61Myology.pptx

SDU.LIZHENHUAMyology 肌学肌学山东大学医学院山东大学医学院 解剖教研室解剖教研室 李振华李振华SDU.LIZHENHUA Myology 肌学肌学nMorphology of skeletal muscleqMuscle belly 肌腹肌腹qTendon 肌腱肌腱 aponeurosis 腱膜腱膜nClassificationqLong muscle 长肌长肌qShort muscle 短肌短肌qBroad muscle 阔肌阔肌qOrbicular muscle 轮匝肌轮匝肌SDU.LIZHENHUAMyology 肌学肌学nOrigin 起点the fixed attachment nInsertion 止点 the movable attachment nAction 作用qAgonist 原动肌qAntagonist 拮抗肌qSynergist 协同肌qFixators 固定肌nNomenclature of mucles 肌的命名qshapeqsize qLocationqtheir points of attachmentSDU.LIZHENHUAMyology 肌学肌学nAccessory structuresqFascia 筋膜nSuperficial fascianDeep fasciaq Synovial bursa 滑膜囊SDU.LIZHENHUAMyology 肌学肌学nAccessory structuresqTendinous sheath 腱鞘 nFibrous layernSynovial layer qMesotendon 腱系膜qvincula tendinum 腱纽qSesamoid bone 籽骨SDU.LIZHENHUASynovial cyst of wrist 腕部腱鞘囊肿腕部腱鞘囊肿SDU.LIZHENHUAMuscles of Head 头肌头肌nFacial muscles 面肌nMasticatory muscles 咀嚼肌SDU.LIZHENHUAFacial muscles 面肌面肌nEpicranius 颅顶肌颅顶肌 qFrontal belly 额腹额腹qOccipital belly 枕腹枕腹qGalea aponeurotica 帽状腱膜帽状腱膜nOrbicularis oculi 眼轮匝肌眼轮匝肌nOral group 口周围肌口周围肌qBuccinator 颊肌颊肌qOrbicularis oris 口轮匝肌口轮匝肌nNasalis 鼻肌鼻肌SDU.LIZHENHUAFacial muscles 面肌面肌SDU.LIZHENHUAMasticatory muscles 咀嚼肌咀嚼肌nTemporalis 颞肌颞肌nMasseter 咬肌咬肌nLateral pterygoid 翼外肌翼外肌nMedial pterygoid 翼内肌翼内肌SDU.LIZHENHUA Masticatory muscles 咀嚼肌咀嚼肌nTemporalis 颞肌颞肌qOrigintemporal fossaqInsertioncoronoid process of mandibleqActionelevates and retracts mandiblenMasseter 咬肌咬肌qOrigininferior border and medial surface of zygomatic archqInsertionmasseteric tuberosityqActionelevates mandibleSDU.LIZHENHUA Masticatory muscles 咀嚼肌咀嚼肌nLateral pterygoid 翼外肌翼外肌nMedial pterygoid 翼内肌翼内肌SDU.LIZHENHUAMuscles of Neck 颈肌颈肌nSuperficial group nAnterior groupqSuprahyoid musclesqInfrahyoid musclenDeep groupSDU.LIZHENHUAMuscles of the necknSuperficial groupqPlatysma 颈阔肌颈阔肌 Sternocleidomastoid 胸锁乳突肌胸锁乳突肌nOrigin:manubrium and sternal end of clavidenInsertion:mastoid process of temporal bonenAction:contraction of one muscle draws head toward the same side,and turn face to opposite side;both muscles act together to draw head backwardSDU.LIZHENHUAMuscles of the necknSuprahyoid muscles qDigastric 二腹肌二腹肌qMylohyoid 下颌舌骨肌下颌舌骨肌qStylohyoid 茎突舌骨肌茎突舌骨肌qGeniohyoid 颏舌骨肌颏舌骨肌nAction:elevate(raise)hyoid bone and depress mandibleSDU.LIZHENHUAMuscles of the necknInfrahyoid muscleqSternohyoid 胸骨舌骨肌胸骨舌骨肌qThyrohyoid 甲状舌骨肌甲状舌骨肌qSternothyroid 胸骨甲状肌胸骨甲状肌qOmohyoid 肩胛舌骨肌肩胛舌骨肌nAction:Depress hyoid or larynx after elevationSDU.LIZHENHUAMuscles of the necknDeep groupqLateral groupnScalenus anterior 前斜角肌前斜角肌qOrigin:transverse processes of C3-C6.qInsertion:tubercle for scalenus anteriorqAction:unilateral,bends neck laterally;bilateral,elevate first rib,an accessory muscle of inspiration;if rib is fixed,flex neck anteriorlynScalenus medius 中斜角肌中斜角肌nScalenus posterior 后斜角肌后斜角肌SDU.LIZHENHUAMajor muscles of the neck Scalene fissure 斜角肌间隙斜角肌间隙 nBoundaries qfirst ribqscalenus anterior and mediusnStructures passing through scalene fissure qbrachial plexus 臂丛臂丛qsubclavine a.