骨學2014雙語

1、1李文春李文春 教授教授 department of anatomyhubei university of medicine 系統(tǒng)解剖學系統(tǒng)解剖學systematic anatomy2【目的和要求目的和要求】 緒緒 論論 1 1掌握系統(tǒng)解剖學的定義，人體的標準姿勢、方位術(shù)掌握系統(tǒng)解剖學的定義，人體的標準姿勢、方位術(shù)語、軸和面。語、軸和面。 2 2熟悉人體的分部和器官系統(tǒng)。熟悉人體的分部和器官系統(tǒng)。 3 3了解系統(tǒng)解剖學的任務、分科及發(fā)展簡史。了解系統(tǒng)解剖學的任務、分科及發(fā)展簡史。 骨骨 學學 1 1掌握骨的分類；椎骨的一般形態(tài)；胸骨的分部及重掌握骨的分類；椎骨的一般形態(tài)；胸骨的分部及重要標志。

2、要標志。顱的組成、腦顱和面顱各骨的名稱；顱整體觀的顱的組成、腦顱和面顱各骨的名稱；顱整體觀的重要結(jié)構(gòu)重要結(jié)構(gòu)。上肢骨、下肢骨的位置和形態(tài)及上、下肢骨的上肢骨、下肢骨的位置和形態(tài)及上、下肢骨的重要體表標志重要體表標志 2 2熟悉骨的構(gòu)造；各部椎骨的主要特征；肋的組成、熟悉骨的構(gòu)造；各部椎骨的主要特征；肋的組成、形態(tài)結(jié)構(gòu)。形態(tài)結(jié)構(gòu)。 3 3了解骨的化學成分和物理性質(zhì)，骨的發(fā)生和發(fā)育，了解骨的化學成分和物理性質(zhì)，骨的發(fā)生和發(fā)育，骨的可塑性。腕骨、掌骨、指骨及跗骨、跖骨、趾骨的位骨的可塑性。腕骨、掌骨、指骨及跗骨、跖骨、趾骨的位置和排列。置和排列。3人體解剖學教研室基本情況人體解剖學教研室基本情況n省

3、級重點學科省級重點學科 n省級精品課程省級精品課程n湖北省湖北省“楚天學者計劃楚天學者計劃”設(shè)崗學科設(shè)崗學科n湖北省教學名師湖北省教學名師( (本校唯一）本校唯一）項仕孝教授項仕孝教授4introduction 一、一、concept and division human anatomy is the science which deals with the morphology and structure of the human body. for medical students, human anatomy is the basic course of preclinical and

4、clinical curriculum. krikjulm 5臺灣學生用書臺灣學生用書 6臺灣的解剖教學臺灣的解剖教學 7澳大利亞悉尼大學的解剖教學澳大利亞悉尼大學的解剖教學 8澳大利亞悉尼大學的解剖教學澳大利亞悉尼大學的解剖教學 9本校建成本校建成7個虛擬解剖實驗室個虛擬解剖實驗室軟件功能演示軟件功能演示操作演示三操作演示三網(wǎng)絡(luò)版：湖北醫(yī)藥學院網(wǎng)絡(luò)版：湖北醫(yī)藥學院/圖書館圖書館/數(shù)字資源數(shù)字資源/vh dissector 5.0 可視化人體解剖學軟件可視化人體解剖學軟件10 systematic anatomy macroanatomy 巨視解剖巨視解剖 regional anatomy h

5、istology microanatomy cytology 微視解剖微視解剖 embryology surgical anatomy surface anatomy x-ray anatomy sectional anatomy locomotive anatomy human anatomy divisionmkruntmi maikruntmi 11解剖學的應用解剖學的應用12解剖學與疾病的診斷和治療解剖學與疾病的診斷和治療顱內(nèi)動脈瘤顱內(nèi)動脈瘤 電解式可脫性彈簧圈栓塞電解式可脫性彈簧圈栓塞治療動脈瘤治療動脈瘤全腦數(shù)字減影動脈造影全腦數(shù)字減影動脈造影 13世界上首顆人造心臟照片世界上首顆人

