1. GS. BS. MIRCEA IFRIM vrN Sf VIN HAN LAM Y KHOA RUMANI ? = , ATLAS GIAI PHAU NGIIO'I Ph;i'n ncji tl!Jng NguiJi d;ch: as. Nguyi}n Kim LQc .. ...~ ? NHA XUAT BAN Y HQC HA N(n - 2004

2. Coordinaitor: Colaborators: Reviewers: Mircea Ifrim Member of the Medical Science Academy Human Anatomy Atlas Mircea !frim Chen Feng Ifrim, Adrian Maghiar, Traian Maghiar, Viscera IAcad. Gh. Niculescu I Prof. Dr. Cezar Niculescu, Prof. Dr. Dumilru Dragoi, Prof. Dr. Mocanu Gh. Illustrations by E. P5.1rascuta Translation into English - L.M.Roller Ifrim, Mircea Human Anatomy Atlas/Mircea Ifrim - Arad: Servo - Sal, 1999. 3 vol.; i1.; 34cm. ISBN 973 - 9442-03-X VaLlI - 1999 - 272 p. Bibliogr. - ISBN 973-9442-04-8 611 (081) 3. Loi lI!a euon Atlas gia.i phau nglidi rna cae b:;m dang d.m tren tay co nQi dung de cl}p chu yeu Wi cae t~mg (cd quan). Tac ph~m dUQc xuat ban b.ng tieng Anh va 18. cang trinh dftu tien thuQc th~ lo~i nay cua nganh Giai phau hQc Rumani. "Atlas giai phau ngudi" truClc het la slJ. ke thua va phat tri~n ttl tudng cua nha gi3.i ph[m h9C VI d~i Francisc Josef Rainer, cha de cua nganh Giai phfru hQc Rumani. Nen tang tli h1dng khaa hQc cua Rainer bit ngu6n tit each ohio nh~n c{lu true thea chile nang: mQi dlu true gi3.i phftu deu dl1Qc nghien CUll va giai thich d1;ta tren Cd sd chuc nang cua chung. Ben c~nh d6, "Atlas giai phau ngl1di" con dang thdi th~ hi~n mQt quan ni~m Cd ban khitc ella y hQc hi~n dlili. D6 chfnh la quan ni~m Him sang.ICu6n sach kh6ng di vaa rno t8 cae cau true giai phftu voi nhung chi tie't ntdm ra va b6. NgUt khoang ao co hinh mong ngl,1a rna chieu cong 16m hl10ng ra sau, dl1qc gidi h~n 0 giua m(>t ben (phia trl1C1c-ngoai) 13 rnoi va rna, va ben kia (phia sautrong) 180 cac cung rang (ham rang) va biJ huy~t rang cua cac Xl1dng ham co lqi che phU16 . Voi chieu caD trung binh ti1 4-5 cm, tien dinh mifi!ng gidi h~n boi cac tui cung, t~o nen cac ranh cua phiu tiin dink tren va dl1(ji (ho~c con gQi 18. vam tie'n dink mi~ng '8 CUllg rang ho~e ham rang va biJ huy~1 rang eua cae l(u'Clng ham c:6lfli phu ~lfc;lc goi chung la cung rang-Ic;li 22. tren va duai). Moi ranh cua tien dinh l~i dUQC phan thanh hai mla-ranh, nita-ranh phai va trai, bdi mQt nep hinh liem gQi la ham moi (frenulum labii superioris et inferioris: ham moi tren va dudi). d phia rna cua tien dinh mi~ng, ngang vdi muc rang ham tren thu hai co 10 rna va~ ming eua 6'ng Stenon, Wc la 5ng bai xuat ella tuyen nuoe bQt mang tai (papilla parotidea: nhu tuye'n mang tai). Tie'n dinh mi~ng thong voi hoc mi~ng ehinh thU:c d khoang sau-rang ham, gioi h0n sau cua khoimg nay la mQt n(p, n:im trong be day CUll. nep 18. day ch6ng chan budm-hiun, huang thiing dung, khi ha to ITIi~ng thi nhin thiy nep nay a phia trong clla h6' v~t. Hoc mi~ng chfnh thLtc (Cavum oris proprium) La phftn sau cua mleng, n6.m d phia sau-trong eua d.c cung riing-lr;Ji; hoe mi~ng chinh thuc hinh b.u dvc, hdi d~t theo ehieu tren-duai, phfin sau rng hdn phftn trudc; kieh thuoc cua hoc mi~ng chinh thuc cung Iii kich thuoe cae ehieu cua di.c cung rang (haITI ran~), Wc la: dUdng klnh truoe sau: 7.6 em, dUdng kieh thiing dung: 2,5 em, va dlfdn~ kinh ngang: 4-5 cm do khoang giua m(lt nhai cua hai rang ham Ion euoi eung a hal ben, va 18. 