Human Anatomy Glossary Explanation and Big Questions (with Answers)
1. Pterion: On the side of the cranium, where the frontal, parietal, temporal, and sphenoid bones meet is the weakest, often forming an H-shaped seam, called the pterion. The anterior branch of the middle meningeal artery passes through it.
2. Anterior fontanel: Located at the junction of the sagittal suture and the coronal suture, it is diamond-shaped, relatively large, and closes at 1-2 years old.
3. Cape (sacrum): The middle part of the upper edge of the bottom of the sacrum protrudes forward, called the cape.
4. Sternal angle: the junction of the sternal manubrium and the body protrudes slightly forward, called the sternal angle, and the two sides are flat against the second rib, which is an important sign for counting ribs.
5. Arcuate line: There are two arcuate lines in anatomy, one is the blunt bony ridge at the lower boundary of the ilium, which is called the arcuate line. It makes up the ossicles.
6. Inguinal canal: Located above the medial half of the inguinal ligament, it is a potential gap obliquely running between the abdominal muscle and the aponeurosis, about 4 to 5 cm long. Males have the spermatic cord and females have the round ligament of the uterus.
7. Inguinal (Hesselbach) triangle (Hesselbach triangle): Located in the lower part of the abdominal wall, the triangular area surrounded by the lateral border of the rectus abdominis, the inguinal ligament, and the inferior epigastric artery is called the inguinal (Hesselbach) triangle.
8. Upper gastrointestinal tract: In clinical work, the section from the oral cavity to the duodenum is usually called the upper gastrointestinal tract. (including oral,
Pharynx, esophagus, stomach, duodenum)
9. Pharyngeal isthmus: The pharyngeal isthmus, which is surrounded by the palate, the free edge of the palatine velum, the palatoglossal arches on both sides, and the root of the tongue, is the boundary between the oral cavity and the pharynx, and is also the narrow part between the oral cavity and the pharynx. Pyriform recess: In the larynx of the pharynx, between the sides of the larynx and the inner surface of the thyroid cartilage, the mucosa is sunken to form a piriform recess. This part is the part where foreign matter is often incarcerated and stays.
10. Pharyngeal recess: It is a predilection site for nasopharyngeal carcinoma.
11. McBurney point: It is the body surface projection of the root of the appendix, and it is the intersection point of the middle and outer 1/3 of the line connecting the umbilical cord and the right anterior superior iliac spine.
12. Anal sinus: feces often accumulate in the sinus, which is prone to infection and anal sinusitis.
13. Dentate line: the serrated circular line formed by the lower end of the anal column and the base of the anal valve, called the dentate line (anal skin line),
14. Anorectal ring: internal anal sphincter, longitudinal muscle of intestinal wall, superficial and deep parts of external anal sphincter, and pubis of levator ani muscle
The skeletal muscles together form a powerful muscular ring around the anal canal, the anorectal ring, which plays a very important role in sphinctering the anal canal.
15. Fossa ovalis (heart): The posterior portion of the medial wall of the right atrium is formed primarily by the atrial septum. There is an oval depression in the middle and lower part of the right side of the atrial septum, called the foramen ovale, which is a relic of the closure of the foramen ovale during the embryonic period. 4. Sinus node: located in the subepicardium of the upper 1/3 of the boundary groove at the junction of the superior vena cava and the right atrium, it is long fusiform, and is the heart
normal pacemaker.
16. Ligamentum arteriosum: There is a cord of fibrous connective tissue attached to the lower border of the aortic arch just to the left of the pulmonary bifurcation. It is
The remains of the ductus arteriosus atresia during the embryonic period are called ligament arteriosus. If the ductus arteriosus is not blocked after birth, it is called patent ductus arteriosus, which is one of the common congenital heart diseases.
17. Carotid sinus: It is the enlarged part of the end of the common carotid artery and the beginning of the internal carotid artery. The adventitia of the sinus wall is thick and rich in
Free nerve endings are baroreceptors that sense changes in blood pressure.
18. Carotid glomerulus: It is an oblate small body connected behind the bifurcation of the common carotid artery by connective tissue.
The organ can sense changes in the partial pressure of carbon dioxide, partial pressure of oxygen and hydrogen ion concentration in the blood.
19. Vein angle: the subclavian vein and the internal jugular vein merge into the brachiocephalic vein behind the sternoclavicular joint, the confluence of the two veins
Called the venous angle. The left and right venous horns are injected by the thoracic duct and right lymphatic duct, respectively.
20. Cistern chyli: In front of the first lumbar vertebra, the left and right lumbar trunks and intestinal trunks meet to form the enlarged thoracic duct origin,
Called the cisterns chyli.
twenty one. Upper respiratory tract: In clinical applications, the nose, pharynx, and larynx are called the upper respiratory tract.
twenty two. Paranasal sinuses: These are some air-containing cavities in the skull around the nasal cavity that open into the nasal cavity. The cavity is lined with mucous membrane and moves with the nasal mucous membrane. There are 4 pairs in total, namely the maxillary sinus, frontal sinus, ethmoid sinus and sphenoid sinus.
twenty three. Pleura and pleural cavity: The pleura is a thin layer of serosa, which can be divided into visceral pleura and parietal pleura. The visceral pleura covers the surface of the lungs, is tightly combined with the lungs and cannot be separated, and extends into the interlobular fissures. The parietal pleura covers the inner surface of the chest wall, the upper surface of the diaphragm, and the surface of the mediastinum. The visceral pleura and the parietal pleura migrate to each other at the root of the lung to form a completely closed serosal sac cavity, that is, the pleural cavity. The left and right serosal sacs are independent, and the left and right pleural cavities are not connected to each other.
twenty four. Renal area: The area between the lateral edge of the erector spinae and the 12th rib is called the renal area.
25．Trigone of the bladder: On the inner surface of the bladder bottom, there is a triangular area between the two ureteral orifices and the urethral orifice. Due to the lack of submucosa, the mucous membrane and muscular layer are closely connected. No matter when the bladder expands or contracts, it remains smooth. This area is called For the bladder triangle. It is a predilection site for tumors, tuberculosis and inflammation.
26．Optic disc: There is a round white bulge at the beginning of the optic nerve, called the optic disc, and its central depression is called the optic nerve fovea, where there are no photoreceptor cells, called the physiological blind spot.
27．Macula: The macula is located slightly below the temporal side of the optic disc and is yellow in color. There is a depression in the center called the fovea, which is the most sensitive part of the body.
28．Spiral organ (Corti organ): Located on the lower wall of the cochlear duct, that is, on the basement membrane, it is called the spiral organ and is an auditory receptor.
29．Gray matter: In the central part, the accumulation of neuron cell bodies and dendrites is called gray matter, because it is rich in blood vessels, it is dark in color in fresh specimens, such as the gray matter of the spinal cord.
30．Nerve nuclei: Outside the central cortex, neuron cell bodies with similar shape and function gather into clusters or columns, called nerve nuclei.
31．White matter: the part where nerve fibers gather in the central part, named because the myelin sheath contains lipids and is white and bright, such as the white matter of the spinal cord.
32．Fiber bundle: In the white matter, all the nerve fibers with basically the same start and end, journey and function are collectively called fiber bundles.
33．Ganglion: In the peripheral part, the place where neuron cell bodies gather is called ganglion. Among them, the sensory ganglion is formed by the accumulation of sensory neuron cell bodies such as pseudounipolar or bipolar neurons, and the visceral motor ganglion is formed by the accumulation of efferent neuron cell bodies and is related to innervating visceral activities.
34．Nerves: Nerve fibers gathered together in the surrounding part are called nerves.