6、造心臟照片 1969年曾跳動三天年曾跳動三天 14用天然平臺制造人工心臟取得成功用天然平臺制造人工心臟取得成功美國科學家利用全器官脫細胞美國科學家利用全器官脫細胞化（化（whole organ decellularization）方法，在實驗室中制成了大鼠方法，在實驗室中制成了大鼠和豬的人工心臟。這一成果有和豬的人工心臟。這一成果有望為人類人工心臟制備提供新望為人類人工心臟制備提供新的方法。相關(guān)論文發(fā)表于的方法。相關(guān)論文發(fā)表于自自然然醫(yī)學醫(yī)學（nature medicine）上。上。15英科學家用胚胎干細胞英科學家用胚胎干細胞3d打印人體器官打印人體器官據(jù)國外媒體報道，科學家離培育重要器官又近

7、一步，據(jù)國外媒體報道，科學家離培育重要器官又近一步，不久可能使從人到人的移植成為歷史。專家已研發(fā)出三維不久可能使從人到人的移植成為歷史。專家已研發(fā)出三維打印技術(shù)，可用胚胎干細胞制造人體組織。這種由愛丁堡打印技術(shù)，可用胚胎干細胞制造人體組織。這種由愛丁堡赫瑞赫瑞-瓦特大學開發(fā)出的方法意味著病入膏肓的病人可輕瓦特大學開發(fā)出的方法意味著病入膏肓的病人可輕易獲得肝臟、心臟和其他器官。易獲得肝臟、心臟和其他器官。16二、二、人體解剖學發(fā)展簡史人體解剖學發(fā)展簡史（自學）（自學）三、三、我國人體解剖學的發(fā)展歷程我國人體解剖學的發(fā)展歷程（自學）（自學）17四、四、the parts and systems o

8、f the body .the human body is divided into ten parts. the head the neck the thorax the back the abdomen the pelvis and perineum the upper limbs the lower limbs:rks perini:m 18locomotor system 運動系統(tǒng)運動系統(tǒng)alimentary (digestive) system 消化系統(tǒng)消化系統(tǒng)respiratory system 呼吸系統(tǒng)呼吸系統(tǒng)urinary system 泌尿系統(tǒng)泌尿系統(tǒng)reproductive

9、 system 生殖系統(tǒng)生殖系統(tǒng)endocrine system 內(nèi)分泌系統(tǒng)內(nèi)分泌系統(tǒng)circulatory system 脈管系統(tǒng)脈管系統(tǒng)sense organs 感覺器感覺器nervous system 神經(jīng)系統(tǒng)神經(jīng)系統(tǒng). there are nine systems in human bodylimentri19五、五、the anatomical position, terms of direction, axis and planes. anatomical position 解剖學姿勢解剖學姿勢 human body is supposed to be in the erect p

10、osture, with the face and toes forward, the arms hanging by the sides and the palms of the hands directed forward, the heels near to each other.hi:lzntmikl尸體擺標準姿勢尸體擺標準姿勢.the terms of direction superior and inferior anterior and posterior (ventral) and ( dorsal) medial and lateral internal and extern

11、al superficial and profound proximal近近 and distal遠遠 ulnar 尺尺and radial橈橈 tibial脛脛 and fibular 腓腓 ln21 .the axis and planes vertical axis axis sagittal axis frontal axis sagittal plane planes frontal plane horizontal planeverticalsagittalfrontalhrizntl22六、人體解剖學的學習方法六、人體解剖學的學習方法（1 1）形態(tài)與功能結(jié)合。）形態(tài)與功能結(jié)合。（

12、2 2）局部與整體結(jié)合。）局部與整體結(jié)合。（3 3）理論與實際結(jié)合。）理論與實際結(jié)合。授課形式：理論實驗授課形式：理論實驗實驗課穿白大衣實驗課穿白大衣人體解剖學實驗教程人體解剖學實驗教程思考題思考題實驗課當堂提問考核，占總成績實驗課當堂提問考核，占總成績303023愛護尸體愛護尸體24運運 動動 系系 統(tǒng)統(tǒng)locomotor system25the locomotor system consists of bones, joints and musclesoriginbellytendoninsertion26chapter 1 osteology 骨學骨學206 according to t

