脑和脊髓的血管ppt课件

单击此处编辑母版标题样式,单击此处编辑母版文本样式,二级,三级,四级,五级,*,脑和脊髓的血管,*,Blood vessels of brain and spinal cord,脑和脊髓的血管,脑和脊髓的血管,Blood vessels of brain and spi,1,脑血管,脑血管的特点：,1.,脑动脉壁较薄，主要为其中、外膜较薄,2.,脑静脉壁因为缺乏平滑肌也较薄,3.,静脉不与动脉伴行,4.,有独特的硬脑膜窦,5.,血液与神经元之间的物质交换，是通过对物质有,选择性的血脑屏障，因此具有重要的临床意义,脑和脊髓的血管,脑血管脑和脊髓的血管,2,脑的动脉,1.,人脑的血供丰富，安静情况下，占体重,2%,的脑需全身供血量的的,20%,。脑组织不仅耗量很大，（占全身总耗氧量,20,30%,），而且无能源物质的储存。故脑组织对血供的依赖性是很强的。同样脑组织对缺氧也是十分敏感的。,2.,脑由两对动脉干供血,颈内动脉,椎,基底动脉,3.,两动脉在脑底形成大的动脉吻合,大脑动,脉环；,4.,脑动脉壁的中膜和外膜的管径远较同等大的,颅外动脉为薄,脑和脊髓的血管,脑的动脉脑和脊髓的血管,3,脑的动脉,1,、 颈内动脉,2,、椎基底动脉,颈内动脉,基底动脉,椎动脉,脑和脊髓的血管,脑的动脉颈内动脉基底动脉椎动脉脑和脊髓的血管,4,Arteries of brain,Two sources,Internal carotid artery,: supplies anterior 2/3 of cerebral hemisphere and parts of diencephalon,Vertebral artery,: supplies postterior 1/3 of cerebral hemisphere and parts of diencephalon, brain stem and cerebellum,脑和脊髓的血管,Arteries of brainTwo sources脑,5,脑血管配布方式,1.,旁正中动脉 是从大脑动脉环内侧发出的中央动 脉_内侧中,央动脉，发出后在中线两侧穿入脑实质， 供应,中线附近的中央核区。,2.,长旋动脉 是从大脑动脉环发出的大脑前、中、后动脉。由,脑的腹侧面绕至内侧面或背外侧面，输送血液经,过长距离达大脑半球表面，形成广泛吻合的软膜,动脉网，再发出分支穿入脑实质。,3.,短旋动脉 是三个大脑动脉接近大脑动脉环处发出的分支_外,侧中央动脉。发出后走行短距离穿入脑实质，供,应长旋动脉与旁正中动脉营养范围以外的 部分。,脑和脊髓的血管,脑血管配布方式1.旁正中动脉 是从大脑动脉环内侧发出的中央,6,脑和脊髓的血管,脑和脊髓的血管,7,皮质支和中央支,供应大脑半球的动脉可分为皮质支和中央支。皮质支进入软膜后先吻合成网，然后从吻合网上发出细小分支，以垂直方向进入皮质，在脑实质内的长短不一，短支分布于皮质，长支可经皮质一直延伸到皮质下髓质。中央支起自动脉主干的近侧端，几乎垂直穿入脑实质供应脑内灰质核团，如基底核、丘脑等，也分布到脑的白质如内囊、外囊等。,脑和脊髓的血管,皮质支和中央支脑和脊髓的血管,8,颈内动脉,颈内动脉,在相当于甲状软骨上缘、或第,4,颈椎水平发自颈总动脉。在颈部上升，无分支，直达颅底。然后穿颞骨岩部颈动脉管，在破裂孔上份进入颅内。弯曲向前通过海绵窦，前进至蝶骨小翼前床突内侧处，穿海绵窦壁的硬脑膜，然后穿蛛网膜，进入蛛网膜下隙，再向后上方弯曲，在脑底面前穿质附近，发出脉络膜前动脉和后交通动脉后，分为大脑前动脉和大脑中动脉两大终支。,颈总动脉,颈内动脉,Internal carotid artery,脑和脊髓的血管,颈内动脉颈总动脉颈内动脉Internal caro,9,颈内动脉颅内段按,X,线解剖可分,5,段：,岩骨段（,C,5,）行于颞骨岩部内，由后外向,前内走形,海绵窦段（,C,4,）行于海绵窦内，由后向前,膝段（虹吸弯段,C,3,）由海绵窦段移行为床,突上段的 转折处，呈“,C”,形走向,床突上段（,C,2,）位于前后床突连线的 稍上,方，由前向后,终段（,C,1,）参与组成脑底动脉环,脑和脊髓的血管,颈内动脉颅内段按X线解剖可分5段：脑和脊髓的血管,10,3,2,4,1,5,C1,终段,C2,床突上段,C3,虹吸段,C4,海绵窦段,C5,岩骨段,脑和脊髓的血管,32415C1终段脑和脊髓的血管,11,Arteries of brain,颈部,岩部,海绵窦部,大脑部,颈内动脉,虹吸部,锁骨下动脉,椎动脉,基底动脉,分段,颈段,颈动脉管段,海绵窦段,脑段,脑和脊髓的血管,Arteries