35．Internal capsule: Composed of a thick white matter fibrous sheet, located between the caudate nucleus, dorsal thalamus, and putamen. On the horizontal section, it is in the shape of a "V" open outward, and can be divided into three parts: the anterior limb of the internal capsule, the posterior limb of the internal capsule, and the genu of the internal capsule. Most of the superior and inferior fibers connecting the cerebral cortex and subcortical structures pass through the internal capsule. Injury to the internal capsule can result in loss of sensation in the contralateral side of the body, contralateral hemiparesis, and hemianopia of the contralateral visual field in both eyes. 17. Dural sinus: It is composed of two separate layers of dura mater lined with endothelial cells. The sinus wall has no smooth muscle and cannot contract. When injured, it is easy to form intracranial hematoma. It is the main route of intracranial venous return. Such as superior sagittal sinus and inferior sagittal sinus.
36．Subarachnoid space: The space between the arachnoid and pia mater of the spinal cord and between the arachnoid and pia mater of the brain is called the subarachnoid space. Contains cerebrospinal fluid and blood vessels.
37．Arachnoid Granules: Brain arachnoid forms many "cauliflower-shaped" protrusions near the superior sagittal sinus formed by the dura mater. Protrude into the dural sinuses, called arachnoid granules. Cerebrospinal fluid leaks through these particles into the dural sinuses and back into the veins.
38．Cerebral artery circle: also known as the circle of Willis, it is composed of the anterior communicating artery, the initial section of the anterior cerebral artery on both sides, the end of the internal carotid artery on both sides, the posterior communicating artery on both sides and the initial section of the posterior cerebral artery on both sides, and is located under the base of the brain Square, above the sella, around the optic chiasm, cinderella and mammary body. This ring can adjust the blood supply and compensation of the brain, and maintain the nutritional supply and functional activities of the brain.
2. Scale gap: A triangular gap is formed between the anterior and middle scalene muscles and the first rib, called the scalene gap, in which the subclavian artery and the brachial plexus pass.
4. Pharyngeal lymphatic ring: around the junction of the nasal cavity, oral cavity and pharyngeal cavity, there are pharyngeal tonsils, eustachian tube tonsils, palatine tonsils and lingual tonsils, which together form the pharyngeal lymphatic ring, which has a defensive function.
5. Hepatic hilum: There are three H-shaped grooves on the surface of the liver, of which the transverse groove is located in the center of the visceral surface, with left and right hepatic vessels, left and right branches of the proper hepatic artery, left and right branches of the hepatic portal vein, nerves and lymphatic vessels of the liver, etc. It enters and exits from here, so it is called the portal of the liver.
6. Gallbladder triangle: The common hepatic duct, the cystic duct above it and the liver below it together form a triangular area, called the gallbladder triangle. The cystic artery passes through the triangle.
7. Pleural cavity: Visceral pleura and parietal pleura are continuous at the root of the lung, forming a completely closed pleural cavity around the left and right lungs. Negative pressure in the pleural cavity, only a little serous fluid.
8. Bronchopulmonary segment: The left and right main bronchi divide into lobar bronchi near the hilum according to the lung lobes, and the lobar bronchus enters the lung lobe and then divides into segmental bronchi, which branch repeatedly in a dendrite form in the lung to form a bronchial tree. Pulmonary segmental bronchi are the branches of the pulmonary lobe bronchi. Each pulmonary segmental bronchus and its branches and the lung tissue it belongs to together form a bronchopulmonary segment, referred to as a pulmonary segment
9. Hilum: There is an oval-shaped depression in the center of the inner surface of the lung called the hilum, which is where the main bronchus, pulmonary artery, pulmonary vein, bronchial artery, vein, lymphatic vessel, and nerve enter and exit.
10. Throat: The entrance of the throat is called the throat. Facing back and upward, it is surrounded by the upper border of epiglottis cartilage, spoon-shaped epiglottis fold and interspoon notch, etc.
11. Mediastinum: the general term for all the organs, structures, and joints between the left and right mediastinal pleura
12. Kidney hilum: The depression in the middle of the medial border of the kidney is where the renal blood vessels, lymphatic vessels, nerves, and renal pelvis come in and out, called the hilum of the kidney.
13. Renal sinus: The renal hilum continues into the kidney with a large cavity, called the renal sinus, which contains the main branches of the renal artery, the main branches of the renal vein, the small calyces, and the major calyces.
15. Perineum: There are narrow sense and broad sense. The perineum in a narrow sense only refers to the soft tissue between the anus and the external genitalia. The perineum in a broad sense refers to all the soft tissues below the pelvic diaphragm that close the lower pelvic opening.
16. Douglas cavity: The depression between the female rectum and uterus is called the rectouterine depression, which is the lowest point of the female peritoneal cavity.
17. Bare pericardial area: Most of the front of the heart is covered by the lungs and pleura, only a small area in the lower part is adjacent to the lower half of the sternal body and the 4th to 5th costal cartilage on the left side through the pericardium. This area is called the naked pericardial area.
18. Sinus node: located in the subepicardium of the right atrium wall near the superior vena cava orifice, it is the beat point of cardiac rhythmic activity.
19. Pericardial cavity: The two layers of the serous pericardial heart and wall move in phase at the root of the large blood vessels entering and leaving the heart, and the gap between the two layers is called the pericardial cavity. The cavity contains a little serous fluid.
20. Carotid sinus: The enlarged part at the end of the common carotid artery and the beginning of the internal carotid artery. There are baroreceptors in the wall, which can sense changes in blood pressure.
21. Palmar deep arch: Located on the deep surface of the tendons of the fingers, at the level of the wrist and metacarpal joints, it is formed by the anastomosis of the end of the radial artery and the deep palmar branch of the ulnar artery.
22. Venous angle: Also known as the innominate vein, it is formed by the confluence of the ipsilateral internal jugular vein and subclavian vein behind the sternoclavicular joint. The angle at the confluence is called the vein angle.
23. Lymph: When the blood travels through the arteries to the arterial end of the capillaries, part of the liquid is filtered out through the walls of the capillaries and enters the interstitial space to form interstitial fluid. After the interstitial fluid exchanges substances with the tissue, most of it is sucked into the vein at the venous end of the capillary and the vein after the capillary, and a small part enters the lymphatic capillary to become lymph.
24. Scleral venous sinus: There is a circular small tube in the deep part of the sclera at the junction of the sclera and the cornea, called the scleral venous sinus, which is the return channel of aqueous humor.
26. Eustachian tube: It is a tube for communicating the tympanic cavity and the nasopharynx, and can be divided into the cartilaginous part and the tympanic part.
27. Macula: At 0.35cm on the temporal side of the optic disc and slightly below it, there is a yellowish small area called the macula. The depression in the center of the macula, called the fovea, is where vision is most acute.
28. Ganglia: In the peripheral nervous system, neuronal cells aggregate into ganglia.
30. Epidural space: A narrow cavity between the dura mater and the periosteum of the spinal canal is called the epidural space. It contains lymphatic vessels, spinal venous plexus, loose connective tissue, and fat.
32. Cortex: The gray matter distributed in layers on the surface of the brain and cerebellum is called the cortex.
35. White communication branch: It is composed of sympathetic preganglionic nerve fibers from the intermedial lateral nucleus cells of the lateral horn of the spinal cord. The fibers have myelin sheath and are white.
36. Striatum: The lenticular nucleus is connected to the head of the caudate nucleus, and there are nerve fibers at the junction to form gray and white stripes, so the two nuclei are collectively called the striatum.
37. Subarachnoid space: Around the brain and spinal cord, the space between the arachnoid and the pia mater is called the subarachnoid space, which contains cerebrospinal fluid
Basal ganglia: It is a mass of gray matter buried in the medulla of the brain, located near the base of the brain, including the caudate nucleus, putamen, claustrum and amygdala.
