骨學(xué)雙語(yǔ)課件

1李文春教授

DepartmentofAnatomy

HubeiUniversityofMedicine

系統(tǒng)解剖學(xué)SystematicAnatomy2【目的和要求】

緒論

1．掌握系統(tǒng)解剖學(xué)的定義，人體的標(biāo)準(zhǔn)姿勢(shì)、方位術(shù)語(yǔ)、軸和面。

2．熟悉人體的分部和器官系統(tǒng)。

3．了解系統(tǒng)解剖學(xué)的任務(wù)、分科及發(fā)展簡(jiǎn)史。骨學(xué)

1．掌握骨的分類；椎骨的一般形態(tài)；胸骨的分部及重要標(biāo)志。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)。上肢骨、下肢骨的位置和形態(tài)及上、下肢骨的重要體表標(biāo)志

2．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)。

3．了解骨的化學(xué)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、趾骨的位置和排列。3人體解剖學(xué)教研室基本情況省級(jí)重點(diǎn)學(xué)科省級(jí)精品課程湖北省“楚天學(xué)者計(jì)劃”設(shè)崗學(xué)科湖北省教學(xué)名師(本校唯一）項(xiàng)仕孝教授5臺(tái)灣學(xué)生用書

6臺(tái)灣的解剖教學(xué)

7澳大利亞悉尼大學(xué)的解剖教學(xué)

9本校建成7個(gè)虛擬解剖實(shí)驗(yàn)室軟件功能演示操作演示三網(wǎng)絡(luò)版：湖北醫(yī)藥學(xué)院/圖書館/數(shù)字資源/VHDissector5.0可視化人體解剖學(xué)軟件10systematicanatomy

macroanatomy

巨視解剖regionalanatomyhistology

microanatomycytology

微視解剖

embryologysurgicalanatomysurfaceanatomyX-rayanatomysectionalanatomylocomotiveanatomy

Humananatomy

division[m?kr?u?'n?t?mi]

[﹐maikr?u?'n?t?mi]

11

解剖學(xué)的應(yīng)用

13世界上首顆人造心臟照片

1969年曾跳動(dòng)三天14用天然平臺(tái)制造人工心臟取得成功美國(guó)科學(xué)家利用全器官脫細(xì)胞化（wholeorgandecellularization）方法，在實(shí)驗(yàn)室中制成了大鼠和豬的人工心臟。這一成果有望為人類人工心臟制備提供新的方法。相關(guān)論文發(fā)表于《自然—醫(yī)學(xué)》（NatureMedicine）上。15英科學(xué)家用胚胎干細(xì)胞3D打印人體器官據(jù)國(guó)外媒體報(bào)道，科學(xué)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)出三維打印技術(shù)，可用胚胎干細(xì)胞制造人體組織。這種由愛(ài)丁堡赫瑞-瓦特大學(xué)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。17四、Thepartsandsystemsofthebody

Ⅰ.Thehumanbodyisdividedintotenparts.theheadtheneckthethoraxthebacktheabdomenthepelvisandperineum

theupperlimbsthelowerlimbs['θ?:r?ks][﹐peri'ni:?m

]18Locomotorsystem運(yùn)動(dòng)系統(tǒng)Alimentary(Digestive)

system消化系統(tǒng)Respiratorysystem呼吸系統(tǒng)Urinarysystem泌尿系統(tǒng)Reproductivesystem生殖系統(tǒng)Endocrinesystem內(nèi)分泌系統(tǒng)Circulatorysystem脈管系統(tǒng)Senseorgans感覺(jué)器Nervoussystem神經(jīng)系統(tǒng)Ⅱ.Thereareninesystemsinhumanbody[﹐?li'ment?ri]19五、Theanatomicalposition,termsofdirection,axisandplanesⅠ.Anatomicalposition

解剖學(xué)姿勢(shì)

Humanbodyissupposedtobeintheerectposture,withthefaceandtoesforward,thearmshangingbythesidesandthepalmsofthehandsdirectedforward,theheelsneartoeachother.[hi:lz][﹐?n?'t?mik?l]尸體擺標(biāo)準(zhǔn)姿勢(shì)21Ⅲ.Theaxisandplanesverticalaxisaxissagittalaxisfrontalaxissagittalplaneplanesfrontalplane

horizontalplaneverticalsagittalfrontal[﹐h?ri'z?nt?l]22六、人體解剖學(xué)的學(xué)習(xí)方法（1）形態(tài)與功能結(jié)合。（2）局部與整體結(jié)合。（3）理論與實(shí)際結(jié)合。授課形式：理論＋實(shí)驗(yàn)實(shí)驗(yàn)課穿白大衣《人體解剖學(xué)實(shí)驗(yàn)教程》思考題實(shí)驗(yàn)課當(dāng)堂提問(wèn)考核，占總成績(jī)30％23愛(ài)護(hù)尸體25Thelocomotorsystemconsistsofbones,jointsandmusclesoriginbellytendoninsertion26Chapter1Osteology

