1、外科学课件合辑之一（共外科学课件合辑之一（共436页）页） 目录目录 1.1.The female reproductive organsThe female reproductive organs 2.The male reproductive organs2.The male reproductive organs 3.Urinary system3.Urinary system 4.Introduction of the nervous system4.Introduction of the nervous system 5.Vestibulochlear organ5.Vestibul
2、ochlear organ 6.visual organ6.visual organ 7.cranial nerves7.cranial nerves 8.spinal nerves8.spinal nerves 9.Spinal Cord9.Spinal Cord 10.The Visceral Nervous System10.The Visceral Nervous System Female Reproductive System 女性生殖系女性生殖系 3 The Reproductive System The male reproductive organs The female r
3、eproductive organs 4 MALE FEMALE Internal genital organs Gonads Testis Ovary Transport ducts Epididymis Ductus deferens Ejaculatory duct Male urethra Uterine tube Uterus Vagina Accessory glands Seminal vesicle Prostate Bulbourethral gland Greater vestibular gland External genital organs Scrotum Peni
4、s Vulva Structures of the reproductive systems 5 Internal Genital Organs: gonad- ovaries (卵巢） ducts - uterine tubes （输卵管） uterus （子宫） vagina（阴道） accessory glands- greater vestibular gland （前庭大腺） External genital organs: vulva or female pudendum The Female Genital Organs 6 7 Location: in the ovarian
5、fossa Features: two surfaces: lateral and medial two extremities: superior and inferior. two borders: two ligaments: suspensory lig. of ovary; proper lig. of ovary . Ovaries 卵巢卵巢 8 Ovary 9 10 four parts: infundibulum of uterine tube(漏斗部） ampulla of uterine tube（壶腹部） isthmus of uterine tube（峡部） uteri
6、ne part（子宫部） two orifices: abdominal orifice（腹腔口） uterine orifice（子宫口） . Uterine tubes 输卵管输卵管: 11 12 . Uterus 子宫子宫: The portion and relations: - in the lesser pelvis - anteversion（前倾） - anteflexion（前屈) relations - anteriorly: urinary bladder, vesicouterine pouch - posteriorly: sigmoid colon, rectum,
7、 rectouterine pouch - inferiorly: vagina 13 Anteversion (前倾）前倾） Anteflexion (前屈）前屈） 14 15 16 17 The features of the uterus : inverted pear shaped 3 portions: the fundus the body the cervix- 2 parts: supravaginal part vaginal part isthmus 峡部峡部 18 isthmus 19 Supports of uterus 子宫的固定装置子宫的固定装置: -Broad l
8、igaments 子宫阔韧带 mesovarium 卵巢系膜 mesosalpinx 输卵管系膜 mesometrium 子宫系膜 - Round ligaments 子宫圆韧带 - Cardinal ligaments 子宫主韧带 - Uterosacral ligaments 骶子宫韧带 20 21 22 The round ligaments 23 24 Cardinal ligaments 25 26 27 The structures: - endometrium 子宫内膜 - myometrium 肌层 - perimetrium 子宫外膜 cavity of uterus cer
9、vical canal internal orifice external orifice 28 29 . Vagina 阴道阴道: The fornix of vagina fornix 30 31 . Female pudendum 女阴女阴 mons pubis 阴阜 greater lips 大阴唇 lesser lips 小阴唇 vaginal vestibule 阴道前庭 vaginal orifice, external orifice of the urethra orifices of the greater vestibular glands clitoris and hy
10、men 阴蒂和处女膜 . Greater vestibular glands 前庭大腺前庭大腺 32 33 Greater vestibular glands 34 . The Mammae in Female: Location features: nipple, areolar glands, Structure: 1520 lobes of mammary gland - lactiferous duct - lactiferous sinus fibrous connective tissue and fat - suspensory ligaments (Coopers ligmen
11、t) 35 36 37 38 思考题思考题 试述女性生殖器的组成 试述输卵管的分部及其意义 试述子宫的分部、位置及其固定装置 试述子宫颈的分部 试述女性乳房的形态结构特征 名词解释：子宫峡、阴道穹、会阴 39 The Male Reproductive System 男性生殖系男性生殖系 41 The Reproductive System The male reproductive organs The female reproductive organs 42 MALE FEMALE Internal genital organs 内生殖器 Gonads 生殖腺 Testis 睾丸 Ova
