随着临床医学的发展，许多原已明确诊断但被视为手术禁区的疾病，现已被突破，新的术式、微创手术也逐渐增多。临床应用解剖学实物图谱丛书更加贴近临床，为使该丛书能让从事临床外科不久的青年医生能提高应用效果，本书将以该部位临床*基础和*经典的手术为主导，选取适当的手术视角来呈现解剖标本，图文并茂，显示手术入路层次、器官的毗邻关系。同时丰富了一些高难度手术区域的解剖结构图及介入治疗相关的解剖结构。

章胸壁

图1-1胸廓前面观 Anterior aspect ofthe thoracic cage

图1-2胸廓侧面观 Lateral aspect of the thoracic cage

图1-3胸廓后面观 Posterior aspect ofthe thoracic cage

图1-4胸骨（前、侧面观） Sternum (anterior and lateral aspects)

图1-5肋骨 Rib

图1-6胸椎（上面、侧面观） Thoracic vertebra (superior and lateral aspects)

乳腺切口的选择及解剖层次

图1-7女性乳腺手术入路切口（一） Incision ofthe female breast surgery (1)

图1-8女性乳腺手术入路切口（二） Incision of the female breast surgery (2)

图1-9女性乳腺（一）Female breast (1)

图1-10女性乳腺（二）Female breast (2)

开胸手术前外侧手术入路的解剖层次

图1-11胸部前外侧手术入路切口（一） Anterolateral incision of the thorax (1)

图1-12胸部前外侧手术入路切口（二）Anterolateral incision of the thorax (2)

图1-13胸大肌Pectoralis major

图1-14锁胸筋膜、胸小肌 Clavipectoral fascia and pectoralis minor

图1-15锁骨下静脉Subclavian vein

锁骨下静脉穿刺术的应用解剖学要点

图1-16前锯肌Serratus anterior

图1-17胸前壁（成人） Anterior wall of the thorax (adult)

图1-18胸前壁（儿童） Anterior wall of the thorax (child)

图1-19胸前壁内侧面血管 Blood vessels on the medial surface of the anterior thoracic wall

胸骨角的应用解剖学要点

开胸手术后外侧切口手术入路的解剖层次

图1-20胸部后外侧手术入路切口（一）Posterolateral incision of the thorax (1)

图1-21 胸部后外侧手术入路切口（二）Posterolateral incision of the thorax (2)

图1-22胸部后外侧手术入路切口（三）Posterolateral incision of the thorax (3)

图1-23胸背部浅层结构 Superficial structure of the thoracodorsal region

图1-24背浅部结构 Superficial structures of the back

图1-25胸背部深层结构 Deep structures of the thoracodorsal region

图1-26胸后壁内侧面血管 Blood vessels on the medial surface of the posterior thoracic wall

图1-27膈的左侧面观 Left aspect of the diaphragm

图1-28膈的右侧面观 Right aspect of the diaphragm

图1-29胸前皮瓣（一） Anterior thoracic skin flap (1)

图1-30胸前皮瓣（二） Anterior thoracic skin flap (2）

胸前皮瓣的应用解剖学要点

图1-31左胸大肌皮瓣 Skin flap over left pectoralis major

图1-32右胸大肌皮瓣 Skin flap over right pectoralis major

图1-33胸大肌皮瓣 Skin flap over pectoralis major

图1-34胸大肌肌瓣（一）Pectoralis major flap (1)

图1-35胸大肌肌瓣（二）Pectoralis major flap (2)

胸大肌肌（皮）瓣的应用解剖学要点

图1-36胸侧皮瓣 Lateral thoracic skin flap

图1-37肋间皮瓣 Intercostal skin flap

侧胸皮瓣的应用解剖学要点

图1-38前锯肌（皮）瓣Serratus anterior (skin) flap

前锯肌瓣乳房再造或丰乳术的应用解剖学要点

图1-39背阔肌（皮）瓣Latissimusdorsi(skin) flap

背阔肌肌瓣的应用解剖学要点

图1-40斜方肌皮瓣 Skin flap over trapezius

图1-41斜方肌皮瓣（X线片） Skin flap over trapezius (X-ray film)

图1-42斜方肌肌皮瓣 Trapezius (skin) flap

图1-43斜方肌瓣（X线片） Trapezius flap (X-ray film)

