S.128-131_p3.FH11 Fri Jan 08 21:19:00 2010 Page 1 C 128 M Y CM MY CY CMY K Øåÿ Neck Ïîâåðõíîñòü òåëà, ñ. 32 Surface p. 32 Ãîðòàíü Larynx Ñêåëåò, ò. II Skeleton Vol. II Ùèòîâèäíàÿ æåëåçà Thyroid gland Ëàðèíãîñêîïèÿ Laryngoscopy a Epiglottis Íàäãîðòàííèê Epiglottis Plica vocalis Ãîëîñîâàÿ ñêëàäêà Vocal fold Cartilago arytenoidea; Cartilago corniculata ×åðïàëîâèäíûé õðÿù; Ðîæêîâèäíûé õðÿù Arytenoid cartilage; Corniculate cartilage Recessus piriformis Ãðóøåâèäíûé êàðìàí Piriform fossa Epiglottis Íàäãîðòàííèê Epiglottis Ventriculus laryngis Æåëóäî÷åê ãîðòàíè Laryngeal ventricle Plica vocalis Ãîëîñîâàÿ ñêëàäêà Vocal fold Ðèñ. 228 a, b Ëàðèíãîñêîïèÿ Laryngoscopy a Íåïðÿìàÿ ëàðèíãîñêîïèÿ. Indirect laryngoscopy. b Ïðÿìàÿ ýíäîñêîïè÷åñêàÿ ëàðèíãîñêîïèÿ. Direct, endoscopic laryngoscopy. b Rima glottidis Ùåëü ãîëîñîâîãî àïïàðàòà [Ãîëîñîâàÿ ùåëü] Rima glottidis Plica vestibularis Ñêëàäêà ïðåääâåðèÿ Vestibular fold Incisura interarytenoidea Ìåæ÷åðïàëîâèäíàÿ âûðåçêà Interarytenoid notch Ðèñ. 229 Ïðÿìàÿ ëàðèíãîñêîïèÿ; ïîëîæåíèå ïðè äûõàíèè Direct laryngoscopy; respiratory position Rima glottidis Ùåëü ãîëîñîâîãî àïïàðàòà [Ãîëîñîâàÿ ùåëü] Rima glottidis Plica vestibularis Ñêëàäêà ïðåääâåðèÿ Vestibular fold Plica aryepiglottica ×åðïàëîâèäíî-íàäãîðòàííàÿ ñêëàäêà Ary-epiglottic fold Cartilago arytenoidea; Cartilago corniculata ×åðïàëîâèäíûé õðÿù; Ðîæêîâèäíûé õðÿù Arytenoid cartilage; Ñorniculate cartilage Incisura interarytenoidea Ìåæ÷åðïàëîâèäíàÿ âûðåçêà Interarytenoid notch Ðèñ. 230 Ïðÿìàÿ ëàðèíãîñêîïèÿ; ïîëîæåíèå ïðè ãîëîñîîáðàçîâàíèè Direct laryngoscopy; phonation position Epiglottis Íàäãîðòàííèê Epiglottis Plica vocalis Ãîëîñîâàÿ ñêëàäêà Vocal fold Rima glottidis, Pars intercartilaginea Ùåëü ãîëîñîâîãî àïïàðàòà [Ãîëîñîâàÿ ùåëü], ìåæõðÿùåâàÿ ÷àñòü Rima glottidis, intercartilaginous part Rima glottidis, Pars intermembranacea Ùåëü ãîëîñîâîãî àïïàðàòà [Ãîëîñîâàÿ ùåëü], ìåæïåðåïîí÷àòàÿ ÷àñòü Rima glottidis, intermembranous part Plica vestibularis Ñêëàäêà ïðåääâåðèÿ Vestibular fold Ðèñ. 231 Ïðÿìàÿ ëàðèíãîñêîïèÿ; ïîëîæåíèå ïðè øåïîòå Direct laryngoscopy; whispering position Ãëîòêà Pharynx S.128-131_p3.FH11 Fri Jan 08 21:19:00 2010 Page 2 C Ìûøöû Muscles Îðãàíû Organs Òîïîãðàôèÿ Topography M Y CM MY CY CMY K 129 Ñðåçû Sections Âíóòðåííèé ðåëüåô ãîðòàíè Inner contour of the larynx Corpus adiposum preepiglotticum Ïðåäíàäãîðòàííîå æèðîâîå òåëî Pre-epiglottic fat body Vestibulum laryngis Ïðåääâåðèå ãîðòàíè Laryngeal vestibule Ventriculus laryngis; Glottis Æåëóäî÷åê ãîðòàíè; Ãîëîñîâîé àïïàðàò Laryngeal ventricle; Glottis Cavitas infraglottica Ïîäãîëîñîâàÿ ïîëîñòü Infraglottic cavity Radix linguae Êîðåíü ÿçûêà Root of tongue Cartilago epiglottica