Human anatomy

1. Human anatomy 山东大学医学院 解剖教研室 李振华

2. Basic Concepts of Anatomy • Definition: human anatomy, the oldest science dealing with the structures and functions of body • Gross anatomy: • systematic anatomy • regional anatomy • Applied anatomy • Clinical anatomy

3. 人体解剖学发展简史 Hippcrates Hippocrates----希波克拉底（公元前460~377）古希腊名医、解剖学鼻祖。

4. Galen Galen-------- 伽林（130~200）古希腊名医、解剖学家，著《医经》，对血液流动、神经分支和脑、心等器官有具体描述。

5. Vesalius------(1514~1564) 现代解剖学的奠基人，1543年出版了《人体构造》这一划时代的解剖学巨著。 Vesalius

6. Harvey Harvey------(1578~1657) 解剖生理学家，发现了血液循环的原理，确定血液是在一个封闭的管道内循环。著有《血液循环论》、《动物的发生》两书。开创了动物实验研究的道路。

7. 我国人体解剖学的发展历程 • 公元前300～200《黄帝内经》已有对人体解剖的记载。 • 两宋时代《五脏六腑》、《存真图》描述了解剖学知识。 • 王清任（1768～1831）编著的《医林改错》更为详细的描述了解剖学知识。 • 1949～2003年我国解剖学工作者队伍迅速成长，编写了多套具有我国特色的解剖学教材和解剖学图谱，对我国解剖学事业的发展做出了巨大的贡献。

8. 人体解剖教学特点 • 人体解剖学的教学包括讲授和实地解剖。主要讲授各系统的总论和各解剖操作区的重点内容。实地解剖采取分组形式，在教师指导下，按照解剖操作指导，参照图谱由学生亲自动手解剖尸体，部分内容观察标本和模型。同时，密切结合活体的观察和触摸，并适当的结合一些临床病例讨论以增强对解剖学内容的理解和记忆。 • 教学大纲所列教学内容按要求程度的不同，分为“掌握内容”和“了解内容”两级。掌握内容为重点内容，学生必须通过反复学习与思考达到牢固掌握、熟练描述、准确指认和联系实际应用的程度。了解内容则要求学生达到一般的认识和了解。

9. Descriptive anatomical terms • The anatomical position: (解剖学姿势) The body is upright, legs together, and directed forwards. The palms are turned forward, with the thumbs laterally.

10. The terms of the direction(方位术语) • superior 上, inferior 下 • anterior (ventral) 前( 腹侧 ) posterior (dorsal) 后 ( 背侧 ) • medial 内侧, lateral 外侧 • internal 内, external 外 • superficial 浅, profound 深 • proximal 近侧, distal 远侧 • ulnar 尺侧, radial 桡侧 • tibial 胫侧，fibular 腓侧

11. Anatomical axesand planes （轴与面） • Axis 轴： • Vertical axis 垂直轴 • Sagittal axis矢状轴 • Coronal axis 冠状轴 • Plane面: • Sagittal plane 矢状面 • Coronal plane 冠状面 • Horizontal plane水平面 或transverse plane 横切面

12. The Locomotor System运动系统 • 运动系统由bone 骨、joints关节和muscles 骨骼肌组成，占成人体重60% • 骨起杠杆作用 • 关节是运动的枢纽 • 骨骼肌是动力器官 • 功能: • support 支持 • Protection 保护 • Locomotion 运动

13. Introduction of the osteology 骨学总论 • Bones in adult are 206 in number. • Classification of bone Bones are classified according to their position and shape • The position can be: • skull 颅骨 • bones of trunk 躯干骨 • appendicular skeleton 四肢骨 • Types of shape include: • long bone 长骨 • short bone 短骨 • flat bone 扁骨 • irregular bone不规则骨

14. Long bones (found in limbs): • Diaphysis or shaft 骨干, which is hollow (called medullary cavity 骨髓腔), filled with bone marrow • Two ends－epiphysis 骺articular surface 关节面, metaphysis干骺端, epiphysial cartilage 骺软骨, and epiphysial line 骺线 • Short bones: cuboidal in shape, e.g. carpal bones

