全身肌由于構(gòu)造不同可分為平滑肌、心肌和骨骼肌。骨骼肌skeletalmuscle具有收縮的特性，是運(yùn)動(dòng)系統(tǒng)的動(dòng)力部分，其收縮受神經(jīng)支配，接受人的意志控制，故稱隨意肌。全身有600余塊肌，占體重40%。每塊肌都是一個(gè)器官：有一定形態(tài)、構(gòu)造，有血管、淋巴管，受神經(jīng)支配，執(zhí)行一定功能。肌學(xué)總論總論

一、骨骼肌的形態(tài)和構(gòu)造2.

classificationofskeletalmuscle：longmuscleshortmuscleflatmuscleorbicularmuscle1..constructionofskeletalmuscle：bellytendonaponeurosis二肌的起止、配布、作用1、起于一塊骨，止于另一塊骨跨過一個(gè)或多個(gè)關(guān)節(jié)。

2、起點(diǎn)（定點(diǎn)）、止點(diǎn)（動(dòng)點(diǎn)），動(dòng)定可互換。

3、肌在關(guān)節(jié)周圍配布的方式和多少與關(guān)節(jié)的運(yùn)動(dòng)類型密切相關(guān)。

4、沿一個(gè)運(yùn)動(dòng)軸周圍應(yīng)配布相對應(yīng)的兩組肌。

三、肌的分部和命名分部：

頭頸?。侯^肌、頸肌

軀干?。罕臣?、胸肌、腹肌、膈、會(huì)陰肌

四肢?。荷现?、下肢肌命名：

按肌的形態(tài)、大小、位置、起止或作用進(jìn)行命名。肌的輔助結(jié)構(gòu)1、淺筋膜superficialfascia---于真皮之下，又稱皮下筋膜，包被全身，由疏松結(jié)締組織構(gòu)成，富含脂肪。內(nèi)有淺動(dòng)脈、淺靜脈、皮神經(jīng)和淺淋巴管穿行。2、深筋膜deepfascia：又稱固有筋膜，致密結(jié)締組織構(gòu)成，位于淺筋膜深面，包被體壁、四肢的肌和血管神經(jīng)等。形成肌間隔、血管神經(jīng)鞘

滑膜囊synovial

bursa：為封閉的結(jié)締組織囊。腱鞘tendinoussheath:包圍在肌腱外的鞘管，存在于腕、踝、手指和足指處。腱纖維鞘、腱滑膜鞘臟層壁層腱系膜腱纖維鞘腱滑膜鞘臟層腱滑膜鞘壁層腱系膜腱指骨頭肌可分為面肌和咀嚼?。ㄒ唬┟婕acialmuscles又稱表情?。褐饕植加诿娌苛芽字車?，呈環(huán)狀和放射狀分布。大體可分為四群：

顱頂肌epicranius：枕額肌：枕腹、額腹、帽狀腱膜

眼輪匝肌orbicularisoculi：使瞼裂閉合

口周圍肌orbicularisoris：口輪匝肌、提上唇肌提口角肌、降下唇肌、降口角肌、

頰肌

鼻肌nasalis

頰肌Facialmuscles面肌咀嚼肌

masticatorymuscles

Masseter咬肌Origin－inferiorborderandmedialsurfaceofzygomaticarchInsertion－lateralsurfaceoframusofmandibleandangleofmandibleAction－elevatesmandibleTemporalis顳肌Origin－temporalfossaInsertion－coronoidprocessofmandibleAction－elevatesandretractsmandible翼外肌Lateralpterygoid收縮時(shí)拉下頜關(guān)節(jié)的關(guān)節(jié)盤連同下頜頭向前至關(guān)節(jié)結(jié)節(jié)的下方，作張口運(yùn)動(dòng)。一側(cè)作用時(shí)使下頜移向?qū)?cè)翼內(nèi)肌Medialpterygoid收縮時(shí)上提下頜骨，并使其向前運(yùn)動(dòng)。一側(cè)作用時(shí)使下頜移向?qū)?cè)Themusclesofneck頸肌一、頸淺層肌和頸外側(cè)肌1.Platysma頸闊肌，菲薄的皮肌，起自胸大肌和三角肌的筋膜，向內(nèi)上止于口角。可拉口角向下。

2.Sternocleidomastoid胸鎖乳突肌origin:Anteriorsurfaceofmanubriumandsternalendofclavicalinsertion:

MastoidprocessoftemporalboneActon:onesideactingalone,drawsheadtowardthesameside,andturnfacetooppositeside;bothsidestogether,drawheaddirectlybackward頸前肌1.舌骨上肌群SuprahyoidmusclesDigastric二腹肌Mylohyoid下頜舌骨肌Stylohyoid莖突舌骨肌Geniohyoid頦舌骨肌