锁骨下动脉锁骨下动脉SDU.LIZHENHUAMuscles of the necknDeep groupqMedial groupnlongus capitis 头长肌头长肌 nlongus colli 颈长肌颈长肌qAction:Flex the head,bends the neck forwardSDU.LIZHENHUAMuscles of trunk 躯干肌躯干肌nMuscles of backnMuscles of thoraxnDiaphragm nMuscles of abdomenSDU.LIZHENHUAMuscles of BacknSuperficial groupqTrapezius 斜方肌斜方肌qLevator scapulae 肩胛提肌肩胛提肌qRhomboideus 菱形肌菱形肌 qLatissimus dorsi 背阔肌背阔肌qThoracolumbar fascia 胸腰筋膜胸腰筋膜SDU.LIZHENHUAThe Muscles of BacknDeep group qSplenius 夹肌夹肌qErector spinae 竖脊肌竖脊肌nPosition:fills the vertebral groove on each side of the spinen Action:extends vertebral column(draw head backwar)SDU.LIZHENHUAMajor Muscles of BacknTrapezius 斜方肌斜方肌 qOrigin:superior nuchal line,external occipital protuberance,ligamentum nuchae and spinous processes of seventh cervical and all thoracic vertebraeqInsertion:lateral third of clavicle,acromion,and spine of scapularqActon:upper fibers elevate scapula,lower fibers depress scapula;if scapula is fixed,one side acting along,draws head toward the same side,and turn face to opposite side;both sides together,draw head directly backwardqNerve supply:accessory nerve(cranial nerve)SDU.LIZHENHUAMajor Muscles of BacknLatissimus dorsi 背阔肌背阔肌qOrigin:nSpinous processes of lower six thoracic and all lumbar vertebraenMedian sacral crestnPosterior part of iliac crestqInsertion:crest of lesser tubercleqAction:trunk fixed,extends,adducts and medially rotates arm;arm fixed,elevates trunk.SDU.LIZHENHUAThoracolumbar Fascia 胸腰筋膜胸腰筋膜Posterior layerMiddle layerAnterior layerSDU.LIZHENHUATrapeziusDeltoid Ausculatory triangleLatissimus dorsiThoracolumbar fasciaLevator scapularRhomboideus Inferior lumbar triangleSDU.LIZHENHUAMuscles of thoraxMuscles connecting the upper limb to the thoracic wallnPectoralis major 胸大肌胸大肌 nPectoralis minor 胸小肌胸小肌 nSerratus anterior 前锯肌前锯肌SDU.LIZHENHUAMuscles of thoraxnIntrinsic musclesqIntercostales externi 肋间外肌肋间外肌qIntercostales interni 肋间内肌肋间内肌qIntercostales intimi 肋间最内肌肋间最内肌qTransverses thoracis 胸横肌胸横肌SDU.LIZHENHUAMajor muscles of thoraxnPectoralis Major 胸大肌胸大肌qOrigin:medial half of clavicle,sternum,upper six costal cartilages.qInsertion:crest of greater tubercleqAction:adducts the arm and rotates it medially;the clavicular fibers also flex the arm;with the arm above the head,raise the body as in climbing SDU.LIZHENHUAMajor muscles of thoraxnIntercostales externi 肋间外肌肋间外肌qOrigin:inferior border of rib aboveqInsertion:superior border of rib belowqReplaced anteriorly by external intercostals membrane qAction:raise ribs adding in forced inspirationSDU.LIZHENHUAMajor muscles of thoraxnIntercostales interni 肋间内肌肋间内肌qOrigin:superior border of rib belowqInsertion:inferior border of rib above qReplaced posteriorly by internal intercostals membrane.qAction:depress ribs for forced expirationSDU.LIZHENHUADiaphragm 膈膈nShape and positionqdome-shaped between thorax and abdomenqconsists of a peripheral muscular part and a central tendonnOriginqSternal part:arising from xiphoid processqCostal part:arising from lower six and costal cartilagesqLumbar part:arising by two crura from upper 2-3 lumbar vertebrae,medial and lateral arcuate ligamentsnInsertion:central tendonSDU.LIZHENHUADiaphragm 膈膈nWeak areas:qLumbocostal triangle qSternocostal triangleSDU.LIZHENHUADiaphragm 膈膈Openings in the diaphragmnAortic hiatus 主动脉裂孔主动脉裂孔 lies anterior to the body of the 12th thoracic vertebra between the crura and transmits the aorta,thoracic ductnEsophageal hiatus 食管裂孔食管裂孔 lies at level of T10.It transmits esophagus and vagus nerves