15. Flat bones: thin, • Irregular bones: have any irregular or mixed shape, e.g. vertebrae, pneumatic bones含气骨 *Sesamoid bones籽骨: develop within tendon

16. General structures of bone骨的构造 • Bone substance 骨质 • compact bone骨密质 • spongy bone骨松质 呈海绵状，由trabeculae骨小梁构成 ※In the flat bones of the skull, the layers of compact bone are called the outer plate and inner plate外板和内板, while the layer of spongy bone is called the diploë 板障

17. Periosteum 骨膜: • Outer or fibrous layer • Inner layer is vascular and provides the underlying bone with nutrition. It also contains osteoblasts(成骨细胞) Endosteum骨内膜is a single-cellular osteogenic layer lining the inner surface of bone. • Bone marrow 骨髓 • Red marrow 红骨髓: haematopoietic 造血 • Yellow marrow黄骨髓: fatty

18. Chemical composition and physical properties化学成分和物理性质 • Organic material有机质： 主要是骨胶原纤维束和粘多糖蛋白。构成支架，赋予骨的弹性和韧性。 • Inorganic salts无机质： 主要是碱性磷酸钙。赋予骨硬度和脆性

19. Bones of trunk 躯干骨 • Composition: vertebrae, sacrum, coccyx, sternum and ribs Vertebrae 椎骨 • There are 33 vertebrae in children, arranged as follows: • Cervical vertebrae 颈椎 C.7 • Thoracic vertebrae胸椎 T.12 • Lumbar vertebrae腰椎L.5 • Sacral vertebrae骶椎S.5 sacrum 骶骨 • Coccygeal vertebrae尾椎Co.3~4 coccyx尾骨

20. General features of vertebrae • Vertebral body 椎体 • Vertebral arch 椎弓 • pedicle of vertebral arch 椎弓根: sup. and inf. Vertebral notch 椎上、下切迹 • lamina of vertebral arch 椎弓板 • process (7): • spinous process 棘突 • transverse process 横突 • sup. and inf. articular processes 上、下关节突 • Vertebral foramen 椎孔 • Vertebral canal 椎管 • Intervertebral foramen 椎间孔

21. Regional variations of vertebrae Cervical vertebrae • Vertebrae Body: small • Vertebral foramen: larger and triangular • Spinous processes: short and bifid in C3 to C5, long in C6,and longer in C7 • Transverse processes: short and bifid, transverse foramen横突孔 • Articular processes: horizontal

22. Atypical vertebeae • Atlas寰椎(C1) • Body and spinous process absent, consists of anterior and posterior arches, and two lateral masses • Groove for vertebral artery 椎动脉沟

23. Axis枢椎(C2): distinguished by dens齿突which articulates with dental fovea of anterior arch of atlas

24. Carotid tubercle: 颈动脉结节: anterior tubercle of transverse process of C6 • Vertebra prominens隆椎(C7):contains long and non-bifid spinous process, it is visible with neck flexed, used as clinical landmark in counting cervical and thoracic spinous processes

25. Thoracic vertebrae • Vertebrae Body ： heart-shape, superior and inferior costal fovea 上、下肋凹 • Vertebral foramen： smaller, rounder • Spinous processes： long, point obliquely downward • Transverse processes： transverse costal fovea 横突肋凹 • Articular processes: coronal

26. Lumbar vertebrae • Vertebrae Body： larger, kidney-shape • Vertebral foramen: larger and triangular • Spinous processes: projects horizontally • Transverse processes: long • Articular processes: sagittal

27. Sacrum • Anterior surface: promontory岬, anterior sacral foramina骶前孔(four pairs) • Posterior surface: median sacral crest 骶正中嵴, posterior sacral foramina (four pairs), sacral hiatus骶管裂孔，sacral cornu 骶角 • Lateral part: auricular surface耳状面, sacral tuberosity骶粗隆

