胸部连续横断层解剖及CT

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纵隔断层解剖及CT图像

胸部
主讲:段菊如
教学目的

熟悉胸部的标志性结构及其临床意义。
掌握纵隔（大血管、纵隔间隙、主要的心包窦与心包隐窝、心）的连续横断层解剖，熟悉其CT、MRI图像。

熟悉纵隔（大血管、纵隔间隙、主要的心包窦与心包隐窝、心）的矢、冠状断层解剖及MRI图像。
4、熟悉心的超声图像。

5、熟悉肺局部淋巴结的ATS图及横断面表现。
纵隔断层解剖及ＣＴ图像
纵隔
mediastinum
为两侧纵隔胸膜之间所有器官、结构及结缔组织的
总称
纵隔的位置与境界
心包 pericardium
为圆锥形的囊，包裹心和出入心的大血管根部，由纤维心包和浆膜心包组成。浆膜心包分脏、壁两层，两层互相转折围成的狭窄而密闭的腔隙称心包腔pericardial cavity，心包腔在大血管和心周围形成了许多窦和隐窝，它们是横窦、斜窦、前下窦、心包上隐窝、腔静脉后隐窝、左肺动脉隐窝、左、右肺静脉隐窝、心包前间隙、心包下间隙和心包后间隙，这些窦和隐窝在断层影像诊断中，会被误诊为变异的血管、左冠状动脉、胸腺病变和肿大的肺局部淋巴结，应以注意。
二、体表标志
胸骨角为胸骨柄与胸骨体连结处形成微向前突的角。胸骨角平面是胸部的重要平面，其标志性意义主要有：①是上、下纵隔的分界平面；②后方平对第4胸椎下缘；③平对主动脉弓的起端和止端；④出现气管杈；⑤ 奇静脉弓在此平面内向前汇入上腔静脉；⑥ 左主支气管于此平面与食管交叉(食管形成第二个生理狭窄)；⑦是胸导管由右转向左行的平面；⑧两侧与第2肋软骨相接，为计数肋的标志性平面。
纵隔间隙
纵隔间隙为纵隔器官之间的结缔组织间隙，含疏松结缔组织和淋巴结等，为低 CT值区。纵隔间隙向上经胸廓上口续于颈部间隙，向下经膈的裂孔与腹膜后间隙相连通。纵隔内若有气体、积血或感染，可沿此间隙向上、下蔓延。

最全的胸部CT断层解剖图！！想不会都不行！

最全的胸部CT断层解剖图！！想不会都不行！从胸廓入口至主肺动脉窗水平，从气管隆突下至肝静脉水平，每层均包括定位层面、轴位CT图像、相应示意图、解剖结构名称、相应简图、淋巴结及肺段名称。

简直不要太全面！第一层：胸廓入口水平1. Deltoid muscle 三角肌2. Head of humerus 肱骨头3. Pectoralis major muscle 胸大肌4. Pectoralis minor muscle 胸小肌5. Sternothyroid muscle 胸骨甲状肌6. Internal jugular vein 颈内静脉7. Internal carotid artery 颈内动脉8. Longus colli muscle 颈长肌9. Thyroid gland 甲状腺10. Trachea 气管11. Esophagus 食管12. Sternocleidomastoid muscle 胸锁乳突肌13. Vagus nerve (ramus) 迷走神经14. Anterior scalene muscle 前斜角肌15. Brachial plexus 臂丛神经16. Subclavian artery 锁骨下动脉17. Joint capsule with capsular ligaments 关节囊及囊韧带18. Infraspinatus muscle 冈下肌19. Spine of scapula 肩胛冈20. Coracoid process 喙突21. Trapezius muscle 斜方肌22. Medial and posterior scalenus muscles 中、后斜角肌23. Costovertebral joint (Rib 1) 肋椎关节（第1肋）24. Thoracic vertebra 1 第1胸椎25. Vertebral arch (lamina) 椎弓（椎板）26. Supraspinous ligament 棘上韧带27. Spinal cord 脊髓28. Erector spinae muscle 竖脊肌29. Serratus anterior muscle 前锯肌30. Rhomboid muscle 菱形肌31. Clavicle 锁骨32. Supraspinatus muscle 冈上肌33. Supraclavicular lymph nodes锁骨上淋巴结34. Subclavicular lymph nodes锁骨下淋巴结35. Jugular lymph nodes颈淋巴结36. Paratracheal lymph nodes气管旁淋巴结37. Anterior cervical lymph nodes颈前淋巴结38. Paraesophageal lymph nodes食管周围淋巴结第二层：锁骨下动、静脉水平1. Deltoid muscle 三角肌2. Subscapularis muscle 肩胛下肌3. Pectoralis minor muscle胸小肌4. Pectoralis major muscle 胸大肌5. Clavicle 锁骨6. Subclavius muscle 锁骨下肌7. Vagus nerve (ramus) 迷走神经8. Internal jugular vein 颈内静脉9. Internal carotid artery 颈内动脉10. Thyroid gland 甲状腺11. Trachea 气管12. Sternocleidomastoid muscle 胸锁乳突肌13. Esophagus 食管14. Subclavian artery 锁骨下动脉15. Left lung 左肺16. Rib 1 第1肋17. Intercostal muscle 肋间肌18. Subclavian artery and vein 锁骨下动、静脉19. Brachial plexus 