解剖篇2-1内脏系统消化呼吸生理学

上 解剖学（humananatomy）下 生理（humanDigestiveDigestive第一化管Sec.1Gastrointestinal第二节Sec.2Digestive第三腹膜Sec.3消化管Gastrointestinal组成：口腔 上、下消化道upper&lowerdigestive内脏的一般结构 eralstructureof中 ：管壁3-4Holloworganshavewallswith3-4实 ：被膜、小叶、Solidorganshaveenvelope,lobeand粘膜Mucous：上皮、固有层（结缔组织）、粘膜肌层（平滑肌）Epithelium,laminapropria,muscularis功能Function：保护、吸收 protection,粘膜下层Submucosa（结缔组织connective肌层Muscularlayer（平滑肌Smoothmuscle—内环circular、外纵outerlongitudinal功能：消化管蠕动、推送食物Functions:agitationandperistalsis,pushing外膜Adventitia（纤维膜fibrousmembranes、浆膜serosa）功能： 浆液、减少摩擦Functions:serousfluid,reduce腹上区，左季肋 胸部标志Surface前正中线，Anteriormedianline锁骨中线，Midclavicularline胸骨线，Sternalline胸骨旁线Parasternal腋前线，Anterioraxillary腋中线，Midaxillary腋后线，Posterioraxillary肩胛线Scapular后正中线Posterior二、口腔（唇、腭、牙、舌、唾液腺Lips,palate,teeth,tongue,salivary三、咽（三部nasopharynx,oropharynx,laryngopharynx）四、食管Esophagus（三狭窄constrictedinthree五、胃stomach（分四部cardia,fundus,body,pylorus六、小肠 intestine（分三段duodenum,jejunum,七、大肠 intestine（分四部分cecum,colon,rectum,epityphlon上消化道：口腔到十二指肠。UpperDigestiveTract:Oralto下消化道：空肠以下的部分。LowerDigestiveTract:Theportionbelowthejejunum.二、口分部：口 、固有口Has2sections:vestibuleandthe （一）口腔壁Oral口唇Lips：上唇Upper下唇Lower颊cheek：皮肤

口裂、人oralRenzhong二、（一）口腔Oral3.腭硬腭(前2/3Hard分隔鼻、口Itformsapartitionbetweenthenasalpassagesandthe软腭(后1/3)、Soft皱襞plica：腭舌弓palatoglossalarch腭咽弓palatopharyngealarch腭扁桃体Palatinetonsil咽峡Isthmusofthe腭舌弓、腭垂、舌根组成，是口腔通向咽抢的门Constitutedbypalataltonguearch,uvulaandrootofIsthegatewaytothepharynxofthe二、口（二）口腔内和口腔旁组TissuesofIntraoral&牙 位于上、下颌牙槽Inthedentalalveolusof二、口腔（二）口腔内和口腔旁牙（形态和构造Teeth(morphologyand牙的形牙冠、牙根、牙 crown,rootand牙的构牙质、牙釉质牙骨质、牙腔、牙Dentin,enamel,cementum, ,牙周组织Periodontal牙周膜、牙槽骨、牙龈Periodontalmembrane,alveolarbone,

二、口腔（二）口腔内和口腔旁组

1.牙（牙的数目和排列amount& 出牙：人的一生中有两组牙发生：乳牙、恒Humanhavetwosetsofteeth:deciduous&permanent 数目与名称Amount& 20（罗马数字表示UseRoman（6月始出begins ofsix 中、侧切牙；尖牙；第一、二磨 Centralincisors:6–12 Lateralincisors:9–16 premolars:13–19 Canineteeth:16–23 Secondpremolars:22–33 恒牙Permanent 28-32个 数useArabicdigit）（6岁始begins ofsixyr. 第一、二、三磨牙（恒牙、智齿 Centralincisor,Lateralincisor,Canine,1stpremolar,2nd二、（二）口腔内和口腔旁组

1.牙（牙的数目和排列amount&arrangement 牙式：II

I

32

12 II

I

32

12

R.R.