13、he location of the bones, it can be divided into skull , bones of trunk, bones of limbs. the former two form the axial bone.section 1 the general descriptionstildi 27一、一、the shape and classification of the bones long bone 長骨長骨 short bone 短骨短骨 flat bone 扁骨扁骨 irregular bone 不規(guī)則骨不規(guī)則骨irejul 281. long bo

14、nes are found in limbs , it consists of a bodyand two ends.medullary cavity epiphysisepiphysial cartilagebodyepiphysis292. short bones the short bones distribute in wrist and foot.30 3. flat bones they distribute in skull and chest.skullchest31 4. irregular bones the irregular bones are varied in sh

15、ape, such as cranial bones and vertebrae.sinusvertebrae32 the living bones consist of bony substance 骨質(zhì)骨質(zhì), periosteum 骨膜骨膜 and bone marrow 骨髓骨髓.periosteumbony substancebone marrow二、二、the structure of bonesperistim 331.bony substance(1) compact bone:堅實致密，配布于骨表面堅實致密，配布于骨表面。(2) spongy bone：呈海綿狀，配布于骨的內(nèi)呈

16、海綿狀，配布于骨的內(nèi) 部，由骨小梁組成。部，由骨小梁組成。34 2. periosteum it covers the surface of the bone (except the articular part) , it consists of two layers : an outer and an inner membrane. periosteum骨膜剝離太多骨折難以愈合骨膜剝離太多骨折難以愈合 增高術(shù)增高術(shù):tikjul 35 3. bone marrow bone marrow is found in the medullary cavities of long bones an

17、d within spaces in spongy bone. there are two kinds of bone marrow, red and yellow . red marrowyellow marrow 骨髓穿刺部位？骨髓穿刺部位？36三、三、the chemical composition and physical properties of boneorganicinorganic living bones are plastic tissues with organic and inorganic.n:nik 37section 2 the axial bone 中軸骨中軸

18、骨一、一、the bones of trunk 軀干骨軀干骨 the bones of trunk include the vertebrae, the sternum and the ribs, which provide framework (支架支架) for the vertebral column(脊柱脊柱), the thoracic cage(胸廓胸廓)and the pelvis(骨盆骨盆).(:) rsik38( (一）一）the vertebrae 椎骨椎骨 in a child, the normal number of the separate vertebrae is

19、 32 or 33.cervical 頸頸vertebrae: c7thoracic胸胸vertebrae: t12lumbar腰腰vertebrae: l5sacral骶骶vertebrae: s5coccygeal尾尾vertebrae: co34ctlscokksidil 391. the general features of vertebraevertebral body 椎體椎體 vertebral foramen vertebral canalvertebral arch 椎弓椎弓 pedicle of vertebral arch intervertebral foramen

20、laminae of vertebral arch spinous processseven processes transverse processes articular processes402. the main characteristics of vertebrae in each region (1) thoracic vertebrae 胸椎胸椎 the body is heart-shaped. there are costal fovea. articular facets of articular processes are relatively coronary. th

21、e spinous process are long and downward sloping krnri41 (2) cervical vertebrae 頸椎頸椎 the body is small. articular facets of articular processes are relatively horizontal. vertebral foramen is large and is nearly triangular. there are the transverse foramen. the spinous process are short and bifid. tr

22、aijul42luschka關(guān)節(jié)關(guān)節(jié)頸椎病頸椎病 4344 the first cervical vertebrae is known as atlas 寰椎寰椎. the second cervical vertebrae is known as axis 樞椎樞椎. the seventh cervical vertebrae is known as vertebra prominens 隆椎隆椎. tlsksis45 (3) lumbar vertebrae 腰椎腰椎 the body is large. vertebral foramen is triangular. articula

23、r facets of articular processes are almost sagittal. the spinous process are strong , short, square and horizontal. 46(4) the sacrum 骶骨骶骨 promontory 岬岬 anterior sacral foramina sacral hiatus 骶管裂孔骶管裂孔 sacral cornu 骶角骶角(5) the coccyx 岬岬prmntri47( (二）二）the sternum 胸骨胸骨 it consists of three parts, the m