臂丛神经20. Teres major muscle and latissimus dorsi muscle 大圆肌和背阔肌21. Spine of scapula 肩胛冈22. Serratus anterior muscle 前锯肌23. Rib 2 第2肋24. Rhomboid muscle 菱形肌25. Costovertebral joint 肋椎关节26. Erector spinae muscle 竖脊肌27. Thoracic vertebra 2 第2胸椎28. Spinal cord 脊髓29. Sympathetic trunk 交感干30. Trapezius muscle 斜方肌31. Supraspinatus muscle 冈上肌32. Scapula 肩胛骨33. Infraspinatus muscle 冈下肌34. Deep axillary lymph nodes深部腋窝淋巴结35. Intercostal lymph nodes肋间淋巴结36. Paratracheal lymph nodes气管旁淋巴结37. Anterior cervical lymph nodes颈前淋巴结38. Paraesophageal lymph nodes食管旁淋巴结39. Jugular lymph nodes颈淋巴结Right Lung1. Apical segment of upper lobe右肺上叶尖段Left Lung1+2 Apicoposterior segment of upper lobe 左肺上叶尖后段第三层：主动脉弓三大分支水平1. Deltoid muscle 三角肌2. Subscapularis muscle 肩胛下肌3. Pectoralis minor muscle 胸小肌4. Pectoralis major muscle 胸大肌5. Right lung 右肺6. Rib 1 第1肋7. Brachiocephalic vein 头臂静脉8. Clavicle 锁骨9. Brachiocephalic artery 头臂干10. Trachea 气管11. Thymus 甲状腺12. Sternum (manubrium) 胸骨（胸骨柄）13. Left common carotid artery 左颈总14. Recurrent laryngeal nerve 喉返神经15. Left subclavian artery 左锁骨下动脉16. Left lung 左肺17. Rib 2 第2肋18. Intercostal muscle 肋间肌19. Axillary artery and vein 腋动、静脉20. Brachial plexus 臂丛21. Teres major muscle and latissimus dorsi muscle 大圆肌和背阔肌22. Triceps brachii muscle (long head) 肱三头肌（长头）23. Infraspinatus muscle 冈下肌24. Supraspinatus muscle 冈上肌25. Serratus anterior muscle 前锯肌26. Rib 3 第3肋27. Rhomboid muscle 菱形肌28. Erector spinae muscle 竖脊肌29. Sympathetic trunk 交感干30. Spinal cord 脊髓31. Thoracic vertebra 胸椎32. Trapezius muscle 斜方肌33. Esophagus 食管34. Scapula 肩胛骨35. Spine of scapula 肩胛冈36. Deep axillary lymph nodes深部腋窝淋巴结37. Interpectoral lymph nodes胸肌间淋巴结38. Intercostal lymph nodes肋间淋巴结39. Paravertebral lymph nodes椎旁淋巴结40. Anterior mediastinal lymph nodes前纵隔淋巴结41. Paratracheal lymph nodes气管旁淋巴结42. Paraesophageal lymph nodes食管旁淋巴结Right Lung1. Apical segment of upper lobe右肺上叶尖段2. Posterior segment of upper lobe右肺上叶后段3. Anterior segment of upper lobe右肺上叶前段Left Lung1+2 Apicoposterior segment of upper lobe 左肺上叶尖后段3. Anterior segment of upper lobe左肺上叶前段第四层：主动脉弓上缘水平1. Deltoid muscle 三角肌2. Subscapularis muscle 肩胛下肌3. Pectoralis minor muscle 胸小肌4. Pectoralis major muscle 胸大肌5. Right lung 右肺6. Rib 肋骨7. Right brachiocephalic vein 右头臂静脉8. Right brachiocephalic artery 右头臂干9. Vagus nerve 迷走神经10. Trachea 气管11. Left brachiocephalic vein 左头臂静脉12. Sternum (manubrium) 胸骨（胸骨柄）13. Left common carotid artery 左颈总14. Phrenic nerve 膈神经15. Left subclavian artery 左锁骨下动脉16. Left lung 左肺17. Intercostal muscle 肋间肌18. Axillary artery and vein 腋动、静脉19. Rib 肋骨20. Teres