖器女性生殖系统 female genital system生殖系统 genital system功能：产生生殖细胞 繁殖后代 分泌激素内 生 殖 器null男性生殖系统生殖腺：睾丸 输送管道：附睾、输精管、 射精管、男尿道 附属腺体：精囊、前列腺、 尿道球腺 外生殖器：阴囊和阴茎组成male genital systemnull睾丸 testis内、外侧面 上、下端 前、后缘位置阴囊内，左右各一形态null结构 白膜 睾丸小隔 睾丸小叶 精曲小管 精直小管 睾丸网 睾丸输出小管功能 产生精子、 雄性激素null男尿道male urethra三狭窄 三扩大 两弯曲起自膀胱尿道内口 止于尿道外口分部前列腺部 膜部 海绵体部耻骨下弯 耻骨前弯尿生殖膈尿道球nullThe male urethra laid open on its anterior (upper) surface Male genital systemMale genital systemThe male genitals include the testes, the epididymes, the ductus deferentes, the vesiculae seminales, the ejaculatory ducts, and the penis, together with the following accessory structures, viz., the prostate and the bulbourethral glands. The testes are two glandular organs, which secrete the semen; they are suspended in the scrotum by the spermatic cords. Male genital systemMale genital systemAccording to the course, the ductus deferens is divided into four parts: the testicular part, the funicular part, the inguinal part and the pelvic part. The male urethra extends from the internal urethral orifice in the urinary bladder to the external urethral orifice at the end of the penis. It is divided into three portions, the prostatic, membranous, and cavernous. It presents a double curve, the prepubic and subpubic curvatures. The narrow parts lies in the internal urethral orifice in the urinary bladder, in the membranous part of the urethra and in the external urethral orifice at the end of the penis.null生 殖 腺：卵巢 输送管道：输卵管、 子宫、阴道 附属腺体：前庭大腺 外生殖器：女阴女性生殖系统 female genital system组成null输卵管 uterine tube4部输卵管子宫部 输卵管峡 输卵管壶腹 输卵管漏斗null子宫 uterus形态: 前后稍扁, 倒置梨形 分底、体、颈（阴道上部、阴道部）子宫腔子宫颈管子宫峡null位于盆腔中央，膀胱和直肠之间，下端接阴道，两侧有输卵管和卵巢位置轻度的前倾前屈位Female genital systemFemale genital systemThe female genital organs consist of an internal and an external group. The internal organs are situated within the pelvis, and consist of the ovaries, the uterine tubes, the uterus, and the vagina. The external organs are placed below the urogenital diaphragm and below and in front of the pubic arch. They comprise the mons pubis, the labia majora et minora pudendi, the clitoris, the bulbus vestibuli, and the greater vestibular glands. Female genital systemFemale genital systemThe uterine tubes convey the ova from the ovaries to the cavity of the uterus. Each tube is described as consisting of four portions: (1) the uterine part; (2) the isthmus, or medial constricted third; (3) the ampulla, or intermediate dilated portion; and (4) the infundibulum with its abdominal ostium, surrounded by fimbriae. The uterus is located in the center of pelvic cavity, between the bladder and the rectum. The uterus is about the size and shape of an inverted pear. The ureter is subdivided into a fundus, a body, and a cervix. null壁腹膜:衬于腹、盆壁内表面 脏腹膜:覆盖腹、盆腔脏器表面腹膜腔与腹腔腹膜的功能：分泌、吸收、支 持、保护、修复等腹 膜 peritoneumnull腹膜内位器官：胃、盲肠、 阑尾、脾、卵巢、 输卵管等 腹膜间位器官：肝、胆囊、 升（降）结肠、子宫、膀胱等 腹膜外位器官：肾、肾上腺、 输尿管、胰等腹膜与脏器的关系null腹膜形成的结构网膜：薄而透明 系膜：连于腹后壁 韧带 隐窝：腹膜皱襞间小间隙 陷凹：腹膜皱襞间大间隙null 网膜 韧带null隐窝、韧带null内分泌腺endocrine gland 内分泌组织内分泌腺：无管腺 激素内分泌系统 endocrine system功能：调节新陈代 谢、生长发育 和生殖活动组成null甲状腺 thyroid gland 形态：H形 位置：峡部，2-4气管软骨环 功能：分泌甲状腺激素 分泌不足易引起呆小症 分泌过多引起甲亢 地方性甲状腺肿null甲状旁腺 　parathyroid gland位置：上、下两对， 均贴附在甲状 腺侧叶的后面 形态：扁椭圆形小体， 形状大小似黄豆 功能：甲状旁腺素nullEndocrine system By definition the endocrine glands are glandular organs producing secretions (hormones) that pass straight into blood stream, either directly by the veins or indirectly through the medium of the lymphatics. Because they have no ducts they are often referred to as ductless glands. The endocrine glands consist of pituitary gland, thyroid gland, parathyroid glands, suprarenal glands, pineal body, thymus, pancreatic islets, testes (ovaries), etc.小 结小 结内脏的概念，胸部标志线和腹部分区 消化系统的组成，上、下消化道的区分 胃的位置和形态结构特征。 肝的位置，两面一缘。肝外胆道的组成及胆汁排出途径。 呼吸系统的组成，上、下呼吸道的区分。 肺的位置、形态、分叶；肺门，肺根。 泌尿系统的组成；肾的位置、形态结构特征和被膜；肾门、肾蒂、肾窦，输尿管的分部和三个狭窄；尿液的产生和排出途径。null生殖系统组成（精子、卵子的产生和排出途径），睾丸、输卵管、子宫的位置和形态结构特征。 男性尿道的分部、弯曲、狭窄；为男性病人导尿，经何具体途径到达膀胱，如何做可成功插入导尿管？ 腹膜的概念：分两层，两层移行形成腹膜腔，与脏器的关系，形成四种结构：网膜，系膜，韧带、陷凹。 内分泌腺的概念，甲状腺的名称、位置、基本形态。 学习方法：掌握系统（组成、位置），突出重点（形态结构特征），与实体相结合。小 结内脏学学习要点及方法内脏学学习要点及方法组成及连通：系统的组成，器官的上、下连通，实质性腺性器官如肝的开口部位。 位置和外形：如肝呈楔形、肾似蚕豆，结肠和盲肠的外形特征有结肠袋、结肠带和脂肪垂，管状器官的走行特点、分部（段）、狭窄、扩大、弯曲。 腔面和剖面结构：中空性器官，如胃的幽门瓣、十二指肠大乳头、声襞、气管隆嵴等；实质性器官，如肾和睾丸的剖面构造。null食物经口腔摄取后,经何途径由肛门排出体外? 外界气体经何途径到何处进行气体交换? 尿液在肾何结构产生，经何具体途径排出体外？ 精子和卵子的产生和排出途径如何? 输精管或输卵管结扎后对第二性征有无影响? 为什么? 腹腔、腹膜腔、网膜、系膜、韧带、隐窝、陷凹的概念的异同?复习思考