肌 学(一) 兰州大学基础医学院人体解剖教研室 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

第一节 总论 第二节 头肌 第三节 颈肌 第四节 躯干肌 January 07 第一节 总论 第二节 头肌 第三节 颈肌 第四节 躯干肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

第一节 总论 横纹肌 不随意肌 随意肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

总论 一、肌的形态和构造 二、肌的起止、配布和作用 三、肌的命名法 四、肌的辅助装置 五、肌的血管、淋巴管和神经 六、肌的发生与异常 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

一、肌的形态和构造 骨 骼 肌 肌的形态 肌腹 muscle belly 肌腱 tendon 长肌 短肌 扁肌 轮匝肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

二、肌的起止、配布和作用 起点或定点 止点或动点 起点 止点 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

肌的起止、配布和作用 原动肌 协同肌 拮抗肌 固定肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

肌的起止、配布和作用 骨骼肌牵引骨骼而产生运动，其作用恰像杠杆装置，具有三种基本形式： 第一种为平衡杠杆运动。 第二种为省力杠杆运动。 第三种为速度杠杆运动。 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

三、肌的命名法 肌按形状、大小、位置、起止点、作用等命名。 按形状命名：斜方肌、三角肌等 按位置命名：冈上肌、冈下肌、骨间肌等 按肌的形态结构和部位综合命名：肱二头肌、股四头肌等 按大小和位置综合命名：胸大肌、腰大肌等 按其起止点命名：胸锁乳突肌、胸骨舌骨肌等 按作用命名：旋后肌、大收肌等 按位置和肌束的方向命名：腹外斜肌、腹横肌等 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

四、肌的辅助装置 在肌的周围有辅助装置协助肌的活动，具有保持肌的位置、减少运动时的摩擦和保护等功能，包括筋膜、滑膜囊、腱鞘和籽骨等。 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

肌的辅助装置—筋 膜 浅筋膜 深筋膜 大腿中部水平切面 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

肌的辅助装置—滑膜囊 滑膜囊 synovial bursa 为封闭的结缔组织囊，壁薄，内有滑液，多位于腱与骨面相接触处，以减少两者之间的摩擦。有的滑膜囊在关节附近和关节腔相通。滑膜囊炎症可影响肢体局部的运动功能。 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

肌的辅助装置—腱 鞘 腱鞘 tendinous sheath 是包围在肌腱外面的鞘管，存在于活动性较大的部位，如腕、踝、手指和足趾等处。腱鞘可分纤维层和滑膜层两部分。 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

肌的辅助装置 腱 鞘 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

肌的辅助装置—籽 骨 籽骨 sesamoid bone 在肌腱内发生，直径一般只有几毫米，但髌骨例外，为全身最大的籽骨。 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

五、肌的血管、淋巴管和神经 血液供应 淋巴回流 神经支配 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

第二节 头肌 一、面肌 二、咀嚼肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

一、面 肌 面肌主要分布于面部口、眼、鼻等孔裂周围。 可分为环形肌和辐射肌两种。 有闭合或开大上述孔裂的作用，同时牵动面部皮肤显示喜怒哀乐等各种表情，故面肌又叫表情肌。 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

头肌—面 肌 面肌包括： 颅顶肌 —— 眼轮匝肌 口周围肌 鼻肌 枕额肌 左右各一 额腹 帽状腱膜 枕腹 January 07 颅顶肌 —— 眼轮匝肌 口周围肌 鼻肌 额腹 枕额肌 左右各一 帽状腱膜 枕腹 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

头肌—面 肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

二、咀嚼肌 咀嚼肌配布于下颌关节周围，参与咀嚼运动。 包括： 咬肌 颞肌 翼外肌 翼内肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

头肌—咀嚼肌 翼内肌 翼外肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

第三节 颈肌 颈以斜方肌前缘为界分为前后两部：前部为狭义的颈部，后部为项部。 一、颈浅肌与颈外侧肌 二、颈前肌 三、颈深肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

一、颈浅肌与颈外侧肌 胸锁乳突肌 颈阔肌 一侧收缩使头向同侧侧屈，脸转向对侧；两侧收缩使头后仰。 拉口角向下，并使颈部皮肤出现皱褶。 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