38. Epidural space: A narrow cavity between the dura mater and the periosteum of the spinal canal is called the epidural space. Contains lymphatic vessels, spinal venous plexus, loose connective tissue, and fat
• 26. Medial lemniscus:
The medial lemniscus transmits proprioception, fine touch, and vibratory sensations from the contralateral trunk and extremities. It originates from the nucleus of the cuneiform tract and the nucleus of the thin tract, and crosses on the ventral side of the central canal as the crossing of the medial lemniscus. The postcrossing fibers are the medial lemniscus, ascending in the medulla, pons, and midbrain, and finally terminate in the ventroposterolateral nucleus of the dorsal thalamus.
27. Spinal lemnis:
The spinal lemniscus conducts pain, temperature and gross touch sensations in the contralateral trunk and extremities. Originate from the gray matter of layers I, IV, and V of the spinal cord, go up 1-2 segments on the same side, pass through the anterior commissure of the white matter, cross to the opposite side, go up the lateral cord of the spinal cord, pass through the brainstem, and end at the ventroposterolateral nucleus of the dorsal thalamus .
28. Trident hill system:
The trigeminal system transmits the pain, temperature and touch of the skin and mucous membranes of the head and face. It originates from the spinal nucleus of the trigeminal nerve (pain and temperature sensation) and the pontine nucleus of the trigeminal nerve (sensation of touch), crosses to the opposite side to form the trigeminal lemniscus, is located outside the medial lemniscus and ascends, and ends at the ventroposteromedial nucleus of the dorsal thalamus.
29. Vertebral bundle:
The vertebral system is composed of giant vertebral cells (Bety cells) and other types of vertebral cell axons located in the precentral gyrus and the front of the paracentral lobule. The fiber bundles descending to the spinal cord are called corticospinal tracts, which end in the brainstem brain The fiber bundles of the motor nucleus are called cortical nucleus bundles. Most of the corticospinal tract bifurcates at the intersection of vertebral bodies to form the lateral corticospinal tract, which reaches the motor neurons in the anterior horn of the contralateral spinal cord; a small number of uncrossing fibers form the anterior corticospinal tract, which leads to the anterior horn of the contralateral spinal cord in the cervical and upper thoracic segments motor neuron. Except for the inferior part of the facial nucleus and the hypoglossal nerve, which only receive the contralateral cortical nucleus tract, the motor nuclei of the other cranial nerves receive the fibers of the bilateral cortical nucleus tract.
30. Sympathetic trunk:
The paravertebral ganglia are located on both sides of the spine, and are connected by intersegmental branches to form two left and right sympathetic trunks. The sympathetic trunk goes up to the base of the skull and down to the coccyx, where the two trunks merge in front of the coccyx. The sympathetic trunk is the structure surrounding the sympathetic nerves.
31. Paravertebral ganglion:
The paravertebral ganglion is the peripheral structure of the sympathetic nerve, located on both sides of the spine, about 19-24 on each side, except for 3 in the neck and 1 in the tail, the rest of the ganglia are similar in number to the vertebrae in this department. The paravertebral ganglion is composed of multiple levels of neurons of varying sizes, and some postganglionic sympathetic fibers originate from these cells.
32. Prevertebral ganglion:
The prevertebral ganglion is the sympathetic ganglion, which is located in front of the spine and is an irregular nodular mass. There are celiac ganglia (pairs) and upper and lower mesenteric ganglia, etc. Some people also include the aortonephroid ganglion Inside. Part of the white communicating branch can be exchanged in the prevertebral segment, such as the viscera greater and lesser nerves.
big question
1. What grooves, canals, fissures, and holes are there on the inner surface of the skull base? What structure does each pass?
Answer: sieve hole - olfactory nerve. Optic canal - optic nerve, ophthalmic artery.
Superior orbital fissure - oculomotor nerve, trochlear nerve, abducens nerve, ophthalmic nerve, superior ophthalmic vein.
Carotid groove, carotid canal ostium - internal carotid artery.
Foramen rotundum - maxillary nerve. Foramen ovale - mandibular nerve. spinous foramen - middle meningeal artery.
Middle meningeal artery sulcus - middle meningeal artery. The mouth of the hypoglossal nerve canal - the hypoglossal nerve.
Inner ear door - facial nerve, vestibulocochlear nerve, labyrinthine artery.
Superior sagittal groove, transverse sinus groove, sigmoid sinus groove—sinus venosus of the same name.
Jugular Foramen - Internal Jugular Vein, Glossopharyngeal Nerve, Vagus Nerve, Accessory Nerve.
Foramen magnum - junction of medulla oblongata and spinal cord. Vertebral arteries, veins, accessory nerves, anterior and posterior spinal arteries.
2. What are the basic structures of joints?
Answer: ⑴ Articular surface: at least two, generally the convex one is the joint head, the concave one is the joint concave, and there is articular cartilage on the articular surface.
(2) Joint capsule: the outer layer is fibrous layer, and the inner layer is synovial layer, which can produce synovial fluid.
(3) Joint cavity: There is a negative pressure in the cavity, and there is a small amount of synovial fluid.
3. What are the auxiliary structures of the joint?
Answer: (1) Ligaments include intracapsular ligaments and extracapsular ligaments.
⑵ articular disc and lip.
(3) Synovial folds and synovial bursa.
4. How are the vertebrae connected?
Answer: ⑴The central part of the intervertebral disc is a jelly-like substance of myeloid elasticity, which is soft and elastic, and the surrounding part is a fibrous ring, which is arranged in concentric circles of fibrocartilage and is full of toughness.
⑵The anterior longitudinal ligament, located in front of the vertebral body, is wide and thick, and can prevent excessive extension of the spine.
(3) The posterior longitudinal ligament, located behind the vertebral body, is narrow and thin, which prevents excessive forward flexion of the spine.
5. What curvatures are visible in the lateral view of the spine? Answer: cervical curvature, lumbar curvature (convex forward); thoracic curvature, sacral curvature (convex backward).
6. How are the upper and lower openings of the thorax formed?
Answer: Upper mouth: Surrounded by the upper edge of the manubrium sternum, the first rib, and the first thoracic vertebrae. Inferior mouth: surrounded by the 12th thoracic vertebra, 12.11th rib, costal arch and xiphoid.
7. How is the temporomandibular joint formed? What are the characteristics?
Answer: It is composed of the mandibular head of the mandible, the mandibular fossa of the temporal bone and the articular tubercle. The joint capsule is loose, there is ligament reinforcement outside the capsule, and there is an articular disc inside the capsule that divides the joint cavity into upper and lower parts
8. What are muscle aids? Answer: Superficial fascia, deep fascia, synovial bursa, tendon sheath.
9. What are the muscles of mastication? Answer: Masseter, temporalis, medial pterygoid, lateral pterygoid
10. Which muscles are involved in breathing?
Answer: Inhalation: pectoralis major, pectoralis minor, external intercostal muscles, serratus anterior, diaphragm.
Exhalation: Internal intercostal muscles, diaphragm, external obliques, internal obliques, transverse abdominis, rectus abdominis.
11. Describe the name, location and passing structure of the three holes in the diaphragm.
Answer: Aortic hiatus: in front of the 12th thoracic vertebra, between the left and right diaphragmatic crus and the spine, through which the aorta and thoracic duct pass.
Esophageal hiatus: On the upper left front of the aortic hiatus, at about the level of the 10th thoracic vertebra, the esophagus and vagus nerve pass through.
Foramen vena cava: In the central tendon above the right front of the esophageal hiatus, approximately at the level of the eighth thoracic vertebra, through the inferior vena cava.
12. When eating fish, the fishbone gets stuck in the pharynx accidentally, where do they stay? piriform recess
13. Describe the stricture of the esophagus.
Answer: There are three stenosis of the esophagus, ① located at the beginning of the esophagus, about 15cm away from the central incisor; ② located at the intersection of the esophagus behind the left main bronchus, about 25cm away from the central incisor; ③ located at the esophageal hiatus where the esophagus passes through the diaphragm at about 40cm from the central incisor.