12、ry 卵巢 Transport ducts 输送管道 Epididymis 附睾 Ductus deferens 输精管 Ejaculatory duct 射精管 Male urethra 男性尿道 Uterine tube 输卵管 Uterus 子宫 Vagina 阴道 Accessory glands 附属腺 Seminal vesicle 精囊腺 Prostate 前列腺 Bulbourethral gland 尿道球腺 Greater vestibular gland 前庭大腺 External genital organs 外生殖器 Scrotum 阴囊 Penis 阴茎 Vulva
13、 女阴 Structures of the reproductive systems 43 The male reproductive organs Internal genital organs: gonad- testis (睾丸）睾丸）, ducts - epididymis （附睾）（附睾）, ductus deferens （输精管）（输精管） ejaculatory ducts （射精管）（射精管） urethra （尿道）（尿道） accessory glands- seminal vesicle (精囊腺精囊腺) prostate (前列腺前列腺) bulbourethral
14、glands (尿道球腺尿道球腺) External genital organs: scrotum (阴囊阴囊), penis (阴茎阴茎) 44 45 46 . The testis 睾丸睾丸: The features of testes- Paired oval-shaped organs They are in the scrotum (crypart) 2 extremities, 2 surfaces, 2 borders: Posterior border (mesorchial border) connected with the epididymis Anterior bo
15、rder- 47 The structure of testes: 48 Position: in the scrotum, attached to the posterior borderof the testis External feature: 3 parts- head, body, tail Structure: . The Epididymis 附睾附睾: 49 . The ductus deferens: 输精管输精管 输精管的分部： 睾丸部 testicular part, 精索部 spermatic part, 腹股沟部 inguinal part, 盆部 pelvic p
16、art: 最长 输精管末端膨大称之为： 输精管壶腹输精管壶腹ampulla ductus deferentis 50 The ductus deferens Testicular part Funicular part Inguinal part Pelvic part 51 Spermatic cord 精索精索: - 位于睾丸上端与腹股沟管内口之间。 - 内含的结构有: 输精管 ductus deferense, 睾丸动脉 testicular artery 蔓状静脉丛 pampiniform plexus of vein 神经丛 nervous plexus 淋巴管 lymphatic
17、vessels - 三层被膜: 精索外筋膜 external spermatic fascia 提睾肌 cremaster muscle 精索内筋膜 internal spermatic fascia 52 53 Descending testis 54 Formation: Its formed by the union of the end portion of the ductus deferens and the seminal vesicle duct. Position: It penetrated the base of the prostate, and opened into
18、 the prostatic portion of urethra. .The Ejaculatory duct 射精管射精管: 55 56 分三部分 前列腺部 prostatic portion 膜部 membranous portion 海绵体部 cavernous portion 三个狭窄的位置 内口 internal orifice 膜部 membranous portion 外口 external orifice 三个扩大的位置 前列腺部 prostatic portion 尿道球部 bulbar portion of urethra 舟状窝 navicular fossa 两个弯曲
19、 耻骨下弯 subpubic curvature 耻骨前弯 prepubic curvature . The male urethra 男性尿道男性尿道: 57 58 Location in the lesser pelvic. Between the urinary bladder and the urogenital diaphragm; in front of the rectum and posterior to the pubic symphysis Features- Chestnut-shaped apex, base, anterior surface, posterior s
20、urface (a prostatic sulcus) the urethra passed it Structure: 5 lobes . The prostate 前列腺前列腺 59 60 61 62 63 . The seminal vesicles 精囊腺精囊腺: oval sacculated organs posterior to the fundus of urinary bladder open to the ejaculatory duct . The bulbourethral gland 尿道球腺尿道球腺 in the urogenital diaphragm open
21、to the bulbar portion of urethra 64 65 External genital organs 外生殖器外生殖器 Scrotum 阴囊阴囊 Penis 阴茎阴茎 66 .The Scrotum 阴囊阴囊: 层次：皮肤 skin, 肉膜 dartos (septum) 内容: 睾丸 testis, 附睾 epididymis, 精索 spermatic cord 67 . Penis 阴茎阴茎 外形分为三部外形分为三部: 头头 head (glans) 体体 body 根根 root 构造和层次构造和层次: - 三条海绵体 cavernous : 两条阴茎海绵体 c
22、avernous bodys of penis 一条尿道海绵体 cavernous body of urethra - 白膜 albuginea - 阴茎深筋膜 deep fascia of penis - 浅筋膜 superficial fascia - 皮肤 skin *阴茎包皮 Prepuce *包皮系带 Frenulum Prepuce 68 69 70 71 思考题思考题 试述男性生殖系统的组成 试述输精管的分部及精索的组成 试述男性尿道的分部及狭窄部位 试述前列腺的分部及其与尿道的关系 试述精子的产生与排出途径 The Urinary System 泌尿系统泌尿系统 泌尿系组成：泌