24、anubrium柄柄, body 體體 and xiphoid process 劍突劍突 sternal angle 胸骨角胸骨角mnu:bri:m bodyxiphoid processsternal anglezifid48( (三）三）the ribs 12 pair 1.general featuresribs 17 called true ribs真肋真肋ribs 812 called false ribs 假肋假肋ribs 810 to form costal arch 肋弓肋弓ribs 1112 called floating ribs 浮肋浮肋 492.characterist

25、ics of rib costal bone costal head costal neck costal tubercle shaft of rib costal angle costal groove costal cartilage tju:bkl 二、二、the skull 顱顱 the skull contains 23 bones. the skull is divided into two parts :cerebral cranium（腦顱）腦顱） and facial cranium(面顱面顱)面面部部的的年年齡齡變變化化 frontal bone額骨額骨 ethmoid b

26、one篩骨篩骨 unpaired sphenoid bone蝶骨蝶骨 occipital bone枕骨枕骨 parietal bone頂骨頂骨 paired temporal bone顳骨顳骨( (一）一）the cerebral cranium the cerebral cranium consists of eight cranial bones. maxillae上頜骨上頜骨 palatine bone 腭骨腭骨 paired zygomatic bone 顴骨顴骨 bones nasal bone 鼻骨鼻骨 lacrimal bone淚骨淚骨 inferior nasal concha

27、e下鼻甲下鼻甲 vomer 犁骨犁骨unpaired mandible下頜骨下頜骨 bones hyoid bone 舌骨舌骨( (二）二）the facial cranium the facial cranium are fifteen in number.( (二）二）the facial cranium 1. the mandible 2. the hyoid boneangle of mandible55世界首例世界首例3d打印下頜移植手術(shù)打印下頜移植手術(shù)技術(shù)人員可根據(jù)移植患者的具體需求來技術(shù)人員可根據(jù)移植患者的具體需求來設(shè)計骨骼部件的效果圖，然后利用高精設(shè)計骨骼部件的效果圖，然后利用

28、高精度的鐳射槍來熔解鈦粉，并將它們一層度的鐳射槍來熔解鈦粉，并將它們一層層地噴涂疊加起來，最終形成一個立體層地噴涂疊加起來，最終形成一個立體的人造骨骼部件成品。的人造骨骼部件成品。 通過通過3d3d立體打印技術(shù)制作人造骨骼立體打印技術(shù)制作人造骨骼對于醫(yī)療移植技術(shù)的未來發(fā)展來說對于醫(yī)療移植技術(shù)的未來發(fā)展來說是至關(guān)重要的，因為它可以貼合各是至關(guān)重要的，因為它可以貼合各種需求制作出復雜精細的骨骼或軟種需求制作出復雜精細的骨骼或軟組織構(gòu)造，提高移植手術(shù)的速度和組織構(gòu)造，提高移植手術(shù)的速度和成功率。成功率。長方臉長方臉圓臉圓臉方臉方臉瓜子臉瓜子臉下頜角與面型的下頜角與面型的關(guān)系關(guān)系按流行的分類方按流行的

29、分類方法，中國人的臉法，中國人的臉形可分為方臉、形可分為方臉、圓臉、長方臉、圓臉、長方臉、長圓臉，其中以長圓臉，其中以長圓臉俗稱瓜子長圓臉俗稱瓜子臉最受青睞。臉最受青睞。 芳齡芳齡2424歲的歲的林小姐下頜角向林小姐下頜角向外膨隆，形成一外膨隆，形成一典型的國字臉。典型的國字臉。這張臉要是男子這張臉要是男子漢倒能顯出幾分漢倒能顯出幾分粗獷，幾分威嚴，粗獷，幾分威嚴，但卻給愛美的林但卻給愛美的林小姐憑添無數(shù)煩小姐憑添無數(shù)煩惱。惱。怎么辦呀！怎么辦呀！ 短臉、方臉通過整形可以變成漂亮的瓜子臉。短臉、方臉通過整形可以變成漂亮的瓜子臉。 下頜角肥大矯正術(shù)下頜角肥大矯正術(shù)( (三）三）the skull