Íàäãîðòàííûé õðÿù Epiglottic cartilage Os hyoideum Ïîäúÿçû÷íàÿ êîñòü Hyoid bone Bursa infrahyoidea Ïîäïîäúÿçû÷íàÿ ñóìêà Infrahyoid bursa Lig. thyrohyoideum medianum Ñðåäèííàÿ ùèòîïîäúÿçû÷íàÿ ñâÿçêà Median thyrohyoid ligament Lig. thyroepiglotticum Ùèòîíàäãîðòàííàÿ ñâÿçêà Thyro-epiglottic ligament Lig. hyoepiglotticum Ïîäúÿçû÷íî-íàäãîðòàííàÿ ñâÿçêà Hyo-epiglottic ligament Tuberculum cuneiforme Êëèíîâèäíûé áóãîðîê Cuneiform tubercle Tuberculum corniculatum Ðîæêîâèäíûé áóãîðîê Corniculate tubercle M. arytenoideus transversus Ïîïåðå÷íàÿ ÷åðïàëîâèäíàÿ ìûøöà Transverse arytenoid Plica vocalis Ãîëîñîâàÿ ñêëàäêà Vocal fold Lamina cartilaginis cricoideae Ïëàñòèíêà ïåðñòíåâèäíîãî õðÿùà Lamina of cricoid cartilage Cartilago thyroidea Ùèòîâèäíûé õðÿù Thyroid cartilage Ventriculus laryngis Æåëóäî÷åê ãîðòàíè Laryngeal ventricle Plica vestibularis Ñêëàäêà ïðåääâåðèÿ Vestibular fold Lig. cricothyroideum medianum Ñðåäèííàÿ ïåðñòíåùèòîâèäíàÿ ñâÿçêà Median cricothyroid ligament Arcus cartilaginis cricoideae Äóãà ïåðñòíåâèäíîãî õðÿùà Arch of cricoid cartilage Isthmus glandulae thyroideae Ïåðåøååê ùèòîâèäíîé æåëåçû Isthmus Tunica mucosa Ñëèçèñòàÿ îáîëî÷êà Mucosa Trachea, Paries membranaceus Òðàõåÿ, ïåðåïîí÷àòàÿ ñòåíêà Trachea, membranous wall (Spatium oesophagotracheale) (Ïèùåâîäíî-òðàõåàëüíîå ïðîñòðàíñòâî) (Oesophagotracheal space) Trachea Òðàõåÿ Cartilagines tracheales Trachea Õðÿùè òðàõåè Tracheal cartilages Ðèñ. 232 Ãîðòàíü Larynx Larynx Radix linguae Êîðåíü ÿçûêà Root of tongue Lig. hyoepiglotticum Ïîäúÿçû÷íî-íàäãîðòàííàÿ ñâÿçêà Hyo-epiglottic ligament Corpus adiposum preepiglotticum Ïðåäíàäãîðòàííîå æèðîâîå òåëî Pre-epiglottic fat body Cartilago epiglottica Íàäãîðòàííûé õðÿù Epiglottic cartilage Tuberculum cuneiforme Êëèíîâèäíûé áóãîðîê Cuneiform tubercle Os hyoideum Ïîäúÿçû÷íàÿ êîñòü Hyoid bone Lig. thyrohyoideum medianum Ñðåäèííàÿ ùèòîïîäúÿçû÷íàÿ ñâÿçêà Median thyrohyoid ligament Tuberculum corniculatum Ðîæêîâèäíûé áóãîðîê Corniculate tubercle Lig. thyroepiglotticum Ùèòîíàäãîðòàííàÿ ñâÿçêà Thyro-epiglottic ligament M. arytenoideus transversus Ïîïåðå÷íàÿ ÷åðïàëîâèäíàÿ ìûøöà Transverse arytenoid Cartilago thyroidea Ùèòîâèäíûé õðÿù Thyroid cartilage Arcus cartilaginis cricoideae Äóãà ïåðñòíåâèäíîãî õðÿùà Arch of cricoid cartilage Lamina cartilaginis cricoideae Ïëàñòèíêà ïåðñòíåâèäíîãî õðÿùà Lamina of cricoid cartilage Cartilagines tracheales Õðÿùè òðàõåè Tracheal cartilages Ðèñ. 233 Ãîðòàíü, Larynx; ïîëîæåíèå íàäãîðòàííèêà ïðè ãëîòàíèè Larynx, Larynx; position of the epiglottis during swallowing S.128-131_p3.FH11 Fri Jan 08 21:19:00 2010 Page 3 C 130 M Y CM MY CY CMY K Øåÿ Neck Ïîâåðõíîñòü òåëà, ñ. 32 Surface p. 32 Ãîðòàíü Larynx