L.L.二、口（二）口腔内和口腔旁组Tongue功能Function：咀嚼吞Chewingandswallowing辅助发AuxiliaryV-shaped前2/3Anterior2/3tongueisapex(alsonamed后1/3舌Posterior1/3is舌系带、舌下阜Frenumlinguae,sublingualcaruncle,sublingual二、口腔（二）口腔内和口腔旁组舌

消化管舌粘膜Lingualmucousmembrane（ Lingualpapillae （味蕾tastebud） （味蕾tastebud舌扁桃体：淋巴lingualtonsil:舌肌Lingualmuscles（骨骼肌skeletal舌内肌、舌外肌：改变舌的形态与位TheintrinsicmusclesacttochangetheshapeofTheextrinsicmusclesacttochangethepositionofthetongue.二、口腔（二）口腔内和大唾液腺Majorsalivary腮腺Parotid位置：耳廓Location:belowandinfrontofeachear 导管：穿过颊肌开口平对上颌第2磨牙的颊粘膜ParotidThroughthecheekmuscle,openingattheparotidpapilla,whichliesacrossthesecondsuperiormolar下颌下腺Submandibular位置：下颌骨体内

Lieininnersideof舌下腺Submandibular位置：舌下襞的深Lieindeepsurfaceofsublingual

共同开口于舌（一）咽的位置和形态Locationand位置：颅底→第6颈椎下缘

三、咽 Location:extendsfromtheskullbasetolowerborderofthecricoid(aroundthe6thcervical形态：上宽下窄，前后略扁漏斗形肌性管道其内腔称咽腔Morphology:infundibuliformtube,lookslikeaninvertedtrapezia,slightlyflatonanteriorandposterior.Theofthepharynxnamed咽腔位于1-6颈椎前方 isinfrontof1st-cervical三、口腔（二）咽的分部与结构咽的分鼻咽部：借鼻后孔→通鼻口咽部：借咽峡 喉咽部借喉口→通喉腔

Communicates Communicatesthroughthechoanaewiththenasal Onitslateralwallisthepharyngealopeningoftheauditorycommunicateswithmiddle Pharyngealrecess:Significantinthatitmaybeinvolvedincertainandneckcancers,notablyNasopharyngeal四、食管（一）食管的位置位置：上端第6颈椎体Upperstarfrominferiorborderof6thcervicalvertebra’s下端第11胸椎Thelowerendliesattheliftsideof11ththoracic接续：上接咽，下接胃Fromthepharynxtothe分部：颈部、胸部、Neck,chest,穿膈：食管裂孔Esophageal四、食（二）食管的狭第一个狭窄：食管起始（与咽接续第三个狭窄：膈的食管裂孔处距中切牙约0c。癌的好发TheTheesophagushas3particularstructurescompresstheAtthestartoftheesophagus,wherethelaryngopharynxjoinstheesophagus,behindthecricoidcartilage.About15cmfromtheincisors.Whereitiscrossedonthefrontbytheaorticarchandtheleftmainbronchus.About25cmfromtheTheesophagealhiatuswhereitpassesthroughdiaphragm.About40cmfromtheThoseareThosearepredilectionsitesofesophagealcancerandretainedforeignbodies.五、胃stomach（一）胃的形形态：勾型二壁：前、后壁Anterior/Posterior二缘：大、小弯二口：出 分部：四部分4胃底Fundus、胃体幽门部Pylorus、贲门部胃溃疡易发：胃小弯幽门部Predilectionsitesofgastriculcer:curvature&（二）胃的位WhenmediumfillingMost:LefthypochondriacFractional:epigastricregionCardia:Leftsideof11th幽门：第1腰椎右Pylorus:Rightsideof1st幽门瓣pyloric幽门括约肌Pyloric幽门螺杆菌Helicobacter）了胃壁的组织结构（4）了粘膜胃底颈粘液细胞：粘

粘膜下肌织膜

幽幽门括约肌、幽门外膜Thestomachwallsconsistofanoutermucosa,andinnersubmucosa,muscularlayer,andserosa.OuterFundusglandsecretesgastricPrimarycells:pepsinogenParietalcells:hydrochloricacidNeckmucuscells:mucusInnerMuscularPyloricsphincter,pyloricSmall六、Small下→盲肠cecum回肠（一）十二指肠长约25cm1-3腰椎Theduodenumisaabout25C-shapedstructuresurroundingpancreas,altituderangeis1st-3rdlumbarvertebra.分部上部superiorpart（十二指肠duodenal降部descendingpart（十二指肠majorduodenalpapilla） hepatopancreaticampulla）水平部horizontalpart升部ascending（二）空肠Jejunum、回肠Ileum（占2/5、积扩大600倍superficialareaextend600times，面积达功能：吸收功能为Absorbingisthemain粘膜

