上肢局部解剖学Theupperlimb.ppt
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1、The upper limb 山东大学医学院 解剖教研室 李振华 The muscles of back Superficial group nTrapezius 斜方肌 nLatissimus dorsi 背阔肌 nLevator scapulae 肩胛提肌 nRhomboideus菱形肌 Deep group nErector spinae 竖脊肌 nSplenius 夹肌 nThoracolumbar fascia 胸腰 筋膜 The muscles of thorax Extrinsic muscles nPectoralis major 胸大肌 nPectoralis minor 胸
2、小肌 nSerratus anterior 前锯肌 Intrinsic muscles nIntercostales externi 肋间外肌 nIntercostales interni 肋间内肌 nIntercostales intimi 肋间最内肌 Major muscles of the trunk Trapezius nOrigin: superior nuchal line, external occipital protuberance, ligamentum nuchae and spinous processes of seventh cervical and all tho
3、racic vertebrae nInsertion: lateral third of clavicle, acromion, and spine of scapulartery nActon: 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 d
4、irectly backward Latissimus dorsi nOrigin: spinous processes of lower six thoracic and all lumbar vertebrae, median sacral crest, and posterior part of iliac crest. nInsertion: floor of intertubercular groove of humerus. nAction: trunk fixed, extends, adducts and medially rotates arm ; arm fixed, el
5、evates trunk. Erector spinae n Position: fills the vertebral groove on each side of the spine n Action: extends vertebral column (draw head backwar) Pectoralis major nOrigin: medial half of clavicle,sternum,1th-6th costal cartilages. nInsertion: crest of greater tubercle of humerus. nAction: flexes,
6、 adducts and rotates arm medially; arm fixed, elevates trunk; elevates ribs 1-6,aidding in forced inspiration. The Muscles of Upper Limb Muscles of shoulder nDeltoid nsupraspinatus nInfraspinatus nTeres minor nTeres major nsubscapularis Muscles of arm nAntererior group qBiceps brachii 肱二头肌 qCoracobr
7、achiali s喙肱肌 qBrachialis 肱肌 nPosterior group triceps brachii肱三头肌 Muscles of forearm nSuperficial layer qBrachioradialis 肱桡肌 qPronator teres 旋前圆肌 qFlexor carpi radialis 桡侧腕屈肌 qPalmaris longus 掌长肌 qFlexor carpi ulnaris 尺侧腕屈肌 nThird layer qFlexor digitorum profundus 指深屈肌 qFlexor pollicis longus 拇长屈肌 nF
8、ourth layer pronator quadratus 旋前 方肌 Action: flex radiocarpal joint and fingers, pronate forearm nSecond layer flexor digitorum superficials 指浅屈肌 Posterior group (10) nSuperficial layer (5) qExtensor carpi radialis longus 桡侧腕长伸肌 qExtensor carpi radialis brevis 桡侧腕短伸肌 qExtensor digitorum 指 伸肌 qExtens
9、or digiti minimi 小指伸肌 qExtensor carpi ulnaris 尺侧腕屈肌 Deep layer (5) nSupinator旋后肌 nAbductor pollicis longus 拇长展肌 nExtensor pollicis brevis 拇短伸肌 nExtensor pollicis longus 拇长伸肌 nExtensor indicis 示指伸肌 nAction: extend radiocapral joint and fingers, and supinate forearm Muscles of hand nLateral groupthena
10、r 鱼际 (4) qAbductor pollicis brevis拇短展肌 qFlexor pollicis brevis 拇短屈肌 qOpponens pollicis 拇对掌肌 qAdductor pollicis 拇收肌 nAction: flex, abduct, adduct and oppose thumb nMedial grouphypothenar (3) qAbductor digiti minimi 小指展肌 qFlexor digiti minimi brevis小指短屈 肌 qOpponens digiti minimi小指对掌肌 nAction: flex, ab
11、duct , and oppose little finger Intermedial group nLumbricales 蚓状肌(4) flex fingers at MP joints; extend fingers at IP joints nPalmar interossei 骨间掌 侧肌(3) adduct fingers towards middle finger at MP joints nDorsal interossei 骨间背 侧肌(3)abduct fingers away from middle finger at MP joints Major muscles of
12、 upper limb Deltoid nOrigin: lateral third of clavicle, acromion, and spine of scapula nInsertion: deltoid tuberosity of humerus nAction: abducts,flexes and medically rotates, extends, and laterally rotates arm Teres major nOrigin: dorsal surface of inferior angle of scapula nInsertion: crest of les
