[局部解剖学]颈部

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1、1重要内容：颈深筋膜的区分、各层的包被关系和形成的结构下颌下三角、颈动脉三角、肌三角的境界和内容甲状腺的形态、位置和毗邻，被膜和血管气管颈部切开的层次颈外侧深淋巴结的区分、魏尔啸淋巴结的位置与临床意义颈根部的境界、内容和毗邻前斜角肌、二腹肌后腹的毗邻枕三角、锁骨上大窝、椎动脉三角的境界和内容概念：颈动脉鞘、胸膜顶、斜角肌间隙、颈袢、胸膜上膜2颈部局部解剖学颈部人体解剖学教研室3第一节概述一、境界与分区1.境界上界：下颌骨下缘、下颌角、乳突尖、上项线和枕外隆凸下界：胸骨颈静脉切迹、胸锁关节、锁骨上缘和肩

2、峰至第7颈椎棘突4舌骨甲状软骨甲状舌骨正中韧带甲状舌骨外侧韧带5甲状软骨环状软骨会厌软骨杓状软骨6甲状软骨前角喉结上切迹上角下角7环状软骨喉软骨中唯一完整的软骨环。前面后面侧面环状软骨弓环状软骨板甲关节面杓关节面甲关节面杓关节面89101112二腹肌后腹茎突舌骨肌颏舌骨肌下颌舌骨肌二腹肌前腹13胸骨舌骨肌肩胛舌骨肌胸骨甲状肌甲状舌骨肌舌骨14斜角肌间隙：前、中斜角肌与第1肋之间的空隙，有锁骨下动脉和臂丛通过。三、颈深肌（一）外侧群前斜角肌中斜角肌后斜角肌（二）内群侧四、颈部筋膜15前斜角肌中斜角肌后斜

3、角肌头长肌颈长肌1617ThearteriesofneckCommoncarotidartery颈总动脉Origin(arisesfrom)BrachiocephalictrunkontherightAorticarchontheleftAscendsinnecktoupperborderofthyroidcartilage;bifurcatesintointernalandexternalcarotidarteries18Carotidsinus颈动脉窦(baroreceptor),locateda

4、talocalizesdilationofterminalpartofcommoncarotidarteryorbeginningofinternalcarotidartery,sensitivetobloodpressurechangesCarotidglomus颈动脉小球(chemoreceptor),liesposteriortothepointofbifurcationofcommoncarotidartery,senseschangesinbloodcarbondioxide(oxygen)

5、levels19Branchesofexternalcarotida.Superiorthyroida.甲状腺上动脉－descendstosupplyupperpoleofthyroidglandandlarynxLinguala.舌动脉Faciala.面动脉Occipitala.枕动脉Posteriorauriculara.耳后动脉Maxillarya.上颌动脉Superficialtemporala.颞浅动脉20Subclavianartery锁骨下动脉Origin(arisesfrom)Brac

6、hiocephalictrunkonrightAorticarchonleftBecomesaxillaryarteryatlateralborderoffirstribBranchesVertebrala.椎动脉Internalthoracica.胸廓内动脉Thyrocervicaltrunk甲状颈干Inferiorthyroidartery甲状腺下动脉－suppliesinferiorpoleofthyroidglandCostocervicaltrunk肋颈干21VeinsDrainingthe

7、neckInternaljugularvein颈内静脉Beginatjugularforamen,descendingtojointhesubclavianveintoformbrachiocephalicveinLieslateralfirsttointernalandthentocommoncarotida.withincarotidsheathChiefextracranialtributariesCommonfacialvein面总静脉Lingualv.舌静脉Pharyngealv.咽静脉Su

8、periorthyroidv.甲状腺上静脉Middlethyroidv.甲状腺中静脉2223SubclavianveinItisancontinuationofaxillaryveinatthelateralborderoffirstribJoinsinternaljugularveintoformthebrachiocephalicvein.Angleofunionistermedvenousangle静脉角24Externaljugularvein颈