斜方肌肌皮瓣的应用解剖学要点

图1-44肋骨瓣 Costal bone flap

图1-45肋软骨（肋弓）瓣 Costal cartilage (costal arch) flap

肋骨骨瓣的应用解剖学要点

第二章胸膜、胸膜腔和肺

图2-1肋胸膜前面观（带胸廓） Anterior aspect of the costal pleura (with thoracic cage)

图2-2肋胸膜左侧面观（带胸廓） Left aspect of the costal pleura (with thoracic cage)

图2-3肋胸膜右侧面观（带胸廓） Right aspect of the costal pleura (with thoracic cage)

图2-4肋胸膜前面观 Anterior aspect of the costal pleura

图2-5肋胸膜左侧面观 Left aspect of the costal pleura

图2-6肋胸膜右侧面观 Right aspect of the costal pleura

图2-7肋纵隔隐窝Costomediastinal recess

图2-8肋膈隐窝（左侧面观）Costodiaphragmatic recess (Left aspect)

胸膜腔穿刺术的应用解剖学要点

图2-9肺的位置（前面观） Localization oflungs (anterior aspect)

图2-10肺的后面观（心包外肺门结构） Posterior aspect of lungs (hilum of lung outside of the pericardium)

图2-11肺根结构 Structures of the root of lung

图2-12左肺根前面观 Anterior aspect of the root ofleft lung

图2-13左肺根后面观 Posterior aspect of the root of left lung

图2-14 左侧胸腔大体观（胸腔镜下观）Overview of the left thoracic cavity (VATS)

图2-15 左肺动脉及其分支（胸腔镜下观一） Left pulmonary artery and branch(VATS-1)

图2-16 左肺静脉及其分支（胸腔镜下观二） Left pulmonary vein and branch(VATS-2)

图2-17左侧肺门结构（心包外） Structures of the left hilum of lung (outside of the pericardium）

图2-18左肺门内结构前面观 Anterior aspect of the hilum of left lung

图2-19左侧肺门内结构 Structures in the hilum of left lung

图2-20右肺根前面观 Anterior aspect of the root of right lung

图2-21右肺根后面观 Posterior aspect of the root of right lung

图2-22 右侧胸腔镜下大体观 overview of the thoracic cavity through VATS

图2-23 右肺动脉及其分支（胸腔镜下观一）Right pulmonary artery and branch(VATS-1)

图2-24 右肺静脉及其分支（胸腔镜下观二）Right pulmonary vein and branch(VATS-2)

图2-25右侧肺门结构（心包外） Structures of the right hilum oflung (outside of the pericardium)

图2-26右侧肺门内结构 Structures of the hilum of right lung

图2-27右肺尖与胸膜顶 Apex of the right lung and cupula of pleura

图2-28肺尖、胸膜顶水平切 Horizontal section through apex of the lung and cupula of pleura 34

图2-29肺尖与第1肋Apex of lung and the first rib

图2-30经肺门胸部横断面 Transverse section of the thorax through the hilum oflung

图2-31经腋中线胸部冠状切 Coronary section of the thorax through midaxillary line

图2-32胸部X线正位片Orthophoria X-ray film of the thorax

图2-33胸部X线侧位片 Lateral X-ray film of the thorax

第三章纵隔

图3-1成人纵隔前面观 Anterior aspect of the mediastinum (adult)

图3-2儿童纵隔前面观 Anterior aspect of the mediastinum (child)

心包穿刺术的应用解剖学要点

图3-3纵隔前面观（肋骨、肺已切除）Anterior aspect of the mediastinum

(ribs and lungs were cut off）

图3-4纵隔前面观（一）（胸骨、肋骨已切除）

Anterior aspect of the mediastinum (1)(sternum and ribs were cut off)

图3-5纵隔前面观（二）（胸骨、肋骨已切除）

Anterior aspect of the mediastinum (2)(sternum and ribs were cut off)

图3-6胸腺的形态 Morphology of the thymus

图3-7纵隔左侧面观（一） Left aspect of the mediastinum (1)

图3-8纵隔左侧面观（二）Left aspect of the mediastinum (2)

图3-9纵隔右侧面观（一） Right aspect of the mediastinum (1)