骨學(xué)206

Accordingtothelocationofthebones,itcanbedividedintoskull,bonesoftrunk,bonesoflimbs.Theformertwoformtheaxialbone.Section1Thegeneraldescription[﹐?sti'?l?d?i

]292.ShortbonesTheshortbonesdistributeinwristandfoot.303.Flatbones

Theydistributeinskullandchest.skullchest31

4.IrregularbonesTheirregularbonesarevariedinshape,suchascranialbonesandvertebrae.sinusvertebrae32Thelivingbonesconsistofbonysubstance骨質(zhì),periosteum

骨膜andbonemarrow骨髓.PeriosteumBonysubstanceBonemarrow二、Thestructureofbones[﹐peri'?sti?m

]331.Bonysubstance(1)Compactbone:堅(jiān)實(shí)致密，配布于骨表面。(2)Spongybone：呈海綿狀，配布于骨的內(nèi)部，由骨小梁組成。342.PeriosteumItcoversthesurfaceofthebone(exceptthearticularpart),itconsistsoftwolayers:anouterandaninnermembrane.Periosteum骨膜剝離太多骨折難以愈合增高術(shù)[ɑ:'tikjul?

]353.Bonemarrow

Bonemarrowisfoundinthemedullarycavitiesoflongbonesandwithinspacesinspongybone.

Therearetwokindsofbonemarrow,redandyellow.

RedmarrowYellowmarrow

骨髓穿刺部位？36三、Thechemicalcompositionandphysicalpropertiesofboneorganicinorganic

Livingbonesareplastictissueswithorganicandinorganic.[﹐?n?:'ɡ?nik

]37Section2Theaxialbone中軸骨一、Thebonesoftrunk軀干骨

Thebonesoftrunkincludethevertebrae,thesternumandtheribs,whichprovideframework(支架)

forthevertebralcolumn(脊柱),thethoraciccage(胸廓)andthepelvis(骨盆).[θ?(:)'r?sik]38(一）Thevertebrae椎骨

Inachild,thenormalnumberoftheseparatevertebraeis32or33.Cervical頸vertebrae:C7Thoracic胸vertebrae:T12Lumbar腰vertebrae:L5Sacral骶vertebrae:S5Coccygeal尾vertebrae:Co3~4CTLSCo[k?k'sid?i?l

]391.Thegeneralfeaturesofvertebraevertebralbody椎體

vertebralforamenvertebralcanalvertebralarch椎弓

pedicleofvertebralarch

intervertebralforamen

laminaeofvertebralarch

spinousprocessSevenprocessestransverseprocesses

articularprocesses402.Themaincharacteristicsofvertebraeineachregion(1)Thoracicvertebrae胸椎

①thebodyisheart-shaped.②therearecostalfovea.③articularfacetsofarticularprocessesarerelativelycoronary.④thespinousprocessarelonganddownwardsloping

①②③④['k?r?n?ri]41(2)Cervicalvertebrae頸椎

①thebodyissmall.②articularfacetsofarticularprocessesarerelativelyhorizontal.③vertebralforamenislargeandisnearlytriangular.④therearethetransverseforamen.⑤thespinousprocessareshortandbifid.

①②③④⑤[trai'??ɡjul?]42

Luschka關(guān)節(jié)頸椎病

4344

⑥

thefirstcervicalvertebraeisknownas

atlas

寰椎.

⑦thesecondcervicalvertebraeisknownas

axis

樞椎.

⑧theseventhcervicalvertebraeisknownasvertebraprominens隆椎.

['?tl?s]['?ksis]45

(3)Lumbarvertebrae腰椎

①thebodyislarge.②vertebralforamenistriangular.③articularfacetsofarticularprocessesarealmostsagittal.④thespinousprocessarestrong,short,squareandhorizontal.①②③④46(4)Thesacrum骶骨

promontory

岬

anteriorsacralforaminasacralhiatus骶管裂孔

sacralcornu骶角(5)Thecoccyx

岬['pr?m?nt?ri]47(二）Thesternum胸骨

Itconsistsofthreeparts,themanubrium柄,body體

andxiphoidprocess劍突

sternalangle胸骨角[m?'nu:bri:?m

]bodyxiphoidprocesssternalangle['zif?id]48(三）Theribs

12pair

1.GeneralfeaturesRibs1～7calledtrueribs真肋Ribs8～12calledfalseribs

假肋Ribs8～10toformcostalarch

肋弓Ribs11～12calledfloatingribs浮肋

492.Characteristicsofrib

costalbonecostalheadcostalneckcostaltubercleshaftofribcostalangle

costalgroove

costalcartilage

['tju:b?kl]