小肠管壁结构了皱襞、绒毛、微绒Pilca,villi,乳糜管小肠液、食糜变Secretintestinalfluidandthe毛细血管吸Capillary粘膜下层Inner肌层Muscular外膜起自Start：回肠末端Endof终于 长度Length：约Absorbwater,mineralsalt,emptying分段盲肠、阑尾、结肠、直肠Cecum,appendix,colon,rectumc（一）盲肠、阑尾Cecum, 回盲瓣Ileocecalvalve：回盲口Ileocecalorifice 内Rightiliacfossa 阑尾Appendix：6-8cm, 位置：右髂窝内iliac 根部位置固Fixedbythe（一）盲肠、阑阑尾根部的体表投影点 麦氏McBurney’spointisthepositionwithintheabdomencorrespondspointofappendixrootonthehumansurface.右髂前上棘与脐连线的LocationofMcBurney’spoint:locatedtwothirdsthedistancefromtheumbilicustotherightanteriorsuperioriliacspine.（二）結肠、直肠 Colon,rectum 结肠升结肠AscendingcolonTransversecolonDescendingcolon乙状结肠Sigmoidcolon三个特征性结3signature结肠带band、结肠袋haustra、肠脂epiploicappendages七、大肠（二）結肠、直肠 消化直肠rectum：位于盆腔Locatedinthe上端Upper：平第3骶椎S3下端Lower：盆隔处续Terminatesattheleveloftheanorectal 、侧面Side：骶曲 （二） 长度：3-上端：盆隔处与直肠connectswiththerectuminpelvic下端：开口Openingat内括约 外括约肌 ine:Alinewhichdividesmucosa,nervesystem,arteryand痔：内痔、外Internalhemorrhoids,external的组成 Smalldigestivegland消化管壁内wallofthedigestive 物→管腔口腔粘膜腺、胃腺、肠腺Oralmucosalgland,stomachgland,intestinal GreatDigestive（唾液腺、肝、胰Salivarygland,liver,pancreas）被膜、小叶envelope,lobule腺实质（腺泡、导管）Glandularsubstance(acinar,腺间质（结缔组织）Glandularstroma(connective一、 重量weight：约 最大的腺体Theglandinthehuman 功能 参与代谢、激素与药物转化和解Participateinmetabolism,conversionofhormonesanddrug, 胆汁、促进脂肪消化和吸收Secretbile,promotefatdigestionand 吞噬防御功能、胚胎时期造血Phagocytosis&defense.Fetalblood（一）形态与位置Morphologyand1.形态：两面：上、下面Superior/两缘：前、后缘Anterior/两叶：左、右left/right上面：镰状韧带（分左右叶）Superior:Falciformligamentofliver,divideleft/rightlobe.下面：肝门（门静脉Inferior:Portahepatic(Portal肝的形态MorphologyofThevisceralsurfaceoftheliverhasanH-ThevisceralsurfaceoftheliverhasanH-shapedgroupofdeepfissuresandfossae. Rightlongitudinalgroove:gallbladder LeftLeftgroove:ligamentumteres TransverseTransversechannel:hepatic 大部分位于 右季肋区和腹上 小部分位于 左季肋 Most:Righthypochondriac&epigastricregion Fractional:Left其体表投影如下右锁骨中左锁骨中上平第５平胸剑结合平第５肋间下右肋弓下剑突下MarkingofliveronMarkingofliveronhumanRightMiddleLeftmid-Upwardasfarasthe5thcostalAtthelevelofthejunctionbetweenthesternumandthexiphoidprocessUpwardasfaras5thintercostalReachthe7thribatthesideofthe3cmbelowthe（三）肝的组织结构 了肝小叶：是肝结构与功能的基本单位Lobules:Thebasicunitofliver’structureand组成 静脉、肝索、肝血窦、胆小Construction:Centralvein,hepaticcords,hepatic bilePortalarea:hepaticlobulebileduct,hepaticartery,hepaticportal胆囊功能 浓缩胆汁Storedandconcentrated位置：胆囊窝Gallbladder分部胆囊底、胆囊体、胆囊颈、胆囊管→小Fundus,body,neckandBilewillbereleasedthroughbileductintothesmallintestine.