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1、人体解剖学Human Anatomy,哈尔滨医科大学解剖教研室2004年2月,供五年制用（据人体解剖学北京大学医学出版社修订）,第三篇 脉管系统 Vascular System,组成,心血管系统,淋巴系统,心,动脉,毛细血管,静脉,淋巴管道,淋巴器官,淋巴组织,第一章 心血管系统 Cardivascular System,本章基本要求 掌握体循环和肺循环和侧支循环；心的位置，外形、各心腔的主要结构；心传导系的组成及各结构的位置；掌握左、右冠状动脉的分支分布；心包及心包腔的概念。 熟悉血管吻合;房间隔与室外间隔的位置及临庆意义。心的静脉。心包窦的名称和位置。 心的纤维骨骼。 了解心的纤维骨骼。,
2、二、血管吻合及其功能意义,侧支循环,一、心血管系统的组成,第一节 总论,一、心的位置心位于胸腔的中纵隔内外面裹以心包。前方对肋骨体和第26肋软骨后方对第58胸椎约23居身体正中矢状(切)面的左侧，13居正中矢状(切)面的右侧。心包裸区,（二）心的外形,一底一尖二面三缘四沟,：心底,：心尖,：胸肋面、膈面,：下缘、右缘、左缘,：冠状沟、前室间沟、后室间沟、房间沟,心底,后室间沟posterior interventricular groove,房室交点atrioventricular crux,冠状沟coronary sulcus,膈面diaphragmatic surface,左心耳left
3、auricle,肺静脉pulmonary v.& left auricle,胸肋面sternocostal surface,心尖切迹cardiac apical incisure,前室间沟anterior interventricular groove,心尖cardiac apex,主动脉弓aotic arch,肺动脉干pulmonary trunk,升主动脉ascending aota,右心耳right auricle,Three bordersRight bordervertical, is formed entirely by right atrium Left borderround,
4、 is mainly formed by the left ventricle and partly by the left auricle Inferior borderhorizontal, is formed by the right ventricle and cardiac apex,Four groovesCoronary sulcus 冠状沟(circular sulcus) which marks the division between atria and ventricles, contains the trunks of the coronary vessels and
5、completely encircles the heartInteratrial sulcus 房间沟separates the two atria and is hidden by pulmonary trunk and aorta in frontInterventricular grooves 室间沟anterior and posterior, mark the division between ventricles (which separates the RV from the LV), the two grooves extend from the base of the ve
6、ntricular potion to a notch called: the cardiac apical incisure 心尖切迹Atrioventricular crux 房室交点a junction of the posterior interventricular groove and coronary sulcus,二、心腔,（一）右心房 right atrium,固有心房,腔静脉窦,界沟、界嵴,右心耳right auricle,冠状窦口orifice of coronary sinosinus,右房室口,界嵴crista terminalis,梳状肌.Pectinate m.,
7、卵圆窝fossa ovalis,（二）右心室 right ventricle,窦部（流入道）,漏斗部（流出道、 动脉圆锥）,室上嵴为界,肉柱trabeculae carneae,乳头肌papillary m.,隔缘肉柱septomarginal trabecula,肺动脉口orifice of pulmonary trunk,三叶瓣tricuspid valve,三叶瓣复合体,右房室口纤维环、三叶瓣、腱索和乳头肌在功能上密切相连，因此，将四者合称三叶瓣复合体。,肺动脉瓣valve of pulmonary trunk,腱索chordae tendineae,室上嵴supraventricula
8、r crest,右房室口right atrioventricular orifice,（三）左心房 left atrium,前部：,后部：,左心耳,五个开口,左肺上、下静脉开口,右肺上、下静脉开口,左房室口,左心耳left auricle,左房室口left atrioventricular orifice,二尖瓣bicuspid valve,腱索chordae tendineae,乳头肌papillary m.,肺静脉口orifice of pulmonary trunk,（四）左心室 left ventricle,左房室口left atrioventricular orifice,主动脉口a
9、otic orifice,窦部（流入道）,主动脉前庭（流出道）,二叶瓣前瓣为界,前叶瓣anterior cusp of bicuspid valve,腱索chordae tendinae,肉柱trabeculae carneae,因左房室口纤维环、二叶瓣、腱索和乳头肌在功能和结构上密切关连，故合称二叶瓣复合体。,乳头肌papillary m.,后叶瓣posterior cusp of bicuspid valve,左、右冠状动脉开口,主动脉窦aotic sinuses,主动脉瓣aotic valve,二尖瓣前叶瓣anterior cusp of bicuspid valve,血 流 方 向,三
10、、心的构造,（一）心纤维支架,心肌和瓣膜附着处的纤维性支架称心纤维骨骼。,肺动脉口纤维环fibrous ring of orifice of pulmonary trunk,主动脉口纤维环fibrous ring of aotic orifice,左纤维三角left fibrous trigone,右纤维三角left fibrous trigone,二尖瓣后瓣posterior valve of bicuspid valve,三尖瓣前瓣anterior valve of tricuspid valve,（二）心壁：由心内膜、心肌层、心外膜构成。心室肌厚于心房肌，左心室肌厚于右心室肌。,（三）房
11、间隔和室间隔,室间隔可分为膜部和肌部,室间隔膜部membranous part of interventricular septum,室间隔肌部muscular part of interventricular septum,四、心传导系,（一）窦房结,位置：,右心房界沟上端的心外膜深面,功能：,心的正常起搏点,（二）房室结,位置：,房间隔下部，冠状窦口上方的心内膜下,功能：,将窦房结传来的兴奋发生短暂延搁再传向心室,（三）房室束（His束）,（四）束支,1、右束支,2、左束支,（五）Purkinje 纤维网,房室束、束支和Purkinje 纤维网的功能是将心房传来的兴奋迅速传播到整个心室。,
12、窦房结sinoatrial node,房室结atrioventricular node,房室束,右束支right bundle branch,左束支left bundle branch,结间束？,五、心的血管,（一）动脉,1、右冠状动脉 right coronary artery,2、左冠状动脉 left coronary artery,分布于右心房、右心室、室间隔后1/3部、部分左心室膈壁,前室间支：,旋支：,左心室前壁、部分右心室前壁和室间隔前2/3,左心房、左心室左侧面和膈面,后室间支,左室后支,旋支circumflex branch,前室间支anterior interventricu
13、lar branch,后室间支posterior interventricular branch,左室后支posterior branch of left ventricle,左冠状动脉 left coronary artery,右冠状动脉 right coronary artery,(二） 静脉,1、心最小静脉,2、心前静脉,心前静脉anterior cardiac v.,3、冠状窦,冠状窦coronary sinus,心大静脉心中静脉心小静脉,心中静脉middle cardiac v.,心大静脉 great cardiac v.,心小静脉 small cardiac v.,六、心包 pericardium,外层：纤维心包,内层：浆膜心包,脏层,壁层,心包腔,（一）组成,（二）心包窦,横窦transverse sinus,斜窦oblique sinus,