Ùèòîâèäíàÿ æåëåçà Thyroid gland Àðòåðèè è íåðâû ãîðòàíè Arteries and nerves of the larynx Papillae vallatae Æåëîáîâèäíûå ñîñî÷êè Vallate papillae Rr. linguales ßçû÷íûå âåòâè Lingual branches N. glossopharyngeus [IX] ßçûêîãëîòî÷íûé íåðâ [IX] Glossopharyngeal nerve [IX] N. glossopharyngeus [IX] ßçûêîãëîòî÷íûé íåðâ [IX] Glossopharyngeal nerve [IX] Rr. tonsillares Ìèíäàëèêîâûå âåòâè Tonsillar branches A. palatina ascendens, R. tonsillaris Âîñõîäÿùàÿ í¸áíàÿ àðòåðèÿ, ìèíäàëèêîâàÿ âåòâü Ascending palatine artery, tonsillar branch Tonsilla palatina ͸áíàÿ ìèíäàëèíà Palatine tonsil Os hyoideum, Cornu majus Ïîäúÿçû÷íàÿ êîñòü, áîëüøîé ðîã Hyoid bone, greater horn Epiglottis Íàäãîðòàííèê Epiglottis N. laryngeus superior (X) Âåðõíèé ãîðòàííûé íåðâ (X) Superior laryngeal nerve (X) A. laryngea superior Âåðõíÿÿ ãîðòàííàÿ àðòåðèÿ Superior laryngeal artery Cartilago thyroidea, Cornu superius Ùèòîâèäíûé õðÿù, âåðõíèé ðîã Thyroid cartilage, superior horn Aditus laryngis Âõîä â ãîðòàíü Laryngeal inlet Vallecula epiglottica ßìêà íàäãîðòàííèêà Epiglottic vallecula N. laryngeus superior (X), Rr. interni Âåðõíèé ãîðòàííûé íåðâ (X), âíóòðåííèå âåòâè Superior laryngeal nerve (X), internal branches Incisura interarytenoidea Ìåæ÷åðïàëîâèäíàÿ âûðåçêà Interarytenoid notch M. arytenoideus obliquus Êîñàÿ ÷åðïàëîâèäíàÿ ìûøöà Oblique arytenoid Cartilago thyroidea, Lamina sinistra Ùèòîâèäíûé õðÿù, ëåâàÿ ïëàñòèíêà Thyroid cartilage, left lamina Cartilago thyroidea, Cornu inferius Ùèòîâèäíûé õðÿù, íèæíèé ðîã Thyroid cartilage, inferior horn M. cricoarytenoideus posterior Çàäíÿÿ ïåðñòíå÷åðïàëîâèäíàÿ ìûøöà Posterior crico-arytenoid A. laryngea inferior Íèæíÿÿ ãîðòàííàÿ àðòåðèÿ Inferior laryngeal artery Glandula thyroidea Ùèòîâèäíàÿ æåëåçà Thyroid gland Rr. tracheales Òðàõåàëüíûå âåòâè Tracheal branches Glandula parathyroidea superior Âåðõíÿÿ îêîëîùèòîâèäíàÿ æåëåçà Superior parathyroid gland A. thyroidea inferior Íèæíÿÿ ùèòîâèäíàÿ àðòåðèÿ Inferior thyroid artery Glandula parathyroidea inferior Íèæíÿÿ îêîëîùèòîâèäíàÿ æåëåçà Inferior parathyroid gland N. laryngeus recurrens (X), Rr. oesophageales Âîçâðàòíûé ãîðòàííûé íåðâ (X), ïèùåâîäíûå âåòâè Recurrent laryngeal nerve (X), oesophageal branches Trachea Òðàõåÿ Trachea 252 N. laryngeus recurrens (X) Âîçâðàòíûé ãîðòàííûé íåðâ (X) Recurrent laryngeal nerve (X) Ðèñ. 234 Àðòåðèè è íåðâû ãîðòàíè, Larynx, è êîðíÿ ÿçûêà, Radix linguae Arteries and nerves of the larynx, Larynx, and the root of the tongue, Radix linguae Ñêåëåò, ò. II Skeleton Vol. II Ãëîòêà Pharynx S.128-131_p3.FH11 Fri Jan 08 21:19:00 2010 Page 4 C Ìûøöû Muscles Îðãàíû Organs Òîïîãðàôèÿ Topography M Y CM MY CY CMY K 131 Ñðåçû Sections Ãîðòàíü, ïîïåðå÷íûå