图3-10纵隔右侧面观（二） Right aspect of the mediastinum (2)

胸外心按压术的应用解剖学要点

图3-11后纵隔前面观 Anterior aspect of the posterior mediastinum

图3-12纵隔后面观 Posterior aspect of the mediastinum

图3-13纵隔后面观，示左肺根 Posterior aspect of the mediastinum to show the root of the left lung

图3-14纵隔后面观，示右肺根 Posterior aspect of the mediastinum to show the root of the right lung

图3-15纵隔前面观 Anterior aspect of the mediastinum

图3-16左侧纵隔胸膜 Left mediastinal pleura

图3-17右侧纵隔胸膜 Right mediastinal pleura

图3-18动脉导管三角 Triangle of ductusarteriosus

图3-19上纵隔结构（一） Structures of the superior mediastinum (1)

图3-20上纵隔结构（二） Structures of the superior mediastinum (2)

图3-21前纵隔上部浅层结构 Superficial structures of the upper part of anterior mediastinum

图3-22气管、支气管前面观 Anterior aspect of the trachea and bronchi

图3-23气管、支气管后面观 Posterior aspect of the trachea and bronchi

图3-24气管隆嵴 Carina oftrachea

气管隆嵴的应用解剖学要点

图3-25气管、支气管的位置毗邻 Localization and adjacent structures of the trachea andbronchi

图3-26支气管、食管和主动脉的位置 Localization of the bronchi, esophagus and aorta

图3-27气管、支气管冠状切面 Coronal section of the trachea and bronchi

图3-28支气管动脉 Arteries of the bronchus

图3-29支气管的神经分布（后面观） Nerve supply of the bronchus (posterior aspect)

图3-30支气管淋巴结 Bronchial lymph nodes

经支气管动脉介入治疗的应用解剖学要点

图3-31食管的动脉分布（后面观） Arteries of the esophagus (posterior aspect)

图3-32食管的神经支配（后面观） Nerves of the esophagus (posterior aspect）

图3-33胸导管胸段（后面观） Thoracic segment ofthoracic duct (posterior aspect)

图3-34 心后面观（胸导管） posterior aspect of the heart(thoracic duct)

图3-35胸段下腔静脉 Thoracic part of inferior vena cava

图3-36肺循环的血管 Blood vessels of the pulmonary circulation

图3-37心底大血管 Great vessels on cardiac base

图3-38肺循环的血管（升主动脉已切除）

Blood vessels of the pulmonary circulation (ascending aorta was cut off) 图3-39肺循环的血管（上腔静脉已切除）

Blood vessels of the pulmonary circulation (superior vena cava was cut off) 图3-40动脉韧带 Arterial ligament

图3-41动脉导管三角（侧面观）Ductusarterious triangle (lateral aspect)

图3-42食管上三角（侧面观） Superior esophagus triangle (lateral aspect)

图3-43白交通支和灰交通支 White and grey communicating branches

图3-44心包前面观（一） Anterior aspect of the pericardium (1)

图3-45心包前面观（二） Anterior aspect of the pericardium (2)

图3-46心包后面观 Posterior aspect of the pericardium

图3-47心的外形前面观（心包前部已切除）

Anterior aspect of the heart (anterior part of the pericardium was cut off)

图3-48心包后面观（心已取出） Posterior aspect of the pericardium (heart was taken out)

图3-49左心房在体后面观 Posterior aspect of the left atrium in thoracic cavity

图3-50左心房后面观（心包已切开）

Posterior aspect of the left atrium (pericardium was opened)

图3-51成人心的位置前面观 Anterior aspect of the position of adults heart

图3-52儿童心的位置前面观 Anterior aspect of the position of childs heart

图3-53 心前面观（一） Anterior aspect of the heart (1)

图3-54心前面观（二） Anterior aspect of the heart (2)

图3-55心右侧面观（一） Right aspect of the heart(1)

图3-56 心右侧面观（二） Right aspect of the heart (2)

图3-57心左侧面观（一） Left aspect of the heart (1)

图3-58 心左侧面观（二） Left aspect of the heart (2)

图3-59 心后面观（一） Posterior aspect of the heart (1)

图3-60心后面观（二） Posterior aspect of the heart (2)

