绪论骨学Osteology

Human anatomy Basic Concepts of Anatomy n Definition: human anatomy, the oldest science dealing with the structures and functions of body q Gross anatomy: n systematic anatomy n regional anatomyq Applied anatomyq Clinical anatomy 人 体 解 剖 学 发 展 简 史HippcratesH ippocrates-希波克拉底（公元前460377）古希腊名医、解剖学鼻祖。 GalenG alen- 伽林（130200）古希腊名医、解剖学家，著医经，对血液流动、神经分支和脑、心等器官有具体描述。 Vesalius-(15141564) 现代解剖学的奠基人，1543年出版了人体构造这一划时代的解剖学巨著。Vesalius Harvey-(15781657)解剖生理学家，发现了血液循环的原理，确定血液是在一个封闭的管道内循环。著有血液循环论、动物的发生两书。开创了动物实验研究的道路。 我 国 人 体 解 剖 学 的 发 展 历 程n公元前300200黄帝内经已有对人体解剖的记载。n两宋时代五脏六腑、存真图描述了解剖学知识。n王清任（17681831）编著的医林改错更为详细的描述了解剖学知识。n 19492003年我国解剖学工作者队伍迅速成长，编写了多套具有我国特色的解剖学教材和解剖学图谱，对我国解剖学事业的发展做出了巨大的贡献。 人 体 解 剖 教 学 特 点n人体解剖学的教学包括讲授和实地解剖。主要讲授各系统的总论和各解剖操作区的重点内容。实地解剖采取分组形式，在教师指导下，按照解剖操作指导，参照图谱由学生亲自动手解剖尸体，部分内容观察标本和模型。同时，密切结合活体的观察和触摸，并适当的结合一些临床病例讨论以增强对解剖学内容的理解和记忆。n教学大纲所列教学内容按要求程度的不同，分为“掌握内容”和“了解内容”两级。掌握内容为重点内容，学生必须通过反复学习与思考达到牢固掌握、熟练描述、准确指认和联系实际应用的程度。了解内容则要求学生达到一般的认识和了解。 Descriptive anatomical termsn The anatomical position: (解 剖 学 姿 势 ) The body is upright, legs together, and directed forwards. The palms are turned forward, with the thumbs laterally. 方 位 术 语 )n superior 上, inferior 下n anterior (ventral) 前 ( 腹侧 ) posterior (dorsal) 后 ( 背侧 )n medial 内侧, lateral 外侧n internal 内, external 外n superficial 浅, profound 深n proximal 近侧, distal 远侧n ulnar 尺侧, radial 桡侧 n tibial 胫侧，fibular 腓侧 Anatomical axes and planes （轴与面）n Axis 轴：q Vertical axis 垂直轴q Sagittal axis 矢状轴q Coronal axis 冠状轴n Plane面: q Sagittal plane 矢状面q Coronal plane 冠状面q Horizontal plane 水平面 或transverse plane 横切面 The Locomotor System 运 动 系 统n运动系统由bone 骨、joints关节和muscles 骨骼肌组成，占成人体重60%q骨起杠杆作用q关节是运动的枢纽q骨骼肌是动力器官n功能: q support 支持q Protection 保护q Locomotion 运动 Introduction of the osteology 骨 学 总论n Bones in adult are 206 in number.n Classification of bone Bones are classified according to their position and shape n The position can be:q skull 颅骨q bones of trunk 躯干骨q appendicular skeleton 四肢骨 n Types of shape include: q long bone 长骨q short bone 短骨q flat bone 扁骨 q irregular bone不规则骨 n Long bones (found in limbs): q Diaphysis or shaft 骨干, which is hollow (called medullary cavity 骨髓腔), filled with bone marrowq Two endsepiphysis 骺 articular surface 关节面, metaphysis干骺端, epiphysial cartilage 骺软骨, and epiphysial line 骺线 n Short bones: cuboidal in shape, e.g. carpal bones n Flat bones: thin, n Irregular bones: have any irregular or mixed shape, e.g. vertebrae, pneumatic bones含气骨* Sesamoid bones籽骨: develop within tendon General structures of bone骨 的 构 造n Bone substance 骨质q compact bone 骨密质q spongy bone 骨松质 呈海绵状，由trabeculae骨小梁构成 In the flat bones of the skull, the layers of compact bone are called the outer plate and inner plate外板和内板, while the layer of spongy bone is called the diplo 板障 n Periosteum 骨膜: q Outer or fibrous layer q Inner layer is vascular and provides the underlying bone with nutrition. It also contains osteoblasts(成骨细胞) Endosteum骨内膜 is a single-cellular osteogenic layer lining the inner surface of bone.n Bone marrow 骨髓 q Red marrow 红骨髓: haematopoietic 造血q Yellow marrow黄骨髓: fatty Chemical composition and physical properties化 学 成 分 和 物 理 性 质n Organic material有机质： 主要是骨胶原纤维束和粘多糖蛋白。