Angiology 脉管系统

1. Angiology 脉管系统 山东大学医学院 解剖教研室 李振华

2. Composition • Cardiovascular system心血管系统 • Lymphatic system淋巴系统

3. The cardiovascular system Organization • Heart 心 • A muscle pump to maintain the flow of blood, • Consist of four chambers (right and left atria, right and left ventricles) • Artery 动脉 a.carry blood away from the heart • Veins 静脉 v.carry blood back to the heart • Capillary 毛细血管microscopic vessels, the area of exchange between blood and tissue fluid

4. Blood circulation • Systemic circulation 体循环 left ventricle→aorta and its branches→capillaries of body→superior and inferior vena cava→right atrium • Pulmonary circulation 肺循环right ventricle→pulmonary a.→capillaries of lung→pulmonary v.→right atrium

5. Vascular anastomosis 血管吻合 • Anastomosis between a. • Anastomosis between v. • Arteriolovenular anastomosis 动静脉吻合 • Collateral vessels侧副管 • Circulation侧支循环

6. Rectal venous plexus

7. The Arteries Characteristics • Symmetry 对称 • In the trunk of the body consist parietal and visceral branches 壁支和脏支 • Shortest possible course • Run on flexor surfaces • Usually do not pass directly through muscles, avoiding compression • Together with the veins and nerves in a sheath of fascia to form neurovascular bundle 血管神经束

8. Arteries of pulmonary circulation肺循环的动脉 Pulmonary trunk肺动脉干 • Arises from right ventricle • Runs up, back ,and to the left • Bifurcates inferior to aortic arch into right and left pulmonary arteries, one for each lung

9. Arteries of systemic circulation体循环的动脉 Aorta 主动脉 • Ascending aorta 升主动脉 • Aortic arch 主动脉弓 • Brachiocephalic trunk 头臂干 • right common carotid a. 右颈总动脉 • right subclavian a. 右锁骨下动脉 • Left common carotid a. 左颈总动脉 • Left subclavian a. 左锁骨下动脉 • Descending aorta 降主动脉 • Thoracic aorta 胸主动脉 • Abdominal aorta 腹主动脉

10. Arteries of head and neck • Common carotid a.颈总动脉 • External carotid a. 颈外动脉 • Internal carotid a. 颈内动脉 • Subclavian a. 锁骨下动脉

11. Arteries of upper limb • Axillary a. 腋动脉 • Brachial a. 肱动脉 • Radial a. 桡动脉 • Ulnar a. 尺动脉 • Superficial palmar arch 掌浅弓 • deep palmar arc 掌深弓

12. Thoracic aorta 胸主动脉 • Parietal branches 壁支 • Nine pairs posterior intercostals arteries 肋间后动脉 • One pair subcostal 肋下动脉 • Visceral branches 脏支

13. Abdominal aorta 腹主动脉 Visceral branches 脏支 • Paired branches • Middle suprarenal artery 肾上腺中动脉 • Renal artery 肾动脉 • Testicular (ovarian) artery 睾丸（卵巢）动脉 • Unpaired branches • Celiac trunk 腹腔干 • Superior mesenteric a. 肠系膜上动脉 • Inferior mesenteric a. 肠系膜下动脉 Parietal branches

14. Arteries of pelvis • Common iliac a. 髂总动脉 • Internal iliac a. 髂内动脉 • External iliac a. 髂外动脉

15. Arteries of lower limb • Femoral a. 股动脉 • Popliteal a. 腘动脉 • Posterior tibial a. 胫后动脉 • Anterior tibial a. 胫前动脉 • dorsal a. of foot 足背动脉

16. The Veins 静脉 General feature • Thin walls, larger lumens, venous valves, venous plexus, venous rete • Two sets • Superficial vein • Deep veins • Special structures: • sinuses of dura mater 硬脑膜窦 • diploic veins 板障静脉

17. Venous valve

18. Diploic veins Sinuses of dura mater

19. Superior vena cava and its tributaries Veins of head and neck • Internal jugular vein • External jugular vein • Brachiocephalic vein: venous angle

20. Veins of upper limb • Deep vein: have the same names as their companion arteries • Superficial veins: • cephalic v. 头静脉 • basilica v. 贵要静脉 • median cubital v. 肘正中静脉

21. Veins of thorax • Superior vena cava 上腔静脉 • Azygos v. 奇静脉 • Hemiazygos v. 半奇静脉 • accessory hemiazygos v.副半奇静脉 • Veins of vertebral column 椎静脉丛

22. Inferior vena cava system • Veins of lower limb • Deep vein: have the same names as their companion arteries • Superficial veins: • great saphenous v. 大隐静脉 • small saphenous 小隐静脉

