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            呼吸系統(2)-2019年專升本醫學綜合復習資料-福建成教

            福建成人高考信息網www.laiwobuy.com 發布時間: 2018年12月19日


              第二節 呼吸道


              二、喉軟骨的名稱和喉腔的形態結構


              喉由數塊喉軟骨借關節構成支架,附有喉肌,內襯黏膜而成。它既是呼吸管道,又是發音器官。上界是會厭上緣,下界達環狀軟骨下緣,即位于喉咽部的前方,相當于第3~6頸椎高度。小兒喉的位置比成人高。向上借喉口通喉咽部,向下以環氣管韌帶連接氣管。


              (一)喉的軟骨

              喉的軟骨包括單塊的甲狀軟骨、環狀軟骨、會厭軟骨和成對的杓狀軟骨。

              1.甲狀軟骨在 喉軟骨中最大.由左、右對稱的兩塊方形板構成,其前緣融合成90°的前角,前角上端向前突出,稱喉結,成年男性的喉結尤為明盟。左、右板的后緣游離并向上、下發出突起,稱上角和下角。

              2.環狀軟骨位于甲狀軟骨的下方,是軟骨中唯一完整的軟骨環,對保證呼吸道的暢通起重要作用。前部低窄稱環狀軟骨弓,平第6頸椎;后部高闊稱環狀軟骨板。

              3會厭軟骨位于舌根的后方,呈上寬下窄的樹葉狀,下端連于甲狀軟骨前角的內面,表面被覆黏膜構成會厭。吞咽時喉上提,喉口即被會厭關閉,防止食物進入喉腔。

              4.杓狀軟骨成對,分為一尖、一底、兩突。尖向上,底坐落于環狀軟骨板的上緣。由底向前伸出的突起稱聲帶突,有聲韌帶附著。向外側伸出的突起稱肌突,有喉股附著。


              (二)喉腔的形態結構

              喉腔是由喉壁(喉軟骨、韌帶、纖維膜和喉肌)內襯黏膜而成,在外側壁上有上、下兩對黏膜皺襞突入喉腔,上方一對稱前庭襞,左、右前庭襞之間的襲隙稱前庭襲;下方一對稱聲襞,左、右聲襞之問的裂隙稱聲門裂。聲門裂是喉腔中最狹窄的部位。喉腔借前庭裂和聲門裂分成三部,前庭裂以上的部分稱喉前庭;前庭裂與聲門裂之間的部分稱喉中間腔,該腔兩側延伸的隱窩稱喉室;聲門裂至環狀軟骨下緣之間稱聲門下腔,此部黏膜下層組織疏松,炎癥時易發生喉水腫,尤以嬰幼兒更易產生急性喉水腫而致喉梗塞,從而則產生呼吸困難。


              三、左、右主支氣管的區別及臨床意義

              左、右主支氣管自氣管分出后,各自向外下方走行,經肺門入肺,再分出肺葉支氣管。右主支氣管粗而短,長2~3cm,走行方向較垂直;左主支氣管細而長,為4~5cm,走行方向較橫平,故誤入氣管的異物多墜入右主支氣管。


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