二、Theskull顱Theskullcontains23bones.Theskullisdividedintotwoparts:cerebralcranium（腦顱）

andfacialcranium(面顱)面部的年齡變化

frontalbone額骨

ethmoidbone篩骨

Unpairedsphenoidbone蝶骨

occipitalbone枕骨

parietalbone頂骨

paired

temporalbone顳骨(一）Thecerebralcranium

Thecerebralcraniumconsistsofeightcranialbones.

maxillae上頜骨

palatinebone

腭骨

pairedzygomaticbone顴骨

bonesnasalbone鼻骨

lacrimalbone淚骨

inferiornasalconchae下鼻甲

vomer犁骨Unpairedmandible下頜骨

boneshyoidbone舌骨(二）Thefacialcranium

Thefacialcraniumarefifteeninnumber.(二）Thefacialcranium

1.Themandible

2.Thehyoidboneangleofmandible55世界首例3D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(lái)設(shè)計(jì)骨骼部件的效果圖，然后利用高精度的鐳射槍來(lái)熔解鈦粉，并將它們一層層地噴涂疊加起來(lái)，最終形成一個(gè)立體的人造骨骼部件成品。通過(guò)3D立體打印技術(shù)制作人造骨骼對(duì)于醫(yī)療移植技術(shù)的未來(lái)發(fā)展來(lái)說(shuō)是至關(guān)重要的，因?yàn)樗梢再N合各種需求制作出復(fù)雜精細(xì)的骨骼或軟組織構(gòu)造，提高移植手術(shù)的速度和成功率。長(zhǎng)方臉圓臉?lè)侥樄献幽樝骂M角與面型的關(guān)系按流行的分類方法，中國(guó)人的臉形可分為方臉、圓臉、長(zhǎng)方臉、長(zhǎng)圓臉，其中以長(zhǎng)圓臉?biāo)追Q瓜子臉最受青睞。

芳齡24歲的林小姐下頜角向外膨隆，形成一典型的國(guó)字臉。這張臉要是男子漢倒能顯出幾分粗獷，幾分威嚴(yán)，但卻給愛(ài)美的林小姐憑添無(wú)數(shù)煩惱。怎么辦呀！

短臉、方臉通過(guò)整形可以變成漂亮的瓜子臉。

下頜角肥大矯正術(shù)(三）Theskullasawhole顱的整體觀

1.Thesuperioraspectoftheskull

coronalsuture冠狀縫

sagittalsuture矢狀縫

lambdoidsuture人字縫

Theskullisgenerallyovoidwhenfromabove,andiswiderbehindthaninfront.Itformedbyfourcranialbones.

2.Theposterioraspectoftheskull

Themostoutstandingfeatureoftheoccipitalboneisexternaloccipitalprotuberance枕外隆凸.Theridge骨嵴

passingoneachsidelaterallyoftheprotuberanceisthesuperiornuchalline上項(xiàng)線

3.Theinternalsurfaceofthebaseofskull

Itisdividedintothreefossa.Thesearetheanterior,the

middleandtheposteriorcranialfossa.frontalcrest額嵴

foramencecum盲孔

cristagalli雞冠

cribriformplat篩板

cribriformforamina篩孔

(1)Theanteriorcranialfossa顱前窩

Inthecenteristhehypophysialfossa

垂體窩.Infrontofthe

hypophysialfossa

isthe

opticcanal視神經(jīng)管.Lateraltothehypophysialfossa

isthe

carotidsulcus

頸動(dòng)脈溝.Thereareaseriesofforaminainthelateralportionofthemiddlecranialfossa:

foramenrotundum圓孔,foramenovale卵圓孔

foramenspinosum棘孔

(2)Themiddlecranialfossa顱中窩Itisthelargestanddeepestofthethreecranialfossa.Thelowestpartofthefossapresentstheforamenmagnum枕骨大孔，

Therearehypoglossalcanal舌下神經(jīng)管內(nèi)口abovetheanterolateralmarginoftheforamenmagnum.