major muscle and latissimus dorsi muscle 大圆肌和背阔肌21. Infraspinatus muscle 冈下肌22. Supraspinatus muscle 冈上肌23. Rhomboid muscle major 菱形肌24. Trapezius muscle 斜方肌25. Thoracic vertebra 胸椎26. Spinal cord (thoracic part) 脊髓（胸段）27. Erector spinae muscle 竖脊肌28. Esophagus 食管29. Recurrent laryngeal nerve 喉返神经30. Scapula 肩胛骨31. Spine of scapula 肩胛冈32. Superficial axillary lymph nodes表浅腋窝淋巴结33. Interpectoral lymph nodes胸肌间淋巴结34. Paravertebral lymph nodes椎旁淋巴结35. Paratracheal lymph nodes气管旁淋巴结36. Anterior mediastinal lymph nodes前纵隔淋巴结37. Parasternal lymph nodes胸骨旁淋巴结38. Paraesophageal lymph nodes食管旁淋巴结39. Intercostal lymph nodes肋间淋巴结Right Lung1. Apical segment of upper lobe右肺上叶尖段2. Posterior segment of upper lobe右肺上叶后段3. Anterior segment of upper lobe右肺上叶前段Left Lung1+2 Apicoposterior segment of upper lobe 左肺上叶尖后段3. Anterior segment of upper lobe左肺上叶前段第五层：主动脉弓水平1. Latissimus dorsi muscle 背阔肌2. Subscapularis muscle 肩胛下肌3. Pectoralis minor muscle 胸小肌4. Pectoralis major muscle 胸大肌5. Right lung 右肺6. Rib 肋骨7. Right brachiocephalic vein 右头臂静脉8. Phrenic nerve 膈神经9. Sternum (manubrium) 胸骨（胸骨柄）10. Azygos vein 奇静脉11. Thymus 胸腺12. Trachea 气管13. Aortic arch 主动脉弓14. Left lung 左肺15. Intercostal muscle 肋间肌16. Thoracodorsal artery 胸背动脉17. Infraspinatus muscle 冈下肌18. Scapula 肩胛骨19. Spine of scapula 肩胛冈20. Rhomboid muscle major 菱形肌21. Trapezius muscle 斜方肌22. Sympathetic trunk 交感干23. Erector spinae muscle 竖脊肌24. Spinal cord 脊髓25. Thoracic vertebra 胸椎26. Thoracic duct 胸导管27. Esophagus 食管28. Teres major muscle 大圆肌29. Superficial axillary lymph nodes表浅腋窝淋巴结30. Interpectoral lymph nodes胸肌间淋巴结31. Intercostal lymph nodes肋间淋巴结32. Paratracheal lymph nodes气管旁淋巴结33. Anterior mediastinal lymph nodes前纵隔淋巴结34. Paraesophageal lymph nodes食管旁淋巴结35. Parasternal lymph nodes胸骨旁淋巴结36. Paravertebral lymph nodes椎旁淋巴结Right Lung1. Apical segment of upper lobe右肺上叶尖段2. Posterior segment of upper lobe右肺上叶后段3. Anterior segment of upper lobe右肺上叶前段6. Superior segment of lower lobe右肺下叶上段Left Lung1+2 Apicoposterior segment of upper lobe 左肺上叶尖后段3. Anterior segment of upper lobe左肺上叶前段6. Superior segment of lower lobe左肺下叶上段第六层：主肺动脉窗水平1. Latissimus dorsi muscle 背阔肌2. Thoracodorsal artery 胸背动脉3. Subscapularis muscle 肩胛下肌4. Pectoralis minor muscle 胸小肌5. Pectoralis major muscle 胸大肌6. Right lung 右肺7. Phrenic nerve 膈神经8. Internal thoracic artery and vein 胸廓内动、静脉9. Superior vena cava 上腔静脉10. Sternum (body) 胸骨体11. Thymus 胸腺12. Ascending aorta 升主动脉13. Recurrent laryngeal nerve 喉返神经14. Aorticopulmonary window 主肺动脉窗15. Left lung 左肺16. Intercostal muscle 肋间肌17. Teres major