14. Where is bile produced? How does it normally drain into the duodenal lumen?
Answer: It is produced by liver cells in the liver and stored in the gallbladder through the intrahepatic bile duct—left and right hepatic duct—common hepatic duct—cystic duct. After eating, the gallbladder contracts, and the gallbladder-cystic duct-common bile duct-hepatopancreatic ampulla sphincter relaxes-duodenal papilla-duodenal lumen.
15. Patients with pancreatic head cancer often have symptoms such as jaundice and intestinal obstruction. Please use anatomical knowledge to explain why?
Answer: Bile is produced by the liver, and passes through the left and right hepatic ducts, the common hepatic duct, and the common bile duct. In the case of pancreatic head cancer, the cancer compresses the common bile duct, which blocks bile discharge and causes jaundice to flow back into the blood. Due to the adjoining relationship between the duodenum and the head of the pancreas, the duodenum can sometimes be oppressed and cause intestinal obstruction.
16. The patient suddenly had severe abdominal pain, nausea, vomiting, and yellow sclera. He came to the emergency department for examination. The doctor initially diagnosed choledocholithiasis. For further diagnosis, doctors use cholangiography, which requires a catheter to be sent from the oral cavity to the large papilla of the duodenum, and a contrast medium is injected into the common bile duct. Excuse me:
①Which organs and physiological narrowings (specific parts) must the duct pass through to reach the mammary gland of the duodenum?
②If this patient undergoes common bile duct surgery to remove stones, choose the right rectus abdominus incision. May I ask: This incision is from shallow to deep. Which structures (indicated by arrows) must be passed through in order to expose the common bile duct? What surrounding structures should be paid attention to when cutting the common bile duct, and what is their relationship with the common bile duct?
Answer: ①Through the oral cavity—pharynx—pharynx—esophagus (three stenosis of the esophagus: the beginning, the intersection with the left main bronchus, and the esophageal hiatus through the diaphragm)—stomach (cardia, pylorus)—ten Upper part of duodenum - descending part of duodenum, large papillae.
②Skin—superficial fascia—anterior layer of rectus sheath—rectus abdominis muscle—posterior layer of rectus sheath—transverse fascia—extraperitoneal fat—parietal peritoneum—incision of twelve fingers The enteric ligament exposes the common bile duct. When cutting the common bile duct, it should be noted that there is the proper hepatic artery on the left side and the hepatic portal vein on the left rear side.
17. When a patient with suspected perforation of the posterior gastric wall undergoes surgery, the doctor wants to explore the posterior gastric wall. What peritoneal structure is the simplest and most feasible approach to incision to see the posterior gastric wall?
Answer: Cut the gastrocolic ligament or transverse mesocolon into the omentum sac, the anterior wall of which is the posterior wall of the stomach. 9. Where is the patient most likely to stay in the supine and sitting positions with a peritoneal effusion?
Answer: In the supine position, it is most likely to stay in the liver and kidney lacuna.
When sitting, it is most likely to stay in the rectal uterine depression (female) and rectal bladder depression (male).
18. What are the structures on the outer wall of the nasal cavity? what's the effect?
Answer: The outer wall of the nasal cavity has the superior turbinate, middle turbinate and inferior turbinate protruding from top to bottom. There is a fissure space below each of the three turbinates, which are the upper meatus, the middle meatus, and the lower meatus. In addition, there is the most superior turbinate above the superior turbinate or the concave-shaped sphenoid ethmoid recess between the posterior upper part of the superior turbinate and the roof of the nasal cavity. The above structures expand the area of the nasal mucosa, which is beneficial to the heating and humidification of the inhaled air. 3. Where is a tracheostomy usually performed?
Answer: It is often performed at the 3rd to 5th tracheal cartilage ring.
19. Which side of the main bronchus do most tracheal foreign bodies fall into, and why?
Answer: Most of the foreign bodies in the trachea fall into the right main bronchus. Because the right main bronchus is thicker and shorter than the left main bronchus, and its direction is steeper than that of the left main bronchus.
20. Use what you have learned to explain how a person who has an abscess in the anterior segment of the right upper lobe naturally coughs up purulent sputum?
Answer: The abscess and purulent sputum in the anterior segment of the right upper lobe is spontaneously coughed up through the anterior segment of the right upper lobe bronchi→right upper lobe bronchus→right main bronchus→trachea→larynx→pharynx→oral cavity→body
twenty one. Describe the divisions and strictures of the ureter.
Answer: The ureter can be divided into the abdomen, pelvis and wall according to its course. There are 3 stenosis in the whole process, the upper stenosis is located at the transition between the ureter and renal pelvis; the middle stenosis is located at the upper opening of the pelvis, where the ureter crosses the iliac vessels; the lower stenosis is inside the wall of the ureter. These strictures are common sites for ureteral stone retention.
twenty two. What is the conduction system of the heart?
Answer: Composed of special cardiomyocytes, it is self-disciplined and conductive. Its main function is to generate and conduct impulses and control the rhythmic activity of the heart. Including: sinoatrial node, nodal bundle, atrioventricular nodal region, atrioventricular bundle, left and right bundle branches and Purkinje fiber network.
twenty three. Hematemesis, hematochezia, and perumbilical varicose veins are often seen in patients with liver cirrhosis and hepatic portal hypertension. Please explain the anatomical basis of the above manifestations according to the characteristics of the hepatic portal vein system and the traffic of the hepatic portal vein system.
Answer: The hepatic portal vein communicates with the superior and inferior vena cava through three pathways: esophageal venous plexus, rectal venous plexus, and abdominal wall venous plexus.
Esophageal venous plexus route: The hepatic portal vein communicates with the azygos and semiazygos veins of the superior vena cava system through the left gastric vein, esophageal venous plexus.
Rectal venous plexus route: The hepatic portal vein communicates with the inferior rectal vein and anal vein of the inferior vena cava system through the inferior mesenteric vein, superior rectal vein, rectal venous plexus and inferior vena cava system.
Approach to the abdominal wall venous plexus: the hepatic portal vein communicates with the superior epigastric vein of the superior vena cava system, the thoraco-abdominal vein, and the inferior epigastric vein and superficial epigastric vein of the inferior vena cava system through the accessory umbilical vein and the periumbilical vein network.
Due to the lack of valves in the hepatic portal vein, when the blood pressure in the hepatic portal vein increases, the blood backflow is blocked or even regurgitated, which causes the communication between the hepatic portal vein and the superior and inferior vena cava to open, resulting in the anastomosis of the blood that originally returned through the hepatic portal vein. The tributary flows into the vena cava system, causing dilation (varicose) of the anastomotic vein, and even rupture and bleeding.
When the above-mentioned varicose esophageal venous plexus ruptures, it will cause hematemesis; when the varicose rectal venous plexus ruptures, it will cause blood in the stool; if the hepatic portal vein communicates with the superior and inferior vena cava through the abdominal wall venous plexus, abdominal wall varices will appear.
twenty four. Intravenous injection of drugs is used for gallbladder inflammation. If intravenous injection is used, it indicates the route of the drug to the gallbladder
And the way of excretion through urine?
Answer: After injection through the median cubital vein, the drug passes through basilic vein, brachial vein, axillary vein, subclavian vein, brachiocephalic vein, superior vena cava, right atrium, right ventricle, pulmonary artery, pulmonary capillary, pulmonary vein, left atrium, The left ventricle, aorta, celiac trunk, common hepatic artery, proper hepatic artery, and right branch of hepatic artery finally reach the gallbladder through the cystic artery.
Urine is excreted from the basilic vein to the aorta in the same way as above, and the aorta then passes down in sequence: renal artery, glomerular capillary, renal capsule, renal tubule, renal small calyx, major renal calyx, renal pelvis, The ureters and bladder are finally excreted through the urethra.
25．Describe the mechanism of action of the refractive system of the eyeball?