23、尿系组成： Kidney 肾肾form urine Ureter 输尿管输尿管conduct urine from kidneys to bladder Bladder 膀胱膀胱receives and stores urine Urethra 尿道尿道conducts urine from bladder to exterior of body (discharged) Kidney 肾肾 1.General features Bean shaped, reddish- brown organs Superior extremitybroad and thin Inferior extrem
24、ity narrow and thick Anterior surfaceconvex Posterior surfaceflat Lateral borderconvex Medial borderconcave Renal hilum 肾门肾门a vertical slit on the medial border of kidney, the structures which enter and leave the renal hilum is called renal pedicle 肾蒂肾蒂, including the renal vein, renal artery, renal
25、 pelvis, lymphatic vessels and nerves Order of structures in the renal pedicle from anterior to posteriorV. A. P.; from superior to inferiorA. V. P. Renal sinus 肾窦肾窦 which is the renal hilum leads into a space within the kidney, the rental sinus is occupied by the： renal vessels 肾血管肾血管 minor renal c
26、alices 肾小盏肾小盏 major renal calices 肾大盏肾大盏 renal pelvis 肾盂肾盂 lymphatic vessels 淋巴管淋巴管 nerves 神经神经 adipose tissue 脂肪组织脂肪组织 2.Structure of the kidney 肾的构造肾的构造 Renal cortex 肾皮质肾皮质 Renal columns 肾柱肾柱 Renal medulla 肾髓质肾髓质 Renal pyramids 肾锥体肾锥体: 1520 Renal papilla 肾乳头肾乳头 Papillary foramina 乳头孔乳头孔 Minor rena
27、l calices 肾小盏肾小盏 (78) Major real calices 肾大盏肾大盏 (23) Renal pelvis 肾盂肾盂 3.Coverings 被膜被膜 （1）Fibrous capsule 纤维囊纤维囊 a strong fibrous capsule which strips easily from a normal kidney surface but adheres firmly to an organ that has been inflamed （2）Fatty renal capsule 肾脂肪囊肾脂肪囊 a thick adipose connective
28、 tissue capsule, surrounds the fibrous capsule. It acts as a shock absorber to protect the kidney from jolting and jarring （3）Renal fascia 肾筋膜肾筋膜 on outside, surrounds both the kidney and suprarenal gland, holding these organs in place 4. Position 位置位置 Lie behind peritoneum one on each side of the v
29、ertebral column high up on the post abdominal wall, upper pole nearer to media plan than lower pole Left kidney lies at the level from T11 to L2; the 12th rib is behind its middle part of the post surface Right kidney lies at the level from T12 to L3; the 12th rib is behind its upper part of the pos
30、t surface Renal hilum at the level of L1, is about 5cm from the posterior median line Renal region 肾区肾区the area between 12th rib and the lateral margin of erector spinae Superiorlysuperarenal gland Posteriorly Three muscles Diaphragm (pleural cavity), Psoas major Quadratus lumborum Three nerves Subc
31、ostal n. Iliohypogastric n. Ilioinguinal n. Medial Left kidneyabdominal aorta Right kidneyinferior ceva vana 5.Relationships 毗邻（作为了解内容）毗邻（作为了解内容） Anteriorly Left kidney Stomach (superior), Pancreas (middle), Loops of intestine and left colic flexure (inferiorly) Right kidney Right lobe of liver (sup
32、erior) Right colic flexure (inferior) Descending part of duodenum (medially) 6.Renal segments 肾段肾段 The kidney is divided into five vascular segments and each is supplied by a branch of the renal artery; between the segments there is no anastomosis. 肾可以分为肾可以分为5段：段： Superior segment 上段上段 Superior ante
33、rior segment 上前段上前段 Inferior anterior segment 下前段下前段 Inferior segment 下段下段 Posterior segment 后段后段 肾的管道铸型肾的管道铸型 Ureters 输尿管输尿管 输尿管分为三部分：输尿管分为三部分： 腹部腹部 Abdominal partdescend on the psoas major behind the peritoneum 盆部盆部 Pelvic partin females, passes 2cm lateral to the neck of uterus and lies below the