(3)Theposteriorcranialfossa

Behindtheforamenmagnum,therearetheinternaloccipitalprotuberance枕內(nèi)隆凸,

sulcusfortransversesinus橫竇溝,sulcusforsigmoidsinus乙狀竇溝,

jugularforamen頸靜脈孔.

internalacousticpore

內(nèi)耳門Cristagalli雞冠Cribriformplate篩板Cribriformforamen篩孔Hypophysialfossa垂體窩Opticcanal

視神經(jīng)管Dorsumsellae鞍背Superiororbitalfissure眶上裂Foramenlacerum破裂孔Foramenovale卵圓孔Foramenspinosum棘孔Trigeminalimpression三叉神經(jīng)壓跡Foramenrotundum圓孔Foramenmagnum

枕骨大孔Hypoglssalcanal

舌下神經(jīng)管內(nèi)口Sulcusfortransversesinum橫竇溝Sulcusforsigmoidsinus乙狀竇溝Jugularforamen

頸靜脈孔Internalacousticpore

內(nèi)耳門Posteriorcranialfossa顱后窩Internaloccipitalprotuberance

枕內(nèi)隆凸Clivus斜坡

4.Theexternalsurfaceofthebaseofskull

incisiveforamen切牙孔

greaterpalatine

foramen腭大孔

posteriornasalapertures鼻后孔

occipitalcondyle枕髁

hypoglossalcanal舌下神經(jīng)管外口

jugularforamen頸靜脈孔

styloidprocess莖突

stylomastiodforamen

莖乳孔70研究顯示愛(ài)情有助于緩解疼痛

疼痛實(shí)驗(yàn)

研究人員在美國(guó)斯坦福大學(xué)招募15名本科生，讓他們手握一個(gè)物體，這一物體在電腦控制下會(huì)慢慢加溫，溫度會(huì)使受試者感到輕微疼痛。

與此同時(shí)，受試者分別觀看自己熱戀對(duì)象和一名熟人的照片。研究人員對(duì)受試者的大腦進(jìn)行功能性核磁共振(fMRI)掃描，記錄大腦活動(dòng)。

實(shí)驗(yàn)結(jié)果顯示，愛(ài)情的方法可緩解疼痛。

“愛(ài)情止痛藥”作用于大腦的獎(jiǎng)勵(lì)中心，刺激大腦深部組織，抑制疼痛感。

5.Thelateralviewofskull

externalacousticpore外耳門

mastoid

process乳突

zygomaticarch

顴弓

temporalfossa顳窩

infratemporalfossa顳下窩

pterion

：inthetemporalfossa,thearea,wherethefourbones,frontal,parietal,temporalandsphenoid,isknownaspterion翼點(diǎn).['(p)ti?ri?n]翼點(diǎn)硬膜外血腫74顱內(nèi)血腫微創(chuàng)穿刺引流術(shù)

6.Thefrontviewofskull(1)theforehead額區(qū)

superciliaryarch眉弓

(2)theorbits眶

①orbitalopening眶口

supraorbitalforamen(notch)眶上孔

infraorbitalforamen眶下孔②orbitalapex:opticcanal視神經(jīng)管口③superiorwall:lacrimalfossa淚腺窩

④

medialwall:lacrimalsacfossa淚囊窩,nasolacrimalcanal

鼻淚管⑤inferiorwall:infraorbitalfissure眶下裂⑥

lateralwall:supraorbitalfissure眶上裂

(3)thebonynasalcavity

nasalseptem

鼻中隔

superiormiddleconchae甲

inferiorsuperiormiddlemeatus道

inferior

sphenoethmoidalrecess

蝶篩隱窩

(4)theparanasalsinuses鼻旁竇

①thefrontal額

sinuses

②theethmoidal篩sinuses

③thesphenoidal蝶sinuses

④themaxillary上頜sinuses

(5)theoralcavity骨性口腔(四）Theskullatbirth（自學(xué)）

anteriorfontanelleposteriorfontanelleSection3Theappendicularskeleton附肢骨ThebriefintroductionIncludethebonesofupperlimbsandlowerlimbs.Becauseoftheerectstanding,theupperlimbsarereleasedfromweightbearingandbecometheorgansoflabour.sothatthebonesofupperlimbsare

lighterandsmaller

inshapeandsize.thebonesoflowerlimbsareveryheavy

andstrong.[,?p?n'd?kj?l?]一、Bonesofupperlimbs上肢骨

Composition:Shouldgirdle

clavicle鎖骨

scapula肩胛骨Bonesoffreeupperlimb

Inarm:

humerus肱骨Inforearm:ulna尺骨radius橈骨

Inhand:carpal腕骨、

metacarpals掌骨phalanges指骨（一）上肢帶骨

1.鎖骨clavicle

內(nèi)側(cè)端：胸骨端外側(cè)端：肩峰端鎖骨骨折多在中、外1/3交界處。（上面觀）（下面觀）83

Theweakestpartoftheclavicleisatthejunctionofthemiddleandlateralthirds

骨折部位2.肩胛骨scapula

位置：貼于胸廓后外面

前面：肩胛