10~内脏神经、内分泌系统(Autonomicn.).ppt
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The Visceral Nervous System
山东大学医学院解剖教研室
李振华
The Visceral Nervous System
Composition
* Visceral motor nerves (autonomic nervous system)
* Sympathetic part交感部
* Parasympathetic part副交感部
* Visceral sensory nerves
Visceral motor nerves
Main differences between somatic motor and visceral motor n.
Sympathetic part 交感部
* Lower center: located in lateral gray horn of spinal cord segments T1~L3
* Sympathetic ganglia
* Paravertebral ganglia椎旁节
* Prevertebral ganglia椎前节
Paravertebral ganglia 椎旁节
* Arranged on either side of vertebral column
* Consist of 19~22 of oval-shaped ganglia
* Three cervical
* 10~12 thoracic
* 4 lumbar
* 2~3 sacral
* Ganglion impar奇神经节: unpaired on the anterior face of coccyx
Sympathetic trunk 交感干
* Formed by paravertebral ganglia and interganglionic branches
* Lie on either side of vertebral column from base of skull to coccyx
* The trunks of two side unite in front of the coccyx at a small swelling, the ganglion impar
Prevertebral ganglia 椎前节
* Lie anterior to vertebral column and near the arteries for which they are named
* Celiac ganglion 腹腔神经节
* Aorticorenal ganglion 主动脉肾节
* Superior mesenteric ganglion 肠系膜上神经节
* Inferior mesenteric ganglion肠系膜下神经节
Three fates of preganglionic fibers
Three fates of preganglionic fibers
* Relay in corresponding ganglion
* Ascend or descend in sympathetic trunk and relay in higher or lower ganglia
* Pass without synapse to a prevertebral ganglion for relay
* Greater splanchnic nerve内脏大神经 formed by preganglionic fibers from T5~T9 ganglia, and relay in celiac ganglion.
* Lesser splanchnic nerve内脏小神经 formed by preganglionic fibers from T10~T12 ganglia, and relay in aorticorenal ganglion.
* The postganglionic fibers supply the liver, spleen, kidney and alimentary tract as far as the left colic flexure.
* Lumbar splanchnic nerve腰内脏神经
* Formed by preganglionic fibers from L1~L4 ganglia, and relay inprevertebral ganglia.
* The postganglionic fibers supplydescending and sigmoid colon, rectum, pelvic viscera and lower limbs.
Three fates of postganglionic fibers
* Back to a spinal nerve along gray communicating branches ( 31 pairs ) to terminate in blood vessels, arrectores pilorum and sweat glands of head, neck, trunk and limbs
* The fibers from their networks around blood vessels passing to visceral end organs
* Terminate directly in certain organs
Distribution of sympathetic nerve
Parasympathetic part 副交感部
* Lower center: located in four pairs parasympathetic nuclei in brain stem and in sacral parasympathetic nucleus of spinal cord segments S2~S4
* Parasympathetic ganglia: terminal ganglia are near or within the wall of avisceral organ
* Para-organ ganglia 器官旁节：
* Ciliary ganglion 睫状神经节
* Pterygopalatine ganglion 翼腭神经节
* Submandibular ganglion 下颌下神经节
* Otic ganglion 耳神经节
* Intramural ganglia 壁内节
Cranial portion颅部
Cranial portion颅部
Ⅲ
accessory oculomotor nucleus〈○sphincter pupillae and ciliary muscles
ciliary ganglion
pterygopalatine ganglion
Ⅶ 〈○lacrimal gland
superior salivatory nucleus
〈○sublingual gland
submandibular ganglionsubmandibular gland
Ⅸ
inferior salivator nucleus 〈○parotid gland
otic ganglion
Ⅹ heart, lungs, liver, spleen,dorsal nucleus of vagus n.〈○ kidneys,alimentary tract
terminal gangliaas far as left colic flexure
Sacral portion 骶部
* Preganglionic fibers from sacral parasympathetic nucleus leave spinal cord with anterior roots of the spinal nerves S2~S4,* Then leave sacral nerves and form pelvic splanchnic nerve and travel by way of pelvic plexus to terminal ganglia in pelvic cavity
* Postganglionic fibers terminate in descending and sigmoid colon, rectum and pelvic viscera
Main differences between sympathetic and parasympathetic
Main differences between sympathetic and parasympathetic
Visceral plexuses
* Cardiac plexuses
* Superficial , below aortic arch
* Deep, anterior to bifurcation on trachea
* Pulmonary plexus
* Celiac plexus
* Abdominal aortic plexus
* Hypogastric plexus
* Superior hypogastric plexus
* Inferior hypogastric plexus (pelvic plexus)
Visceral sensory nerves
Referred pain 牵涉痛
The Endocrine System
山东大学医学院解剖教研室
李振华
The Endocrine System
Composition
