20感覺器總論視器

1、january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 感 覺 器 sensory organs蘭州大學(xué)基礎(chǔ)醫(yī)學(xué)院人體解剖學(xué)教研室蘭州大學(xué)基礎(chǔ)醫(yī)學(xué)院人體解剖學(xué)教研室january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 概 述感

2、覺器(sensory organs)是感受器及其附屬結(jié)構(gòu)的總稱，是機(jī)體感受刺激的裝置。感受器的功能是接受機(jī)體內(nèi)、外環(huán)境的各種不同刺激，并將其轉(zhuǎn)變?yōu)樯窠?jīng)沖動或神經(jīng)興奮。感覺感覺神經(jīng)神經(jīng)中樞中樞產(chǎn)生感覺高級高級中樞中樞神經(jīng)沖動運(yùn)動運(yùn)動神經(jīng)神經(jīng)效應(yīng)器效應(yīng)器january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 正常情況下，一種感受器一種感受器只能對某一適宜的刺激某一適宜的刺激特別敏感。感覺器的種類繁多，形態(tài)和功能各異

3、。特殊感覺器或感覺器官是由感受器感受器及其輔助裝置輔助裝置共同構(gòu)成的特殊感覺器官。january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 感受器的分類以感受其所在的部位、接受刺激的來源可分為三類： 外感受器：外感受器：分布在皮膚、粘膜、視器和聽器皮膚、粘膜、視器和聽器等處， 感受來自外界環(huán)境的刺激； 內(nèi)感受器內(nèi)感受器：分布于內(nèi)臟器官和心血管內(nèi)臟器官和心血管等處，接受物 理刺激和化學(xué)刺激；本體感受器：本體感受器：

4、分布在肌、肌腱、關(guān)節(jié)和內(nèi)耳的位覺器肌、肌腱、關(guān)節(jié)和內(nèi)耳的位覺器 等處，接受機(jī)體運(yùn)動和平衡變化時(shí)所產(chǎn) 生的刺激。january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 以感受器特化的程度可分為兩類： 一般感受器：分布在全身各部； 特殊感受器：分布在眼、耳、鼻、口，包括視、 聽、平衡、嗅、味等感受器。january, 2007copyright depart. anatomy, school of medicine

5、, lanzhou university. all right reserved by yp hou and yf song 視 器視器(visual organ)由眼球和眼副器共同構(gòu)成。眼球：接受光波的刺激 轉(zhuǎn)變?yōu)樯窠?jīng)沖動 經(jīng)視覺傳導(dǎo)通路 至大腦視覺中樞 產(chǎn)生視覺。眼副器：位于眼球的周圍或附近，包括眼瞼、結(jié)膜、淚器、眼球外肌、眶脂體和眶筋膜等，對眼球起支持、保護(hù)和運(yùn)動作用。january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou an

6、d yf song 第一節(jié) 眼 球第二節(jié) 眼副器第三節(jié) 眼的血管和神經(jīng)視 器january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 第一節(jié) 眼 球眼球(eyeball)由眼球壁和眼球的內(nèi)容物構(gòu)成。眼球眼球 眼球壁內(nèi)容物房水晶狀體玻璃體纖維膜血管膜視網(wǎng)膜角膜鞏膜虹膜睫狀體脈絡(luò)膜虹膜部脈絡(luò)膜部睫狀體部盲部盲部視部視部january, 2007copyright depart. anatomy, school of

7、medicine, lanzhou university. all right reserved by yp hou and yf song 右眼球水平斷面january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 一、眼球壁從外向內(nèi)眼球壁分為三層：眼球纖維膜眼球纖維膜眼球血管膜眼球血管膜眼球視網(wǎng)膜眼球視網(wǎng)膜january, 2007copyright depart. anatomy, school of medi