胆囊底的体表SurfaceMarkingofbile右腹直肌外侧缘与右肋弓相交处深Thefundusofthegallbladderapproachesthesurfacebehindtheanteriorendofthe9thrightcostalcartilageclosetothelateralmarginoftherectusabdominis.输胆管道Transportductsof左右肝管、肝总管胆囊管、胆总管Left/righthepaticduct,Commonhepaticduct,CysticCommonbile左、右肝内的毛细胆管Bilecapillariesofleft&rightlobes.→逐汇合肝左、右肝管Toleft/righthepatic→汇合肝总管。ToCommonhepatic肝总管+胆囊管→胆总管胆总管+胰管→肝 肌）肝 →十二指 头major二、胰（二）位置腹后壁第1-2腰椎水Liesinfrontofthe1st- lumbar前面有腹膜覆 coverstheanterior（一）形分部:头、体、尾Head,body,头：十二指肠环抱Occupiesthecurveofthe尾：脾门Splenic胰管：Pancreiatic开口于十二指 头Openingatmajorduodenal（一）腮（一）腮（二）下颌下腺（三）舌下腺三、唾液腺（前面已述）Majorsalivaryglads腹膜 ：浆膜--脏层、壁Serosa---viscerallayer,parietal腹膜腔:脏层与壁层之Thepotentialspacebetweenthesetwolayersthe：完全封闭囊与外界不Male: y Female:communicatewiththroughfallopiantubes,uterus&腹膜 Secretsperitonealfluidforlubricating.Supportstheabdominalorgansandservesasconduitfortheirbloodvessels,lymphvessels,and作业题消化管 由哪 组成人一生牙有几套（名称、数量、出齐时间 的组成？咽分为哪几部分、各通向什么腔食管有哪3个生理性狭窄胃分几部分？上、下两口的名称和接续 名称小肠分几段？大肠分几部分阑尾压痛点、胆囊压痛点在肝的位置、胆囊的形态、输胆管道的组成胰腺分部？胰管与胆总管汇合后的名称、开口解释名词：咽峡、十二指 头、恒牙、腹膜WhichorgansconstitutedigestivetubeanddigestiveHowmanysetsofteethdothehumanhave? tyWhataretheconstitutionsoflingualpapilla?Howmanysectionsareinpharynx?AndwhatcavitieswilltheyWhatis“constrictedinthreeHowmanysectionsarethereinstomach?Whatarethenameoftheopening,loweropeningandtheircorrelativeHowmanysectionsarethereinlargeintestineandsmallWhereareMcBurney'spoint(tendernesspointofappendicopathy)tendernesspointofgallbladderWhereisthelocationoftheliver?Whatisthemorphologyofgallbladder?WhatareconstitutionsthetransportductsofWhatarethepancreas’sections?Whatisthenameoftissuecombinepancreaticductandcommonbileduct?AndwherewillitExplainthefollowingIsthmusoftheMajorduodenalPermanentRespiratory一、（一）外鼻：鼻根、鼻背、鼻尖翼、Externalnose:nasion,nasaldorsum,apexnasi,alanasi,nostril ：鼻中隔nasalseptum、鼻腔 nasalvestibule、固有鼻腔nasal 固有鼻腔：内侧壁medialwall-鼻中隔（ Easybleedingarea外侧壁lateralwall-上、中、下鼻甲turbinate（鼻道第一一、鼻（二）鼻 固有鼻腔 外侧壁-上、中、下鼻甲鼻粘膜Nasalmucosa 部respiration呼吸部Smell嗅部一、（三）鼻旁额窦Frontalsinus：开口于中鼻opensintomiddlenasal上颌窦Maxillarysinus：开口于中鼻道opensintomiddlenasal筛窦Ethmoidalsinus：前组和中组开口于中鼻道posterior&middlegroupareopenintomiddlenasalmeatus.后组开口上鼻道。group(sometimestheanteriorsinus)drainsintothesuperiornasal蝶窦：开口于蝶筛隐Sphenoidsinus:Openssphenoethmoidal三、喉LarynxRespiratoryandarticulatory位位于颈前部正中，上端第４、５颈椎之间，下端平第颈椎下缘Locatedwithintheanterioraspecttheneck,upperboardisonthesamelevelofC4-5cervicalvertebra;lowerboardisonthesamelevelofC6cervicalvertebra’slowerlimit. 喉软骨cartilagines甲状软骨喉valveofaditus环状软骨cricoid