28. Cornua Sacral hiatus palpation Transsacral (epidural) anasthesia

29. Sternum • Manubrium sterni 胸骨柄: jugular notch 颈静脉切迹, clavicular notch 锁切迹 • Body of sternum 胸骨体 • Xiphoid process ★ Sternal angle 胸骨角: the junction of manubrium and body, which connects 2nd costal cartilage laterally, and lies opposite lower border of T4 posteriorly

30. ★ Sternal angle 胸骨角 which connects 2nd costal cartilage laterally, and lies opposite lower border of T4 posteriorly

31. Ribs肋: 12 pair • General features • Ribs 1~7 called true ribs真肋 • Ribs 8~10 called false ribs假肋 • Ribs 11~12 called floating ribs浮肋

32. Characteristics of “typical” rib • Posterior end: costal head 肋头, costal neck肋颈, costal tubercle肋结节 • Shaft: costal angle肋角, costal groove 肋沟 • Anterior end

33. Atypical rib • First rib: tubercle for scalenus anterior前斜角肌结节, sulcus for subclavian artery and vein 锁骨下动、静脉沟 • 11th and 12th ribs lack costal necks, tubercles and angles

34. The Bones of Limbs 山东大学医学院 解剖教研室 李振华

35. Bones of upper limbs Composition: • Should girdle 上肢带骨clavicle锁骨，scapula肩胛骨 • Bones of free upper limb 自由上肢骨 • Humerus肱骨in arm • Radius桡骨and ulna尺骨in forearm • Carpal腕骨, metacarpals掌骨 and phalanges指骨in hand

36. Clavicle 锁骨 • “S” shaped, medial 2/3 convex forward and lateral 1/3 convex backward • Sternal end胸骨端medially and acromial end肩峰端laterally

37. Scapula肩胛骨 • Three borders • Superior: coracoid process 喙突 , scapular notch 肩胛切迹 • Lateral (axillary) border腋缘 • Medial (vertebral) border脊柱缘 • Three angles • Superior: opposite to the 2nd rib • Inferior: opposite to the 7th rib or 7th intercostals space • Lateral: glenoid cavity关节盂, supra- and infraglenoid tubercles 盂上、下结节 • Two surfaces • Anterior surface concave: subscapular fossa肩胛下窝 • Posterior surface: supra- and infraspinous fossae冈上、下窝,spine of scapula 肩胛冈, acromion 肩峰

38. Humerus肱骨 • Upper end: head of humerus肱骨头, anatomical neck解剖颈, greater and lesser tubercles大、小结节, crests of greater and lesser tubercle, 大、小结节嵴，intertubercular groove结节间沟, surgical neck外科颈 • Shaft: deltoid tuberosity三角肌粗隆on lateral surface, and a groove for radial nerve桡神经沟on posterior surface • Lower end: lateral and medial epicondyles内、外上髁, capitulum 肱骨小头, trochlea 肱骨滑车, coranoid fossa 冠突窝and radial fossa 桡窝(anteriorly) and olecranon fossa鹰嘴窝(posteriorly), and sulcus for ulnar nerve 尺神经沟

39. Radius • Upper end: head of radius桡骨头, neck of radius桡骨颈, radial tuberosity 桡骨粗隆, and articular circumference环状关节面 • Shaft：interosseous border骨间缘 • Lower end: styloid process茎突laterally, ulnar notch尺切迹medially, and carpal articular surface腕关节面inferiorly

40. Fracture of the distal end pf the radius

41. Ulnar • Upper end: olecranon鹰嘴 coronoid process冠突 trochlear notch滑车切迹 radial notch桡切迹 ulnar tubersity尺骨粗隆 • Lower end styloid process 尺骨茎突 head of ulna 尺骨头

