脑和脊髓的被膜血管.ppt
脑和脊髓的被膜与血管脑和脊髓的被膜与血管脑脊液循环脑脊液循环The Meninges and Blood Vessels of Brain and Spinal Cord,the Cerebrospinal Fluid脑和脊髓的被膜脑和脊髓的被膜The Meninges of Brain and Spinal Cord 硬硬 膜膜 dura mater 蛛网膜蛛网膜 arachnoid 软软 膜膜 pia mater 脊髓的被膜脊髓的被膜The meninges of spinal cord 硬脊膜硬脊膜 spinal dura mater 脊髓蛛网膜脊髓蛛网膜 spinal arachnoid mater 软脊膜软脊膜 spinal pia mater 1、硬脊膜硬脊膜 spinal dura mater 枕骨大孔边缘枕骨大孔边缘-S2水平。水平。n 硬膜外隙硬膜外隙 Epidural space 位置位置 内容物内容物 特点特点 临床意义：硬膜外麻醉临床意义：硬膜外麻醉n Subdural space 硬膜下隙硬膜下隙 脊髓脊髓硬脊膜硬脊膜脊神经根脊神经根硬膜外隙硬膜外隙2、脊髓蛛网膜脊髓蛛网膜 Spinal arachnoid matern特点：缺乏血管和神经特点：缺乏血管和神经 与脑蛛网膜相延续与脑蛛网膜相延续nSubarachnoid space 蛛网膜下隙蛛网膜下隙 Terminal cistern 终池：终池：脊髓下端脊髓下端S2水平水平 内含马尾和终丝内含马尾和终丝 腰穿腰穿蛛网膜下隙蛛网膜下隙终池终池Lumbar spinal puncture 3、Spinal pia mater 软脊膜软脊膜n特点：特点：血管丰富，深入沟裂血管丰富，深入沟裂nFilum terminale 终丝终丝nDenticulate ligament 齿状韧带齿状韧带:齿齿状状韧韧带带脑的被膜脑的被膜The Meninges of BrainnCerebral dural mater 硬脑膜硬脑膜nCerebral arachnoid mater 脑蛛网膜脑蛛网膜nCerebral pia mater 软脑膜软脑膜硬脑膜硬脑膜 cerebral dural mater 1、特点、特点 坚韧、无弹性 两层合成 与颅盖骨连接疏松 与颅底骨结合紧密2、形成结构：、形成结构：1）四个隔幕）四个隔幕Cerebral falx 大脑镰大脑镰Tentorium of cerebellum小脑幕小脑幕Cerebellar falx 小脑镰小脑镰Diaphragma sellae 鞍隔鞍隔2）Sinuses of dura mater 硬脑膜窦硬脑膜窦 窦壁无平滑肌、内衬内皮、窦壁无平滑肌、内衬内皮、无瓣膜无瓣膜、Superior sagittal sinus 上矢状窦上矢状窦 Inferior sagittal sinus 下矢状窦下矢状窦 Straight sinus 直窦直窦 Confluence of sinus 窦汇窦汇 Transverse sinus 横窦横窦 Sigmoid sinus 乙状窦乙状窦Superior petrosal sinuses 岩上窦岩上窦inferior petrosal sinuses 岩下窦岩下窦Cavernous sinus 海绵窦海绵窦位置：位置：蝶鞍两侧通过结构：通过结构：颈内动脉 动眼神经 滑车神经 眼神经 上颌神经 展神经与周围静脉的交通：与周围静脉的交通：蝶窦蝶窦颈内动脉颈内动脉 The flowing of the blood in dural sinus硬脑膜窦的血液流注硬脑膜窦的血液流注 Sup.sagittal sinus上矢状窦上矢状窦 Inf.sagittal sinus下矢状窦下矢状窦 Straight sinus直窦直窦 Confluence of sinus窦汇窦汇 Transverse sinus横窦横窦 Cavernous sinus海绵窦海绵窦 Sup.petrosal sinus岩上窦岩上窦 Inf.petrosal sinus岩下窦岩下窦 Internal jugular vein 颈内静脉颈内静脉Sigmoid sinus乙状窦乙状窦脑蛛网膜脑蛛网膜cerebral arachnoid matern特点：缺乏血管和神经、特点：缺乏血管和神经、跨越沟裂（除外大脑纵裂跨越沟裂（除外大脑纵裂和大脑横裂）和大脑横裂）nSubarachnoid space 蛛网膜下隙蛛网膜下隙nSubarachnoid cisterns 蛛网膜下池蛛网膜下池q小脑延髓池小脑延髓池q脚间池脚间池q桥池桥池q交叉池交叉池q四叠体上池四叠体上池ABCDECerebellomedullary cistern nArachnoid granulations 蛛网膜粒蛛网膜粒上矢状窦上矢状窦硬脑膜硬脑膜脑蛛网膜脑蛛网膜软脑膜软脑膜蛛网膜粒蛛网膜粒大脑镰大脑镰软脑膜软脑膜cerebral pia matern特点：富血管神经、深入沟裂n脉络组织脉络组织：在脑室的一定部位，软脑膜及其血管与室管膜上皮共同形成。