构成支架，赋予骨的弹性和韧性。n Inorganic salts无机质： 主要是碱性磷酸钙。赋予骨硬度和脆性 Organic material Inorganic saltsChildren 1 1Adult 3 7Old 1 4 Bones of trunk 躯 干 骨n Composition: vertebrae, sacrum, coccyx, sternum and ribs Vertebrae 椎骨n There are 33 vertebrae in children, arranged as follows:n Cervical vertebrae 颈椎 C.7n Thoracic vertebrae 胸椎 T.12 n Lumbar vertebrae 腰椎 L.5n Sacral vertebrae 骶椎 S.5 sacrum 骶骨n Coccygeal vertebrae 尾椎 Co.34 coccyx尾骨 General features of vertebraen Vertebral body 椎体n Vertebral arch 椎弓q pedicle of vertebral arch 椎弓根: sup. and inf. Vertebral notch 椎上、下切迹 q lamina of vertebral arch 椎弓板n process (7): q spinous process 棘突q transverse process 横突q sup. and inf. articular processes 上、下关节突n Vertebral foramen 椎孔 n Vertebral canal 椎管n Intervertebral foramen 椎间孔 Regional variations of vertebraeCervical vertebraen Vertebrae Body: small n Vertebral foramen: larger and triangularn Spinous processes: short and bifid in C3 to C5, long in C6,and longer in C7n Transverse processes: short and bifid, transverse foramen横突孔 n Articular processes: horizontal Atypical vertebeaen Atlas寰椎 (C1) q Body and spinous process absent, consists of anterior and posterior arches, and two lateral massesq Groove for vertebral artery 椎动脉沟 n Axis枢椎 (C2): distinguished by dens齿突 which articulates with dental fovea of anterior arch of atlas n Carotid tubercle: 颈动脉结节: anterior tubercle of transverse process of C6n Vertebra prominens 隆椎(C7):contains long and non-bifid spinous process, it is visible with neck flexed, used as clinical landmark in counting cervical and thoracic spinous processes Thoracic vertebrae n Vertebrae Body ： heart-shape, superior and inferior costal fovea 上、下肋凹n Vertebral foramen： smaller, rounder n Spinous processes： long, point obliquely downward n Transverse processes： transverse costal fovea 横突肋凹 n Articular processes: coronal Lumbar vertebrae n Vertebrae Body： larger, kidney-shape n Vertebral foramen: larger and triangular n Spinous processes: projects horizontally n Transverse processes: long n Articular processes: sagittal Sacrum n Anterior surface: promontory岬, anterior sacral foramina 骶前孔(four pairs) n Posterior surface: median sacral crest 骶正中嵴, posterior sacral foramina (four pairs), sacral hiatus骶管裂孔，sacral cornu 骶角 n Lateral part: auricular surface耳状面, sacral tuberosity骶粗隆 Transsacral (epidural) anasthesia Cornua palpationSacral hiatus Sternum n Manubrium sterni 胸骨柄: jugular notch 颈静脉切迹, clavicular notch 锁切迹n Body of sternum 胸骨体 n Xiphoid process Sternal angle 胸骨角: the junction of manubrium and body, which connects 2nd