muscle 大圆肌18. Infraspinatus muscle 冈下肌19. Scapula 肩胛骨20. Rhomboid major muscle 大菱形肌21. Rib 肋骨22. Right main stem bronchus 右主支气管23. Trapezius muscle 斜方肌24. Erector spinae muscle 竖脊肌25. Spinal cord 脊髓26. Thoracic vertebra 胸椎27. Thoracic duct 胸导管28. Esophagus 食管29. Descending aorta 降主动脉30. Left main stem bronchus 左主支气管31. Teres minor muscle 小圆肌32. Tracheobronchial lymph nodes气管支气管淋巴结33. Middle mediastinal lymph nodes中纵隔淋巴结34. Paratracheal lymph nodes气管旁淋巴结35.Anterior mediastinal lymph nodes前纵隔淋巴结36. Parasternal lymph nodes胸骨旁淋巴结37. Paraesophageal lymph nodes食管旁淋巴结38. Lymph nodes of the aorticopulmonary window 主肺动脉窗淋巴结39. Paravertebral lymph nodes椎旁淋巴结40. Intercostal lymph nodes肋间淋巴结Right Lung2. Posterior segment of upper lobe右肺上叶后段3. Anterior segment of upper lobe右肺上叶前段6. Superior segment of lower lobe右肺下叶上段Left Lung1+2 Apicoposterior segment of upper lobe左肺上叶尖后段3. Anterior segment of upper lobe左肺上叶前段6. Superior segment of lower lobe左肺下叶上段第七层：气管隆突下水平1. Latissimus dorsi muscle 背阔肌2. Thoracodorsal artery 胸背动脉3. Subscapularis muscle 肩胛下肌4. Pectoralis minor muscle 胸小肌5. Right lung 右肺6. Pectoralis major muscle 胸大肌7. Superior vena cava 上腔静脉8. Phrenic nerve 膈神经9. Ascending aorta 升主动脉10. Sternum 胸骨11. Right pulmonary artery 右肺动脉12. Pulmonary trunk 肺动脉干13. Recurrent laryngeal nerve 喉返神经14. Left pulmonary artery 左肺动脉15. Descending aorta 降主动脉16. Intercostal muscle 肋间肌17. Rib 肋骨18. Teres major muscle 大圆肌19. Infraspinatus muscle 冈下肌20. Scapula 肩胛骨21. Rhomboid major muscle 大菱形肌22. Trapezius muscle 斜方肌23. Right main stem bronchus 右主支气管24. Thoracic vertebra 胸椎25. Spinal cord 脊髓26. Esophagus 食管27. Erector spinae muscle 竖脊肌28. Thoracic duct 胸导管29. Left main stem bronchus 左主支气管30. Left lung 左肺31. Serratus anterior muscle 前锯肌32. Intercostal lymph nodes肋间淋巴结33. Middle mediastinal lymph nodes中纵隔淋巴结34. Anterior mediastinal lymph nodes前纵隔淋巴结35. Paratracheal lymph nodes气管旁淋巴结36. Paraesophageal lymph nodes食管旁淋巴结37. Parasternal lymph nodes胸骨旁淋巴结38. Bronchopulmonary lymph nodes支气管肺淋巴结39. Lymph nodes of the aorticopulmonary window 主肺动脉窗淋巴结40. Para-aortal lymph nodes主动脉旁淋巴结Right Lung 右肺3. Anterior segment of upper lobe上叶前段6. Superior segment of lower lobe下叶上段Left Lung 左肺3. Anterior segment of upper lobe上叶前段6. Superior segment of lower lobe下叶上段第八层：肺动脉干水平1. Latissimus dorsi muscle 背阔肌2. Long thoracic nerve 胸长神经3. Serratus anterior muscle 前锯肌4. Glandular tissue of the breast and nipple 乳腺腺体及乳头5. Right lung 右肺6. Pectoralis major muscle 胸大肌7. Right pulmonary artery 右肺动脉8. Superior vena cava 上腔静脉9. Internal thoracic artery and vein 