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1、2021/9/16ChengchunChenDeptofAnatomyWZMC1溫州醫(yī)科大學(xué)局部解剖學(xué)歡迎2012臨床醫(yī)學(xué)專業(yè)同學(xué)們!外科學(xué)的重要基礎(chǔ)2021/9/16ChengchunChenDeptofAnatomyWZMC2SECTION2Axillaryregion腋區(qū)腋窩與腋腔的區(qū)別?腋腔的境界:四棱錐,一頂一底(腋窩)四壁腋腔的內(nèi)容腋動脈分段及分支腋靜脈及屬支和腋淋巴結(jié)的分組及回流規(guī)律臂叢的合成(根、干、股和束)及分支4.目的:回顧系統(tǒng)解剖內(nèi)容和訓(xùn)練外科技能5.乳房腫瘤腋窩淋巴結(jié)清掃的主要事項?胸長n和胸
2、背n2021/9/16ChengchunChenDeptofAnatomyWZMC3Axillaryregion:體表2021/9/16ChengchunChenDeptofAnatomyWZMC4Axillaryregion:體表2021/9/16ChengchunChenDeptofAnatomyWZMC5Axillarycavity:腋腔的境界2021/9/16ChengchunChenDeptofAnatomyWZMC6Axillarycavity:腋腔的境界2021/9/16ChengchunChenDep
3、tofAnatomyWZMC7Branches:Axillarycavity:Axillarya2021/9/16ChengchunChenDeptofAnatomyWZMC8Axillarycavity:Axillarya2021/9/16ChengchunChenDeptofAnatomyWZMC9Axillarycavity:Axillarya2021/9/16ChengchunChenDeptofAnatomyWZMC10Axillarycavity:AxillaryV&LN2021/9/16Chengchu
4、nChenDeptofAnatomyWZMC11Axillarycavity:Axillarya2021/9/16ChengchunChenDeptofAnatomyWZMC123rdsegmentanterior:胸大肌、正中神經(jīng)內(nèi)側(cè)根。posterior:橈神經(jīng)、腋神經(jīng)、旋肱后血管、肩胛下肌、背闊肌和大圓肌腱Lateral:正中神經(jīng)外側(cè)根、、肌皮神經(jīng)、肱二頭肌短頭、喙肱肌。medial:尺神經(jīng)、前臂內(nèi)側(cè)皮神經(jīng)、腋靜脈2021/9/16ChengchunChenDeptofAnatomyWZMC13Axillary
5、cavity:brachialplexus臂叢2021/9/16ChengchunChenDeptofAnatomyWZMC14Axillarycavity:brachialplexus2021/9/16ChengchunChenDeptofAnatomyWZMC15Axillaryregion:brachialplexus2021/9/16ChengchunChenDeptofAnatomyWZMC16(1)胸肌淋巴結(jié)。(3)外出淋巴結(jié)。(3)肩胛下淋巴結(jié)。(4)中央淋巴結(jié):收納上述3群淋巴結(jié)的輸出管。(5)尖淋巴
6、結(jié):收納中央淋巴結(jié)、乳房上部淋巴管。輸出管大部分組成左右鎖骨下干。乳腺淋巴2021/9/16ChengchunChenDeptofAnatomyWZMC172021/9/16ChengchunChenDeptofAnatomyWZMC182021/9/16ChengchunChenDeptofAnatomyWZMC19乳腺淋巴回流途徑2021/9/16ChengchunChenDeptofAnatomyWZMC20Axillaryregion腋區(qū)皮膚切口處理腋窩底:皮膚、淺筋膜、觀察淺av皮n處理腋腔深筋膜、觀察
7、腋LN及分組、保護血管神經(jīng)束鈍性分離:腋鞘、篩狀筋膜結(jié)扎腋靜脈主干解剖腋動脈及分支解剖臂叢及分支:胸長n和胸北n觀察腋腔4壁和頂?shù)臉?gòu)成