costal cartilage laterally, and lies opposite lower border of T4 posteriorly Sternal angle 胸骨角 which connects 2nd costal cartilage laterally, and lies opposite lower border of T4 posteriorly Ribs肋 : 12 pairn General featuresq Ribs 17 called true ribs真肋q Ribs 810 called false ribs 假肋 q Ribs 1112 called floating ribs 浮肋 Characteristics of “typical” ribn Posterior end: costal head 肋头, costal neck肋颈, costal tubercle肋结节 n Shaft: costal angle肋角, costal groove 肋沟n Anterior end Atypical ribn First rib: tubercle for scalenus anterior前斜角肌结节, sulcus for subclavian artery and vein 锁骨下动、静脉沟n 11th and 12th ribs lack costal necks, tubercles and angles The Bones of Limbs山东大学医学院 解剖教研室李振华 Bones of upper limbsComposition:n Should girdle 上肢带骨clavicle锁骨，scapula肩胛骨n Bones of free upper limb 自由上肢骨q Humerus肱骨 in arm q Radius桡骨 and ulna尺骨 in forearmq Carpal腕骨, metacarpals掌骨 and phalanges指骨 in hand Clavicle 锁 骨n “S” shaped, medial 2/3 convex forward and lateral 1/3 convex backwardn Sternal end胸骨端 medially and acromial end肩峰端 laterally Scapula 肩 胛 骨n Three bordersq Superior: coracoid process 喙突 , scapular notch 肩胛切迹q Lateral (axillary) border腋缘q Medial (vertebral) border脊柱缘n Three anglesq Superior: opposite to the 2nd rib q Inferior: opposite to the 7th rib or 7th intercostals spaceq Lateral: glenoid cavity关节盂, supra- and infraglenoid tubercles 盂上、下结节n Two surfacesq Anterior surface concave: subscapular fossa肩胛下窝q Posterior surface: supra- and infraspinous fossae冈上、下窝, spine of scapula 肩胛冈, acromion 肩峰 Humerus 肱 骨n Upper end: head of humerus肱骨头, anatomical neck解剖颈, greater and lesser tubercles大、小结节, crests of greater and lesser tubercle, 大、小结节嵴，intertubercular groove结节间沟, surgical neck外科颈n Shaft: deltoid tuberosity三角肌粗隆on lateral surface, and a groove for radial nerve桡神经沟 on posterior surface n Lower end: lateral and medial epicondyles内、外上髁, capitulum 肱骨小头, trochlea 肱骨滑车, coranoid fossa 冠突窝and radial fossa 桡窝 (anteriorly) and olecranon fossa鹰嘴窝 (posteriorly), and sulcus for ulnar nerve 尺神经沟 Radiusn Upper end: head of radius桡骨头, neck of radius桡骨颈, radial tuberosity 桡骨粗隆, and articular circumference环状关节面n Shaft：interosseous border骨间缘n Lower end: styloid process 茎突laterally, ulnar notch尺切迹 medially, and carpal articular surface腕关节面 inferiorly Fracture of the distal end pf the radius Ulnarn Upper end: olecranon鹰嘴 coronoid process 冠突 trochlear notch滑车切迹 radial notch 桡切迹 ulnar tubersity尺骨粗隆 n Lower end styloid process 尺骨茎突 head of ulna 尺骨头 Carpal bones 腕 骨n Proximal row (lateral to medial) scaphoid手舟骨, lunate月骨, triquetral三角骨 and pisiform豌豆骨n Distal row (lateral to medial) trapezium大多角骨, trapezoid小多角骨, capitate头状骨 and hamate钩骨Metacarpal bones掌 骨n Numbered one to five from thumb to little finger n Structure of eachbase (proximally), shaft, and head (distally)Phalanges of fingers 指 骨n Consist of 14 two for first digit (thumb) and three for each of