Giải phẫu tập 1 đh y thái nguyên (326p)

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  • 1. TRNG I HC Y KHOA THI NGUYNB MN GII PHU HCBI GINGGII PHU HCTP 1NH XUT BN Y HCH NI - 2008

2. CH BIN:TS. Trnh Xun nBAN BIN SON:TS. Trnh Xun nThS. inh Th HngThS. Nguyn HunhThS. Trng ng TmBS. Trn Ngc BoTH K BIN SON: Nguyn c Vinh 3. 1LI NI UCun Bi ging Gii phu hc l ti liu dy/ hc chnh cho sinh vintheo hc chng trnh o to bc s a khoa c B Gio dc v o toban hnh nm 2001 vi 5 n v hc trnh l thuyt (75 tit) v 3 n v hctrnh thc hnh (45 tit), vi 2 hc phn c b tr hc vo nm hc th nht.Vi khun kh thi gian v khung chng trnh trn, vi mc tiu chung, mctiu c th mn hc cng chnh l mc tiu ca cun sch ny, c xcnh l: (1) M t c nhng nt c bn v v tr, hnh th, lin quan v cuto ca cc b phn, c quan, h c quan cng nh h thng mch mu, thnkinh ca c quan trong c th ngi (2) Nu c nhng lin h v chc nngv lm sng thch hp ng dng cc kin thc mn hc vo cc mn y hckhc trong thc t lm sng. t c 2 mc tiu trn, cun sch ny c trnh by theo quanim kt hp gia:- M t gii phu nh khu theo tng vng c th m t chi tit nhnglin quan su, nhm cung cp cho sinh vin v cn b y t c th vn dng vothc hnh trong lm sng.- M t gii phu i cng v h thng theo tng phn c th sinhvin d dng tng hp cng nh nhng gi lin quan n cc mn hc khcca y hc v mt s p dng thc tin lm sng cn t.Sch c bin son theo 2 tp:Tp 1. i cng v gii phu hc cc h xng, c, khp. Gii phunh khu chi trn, chi di, (sau mi phn c h thng ha). Gii phu u mtc v gic quan.Tp 2. Gii phu ngc, bng, thn kinh (thnh ngc, bng: xng, khp,c ca thn mnh. Cc c quan trong lng ngc v trong bng: phi v h hhp, tim v h tun hon, trung tht, h tiu ha, h tit iu - sinh dc v hthn kinh trung ng).y l cun sch nng v m t da trn cc hnh v nn vic m t ngn 4. gn nhng y v chnh xc l rt kh. Tp th ging vin ca b mn Giiphu hc c nhiu c gng trong vic bin son tp bi ging ny, cng vivic chn lc tranh, s v t t yu gip ngi hc d hiu, d hc v dnh. ng thi a vo nhng danh t gii phu quc t vit ho ca TrnhVn Minh (Nh xut bn Y hc 1999) gip cho sinh vin v c nhng bc skhi c cc ti liu tham kho trong nghin cu khoa hc, cng nh vic ichiu vi ti liu nc ngoi.2Trong khun kh cn hn hp v nhiu mt cng nh kinh nghim cn ti, khng th trnh khi u st v khim khuyt. Rt mong bn c gp phbnh v mi phng din ln ti bn sau c hon Thin hn.Xin trn trng cm n v gii Thiu cng bn c.Thi Nguyn, ngy 15 thng 12 nm 2007THAY MT BAN BIN SONTS. Trnh Xun n 5. 3MC LCLI NI U ...................................................................................................................1Chng 1 GII PHU I CNG...............................................................................4NHP MN GII PHU HC....................................................................................4I CNG H VN NG...................................................................................12Chng 2 GII PHU CHI TRN .................................................................................28XNG KHP CHI TRN........................................................................................28VNG NCH..............................................................................................................44VNG CNH TAY.....................................................................................................53VNG KHUU TAY..................................................................................................62VNG CNG TAY.....................................................................................................66VNG BN TAY........................................................................................................76TNG HP V H THNG V NH KHU CHI TRN .......................................84Chng 3 GII PHU CHI DI................................................................................105XNG KHP CHI DI ......................................................................................105VNG MNG...........................................................................................................121VNG I SAU .......................................................................................................127VNG I TRC .................................................................................................130VNG KHOEO .........................................................................................................141VNG CNG CHN SAU.......................................................................................146VNG CNG CHN TRC.................................................................................151BN CHN...............................................................................................................156TNG HP V H THNG V NH KHU CHI DI......................................166TNG HP SO SNH GIA CHI TRN V CHI DI .....................................187Chng 4 GII PHU U-MT C ........................................................................190XNG U MT..................................................................................................190KHP CA U - MT..........................................................................................210H