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1、2024/8/21第一章第一章眼科学基础眼科学基础ChapteroneBasicophthalmology2024/8/22第一节第一节眼的组织解剖眼的组织解剖anatomyofeyeball一眼球一眼球Theglobe(eyeball)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.3岁时达岁时达23mm.成年时成年时24mm.anteriorandposteriordistanceofnormaleyeballis16mminborn.Atage323mm,atadult24mm2024/8/23(一)(一)眼球壁眼球壁Eyecoat1.外层外层Theoutercoat1/6角膜
2、角膜Cornea5/6巩膜巩膜Sclera2024/8/24(1)角膜)角膜Cornea横径横径Thetransversediameter11.5-12mm垂直径垂直径Theverticaldiameter10.5-11mm2024/8/25前表面曲率半径前表面曲率半径The radius of convex curvature in front 7.8mm后表面曲率半径后表面曲率半径The radius of convex curvature in back 6.8mm角膜厚度中央部角膜厚度中央部Thecentralthickness0.5-0.55mm角膜厚度周边部角膜厚度周边部Thepe
3、ripherythickness1mm 2024/8/26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Endothelium2024/8/272024/8/28(2)巩膜巩膜Sclera组织学分层组织学分层表层巩膜Theepisclera巩膜实质层Thescleralstroma棕黑板层Thelaminafascia2024/8/29角巩膜缘Limbus前房角Anteriorchamberangle2024/8/2102中层中层Themiddlecoat葡萄膜Uvea色素膜Tuni
4、capigmentosa 2024/8/211(1)虹膜虹膜Iris分层:基质层Stroma色素上皮层Pigmentepitheliallayer 瞳孔Pupil: 直径2.5-4mm 2024/8/212(2)睫状体睫状体Ciliarybody睫状冠Parsplicata:前1/3睫状突Cliaryprocesses:睫状体扁平部Parsplana:后2/3锯齿缘Oraserrata:2024/8/213(3)脉络膜脉络膜Choroid组成大血管层Largevascularlayer中血管层Middlevascularlayer毛细血管层Capillarylayer2024/8/2143内层
5、内层Innerlayer视网膜视网膜Retina中心凹Fovea黄斑Maculalutea中心小凹Foveola黄斑中心凹Foveacentralis视盘Opticdisc视乳头Opticpapilla视杯、杯凹Opticcup2024/8/215视网膜分层视网膜分层外层视网膜色素上皮层Retinalpigmentepithelium,RPE2024/8/216内层内层视网膜神经感觉层视网膜神经感觉层 视锥、视杆细胞层(光感受器细胞层)视锥、视杆细胞层(光感受器细胞层)ConeandrodlayerConeandrodlayer 外界膜外界膜ExternallimitingmembraneEx
6、ternallimitingmembrane 外核层外核层OuternuclearlayerOuternuclearlayer 外丛状层外丛状层OuterplaxiformOuterplaxiform 内核层内核层InnernuclearlayerInnernuclearlayer 内丛状层内丛状层InnerplexiformlayerInnerplexiformlayer 神经节细胞层神经节细胞层GanglioncelllayerGanglioncelllayer 神经纤维层神经纤维层NervefiberlayerNervefiberlayer 内界膜内界膜LimitingmembraneL
7、imitingmembrane2024/8/2172024/8/218(二)(二)眼球内容眼球内容Contentsoftheeye1.房水Aqueoushumor前房Anteriorchamber后房Posteriorchamber2024/8/2192.晶状体晶状体Lens2024/8/2203.玻璃体玻璃体Vitreousbody2024/8/2212024/8/2221.视路视路Visualpathway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retinalphotoreceptorbipolarcellnervousganglioncellsopticdi
8、skopticnerveopticchasmoptictractlateralgeniculatebodyopticradiationvisualcortex. 2024/8/223二、眼眶及附属器二、眼眶及附属器Orbitandaccessoryapparatus(一)眼眶Orbit1.视神经孔和视神经管Opticforamenandcanal2.眶上裂Superiororbitalfissure3.眶下裂Inferiororbitalfissure4.眶上切迹(或孔)Thesupraorbitalnotch2024/8/224(二)眼睑(二)眼睑Eyelids1皮肤层Theskin2皮下组
9、织层Subcutaneous3肌层Muscularlayer4睑板层Layerofthetarsalplate5结膜层Theconjunctivallayer2024/8/2252024/8/226(三三)结膜结膜Conjunctiva1睑结膜Palpebralconjunctiva2球结膜Bulbarconjunctiva3穹窿结膜Fornicalconjunctiva 2024/8/2272024/8/228(四四)泪器泪器Lacrimalapparatus1泪腺Lacrimalgland2泪道Lacrimalpassages(1)泪小点Lacrimalpuncta(2)泪小管Lacrim
10、alcanaliculi(3)泪囊Lacrimalsac(4)鼻泪管Nasolacrimalduct2024/8/2292024/8/230(五五)眼外肌眼外肌Extraocularmuscles4条直肌Rectus上直肌superiorrectimuscles下直肌inferiorrectimuscles内直肌medialrectimuscles外直肌externalrectimuscles2条斜肌Obliquemuscle上斜肌superiorobliquemuscles下斜肌Inferiorobliquemuscles2024/8/2312024/8/232三、视路三、视路Visualp
11、athway (一)视神经Opticnerve(1)眼内段Intraocular(2)眶内段Intraorbital(3)管内段Intracanalicular(4)颅内段Intracranial(二)视交叉Opticchiasm(三)视束Optictract(四)外侧膝状体Lateralgeniculatebody(五)视放射Opticradiation(六)视皮质Visualcortex2024/8/2332.瞳孔反射路瞳孔反射路Pathwayofpapillaryreflex光反射Lightreflex直接光反射Directreflex间接光反射Indirectreflex近反射Near
12、reflex2024/8/2342024/8/235四、眼球的血液循环和神经分布四、眼球的血液循环和神经分布Bloodcirculationandinnervationoftheglobe(一)血液循环Bloodcirculation动脉Artery视网膜中央血管系统thecentralretinalvascularsystem睫状血管系统theciliaryvascularsystem2024/8/2361.视网膜中央血管系统Thecentralretinalvascularsystem视网膜中央动脉Centralretinalartery,CRA2024/8/2372.睫状血管系统睫状血管
13、系统theciliaryvascularsystem(1)睫状后短动脉Shortposteriorciliaryartery(2)睫状后长动脉Longposteriorciliaryartery(3)睫状前动脉Anteriorciliaryartery2024/8/238静脉静脉Vein1.视网膜中央静脉CentralretinalveinCRV2.涡静脉Vortexvein3.睫状前静脉Anteriorciliarvein 2024/8/239(二)神经(二)神经Nerve1睫状神经节Ciliaryganglion2鼻睫状神经Nasociliarynerve2024/8/240视路及瞳孔反射
14、Opticpathwayandpupillaryreflex 2024/8/2411瞳孔反射路瞳孔反射路Pathwayofpupillaryreflex光反射Lightreflex直接光反射directreflex间接光反射indirectreflex近反射Nearreflex2024/8/2422.视路视路Visualpathway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retinalphotoreceptorbipolarcellnervousganglion cellsoptic diskoptic nerveopticchasmoptictractlateralgeniculatebodyopticradiationvisualcortex.2024/8/2432024/8/244