图3-61心后面观（三） Posterior aspect of the heart (3)

图3-62 心底面观Basal aspect of the heart

图3-63右心的位置 Localization of theright part of heart

图3-64 右心房和右心室腔 Right atrium and right ventricle cavity

图3-65右心房内结构（一） Internal structure of the right atrium(1)

图3-66右心房内结构（二） Internal structure of the right atrium (2)

图3-67右心房内结构（三） Internal structures of the right atrium (3)

卵圆窝的应用解剖学要点

图3-68 右房室瓣Right atrioventricular valve

图3-69右房室瓣心房面观 Atrial-side aspect of the right atrioventricular valve

图3-70右房室口上面观 Superior aspect of the right ventricular orifice

图3-71右心房、右心室 Right atrium and right ventricle

图3-72右心室内结构（一） Internal structures of the rightventricle (1)

图3-73右心室内结构（二） Internal structures of the right ventricle(2)

图3-74 左、右心室腔Left ventricle and right ventricle

图3-75右心室流出道结构 Structures of the outflow path of right ventricle

图3-76右心室流出道 Outflow path ofright ventricle

图3-77 右心室流入道和流出道Inflow and outflow path of right ventricle

图3-78右心室内节制索（隔缘肉柱）（一）

Moderator band of right ventricle (septomarginaltrabecula) (1)

图3-79右心室内节制索（隔缘肉柱）（二）

Moderator band of right ventricle (septomarginaltrabecula)(2)

图3-80心腔内注射进针的部位和层次

Positions and layers of the intracavitary administration into the heart

右心室内注射术的应用解剖学要点

图3-81室间隔右侧面观 Right aspect of theinterventricular septum

图3-82室间隔膜部形态（透射照像法一）

Morphology of the membranous part of interventricular septum (transmission method, 1）

图3-83室间隔膜部形态（透射照像法二）

Morphology of the membranous part of interventricular septum (transmission method, 2)

图3-84室间隔膜部形态（透射照像法三）

Morphology of the membranous part of interventricular septum (transmission method, 3)

图3-85室间隔膜部形态（心冠状切面一）

Morphology of the membranous part of interventricular septum (coronary section, 1)

图3-86室间隔膜部形态（心冠状切面二）

Morphology of the membranous part of interventricular septum (coronary section, 2)

室间隔膜部的应用解剖学要点

图3-87左心房后面观 Posterior aspect of the left atrium

图3-88左心房内结构后面观（左心房后壁已切开）

Posterior aspect of the left atrium (posterior wall of the left atrium was opened）

图3-89左心房、左心室 Left atrium and left ventricle

图3-90 二尖瓣复合体 Mitral complex

图3-91左房室口上面观 Superior aspect of the left atrioventricular orifice

图3-92左房室瓣心室面观Ventriculsurface-side aspect of the left atrioventricular valve

图3-93左房室瓣展平观（一） Spread aspect of thethe left atrioventricular valve (1)

图3-94左房室瓣展平观（二） Spread aspect of the left atrioventricular valve (2)

图3-95左房室瓣心房面观（透射照像法）

Atrial-side aspect of the left atrioventricular valve (transmission method)

图3-96左房室瓣心室面观（透射照像法）

Ventricular-side aspect of the left atrioventricular valve (transmission method)

图3-97左房室瓣前尖扫描电子显微镜照片，2000

Anterior cusp of left atrioventricular valve under scanning electronmicroscopy,2000

图3-98二尖瓣前尖扫描电子显微镜照片，剥除瓣膜表面心内膜层，800

Anterior cusp of left atrioventricular valve under scanning electronmicroscopy, endocardium has been divested, 800

图3-99二尖瓣前尖扫描电子显微镜照片，矢状切面，1280

Anterior cusp of left atrioventricular valve under scanning electronmicroscopic, sagittal section, 1280

图3-100二尖瓣前尖组织结构（一）VG染色，石蜡切片，3.24

Structure the of anterior cusp of left atrioventricular valve (1)VG staining,paraffin section, 3.24

图3-101二尖瓣前尖组织结构（二）VG染色，石蜡切片，3.24

Structure of the anterior cusp of left atrioventricular valve (2)VG staining,paraffin section, 3.24