of brain颈部岩部海绵窦部大脑部颈,12,颈内动脉分支,Anterior cerebral artery,大脑前动脉,Middle cerebral artery,大脑中动脉,Anterior choroidal artery,脉络丛前动脉,Posterior communicating artery,后交通动脉,脑和脊髓的血管,颈内动脉分支Anterior cerebral artery,13,Internal carotid artery,颈内动脉,Anterior cerebral artery,大脑前动脉,Middle cerebral artery,大脑中动脉,Anterior choroidal artery,脉络丛前动脉,Posterior communicating artery,后交通动脉,前交通,动脉,脑和脊髓的血管,Internal carotid artery 颈内动脉An,14,Anterior cerebral artery,大脑前动脉,Joined the fellow of the opposite side by the,anterior communicating artery,Cortical branches,: supply all medial surface of the cerebral cortex as far back as the parietooccipital sulcus and superior border of the suprolateral surface of the cerebral hemisphere,Central branches,: supply caudate nucleus, anterior part of lentiform nucleus and anterior limb of internal capsule,脑和脊髓的血管,Anterior cerebral artery大脑前动脉脑,15,脑和脊髓的血管,脑和脊髓的血管,16,大脑后动脉,大脑前动脉,眶动脉,额极动脉,额叶前内侧支,额叶中内侧支,额叶后内侧支,旁中央动脉,楔前动脉,胼周动脉,脑和脊髓的血管,大脑后动脉大脑前动脉眶动脉额极动脉额叶前内侧支额叶中内侧支额,17,大脑后动脉,大脑前动脉,大脑中动脉,脑和脊髓的血管,大脑后动脉大脑前动脉大脑中动脉脑和脊髓的血管,18,Middle cerebral artery,大脑中动脉,Cortical branches,: supply most of superolateral surface of cerebral hemisphere and insular lobe,Central branches,: supply lentiform and caudate nuclei, genu and posterior limb of internal capsule (lenticulostriate artery),脑和脊髓的血管,Middle cerebral artery大脑中动脉脑和脊,19,脑和脊髓的血管,脑和脊髓的血管,20,脑和脊髓的血管,脑和脊髓的血管,21,脑和脊髓的血管,脑和脊髓的血管,22,Anterior choroidal artery,脉络丛前动脉,: passes backward, enters inferior horn of lateral ventricle, and ends in choroid plexus. It supplies lateral geniculate body, posterior limb of internal capsule, middle 3/5 of crus cerebri,and globus pallidus,Posterior communicating artery,后交通动脉,: runs backward to join posterior cerebral artery,脑和脊髓的血管,Anterior choroidal