二、颈前肌 颈前肌 舌骨上肌群 舌骨下肌群 作用： 上提舌骨 二腹肌 使舌升高 下颌舌骨肌茎突舌骨肌颏舌骨肌 推挤食团入咽 关闭咽峡 胸骨舌骨肌 肩胛舌骨肌 胸骨甲状肌 甲状舌骨肌 作用： 下降舌骨和喉 舌骨下肌群 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

颈前肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

颈前肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

三、颈深肌 颈深肌 外侧群 内侧群 前斜角肌 中斜角肌 后斜角肌 头长肌 椎前肌 颈长肌 作用： 一侧收缩，颈侧屈 两侧收缩，助深吸气，或者颈前屈。 前斜角肌 中斜角肌 后斜角肌 外侧群 颈深肌 头长肌 颈长肌 作用： 屈头、屈颈 内侧群 椎前肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

颈深肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

第四节 躯干肌 一、背肌 二、胸肌 三、膈 四、腹肌 五、会阴肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

一、背肌 背肌 背浅肌 背深肌 一侧收缩使颈向同侧屈、脸转向对侧；两侧同时收缩使头后仰 斜方肌 背阔肌 使肱骨内收、旋内和后伸 肩胛提肌 上提肩胛骨，肩胛下角转向内 背肌 牵引肩胛骨向内上并向脊柱靠拢 菱形肌 背深肌 使脊柱后伸和仰头，一侧收缩使脊柱侧屈 竖脊肌 单侧收缩使头转向同侧，两侧收缩使头后仰 夹肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

躯干肌 背肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

躯干肌 背肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

躯干肌—背肌 背部筋膜被覆于斜方肌和背阔肌表面的深筋膜较薄弱，但在竖脊肌周围的筋膜特别发达，称胸腰筋膜。 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

二、胸肌 胸肌 胸上肢肌 胸固有肌 肩关节内收、旋内及前屈 胸大肌 拉肩胛骨向下 胸小肌 拉肩胛骨向前 前锯肌 提肋助吸气 肋间外肌 降肋助呼气 肋间内肌 胸固有肌 降肋助呼气 肋间最内肌 胸横肌 拉肋向下助呼气 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

躯干肌—胸肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

三、膈 分为三部： 三个裂孔： 作用： 胸骨部—起自剑突后面 肋部—起自下6对肋骨和肋软骨 腰部—左、右膈脚起自上2-3个腰椎 主动脉裂孔 食管裂孔 腔静脉裂孔 作用： 主要的呼吸肌 与腹肌同时收缩能增加腹压 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

躯干肌—膈 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

四、腹肌 后群：腰方肌和腰大肌 位于胸廓与骨盆之间，参与组成腹壁，分为两部分： 前外侧群：腹外斜肌、腹内斜肌、腹横肌和腹直肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

前外侧群 腹外斜肌 腹内斜肌 腹横肌 腹直肌 腹股沟韧带 腔隙韧带 耻骨梳韧带 腹股沟管浅环 联合腱 腱划 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

腹直肌鞘和白线 腹直肌鞘：包绕腹直肌，由腹前外侧壁三块扁肌的腱膜形成。分前、后两层。 白线：位于腹前壁正中线上，为左右腹直肌鞘之间的隔。 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

后 群 腰大肌 腰方肌 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

腹股沟管 腹股沟管：为男性精索或女性子宫圆韧带所通过的一条肌和腱之间的裂隙。 腹股沟管深环 腹股沟管浅环 January 07 腹股沟管深环 腹股沟管浅环 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

股股沟三角 股股沟三角：位于腹前壁下部，由腹直肌外侧缘、股股沟韧带和腹壁下动脉围成的三角区。 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song

腹部筋膜 腹部筋膜包括： 浅筋膜：Camper筋膜、Scarpa筋膜。 深筋膜 腹内筋膜：如腹横筋膜、膈下筋膜盆筋膜等。 January 07 Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All rights reserved by Prof.YP Hou and YF Song