Answer: The mechanism of action of the refractive system of the eyeball: When viewing near objects, the ciliary muscle contracts, the ciliary body moves forward, the suspensory ligament of the lens is relaxed, the convexity of the lens becomes thicker, and the refractive power is strengthened, so that the object image is gathered on the retina. The opposite is true when looking at distant objects.
26．What are the refraction devices of the eye?
Answer: The refraction device of the eye includes: cornea, aqueous humor, lens and vitreous body, these structures are colorless, transparent and have no blood vessels, and have a refractive effect.
27．Describe the circulation pathway of aqueous humor?
Answer: It is produced by the ciliary body from the posterior chamber to the anterior chamber through the pupil, then enters the scleral venous sinus through the iridocorneal angle, and then enters the ophthalmic vein through the anterior ciliary vein.
28．Describe myopia, hyperopia, glaucoma, cataract, chalazion, and stye from an anatomical point of view.
Answer: Myopia: The refractive power of the eyeball is strengthened due to various reasons, so that the light entering the eyeball is focused in front of the retina.
Farsightedness: The refractive power of the eyeball is weakened due to various reasons, so that the light entering the eyeball is focused on the back of the retina.
Glaucoma: The circulation of aqueous humor is blocked and stagnated in the back chamber of the eye, resulting in increased intraocular pressure, which is called glaucoma.
Cataract: The clouding of the lens due to various reasons is called cataract.
Chalazion: Due to the obstruction of the meibomian gland duct, a meibomian cyst is formed, which is called a chalazion.
Stye: when the meibomian gland is purulently infected, it is called an inner stye, and if the infection site is located in the eyelash follicle or eyelash gland, it is called an outer stye.
29．Describe the pathways of tear production and drainage?
Answer: Tears are produced in the lacrimal gland → through the excretory duct → superior fornix of the conjunctiva → lacrimal lake → lacrimal puncta → lacrimal canaliculus → lacrimal sac → nasolacrimal duct → lower nasal passage. 6. Describe the walls of the tympanum and their adjacencies.
Answer: The upper wall is also called the cover wall, which is adjacent to the middle cranial fossa through a thin bone plate; the lower wall is also called the jugular vein wall, which is adjacent to the jugular fossa through a thin bone plate; the anterior wall is also called the carotid artery wall, which is adjacent to the jugular fossa The carotid artery tube is adjacent, and there is the opening of the eustachian tube above it; the posterior wall is also called the mastoid wall, and the upper part has the opening of the mastoid antrum and passes through the mastoid chamber, and there is a cone protuberance below which contains the stapedius muscle. The outer wall, also known as the tympanic membrane wall, and the inner wall, also known as the labyrinth wall, are adjacent to the inner ear.
30．Describe the location, divisions and main conduction bundles of each division of the internal capsule.
Answer: The internal capsule is composed of a wide and thick white matter fiber plate, located between the caudate nucleus, dorsal thalamus and putamen. On the horizontal section, the internal capsule is in the shape of a "V" open outward, and can be divided into three parts: ①The anterior limb of the internal capsule: located between the lenticular nucleus and the caudate nucleus, containing the frontopontine tract and the anterior radiation of the thalamus; ② The posterior limb of the internal capsule: located between the lenticular nucleus and the dorsal thalamus, through which the corticospinal tract, the cortical red nucleus tract, the central radiation of the thalamus, the parieto-occipital-temporal bridge tract, the visual radiation and the auditory radiation pass; , The confluence of the hind limbs, there is a cortical nuclear tract passing through.
31．What are the limbic lobes and the limbic system, and what are their main functions?
A: The marginal lobe consists of the septum, cingulate gyrus, parahippocampal gyrus, hippocampus, dentate gyrus, anterior insula, and temporal pole. The limbic system consists of the limbic lobe and its subcortical structures (such as the amygdala, septal nucleus, hypothalamus, epithalamus, dorsal anterior nucleus of the thalamus, and tegmentum of the midbrain, etc.). Its main functions are ① regulating internal organs, emotional response, sexual activity, etc. ②The hippocampus is related to high-level neural activities such as learning and memory.
32．Describe the composition and fiber composition of the spinal nerve?
Answer: There are 31 pairs of spinal nerves. Each pair of spinal nerves is connected to the spinal cord through the anterior root and the posterior root. The anterior root is motor and the posterior root is sensory. Mixed, so the spinal nerve is a mixed nerve. According to the distribution and function of spinal nerves, its constituent fibers can be divided into four categories:
Sensory nerve fibers: Somatosensory fibers: Distributed in the skin, skeletal muscles, tendons and joints, transmitting superficial and deep sensations to the center.
Visceral sensory fibers: Distributed in viscera, cardiovascular and glands, conduct visceral sensation.
Motor Nerve Fibers: Somatic motor fibers: Distributed in skeletal muscles and control their movement.
Visceral motor fibers: distributed in viscera, cardiovascular and glands, control the movement of smooth muscle and cardiac muscle, and control the secretion of glands.
33．What is reflection? What links does the reflex arc include?
Answer: Reflex is the basic activity mode of the nervous system, and the morphological basis of completing reflex activity is called reflex arc. The composition of the reflex arc includes receptors, afferent nerves, central nerves, efferent nerves, and effectors. Simple reflex arcs involve only two neurons, while complex reflex arcs require the participation of interneurons between the afferent and efferent nerves.
34．Briefly describe the composition, course and innervation of the phrenic nerve.
Answer: The phrenic nerve is composed of C3-C5 anterior branches. It runs on the outside, front and inside of the anterior scalene muscle in the neck, enters the thoracic cavity between the subclavian artery and vein, enters the thoracic cavity, and descends to the diaphragm through the front of the lung root. It penetrates into the diaphragm and innervates the diaphragm. The sensory fibers are distributed in the thorax, pericardium and part of the peritoneum below the diaphragm. The right phrenic nerve still innervates the serosa of the liver, gallbladder and extrahepatic biliary tract.
35．It illustrates the morphological basis of "claw hand" in ulnar nerve injury.
Answer: The ulnar nerve innervates the 3rd and 4th lumbrical muscles, and the function of the lumbrical muscles is to flex the metacarpophalangeal joints and extend the interphalangeal joints. When the ulnar nerve is injured, the metacarpophalangeal joints of the 4th and 5th fingers are hyperextended, and the interphalangeal joints are hyperflexed, forming a "claw hand".
36．Briefly describe the origin, course, distribution of branches and appearance of the sciatic nerve after injury.
Answer: The sciatic nerve originates from the sacral plexus, exits the pelvic cavity through the subpiriformis foramen, descends between the ischial tuberosity and the greater trochanter, divides into the tibial nerve and common peroneal nerve above the popliteal fossa, and innervates the biceps femoris in the posterior femoral region , semitendinosus, and semimembranosus.
The tibial nerve distributes to the calf muscles and plantar muscles, the skin on the back of the calf and the plantar of the foot. After the injury, the posterior calf muscles were weak, the foot could not plantarflex, the varus force was weak, the foot was dorsiflexed and valgus, and the deformity of "hooked foot" appeared.
The common peroneal nerve is divided into the superficial peroneal nerve and the deep peroneal nerve, distributed in the anterior and lateral groups of the calf, the dorsalis muscle of the foot and the skin of the lateral calf, dorsum of the foot, and dorsum of the toes. After the injury, the foot cannot be dorsiflexed, the toes cannot be extended, the foot droops and turns inward, showing the deformity of "clubfoot".
37．Why do patients with severe otitis media easily injure the facial nerve, and what are the manifestations after the injury?
Answer: The facial nerve goes out of the brain and enters the inner ear door, passes through the bottom of the inner auditory canal and enters the facial nerve canal. The facial nerve canal is located behind the side wall of the tympanic cavity, forming a convex facial canal. The bone of the canal wall is very thin, or even absent. In otitis media, it is injured The facial nerve that runs inside, the facial muscles on the injured side are paralyzed after the injury, such as the corners of the mouth are inclined to the healthy side when smiling, the cheeks cannot be bulged, the corners of the mouth are salivating, the forehead lines disappear, the nasolabial folds become shallow or flat, it is difficult to close the eyes, the corneal reflex disappears, and the auditory Allergies, dysgeusia in the front 2/3 of the tongue, lacrimal gland and salivary gland secretion disturbance and other symptoms.