THNG C U MT C...............................................................................213CC C U MT .................................................................................................213C V MC VNG C ..........................................................................................218NG MCH CA U - MT - C ...................................................................226H NG MCH CNH.........................................................................................227NG MCH DI N ......................................................................................237TNH MCH U - MT - C ..............................................................................242BCH MCH U - MT - C.............................................................................245THN KINH U - MT - C...............................................................................248M RI THN KINH C.....................................................................................249TUYN GIP TRNG V CN GIP TRNG....................................................252MING.......................................................................................................................256CC TUYN N C BT ......................................................................................262HU...........................................................................................................................266THANH QUN.........................................................................................................271Chng 5 GII PHU GIC QUAN ...........................................................................279MT...........................................................................................................................279MI............................................................................................................................292TAI.............................................................................................................................301TI LIU THAM KHO..........................................................................................322 6. 4Chng 1GII PHU I CNGNHP MN GII PHU HC1. NH NGHA V LCH S MN GII PHU HCGii phu hc ngi (human anatomy) l mn khoa hc nghin cu cutrc c th con ngi. Tu thuc vo phng tin quan st, gii phu hc cchia ra thnh 2 phn mn: gii phu i th (gross anatomy hay macroscopicanatomy) nghin cu cc cu trc c th quan st bng mt thng; gii phuvi th (microscopic anatomy hay histology) nghin cu cc cu trc nh ch cth quan st di knh hin vi. Tuy nhin hu ht cc trng i hc y, giiphu hc ch trnh by gii phu i th cn gii phu vi th hay m hc lmt b mn ring tch ri vi gii phu i th.Vic nghin cu gii phu hc c t thi Ai Cp c i, nhng n giath k th t (trc cng nguyn) Hypocrates Ngi cha ca y hc a giiphu vo ging dy Hy Lp. ng cho rng khoa hc y hc bt u bngvic nghin cu cu to c th con ngi. Mt nh y hc ni ting khc caHy Lp, Aristotle (384-322 trc cng nguyn), ngi sng lp ra mn giiphu hc so snh v cng l ngi c cng ln trong gii phu hc pht trinv phi thai hc. ng l ngi u tin s dng t anatome, mt t Hy Lpc ngha l chia tch ra hay phu tch. T phu tch dissection bt ngunt ting Latin c ngha l ct ri thnh tng mnh. T ny lc u ngngha vi t gii phu (anatomy) nhng ngy nay n ch l t dng ch mtk thut bc l v quan st cc cu trc c th nhn thy c bng mtthng (gii phu i th), trong khi t gii phu l t ch mt chuynngnh hay mt lnh vc nghin cu khoa hc m nhng k thut c s dngnghin cu bao gm khng ch phu tch m c nhng k thut khc nh sium, chp X-quang.2. CC PHNG TIN V PHNG THC M T GII PHUNgoi phn tch, ngi ta c th quan st c cc cu trc c th (hxng - khp v cc khoang c th) bng chp tia X gi l gii phu X-quang(radiological anatomy). Gii phu X-quang l mt phn quan trng ca giiphu i th v l c s ca chuyn ngnh X-quang. Ch khi hiu c s bnh 7. thng ca cc cu trc trn phim chp X-quang th ta mi nhn ra c ccbin i bt thng ca chng trn phim chp do bnh tt hoc chn thnggy ra. Ngy nay, c thm nhiu k thut mi lm hin r hnh nh cu trcc th (chn on hnh nh) nh siu m, chp ct lp vi tnh (CT scanner),chp cng hng t ht nhn (MRI)...Tu theo mc ch nghin cu, c nhiu cch m t gii phu khc nhau.5Cc cch tip cn chnh trong nghin cu gii phu l:2.1. Gii phu hc h thng (systemic anatomy)L m t cu trc gii phu theo tng h thng cc c quan, b phn(cng thc hin mt chc nng) nhm gip cho ngi hc hiu c chcnng ca tng h c quan. Cc h c quan trong c th l: h da, h xng, hkhp, h c, h tiu ho, h tun hon, h h hp, h tit niu, sinh dc v hni tit. Cc gic quan l mt phn ca h thn kinh.2.2. Gii phu vng (regional anatomy)Gii phu vng hay gii phu nh khu (topographical) l nghin cu vm t cc cu trc (thuc cc h c quan khc nhau) trong mt vng bao gmc nhng lin quan ca chng vi nhau. Cch m t ny ph hp vi quanim Gii phu ng dng hay Gii phu lm sng, nhm phc v ch yucho cc thy thuc lm sng hng ngy phi thc hnh khm v can thip trnbnh nhn. C th c chia thnh nhng vng ln nh: ngc, bng, chuhng v y chu, chi, lng, u v c. Mi vng ln li c chia thnhnhiu vng nh hn.2.3. Gii phu b mt (surface anatomy)L m t hnh dng b m