30、 as a whole 顱的整體觀顱的整體觀 1.the superior aspect of the skull coronal suture冠狀縫冠狀縫 sagittal suture矢狀縫矢狀縫 lambdoid suture人字縫人字縫 the skull is generally ovoid when from above, and is wider behind than in front. it formed by four cranial bones. 2.the posterior aspect of the skull the most outstanding featur

31、e of the occipital bone is external occipital protuberance枕外隆凸枕外隆凸. the ridge骨嵴骨嵴 passing on each side laterally of the protuberance is the superior nuchal line上項線上項線 3.the internal surface of the base of skull it is divided into three fossa. these are the anterior, the middle and the posterior cran

32、ial fossa. frontal crest額嵴額嵴 foramen cecum盲孔盲孔 crista galli 雞冠雞冠 cribriform plat 篩板篩板 cribriform foramina篩孔篩孔 (1) the anterior cranial fossa 顱前窩顱前窩 in the center is the hypophysial fossa 垂體窩垂體窩. in front of the hypophysial fossa is the optic canal 視神經(jīng)管視神經(jīng)管. lateral to the hypophysial fossa is the ca

33、rotid sulcus 頸動脈溝頸動脈溝. there are a series of foramina in the lateral portion of the middle cranial fossa: foramen rotundum 圓孔圓孔, , foramen ovale 卵圓孔卵圓孔 foramen spinosum 棘孔棘孔 (2) the middle cranial fossa 顱中窩顱中窩 it is the largest and deepest of the three cranial fossa. the lowest part of the fossa pre

34、sents the foramen magnum枕骨大孔，枕骨大孔， there are hypoglossal canal 舌下神經(jīng)管內(nèi)口舌下神經(jīng)管內(nèi)口 above the anterolateral margin of the foramen magnum. (3) the posterior cranial fossa behind the foramen magnum, there are the internal occipital protuberance枕內(nèi)隆凸枕內(nèi)隆凸, sulcus for transverse sinus橫竇溝橫竇溝, sulcus for sigmoid

35、sinus乙狀竇溝乙狀竇溝, jugular foramen頸靜脈孔頸靜脈孔. internal acoustic pore 內(nèi)耳門內(nèi)耳門crista galli 雞冠雞冠cribriform plate 篩板篩板cribriform foramen 篩孔篩孔hypophysial fossa 垂體窩垂體窩optic canal 視神經(jīng)管視神經(jīng)管dorsum sellae鞍背鞍背superior orbital fissure眶上裂眶上裂foramen lacerum破裂孔破裂孔foramen ovale卵圓孔卵圓孔foramen spinosum棘孔棘孔trigeminal impressi

36、on 三叉神經(jīng)壓跡三叉神經(jīng)壓跡foramen rotundum 圓孔圓孔foramen magnum 枕骨大孔枕骨大孔hypoglssal canal 舌下舌下神經(jīng)管神經(jīng)管內(nèi)口內(nèi)口sulcus for transverse sinum橫竇溝橫竇溝 sulcus for sigmoid sinus乙狀竇乙狀竇溝溝jugular foramen 頸靜脈頸靜脈孔孔internal acoustic pore 內(nèi)耳門內(nèi)耳門posterior cranial fossa 顱后窩顱后窩internal occipital protuberance 枕枕內(nèi)隆凸內(nèi)隆凸clivus 斜坡斜坡 4.the ext

37、ernal surface of the base of skull incisive foramen 切牙孔切牙孔 greater palatine foramen腭大孔腭大孔 posterior nasal apertures鼻后孔鼻后孔 occipital condyle 枕髁枕髁 hypoglossal canal舌下神經(jīng)管外口舌下神經(jīng)管外口 jugular foramen 頸靜脈孔頸靜脈孔 styloid process 莖突莖突 stylomastiod foramen 莖乳孔莖乳孔70研究顯示愛情有助于緩解疼痛研究顯示愛情有助于緩解疼痛 疼痛實驗疼痛實驗 研究人員在美國斯坦福大學