胸内动脉、静脉10. Ascending aorta 升主动脉11. Sternum 胸骨12. Pulmonary trunk 肺动脉干13. Rib (costal cartilage) 肋骨（肋软骨）14. Left pulmonary vein 左肺静脉15. Left atrium 左心房16. Intercostal muscle 肋间肌17. Rib 肋骨18. Teres major muscle 大圆肌19. Infraspinatus muscle 冈下肌20. Scapula 肩胛骨21. Trapezius muscle 斜方肌22. Right inferior lobar bronchus 右肺下叶支气管23. Erector spinae muscle 竖脊肌24. Thoracic vertebra 胸椎25. Spinal cord 脊髓26. Azygos vein 奇静脉27. Thoracic duct 胸导管28. Esophagus 食管29. Descending aorta 降主动脉30. Left inferior lobar bronchus 左肺下叶支气管31. Rhomboid muscle major 菱形肌32. Left lung 左肺33. Subscapularis muscle 肩胛下肌34. Bronchopulmonary lymph nodes支气管肺淋巴结35. Paravertebral lymph nodes椎旁淋巴结36. Parasternal lymph nodes胸骨旁淋巴结37. Juxtaesophageal lymph nodes食管旁淋巴结38. Anterior mediastinal lymph nodes前纵隔淋巴结39. Para-aortal lymph nodes主动脉旁淋巴结40. Intercostal lymph nodes肋间淋巴结Right Lung 右肺3. Anterior segment of upper lobe上叶前段6. Superior segment of lower lobe下叶上段Left Lung 左肺3. Anterior segment of upper lobe上叶前段6. Superior segment of lower lobe下叶上段第九层：左肺静脉水平1. Latissimus dorsi muscle 背阔肌2. Long thoracic nerve 胸长神经3. Serratus anterior muscle 前锯肌4. Right lung 右肺5. Pectoralis major muscle 胸大肌6. Right inferior lobar bronchus 右肺下叶支气管7. Superior vena cava上腔静脉8. Right auricle 右心耳9. Internal thoracic artery and vein 胸内动脉、静脉10. Left atrium 左心房11. Sternum 胸骨12. Right coronary artery 右冠状动脉13. Ascending aorta 升主动脉14. Rib (costal cartilage) 肋骨（肋软骨）15. Conus arteriosus 动脉圆锥16. Left ventricle 左心室17. Left coronary artery 左冠状动脉18. Rib 肋骨19. Intercostal muscle 肋间肌20. Scapula 肩胛骨21. Right lung in retroesophageal recess食管后隐窝处的右肺22. Trapezius muscle 斜方肌23. Erector spinae muscle 竖脊肌24. Thoracic vertebra 胸椎25. Azygos vein 奇静脉26. Spinal cord 脊髓27. Esophagus 食管28. Thoracic duct 胸导管29. Descending aorta 降主动脉30. Left pulmonary vein 左肺静脉31. Left inferior lobar bronchus 左肺下叶支气管32. Left lung 左肺33. Bronchopulmonary lymph nodes支气管肺淋巴结34. Paravertebral lymph nodes椎旁淋巴结35. Parasternal lymph nodes胸骨旁淋巴结36. Prepericardial lymph nodes心包前淋巴结37. Juxtaesophageal lymph nodes食管旁淋巴结38. Para-aortal lymph nodes主动脉旁淋巴结39. Intercostal lymph nodes肋间淋巴结Right Lung 右肺4. Lateral segment of middle lobe中叶外侧段5. Medial segment of middle lobe中叶内侧段6. Superior segment of lower lobe下叶上段10. Posterior basal segment of lower lobe下叶后基底段Left Lung 左肺4. Superior lingular segment上舌段5. Inferior lingular segment下舌段6. Superior segment of lower lobe下叶上段10. Posterior basal segment of lower lobe下叶后基底段第十层：升主动脉根部水平1. Latissimus dorsi muscle 背阔肌2. Thoracodorsal artery 胸背动脉3. Long thoracic nerve 胸长神经4. Serratus anterior muscle 前锯肌5. Right lung 