8、cine, lanzhou university. all right reserved by yp hou and yf song （一）眼球纖維膜：可分為角膜和鞏膜兩部分。角膜(cornea)眼球纖維膜的前1/6，富有彈性，有屈光作用，無色透明，無血管但富有感覺神經(jīng)末梢。其營養(yǎng)物質(zhì)一般認(rèn)為有3個(gè)來源：角膜周圍的毛細(xì)血管、淚液和房水。鞏膜(sclera)眼球纖維膜的后5/6，厚而堅(jiān)韌，乳白色不透明。靠近角膜緣處的鞏膜實(shí)質(zhì)內(nèi)，有環(huán)形的鞏膜靜脈竇，是房水流出的通道。january, 2007copyright depart. anatomy, school of medicine, lanzho

9、u university. all right reserved by yp hou and yf song 右眼球水平斷面january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song （二）眼球血管膜：富有血管、神經(jīng)和色素，棕黑色，由前向后分為虹膜、睫狀體和脈絡(luò)膜。 右眼球水平斷面january, 2007copyright depart. anatomy, school of medicine, lanzhou

10、university. all right reserved by yp hou and yf song 虹膜(iris)呈冠狀位，是血管膜最前部的圓盤形薄膜。眼球前面斷面 瞳孔(pupil) 眼房(chambers of eyeball)january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 虹膜、瞳孔虹膜、瞳孔眼球前半部后面觀晶狀體瞳孔虹膜睫狀體睫狀小帶視網(wǎng)膜脈絡(luò)膜鞏膜january, 2007copyri

11、ght depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 在虹膜的基質(zhì)內(nèi)，有兩種平滑肌纖維：瞳孔括約?。涵h(huán)繞瞳孔周緣呈環(huán)形排列，可縮小瞳孔，由副交感神經(jīng)支配。瞳孔開大?。涸谕字車史派錉钆帕校砷_大瞳孔，由交感神經(jīng)支配。january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf

12、song 睫狀體(ciliary body)是血管膜中最肥厚的部分，有調(diào)節(jié)晶狀體曲度和產(chǎn)生房水的作用。其前部有許多向內(nèi)突出呈放射狀排列的皺襞，稱為睫狀突；其后部較為平坦，為睫狀環(huán)；睫狀體內(nèi)的平滑肌，稱睫狀肌，由副交感神經(jīng)支配。january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 右眼球水平斷面january, 2007copyright depart. anatomy, school of medicine,

13、 lanzhou university. all right reserved by yp hou and yf song 脈絡(luò)膜(choroid)占血管膜的后2/3，后方有視神經(jīng)穿過。作用是供應(yīng)球內(nèi)組織營養(yǎng)和吸收眼內(nèi)分散光線以免擾亂視線。 右眼球水平斷面january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song （三）視網(wǎng)膜(retina)在血管的內(nèi)面，分為兩層。色素上皮層神經(jīng)層january, 2007copy

14、right depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 視網(wǎng)膜自前向后分三部：虹膜部 盲部睫狀體部 脈絡(luò)膜部 視部視網(wǎng)膜january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 右側(cè)眼底 視神經(jīng)乳頭視神經(jīng)乳頭 黃斑黃斑 中央凹中央凹january, 2007cop

15、yright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 視網(wǎng)膜視部的神經(jīng)層主要有三層神經(jīng)細(xì)胞組成 視網(wǎng)膜的神經(jīng)細(xì)胞示意圖january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 二、眼球的內(nèi)容物眼球的內(nèi)容物透明而無血管，具有屈光作用，與角膜合稱為眼的屈光裝置。眼

16、球的內(nèi)容物包括三部分：右眼球水平斷面房水晶狀體玻璃體january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song （一）房水(aqueous humor)：無色透明的液體，充滿在眼房內(nèi)。其功能是為角膜和晶狀體提供營養(yǎng)并維持正常的眼內(nèi)壓。 房水的循環(huán)如下：睫狀體產(chǎn)生 眼后房 瞳孔 眼前房 虹膜角膜角 鞏膜靜脈竇 睫前靜脈 眼上、下靜脈january, 2007copyright depart. anatomy, sch

17、ool of medicine, lanzhou university. all right reserved by yp hou and yf song （二）晶狀體(lens)位于虹膜的后方、晶狀體的前方，呈雙凸透鏡狀，前面曲度小，后面曲度大。 右眼球水平斷面january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 晶狀體是屈光系統(tǒng)的主要裝置，曲度隨所視物體的遠(yuǎn)近不同而改變。 晶狀體的調(diào)節(jié)如下視近物時(shí)： 睫狀