13、ser tubercle of humerus nAction: medially rotates and adducts arm Biceps brachii nOrigin: long head, supraglenoid tubercle; short head, coracoid process nInsertion: radical tuberosity nAction: supinator of forearm, flexor of elbow joint, weak flexor of should joint Pronator teres nOrigin: medical ep
14、icondyle of humerus and deep fascia of forearm nInsertion: middle of lateral surface of radius nAction: pronation of forearm and flexion of elbow Triceps brachii nOrigin: long head, infraglenoid tubercle; lateral head, above groove for radical n., medical head, below groove for radical n. nInsertion
15、: olecranon of ulna nAction: extends elbow joint), long head can extend and adduct shoulder joint Supinator nOrigin: lateral epicondyle of humerus and upper part of lateral border of ulna nInsertion: upper third of anterior surface of radius nAction: supination of forearm Arteries of upper limb Axil
16、lary artery nContinuation of subclavian artery at lateral border of first rib nBecomes brachial artery at lower border of teres major nDivided into three parts by overlying pectoralis minor qFirst portion, above musclegives rise to thoracoacromial a. 胸肩峰动脉 qSecond portion, behind muscle gives rise t
17、o lateral thoracic a. 胸外侧 动脉 qThird portion, below musclegives rise to subscapular a. 肩胛下动脉, anterior and posterior humeral circumflex a. 旋肱前、后动脉; the former then divides into throcodorsal a. 胸背动脉 and circumflex scapular a. 旋肩胛动脉 Brachial artery nContinuation of axillary artery nDivides into radial
18、and ulnar arteries at level of neck of radius nBranches qDeep brachial a. 肱深动脉 accompanies with radial nerve qSuperior ulnar collaeral a. 尺侧上副动脉 accompanies with ulnar nerve qInferior ulnar collateral a. 尺侧下副动脉 Radial artery and branches nRadial recurrent a. 桡侧返动脉 nSuperfical palmar branch 掌浅支 nPrin
19、cipal artery of thumb 拇主要动 脉 Ulnar artery and branches nUlnar recurrent a. 尺侧返动脉 nCommon interosseous artery 骨间总动脉 qAnterior interossous a. 骨间前动脉 qPosterior interosseous a. 骨间后动脉 nDeep palmar branch 掌深支 Superficial palmar arch 掌浅弓 nFormed by ulnar artery and superficial palmar branch of radial arter
20、y nCurve of arch lies across the palm, level with the distal border of fully extended thumb nGives rise to three common palmar digital arteries each then divides into two proper palmar digital arteries Deep palmar arch 掌深弓 nFormed by radial artery and deep palmar branch of ulnar artery nCurve of arc
21、h lies across upper part of palmar at level with proximal border of extended thumb nGives rise to three palmar metacarpal arteries Veins of the upper limb Deep veins: accompany the arteries of the same region and bear similar names Superficial veins nCephalic vein 头静脉 qArises from the lateral side o
22、f the dorsal venous rete of hand qAscends on radial side of the forearm to the elbow and then in the lateral side of biceps brachii furrow, continues up the arm in the deltopectoral groove and then to the infraclavicular fossa, where it pierces clavipectoral fascia to drain into axillary vein nBasil
23、ic vein 贵要静脉 qArises from the medial side of the dorsal venous rete of hand qAscends on the ulnar side of forearm to the elbow and then in the medial bicepital brachii furrow to middle of the arm where it pierces the deep fascia and joins the brachial vein or axillary vein nMedian cubital vein 肘正中 静
24、脉 links cephalic vein and basilic vein in the cubital fossa. It is a frequent site for venipuncture to remove a sample of blood or add fluid to the blood The lymphatic drainage of upper limb Lymphatic vessels nSuperficialfollow the superficial veins, drain into supratrochlear and axillary lymph node
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