《动脉系统》PPT课件.ppt

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1、January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,动脉系统Arterial system,兰州大学基础医学院人体解剖学研究所,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,动脉示意图,January,2007,Copyright

2、 Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,第一部分,动脉总论,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,动脉总论,动脉的定义动脉的分布规律,January,2007,Copyright Depart.Anatomy,School of Medicine,Lan

3、zhou University.All right reserved by YP HOU and YF SONG,一、动脉的定义,动脉(artery):指从心脏起始输送血液到全身各器官的血管。由左心室发出的主动脉及各级分支运送动脉血；由右心室发出的肺动脉干及其分支则输送静脉血。动脉干的分支，离开主干入器官前的一段称为器官外动脉，入器官后叫器官内动脉。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,二、动脉的分

4、布规律,器官外动脉的分布规律器官内动脉的分布规律,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,上下肢的供血动脉,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,动脉血管分布特点,January,2007,Copyright

5、Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,动脉血管分布特点,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,2.器官内动脉的分布规律,器官内动脉的分布与器官的构造有关，结构相似的器官其动脉分布状况大致相同。实质性器官：放射型、纵行型和集中型中空性器官：放射型、纵行型和

6、横行型分叶状器官：放射型肌：沿肌纤维束走行,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,动脉血管分布特点,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,第二部分,动脉各论,January,2007,Copyright De

7、part.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,动脉的分类,肺循环的动脉体循环的动脉,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,肺循环的动脉,肺动脉(pulmonary trunk)位于心包内，系一粗短的动脉干。起于右心室，在升主动脉前方向左后上方斜行，至主动脉弓下分左、

8、右肺动脉。经再次分支后进入左、右肺相应肺叶。,动脉韧带（arterial ligament）动脉导管闭锁遗迹，由肺动脉干分叉处稍左连于主动脉弓下缘。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,体循环的动脉,左颈总动脉 左锁骨下动脉 左髂总动脉髂内动脉 左心室升主动脉主动脉弓降主动脉 右髂总动脉髂外动脉（冠状动脉）头臂干,January,2007,Copyright Depart.Anatomy,Schoo

9、l of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,主动脉,主动脉(aorta)是体循环的动脉主干。,走行：左心室发出，起始段为升主动脉，向右前上方斜行，在右侧第2胸肋关节高度移行为主动脉弓，弯向左后方，达第4胸椎下缘处移行为胸主动脉，下行，达第12胸椎穿主动脉裂孔，移行为腹主动脉，下行至第4腰椎下缘处分为左、右髂总动脉。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right res

10、erved by YP HOU and YF SONG,升主动脉发出左、右冠状动脉。主动脉弓凸侧从右向左发出3大分支：头臂干、左颈总动脉和左锁骨下动脉。,主动脉弓壁外膜下有丰富的游离神经末梢称压力感受器;主动脉弓下，靠近动脉韧带处有2-3个粟粒样小体，称主动脉小球，为化学感受器。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,（一）颈总动脉,颈总动脉是头颈部的主要动脉干。左侧发自主动脉弓,右侧起于头臂干。主要

11、分支（供应：头、面、颈部）：颈外动脉面动脉颞浅动脉（注意：脑膜中动脉）上颌动脉颈内动脉特殊的动脉结构：颈动脉窦和颈动脉小体。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,颈总动脉,颈总动脉上段位置表浅，头面部大出血时，在胸锁乳突肌前缘，平环状软骨弓的侧方，将动脉压向后内方的第6颈椎横突上急救止血。,颈总动脉是头颈部的主要动脉干。左侧发自主动脉弓,右侧起于头臂干。,January,2007,Copyright

12、 Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,颈动脉窦和颈动脉小球,颈动脉窦（压力感受器）是颈总动脉末端和颈内动脉起始部膨大部分，其中有丰富的游离神经末梢，称压力感受器。血压增高时，可反射性降低血压。,颈动脉小球（化学感受器）是一个扁椭圆形小体，借结缔组织连于动脉杈的后方，为化学感受器，可感受血液中的CO2分压、O2分压、H+浓度变化。当血中O2分压降低或CO2分压增高时，反射性地使呼吸加深加快。,January,2007,Copyright Depa