右肺6. Crista terminalis 界嵴7. Superior vena cava 上腔静脉8. Right atrium 右心房9. Internal thoracic artery and vein 胸内动脉、静脉10. Right coronary artery 右冠状动脉11. Aortic valve 主动脉瓣12. Sternum 胸骨13. Conus arteriosus 动脉圆锥14. Rib (costal cartilage) 肋骨（肋软骨）15. Left coronary artery 左冠状动脉16. Coronary sulcus 冠状沟17. Left ventricle 左心室18. Left coronary artery 左冠状动脉19. Phrenic nerve and pericardium 膈神经和心包20. Left lung 左肺21. Scapula 肩胛骨22. Intercostal muscle 肋间肌23. Rib 肋骨24. Right pulmonary vein 右肺静脉25. Left atrium 左心房26. Trapezius muscle 斜方肌27. Erector spinae muscle 竖脊肌28. Thoracic vertebra 胸椎29. Azygos vein 奇静脉30. Spinal cord 脊髓31. Esophagus 食管32. Transverse process 横突33. Costovertebral joint 肋椎关节34. Thoracic duct 胸导管35. Descending aorta 降主动脉36. Left pulmonary vein 左肺静脉37. Left inferior lobar bronchus 左肺下叶支气管38. Bronchopulmonary lymph nodes支气管肺淋巴结39. Paravertebral lymph nodes椎旁淋巴结40. Parasternal lymph nodes胸骨旁淋巴结41. Prepericardial lymph nodes心包前淋巴结42. Juxtaesophageal lymph nodes食管旁淋巴结43. Para-aortal lymph nodes主动脉旁淋巴结44. Intercostal lymph nodes肋间淋巴结Right Lung 右肺4. Lateral segment of middle lobe中叶外侧段5. Medial segment of middle lobe中叶内侧段8. Anterior basal segment of lower lobe 下叶前基底段9. Lateral basal segment of lower lobe下叶外基底段10. Posterior basal segment of lower lobe 下叶后基底段Left Lung 左肺4. Superior lingular segment上舌段5. Inferior lingular segment下舌段8. Anterior basal segment of lower lobe 下叶前基底段9. Lateral basal segment of lower lobe下叶外基底段10. Posterior basal segment of lower lobe 下叶后基底段第十一层：四腔心水平1. Latissimus dorsi muscle 背阔肌2. Serratus anterior muscle 前锯肌3. Right lung 右肺4. Right atrium 右心房5. Internal thoracic artery and vein 胸内动脉、静脉6. Right coronary artery 右冠状动脉7. Right atrioventricular (tricuspid) valve 三尖瓣8. Sternum (body) 胸骨体9. Right ventricle 右心室10. Interventricular septum 室间隔11. Left atrium 左心房12. Rib (costal cartilage) 肋软骨13. Left coronary artery (interventricular branch) 左冠状动脉（室间支）14. Left ventricle 左心室15. Coronary sinus 冠状窦16. Left coronary artery (circumflex branch) 左冠状动脉（回旋支）17. Phrenic nerve and pericardium 膈神经及心包18. Myocardium 心肌19. Rib 肋骨20. Intercostal muscle 肋间肌21. Azygos vein 奇静脉22. Erector spinae muscle 竖脊肌23. Trapezius muscle 斜方肌24. Spinal cord 脊髓25. Spinous process 棘突26. Esophagus食管27. Sympathetic trunk 交感干28. Thoracic duct 胸导管29. Descending aorta 降主动脉30. Left lung 左肺31. Paramammary lymph nodes乳房旁淋巴结32. Paravertebral lymph nodes椎旁淋巴结33. Lateral pericardial lymph nodes心包外侧淋巴结34. Parasternal lymph nodes胸骨旁淋巴结35. Prepericardial lymph nodes心包前淋巴结36. Juxtaesophageal lymph nodes食管旁淋巴结37. Para-aortal lymph