2023年颈部解剖（教学课件）.ppt

January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 颈颈 部部 一、概述一、概述 二、浅层结构二、浅层结构 三、颈部深筋膜三、颈部深筋膜 四、颈前区四、颈前区 五、胸锁乳突肌区五、胸锁乳突肌区 六、颈根部六、颈根部 七、颈侧区七、颈侧区 January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 一、概述一、概述 境界：境界：内容：内容：January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 颈局部区：颈局部区：项部项部 固有颈部固有颈部颈部颈部 颈前区颈前区 胸锁乳突肌区胸锁乳突肌区 颈侧区颈侧区 January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 舌骨上区舌骨上区:下颌下三角下颌下三角 颏下三角颏下三角 舌骨下区舌骨下区:颈动脉三角颈动脉三角 肌三角肌三角 颈前区：颈前区：January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 胸锁乳突肌区胸锁乳突肌区 颈侧区：颈侧区：枕三角枕三角 锁骨上大窝锁骨上大窝 January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 二、二、浅层结构浅层结构 1.颈阔肌颈阔肌 2.浅静脉浅静脉 3.皮神经皮神经 January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 1.颈阔肌颈阔肌 起点：起点：三角肌和三角肌和胸大肌外表的筋胸大肌外表的筋膜。膜。止点：止点：口角口角 颈阔肌深面有浅颈阔肌深面有浅静脉和皮神经。静脉和皮神经。January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 2.浅静脉浅静脉 颈前静脉颈前静脉 注入颈外静脉注入颈外静脉 颈外静脉颈外静脉 注入锁骨下静注入锁骨下静脉或静脉角脉或静脉角 January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 3.皮神经皮神经(1)为颈丛的皮支为颈丛的皮支:颈横神经颈横神经 耳大神经耳大神经 枕小神经枕小神经 锁骨上神经锁骨上神经 颈部麻醉点：颈部麻醉点：(2)面神经颈支面神经颈支 January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 三、颈部深筋膜三、颈部深筋膜 分浅分浅、中中、深深 三层三层。January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 包裹二肌二腺包裹二肌二腺，形形成肌鞘和腺鞘成肌鞘和腺鞘。二 肌：斜 方 肌二 肌：斜 方 肌 胸锁乳突肌胸锁乳突肌 二腺：下颌下腺二腺：下颌下腺 腮腮 腺腺 1.深筋膜浅层 封套筋膜 January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 位于舌骨下肌群位于舌骨下肌群的前方的前方，上附上附于舌骨于舌骨，下续下续纤维性心包纤维性心包，分二层包绕甲分二层包绕甲状腺状腺，形成甲形成甲状腺鞘状腺鞘。2.深筋膜中层深筋膜中层 气管前筋膜气管前筋膜 January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 上自颅底上自颅底，下续下续前纵韧带与胸前纵韧带与胸内筋膜内筋膜，并向并向下外包绕腋血下外包绕腋血管及臂丛管及臂丛，形形成腋鞘成腋鞘。3.深层深层椎前筋膜椎前筋膜 January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 为包绕颈为包绕颈部大血管部大血管和迷走神和迷走神经的筋膜经的筋膜鞘。鞘。颈动脉鞘：颈动脉鞘：January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 颈动脉鞘内上部颈动脉鞘内上部有颈内动脉、下有颈内动脉、下部有颈总动脉，部有颈总动脉，颈内静脉位于动颈内静脉位于动脉的外侧，迷走脉的外侧，迷走神经位于两者之神经位于两者之间的前方。间的前方。January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 颈部的筋膜间隙颈部的筋膜间隙：主要有：主要有：(1)胸骨上间隙胸骨上间隙 (2)气管前间隙气管前间隙 (3)咽后间隙咽后间隙 (4)椎前间隙椎前间隙 January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 位于胸骨柄上方位于胸骨柄上方深筋膜浅层的二深筋膜浅层的二层之间。层之间。内有颈前静脉下内有颈前静脉下段、颈静脉弓、段、颈静脉弓、淋巴结、脂肪组淋巴结、脂肪组织等。织等。(1)胸骨上间隙胸骨上间隙 January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 位于气管前位于气管前筋膜与气管筋膜与气管之间。之间。通向：通向：向下向下通上纵隔。通上纵隔。(2)气管前间隙气管前间隙 January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 甲状腺下静脉甲状腺下静脉 奇静脉丛奇静脉丛 头臂干头臂干 甲状腺最下动脉甲状腺最下动脉 左头臂静脉左头臂静脉 小儿有胸腺上部小儿有胸腺上部 气管前间隙内有气管前间隙内有 January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 位于椎前筋膜与位于椎前筋膜与咽颅底筋膜之间。咽颅底筋膜之间。内有淋巴结及结内有淋巴结及结缔组织。咽壁侧缔组织。咽壁侧方的局部为咽旁方的局部为咽旁间隙。间隙。(3)咽后间隙咽后间隙 January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 位于脊柱颈段位于脊柱颈段与椎前筋膜之与椎前筋膜之间。颈椎结核间。颈椎结核脓肿多积于此脓肿多积于此间隙。向下通间隙。向下通后纵隔。后纵隔。(4)椎前间隙椎前间隙 January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 一一 舌骨上区舌骨上区 下颌下三角下颌下三角 颏下三角颏下三角 二二 舌骨下区舌骨下区 颈动脉三角颈动脉三角 肌三角肌三角 四、颈前区四、颈前区 January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 一一 舌骨上区舌骨上区 1.下颌下三角下颌下三角 周界：周界：位于下颌位于下颌骨下缘与二腹肌骨下缘与二腹肌前、后腹之间。前、后腹之间。January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 主要为下主要为下颌下腺及其周颌下腺及其周围的血管神经。围的血管神经。内容内容 January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 浅面有：面静脉浅面有：面静脉 深面有：面动脉深面有：面动脉 内下方有：舌下神经内下方有：舌下神经 舌动脉、舌静脉舌动脉、舌静脉 内上方有：舌神经内上方有：舌神经 下颌下神经节下颌下神经节 下颌下腺周围的结构：下颌下腺周围的结构：January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 二二 舌骨下区舌骨下区 颈动脉三角颈动脉三角 肌三角肌三角 January,2007 Copyright Depart.Anatomy,School of Medicine,Lanzhou University.All right reserved by YP HOU and YF SONG 1.颈动脉三角颈动脉三角 境界：境界：胸锁乳突肌前缘上份胸锁乳突肌前缘上份 二腹肌后