13、rt.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,在颈部无分支,自颈总动脉发出后，垂直上行至颅底，经颈动脉管入颅腔，分支分布于视器和脑。,颈内动脉,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,分支：1.甲状腺上动脉2.舌动脉3.面动脉4.枕动脉5.耳后动脉6.上颌动脉7.颞浅动脉

14、8.咽升动脉,颈外动脉,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,（二）锁骨下动脉,锁骨下动脉，左侧起于主动脉弓，右侧起于头臂干。其主干直接延续为腋动脉。主要分支（供应：上肢、胸壁、脑、脊髓）：椎动脉胸廓内动脉甲状颈干,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved

15、 by YP HOU and YF SONG,锁骨下动脉,椎动脉：起于前斜角肌内侧，向上穿6-1颈椎横突孔，经枕骨大孔入颅，分支分布于脑和脊髓。,胸廓内动脉：起于锁骨下动脉下面,向下入胸腔,沿1-6肋软骨后面下降,分布于胸前壁、心包、膈和乳房等。,甲状颈干：起于椎动脉外侧,分为甲状腺下动脉、肩胛上动脉,分布于甲状腺、咽喉、气管食管及肩部肌等处。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,1.腋动脉,胸上动

16、脉：分布于第1、2肋间隙。,腋动脉行于腋窝深部，至背阔肌的下缘移行为肱动脉。,胸肩峰动脉：分布于胸大、小肌，三角肌和肩关节。,胸外侧动脉：分布于前锯肌、胸大、小肌和乳房。,肩胛下动脉：分为胸背动脉和旋肩胛动脉。前者至背阔肌和前锯肌，后者至冈下窝附近诸肌。,旋肱后动脉：伴腋神经穿四边孔，绕肱骨外科颈至三角肌和肩关节等处。,旋肱前动脉：分布至肩关节及邻近肌；与旋肱后动脉吻合。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF

17、SONG,2.肱动脉,肱动脉沿肱二头肌内侧下行至肘窝，平桡骨颈高度分为桡动脉和尺动脉。,分支：肱深动脉，尺侧上、下副动脉、肱骨滋养动脉和肌支。分支营养臂肌和肱骨。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,3.桡动脉,经肱桡肌和旋前圆肌之间，继而在肱桡肌腱与桡侧腕屈肌腱之间下行，绕桡骨茎突至手背。末端与尺动脉掌深支吻合成掌深弓。,分支：掌浅支,拇主要动脉。,January,2007,Copyright D

18、epart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,4.尺动脉,在尺侧腕屈肌与指浅屈肌之间下行，经豌豆骨桡侧至手掌。末端与桡动脉掌浅支吻合成掌浅弓。,分支：掌深支,骨间总动脉。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,前臂主要动脉,January,2007,Copyrig

19、ht Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,5.掌浅弓,掌浅弓由尺动脉末端与桡动脉的掌浅支吻合而成，位于掌腱膜的深面。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,6.掌深弓,掌深弓由桡动脉末端与尺动脉的掌深支吻合而成，位于指深屈肌腱的深面。,January,

20、2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,（三）胸主动脉,胸主动脉（thoracic aorta）是胸部的动脉主干，位于胸腔后纵隔内，其分支有壁支和脏支。壁支：有肋间后动脉、肋下动脉和膈上动脉，分布于（胸壁、腹壁上部、背部和脊髓）等处。脏支：包括支气管支、食管支和心包支，分布于（气管、支气管、食管和心包）等处。,January,2007,Copyright Depart.Anatomy,School of Medicin