23. Veins of pelvis • Internal iliac v. 髂内静脉 • External iliac v.髂外静脉 • Common iliac v.髂总静脉

24. Inferior vena cava and its tributaries • Hepatic portal v.

25. The Lymphatic System Heart Vein Lymphatic duct Artery Lymphatic trunk Capillaries Lymphatic node Cell Tissue fluid Lymphatic capillary Lymphatic vessel

26. Composition • Lymphatic vessel • Lymphatic capillary • Lymphatic vessels: two sets, superficial and deep • Lymphatic trunks: nine • Lymphatic ducts: thoracic duct, right lymphatic duck • Lymphatic organ • Lymphatic nodes • Tonsil, spleen, thymus • Lymphatic tissue

27. Lymphatic capillary

28. Afferent vessels Afferent vessels Lymphatic node

29. Thoracic duct Right lymphatic duck

30. Lymphatic vessels

31. Introduction of the nervous system 山东大学医学院 解剖教研室 李振华

32. The Nervous System --Divisions • Central nervous system (CNS) 1. Brain（脑） 2. Spinal cord（脊髓） • Peripheral nervous system (PNS) 1. Cranial n. （脑神经 12 pairs) 2. Spinal n. (脊神经 31 pairs) 3. Visceral n.（内脏神经） • Visceral sensory n. • Visceral motor n. • Sympathetic part （交感神经） • Parasympathetic part （副交感神经）

33. The Cranial Nerves 脑神经 • Ⅰ Olfactory nerve 嗅神经 • Ⅱ Optic nerve 视神经 • Ⅲ Oculomotor nerve 动眼神经 • Ⅳ Trochlear nerve 滑车神经 • Ⅴ Trigeminal nerve 三叉神经 • Ⅵ Abducent nerve 展神经 • Ⅶ Facial nerve 面神经 • Ⅷ Vestibulocochlear nerve 前庭蜗神经 • Ⅸ Glossopharyngeal nerve舌咽神经 • Ⅹ Vagus nerve 迷走神经 • Ⅺ Accessory nerve 副神经 • Ⅻ Hypoglossal nerve 舌下神经

34. General description • 31 pairs spinal nerves: 8 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 1 coccygeal nerve. • Formation: each spinal nerve is formed by union of anterior and posterior roots at intervertebral foramen 1.The anterior root Contains motor fibers for skeletal muscles. Those from T1 to L2 contain sympathetic fibers; S2 to S4 also contain parasympathetic fibers. 2. The posterior root Contains sensory fibers whose cell bodies are in the spinal ganglion.

35. Functional components 1. Somatic efferent nerve fibers 躯体传出纤维(SE): fibers that transmit motor impulses from spinal cord to skeletal muscles. 2. Visceral efferent nerve fibers内脏传出纤维(VE): fibers that transmit motor impulses from spinal cord to smooth muscles, cardiac muscle and glands. 3. Somatic afferent nerve fibers躯体传入纤维(SA): fibers that transmit exteroceptive and proprioceptive impulses from body to spinal cord 4. Visceral afferent nerve fibers内脏传入纤维(VA): fibers that transmit interoceptive impulses from the viscera to spinal cord

36. Branches of spinal nerves 1. Anterior branch 前支: largest , innervates anterolateral body wall and limbs，the great nerve plexus, e.g. the cervical, brachial, lumbar, and sacral, are formed by anterior rami 2. Posterior branch 后支: innervates the back of the trunk 3. Communicating branch 交通支: connect the spinal nerve to the sympathetic trunk 4. Meningeal branch 脊膜支: re-enters vertebral canal through intervertebral foramen to dura mater

37. Cervical plexus 颈丛 • Formation: formed by anterior rami of C1-C4 spinal nerves • Position: lies in front of the origin of levator scapulae and scalenus medius and deep to the superior part of the sternocleidomastoid

38. Brachial plexus 臂丛 • Formation: Formed by anterior rami of C5-C8 and T1 spinal nerves • Position: Passes through the scalene fissure to posterosuperior of subclavian artery, then enters the axilla to form three cords

39. Anterior branches of thoracic nerves • Intercostal nerves 肋间神经(anterior rami of T1- T11) • Subcostal nerve 肋下神经(anterior ramus of T12) • Distribution: distributed to intercostales and anterolateral abdominal muscles, skin of thoracic and abdominal wall, parietal pleura and peritoneum

40. Lumbar plexus腰丛 • Formation: formed by anterior rami of L1-L3, a part of anterior rami of T12and L4 • Position: lies within substance of psoas major • Branches • Iliohypogastric n. 髂腹下神经 • Ilioinguinal n. 髂腹股沟神经 • Lateral femoral cutaneous n.股外侧皮神经 • Femoral n. 股神经 • Obturator n. 闭孔神经 • Genitofemoral n. 生殖股神经

41. Sacral plexus 骶丛 • Formation: formed by anterior rami of L4 and L5 spinal nerves (the lumbrosacral trunk) and anterior rami of sacral and coccygeal nerves • Position: lies in pelvic cavity, anterior to sacrum and piriformis