other four digitsn Structure of each base (proximally), shaft, and trochlea of phalanx (distally), tuberosity of distal phalanx远节指骨粗隆 Bones of Lower LimbComposition: n Pelvic girdle: hip bone髋骨n Bones of free lower limb:q Femur股骨 in thigh ( patella髌骨) q Tibia胫骨 and fibula腓骨 in leg q Tarsals跗骨, metatarsals跖骨, phalanges of toes趾骨 in foot Hip bone Consisting of three fused bones, ilium, ischium, pubisn Ilium髂骨q Body of ilium 髂骨体 to form superior 2/5 of acetabulum髋臼q Ala of ilium 髂骨翼: iliac crest 髂嵴, anterior superior iliac spine 髂前上棘， anterior inferior iliac spine 髂前下棘, tubercle of iliac crest髂结节, posterior superior iliac spine 髂后上棘，posterior inferior iliac spine 髂后下棘, greater sciatic notch 坐骨 大切迹, gluteal surface 臀面，iliac fossa 髂窝, arcuate line弓状线, auricular surface 耳状面, iliac tuberosity 髂粗隆, n Ischium 坐骨q Body of ischium 坐骨体to form posterior and inferior 2/5 of acetabulum, ischial spine坐骨棘, lesser sciatic notch 坐骨小切迹q Ramus of ischium 坐骨支, ischial tuberosity 坐骨结节n Pubis 耻骨q Body of pubis 耻骨体to form anterior and inferior 1/5 of acetabulum, iliopubic eminence 髂耻隆起 q Superior ramus of pubis 耻骨上支: pecten of pubis 耻骨梳, pubic tubercle 耻骨结节, pubic crest 耻骨嵴, symphysial surface耻骨联合面q Inferior ramus of pubis耻骨下支: obturator foramen 闭孔n Acetabulum 髋臼formed by bodies of ischium, ilium and pubis Lunate surface月状面, acetabular fossa髋臼窝, acetabular notch髋臼切迹 Femur 股 骨n Upper end: femoral head股骨头, fovea of femoral head 股骨头凹, neck of femur 股骨颈, greater trochanter 大转子，lesser trochanter 小转子, intertrochanteric line 转子间线, intertrochanteric crest 转子间嵴n Shaft: linea aspera 粗线, gluteal tuberosity 臀肌粗隆, pectineal line耻骨肌线 ，popliteal surface 腘面 n Lower end: medial and lateral condyles内、外侧髁， medial and lateral epicondyles内、外上髁, adductor tubercle 收肌结节， intercondylar fossa髁间窝, patellar surface髌面 Fracture of the femoral neck Tibia 胫 骨n Upper end: medial and lateral condyles 内、外侧髁, intercondylar eminence 髁间隆起, fibular articular surface 腓关节面, tuberosity of tibia胫骨粗隆 n Shaft: interosseous border 骨间缘, soleal line 比目鱼肌线 n Lower end: fibular notch腓切迹, medial malleolus 内踝 Fibula 腓 骨n Upper end: fibular head 腓骨头, neck of fibula 腓骨颈n Shaft: interosseous border骨间缘n Lower end: lateral malleolus 外踝Patella 髌 骨n triangular sesamoid bone Tarsal bones 跗 骨Consist of seven short bones arranged in three rown Posterior row talus 距骨, calcaneus 跟骨n Intermediate row navicular bone 足舟骨n Anterior row medial, intermediate, and lateral cuneiforms 内侧、中间和外侧楔骨, cuboid bone 骰骨 Metatarsal bones 跖 骨n Consist of five elongated bones, numbered one to five medial to lateraln Structure of each base (proximally), shaft, and head (distally) in eachPhalanges of toes 趾 骨n Consist of 14two for first toe (hallux) and three for each of other four toes Surface landmarks: trochlea of talus距骨滑车, calcaneal tuberosity 跟骨结节, tuberosity of navicular bone 舟骨粗隆, and tuberosity of fifth metatarsal