* Endocrine glands: have no ducts, theirsecretions (hormone) release directly into bloodstream to its target organ
* Endocrine tissue
Thyroid gland 甲状腺
* Shape and position
* H-shape
* Left and right lobes: lie on either side of inferior part of larynx and superior part of trachea, extend from middle of thyroid cartilage to level of sixth trachea cartilage
* Isthmus: overlies 2nd to 4th tracheal cartilage
* Pyramidal lobe: some times arises from isthmus
* Fibrous capsule: a sheath of pretracheal fascia which is attached to arch of cricoid and thyroid cartilages, hence, the thyroid gland moves with larynx during swallowing and oscillates during speaking
* Function: to produce thyroxin, regulating the rate of metabolism and growth of bony and nervous system
Parathyroid gland 甲状旁腺
* Yellowish-brown, ovoid bodies
* Position
* Two superior parathyroid glands: lie at junction of superior and middle third of posterior border of thyroid gland
* Two inferior parathyroid glands: lie near the inferior thyroid artery, close to the inferior poles of thyroid gland
* Function: regulate calcium and phosphate balance and is therefore essential for life
Suprarenal gland
* Shape and position
* Right is pyramidal in shape, left one semilunar in shape, consisting of out cortex and inner medulla
* Located retroperitoneally, superomedial to superior poles of each kidney, enclose with the kidney by the renal fascia
* Function: secretes adrenaline, noradrenaline and several steroid hormones
Hypophysis
* Shape and position
* Pea-sized organ, attached by infundibulum to hypothalamus, lies in hypophysial fossa
* Consists of two parts:
* Adenohypophysis
* Neurohypophysis
* Relationship
* Above-diaphragm sellae
* Anterosuperior-optic chiasma and optic nerve
* Laterally-cavernous sinus
* Below-sphenoid sinus
Pineal body 松果体
* locates in posterosuperior to thalamus, attached by stalk to posterior part of roof of third ventricle
Thymus 胸腺
* Position:
* Located in superior mediastinum
* Posterior to sternum and between the lungs
* Function:
* Secrets thymosin: to aid in maturation of T-cell
* Secrets thymopoietin
Endocrinetissue
* Pancreatic islet
* Gonad
* Ovary
* Testis
The Visceral Nervous System
山东大学医学院解剖教研室
李振华
The Visceral Nervous System
Composition
* Visceral motor nerves (autonomic nervous system)
* Sympathetic part交感部
* Parasympathetic part副交感部
* Visceral sensory nerves
Visceral motor nerves
Main differences between somatic motor and visceral motor n.
Sympathetic part 交感部
* Lower center: located in lateral gray horn of spinal cord segments T1~L3
* Sympathetic ganglia
* Paravertebral ganglia椎旁节
* Prevertebral ganglia椎前节
Paravertebral ganglia 椎旁节
* Arranged on either side of vertebral column
* Consist of 19~22 of oval-shaped ganglia
* Three cervical
* 10~12 thoracic
* 4 lumbar
* 2~3 sacral
* Ganglion impar奇神经节: unpaired on the anterior face of coccyx
Sympathetic trunk 交感干
* Formed by paravertebral ganglia and interganglionic branches
* Lie on either side of vertebral column from base of skull to coccyx
* The trunks of two side unite in front of the coccyx at a small swelling, the ganglion impar
Prevertebral ganglia 椎前节
* Lie anterior to vertebral column and near the arteries for which they are named
* Celiac ganglion 腹腔神经节
* Aorticorenal ganglion 主动脉肾节
* Superior mesenteric ganglion 肠系膜上神经节
* Inferior mesenteric ganglion肠系膜下神经节
Three fates of preganglionic fibers
Three fates of preganglionic fibers
* Relay in corresponding ganglion
* Ascend or descend in sympathetic trunk and relay in higher or lower ganglia
* Pass without synapse to a prevertebral ganglion for relay
* Greater splanchnic nerve内脏大神经 formed by preganglionic fibers from T5~T9 ganglia, and relay in celiac ganglion.
* Lesser splanchnic nerve内脏小神经 formed by preganglionic fibers from T10~T12 ganglia, and relay in aorticorenal ganglion.
* The postganglionic fibers supply the liver, spleen, kidney and alimentary tract as far as the left colic flexure.
* Lumbar splanchnic nerve腰内脏神经
* Formed by preganglionic fibers from L1~L4 ganglia, and relay inprevertebral ganglia.
* The postganglionic fibers supplydescending and sigmoid colon, rectum, pelvic viscera and lower limbs.