ñðåçû Larynx, transverse sections Sacculus laryngis Ìåøî÷åê ãîðòàíè Laryngeal saccule Sacculus laryngis Ìåøî÷åê ãîðòàíè Laryngeal saccule Glandulae laryngeales Ãîðòàííûå æåëåçû Laryngeal glands Ventriculus laryngis Æåëóäî÷åê ãîðòàíè Laryngeal ventricle M. thyroarytenoideus Ùèòî÷åðïàëîâèäíàÿ ìûøöà Thyro-arytenoid Plica vocalis Ãîëîñîâàÿ ñêëàäêà Vocal fold N. laryngeus superior (X), R. internus Âåðõíèé ãîðòàííûé íåðâ (X), âíóòðåííÿÿ âåòâü Superior laryngeal nerve (X), internal branch M. vocalis Ãîëîñîâàÿ ìûøöà Vocalis A. laryngea superior Âåðõíÿÿ ãîðòàííàÿ àðòåðèÿ Superior laryngeal artery Cartilago thyroidea, Lamina sinistra Ùèòîâèäíûé õðÿù, ëåâàÿ ïëàñòèíêà Thyroid cartilage, left lamina Vv. laryngeae superiores Âåðõíèå ãîðòàííûå âåíû Superior laryngeal veins Cartilago arytenoidea ×åðïàëîâèäíûé õðÿù Arytenoid cartilage Plica vestibularis Ñêëàäêà ïðåääâåðèÿ Vestibular fold Recessus piriformis Ãðóøåâèäíûé êàðìàí Piriform fossa Rima glottidis Ùåëü ãîëîñîâîãî àïïàðàòà [Ãîëîñîâàÿ ùåëü] Rima glottidis M. constrictor pharyngis medius Ñðåäíèé êîíñòðèêòîð ãëîòêè Middle constrictor M. constrictor pharyngis inferior Íèæíèé êîíñòðèêòîð ãëîòêè Inferior constrictor Mm. arytenoidei transversus et obliqui Ïîïåðå÷íàÿ è êîñûå ÷åðïàëîâèäíûå ìûøöû Transverse and oblique arytenoids 235 236 Plexus venosus pharyngeus Ãëîòî÷íîå âåíîçíîå ñïëåòåíèå Pharyngeal venous plexus Cavitas pharyngis Ïîëîñòü ãëîòêè Cavity of pharynx Ðèñ. 235 Ãîðòàíü, Larynx. Áåëîé ñòðåëêîé ïîêàçàíî ñîîáùåíèå ìåæäó æåëóäî÷êîì, Ventriculus laryngis, è ìåøî÷êîì ãîðòàíè, Sacculus laryngis Larynx, Larynx. The white arrow indicates the connection between the laryngeal ventricle, Ventriculus laryngis, and the laryngeal saccule, Sacculus laryngis Rima glottidis, Pars intermembranacea Ùåëü ãîëîñîâîãî àïïàðàòà [Ãîëîñîâàÿ ùåëü], ìåæïåðåïîí÷àòàÿ ÷àñòü Rima glottidis, intermembranous part Lig. vocale Ãîëîñîâàÿ ñâÿçêà Vocal ligament M. vocalis Ãîëîñîâàÿ ìûøöà Vocalis Cartilago arytenoidea, Proc. vocalis ×åðïàëîâèäíûé õðÿù, ãîëîñîâîé îòðîñòîê Arytenoid cartilage, vocal process M. thyroarytenoideus Ùèòî÷åðïàëîâèäíàÿ ìûøöà Thyro-arytenoid N. laryngeus superior (X) Âåðõíèé ãîðòàííûé íåðâ (X) Superior laryngeal nerve (X) Rima glottidis, Pars intercartilaginea Ùåëü ãîëîñîâîãî àïïàðàòà [Ãîëîñîâàÿ ùåëü], ìåæõðÿùåâàÿ ÷àñòü Rima glottidis, intercartilaginous part A. laryngea superior Âåðõíÿÿ ãîðòàííàÿ àðòåðèÿ Superior laryngeal artery Vv. laryngeae superiores Âåðõíèå ãîðòàííûå âåíû Superior laryngeal veins Cartilago arytenoidea ×åðïàëîâèäíûé õðÿù Arytenoid cartilage Articulatio cricoarytenoidea Ïåðñòíå÷åðïàëîâèäíûé ñóñòàâ Ñrico-arytenoid joint Cartilago thyroidea, Lamina sinistra Ùèòîâèäíûé