临床医学眼科学基础.pptx

2024/5/1 周三1n第一节第一节眼的组织解剖眼的组织解剖anatomyofeyeballn一眼球一眼球Theglobe(eyeball)n正常眼球的前后径出生时约正常眼球的前后径出生时约16mm.n3岁时达岁时达23mm.n成年时成年时24mm.nanteriorandposteriordistanceofnormaleyeballis16mminborn.Atage323mm,atadult24mm2024/5/1 周三2（一）（一）眼球壁眼球壁Eyecoatn1.外层外层Theoutercoat1/6角膜角膜Cornea5/6巩膜巩膜Sclera2024/5/1 周三3（1）角膜）角膜Cornean横径横径Thetransversediameter11.5-12mmn垂直径垂直径Theverticaldiameter10.5-11mm2024/5/1 周三4n前前表面曲率半径表面曲率半径The radius of convex curvature in front 7.8mmn后表面曲率半径后表面曲率半径The radius of convex curvature in back 6.8mmn角膜厚度中央部角膜厚度中央部Thecentralthickness0.5-0.55mmn角膜厚度周边部角膜厚度周边部Theperipherythickness1mm 2024/5/1 周三5组织学分层组织学分层上皮细胞层Epithelium前弹力层Bowmansmembrane基质层Stroma后弹力层Descemetsmembrane内皮细胞层Endothelium2024/5/1 周三62024/5/1 周三7(2)巩膜Sclera组织学分层n表层巩膜Theepiscleran巩膜实质层Thescleralstroman棕黑板层Thelaminafascia2024/5/1 周三8n角巩膜缘Limbusn前房角Anteriorchamberangle2024/5/1 周三9 2中层 Themiddlecoat n葡萄膜Uvean色素膜Tunicapigmentosa 2024/5/1 周三10（1）虹膜Irisn分层：n基质层Stroman色素上皮层Pigmentepitheliallayern 瞳孔 Pupil:直径2.5-4mm 2024/5/1 周三11(2)睫状体Ciliarybodyn睫状冠Parsplicata:前1/3n睫状突Cliaryprocesses:n睫状体扁平部Parsplana:后2/3n锯齿缘Oraserrata:2024/5/1 周三12(3)脉络膜Choroidn组成n大血管层Largevascularlayern中血管层Middlevascularlayern毛细血管层Capillarylayer2024/5/1 周三133内层Innerlayer视网膜Retinan中心凹Fovea黄斑Maculalutean中心小凹Foveola黄斑中心凹Foveacentralisn视盘Opticdisc视乳头Opticpapillan视杯、杯凹Opticcup2024/5/1 周三14视网膜分层外层n视网膜色素上皮层Retinalpigmentepithelium,RPE2024/5/1 周三15内层视网膜神经感觉层n视锥、视杆细胞层（光感受器细胞层）Coneandrodlayern外界膜Externallimitingmembranen外核层Outernuclearlayern外丛状层Outerplaxiformn内核层Innernuclearlayern内丛状层Innerplexiformlayern神经节细胞层Ganglioncelllayern神经纤维层Nervefiberlayern内界膜Limitingmembrane2024/5/1 周三162024/5/1 周三17（二）眼球内容Contentsoftheeyen1.房水Aqueoushumorn前房Anteriorchambern后房Posteriorchamber2024/5/1 周三182.晶状体Lens2024/5/1 周三193.玻璃体Vitreousbody2024/5/1 周三202024/5/1 周三211.视路Visualpathwayn光感受器双级细胞神经节细胞视乳头视神经视交叉视束外侧膝状体视放射视皮质nretinalphotoreceptorbipolarcellnervousganglioncellsopticdiskopticnerveopticchasmoptictractlateralgeniculatebodyopticradiationvisualcortex.2024/5/1 周三22二、眼眶及附属器Orbitandaccessoryapparatusn(一)眼眶Orbitn1.视神经孔和视神经管Opticforamenandcanaln2.眶上裂Superiororbitalfissuren3.眶下裂Inferiororbitalfissuren4.眶上切迹（或孔）Thesupraorbitalnotch2024/5/1 周三23（二）眼睑Eyelids n1皮肤层Theskinn2皮下组织层Subcutaneousn3肌层Muscularlayern4睑板层Layerofthetarsalplaten5结膜层Theconjunctivallayer2024/5/1 周三242024/5/1 周三25(三)结膜Conjunctivan1 睑 结 膜 Palpebralconjunctivan2球结膜Bulbarconjunctivan3穹窿结膜Fornicalconjunctiva 2024/5/1 周三262024/5/1 周三27(四)泪器Lacrimalapparatus1泪腺Lacrimalgland2泪道Lacrimalpassages(1)泪小点Lacrimalpuncta(2)泪小管Lacrimalcanaliculi(3)泪囊Lacrimalsac(4)鼻泪管Nasolacrimalduct2024/5/1 周三282024/5/1 周三29(五)眼外肌Extraocularmusclesn4条直肌Rectusn上直肌superiorrectimusclesn下直肌inferiorrectimusclesn内直肌medialrectimusclesn外直肌externalrectimusclesn2条斜肌Obliquemusclen上斜肌superiorobliquemusclesn下斜肌Inferiorobliquemuscles2024/5/1 周三302024/5/1 周三31三、视路Visualpathwayn（一）视神经Opticnerven(1)眼内段Intraocularn(2)眶内段Intraorbitaln(3)管内段Intracanalicularn(4)颅内段Intracranialn（二）视交叉Opticchiasmn（三）视束Optictractn（四）外侧膝状体Lateralgeniculatebodyn（五）视放射Opticradiationn（六）视皮质Visualcortex2024/5/1 周三322.瞳孔反射路Pathwayofpapillaryreflexn光反射Lightreflexn直接光反射Directreflexn间接光反射Indirectreflexn近反射Nearreflex2024/5/1 周三332024/5/1 周三34四、眼球的血液循环和神经分布Bloodcirculationandinnervationofthegloben（一）血液循环Bloodcirculationn动脉Arteryn视网膜中央血管系统thecentralretinalvascularsystemn睫状血管系统theciliaryvascularsystem2024/5/1 周三35n1.视网膜中央血管系统Thecentralretinalvascularsystemn视网膜中央动脉Centralretinalartery,CRA2024/5/1 周三362.睫状血管系统theciliaryvascularsystemn(1)睫状后短动脉Shortposteriorciliaryarteryn(2)睫状后长动脉Longposteriorciliaryarteryn(3)睫状前动脉Anteriorciliaryartery2024/5/1 周三37静脉Veinn1.视网膜中央静脉CentralretinalveinCRVn2.涡静脉Vortexveinn3.睫状前静脉Anteriorciliarvein 2024/5/1 周三38（二）神经Nerven1睫状神经节Ciliaryganglionn2鼻睫状神经Nasociliarynerve2024/5/1 周三39视路及瞳孔反射Opticpathwayandpupillaryreflex 2024/5/1 周三401瞳孔反射路Pathwayofpupillaryreflexn光反射Lightreflexn直接光反射directreflexn间接光反射indirectreflexn近反射Nearreflex2024/5/1 周三412.视路Visualpathwayn光感受器双级细胞神经节细胞视乳头视神经视交叉视束外侧膝状体视放射视皮质nretinal photoreceptorbipolar cellnervous ganglioncellsoptic diskoptic nerveoptic chasmoptictractlateral geniculate bodyoptic radiationvisualcortex.2024/5/1 周三422024/5/1 周三43