21、e,Lanzhou University.All right reserved by YP HOU and YF SONG,胸主动脉,壁支：有肋间后动脉、肋下动脉和膈上动脉，分布于胸壁、腹壁上部、背部和脊髓等处。,脏支：较细小，包括支气管动脉、食管动脉和心包支，分布于同名器官。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,（四）腹主动脉,腹主动脉（abdominal aorta），腹部的动脉主干，分支有脏支

22、和壁支之分，脏支较壁支粗大。壁支：主要有腰动脉、膈下动脉、骶正中动脉等。脏支：分为成对脏支和不成对脏支。成对脏支：肾上腺中动脉、肾动脉、睾丸动脉（男）或卵巢动脉（女）（主要供应：肾、肾上腺、睾丸或卵巢、输尿管）；不成对脏支：腹腔干、肠系膜上动脉和肠系膜下动脉。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,腹主动脉,壁支：膈下动脉、腰动脉和骶正中动脉。,成对脏支:肾上腺中动脉,肾动脉和睾丸动脉(卵巢动脉)。,

23、不成对脏支：腹腔干、肠系膜上动脉和肠系膜下动脉。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,腹腔干及其分支,腹腔干，为一粗短的动脉干，在主动脉裂孔稍下方起自腹主动脉前壁，迅即分为胃左动脉、肝总动脉和脾动脉。主要分支（供应：食管腹段、胃、肝胆脾胰、十二指肠上部）：胃左动脉肝总动脉脾动脉,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanz

24、hou University.All right reserved by YP HOU and YF SONG,腹腔干及其分支,胃左动脉：向左上方行至贲门附近，沿胃小弯在小网膜两层间折向右行，与胃右动脉吻合。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,腹腔干及其分支,肝总动脉：向右行至十二指肠上部上缘进入肝十二指肠韧带，分为肝固有动脉和胃十二指肠动脉。,脾动脉：沿胰上缘左行至脾门，入脾门前发出胰支、胃后动

25、脉、胃短动脉、胃网膜左动脉和脾支。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,肠系膜上动脉及其分支,肠系膜上动脉，在腹腔干稍下方，约平第1腰椎高度起自腹主动脉前壁，经胰头与胰体交界处后方下行，越过十二指肠水平部前面进入肠系膜根，向右髂窝方向走行。其分支如下：胰十二指肠下动脉空肠动脉和回肠动脉回结肠动脉右结肠动脉中结肠动脉,January,2007,Copyright Depart.Anatomy,Scho

26、ol of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,肠系膜上动脉,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,回结肠动脉及分支,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserv

27、ed by YP HOU and YF SONG,肠系膜下动脉及其分支,肠系膜下动脉，约平第3腰椎高度起于腹主动脉前壁，行向左下方，分支分布于降结肠、乙状结肠和直肠上部。主要分支：左结肠动脉乙状结肠动脉直肠上动脉,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,肠系膜下动脉,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou Univ

28、ersity.All right reserved by YP HOU and YF SONG,（五）髂总动脉,分支：髂内动脉髂外动脉,髂总动脉自腹主动脉分出后，沿腰大肌内侧下行至骶髂关节处分为髂内动脉和髂外动脉。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,1、髂内动脉,髂内动脉是盆部的动脉主干，为一短干，沿盆腔侧壁下行，发出壁支和脏支。壁支：闭孔动脉臀下动脉和臀上动脉髂腰动脉和骶外侧动脉脏支：脐动脉膀胱

29、下动脉和直肠下动脉阴部内动脉子宫动脉,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,髂内动脉(壁支),闭孔动脉：沿骨盆侧壁行向前下，穿闭孔膜至大腿内侧，分支至大腿内侧群肌和髋关节。,臀下动脉和臀上动脉：分别经梨状肌上、下孔至臀部，分支至臀肌和髋关节。,髂腰动脉和骶外侧动脉：前者分布于髂肌和腰大肌；后者分布于盆腔后壁及骶管内结构。,January,2007,Copyright Depart.Anatomy,Sc

