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            呼吸系統(4)-2019年專升本醫學綜合考試重點-福建成教

            福建成人高考信息網www.laiwobuy.com 發布時間: 2018年12月22日



              第四節 胸膜

              一、胸膜和胸膜腔的概念


              胸膜是覆蓋在肺表面、胸壁內斷、縱隔側面和膈上面的一層薄而光滑的漿膜,可分臟胸膜和壁胸膜兩部分。臟胸膜包被于肺的表面,并深入肺裂。壁胸膜依其所在部位可分為4部分:(1)胸膜頂是包圍肺尖的部分,高出鎖骨內側半上方2~3cm;(2)肋胸膜襯于胸壁內表面;(3)膈胸膜覆蓋于膈的上面;(4)縱隔胸膜襯貼在縱隔的兩側。


              胸膜腔是臟、壁兩部分胸膜在肺根處互相移行,共同形成的潛在性密閉腔隙。胸膜腔左、右各一,互不相通,腔內含少量漿液,可減少呼吸時兩層胸膜的摩擦。正常胸膜腔為負壓。壁胸膜相互移行轉折處的胸膜腔稱胸膜隱窩,其中肋胸膜和膈胸膜相互移行處所形成的半環狀潛在性腔隙,為肋膈隱窩,又稱肋膈竇。左右各一。深吸氣時,肺的下緣也不能進入其內。肋膈隱窩是胸膜腔位置最低的部位,胸膜炎癥的滲出液常積聚于此,為臨床胸膜腔穿刺或引流的部位。


              胸膜下界為肋胸膜與膈胸膜的返折線,在平靜呼吸時,該線較肺下緣低兩個肋骨。


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