nodes主动脉旁淋巴结38. Intercostal lymph nodes肋间淋巴结Right Lung 右肺4. Lateral segment of middle lobe中叶内侧段5. Medial segment of middle lobe中叶外侧段7. Medial basal (cardiac) segment of lower lobe 下叶内基底段8. Anterior basal segment of lower lobe下叶前基底段9. Lateral basal segment of lower lobe下叶外基底段10 Posterior basal segment of lower lobe下叶后基底段Left Lung 左肺5. Inferior lingular segment下舌段7. Medial basal (cardiac) segment of lower lobe下叶内基底段8. Anterior basal segment of lower lobe下叶前基底段9. Lateral basal segment of lower lobe下叶外基底段10. Posterior basal segment of lower lobe下叶后基底段第十二层：冠状窦水平1. Latissimus dorsi muscle 背阔肌2. Intercostal muscle 肋间肌3. Rib 肋骨4. Right lung 右肺5. Inferior vena cava 下腔静脉6. Internal thoracic artery and vein 胸内动脉、静脉7. Right atrium 右心房8. Xiphoid process 剑突9. Right coronary artery 右冠状动脉10. Right atrioventricular (tricuspid) valve 三尖瓣11. Coronary sinus 冠状窦12. Rib (costal cartilage) 肋软骨13. Right ventricle 右心室14. Circumflex branch of left coronary artery 左冠状动脉回旋支15. Left ventricle 左心室16. Phrenic nerve and pericardium 膈神经及心包17. Serratus anterior muscle 前锯肌18. Sympathetic trunk 交感干19. Thoracic vertebra 胸椎20. Trapezius muscle 斜方肌21. Erector spinae muscle 竖脊肌22. Esophagus 食管23. Spinal cord 脊髓24. Azygos vein 奇静脉25. Thoracic duct 胸导管26. Vagus nerve 迷走神经27. Descending aorta 降主动脉28. Left lung 左肺29. Myocardium of the left ventricle 左心室心肌30. Paravertebral lymph nodes椎旁淋巴结31. Parasternal lymph nodes胸骨旁淋巴结32. Prepericardial lymph nodes心包前淋巴结33. Juxtaesophageal lymph nodes食管旁淋巴结34. Para-aortal lymph nodes主动脉旁淋巴结35. Intercostal lymph nodes肋间淋巴结36. Lateral pericardial lymph nodes心包外侧淋巴结Right Lung 右肺4. Lateral segment of middle lobe中叶内侧段5. Medial segment of middle lobe中叶外侧段7. Medial basal (cardiac) segment of lower lobe 下叶内基底段8. Anterior basal segment of lower lobe下叶前基底段9. Lateral basal segment of lower lobe下叶外基底段10 Posterior basal segment of lower lobe下叶后基底段Left Lung 左肺5. Inferior lingular segment下舌段7. Medial basal (cardiac) segment of lower lobe 下叶内基底段8. Anterior basal segment of lower lobe下叶前基底段9. Lateral basal segment of lower lobe下叶外基底段10. Posterior basal segment of lower lobe下叶后基底段第十三层：心底水平1. Serratus anterior muscle 前锯肌2. Rib 肋骨3. Intercostal muscle 肋间肌4. Liver 肝脏5. Rib (costal cartilage) 肋软骨6. Diaphragm 膈肌7. Inferior vena cava 下腔静脉8. Esophagus 食管9. Rectus abdominis muscle 腹直肌10. Base of heart 心底11. Left lung 左肺12. Latissimus dorsi muscle 背阔肌13. Right lung 右肺14. Sympathetic trunk 交感干15. Azygos vein 奇静脉16. Thoracic duct 胸导管17. Spinal cord 脊髓18. Thoracic vertebra 胸椎19. Costovertebral joint 肋椎关节20. Erector spinae muscle 竖脊肌21. Descending