图3-102瓣膜内有髓神经纤维（透射电子显微镜照片），3000

Myelinated nerve fibers of the valve transmission electronmicroscopy, 3000

图3-103左心室内部结构 Structures of the left ventricle

图3-104左心室流出道结构（一） Structures of the outflow path ofleft ventricle (1)

图3-105左心室流出道结构（二） Structures of the outflow path of left ventricle (2)

图3-106 左心室流入道和流出道Inflow and outflow path of left ventricle

图3-107左心室流入、流出道 Inflow and outflow path ofleft ventricle

图3-108腱索（一） Chordae tendineae(1)

图3-109腱索（二） Chordae tendineae(2)

图3-110腱索（三） Chordae tendineae(3)

图3-111腱索纵切面观，VG染色，石蜡切片，3.24

Longitudinal section of the chordae tendineae, VG staining,paraffin section, 3.24

图3-112腱索扫描电子显微镜照片（一）示腱索表面内皮细胞排列，400

Chordinaetendineae under scanning electronmicroscopy (1), showing arrangement of endothelial cells on chordae tendineae, 400

图3-113腱索扫描电子显微镜照片（二），300

Chordinaetendineae under scanning electronmicroscopy (2), 300

图3-114腱索扫描电子显微镜照片（三）示胶原纤维的形态，1960

Chordinaetendineae under scanning electronmicroscopy (3), showing morphology of collagenous fibers, 1960

图3-115腱索扫描电子显微镜照片（四）示弹力纤维，3000

Chordinaetendineae under scanning electronmicroscopy (4), showing elastic fibers, 3000

腱索的应用解剖学要点

图3-116心房肌、心室肌后面观Posterior aspect of the atrial and ventricular myocardium

图3-117右心房肌（前外侧面观） Right atrium (anterolateral aspect)

图3-118心房肌（前上面观） Atrial myocardium(anterosuperior aspect)

图3-119心肌袖组织切片（VG染色） Slice of myocardial sleeve(VG staining)

图3-120心纤维环（上面观） Fibrous ring of heart(superior aspect)

图3-121心室肌（后面观）Venticular myocardium(posterior aspect)

图3-122心室肌的排列层次（左心室前外侧壁）

Layers of ventricular myocardium(anterolateral wall of left ventricle)

图3-123心尖部心肌的形态 Morphology of the cardiac apical myocardium

图3-124心室肌横切面 Cross section of the ventricular myocardium

图3-125左心室肌矢状切面 Longitudinal section of the left ventricular myocardium

图3-126左心室肌（透射电子显微镜照片），4000

Myocardium of the left ventricle (transmission electronmicroscopic photo), 4000

图3-127心浅丛 Superficial cardiac plexus

图3-128窦房结的位置（一）Position of the sinuatrial node (1)

图3-129窦房结的位置（二）石蜡切片，H-E染色，3.34

Position of thesinuatrial node (2) Paraffin section, H-E staining, 3.34

图3-130房室结的位置 Position of theatrioventricular node

图3-131房室结的动脉（起始于右冠状动脉）

Artery of the atrioventricular node (arising from right coronary artery)

图3-132房室结的位置，Masson染色，40

Position of theatrioventricular node, Masson staining, 40

图3-133心肌袖（心房肌）内的传导组织箭头示传导组织，横纹不发达

Conducting tissue in the myocardial sleeve (atrial muscle)

Arrows show the conducting tissue with incompletely developed striations

图3-134心肌袖（心房肌）传导组织内的P细胞透射电子显微镜照片，5000

P cell in the conducting tissue of myocardial sleeve (atrial myocardium), transmission electronmicroscopic photo, 5000

图3-135右心房动脉（上面观） Arteries of the right atrium (superior aspect)

图3-136右心房动脉（前外侧面观）Arteries of the right atrium(anterolateral aspect)

图3-137左心房动脉（上面观） Arteries of the left atrium (superior aspect)

图3-138左心房动脉（前面观） Arteries of the left atrium (anterior aspect)

图3-139左心房动脉（后面观一） Arteries of the left atrium (posterior aspect 1)

图3-140左心房动脉（后面观二） Arteries of the left atrium (posterior aspect 2)

图3-141左冠状动脉（心房已切除） Left coronary artery (atria have been resected)