18、體內(nèi)縱行肌纖維收縮 牽引脈絡(luò)膜向前 睫狀突內(nèi)伸 睫狀小帶松弛 晶狀體借助彈性變凸 看近物 視遠(yuǎn)物時(shí)，與之相反。january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song （三）玻璃體(vitreous body)無色透明的膠狀物質(zhì)，表面被覆玻璃體膜。約占眼球內(nèi)腔的4/5。玻璃體前面以晶狀體及其懸韌帶為界，呈凹面狀，稱玻璃體凹。 右眼球水平斷面january, 2007copyright depart. anatom

19、y, school of medicine, lanzhou university. all right reserved by yp hou and yf song 第二節(jié) 眼副器眼副器(accessory organs of eyes)對眼球起支持、保護(hù)和運(yùn)動作用。包括：眼瞼結(jié)膜淚器眼球外肌眶脂體和 眶筋膜 經(jīng)右眼 瞳孔矢 狀切面january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 一、眼瞼眼瞼(palp

20、ebrace)位于眼球的前方，分上瞼和下瞼。 上瞼 下瞼 瞼裂 內(nèi)眥 外眥 瞼緣 睫毛右眼前面觀 january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 眼瞼由淺至深可分5層：皮膚細(xì)??；皮下組織疏松，缺乏脂肪 組織；肌層主要是眼輪匝肌瞼部瞼板半月形致密結(jié)締組織 板，上下各一，內(nèi)含 瞼板腺；瞼結(jié)膜襯于眼瞼的最內(nèi)面。january, 2007copyright depart. anatomy, school of

21、medicine, lanzhou university. all right reserved by yp hou and yf song 瞼瞼 板板january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 二、結(jié)膜 結(jié)膜(conjunctiva)是一層薄而光滑、富含血管的粘膜，透明，覆蓋在眼球的前面和眼瞼的后面。可分三部：瞼結(jié)膜球結(jié)膜結(jié)膜穹隆右眼眶右眼眶矢狀切面矢狀切面january, 2007copyrig

22、ht depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 三、淚器 淚腺 淚器(lacrimal aparatus) 淚點(diǎn) 淚小管 淚道 淚囊 鼻淚管january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song （一）淚腺(lacrimal land)位于眶上壁前外側(cè)部的淚腺

23、窩內(nèi)，分泌淚液。淚腺的作用有： 防止角膜干燥和沖洗微塵；滅菌作用。january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song （二）淚小管(lacrimal ductule)為連接淚點(diǎn)和淚小囊的小管。分上淚小管和下淚小管，它們分別垂直上、下行，之后匯集在一起開口于淚囊上部。淚湖：內(nèi)眥附近一圓鈍微凹陷的空隙；淚阜：淚湖底部的薔薇色隆起；淚乳頭：上、下瞼緣附近內(nèi)側(cè)端的小隆起；淚點(diǎn)：淚乳頭頂部的小孔。january, 2

24、007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song （三）淚囊(lacrimal sac)位于眶內(nèi)側(cè)壁前部的淚囊窩中，為一膜性的盲端。上端為盲端，下端移行為鼻淚管。january, 200

25、7copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song （四）鼻淚管(nasolacrimal duct)為膜性管道。 上部包埋在骨性鼻淚管中； 下部在鼻腔外側(cè)壁粘膜的深面，開口于下鼻道外側(cè)壁的前部。january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf son

26、g 四、眼球外肌眼球外肌(extraocular muscles)均為骨骼肌，包括：4塊直肌、2塊斜肌和上瞼提肌。january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 上瞼提?。浩鹱砸暽窠?jīng)管前上方的眶壁，前端為腱膜，止于上瞼的皮膚、上瞼板。此肌收縮可上提眼瞼，開大眼裂，由動眼神經(jīng)支配。 january, 2007copyright depart. anatomy, school of medicine, la