aorta 降主动脉22. Vagus nerve 迷走神经23. Intercostal lymph nodes肋间淋巴结24. Parasternal lymph nodes胸骨旁淋巴结25. Paravertebral lymph nodes椎旁淋巴结26. Para-aortal lymph nodes主动脉旁淋巴结27. Superior phrenic lymph nodes 膈上淋巴结28. Prepericardial lymph nodes心包前淋巴结29. Lateral pericardial lymph nodes 心包外侧淋巴结Right Lung 右肺5. Medial segment of middle lobe中叶内侧段8. Anterior basal segment of lower lobe下叶前基底段9. Lateral basal segment of lower lobe下叶外基底段10. Posterior basal segment of lower lobe下叶后基底段Left Lung 左肺5. Inferior lingular segment下舌段7. Medial basal (cardiac) segment of lower lobe 下叶内基底段8. Anterior basal segment of lower lobe下叶前基底段9. Lateral basal segment of lower lobe下叶外基底段10. Posterior basal segment of lower lobe下叶后基底段第十四层：肝静脉水平1. Intercostal muscle 肋间肌2. Rib 肋骨3. External oblique muscle 腹外肌4. Right hepatic vein 肝右静脉5. Inferior vena cava 下腔静脉6. Left hepatic vein 肝左静脉7. Diaphragm 膈肌8. Vagus nerve 迷走神经9. Esophagus 食管10. Liver (left lobe) 肝左叶11. Rectus abdominis muscle 腹直肌12. Stomach 胃13. Left lung 左肺14. Latissimus dorsi muscle 背阔肌15. Liver (right lobe) 肝右叶16. Right lung 右肺17. Sympathetic trunk 交感干18. Erector spinae muscle 竖脊肌19. Azygos vein 奇静脉20. Thoracic duct 胸导管21. Spinal cord 脊髓22. Thoracic vertebra 胸椎23. Descending aorta 降主动脉24. Posterior vagal trunk 迷走神经后干25. Spleen 脾脏26. Intercostal lymph nodes肋间淋巴结27. Paravertebral lymph nodes椎旁淋巴结28. Para-aortal lymph nodes主动脉旁淋巴结29. Superior phrenic lymph nodes 膈上淋巴结30. Inferior phrenic lymph nodes膈下淋巴结31. Right gastric lymph nodes胃右淋巴结32. Left gastroomental lymph nodes 胃网膜左淋巴结Right Lung 右肺9. Lateral basal segment of lower lobe下叶外侧基底段10. Posterior basal segment of lower lobe 下叶后基底段Left Lung 左肺5. Inferior lingular segment下舌段8. Anterior basal segment of lower lobe 下叶前基底段9. Lateral basal segment of lower lobe下叶外侧基底段10. Posterior basal segment of lower lobe 下叶后基底段。

胸部断层解剖医学课件

5·肋弓肋弓最低点平对第3腰椎。
6·乳头男性乳头一般在锁骨中线与第4 肋间隙交界处, 女性者略低, 并偏外下方
纵隔的分区
纵隔Mediastinum是纵隔胸膜间的全部器官、结构与结缔组织的总称。
纵隔前界:胸骨, 后界:脊柱胸段, 两侧为纵隔胸膜, 上
达胸廓上口, 下至膈。纵隔分区方法有多种, 常用有
特点:1）锁骨下静脉与颈内静脉于锁骨内侧端的后方合成了头臂静脉。
2）肺尖出现, 此区手术易伤及肺尖和胸膜腔, 故应注意锁骨与胸膜腔的关系。锁骨内1/3段的深面, 两侧均见胸膜腔;中1/3段深面左侧有者占80%, 右侧有者占90%, 但多居中1/3段的内侧半深面; 外1/3段深面均未见胸膜腔。胸膜腔的最前点适在颈内静脉与锁骨下静脉汇合处后方, 此点距前体表的距离:左侧平均2·8cm, 右侧平均2·9cm。在锁骨下手术时, 应注意这一关系。
胸部上方以颈静脉切迹、胸锁关节、锁骨上缘、肩峰至第7颈椎棘突的连线与颈、项部分界;
下方借膈与腹部结构为邻;
两侧上部以三角肌前、后缘上份和腋前、后壁下缘与胸壁相交处的连线与上肢分开。
标志性结构
1、颈静脉切迹后方平对第2.3胸椎之间，左、右头臂
静脉通常于此平面内合成。 2.胸骨角 Sternal angle 胸骨角平面是胸部的重要平面，其标志
在主动脉弓右侧、上腔静脉后方和气管前方之间充满疏松结缔组织, 在CT图像上, 为一低密度三角区, 称气管前间隙, 常见直径约7mm的正常右下气管旁淋巴结。纵隔前方为尖朝胸骨的三角区, 在CT图像上称血管筋间隙, 由胸腺充填。
陶腺的形态、位置、大小、毗邻有明显的年龄及个体差异, 成人多呈上尖下宽的锥体形或窄长形, 多具并不对称的两叶, 通常左叶大干右叶。