作用：當(dāng)舌骨固定時(shí)，拉下頜骨向下而張口吞咽時(shí)，下頜骨固定，上提舌骨。

2.舌骨下肌群InfrahyoidmuscleSternohyoid胸骨舌骨肌Thyrohyoid甲狀舌骨肌Sternothyroid胸骨甲狀肌Omohyoid肩胛舌骨肌--下降舌骨和喉.頸前肌Musclesoftheneck頸深肌群Deepgroup位于脊柱頸部兩側(cè)和前方。LateralScalenusanterior前斜角肌Scalenusmedius中斜角肌Scalenusposterior后斜角肌Mediallonguscapitis頭長肌

longuscolli頸長肌一側(cè)肌收縮,使頸側(cè)屈;兩側(cè)肌同時(shí)收縮可上提第1、2肋助吸氣.Scalenefissure

斜角肌間隙Boundaries

firstribscalenusanteriorandmediusStructurespassingthroughscalenefissurebrachialplexus臂叢subclaviana.鎖骨下動(dòng)脈Musclesoftrunk軀干肌Musclesofback背肌Musclesofthorax胸肌Diaphragm膈Musclesofabdomen腹肌musclesofperineum會(huì)陰肌TheMusclesofBack淺層Superficialgroup斜方肌Trapezius肩胛提肌Levatorscapulae菱形肌Rhomboideus背闊肌Latissimusdorsi深層deepgroupErectorspinae豎脊肌Splenius夾肌TheMusclesofBackDeepgroup

Splenius

夾肌Erectorspinae

豎脊肌Position:fillsthevertebralgrooveoneachsideofthespineAction:bothsidestogetherextendsvertebralcolumnandhead.actingalong,flexthevertebralcolumnlaterally.MajorMusclesofBackTrapezius

斜方肌Origin:superiornuchalline,externaloccipitalprotuberance,ligamentumnuchaeandspinousprocessesofseventhcervicalandallthoracicvertebraeInsertion:lateralthirdofclavicle,acromion,andspineofscapularActon:drawthescapulatowardvertebralcolumn.supperfiberselevatescapula,lowerfibersdepressscapula;ifscapulaisfixed,onesideactingalong,drawsheadtowardthesameside,andturnfacetooppositeside;bothsidestogether,drawheaddirectlybackwardMajorMusclesofBackLatissimusdorsi

背闊肌Origin:SpinousprocessesoflowersixthoracicandalllumbarvertebraeMediansacralcrestPosteriorpartofiliaccrestInsertion:crestoflessertubercleAction:trunkfixed,extends,adductsandmediallyrotatesarm;armfixed,elevatestrunkThoracolumbarFascia胸腰筋膜

PosteriorlayerMiddlelayerAnteriorlayer指在豎脊肌周圍的筋膜，在腰部可分為三層：后層：豎脊肌后面；中層：分隔豎脊肌和腰方??；深層：覆蓋在腰方肌前面MusclesofthoraxMusclesconnectingtheupperlimbtothethoracicwallPectoralismajor

胸大肌

Pectoralisminor

胸小肌

Serratusanterior

前鋸肌★Major

musclesofthorax

PectoralisMajor

胸大肌★Origin:medialhalfofclavicle,sternum,uppersixcostalcartilages.Insertion:crestofgreatertubercleAction:adductsthearmandrotatesitmedially;theclavicularfibersalsoflexthearm;withthearmabovethehead,raisethebodyasinclimbingThemusclesofthorax

ExtrinsicmusclesPectoralismajorPectoralisminorSerratusanteriorIntrinsicmusclesIntercostalesexterni肋間外肌Intercostalesinterni肋間內(nèi)肌Intercostalesintimi肋間最內(nèi)肌Transversusthoracis胸橫肌Major

musclesofthorax

Intercostalesexterni

肋間外肌Origin:inferiorborderofribaboveInsertion:superiorborderofribbelowReplacedanteriorlybyexternalintercostalsmembrane

Action:raiseribsaddinginforcedinspiration★Majormusclesofthorax

Intercostalesinterni

肋間內(nèi)肌★Origin:superiorborderofribbelowInsertion:inferiorborderofribaboveReplacedposteriorlybyinternalintercostalsmembrane.Action:depressribsforforcedexpirationIntercostalesintimi肋間最內(nèi)肌★Diaphragm膈Shapeandpositiondome-shapedbetweenthoraxandabdomenconsistsofaperipheralmuscularpartandacentraltendonOriginSternalpart:arisingfromxiphoidprocessCostalpart:arisingfromlowersixandcostalcartilagesLumbarpart:arisingbytwocrurafromupper2-3lumbarvertebrae,medialandlateralarcuateligamentsInsertion:centraltendon★Diaphragm膈Weakareas:

LumbocostaltriangleSternocostaltriangleOpeningsinthediaphragmAortichiatus主動(dòng)脈裂孔－liesanteriortothebodyofthe12ththoracicvertebrabetweenthecrura.Ittransmitstheaorta,thoracicductEsophagealhiatus食管裂孔－foresophagusandvagusnervesatlevelofT10.Venacavaforamen腔靜脈孔－forinferiorvenacava,throughcentraltendonatT8levelT8T10T12Action:Contraction:thedomemovingdownward,increasesthevolumeofthoraciccavitywhichresultsininspiration,atthesametimetheintra-abdominalpressureisincreasedassistsindefecation排便,vomiting嘔吐orchildbirth.Relaxation:thedomereturnstotheformerposition,reducesthevolumetothethoraciccavity,resultinginexpiration.

四、腹肌MusclesofabdomenAnterolateralgroupObliquusexternusabdominis腹外斜肌Oblequusenternusabdominis腹內(nèi)斜肌Transversusabdominis腹橫肌Rectusabdominis腹直肌腹外斜肌腹內(nèi)斜肌Posteriorgroup

Quadratuslumborum腰方肌Psoasmajor腰大肌髂肌iliacusObliquusexternusabdominis腹外斜肌Generaldirectionoffibers:downward,forwardStructuresInguinalligament

腹股溝韌帶Lacunarligament

腔隙韌帶pectinealligament恥骨梳韌帶Superficialinguinalring

腹股溝管淺環(huán)－triangular-shapeddefect缺損inaponeurosisofobliquusexternusabdominisabovepubictubercleObliquusinternusabdominis腹內(nèi)斜肌Position:deeptoobliquusexternusabdominisGeneraldirectionoffibres:upwards,forwardsTransversusabdominis

腹橫肌Position:deeptoobliquusinternusGeneraldirectionoffibres:runmoreorlesshorizontally.腹外斜肌腹內(nèi)斜肌腹橫肌腹橫肌腹內(nèi)斜肌腹直肌Inguinalfalx腹股溝鐮:archoverspermaticcord,insertedwithtransversesabdominisfiberintomedialpartofpectenofpubisCremaster提睪肌:aroundthespermaticcord精索andtestis睪丸腹股溝鐮Rectusabdominis腹直肌

Position:lieontoeitherofmidlineOrigin:pubiccrestandsymphysisInsertion:xiphoidand5th-7thcostalcartilagesHas3-4tendinousintersections

腱劃

Similarfunctionsforabovefourpairsofmuscles1.Supportandcompresstheabdominalviscera2.Increaseintra-abdominalpressure,aidinvomiting嘔吐,coughing,sneezing,defecation排便,urination排尿andchildbirth.3.Depressribs,assistin(theactofforce(4)expiration.4.Flex,lateralflex,androtatevertebralcolumn.Sheathofrectusabdominis

腹直肌鞘Antlayer－formedbyfusionofaponeurosisofobliquusexternusabdominisandanteriorleafofaponeurosisofobliquusinternusabdominisPostlayerFormedbyfusionofposterionleafofaponeurosisofobliquusinternusabdominisandaponeurosisoftransversesabdominisAbsentinabout4-5cmbelowtheumbilicus,whereaponeurosesofallthreemusclesformanteriorlayerthelowerfreebordernamedarcuatelineBelowthislinerectusabdominisincontactwithtransversefasciaLineaalba白線－tendinousraphe縫betweenrightandleftrectifromxiphoidtopubicsymphysis.Inguinalcanal

腹股溝管Position:obliquepassage,4cmlong,located1.5cmabovemedialhalfofinguinallig.BoundariesAnteriorwallAponeurosisofobliquusexternusabdominisObliquusinternusabdominis(lateralthirdofwall)PosteriorwallTransversefasciaInguinalfalxmediallySuperiorwall－archedlowerfibersofobliquusinternusandtransversuaabdominisinferiorwall－inguinallig．TwoopeningsSuperficialinguinalring腹股溝管淺環(huán)Deepinguinalring腹股溝管深環(huán)－defectintransversefascia1.5cmabovemidpointofinguinalligamentStructurespassingthroughtheinguinalcanalSpermaticcord

精索

andilioinguinalnerve髂腹股溝神經(jīng)

inmalesRoundligamentofuterus

子宮圓韌帶andilioinguinalnerve髂腹股溝神經(jīng)

infemales

InguinalTriangle(ofHesselbach)腹股溝三角

Boundaries

InguinalligamentinferiorlyLateralborderofrectusabdominismediallyInferiorepigastricarterylaterally內(nèi)面觀Teachingoutline1