胸部thorax

胸廓(Thoracic cage)
• 骨骼bone
– 胸骨(stemum)
– 十二塊胸椎(Thoracic vertebrae) T1~T12
– 十二對肋骨 (Rlbs)
• 關節(joint)
– 肋軟骨關節(Costochondral joint)
– 胸肋關節(肋軟骨與胸骨間的關節) sternocostal
(chondrosternal) Joints
– 胸段脊柱(Thoraclc vertebral column)
 背部肌肉(Muscle of the Back)
• 淺層背部肌肉
• rhomboid major muscle(大菱形肌)
• rhomboid minor muscle(小菱形肌)
• Latissimus Dorsi Muscle(背闊肌)
• 背部呼吸肌(respiratory muscles of the back)
• Serratus Posterior Superior Muscle(後上鋸肌)
• Serratus Posterior inferior Muscle(後下鋸肌)
• Levatores costarum muscle(提肋肌)
• 豎脊肌群(Erector Spinae Muscles)
• iliocostalis muscle(髂肋肌) (最外)
• Longissimus muscle(最長肌)
• Spinalis(棘肌) (最內)
• 橫脊肌群(transversospinalis muscles)
• semispinalis muscle(半棘肌)
• mutifidus muscle(多裂肌)
• rotatores muscle(迴旋肌)
• 棘突橫突肌群(Spinotransversales Muscles)
• splenius capitis muscle(頭夾肌)
• splenius cervicis muscle(頸夾肌)
• interspinales muscle(棘突間肌)
• 節肌群(Segmental Musles)
• Levatores costarum muscle(提肋肌)
• Intertransversarii muscle(橫突間肌)
• interspinales muscles(棘突間肌)
http://anatomy.kmu.edu.tw/video/Transverspinal.html
• 胸內複合體(Inner Complex)
– External Intercostals muscle(肋間外肌)
– Internal Intercostals muscle(肋間內肌)
– Subcostales muscle(肋骨下肌)
– Innermost muscle(最內肋間肌)
– Transverse Thoracis muscle(胸橫肌)
骨骼bone
胸骨Sternum

胸骨柄manubrium
胸骨角sternal angle
胸骨體body of sternum
劍突xiphoid process
肋骨rib
肋軟骨Costal cartilages
真肋True ribs(1~7)

假肋False ribs(T8~T10)

胸椎Thoracic vertebrae
浮肋Floating ribs (11-12)
 scapula

胸椎Thoracic vertebrae

肋骨rib

Costal cartilages

True ribs(1~7)

False ribs(T8~T10)
橫突Transverse process
Floating ribs (11-12)
棘突Spinous proces
Sternal Angle
• 肩胛骨是貼在第二至第八肋上
(scapula is attached on the second to eighth rib)
• 肩胛棘的根部----第三胸椎棘突尖端
(inferior spine of scapula---the spinal process of
the third thoracic)
• 肩胛骨的下角--七胸椎的棘突尖端
(inferior angle of scapula-- the spinal process of
the seven thoracic)
 Rib 2

T3 Spine of scapula

Rib 8
T7 Inferior angle of scapula
• 胸腔入口(inlet of thorax)
– 胸骨柄 (Manubrium)
– 第一肋 (1st rib)
– 第一胸椎(1st thoracic vertebral)
• 胸腔出口(outlet of thorax)
– 劍突 (Xiphoid process)
– 第七、八、九、十對肋骨的肋軟骨 (7th ,8th ,9th
10th Costal cartilages)
– 第十一肋的尖端 (tip of the 11th rib)
– 第十二肋整段 (whole part of 12th rib)
前彎Lordosis

後彎(kyphosis)，

脊椎側彎（Scoliosis
Sternal notch

胸骨柄manubrium

胸骨角sternal angle

胸骨體body of sternum

劍突xiphoid process

肋軟骨Costal cartilages
 肋骨(Rlbs)
• 胸廓兩側各有十二根肋骨
• 第八肋最長、第十二肋最短
• 肋骨會藉由它們頭部和結節部的小面(facets)
與後方的椎骨體和橫突分別形成關節
• 第一、第十、第十一、第十二根肋骨的頭部只
有一個關節小面，其餘肋骨者有兩個小面
• 第十一、第十二肋骨也沒有結節
 Left 1st and 2nd Ribs Superior View

肋骨頭head

肋骨頸Neck
粗隆Tubercle

中斜角肌
Middle scalene muscle

前鋸肌
Serratus anterior muscle (1st digitation)

前鋸肌
Serratus anterior muscle (2st digitation)
Posterior scalene muscle Angle
關節Joint
 Sternocostal Articulations Anterior View

Seternal notch

柄胸關節
胸鎖關節
Manubriosternal joint sternoclavicular joint

Costal cartilages
胸肋關節
sternocostal joint

肋軟骨關節
Costochondral joints
(上下)關節突關節
(zygapophyseal joint)
 Middle Rib Posterior View

上關節面Superior articular facet of rib head

articular facet for transverse process of vertebra

肋橫突關節面
肋橫突關節(Costotransverse joint)