30、hool of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,髂内动脉(脏支),脐动脉：胎儿时期动脉干，远端闭锁，近端发出2-3条膀胱上动脉，分布于膀胱上、中部。,膀胱下动脉：分布于膀胱底、精囊和前列腺。在女性分布于膀胱和阴道。,直肠下动脉：分布于直肠下部，并与直肠上动脉的分支吻合。,子宫动脉：沿盆侧壁下行，在子宫颈外侧2cm处从输尿管前方跨过并与之交叉，分支营养子宫、卵巢、输卵管和阴道。,阴部内动脉：臀下动脉前方下行，穿梨状肌下孔出骨盆，发出肛动脉、会阴动脉和阴茎动脉。分布于肛门、会阴部和外生殖器。,

31、January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,会阴部的动脉(男性),January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,2、髂外动脉,髂外动脉沿腰大肌内侧缘下行，经腹股沟韧带中点深面至股前部，移行为股动脉。主要分支：腹壁下动脉（腹

32、直肌）旋髂深动脉（髂嵴及邻近肌）,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,髂外动脉,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,3、股动脉,股动脉是下肢的动脉主干，在股三角内下行，经收肌管，出收肌腱裂孔至腘窝，移行腘

33、动脉。主要分支（供应：大腿肌、髋关节、膝关节）：股深动脉 旋股内、外侧动脉 穿动脉腹壁浅动脉旋髂浅动脉阴部外动脉,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,走行：股动脉是下肢的动脉主干，在股三角内下行，经收肌管，出收肌腱裂孔至腘窝，移行腘动脉。,股动脉,分支：股深动脉旋股内侧动脉旋股外侧动脉 穿动脉腹壁浅动脉旋髂浅动脉阴部外动脉,January,2007,Copyright Depart.Anatomy,

34、School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,4、腘动脉,腘动脉在腘窝深部下行，至腘肌下缘，分为胫前动脉和胫后动脉。腘动脉在腘窝发出关节支和肌支至膝关节及邻近肌。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,5、胫后动脉,胫后动脉沿小腿后面浅、深屈肌之间下行，经内踝后方转到足底，分为足底内侧动脉和

35、足底外侧动脉两终支。主要分支（供应：小腿后群、外侧群肌肉及足底）：腓动脉足底内侧动脉足底外侧动脉,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,胫后动脉及分支,腓动脉：起于胫后动脉上部，沿腓骨内侧下行，分支营养邻近诸肌和胫、腓骨。,足底内侧动脉和足底外侧动脉：前者分布于足底内侧；后者分布于足底外侧及足趾。,January,2007,Copyright Depart.Anatomy,School of Medi

36、cine,Lanzhou University.All right reserved by YP HOU and YF SONG,6、胫前动脉,胫前动脉由腘动脉发出后，穿小腿骨间膜至小腿前面，在小腿前群肌之间下行，至踝关节前方移行为足背动脉。胫前动脉，沿途分支营养小腿前群肌，并分支参与形成膝关节网。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,胫前动脉及分支,胫前动脉由腘动脉发出后,穿小腿骨间膜至小腿前面,

37、在小腿前群肌之间下行,至踝关节前方移行为足背动脉。,胫前动脉沿途分支营养小腿前群肌，并分支参与形成膝关节网。,January,2007,Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG,7、足背动脉,足底深支穿第1跖骨间隙至足底，与足底外侧动脉末端吻合成足底深弓。,走行：是胫前动脉的直接延续，经母长伸肌腱和趾长伸肌腱之间前行，发出第1跖背动脉和足底深支两终止。分支：（1）足底深支（2）第1跖背动脉（3）弓状动脉,第1跖背动脉沿第1跖骨间隙前行，分支至母指背面侧缘及第2趾背内侧缘。,弓状动脉沿跖骨底呈弓形向外行，发出3支跖背动脉，后者又各分出2支趾背动脉，分布于2-5趾。,