õðÿù, ëåâàÿ ïëàñòèíêà Thyroid cartilage, left lamina Recessus piriformis Ãðóøåâèäíûé êàðìàí Piriform fossa Cavitas pharyngis Ïîëîñòü ãëîòêè Cavity of pharynx Tunica mucosa Ñëèçèñòàÿ îáîëî÷êà Mucosa M. cricoarytenoideus posterior Çàäíÿÿ ïåðñòíå÷åðïàëîâèäíàÿ ìûøöà Posterior crico-arytenoid M. constrictor pharyngis inferior Íèæíèé êîíñòðèêòîð ãëîòêè Inferior constrictor Tunica mucosa Ñëèçèñòàÿ îáîëî÷êà Mucosa Lamina cartilaginis cricoideae Ïëàñòèíêà ïåðñòíåâèäíîãî õðÿùà Lamina of cricoid cartilage Ðèñ. 236 Ãîðòàíü Larynx Larynx S.212-215_p3.FH11 Fri Jan 08 17:07:29 2010 Page 1 C 212 Âåðõíÿÿ êîíå÷íîñòü Upper limb M Y CM MY CY CMY K Ïîâåðõíîñòü òåëà Surface Îáçîð Overview Ñêåëåò Skeleton Ïëå÷åâîé ïîÿñ Shoulder Ìûøöû êèñòè Muscles of the hand M. interosseus dorsalis III Òûëüíàÿ ìåæêîñòíàÿ ìûøöà III Dorsal interosseus III M. interosseus dorsalis IV Òûëüíàÿ ìåæêîñòíàÿ ìûøöà IV Dorsal interosseus IV Mm. interossei palmares, Tendines Ëàäîííûå ìåæêîñòíûå ìûøöû, ñóõîæèëèÿ Palmar interossei, tendons M. interosseus dorsalis II Òûëüíàÿ ìåæêîñòíàÿ ìûøöà II Dorsal interosseus II M. interosseus dorsalis I Òûëüíàÿ ìåæêîñòíàÿ ìûøöà I Dorsal interosseus I M. extensor digitorum, Tendines Ðàçãèáàòåëü ïàëüöåâ, ñóõîæèëèÿ Extensor digitorum, tendons Mm. lumbricales, Tendines ×åðâåîáðàçíûå ìûøöû, ñóõîæèëèÿ Lumbricals, tendons Ðèñ. 382 Òûëüíûå ìåæêîñòíûå ìûøöû, Mm. interossei dorsales; âèä ñçàäè Dorsal inteosseous muscles, Mm. interossei dorsales; dorsal view T 37 M. interosseus palmaris III Ëàäîííàÿ ìåæêîñòíàÿ ìûøöà III Palmar interosseus III Ðèñ. 383 Ëàäîííûå ìåæêîñòíûå ìûøöû, Mm. interossei palmares; âèä ñïåðåäè. Ñóõîæèëèÿ ìåæêîñòíûõ è ÷åðâåîáðàçíûõ ìûøö âïëåòàþòñÿ â òàê íàçûâàåìûå òûëüíûå àïîíåâðîçû ïàëüöåâ (óêàçàíî ñòðåëêàìè) Palmar inteosseous muscles, Mm. interossei palmares; palmar view. The tendons of the interosseous and the lumbrical muscles radiate into the so-called dorsal aponeurosis of the fingers (arrows) T 37 M. interosseus palmaris II Ëàäîííàÿ ìåæêîñòíàÿ ìûøöà II Palmar interosseus II M. interosseus palmaris I Ëàäîííàÿ ìåæêîñòíàÿ ìûøöà I Palmar interosseus I Ìûøöû Muscles Ïëå÷î Arm S.212-215_p3.FH11 Fri Jan 08 17:07:29 2010 Page 2 C Òîïîãðàôèÿ Topography M Y CM MY CY CMY K 213 Ñðåçû Sections Ïðåäïëå÷üå Forearm Êèñòü Hand Ìûøöû êèñòè Muscles of the hand M. flexor digitorum profundus, Tendines Ãëóáîêèé ñãèáàòåëü ïàëüöåâ, ñóõîæèëèÿ Flexor digitorum profundus, tendons M. lumbricalis IV ×åðâåîáðàçíàÿ ìûøöà IV Lumbrical IV M. lumbricalis II ×åðâåîáðàçíàÿ ìûøöà II Lumbrical II M. lumbricalis III ×åðâåîáðàçíàÿ ìûøöà III Lumbrical III M. lumbricalis I ×åðâåîáðàçíàÿ ìûøöà I Lumbrical I M. flexor digitorum superficialis, Tendines