34、 uterine artery 壁内部壁内部 Intramural partpasses obliquely through the bladder wall for 2cm long 三个狭窄（三个狭窄（constrictions） At the pelvoureteric junction Where it crosses the pelvic inlet and iliac vessels Where it pierces the bladder wall obliquely (at intramural part) Stone in ureter 输尿管结石输尿管结石 Bladder
35、膀胱膀胱 1.外形外形 尖尖 Apex, 底底 Fundus 体体 Body of bladder 颈颈 Neck 尖尖 体体 底底 颈颈 2.膀胱的内面膀胱的内面 Mucous membrane folded, except for trigone of bladder Trigone of bladder 膀胱三角膀胱三角 formed by internal urethral orifice 尿道内口尿道内口anteriorly and two ureteric orifices 输尿管口输尿管口 Interureteric fold 输尿管间襞输尿管间襞 muscular elevat
36、ion, between ureteric orifices.2. 3.Location 位置位置 In the adult, it lies in the lesser pelvis, behind the pubic symphysis 耻骨耻骨 联合联合, in front of seminal vesicle精囊精囊, ampulla ductus deferentis 输精管输精管 and rectum in the male, and in front of uterus and vagina in the female. In the young child the empty
37、bladder projects above the pelvic inlet 骨骨 盆入口盆入口. Urethra 尿道尿道 1.女性尿道女性尿道 特点：粗、短（特点：粗、短（5cm)、直。、直。 开口部位：阴道前庭开口部位：阴道前庭 分分3部部 prostatic portion 前列腺部前列腺部 membranous portion 膜部膜部 cavernous portion 海绵体部海绵体部 3个狭窄（个狭窄（constrictions） internal orifice 内口内口 membranous portion 膜部膜部 external orifice 外口外口 3个扩张（
38、个扩张（dilations） prostatic portion 前列腺部前列腺部 bulbar portion of urethra 尿道球部尿道球部 navicular fossa 舟状窝舟状窝 2个弯曲（个弯曲（curvatures） subpubic curvature 耻骨下弯耻骨下弯 prepubic curvature 耻骨前湾耻骨前湾 2.男性尿道男性尿道 Retroperitoneal space 腹膜后间隙腹膜后间隙 Positionit lies between the parietal peritoneum and transvers fascia of the pos
39、terior abdominal wall, from diaphragm to promontory of sacrum, continuation with extraperitoneal fascia. Contentskidney, suprarenal gland, ureter, abdominal aorta, inferior vena cava, nervers and lymphatics, loose connective tissue Suprarenal gland 肾上腺肾上腺 Position Located retroperitoneally, superome
40、dial to superior poles of each kidney, enclose with the kidney by the renal fascia Shape Right： pyramidal Left：semilunar Arteries Superior suprarenal a. Middle suprarenal a. Inferior suprarenal a. Venous drainge Right suprarenal v. drains into inferior vena cava Left suprarenal v. joins left renal v
41、. Blood supply of Suprarenal gland 思考题思考题 试述泌尿系统的组成，思考尿液产生和排出的 途径。 试述肾的形态、结构、被膜、位置与毗邻 试述输尿管的行程及狭窄部位 名词解释：肾门、肾窦、肾盂、肾锥体、肾柱、 膀胱三角 Introduction of the nervous system 神经系统总论神经系统总论 Contents Organization of Nervous System Elements of Nervous system Reflex and reflex Arcs Functions of Nervous System Teminol
42、ogy Organization of Nervous System Central nervous system 中枢神经系统中枢神经系统 1. Brain 脑脑 2. Spinal cord 脊髓脊髓 Peripheral nervous system 周围神经系统周围神经系统 1. Cranial n. 脑神经（脑神经（12 pairs) 2. Spinal n. 脊神经脊神经 (31 pairs) 3. Visceral n. 内脏神经内脏神经 Elements of Nervous system Neurons 神经元神经元 Basic functioning units of th
43、e nervous system Neuroglia 神经胶质神经胶质 Supporting cells Neuron 神经元 Cell body：perikaryon (核周体） Dendrites：receive messages from other neurons and send them to the cell body Axons：carry messages away from the cell body Silver Stain Nissl Stain Types of nerve cells (1) according to number of their processe
44、s Bipolar neuron 双级神经元 Pseudounipolar neuron 假单级神经元 Multipolar neuron 多级神经元 Types of nerve cells (2) sensory neurone 感觉神经元 relay neurone 中间神经元 motor neurone 运动神经元 according to their functions Sensory neurons Receive information Send impulses to the brain or spinal cord Relay neuron (Interneurons) Carries impulses from sensory nerves to motor nerves. Motor neuron Conduct impul