2,6 em neu do khoang giua hai rang ham be d hai ben. Hoc mi~ng chinh thue gioi h~n a phia trEm b6i vbm kh6u cai xudng eo niem ml-C phil, niem mSic nay tiep tvc ra phia sau d~ phu khung Cd-ml-c cua man kh6u cai (khdu cai nre'm) (hinh 7-9). Ve phia trude-ben, hoc mi~ng ehinh thli:c dUQe gioi hl;ln bdi cung ding va bai bd xUdng co 19i ehe phu cua cac xUdng ham (We bd huy~t ding cua dic xUdng ham tren va dudi)17. d phia sau, hoe ml~ng chinh thue thu nha dftn chieu ngang ve phia eo h9ng-mi~ng va nllm sau giil'a cae bd trude cua hai nganh len eua X1dng ham dudi, loi vao trong hoc mi~ng khi ml~ng ha to, va thanh dung thiing cua tien dinh h.lu, ph.ln nay cua hoc mi~ng chinh thuc nftm giua hai viing chan budm-khdu ccii d hai ben, do d6 e6 th@ van dUQc vung chan budm-kh6u cai d dOl-n nay b~ng dU:Clng mi~ng. Gioi h~n dudi cua hoe mi~ng ch(nh thuc 1a ne'n mi~ng (ho$.c san mi~ng). Phftn giil'a eua nen mi~ng la luBi, lUdi 10i len thanh mQt khoi IOn van trong hOc mi~ng ehfnh thuc, va cung voi eung rang-IQi d hai ben gidi h?-n eae d.nh gqi la ranh huyt-ludi. Ranh huyt-lu?!i (a moi ben) la m9t khoang hinh tam giac keo dai, vdi dinh a phfa sau gidi hl-n bai bd lc;li-huy~t rang nftm d phia ngoai cua day luai. Ph.ln truCle cua ranh huyt-lUdi c6 V cua tuyen nude bQt duoi luai nho len, v nay a phia sau tiep sat vdi miu nha ra truoc cua tuyen nude bot dudi ham, cung vdi 5ng bai xuit cua tuyen nay gQi la f/ng Wharton (dQc theo am Vi~t 1a Oac-tong). Nhung V 16i cua ca.e tuyen dudl ludi tl;lo nen dudi ludi, doi khi la hai V hinh mao ga, nen gQi la mao duai IUdi. atren dUClng giGa, c6 ham lu?!i (frenulum linguae), khoang 1 cm phfa sau ch6 bam cua ham nay co mQt u nha gQi la cc tuye'n nudc bqt, a giGa dinh cua eVe nay c6 10 rna van mi~ng eua ong Wharton (ductus subman- dibularis: ong dudi ham), hdi l~eh ra ngoai eua 10 ong Wharton co 10 cua ang bai xuU"t ehinh cua tuyen dudi 1uai, gQi 18. ong Rivinus. Tuyen nuoe bQt duai lUdi con eo nhieu ong bai xuit phV (tu 1012 ong) cung rna th~ng van ranh huy~t-luai, va chi eo thd nhin thiy khi sOl kinh phong dl-i. 17 Gac r!l.n9 cua hai ham phal lrign W Irong cac ho 991 la cac huy~t rang, d cac bo duai va Iren cua cac xl1dn9 ham Iren va duoi Il1dng ltng. Cac bo nay dU'Qc 99i la bel lJuy~t nMg, c6 niem m~c mi~ng phu 99i la 11);. D~ cho dli hinh dung, m91 so 5ach giao khoa liang Vi~t 99i t~p hQp cac rang va cac bo huy~t rang c6 I~i phu nhu'lay la cung rang It:;Ji. 25 23. Niem. m.~c m.i~ng: Toil.ll b9 hac mi~ng dUQC lat deu d*n bdi niem m:;tc, niem m~c nay chi' khang phu ph:in vanh cua cac rang. Tu}' thea tung vung trong h6c mi~ng, niem m~c mi~ng rat khac bi~t va c6 cau truc thich nghi voi nhi1ng giai do:;tn tien- tieu hO{l khac nhau cua kh6i thuc an. 'Bi1t dAu tU 10 mi~ng (khe mi~ng) d ndi tiep n6i gii1a da va niem m:;tc tren cac moi, niem m:;tc mi~ng tiep tl,lC phu be mQ.t trong cua d.c moi va rna, va chua d1,1ng nhieu tuycn miOc b9t mioc_nhaylH (c6 ca te baa tict nuoc b9t loang va te baa tiet nuoc nhay), rat nha, n~m rai rac trang tfing bi~u m6. Can phai n6i rftng cac tuyen nhi) nay aUQc phan b6 t$.p trung d:;ic bi~t anhi1ng vung c6 ho:;tt d9ng chilc nang m:;tnh hem, vi dl,l cac tuyen d vung rang ham cua tien dinh. Khi tU m$-t trong cua moi va rna quQ.t len phu bd huy~t rang cua cac xUdng ham, t.hi niem m:;tc mi~ng I:;ti thich nghi voi mQt chuc nang moi, d6 la chiu suc ep. Do v$.y, niem m:;tc a day tra nen dfiy hdn, dai ben hdn, kern long leo hdn va giau rna sQi hdn, tra thanh m9t mang sQi-nhay, va dUQc g9i Ia lqi. Lqi phu lien t).c tu m:;it tien dinh (m$-t t.ruoc-ngoai) cua cac bd huy~t ding sang m*t Ivai (m:;it sau trong) cua cac bd nay, Iuan qua cac khe giua cac rang, va t