杓状软骨arytenoid喉肌Laryngeal声韧带vocal声带肌vocalis喉腔内粘膜 声带vocal三、襞plicarima声襞vocal声门裂fissureof发音、Pronunciation,breath/hold四、气管主支气管Trachea,mainThetracheaissurroundedbyringshyalinecartilage;theseringspleteandC-shaped,exceptfor ring,calledthecricoidcartilage;Connectinglarynxandlung;thegapscoverbyconnectivetissueandsmoothmusle.（一）上平环状软左、右主支气管，分杈处称为气管杈Thetracheabeginslevelwiththecricoidcartilageandthelowerlimitisfoundatthelevelofthe4ththoracicvertebra(sternalangle).Dividedintoleftandrightmainbronchus,thedividedpointcalledthebifurcationoftrachea.四、气管主支气（二）Compareleft&rightmain管径长与气细、管径长与气细、倾粗、较垂管径和长度andlength

与气管中线线的Anglewiththetracheamidlineextensionline左主支气管Leftmain

细、长Thin,

倾斜

右主支气管Rightmain

粗、短Thick,

较垂直

一、肺的位位于胸腔内、纵膈两Locatedinthechest,bothsidesofthe二、形态和结Coniform,leftlungisnarrowerandlongerthanrightlung.1apex,1base,3surfaces,3Coniform,leftlungisnarrowerandlongerthanrightlung.1apex,1base,3surfaces,3肺二、形态和结肺肺的内侧面肺门hilusof肺的内侧面肺门hilusof肺根rootof幼儿肺Infant成年肺Adult灰色有黑斑graywithdark肺附肺的组织结构：肺附肺的组织结构：了 肺终末细支气管小呼吸性细支气叶肺泡管 了了（一）导管部叶支气管lobar小支气管细支气管终末细支气管bronchioliterminales（肺泡pulmonaryalveoli）了肺了（二）呼吸部呼吸性细支气管肺泡管alveolar 、肺泡alveolarsac：肺泡alveolus：肺小叶lobule：气体交换基本构单位Thebasicstructuralunitof肺泡：I型细胞Type1—气体弥散gas-II型细胞Type2—稳定肺泡形态stableform第三和纵胸一、胸膜脏胸膜visceral称肺胸膜Itcoverthelung,soitalsocalledpulmonarypleurae壁胸膜分四部4sections：纵隔胸膜、Pleuralpleura,diaphragmaticpleura,mediastinalpleura,pleural isthethinfluid-filledspacebetweentwopulmonarypleurae(visceralandparietal)ofeachlung,ithasapotential (negativepressure)and yclosed.第三和纵膜二、纵膈之间的全部、结构和纵隔的划分通过胸骨Themediastinumisacentralcompartmentofthe ,containsagroupofstructureswithinthethorax.Themediastinumcanbedividedintoanuppersuperior)andlower(orinferior)Thethoracicplaneseparatesthesuperiorandinferiormediastinum.Itisaplaneatthelevelofthesternalangle,andtheintervertebraldiscofT4–T5.Theinferiormediastinumfromthisleveltothediaphragm.Thislowerpartissubdividedintothreeregions,allrelativetothepericardium.作业题呼吸系统由哪 组成鼻旁窦的名称、开喉的软骨有哪几部分？喉的功能？喉腔的分左、右主支气管有什么区别肺尖在何处？左右肺各分为几个叶鼻由哪几部分组成？鼻腔粘膜的胸膜、胸纵膈？如何划分区域