bone 第五跖骨粗隆 Skull颅山东大学医学院解剖教研室李振华 The skull is composed of 23 bones, which may be divided into the cerebral cranium and facial cranium n Cerebral cranium 脑颅(8) larger, upper and posterior part, contains and protects the brainq Single bones: include frontal bone 额骨, ethmoid bone 筛骨, sphenoid bone 蝶骨, occipital bone 枕骨 q Paired bones: include temporal bone 颞骨 parietal bone 顶骨 n Bones of facial cranium 面颅(15) smaller, lower, and anterior part, contains bones that surrounded the eye, nose and mouthq Single bones: include mandible下颌骨, vomer 犁骨 hyoid bone舌骨 q Paired bones: include maxilla 上颌骨, nasal bone 鼻骨, lacrimal bone 泪骨, palatine bone 腭骨, zygomatic bone 颧骨, inferior nasal concha 下鼻甲 Frontal boneZygomatic boneNasal boneMaxilla Mandible Sphenoid bone parietal bone Temporal boneOccipital bone 面颅上颌为中心，上鼻泪，下下颌，外颧内甲后犁腭，舌骨颈前单落脚。 Mandible下 颌 骨n Body of mandible q Superior border: alveolar arch 牙槽弓 q Inferior border: base of mandible下颌底q Outer surface: mental protuberance 颏隆凸, mental foramen 颏孔q Inner surface: mental spine颏棘, digastric fossa二腹肌窝n Ramus: has two vertical processes separated by mandibular notch下颌切迹 q Coronoid process 冠突q Condylar process 髁突n head of mandible 下颌头 n neck of mandible 下颌颈q Mandibular foramen 下颌孔， mandibular lingula下颌小舌q Angle of mandible下颌角q Masseteric tuberocity 咬肌粗隆 The skull as a whole 颅 的 整 体 观Skull viewed from above (superior view)n Bones: frontal额, paired parietal顶, occipital枕n Sutures: q coronal冠状缝, q sagittal 矢状缝, q lambdoid人字缝n parietal tuber 顶结节， parietal foramen顶孔Internal surface of the calvaria n sulcus for superior sagittal sinus上矢状窦沟n granular foveola 颗粒小凹 n arterial grooves 动脉沟Skull viewed from behind n external occipital protuberance 枕外隆凸n superior nuchal line上项线 Internal view of base of skull 颅 底 内 面 观Base of skull forms three fossae n Anterior cranial fossa 颅前窝n Meddle cranial fossa 颅中窝n Posterior cranial fossa 颅后窝 Anterior cranial fossa 颅 前 窝n Formed by orbital part of frontal bone, cribriform plate of ethmoid, and lesser wings of sphenoidn Structures: q frontal crest额嵴 q foramen cecum 盲孔 q crista galli 鸡冠 q cribriform plate 筛板 q cribriform foramina 筛孔 Meddle cranial fossa 颅 中 窝n Formed by the body and greater wings of sphenoid, petrous part of temporaln Structures:q body of sphenoid bone 蝶骨体 q hypophysial fossa 垂体窝 q optic canal 视神经管 q anterior clinoid process 前床突 q tuberculum sellae 鞍结节 q dorsum sellae 鞍背 q posterior clinoid process 后床突 q sella turcica 蝶鞍 Meddle cranial fossa 颅 中 窝q carotid sulcus 颈动脉沟 q superior orbital fissure 眶上裂q foramen rotundum 圆孔 q foramen ovale 卵圆孔 q foramen spinosum 棘孔q sulcus for middle meningeal artery 脑膜中动脉沟 q foramen lacerum 破裂孔 q internal opening of carotid canal 颈脉管内口q trigeminal impression 三叉神经压迹q tegmen tympani 鼓室盖 Posterior cranial fossa 颅 后 窝n Formed by occipital and the petrous part of temporaln Structures: q foramen magnum 枕骨大孔 q