图3-142左冠状动脉左前外侧面观（一）

Left anterolateral aspect of the left coronary artery (1)

图3-143左冠状动脉左前外侧面观（二）

Left anterolateral aspect of the left coronary artery (2)

图3-144左冠状动脉左前外侧面观（三）

Left anterolateral aspect of the left coronary artery (3)

图3-145左冠状动脉左前外侧面观（四）

Left anterolateral aspect of the left coronary artery (4)

图3-146右冠状动脉前面观 Anterior aspect of the right coronary artery

图3-147心肌桥（左室前壁） Myocardial bridge (anterior wall of left ventricle)

壁冠状动脉的应用解剖学要点

图3-148心尖部的动脉吻合 Arterial anastomosis of the cardiac apex

图3-149乳头肌血供 Blood supply of the papillary muscles

图3-150乳头肌血供（钼靶X线片）

Blood supply of the papillary muscles (molybdenum target X-ray film)

图3-151动脉圆锥支Branch of arterialconus

图3-152心室膈面的动脉分布（左优势型一）

Arteries of the diaphragmatic surface of ventricles (left-dominant type 1 )

图3-153心室膈面的动脉分布（左优势型二）

Arteries of the diaphragmatic surface of ventricles (left-dominant type 2 )

图3-154心室膈面动脉分布（右优势型一）

Arteries of the diaphragmatic surface of ventricles (right-dominant type 1 )

图3-155心室膈面动脉分布（右优势型二）

Arteries of the diaphragmatic surface of ventricles (right-dominant type 2 )

图3-156心室膈面动脉分布（右优势型三）

Arteries of the diaphragmatic surface of ventricles (right-dominant type 3 )

图3-157心室膈面动脉分布（右优势型四）

Arteries of the diaphragmatic surface of ventricles (right-dominant type 4 )

图3-158心室膈面动脉分布（均衡型一）

Arteries of the diaphragmatic surface of ventricles (balanced type 1 )

图3-159心室膈面动脉分布（均衡型二）

Arteries of the diaphragmatic surface of ventricles (balanced type 2)

图3-160心室膈面动脉分布（均衡型三）

Arteries of the diaphragmatic surface of ventricles (balanced type 3)

图3-161心室膈面动脉分布（均衡型四）

Arteries of the diaphragmatic surface of ventricles (balanced type 4)

图3-162心室膈面动脉分布（均衡型五）

Arteries of the diaphragmatic surface of ventricles (balanced type 5 )

图3-163胸部动脉铸型Cast of the thoracic arteries

图3-164 心冠状动脉数字减影血管造影图 DSA of the coronary artery

冠状动脉分布类型的应用解剖学要点

图3-165心大静脉 Great cardiac vein

图3-166左缘静脉 Left marginal vein

图3-167冠状窦（一） Coronary sinus (1)

图3-168冠状窦（二） Coronary sinus (2)

图3-169心的血管铸型（前面观）Vascular cast of the heart (anterior aspect)

图3-170心的血管铸型（后面观）Vascular cast of the heart (posterior aspect)

图3-171心的横切面（经冠状沟平面）

Transverse section of the heart (through coronary sulcus level)

图3-172心的冠状切面（经主动脉瓣）

Coronary section of the heart (through aortic valve)

图3-173心的冠状切面（经肺动脉干）

Coronary section of the heart (through pulmonary trunk)

图3-174胸上部水平切面

Transverse section of the superior part of thorax

图3-175经肺动脉干胸部横断面

Transverse section of the thorax through pulmonary trunk

图3-176经动脉圆锥的胸部冠状切面

Coronary section of the thorax through conusarteriosus

图3-177经升主动脉的胸部冠状切面

Coronary section of the thorax through ascending aorta

图3-178经室间隔的胸部矢状切面

Sagittal section of the thorax through interventricular septum

图3-179经主动脉根部的CT检查（X线片)

X-ray film of the CT examination through the root of aorta

图3-180右前瓣斜位心长轴MRI检查（X线片）

Right anterior oblique section through long axis of the heart (X-ray film of MRI examination）

图3-181体轴冠状位的MRI检查(X线片)

X-ray film of MRI examination through coronary axis of body

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英文索引