第一章眼科学基础.ppt

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1、第一章第一章眼科学基础眼科学基础ChapteroneBasicophthalmology1/23/20231n第一节第一节眼的组织解剖眼的组织解剖anatomyofeyeballn一眼球一眼球Theglobe(eyeball)n正常眼球的前后径出生时约正常眼球的前后径出生时约16mm.n3岁时达岁时达23mm.n成年时成年时24mm.nanteriorandposteriordistanceofnormaleyeballis16mminborn.Atage323mm,atadult24mm1/23/20232（一）（一）眼球壁眼球壁Eyecoatn1.外层外层Theoutercoat1/6角膜

2、角膜Cornea5/6巩膜巩膜Sclera1/23/20233（1）角膜）角膜Cornean横径横径Thetransversediameter11.5-12mmn垂直径垂直径Theverticaldiameter10.5-11mm1/23/20234n前前表面曲率半径表面曲率半径The radius of convex curvature in front 7.8mmn后表面曲率半径后表面曲率半径The radius of convex curvature in back 6.8mmn角膜厚度中央部角膜厚度中央部Thecentralthickness0.5-0.55mmn角膜厚度周边部角膜厚度

3、周边部Theperipherythickness1mm 1/23/20235组织学分层组织学分层上皮细胞层Epithelium前弹力层Bowmansmembrane基质层Stroma后弹力层Descemetsmembrane内皮细胞层Endothelium1/23/202361/23/20237(2)巩膜Sclera组织学分层n表层巩膜Theepiscleran巩膜实质层Thescleralstroman棕黑板层Thelaminafascia1/23/20238n角巩膜缘Limbusn前房角Anteriorchamberangle1/23/20239 2中层 Themiddlecoat n葡萄

4、膜Uvean色素膜Tunicapigmentosa 1/23/202310（1）虹膜Irisn分层：n基质层Stroman色素上皮层Pigmentepitheliallayern 瞳孔 Pupil:直径2.5-4mm 1/23/202311(2)睫状体Ciliarybodyn睫状冠Parsplicata:前1/3n睫状突Cliaryprocesses:n睫状体扁平部Parsplana:后2/3n锯齿缘Oraserrata:1/23/202312(3)脉络膜Choroidn组成n大血管层Largevascularlayern中血管层Middlevascularlayern毛细血管层Capilla

5、rylayer1/23/2023133内层Innerlayer视网膜Retinan中心凹Fovea黄斑Maculalutean中心小凹Foveola黄斑中心凹Foveacentralisn视盘Opticdisc视乳头Opticpapillan视杯、杯凹Opticcup1/23/202314视网膜分层外层n视网膜色素上皮层Retinalpigmentepithelium,RPE1/23/202315内层视网膜神经感觉层n视锥、视杆细胞层（光感受器细胞层）Coneandrodlayern外界膜Externallimitingmembranen外核层Outernuclearlayern外丛状层Out

6、erplaxiformn内核层Innernuclearlayern内丛状层Innerplexiformlayern神经节细胞层Ganglioncelllayern神经纤维层Nervefiberlayern内界膜Limitingmembrane1/23/2023161/23/202317（二）眼球内容Contentsoftheeyen1.房水Aqueoushumorn前房Anteriorchambern后房Posteriorchamber1/23/2023182.晶状体Lens1/23/2023193.玻璃体Vitreousbody1/23/2023201/23/2023211.视路Visual

7、pathwayn光感受器双级细胞神经节细胞视乳头视神经视交叉视束外侧膝状体视放射视皮质nretinalphotoreceptorbipolarcellnervousganglioncellsopticdiskopticnerveopticchasmoptictractlateralgeniculatebodyopticradiationvisualcortex.1/23/202322二、眼眶及附属器Orbitandaccessoryapparatusn(一)眼眶Orbitn1.视神经孔和视神经管Opticforamenandcanaln2.眶上裂Superiororbitalfissuren3

8、.眶下裂Inferiororbitalfissuren4.眶上切迹（或孔）Thesupraorbitalnotch1/23/202323（二）眼睑Eyelids n1皮肤层Theskinn2皮下组织层Subcutaneousn3肌层Muscularlayern4睑板层Layerofthetarsalplaten5结膜层Theconjunctivallayer1/23/2023241/23/202325(三)结膜Conjunctivan1 睑 结 膜 Palpebralconjunctivan2球结膜Bulbarconjunctivan3穹窿结膜Fornicalconjunctiva 1/23/

9、2023261/23/202327(四)泪器Lacrimalapparatus1泪腺Lacrimalgland2泪道Lacrimalpassages(1)泪小点Lacrimalpuncta(2)泪小管Lacrimalcanaliculi(3)泪囊Lacrimalsac(4)鼻泪管Nasolacrimalduct1/23/2023281/23/202329(五)眼外肌Extraocularmusclesn4条直肌Rectusn上直肌superiorrectimusclesn下直肌inferiorrectimusclesn内直肌medialrectimusclesn外直肌externalrecti

10、musclesn2条斜肌Obliquemusclen上斜肌superiorobliquemusclesn下斜肌Inferiorobliquemuscles1/23/2023301/23/202331三、视路Visualpathwayn（一）视神经Opticnerven(1)眼内段Intraocularn(2)眶内段Intraorbitaln(3)管内段Intracanalicularn(4)颅内段Intracranialn（二）视交叉Opticchiasmn（三）视束Optictractn（四）外侧膝状体Lateralgeniculatebodyn（五）视放射Opticradiationn（六

11、）视皮质Visualcortex1/23/2023322.瞳孔反射路Pathwayofpapillaryreflexn光反射Lightreflexn直接光反射Directreflexn间接光反射Indirectreflexn近反射Nearreflex1/23/2023331/23/202334四、眼球的血液循环和神经分布Bloodcirculationandinnervationofthegloben（一）血液循环Bloodcirculationn动脉Arteryn视网膜中央血管系统thecentralretinalvascularsystemn睫状血管系统theciliaryvascular

12、system1/23/202335n1.视网膜中央血管系统Thecentralretinalvascularsystemn视网膜中央动脉Centralretinalartery,CRA1/23/2023362.睫状血管系统theciliaryvascularsystemn(1)睫状后短动脉Shortposteriorciliaryarteryn(2)睫状后长动脉Longposteriorciliaryarteryn(3)睫状前动脉Anteriorciliaryartery1/23/202337静脉Veinn1.视网膜中央静脉CentralretinalveinCRVn2.涡静脉Vortexve

13、inn3.睫状前静脉Anteriorciliarvein 1/23/202338（二）神经Nerven1睫状神经节Ciliaryganglionn2鼻睫状神经Nasociliarynerve1/23/202339视路及瞳孔反射Opticpathwayandpupillaryreflex 1/23/2023401瞳孔反射路Pathwayofpupillaryreflexn光反射Lightreflexn直接光反射directreflexn间接光反射indirectreflexn近反射Nearreflex1/23/2023412.视路Visualpathwayn光感受器双级细胞神经节细胞视乳头视神经视交叉视束外侧膝状体视放射视皮质nretinal photoreceptorbipolar cellnervous ganglioncellsoptic diskoptic nerveoptic chasmoptictractlateral geniculate bodyoptic radiationvisualcortex.1/23/2023421/23/2023431/23/202344