胸部ct纵隔窗课件.ppt

Sectional anatomy of mediastinum 李 振 平The medical college of shandong universitySup.Inf.Ant.Mid.Pos.Sternal angleManubrium sternidiaphragmSympathetic trunkAzygos V.Vagus N.esophagusdiaphragmSup.vena cavaR.P.A.R.P.V.pericardiumR.Principal bronchusVagus N.L.P.V.pericardiumL.Principal bronchusdiaphragmL.P.A.Phrenic N.thymusAortic archL.Subclavian A.Thoracic aortaManubrium sterniSup.vena cavapericardiumR.auricleL.auricleAscending aortaAortic archR.ventricleL.ventricleR.L.brachiocephalic V.Sup.vena cavapericardiumAscending aortaR.ventricleL.ventricleR.auriclePulmonary trunkL.Subclavian A.L.C.carotid A.Brachiocephalic trunkaorticopulmonary aorticopulmonary windowwindowCoronary sinusSmall cardiac V.Middlecardiac V.great cardiac V.L.atriumPos.view of heartaorticopulmonary aorticopulmonary windowwindowTransvers sinus.Oblique sinus.美国胸科学会肺局部淋巴结图American Thoracic Society map of regional pulmonary nodes,ATSAmerican Thoracic Society map of regional pulmonary nodes,ATS 一竖、四横、一斜一竖、四横、一斜竖线竖线 为气管的正中垂线，区分开为气管的正中垂线，区分开 气管左、右侧的淋巴结群气管左、右侧的淋巴结群第一条横线第一条横线 为经主动脉弓上缘的水平线，为经主动脉弓上缘的水平线，将右侧的气管旁淋巴结分为上方的将右侧的气管旁淋巴结分为上方的2R2R区和下方的区和下方的4R4R区，区，将左侧的气管旁淋巴结分为上方的将左侧的气管旁淋巴结分为上方的2L2L区和下方的区和下方的4L4L区区第二条横线第二条横线 为经奇静脉弓上缘的水平线，分开为经奇静脉弓上缘的水平线，分开4R4R区和区和10R10R区区 一竖、四横、一斜一竖、四横、一斜第三条横线第三条横线 为经气管隆嵴上缘的水平线，为经气管隆嵴上缘的水平线，分开分开4L4L区和区和10L10L区；区；第四条横线第四条横线 为经左肺下叶支气管起始部的水平线，为经左肺下叶支气管起始部的水平线，为为7 7区的下界和区的下界和11L11L区的上界。区的上界。斜斜 线线 为自右肺上叶支气管起始部斜向右上的线，为自右肺上叶支气管起始部斜向右上的线，是是10R10R区和区和11R11R区的分界。区的分界。R.upper R.upper paratrachealparatracheal LnLn.L.upper L.upper paratrachealparatracheal LnLn.L.lowerL.lower paratrachealparatracheal LnLn.R.lowerR.lower paratrachealparatracheal LnLn.Subcarinal Ln.aortopulmonaryaortopulmonary LnLn.Ant.Ant.mediastinalmediastinal LnLn.肺局部淋巴结ATS图注解 X X 锁骨上淋巴结锁骨上淋巴结 supraclavicularsupraclavicular nodes nodes 2R 2R 右上气管旁淋巴结右上气管旁淋巴结 right upper right upper paratrachealparatracheal nodes nodes 2L 2L 左上气管旁淋巴结左上气管旁淋巴结 left upper left upper paratrachealparatracheal nodes nodes 4R 4R 右下气管旁淋巴结右下气管旁淋巴结 right lower right lower paratrachealparatracheal nodes nodes 4L 4L 左下气管旁淋巴结左下气管旁淋巴结 left lower left lower paratrachealparatracheal nodes nodes 肺局部淋巴结ATS图注解 5 5 主动脉肺淋巴结主动脉肺淋巴结 aortopulmonaryaortopulmonary nodes nodes 6 6 前纵隔淋巴结前纵隔淋巴结 anterior anterior mediastinalmediastinal nodes nodes 7 7 隆嵴下淋巴结隆嵴下淋巴结 subcarinalsubcarinal nodes nodes 8 8 食管旁淋巴结食管旁淋巴结 paraesophagealparaesophageal nodes nodes 9 9 肺韧带淋巴结肺韧带淋巴结 right or left pulmonary ligament nodesright or left pulmonary ligament nodes 10R 10R右右气管气管支气管淋巴结支气管淋巴结 right pulmonary ligament nodesright pulmonary ligament nodes 10L 10L 左左气管气管支气管淋巴结支气管淋巴结 left left peribronchialperibronchial nodes nodes 11 11 肺内淋巴结肺内淋巴结 intrapulmonary nodesintrapulmonary nodes The transvers section of mediastinumTransverse section through venous anglesEAAATRBVLBVTransverse section through sup.part sternoclavicular jointELBVAAATRBVTransverse section through inf.part sternoclavicular jointEAAATLBVRBVTransverse section through 1th.Sternocostal synochodrosisEAAATLBVRBVTransverse section through sup.part of aortic archERBVAAATLBVTransverse section through aortic archESVCAATTransverse section through aorticopulmonary windowEAVSVCa aTATTransverse section through L.pulmonary A.LPBESVCa aLPATAAVRPBTransverse section through R.pulmonary A.ESVCa aLPARPATARPBLPBPTTransverse section through L.auricleESVCa aRPATARPBLPBPTTransverse section through R.sup.pulmonary V.EVVARVLASVCa aRPARPBTransverse section through R.inf.pulmonary V.ETARVLAa aTransverse section through aortic orificeERVLARAA OTATransverse section through fossa ovalisERVLVLARATATransverse section through 8th thoracic vertebraERVLVLARATATransverse section through coronary sinusEIVCRVLVTATransverse section through sup.part of 9th thoracic vertebraEIVCRVLVTATransverse section through cardiac apexEIVCRVTATransverse section through second porta hepatisEIVCRVTA The transverse scan of mediastinum by CT mediastinal windowDoppler ultrasound of heartALRPE EALRPE EALRPE EALRPE EALRPE EALRPAL LRPE EThanks !