38．Briefly describe the nerves and functions that govern the tongue.
Answer: The nerve that innervates the movement of the tongue muscle is the hypoglossal nerve; the general sensory nerve that controls the anterior 2/3 of the tongue is the branch of the trigeminal nerve—the lingual nerve. The taste sensation in the front 2/3 of the tongue is transmitted by the branch of the facial nerve - the chorda tympani. The nerve that controls the general sensation and taste sensation in the posterior 1/3 of the tongue is the glossopharyngeal nerve.
39．Briefly describe the source, nature and function of the innervation of the eye (visual organ).
Answer: The innervation of the optic organ is more.
1 The optic nerve consists of the axons of ganglion cells in the retina, 2 transmits visual impulses to the cerebral cortex, and 3 is a special somatosensory nerve.
4 The somatosensory nerve of the optic organ comes from the trigeminal nerve, and the 5 senses the pain, temperature, touch and pressure of the optic apparatus.
③ The oculomotor nerve, trochlear nerve, and abducens nerve all belong to the body motor nerves that innervate the extraocular muscles.
④ Parasympathetic fibers from the EW nucleus join the oculomotor nerve and innervate the ciliary muscle and pupil after the ciliary ganglion exchange
sphincter. Department of pupil reduction function.
⑤ Sympathetic nerve fibers from the superior cervical segment attach to the internal carotid artery to the optic apparatus, innervate the pupillary dilator muscle, and perform the function of pupillary dilation.
40．Describe the muscles, innervations, and sources that govern pupillary dilation and constriction.
A: The muscle that manages miosis is the pupillary sphincter, innervated by parasympathetic fibers in the oculomotor nerve that originate from the miotic nucleus in the midbrain. The muscle that manages pupillary dilation is the pupillary dilator muscle, which is innervated by the sympathetic nerve. This fiber originates from the sympathetic postganglionic fibers of the superior cervical segment, and reaches the eyeball through the internal carotid plexus and ciliary ganglion.
41．Describe the pupillary reflex to light.
Answer: The pathway of pupillary light reflex is as follows: retina→optic nerve→optic chiasm→both optic tracts→superior colliculus arm→anterior area of tectum→both sides of oculomotor nucleus→oculomotor nerve→ciliary ganglion→postganglion Fiber → Pupillary sphincter contraction → Miosis on both sides.
42．One side of the optic nerve injury and one side of the oculomotor nerve injury, how is the pupillary light reflex of the affected eye?
Answer: optic nerve damage on one side: direct light reflex (-) and indirect light reflex (+) on the affected side.
Oculomotor nerve damage on one side: direct light reflex (-) on the affected side, and indirect light reflex (-).
43．What are the clinical manifestations of central branch embolism of the middle cerebral artery? Why?
Answer: The central branch of the middle cerebral artery nourishes the caudate nucleus, lenticular nucleus, internal capsula genu and hindlimbs. Symptoms of "triple deviation" may occur during embolization: ① Contralateral hemiplegia (upper and lower limb upper neuron paralysis, facial nerve supranucleus paralysis) , supranuclear palsy of the hypoglossal nerve), because of damage to the internal capsular genu and the pyramidal tract of the hindlimb.
②Shallow and deep sensory impairment in the contralateral half of the body, because the central radiation of the thalamus of the posterior limb of the internal capsule was damaged.
③ Homotropic hemianopia in contralateral visual field. Because of damage to the optic radiation of the hindlimb of the internal capsule.
44．What structures are damaged in Cerebropedial Syndrome (Weber Syndrome)? What are the clinical manifestations?
Answer: The main damage to the ipsilateral oculomotor nerve root and pyramidal tract can cause ① paralysis of all ophthalmologic muscles except the lateral rectus and superior oblique muscles on the ipsilateral side, manifested as exotropia, ptosis, dilated pupils, and concentric pupils. Light reflections disappear. ②Contralateral upper and lower limb spastic paralysis, supranuclear paralysis of the facial nerve, supranuclear paralysis of the hypoglossal nerve.
45. Answer: ①Pyramidal tract can be damaged, resulting in paralysis of upper and lower extremity neurons on the opposite side.
②The medial lemniscus can be damaged, resulting in conscious proprioceptive and fine tactile disturbances in the contralateral upper and lower limbs and trunk.
③The hypoglossal nerve root on the same side can be damaged, and the hemiglossus muscle on the same side can be paralyzed.
46．What are the clinical manifestations of spinal cord hemitransection (Brown-Sequard syndrome)?
Answer: ① rigid paralysis of the ipsilateral limb.
②Loss of position sense, vibration sense, movement sense and fine touch sense below the ipsilateral injury level.
③Loss of pain and temperature sensation below the level of the contralateral injury.
47．When blood is collected from the left index finger, how is the pain transmitted to the central nervous system?
Answer: The cell body of the first-order neurons of this pain transmission is in the spinal ganglion of C6-T1, and its surrounding processes are distributed to the palm side skin of the left index finger through the posterior root of the spinal nerve, the anterior branch of the spinal nerve, the brachial plexus, and the left median nerve. The dorsal root of the spinal nerve enters the spinal cord and ends at the second-order neurons (lamina I, IV-VII). The fibers from the second-order neurons cross the anterior commissure of the white matter to the right lateral cord, join the lateral spinothalamic tract and ascend to the third-order neurons (ventroposterolateral nucleus of the thalamus), and the fibers from this are called the central radiation of the thalamus. The posterior limb of the capsule projects to the middle and upper part of the central posterior gyrus.
48．Describe the composition and function of the cerebral artery ring.
Answer: Below the base of the brain, above the sella, the left and right anterior cerebral arteries originating from the internal carotid artery around the optic chiasm, gray tubercle and mammillary body and the anterior communicating artery between them, the ends of the internal carotid arteries on both sides, The arterial ring formed by the two posterior cerebral arteries from the basilar artery synthesized by the two vertebral arteries and the two posterior communicating arteries between the posterior cerebral artery and the internal carotid artery is called the cerebral artery ring, also known as the circle of Willis. This ring communicates with the internal carotid and basilar arteries on both sides. When the blood flow of a certain artery that constitutes this ring is reduced or blocked, the blood can be redistributed and compensated to a certain extent through the cerebral artery ring to maintain the nutritional supply and functional activities of the brain.
49．Describe the production and circulation of cerebrospinal fluid.
Answer: The cerebrospinal fluid is produced by the choroid plexus of the lateral ventricle, flows to the third ventricle through the interventricular foramen, together with the cerebrospinal fluid produced by the choroid plexus of the third ventricle, flows into the fourth ventricle through the midbrain aqueduct, and then joins the cerebrospinal fluid produced by the choroid plexus of the fourth ventricle Inject into the subarachnoid space through the median and lateral holes of the fourth ventricle, so that the brain, spinal cord, cranial nerves, and spinal nerve roots are all soaked in cerebrospinal fluid. Then, the cerebrospinal fluid flows along the subarachnoid space to the back of the brain, and penetrates through the arachnoid granules into the dural sinuses (mainly the superior sagittal sinus, which flows back into the blood). If the cerebrospinal fluid is blocked during circulation, it can lead to hydrocephalus and increased intracranial pressure, which will cause pressure and displacement of brain tissue, and even form a brain herniation.