27、nzhou university. all right reserved by yp hou and yf song 運(yùn)動眼球的各直肌共同起自視神經(jīng)管周圍和眶上裂內(nèi)側(cè)的總腱環(huán)，在赤道的前方，分別止于鞏膜的上、下、內(nèi)側(cè)和外側(cè)。上直肌內(nèi)直肌下直肌外直肌上斜肌下斜肌january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 向上外（下斜肌） 向上內(nèi)（上直?。?向外 向內(nèi)（外直?。?（內(nèi)直?。?向下外（上斜?。?向下內(nèi)（下

28、直?。﹋anuary, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 眼球的正常運(yùn)動，并非單一肌肉的收縮，而是兩眼數(shù)條肌協(xié)同作用的結(jié)果。聚視中線兩眼內(nèi)直肌仰視上直肌下斜肌俯視下直肌上斜肌側(cè)視一側(cè)眼的外直肌另一側(cè)眼的內(nèi)直肌january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by

29、 yp hou and yf song 五、眶脂體和眶筋膜（一）眶脂體(adipose body of orbit)是填充于眼球、眼外球肌與眶骨膜之間的脂肪組織團(tuán)塊。功能是固定眶內(nèi)各種軟組織，對眼球、視神經(jīng)、血管和淚器起彈性軟墊樣的保護(hù)作用，尤其是使眼球運(yùn)動自如。january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song （二）眶筋膜(orbital fasciae) 眶骨膜：疏松地襯于眶壁的內(nèi)面，在面前部與周圍骨

30、膜相續(xù)，在視神經(jīng)管處與硬腦膜的外層相續(xù)。眼球筋膜鞘：是眶脂體與眼球之間的薄而致密的纖維膜，又稱tenon囊，向前在角膜緣后方與鞏膜融合在一起，向后與視神經(jīng)硬膜鞘結(jié)合?？艏〗钅で剩撼是薁畎@各眼球外肌?？舾簦涸谏喜€板的上緣和下瞼板的下緣各有一連于眶上緣的眶下緣的薄層結(jié)締組織，它們稱為眶隔。january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 第三節(jié) 眼的血管和神經(jīng)january, 2007copyright d

31、epart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 一、眼的動脈眼球和眶內(nèi)結(jié)構(gòu)血液供應(yīng)主要來自于眼動脈。頸內(nèi)動脈穿過海綿竇后發(fā)出眼動脈，眼動脈經(jīng)視神經(jīng)管入眶，先居視神經(jīng)外側(cè)，再到視神經(jīng)上方，向前行于上斜肌和上直肌之間，終支出眶，終于額動脈。主要分支有： 視網(wǎng)膜中央動脈 睫后短動脈 睫后長動脈 睫前動脈january, 2007copyright depart. anatomy, school of medicine, lanzhou university

32、. all right reserved by yp hou and yf song 眼動脈發(fā)出 視網(wǎng)膜中央動脈 行于視神經(jīng)下方距眼球10-15mm處 在視神經(jīng)下方穿入視神經(jīng)鞘走行0.9-2.5mm行于視神經(jīng)內(nèi)直至鞏膜后視神經(jīng)盤視網(wǎng)膜鼻側(cè)上支視網(wǎng)膜顳側(cè)上支視網(wǎng)膜鼻側(cè)下支視網(wǎng)膜顳側(cè)下支上支下支（一）視網(wǎng)膜中央動脈：是供應(yīng)視網(wǎng)膜內(nèi)層的唯一動脈，阻塞時(shí)可導(dǎo)致全盲。january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song

33、 （二）睫后短動脈：又稱脈絡(luò)膜動脈，在視神經(jīng)周圍穿入鞏膜，分布于脈絡(luò)膜。（三）睫后長動脈：又稱虹膜動脈，在視神經(jīng)內(nèi)、外側(cè)穿入鞏膜，在鞏膜和脈絡(luò)膜間前行直達(dá)睫狀體，發(fā)出三個(gè)分支： 回歸動脈支睫狀肌分支虹膜動脈大環(huán)支（四）睫前動脈：營養(yǎng)鞏膜前部、虹膜和睫狀體。january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song january, 2007copyright depart. anatomy, school of medicine, lanzhou university. all right reserved by yp hou and yf song 二、眼的靜脈眼球內(nèi)的靜脈主要有：視網(wǎng)