nVena cava foramen 腔静脉孔腔静脉孔 lies at T8 level in the central tendon.It transmits the inferior vena cava.SDU.LIZHENHUADiaphragm 膈膈Action:nContraction:the dome moving downward,increases the volume of thoracic cavity which results in inspiration,at the same time the intra-abdominal pressure is increased assists in defecation,vomiting or child birth.nRelaxation:the dome returns to the former position,reduces the volume to the thoracic cavity,resulting in expiration.SDU.LIZHENHUA Muscles of abdomenAnterolateral groupnObliquus externus abdominis 腹外斜肌腹外斜肌nObliquus internus abdominis 腹内斜肌腹内斜肌nTransversus abdominis 腹横肌腹横肌nRectus abdominis 腹直肌腹直肌SDU.LIZHENHUAObliquus externus absominis 腹外斜肌腹外斜肌nGeneral direction of fibers:downward,forward and medially(run down and inward)SDU.LIZHENHUAObliquus externus absominis 腹外斜肌腹外斜肌StructuresnInguinal ligament 腹股沟韧带腹股沟韧带nLacunar ligament 腔隙韧带腔隙韧带nSuperficial inguinal ring 腹股沟管浅环腹股沟管浅环 triangular-shaped defect in aponeurosis of obliquus externus abdominis above pubic tubercleSDU.LIZHENHUAObliquus externus absominis 腹外斜肌腹外斜肌Superficial inguinal ring 腹股沟管浅环腹股沟管浅环SDU.LIZHENHUAObliquus internus abdominis 腹内斜肌腹内斜肌nDeep to obliquus externus abdominisnGeneral direction of fibres:upwards,forwards and mediallySDU.LIZHENHUATransversus abdominis 腹横肌腹横肌nDeep to obliquus internusnGeneral direction of fibers:run horizontally forward.SDU.LIZHENHUATransversus abdominis 腹横肌腹横肌nInguinal falx 腹股沟镰腹股沟镰 qObliquus internus abdominis has a lower,free border that arches over spermatic cordqInserted with transversus abdominis fiber into medial part of pecten of pubis nCremaster 提睾肌提睾肌 qDirived from the lower fibers of the obliquus internus abdominis and transversus abdominisqAround the spermatic cord and testisSDU.LIZHENHUARectus abdominis 腹直肌腹直肌nPosition:lie on to either of midlinenOrigin:pubic crest and symphysisnInsertion:xiphoid and 5th-7th costal cartilagesnTendinous intersections 腱划腱划 3-4 nlinea semiluaris 半月线半月线 SDU.LIZHENHUASimilar functions for above four pairs of musclesnSupport and compress the abdominal visceranIncrease intra-abdominal pressure,aid in expulsive efforts-vomiting,coughing,sneezing,defecation,urination and childbirth.nDepress ribs,assist in(the act of force(4)expiration.nFlex,lateral flex,and rotate vertebral columnSDU.LIZHENHUASheath of rectus abdominis 腹直肌鞘腹直肌鞘Anterior layernFormed by fusion of aponeurosis of obliquus externus abdominis and anterior leaf of aponeurosis of obliquus internus abdominisSDU.LIZHENHUASheath of rectus abdominis 腹直肌鞘腹直肌鞘Posterior layer nFormed by fusion of posterion leaf of aponeurosis of obliquus internus abdominis and aponeurosis of transversus abdominisnAbsent in about 4-5cm below the umbilicus,where aponeuroses of all three muscles form anterior layer the lower free border named arcuate line 弓状线弓状线nBelow this line rectus abdominis in contact with transverse fasciaSDU.LIZHENHUAMuscles of abdomennLinea alba 白线白线 tendinous raphe between right and left recti from xiphoid to pubic symphysisSDU.LIZHENHUALandmarks and surface anatomynLinea alba nRectus abdominisnTendinous intersectionsnLinea semilunarisnUmbilicus:at the level of L3 L4nInguinal ligamentSDU.LIZHENHUAMuscles of abdomenPosterior group nQuadratus lumborum 腰方肌腰方肌nPsoas major 腰大肌腰大肌