50．A hypertensive patient fainted suddenly. After regaining consciousness, he could not speak clearly. After examination, it was found that: (1) Right upper and lower limbs could not move, muscle stiffness, patellar tendon reflex and biceps brachii reflex were hyperreflexic, Babinski sign was positive, frontal lines on both sides Equal, eyes can be closed, the right nasolabial fold becomes shallower, the corner of the mouth is tilted to the left, and the tip of the tongue is tilted to the right when sticking out the tongue. (2) Loss of pain sensation in the right side of the body, unable to tell the state and posture of passive movement of the right upper and lower limbs when the eyes are closed. (3) Hemianopia in the right half of the visual field of both eyes. Question: (1) Where is the lesion located? (2) Why do the above symptoms appear?
Answer: (1) The lesion is located in the left internal capsule.
(2) Due to damage to the left pyramidal tract, spastic paralysis of the right upper and lower limbs, supraparesis of the right facial nerve nucleus, and paralysis of the right hypoglossal nerve nucleus; damage to the central radiation of the left thalamus, which conducts to the right half of the body The deep and shallow sensations caused by the loss of pain and temperature sensation on the right side and the loss of proprioception on the right side; the left optic radiation was damaged, causing homonymous hemianopia in the right half of the visual field of both eyes.
All the above-mentioned conduction bundles go through the internal capsule, so the internal capsule injury appears "three-bias" symptoms.
Sixteen key questions
The circulation of cerebrospinal fluid
The cerebrospinal fluid produced by the lateral ventricle flows to the third chamber through the interventricular foramen, together with the cerebrospinal fluid produced by the choroid of the third ventricle flows into the fourth ventricle through the midbrain aqueduct, and then joins the fourth chamber, and the vasculature flows together with the cerebrospinal fluid produced , into the subarachnoid space through the middle foramen of the fourth ventricle and the two outer foramina, and then the cerebrospinal fluid flows along the subarachnoid space to the renal surface of the brain, penetrates through the arachnoid granules into the dural sinuses, and flows back into the blood.
The conduction system of the heart
The conduction system of the heart is composed of special cardiomyocytes, which are self-disciplined and conductive. Its main function is to conduct impulses and control the rhythmic activity of the heart. Including sinoatrial node, internode bundle, atrioventricular node, atrioventricular bundle, left and right bundle friends and purkinje fiber mesh.
3. Shape, position and fixation of the uterus
Morphology: The uterus of a non-pregnant adult is pear-shaped, slightly flattened and upside down, divided into three parts: the base and the body neck. The cervix protrudes from the cervix into the vagina.
The vagina and the upper part of the cervix and vagina above the vagina, the junction of the uterus and the fallopian tubes is called the uterine horn, and the relatively narrow part between the uterine body and the upper part of the upper part of the cervix and the vagina is called the uterine isthmus. The cervix has two parts.
Location: The uterus is located in the center, between the bladder and the rectum, connected to the vagina, with fallopian tubes and ovaries at both ends. The fundus of the uterus is located below the entrance level of the small pelvis when not pregnant, and the lower end of the cervix is slightly above the plane of the ischial spine. When the bladder is empty, the adult uterus Slight forward flexion.
Fixtures: The uterus maintains its normal position by means of ligaments, vagina, urogenital septum, and pelvic floor muscles. Ligaments (1) The broad ligament of the uterus can be limited to the tipping of the uterus to both sides (2) The round ligament of the uterus plays a certain role in maintaining the anterior tilt of the uterus (3) The main ligament of the uterus: It is to maintain the normal position of the cervix and prevent it from prolapse (4) Uterosacral ligament: the round ligament of the uterus coordinates and maintains the flexion of the uterus.
4. Aqueous humor circulation route
Aqueous humor produced by old ciliary body → back of eye → pupil → anterior chamber → iris corneal angle space → scleral venous sinus → anterior ciliary vein → superior and inferior ocular veins
5. The structure of the eyeball wall
The eyeball wall is composed of three layers of eyeball fibrous membrane, eyeball blood vessels and eyeball endometrium (the role of each part). The eyeball fibrous membrane has a supporting and containing function. It is composed of cornea and sclera. The cornea accounts for the anterior 1/6 of the fibrous membrane and the posterior 5/6 is the sclera . The front part of the media is called the ciliary body in the middle of the iris, and the back part is the choroidal endometrium, which is called the retina. The omentum is divided into three parts from front to back, namely, the iris part of the retina, the ciliary body and the blind part of the choroid part. The choroid is the optic part.
6. The structure of the kidney
From the coronal section of the kidney, the renal parenchyma can be seen, which is divided into two parts: cortex and medulla. The cortex is located in the superficial layer, rich in blood vessels. Fresh specimens are reddish-brown leaves about 1-5cm, and the renal medulla is located in the deep part, which is composed of 15-20 light-colored pyramid-shaped renal pyramids. It is called the renal papilla, and it is often composed of 2-3 renal pyramid tips to form a renal papilla, and part of the renal cortex extends into the space between the renal vertebral bodies and is called the renal column. There are many small holes on the top of the nipple, which are called nipple holes. Urine flows into the small calyx from the nipple hole. The small calyx is funnel-shaped and tightly surrounds the renal papilla to receive urine. One small calyx surrounds 1— - 2 renal papillae, a total of 7 - 8. Every 2-3 finally merge to form a funnel-shaped renal pelvis. After the renal pelvis, it gradually narrows in the direction of the renal hilum, and after exiting the renal hilum, it goes down to the upper edge of the second lumbar pyramid and continues to the ureter.
7. Lung, pleura division and body surface projection
The pleura is a layer of serosa lining the inner surface of the chest wall, the top of the diaphragm, both sides of the mediastinum, and the surface of the lungs, etc. The pleura can be divided into costal pleura, diaphragmatic pleura, mediastinal pleura and pleural roof. The visceral pleura that covers the lung surface is called the visceral pleura.
Body surface projection of the lungs: The body surface projections of the lower borders of the two lungs are the same, and the lower border of the lungs is generally two ribs higher than the lower border of the pleura at the same location. It meets the 6th rib at the midclavicular line, the 8th rib at the midaxillary line, and the 10th rib at the scapular line, at the level of the 11th thoracic vertebra.
The anterior body surface projection of the pleura: both sides start from the top of the pleura about 2.5cm above the junction of the middle 1/3 of the clavicle, obliquely downward and inward at the level of the second sternocostal joint, close to the midline, and close to the midline Straight down, the right side crosses the xiphoid angle at the 6th sternocostal joint and turns to the outside, moving to the lower boundary. The right side turns from the 4th sternocostal joint to the outside and descends at about 2-2.5cm lateral to the lateral border of the sternum, descends behind the 6th cartilage on the right side and moves to the inferior border. The interval between the anterior pleural reflex extension lines on both sides is located above the back of the sternum manubrium and is called the thymus area; the lower part of the sternum body and behind the 45th costal cartilage is called the pericardial area, and the right xiphoid angle is the Linshe pericardium Puncture zone safe zone.
Body surface projection of the lower pleura: the right side starts from the 6th sternal rib joint, the left side starts from the midpoint of the 6th costal cartilage, both sides turn outward and downward, intersects with the 8th rib at the midclavicular line, and meets the 10th rib at the midaxillary line The intercostal intersection, where the scapular line intersects with the 11th rib, ends at the height of the 12th thoracic vertebra.
Eight, the excretion route of bile
Bile is produced by liver cells in the liver and stored in the intrahepatic bile duct → left and right hepatobiliary → common hepatic duct → cystic duct → gallbladder
After eating, the gallbladder contracts, from gallbladder→cystic duct→biliary and pancreatic ampulla (sphincter relaxation)→duodenal papilla→duodenal cavity
9. Shape of liver
The liver can be divided into two sides, the front, the front, the left, the left, and the left. The inlaid ligament on the surface of the gallbladder diaphragm divides the liver into two lobes, the left and right. There is a wide groove on the left side, which is called the vena cava groove, in which the inferior vena cava passes through the unevenness below the liver, called the visceral surface, and there is an H-shaped groove in the middle of this surface, in which there are right and left hepatic vessels in the transverse groove, and left and right hepatic proper arteries The left and right branches of the anti-hepatic portal vein and the entry and exit of the lymphatic nerves of the liver are called the hepatic hilum. These structures that enter and exit the hepatic portal are surrounded by connective tissue and are called the hepatic pedicle. Centered behind the left and right hepatic portal veins. The left longitudinal groove is narrow and deep, and there is the round ligament of the liver in front of it, which is called the round ligament fissure. The round ligament is the lock bar formed after the umbilical vein is atresiad. The ligamentum venosus is formed by the atresia of the ductus venosus. The left longitudinal groove is wide, and the shallow fossa in the front accommodates the gallbladder, which is called the gallbladder fossa. It is called the second porta hepatis.