artery脉络丛前动,23,大脑中动脉,眶额,a,中央前沟,a,中央沟,a,中央后沟,a,颞叶前,a,顶后,a,（顶前,a）,角回,a,颞叶中,a,颞叶后,a,脑和脊髓的血管,大脑中动脉眶额a中央前沟a中央沟a中央后沟a颞叶前a顶后a（,24,后交通动脉,脉络丛前动脉,脉络丛后动脉,大脑后动脉,颈内动脉,脑和脊髓的血管,后交通动脉脉络丛前动脉脉络丛后动脉大脑后动脉颈内动脉脑和脊髓,25,前交通动脉,大脑前动脉,颈内动脉,后交通动脉,大脑后动脉,大脑动脉环（,Willis,环）,脑和脊髓的血管,前交通动脉大脑前动脉颈内动脉后交通动脉大脑后动脉大脑动脉环（,26,Vertebral artery,椎动脉,Cranial branche,Anterior and posterior spinal arteries,脊髓前、后动脉,Posterior inferior cerebellar artery,小脑下后动脉,Branches of basilar artery,Anterior inferior cerebral artery,小脑下前动脉,Labyrinthine artery,迷路动脉,Pontine arteries,脑桥动脉,Superior cerebellar artery,小脑上动脉,Posterior cerebral artery,大脑后动脉,脑和脊髓的血管,Vertebral artery 椎动脉脑和脊髓的血管,27,Arteries of brain,颈部,岩部,海绵窦部,大脑部,颈内动脉,虹吸部,锁骨下动脉,椎动脉,基底动脉,脑和脊髓的血管,Arteries of brain颈部岩部海绵窦部大脑部颈,28,基底动脉,脊髓前动脉,椎动脉,脊髓后动脉,小脑下后动脉,小脑下前动脉,小脑上动脉,大脑后动脉,脑和脊髓的血管,基底动脉脊髓前动脉椎动脉脊髓后动脉小脑下后动脉小脑下前动脉小,29,基底动脉,椎动脉,小脑下后动脉,脊髓前动脉,大脑后动脉,小脑上动脉,脑桥动脉,迷路动脉,小脑下前动脉,脑和脊髓的血管,基底动脉椎动脉小脑下后动脉脊髓前动脉大脑后动脉小脑上动脉脑桥,30,后交通动脉,脉络丛前动脉,脉络丛后动脉,大脑后动脉,颈内动脉,脑和脊髓的血管,后交通动脉脉络丛前动脉脉络丛后动脉大脑后动脉颈内动脉脑和脊髓,31,Posterior cerebral artery,Cortical branches,: supply medial and inferior surfaces of temporal lobe and occipital lobe,Central branches,: supply dorsal thalamus, medial and lateral geniculate bodies, hypothalamus and subthalamus,脑和脊髓的血管,Posterior cerebral artery脑和脊髓的,32,大脑后动脉,大脑前动脉,顶枕,a,距状沟,a,颞下后动脉,颞下中动脉,颞下前动脉,颞极,a,脑和脊髓的血管,大脑后动脉大脑前动脉顶枕a距状沟a颞下后动脉颞下中动脉颞下前,33,大脑后动脉,大脑前动脉,大脑中动脉,脑和脊髓的血管,大脑后动脉大脑前动脉大脑中动脉脑和脊髓的血管,34,脑和脊髓的血管,脑和脊髓的血管,35,脑和脊髓的血管,脑和脊髓的血管,36,Cerebral arterial circle,( circle of Willis ),Formation,: formed by anterior,communicating artery, both,anterior cerebral arteries,internal carotid arteries,posterior communicating arteries, and,posterior cerebral arteries,Position,: lies on sella turcica around optic chiasma, tuber cinereum and mamillary bodies,脑和脊髓的血管,Cerebral arterial circle ( cir,37,脑和脊髓的血管,脑和脊髓的血管,38,前交通动脉,大脑前动脉,颈内动脉,后交通动脉,大脑后动脉,大脑中动脉,基底动脉,海绵窦,脑和脊髓的血管,前交通动脉大脑前动脉颈内动脉后交通动脉大脑后动脉大脑中动脉基,39,脑和脊髓的血管,脑和脊髓的血管,40,脑和脊髓的血管,脑和脊髓的血管,41,Blockage,Area of oxygendeprives brain,Thrombus,Plaque,脑和脊髓的血管,Blockage Area of oxygendeprive,42,脑和脊髓的血管,脑和脊髓的血管,43,Subarachnoid hemorrhage,Microaneurysm,Lenticulostriate arteries,豆纹动脉微动脉瘤,视网膜下出血,脑和脊髓的血管,Subarachnoid hemorrhageMicroan,44,Intracerebral,hemorhage,Arteriovenous,malformation,脑和脊髓的血管,Intracerebral Arteriovenous 脑和,45,脑和脊髓的血管,脑和脊髓的血管,46,脑的静脉与一般体静脉相比，有以下特点,1、管壁缺乏肌肉和弹力纤维，管壁薄，无弹性。