clivus 斜坡 q internal opening of hypoglossal canal 舌下神经管内口 q internal occipital protuberance 枕内隆凸q internal occipital crest枕内嵴 q sulcus for transverse sinus 横窦沟 q sulcus for sigmoid sinus 乙状窦沟 q jugular foramen 颈静脉孔 q internal acoustic pore 内耳门q internal acoustic meatus 内耳道 Skull seen from below (inferior view)n alveolar arch 牙槽弓n bony palate 骨腭n median palatine suture 腭正中缝n incisive foramina 切牙孔n incisive canal 切牙管n greater palatine foramen 腭大孔n posterior nasal apertures 鼻后孔n pterygoid process 翼突n occipital condyle 枕髁 n external opening of hypoglossal canal 舌下神经管外口n external opening of carotid canal 颈动脉管外口n styloid process 茎突n stylomastoid foramen 茎乳孔n mandibular fossa 下颌窝n articular tubercle 关节结节 Lateral view of the skull 颅 侧 面 观n external acoustic pore 外耳门 n mastoid process 乳突 n zygomatic arch 颧弓 n temporal fossa 颞窝 n pterion 翼点n pterygomaxillary fissure 翼上颌裂 n pterygopalatine fossa 翼腭窝 n sphenopalatine foramen 蝶腭孔 Skull viewed from the front (anterior view)颅 的 前 面 观n Frontal region: q frontal squama 额鳞 q frontal tuber 额结节 q superciliary arch 眉弓 q glabella 眉间 Orbit 眶pyramid-shaped paired cavitiesn Base: supraorbital notch 眶上切迹 infraorbital foramen 眶下孔n Apex: optic canal 视神经管n Walls q Superior: fossa for lacrimal gland 泪腺窝 q Medial: fossa for lacrimal sac 泪囊窝q Inferior: infraorbital fissure 眶下裂 q infraorbital groove 眶下沟 q infraorbital canal 眶下管 Bony nasal cavity 骨 性 鼻 腔n Roof: cribriform plate of ethmoidn Floor: bony palate n Lateral wall q Three nasal conchae (superior, middle and inferior) 上、中、下鼻甲q Nasal meatus underlying each concha (superior, middle and inferior) 上、中、下鼻道 q Sphenoethmoidal recess蝶筛隐窝 above superior nasal conchan Anterior piriform aperture 梨状孔n Posterior posterior nasal aperture 鼻后孔 communicates with pharynx Paranasal sinuses 鼻 旁 窦n Frontal sinus 额窦q Lies in frontal bone, deep to superciliary archq Drain to anterior part of middle meatus n Maxillary sinus 上颌窦q Largest paired sinus, lie in the body of maxilla;q Opening into middle nasal meatus n Ethmoidal cellules 筛窦q Lie in ethmoidal bone, contains large number of air cells, divided into anterior, middle and posterior groupsq Anterior and middle groups drain into middle nasal meatus, while posterior group drains into superior nasal meatusn Sphenoidal sinus 蝶窦 q Lies in body of sphenoid boneq Drain into sphenoethmoidal recess General characters of the skull at birthn The skull at birth is large in proportion to rest of the skeleton 1/4 (adult 1/7)n The facial portion equals about one eight that of the cranium in size, whereas in adult it is one half (1/4)n Many bones consist of more than one piecen Cranial frontanelles unossified membrane between the bones at the angles of parietal q Anterior frontanelle closes during middle of 2nd yearq Posterior frontanelle closes by the end of 2nd month after birthq Mastoid fontanelleq Sphenoidal fontanelle