The surface of the liver is divided into thousands of lobes by the "H" groove and fossa: the left side of the left longitudinal groove is the left lobe, the right side of the right longitudinal groove is the right lobe, and the part between the two grooves is divided into square lobe and In the caudate lobe, the anterior border of the liver is thin and sharp. There are two notches on the right called gallbladder notch and those on the left called notch of round ligament of liver. Or the umbilical notch, the posterior edge of the liver is blunt and round, facing the spine, the right edge of the liver is the right lower edge of the right lobe of the liver, which is also blunt, and the left edge of the liver is thin and sharp.
10. Auxiliary structure and movement form of shoulder, shoulder, hip and knee joints
1. The shoulder joint consists of the humeral head and the glenoid of the scapula. The glenoid is superficial and small, the articular lip deepens the articular fossa and still only accommodates 1/4-1/3 of the humeral head, the joint capsule is thin and loose, and there is a synovial sheath or synovial sac inside, and the biceps tendon slips between the tuberosity The fluid sheath passes through the joint, the upper wall of the capsule has the coracohumeral ligament, the anterior and posterior walls are also joined by tendons, and the lower wall is relatively weak. Telekinesis can be used for flexion, extension, extension, external rotation and circular movement. 2 The elbow joint is composed of the lower end of the humerus and the upper end of the ulna and radius, including (1) the humerus-ulnar joint; it is composed of the humeral trochlear and the celestial trochlea (2) the humeral-radial joint is composed of the humeral head and the radius joint (3) the proximal radius and ulnar The lateral joint is composed of the annular articular surface of the radius and the radial notch of the ulna. Three joints are enclosed in a joint capsule, and there is a radial annular ligament in the joint capsule: the radial side of the capsule has the capsule's collateral ligament, and the ulnar side has the ulnar collateral ligament , the ulnar side is reinforced by the ulnar collateral ligament; the anterior and posterior walls of the capsule are thin and loose, and the posterior wall is the weakest.
Posterior dislocation of the ulna. Telemotion form: flexion and extension of the hip joint is formed by the acetabulum and the hip bone. The acetabular lip is attached to the periphery of the acetabulum. The joint capsule is tense and tough. The joint capsule attaches upward to the acetabulum and downward to the femoral neck. The front reaches the intertrochanteric line, and the back covers the medial 2/3 of the femoral neck. There are iliac ligament, femoral head ligament, and pubis ligament around the joint capsule. , ischial ligament, and wheel belt reinforcement.
Telemotion form; flexion, extension, extension, rotation, internal rotation, external rotation and circular rotation.
11. Basic structure and auxiliary structure of joints
Basic structure of joints
1. The articular surface refers to the opposite surface or contact surface of the articular bone. At least two articular surfaces of each joint are generally concave to convex. The convex one is the joint head, and the concave one is the joint fossa. The articular surface is covered with a layer of Articular cartilage composed of hyaline cartilage or fibrocartilage is smooth and elastic, which can reduce friction and cushion shock during exercise.
2. The joint capsule is composed of a fibrous connective tissue membrane, which is attached to the periphery of the joint and fused with the periosteum. It is divided into two layers, the outer layer is the fibrous membrane, which is composed of dense connective tissue rich in blood vessels and nerves, and the inner layer is the synovium, which is composed of loose The connective tissue membrane forms the inner surface of the fiber and attaches to the edge of the articular cartilage, covering all the synovial membranes in the joint except the articular cartilage lip and the articular disc, which can secrete a small amount of synovial fluid to lubricate and protect the articular cartilage Certain nutritional effects.
3. Joint cavity: a closed cavity composed of the synovial layer of the joint capsule and the articular cartilage. The cavity has negative pressure and only a small amount of synovial fluid.
Knee Joint: Consists of the lower end of the femur, the upper end of the femur, and the patella.
Auxiliary structures: including ligaments, disc and labrum, synovial wall and bursa
1) The ligament is composed of dense connective tissue and is located outside the joint capsule between two adjacent bones. It is called an external ligament. It can be a local thickening of the fibrous layer of the joint capsule, or it can be independent of the outside of the joint capsule and is called a capsule inside the joint capsule. The internal ligament, the local thickening of the fibrous layer, can also be independent of the joint capsule, and the one located in the joint capsule is called the intracapsular ligament. The existence of the ligament can increase the stability of the joint
2) 2 articular discs and articular lips (1) Articular pelvis: it is a fibrocartilage plate located between the two articular surfaces. Improve the stability of the joint and diversify the joint movement. (2) Articular labrum: the fibrocartilage ring attached to the periphery of the articular fossa, the joint capsule is cut deeply, and the articular surface is enlarged to increase the stability of the joint. (3) The folds formed by the synovial wall and the synovial sac synovium protruding into the joint cavity are the synovial wall, which contains fat, which is called synovial lipid, and the synovial wall or synovial fat pad can move in the joint At the same time, it plays the role of filling and regulating the joint cavity, and at the same time expands the area of the synovial membrane, which is beneficial to the secretion and absorption of synovial fluid. The synovial fluid is located between the tendon and the bone surface, and the synovial bursa can reduce the friction between the two during exercise.
12. Intima or Retina; Blind and Optic
Optic: The outer layer is the pigment epithelium, and the inner layer is the nerve layer. The nerve layer is mainly composed of 3 types of nerve cells. From the outside to the inside, there are cones, rods, and bipolar cells.
Cones; perceive bright light and color, denser in the macula.
Rod cells; sense low light, widely divided and optic.
Blind spot: At the beginning of the optic nerve, there is a white round bulge, called the optic disc, where there are no photoreceptor cells in the center, it is called the physiological blind spot.
Macula: 3.5 mm below the optic disc side, there is a yellow area composed of dense cone cells. It is called the macula, and its depression is called the fovea, which is the most sensitive part of light.
The blood supply to the retina comes from the central retinal artery, which divides into many branches in the center of the blind spot into the eyeball.
13. Male urethra
The male urethra is about 16-22CM long, and can be divided into three parts according to its formation; the prostatic part (passing through the prostate), the membranous part (passing through the urinary fat diaphragm) and the spongy body part (longitudinal through the urethral spongy body) in which the membranous part The shortest, relatively fixed location, clinical traumatic segmental urethral fissures are likely to occur here, the three strictures of the male urethra are located at the internal urethral opening, membranous portion, and external urethral opening, and urinary stones tend to stay here. Two bends of the viscous urethra: one is below the pubic symphysis, called the pubic subcurvation, convex upward, and this bend is fixed; the other is below the pubic symphysis, called the pubic anterior curve, concave downward, such as lifting the penis upward , the bend disappears and becomes straight. Clinically, when inserting a catheter or other inspection instruments into the male urethra, attention should be paid to the narrow and curved parts of the urethra to avoid damage to the urethra.
14. Shallow and deep sensory conduction pathways in the trunk and limbs
15. Headache and temperature conduction pathways in the head and face
16. Visual conduction pathway and pupillary light reflex
Pupil light reflex:
Retina → optic nerve → optic chiasm → optic tracts on both sides → superior colliculus arm → pretectal region →
→ Oculomotor Nerve → Gesteform Ganglion → Postganglionic Fibers → Pupillary Sphincter