Ïîâåðõíîñòíûé ñãèáàòåëü ïàëüöåâ, ñóõîæèëèÿ Flexor digitorum superficialis, tendons M. flexor digitorum superficialis, Tendines Ïîâåðõíîñòíûé ñãèáàòåëü ïàëüöåâ, ñóõîæèëèÿ Flexor digitorum superficialis, tendons M. flexor digitorum profundus, Tendines Ãëóáîêèé ñãèáàòåëü ïàëüöåâ, ñóõîæèëèÿ Flexor digitorum profundus, tendons Ðèñ. 384 ×åðâåîáðàçíûå ìûøöû, Mm. lumbricales; âèä ñïåðåäè Lumbrical muscles, Mm. lumbricales; palmar view T 37 M. interosseus palmaris Ëàäîííàÿ ìåæêîñòíàÿ ìûøöà Palmar interosseus Os metacarpi II Ïÿñòíàÿ êîñòü II Metacarpal II M. extensor indicis, Tendo Ðàçãèáàòåëü óêàçàòåëüíîãî ïàëüöà, ñóõîæèëèå Extensor indicis, tendon M. interosseus dorsalis I Òûëüíàÿ ìåæêîñòíàÿ ìûøöà I Dorsal interosseus I M. interosseus palmaris I Ëàäîííàÿ ìåæêîñòíàÿ ìûøöà I Palmar interosseus I M. lumbricalis I ×åðâåîáðàçíàÿ ìûøöà I Lumbrical I M. flexor digitorum superficialis, Tendo Ïîâåðõíîñòíûé ñãèáàòåëü ïàëüöåâ, ñóõîæèëèå Flexor digitorum superficialis, tendon Vincula longa Äëèííûå ñâÿçêè Vincula longa M. flexor digitorum profundus, Tendo Ãëóáîêèé ñãèáàòåëü ïàëüöåâ, ñóõîæèëèå Flexor digitorum profundus, tendon Vinculum breve Êîðîòêàÿ ñâÿçêà Vinculum breve M. flexor digitorum profundus, Tendo Ãëóáîêèé ñãèáàòåëü ïàëüöåâ, ñóõîæèëèå Flexor digitorum profundus, tendon M. interosseus dorsalis I Òûëüíàÿ ìåæêîñòíàÿ ìûøöà I Dorsal interosseus I Articulatio metacarpophalangea II, Capsula articularis Ïÿñòíî-ôàëàíãîâûé ñóñòàâ II, ñóñòàâíàÿ êàïñóëà Metacarpophalangeal joint II, joint capsule Vagina tendinis, Stratum fibrosum Âëàãàëèùå ñóõîæèëèÿ, ôèáðîçíûé ñëîé Tendinous sheath, fibrous layer M. lumbricalis I ×åðâåîáðàçíàÿ ìûøöà I Lumbrical I M. flexor digitorum superficialis, Tendo Ïîâåðõíîñòíûé ñãèáàòåëü ïàëüöåâ, ñóõîæèëèå Flexor digitorum superficialis, tendon Vagina tendinis, Stratum synoviale Âëàãàëèùå ñóõîæèëèÿ, ñèíîâèàëüíûé ñëîé Tendinous sheath, synovial membrane Vincula tendinum Ñâÿçêè ñóõîæèëèé Vincula tendinum Lig. collaterale Êîëëàòåðàëüíàÿ ñâÿçêà Collateral ligament Lig. collaterale Êîëëàòåðàëüíàÿ ñâÿçêà Collateral ligament a b Ðèñ. 385 a, b Ïðèêðåïëåíèÿ ñóõîæèëèé íà ïðàâîì óêàçàòåëüíîì ïàëüöå; ñóõîæèëèÿ îáîèõ ñãèáàòåëåé âûäåëåíû èç ñóõîæèëüíîãî âëàãàëèùà Tendon insertions at the right index; the tendons of both flexors have been dissected from the tendon sheath a âèä ñïåðåäè; palmar view. b âèä ñ ëàòåðàëüíîé ñòîðîíû; lateral view. Tuberositas phalangis distalis Áóãðèñòîñòü äèñòàëüíîé ôàëàíãè Tuberosity of distal phalanx S.212-215_p3.FH11 Fri Jan 08 17:07:29 2010 Page 3 C 214 M Y CM MY CY CMY K Âåðõíÿÿ êîíå÷íîñòü Upper limb Ïîâåðõíîñòü òåëà Surface Îáçîð Overview Ïëå÷åâîå ñïëåòåíèå Brachial plexus C4 IV * C5 V * C6 1 2 * Pars supraclavicularis Íàäêëþ÷è÷íàÿ ÷àñòü Supraclavicular part Divisiones anteriores Ïåðåäíèå ðàçäåëåíèÿ Anterior divisions Divisiones posteriores Çàäíèå ðàçäåëåíèÿ Posterior divisions C7 +a 4 5 A. axillaris Ïîäìûøå÷íàÿ àðòåðèÿ Axillary artery I * b a c T1 II 7 9 10 N. cutaneus brachii medialis (T1) Ìåäèàëüíûé êîæíûé íåðâ ïëå÷à (T1) Medial cutaneous nerve of arm (T1) N. medianus (C5T1) Ñðåäèííûé íåðâ (C7T1) Median nerve (C7T1) N. cutaneus antebrachii medialis (C8, T1) Ìåäèàëüíûé êîæíûé íåðâ ïðåäïëå÷üÿ (C8, T1) Medial cutaneous nerve of forearm (C8, T1) N. ulnaris (C7T1) Ëîêòåâîé íåðâ (C7T1) Ulnar nerve (C7T1) * Nn. spinales, Rr. anteriores Cïèííîìîçãîâûå íåðâû, ïåðåäíèå âåòâè Spinal nerves, anterior branches + a Truncus superior Âåðõíèé ñòâîë Superior trunk b Truncus medius Ñðåäíèé ñòâîë Middle trunk c Truncus inferior Íèæíèé ñòâîë Inferior trunk a Fasciculus lateralis Ëàòåðàëüíûé ïó÷îê Lateral cord b Fasciculus posterior Çàäíèé ïó÷îê Posterior cord c Fasciculus medialis Ìåäèàëüíûé ïó÷îê Medial cord T 24, T 25 * 11 N. musculocutaneus (C5C7) Ìûøå÷íî-êîæíûé íåðâ (C5C7) Musculocutaneous nerve (C5C7) N. radialis (C5T1) Ëó÷åâîé íåðâ (C5T1) Radial nerve (C5T1) VII C8 +c 8 N. axillaris (C5, C6) Ïîäìûøå÷íûé íåðâ (C5, C6) Axillary nerve (C5, C6) * 3 +b 6 Pars infraclavicularis Ïîäêëþ÷è÷íàÿ ÷àñòü Infraclavicular part VI 3 1 N. phrenicus (C3C5) Äèàôðàãìàëüíûé íåðâ (C3C5) Phrenic nerve (C3C5) 2 N. dorsalis scapulae (C5) Äîðñàëüíûé íåðâ ëîïàòêè (C5) Dorsal scapular nerve (C5) 3 Rr. musculares Ìûøå÷íûå âåòâè Muscular branches 4 N. suprascapularis (C5, C6) Íàäëîïàòî÷íûé íåðâ (Ñ5, Ñ6) Suprascapular nerve (Ñ5, Ñ6) 5 N. subclavius (C5, C6) Ïîäêëþ÷è÷íûé íåðâ (Ñ5, Ñ6) Subclavian nerve (Ñ5, Ñ6) 6 N. pectoralis lateralis (C5C7) Ëàòåðàëüíûé ãðóäíîé íåðâ (C5C7) Lateral pectoral nerve (C5C7) 7 N. subscapularis (C5C7) Ïîäëîïàòî÷íûé íåðâ (C5C7) Subscapular nerve (C5C7) 8 N. thoracodorsalis (C6C8) Ãðóäîñïèííîé íåðâ (C6C8) Thoracodorsal nerve (C6C8) 9 N. pectoralis medialis (C8, T1) Ìåäèàëüíûé ãðóäíîé íåðâ (C8, T1) Medial pectoral nerve (C8, T1) 10 N. thoracicus longus (C5C7) Äëèííûé ãðóäíîé íåðâ (C5C7) Long thoracic nerve (C5C7) 11 N. intercostalis (T1) Ìåæðåáåðíûé íåðâ (Ò1) Intercostal nerve (T1) Ðèñ. 386 Ïëå÷åâîå ñïëåòåíèå Plexus brachialis Brachial plexus Ñêåëåò Skeleton Ïëå÷åâîé ïîÿñ Shoulder Ìûøöû Muscles Ïëå÷î Arm S.212-215_p3.FH11 Fri Jan 08 17:07:29 2010 Page 4 C Òîïîãðàôèÿ Topography M Y CM MY CY CMY K 215 Ñðåçû Sections Ëîêòåâàÿ ÿìêà Cubital fossa Ïðåäïëå÷üå Forearm Êèñòü Hand Íåðâû âåðõíåé êîíå÷íîñòè Nerves of the upper limb Plexus brachialis, Pars infraclavicularis Ïëå÷åâîå ñïëåòåíèå, ïîäêëþ÷è÷íàÿ ÷àñòü Brachial plexus, infraclavicular