,2、脑静脉大多不与动脉伴行。,3、脑静脉分浅、深两组，两组之间均存在吻合。,4、脑静脉干穿出软膜，跨过蛛网模下隙，注入,硬脑膜窦。,5、脑静脉和硬脑膜窦内没有防止血液倒流的静脉瓣,装置，仅在脑静脉开口于硬脑膜窦处有瓣膜，,起改变血流方向的作用。,Veins of brain,脑和脊髓的血管,脑的静脉与一般体静脉相比，有以下特点1、管壁缺乏肌肉和弹力纤,47,Veins of brain,Superficial cerebral veins,Drain blood from cortex and subcortical medullary substance and empty into adjacent sinuses of dura mater,脑和脊髓的血管,Veins of brainSuperficial cere,48,脑和脊髓的血管,脑和脊髓的血管,49,以外侧沟为界，分为上、中、下三组,大脑上静脉 上矢状窦,大脑中浅静脉 大交通静脉 大脑上静脉 上矢状窦,枕交通静脉 横窦,大脑下静脉 横窦,脑和脊髓的血管,以外侧沟为界，分为上、中、下三组大脑上静脉 上,50,Veins of brain,Deep cerebral veins,: drain deeper parts of hemispheres, basal nuclei, internal capsule, diencephalon and choroid plexus, ultimately form,great cerebral vein,which enter straight sinus,脑和脊髓的血管,Veins of brainDeep cerebral ve,51,大脑深静脉,大脑内静脉,大脑大静脉,基底静脉,枕内静脉,透明隔静脉,后终静脉,脉络膜静脉,前终静脉,丘脑纹状体上静脉,第三脑室,松果体,脑和脊髓的血管,大脑深静脉大脑内静脉大脑大静脉基底静脉枕内静脉透明隔静脉后终,52,大,脑,内,静,脉,大脑内静脉,位于第三脑室顶中缝两侧,由透明隔静脉、脉络膜静脉,和丘脑纹体上静脉在室间孔,后上缘汇合而成,后行，沿途接受侧脑室静脉,至松果体后方,两侧大脑内静脉合成,大脑大静脉,脑和脊髓的血管,大大脑内静脉位于第三脑室顶中缝两侧脑和脊髓的血管,53,基底静脉,大脑大静脉,大脑前静脉,大脑中深静脉,脑和脊髓的血管,基底静脉大脑大静脉大脑前静脉大脑中深静脉脑和脊髓的血管,54,脑和脊髓的血管,脑和脊髓的血管,55,脑和脊髓的血管,脑和脊髓的血管,56,脑和脊髓的血管,脑和脊髓的血管,57,Blood vessels of spinal cord,Arteries of spinal cord,Two sources,Anterior and posterior spinal arteries,Branches of segmental arteries,: radicular arteries of posterior intercostals arteries, lumbar arteries, and lateral sacral arteries,Damage area: T1T4,ventral part of L1,vascular ring ( vasocorona ),脑和脊髓的血管,Blood vessels of spinal cordAr,58,2,、脊髓的血管,（,1,）脊髓的动脉,脊髓前动脉,脊髓后,动脉,椎动脉,椎动脉分支,肋间后动脉分支,腰动脉分支,节段动脉,脑和脊髓的血管,2、脊髓的血管脊髓前动脉脊髓后椎动脉椎动脉分支肋间后动脉分支,59,Blood vessels of spinal cord,Spinal veins:,drain into internal vertebral venous plexus,脑和脊髓的血管,Blood vessels of spinal cordS,60,