Three fates of postganglionic fibers
* Back to a spinal nerve along gray communicating branches ( 31 pairs ) to terminate in blood vessels, arrectores pilorum and sweat glands of head, neck, trunk and limbs
* The fibers from their networks around blood vessels passing to visceral end organs
* Terminate directly in certain organs
Distribution of sympathetic nerve
Parasympathetic part 副交感部
* Lower center: located in four pairs parasympathetic nuclei in brain stem and in sacral parasympathetic nucleus of spinal cord segments S2~S4
* Parasympathetic ganglia: terminal ganglia are near or within the wall of avisceral organ
* Para-organ ganglia 器官旁节：
* Ciliary ganglion 睫状神经节
* Pterygopalatine ganglion 翼腭神经节
* Submandibular ganglion 下颌下神经节
* Otic ganglion 耳神经节
* Intramural ganglia 壁内节
Cranial portion颅部
Cranial portion颅部
Ⅲ
accessory oculomotor nucleus〈○sphincter pupillae and ciliary muscles
ciliary ganglion
pterygopalatine ganglion
Ⅶ 〈○lacrimal gland
superior salivatory nucleus
〈○sublingual gland
submandibular ganglionsubmandibular gland
Ⅸ
inferior salivator nucleus 〈○parotid gland
otic ganglion
Ⅹ heart, lungs, liver, spleen,dorsal nucleus of vagus n.〈○ kidneys,alimentary tract
terminal gangliaas far as left colic flexure
Sacral portion 骶部
* Preganglionic fibers from sacral parasympathetic nucleus leave spinal cord with anterior roots of the spinal nerves S2~S4,* Then leave sacral nerves and form pelvic splanchnic nerve and travel by way of pelvic plexus to terminal ganglia in pelvic cavity
* Postganglionic fibers terminate in descending and sigmoid colon, rectum and pelvic viscera
Main differences between sympathetic and parasympathetic
Main differences between sympathetic and parasympathetic
Visceral plexuses
* Cardiac plexuses
* Superficial , below aortic arch
* Deep, anterior to bifurcation on trachea
* Pulmonary plexus
* Celiac plexus
* Abdominal aortic plexus
* Hypogastric plexus
* Superior hypogastric plexus
* Inferior hypogastric plexus (pelvic plexus)
Visceral sensory nerves
Referred pain 牵涉痛
The Endocrine System
山东大学医学院解剖教研室
李振华
The Endocrine System
Composition
* Endocrine glands: have no ducts, theirsecretions (hormone) release directly into bloodstream to its target organ
* Endocrine tissue
Thyroid gland 甲状腺
* Shape and position
* H-shape
* Left and right lobes: lie on either side of inferior part of larynx and superior part of trachea, extend from middle of thyroid cartilage to level of sixth trachea cartilage
* Isthmus: overlies 2nd to 4th tracheal cartilage
* Pyramidal lobe: some times arises from isthmus
* Fibrous capsule: a sheath of pretracheal fascia which is attached to arch of cricoid and thyroid cartilages, hence, the thyroid gland moves with larynx during swallowing and oscillates during speaking
* Function: to produce thyroxin, regulating the rate of metabolism and growth of bony and nervous system
Parathyroid gland 甲状旁腺
* Yellowish-brown, ovoid bodies
* Position
* Two superior parathyroid glands: lie at junction of superior and middle third of posterior border of thyroid gland
* Two inferior parathyroid glands: lie near the inferior thyroid artery, close to the inferior poles of thyroid gland
* Function: regulate calcium and phosphate balance and is therefore essential for life
Suprarenal gland
* Shape and position
* Right is pyramidal in shape, left one semilunar in shape, consisting of out cortex and inner medulla
* Located retroperitoneally, superomedial to superior poles of each kidney, enclose with the kidney by the renal fascia
* Function: secretes adrenaline, noradrenaline and several steroid hormones
Hypophysis
* Shape and position
* Pea-sized organ, attached by infundibulum to hypothalamus, lies in hypophysial fossa
* Consists of two parts:
* Adenohypophysis
* Neurohypophysis
* Relationship
* Above-diaphragm sellae
* Anterosuperior-optic chiasma and optic nerve
* Laterally-cavernous sinus
* Below-sphenoid sinus
Pineal body 松果体
* locates in posterosuperior to thalamus, attached by stalk to posterior part of roof of third ventricle
Thymus 胸腺
* Position:
* Located in superior mediastinum
* Posterior to sternum and between the lungs
* Function:
* Secrets thymosin: to aid in maturation of T-cell
* Secrets thymopoietin
Endocrinetissue
* Pancreatic islet
* Gonad
* Ovary
* Testis
相关资料1：
- 《内分泌代谢急症》扫描版.pdf
- [针灸名师临床笔记丛书.内分泌代谢病证卷].周丽莎.朱总秀.扫描版.pdf
- 内分泌科专病与风湿病中医临床诊治（第2版）.pdf
- 临床医师诊疗全书—内分泌.pdf
- 内分泌学基础与临床（池芝盛）.pdf
- 针灸名师临床笔记丛书·内分泌代谢病证卷.pdf
- 内分泌代谢急症.pdf
- 美国内分泌学第三版.pdf
- 6.内科学 内分泌科分册.pdf
- 穴位埋线疗法对雌性去势大鼠生殖内分泌激素及体重变化的影响.PDF
- 实用临床诊疗规范——内分泌和代谢疾病：第一节 单纯性甲状腺肿.pdf
- 706-内分泌科住院医师手册.pdf
- 内分泌代谢疾病手册.pdf
- 临床诊疗指南 — 内分泌及代谢性疾病分册.pdf
- 《实用内分泌与代谢性疾病处方用药手册》.修玲玲.扫描版.pdf