part Fasciculus medialis Ìåäèàëüíûé ïó÷îê Medial cord Fasciculus posterior Çàäíèé ïó÷îê Posterior cord Fasciculus lateralis Ëàòåðàëüíûé ïó÷îê Lateral cord Plexus brachialis, Pars supraclavicularis Ïëå÷åâîå ñïëåòåíèå, íàäêëþ÷è÷íàÿ ÷àñòü Brachial plexus, supraclavicular part A. axillaris Ïîäìûøå÷íàÿ àðòåðèÿ Axillary artery Radix lateralis nervi mediani Ëàòåðàëüíûé êîðåøîê ñðåäèííîãî íåðâà Lateral root of median nerve N. cutaneus brachii medialis Ìåäèàëüíûé êîæíûé íåðâ ïëå÷à Medial cutaneous nerve of arm N. medianus Ñðåäèííûé íåðâ Median nerve N. axillaris Ïîäìûøå÷íûé íåðâ Axillary nerve Radix medialis nervi mediani Ìåäèàëüíûé êîðåøîê ñðåäèííîãî íåðâà Medial root of median nerve N. cutaneus brachii lateralis superior Âåðõíèé ëàòåðàëüíûé êîæíûé íåðâ ïëå÷à Superior lateral cutaneous nerve of arm N. cutaneus antebrachii medialis Ìåäèàëüíûé êîæíûé íåðâ ïðåäïëå÷üÿ Medial cutaneous nerve of forearm N. musculocutaneus Ìûøå÷íî-êîæíûé íåðâ Musculocutaneous nerve N. radialis Ëó÷åâîé íåðâ Radial nerve N. cutaneus brachii posterior Çàäíèé êîæíûé íåðâ ïëå÷à Posterior cutaneous nerve of arm N. cutaneus brachii lateralis inferior Íèæíèé ëàòåðàëüíûé êîæíûé íåðâ ïëå÷à Inferior lateral cutaneous nerve of arm N. ulnaris Ëîêòåâîé íåðâ Ulnar nerve N. cutaneus antebrachii lateralis Ëàòåðàëüíûé êîæíûé íåðâ ïðåäïëå÷üÿ Lateral cutaneous nerve of forearm R. superficialis (N. radialis) Ïîâåðõíîñòíàÿ âåòâü (Ëó÷åâîé íåðâ) Superficial branch (Radial nerve) R. profundus (N. radialis) Ãëóáîêàÿ âåòâü (Ëó÷åâîé íåðâ) Deep branch (Radial nerve) N. cutaneus antebrachii posterior Çàäíèé êîæíûé íåðâ ïðåäïëå÷üÿ Posterior cutaneous nerve of forearm N. interosseus antebrachii anterior Ïåðåäíèé ìåæêîñòíûé íåðâ ïðåäïëå÷üÿ Anterior interosseous nerve R. dorsalis (N. ulnaris) Òûëüíàÿ âåòâü (Ëîêòåâîé íåðâ) Dorsal branch (Ulnar nerve) R. palmaris (N. ulnaris) Ëàäîííàÿ âåòâü (Ëîêòåâîé íåðâ) Palmar branch (Ulnar nerve) R. communicans cum nervo ulnari Ñîåäèíèòåëüíàÿ âåòâü ñ ëîêòåâûì íåðâîì Communicating branch with ulnar nerve Nn. digitales palmares communes Îáùèå ëàäîííûå ïàëüöåâûå íåðâû Ñommon palmar digital nerves R. profundus (N. ulnaris) Ãëóáîêàÿ âåòâü (Ëîêòåâîé íåðâ) Deep branch (Ulnar nerve) R. superficialis (N. ulnaris) Ïîâåðõíîñòíàÿ âåòâü (Ëîêòåâîé íåðâ) Superficial branch (Ulnar nerve) Nn. digitales palmares communes Îáùèå ëàäîííûå ïàëüöåâûå íåðâû Ñommon palmar digital nerves Nn. digitales palmares proprii Ñîáñòâåííûå ëàäîííûå ïàëüöåâûå íåðâû Proper palmar digital nerves Nn. digitales palmares proprii Ñîáñòâåííûå ëàäîííûå ïàëüöåâûå íåðâû Proper palmar digital nerves Ðèñ. 387 Íåðâû âåðõíåé êîíå÷íîñòè; îáçîð Nerves of the upper limb; overview T 24, T 25