Angle 下關節面
Inferior articular facet
of rib head
肋椎關節
(Costovetebral joint)
 Thoracic Vertebra (T6) Superior View

Body

椎孔Vertebral foramen

上肋骨關節面
Superior costal facet
肋椎關節
(costovertebral joints) Superior articular facet
關節突關節(zygapophys

橫肋骨關節面
Transverse costal facet
 Thoracic Vertebra (T6)

Superior costal facet

Superior articular facet

Body

Transverse costal facet

Spinous process

Inferior costal facet

Inferior articular facet
Thoracic Vertebra (T6) Thoracic Vertebra (T12)
Inferior costal facet (for head of rib one number higher)

前側縱韌帶Anterior longitudinal ligament

Superior costal facet (for head of rib of same number)

Muscle
Muscle
 背部呼吸肌
(respiratory muscles of the back)

Serratus Posterior inferior Muscle

(後下鋸肌)
o:Vertebrae T11 - L2
I:The inferior borders of the 9th through 12th ribs

Serratus Posterior Superior Muscle

(後上鋸肌)
O:the spinous processes of the vertebrae C7 through T3
I:The upper borders of the 2nd through 5th ribs

Levatores costarum muscle

(提肋肌)
O:Transverse processes of C7 to T12 vertebrae
I:Superior surfaces of the ribs
豎脊肌群(Erector Spinae Muscles)
Longissimus muscle(最長肌) iliocostalis muscle(髂肋肌)
Spinalis(棘肌)
橫脊肌群(transversospinalis
muscles)
multifidus muscle(多裂肌)
O: Sacrum, Erector spinae Aponeurosis, PSIS, and Iliac crest
I: spinous process

semispinalis muscle(半棘肌)

rotatores muscle(迴旋肌)
O: Transverse process
I: Junction of transverse process and lamina, spinous process
 節肌群(Segmental Musles)
Intertransversarii muscle(橫突間肌)

interspinales muscles(棘突間肌)

Levatores costarum muscle(提肋肌)

胸內複合體(Inner Complex)
External Intercostals muscle(肋間外肌)

Internal Intercostals muscle(肋間內肌)

Subcostales muscle(肋骨下肌)

Transversus Thoracis muscle(胸橫肌)

O: Costal cartilages of last 3-4 true ribs, body of sternum and xiphoid process
I: Ribs/costal cartilages 2-6

Innermost Intercostals muscle(最內肋間肌)

 Pectoralis major muscle Pectoralis minor muscle
胸大肌 胸小肌

Sternocleidomastoid muscle

Deltoid muscle
三角肌

serratus anterior muscle

前鋸肌

External oblique muscle

外斜肌

Rectus abdominis muscle

腹直肌
 Trapezius muscle斜方肌

Levator scapulae muscle

肩夾提肌
Rhomboid minor muscle
菱形肌

Deltoid muscle

Latissimus doisi muscle

Serratus anterior muscle
前鋸肌

External oblique muscle

外斜肌
Iliocostalis muscle髂肋肌
(Erector spinae muscle豎脊肌 )

Longissimus muscle最長肌
(Erector spinae muscle)

Spinalis muscle棘肌
(Erector spinae muscle)
斜角肌 Anterior scalene muscles
 Sternocleidomastoid muscle Sternohyoid muscle
Trapezius muscle
Omohyoid muscle
肩胛舌骨肌
Pectoralis major muscle胸大肌

Deltoid muscle三角肌

Latissimus doisi muscle

背闊肌
Rectus abdominis muscle
腹直肌
serratus anterior muscle
前鋸肌
Internal oblique muscle
External oblique muscle
內斜肌
外斜肌
 Pectoralis major muscle

Deltoid muscle

Rectus abdominis muscle

Latissimus doisi muscle

serratus anterior muscle

Umbilicus
External oblique muscle
 Superior nuchal line
Levator scapulae muscle
肩胛提肌
Trapezius muscle斜方肌
Infraspinatus muscle肩胛棘下肌 Rhomboid minor muscle
菱形肌
Deltoid muscle
Teres minor muscle小圓肌 Supraspinatus muscle
肩胛棘上肌
Teres major muscle大圓肌

Latissimus doisi muscle

Serratus anterior muscle
前鋸肌

External oblique muscle

外斜肌

Serratus posterior inferior muscle

後鋸肌
 Longissimus capitis muscle
Semispinalis capitis muscle頭半棘肌

Serratus posterior superior muscle

Splenius capitis and splenius cervicis muscles頭夾肌頸夾肌

Iliocostalis muscle髂肋肌 (Erector spinae muscle豎脊肌 )

Longissimus muscle最長肌 (Erector spinae muscle)

Spinalis muscle棘肌(Erector spinae muscle)

Serratus posterior inferior muscle

 Trapezius muscle Spinous process of C7 vertebra

Deltoid muscle

Infraspinatus muscle

Teres major muscle

Latissimus dorsi muscle

Sacrum

Iliac crest

Gluteus maximus muscle

 Levator scapulae muscle肩胛提肌

Middle scalene muscle斜角肌

Teres major muscle

Subscapulars muscle

External intercostal muscle

Serratus anterior muscle

internal intercostal muscle

Thanks for your attentions