脉络丛脉络丛 Choroid plexus脑脊液循环脑脊液循环 Circulation of cerebrospinal fluid(CSF)Circulation of cerebrospinal fluidCSF drains from lateral ventricle侧脑室的脑脊液侧脑室的脑脊液interventricular foramina室间孔室间孔third ventricle第三脑室第三脑室mesencephalic aqueduct中脑水管中脑水管fourth ventricle第四脑室第四脑室median and two lateral apertures第四脑室正中孔和外侧孔第四脑室正中孔和外侧孔subarachnoid space蛛网膜下隙蛛网膜下隙arachnoid granulations蛛网膜粒蛛网膜粒superior sagittal sinus上矢状窦上矢状窦Vein静脉静脉脑和脊髓的血管脑和脊髓的血管Blood vessels of brain and spinal cord椎动脉椎动脉脑的动脉的来源：脑的动脉的来源：nInternal carotid artery 颈内动脉颈内动脉 供应：端脑前供应：端脑前2/3、部分、部分间脑间脑nVertebral artery 椎动脉椎动脉 供应：端脑后供应：端脑后1/3、部分、部分间脑、脑干、小脑间脑、脑干、小脑 分支类型：分支类型：皮质支、中央支皮质支、中央支颈内动脉颈内动脉 颈内动脉颈内动脉 internal carotid arteryn行径行径 颈部、岩部、海绵窦部、颈部、岩部、海绵窦部、前床突上部前床突上部 虹吸部虹吸部n分支分支 大脑前动脉大脑前动脉 大脑中动脉大脑中动脉 脉络丛前动脉脉络丛前动脉 后交通动脉后交通动脉大脑前动脉大脑前动脉Anterior cerebral皮质支皮质支中央支中央支大脑中动脉大脑中动脉Middle cerebral arteryn皮质支皮质支:n中央支中央支:大脑中动脉大脑中动脉豆纹动脉豆纹动脉后交通动脉后交通动脉n脉络丛前动脉脉络丛前动脉 Anterior choroidal artery :n后交通动脉后交通动脉 Posterior communicating artery颈内动脉颈内动脉脉络丛前动脉脉络丛前动脉n椎动脉椎动脉 Vertebral artery 脊髓前、后动脉脊髓前、后动脉 小脑下后动脉小脑下后动脉n基底动脉基底动脉 basilar artery 小脑下前动脉小脑下前动脉 迷路动脉迷路动脉 脑桥动脉脑桥动脉 小脑上动脉小脑上动脉 大脑后动脉大脑后动脉 大脑后动脉大脑后动脉 Posterior cerebral arterynCortical branches皮质支皮质支:nCentral branches中央支中央支:大脑后动脉大脑后动脉大脑前动脉大脑前动脉Cerebral arterial circle(circle of Willis)大脑动脉环大脑动脉环Blockage Area of oxygendeprives brainThrombus Plaque Subarachnoid hemorrhageMicroaneurysm Lenticulostriate arteriesIntracerebral hemorhage Arteriovenous malformationVeins of brain 脑的静脉脑的静脉Superficial cerebral veins大脑浅静脉大脑浅静脉 nDrain blood from cortex and subcortical medullary substance and empty into adjacent sinuses of dura mater 脑的静脉无静脉瓣，不与动脉伴行，分浅、深组。脑的静脉无静脉瓣，不与动脉伴行，分浅、深组。nDeep cerebral veins 大脑静脉深组大脑静脉深组 drain deeper parts of hemispheres,basal nuclei,internal capsule,diencephalon and choroid plexus,ultimately form great cerebral vein 大脑大大脑大静脉静脉which enter straight sinusBlood vessels of spinal cord 脊髓的血管脊髓的血管Arteries of spinal cord 脊髓的动脉脊髓的动脉n来源来源 q椎动脉：发出脊髓前、后动脉椎动脉：发出脊髓前、后动脉q节段性动脉：节段性动脉：nDamage area 危险区:T1T4,ventral part of L1n动脉冠动脉冠 Spinal veins 脊髓的静脉脊髓的静脉:drain into internal vertebralvenous plexus.