38、招募研究人員在美國斯坦福大學招募1515名本科生，讓他們手握一個物體，名本科生，讓他們手握一個物體，這一物體在電腦控制下會慢慢加溫，這一物體在電腦控制下會慢慢加溫，溫度會使受試者感到輕微疼痛。溫度會使受試者感到輕微疼痛。 與此同時，受試者分別觀看自己與此同時，受試者分別觀看自己熱戀對象和一名熟人的照片。研究人熱戀對象和一名熟人的照片。研究人員對受試者的大腦進行功能性核磁共員對受試者的大腦進行功能性核磁共振振(fmri)掃描，記錄大腦活動。掃描，記錄大腦活動。 實驗結(jié)果顯示，愛情的方法可緩實驗結(jié)果顯示，愛情的方法可緩解疼痛。解疼痛。 “愛情止痛藥愛情止痛藥”作用于大腦的獎作用于大腦的獎勵中心，刺

39、激大腦深部組織，抑制疼勵中心，刺激大腦深部組織，抑制疼痛感。痛感。 5.the lateral view of skull external acoustic pore外耳門外耳門 mastoid process 乳突乳突 zygomatic arch 顴弓顴弓 temporal fossa 顳窩顳窩 infratemporal fossa 顳下窩顳下窩 pterion ：in the temporal fossa, the area, where the four bones, frontal, parietal, temporal and sphenoid, is known as pte

40、rion 翼點翼點.(p)tirin 翼點翼點硬膜外血腫硬膜外血腫74顱內(nèi)血腫微創(chuàng)穿刺引流術(shù)顱內(nèi)血腫微創(chuàng)穿刺引流術(shù) 6.the front view of skull (1) the forehead 額區(qū)額區(qū) superciliary arch 眉弓眉弓 (2) the orbits 眶眶 orbital opening 眶口眶口 supraorbital foramen (notch)眶上孔眶上孔 infraorbital foramen眶下孔眶下孔 orbital apex: optic canal 視神視神經(jīng)管口經(jīng)管口 superior wall: lacrimal fossa淚腺窩淚

41、腺窩 medial wall: lacrimal sac fossa淚囊窩淚囊窩, nasolacrimal canal 鼻淚管鼻淚管 inferior wall: infraorbital fissure 眶下裂眶下裂 lateral wall: supraorbital fissure 眶上裂眶上裂 (3) the bony nasal cavity nasal septem 鼻中隔鼻中隔 superior middle conchae甲甲 inferior superior middle meatus道道 inferior sphenoethmoidal recess 蝶篩隱窩蝶篩隱窩

42、(4) the paranasal sinuses 鼻旁竇鼻旁竇 the frontal 額額 sinuses the ethmoidal 篩篩sinuses the sphenoidal 蝶蝶sinuses the maxillary上頜上頜 sinuses (5) the oral cavity 骨性口腔骨性口腔 ( (四）四）the skull at birth（自學）（自學） anterior fontanelleposterior fontanellesection 3 the appendicular skeleton附肢骨附肢骨nthe brief introduction in

43、clude the bones of upper limbs and lower limbs. because of the erect standing,the upper limbs are released from weight bearing and become the organs of labour. so that the bones of upper limbs are lighter and smaller in shape and size. the bones of lower limbs are very heavy and strong.,pndkjl一、一、bo

44、nes of upper limbs上肢骨上肢骨composition:nshould girdle clavicle 鎖骨鎖骨 scapula 肩胛骨肩胛骨nbones of free upper limb lin arm: humerus 肱骨肱骨lin forearm: ulna尺骨尺骨 radius 橈骨橈骨 lin hand: carpal 腕骨、腕骨、 metacarpals 掌骨掌骨phalanges 指骨指骨（一）上肢帶骨（一）上肢帶骨 1.鎖骨鎖骨 clavicle 內(nèi)側(cè)端：胸骨端內(nèi)側(cè)端：胸骨端 外側(cè)端：肩峰端外側(cè)端：肩峰端 鎖骨骨折多在中、外鎖骨骨折多在中、外 1/3交界處。交界處。（上面觀）（上面觀）（下面觀）（下面觀）83 the weakest part of the clavicle is at the junction of the middle and lateral thirds 骨折部位骨折部位2.2.肩胛骨肩胛骨 scapula 位置：貼于胸廓后外