42. Carpal bones 腕骨 • Proximal row ― (lateral to medial) scaphoid手舟骨, lunate月骨, triquetral三角骨and pisiform豌豆骨 • Distal row ― (lateral to medial) trapezium大多角骨, trapezoid小多角骨, capitate头状骨and hamate钩骨 Metacarpal bones掌骨 • Numbered one to five from thumb to little finger • Structure of each―base (proximally), shaft, and head (distally) Phalanges of fingers 指骨 • Consist of 14 ―two for first digit (thumb) and three for each of other four digits • Structure of each ―base (proximally), shaft, and trochlea of phalanx (distally), tuberosity of distal phalanx远节指骨粗隆

43. Bones of Lower Limb Composition: • Pelvic girdle: hip bone髋骨 • Bones of free lower limb: • Femur股骨in thigh ( patella髌骨) • Tibia胫骨and fibula腓骨 in leg • Tarsals跗骨, metatarsals跖骨, phalanges of toes趾骨in foot

44. Hip bone Consisting of three fused bones, ilium, ischium, pubis • Ilium髂骨 • Body of ilium 髂骨体 to form superior 2/5 of acetabulum髋臼 • Ala of ilium 髂骨翼: iliac crest 髂嵴, anterior superioriliac spine 髂前上棘， anterior inferior iliac spine 髂前下棘, tubercle of iliac crest髂结节, posterior superioriliac spine 髂后上棘，posterior inferior iliac spine 髂后下棘, greater sciatic notch 坐骨大切迹, gluteal surface 臀面，iliac fossa 髂窝, arcuate line弓状线, auricular surface 耳状面, iliac tuberosity 髂粗隆,

45. Ischium 坐骨 • Body of ischium 坐骨体―to form posterior and inferior 2/5 of acetabulum, ischial spine坐骨棘, lesser sciatic notch 坐骨小切迹 • Ramus of ischium 坐骨支, ischial tuberosity 坐骨结节 • Pubis耻骨 • Body of pubis 耻骨体―to form anterior and inferior 1/5 of acetabulum, iliopubic eminence 髂耻隆起 • Superior ramus of pubis 耻骨上支: pecten of pubis 耻骨梳, pubic tubercle 耻骨结节, pubic crest 耻骨嵴, symphysial surface耻骨联合面 • Inferior ramus of pubis耻骨下支: obturator foramen 闭孔 • Acetabulum 髋臼―formed by bodies of ischium, ilium and pubis Lunate surface月状面, acetabular fossa髋臼窝, acetabular notch髋臼切迹

46. Femur股骨 • Upper end: femoral head股骨头, fovea of femoral head 股骨头凹, neck of femur 股骨颈, greatertrochanter 大转子，lesser trochanter 小转子,intertrochanteric line 转子间线, intertrochanteric crest 转子间嵴 • Shaft: linea aspera 粗线, gluteal tuberosity 臀肌粗隆, pectineal line耻骨肌线 ，popliteal surface 腘面 • Lower end: medial and lateral condyles内、外侧髁， medial and lateralepicondyles内、外上髁, adductor tubercle 收肌结节，intercondylar fossa髁间窝, patellar surface髌面

47. Fracture of the femoral neck

48. Tibia胫骨 • Upper end: medial and lateral condyles 内、外侧髁, intercondylar eminence 髁间隆起, fibular articular surface 腓关节面, tuberosity of tibia胫骨粗隆 • Shaft: interosseous border 骨间缘, soleal line 比目鱼肌线 • Lower end: fibular notch腓切迹, medial malleolus 内踝

49. Fibula腓骨 • Upper end: fibularhead 腓骨头, neck of fibula 腓骨颈 • Shaft: interosseous border骨间缘 • Lower end: lateral malleolus 外踝 Patella 髌骨 • triangular sesamoid bone

50. Tarsal bones跗骨 Consist of seven short bones arranged in three row • Posterior row ―talus 距骨, calcaneus 跟骨 • Intermediate row ―navicular bone 足舟骨 • Anterior row ―medial, intermediate, and lateral cuneiforms 内侧、中间和外侧楔骨, cuboid bone 骰骨