项背部肩胛区解剖(4ipxueshi)

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1、项背部、肩胛区解剖Thescapularregionandthebackvertebralregion(1)自枕外隆凸至尾骨尖做一纵行切口(2)自枕外隆凸沿上项线至乳突做一横切口(3)自隆椎棘突向外横向切至肩峰翻皮：沿以上切口将皮肤向外翻开一、皮肤skin切口incisions:⑴⑶⑵1.皮神经cutaneousnerves颈、胸、腰神经后支的皮支,第2颈神经后支的皮支粗大称为枕大神经greateroccipitaln.,第3颈神经后支的分支粗大称为第三枕神经thirdoccipitaln.2.浅血管superficialbloodvesse

2、l肋间后动、静脉的后支腰动、静脉的后支二、浅筋膜superficialfascia三、深筋膜deepfascia项筋膜nuchalfascia胸腰筋膜thoracolumbarfascia上部的深筋膜较浅，下部的深筋膜较厚，呈菱形，称胸腰筋膜，分为三层，包绕竖棘肌。前层anteriorlayer中层middlelayer后层posteriorlayer斜方肌Trapezius—副神经背阔肌Latissimusdorsi—胸背N菱形肌rhomboideus—肩胛背N肩胛提肌levatorscapulae—肩胛背N四、肌层muscularlaye

3、r①浅层superficiallayer斜方肌Trapezius背阔肌Latissimusdorsi1.项背部肌themusclesoftheback肩胛提肌levatorscapulae菱形肌rhomboideus②深层deeplayer竖脊肌erectorspinae作用：使脊柱后伸和仰头，一侧收缩使脊柱侧屈。神经支配：颈、胸、腰神经的后支。为背肌中最长、最大的肌，纵列于脊柱两侧的沟内。包括髂肋肌iliocostalis、最长肌longissimus、棘肌spinalis。髂肋肌iliocostalis最长肌longissimus、棘肌s

4、pinalis①三角肌Deltoid—腋N②冈上Supraspinatus—肩胛上N③冈下Infraspinatus—肩胛上N④小圆肌Teresminor—腋N⑤大圆肌Teresmajor—肩胛下N⑥肩胛下肌Subscapularis—肩胛下N2.肩胛区肌Musclesoftheshoulder三角肌Deltoid冈上肌Supraspinatus冈下肌Infraspinatus小圆肌Teresminor大圆肌Teresmajor肩胛下肌subscapularis肱三头肌Tricepsbrachii长头Longhead外侧头Lateralhea

5、d内侧头medialhead五、血管bloodvessels1.肩胛上动脉Suprascapulara.2.肩胛背动脉Dorsalscapulara.3.颈横动脉Transversecervicala.4.颈浅动脉Superficialcervicala.5.旋肩胛动脉Circumflexscapulara.6.旋肱前动脉Anteriorcircumflexhumerala7.旋肱后动脉Posteriorcircumflexhumerala.肩胛上动脉Suprascapulara.旋肱后动脉Posteriorcircumflexhumeral

6、a.旋肩胛动脉Circumflexscapulara.肩胛背动脉Dorsalscapulara.肩胛上动脉Suprascapulara.颈横动脉transversecervicala.肩胛背动脉dosalscapulaa.颈浅动脉superficialcervicala.甲状颈干thyrocervicaltrunk六、神经nerves1.肩胛上神经suprascapularn.2.肩胛背神经dosalscapulan.3.腋神经axillaryn.4.副神经accessoryn.肩胛背神经dosalscapulan.肩胛上神经suprasca

7、pularn.腋神经Axillaryn.1.三边孔Triangularforamen上superior：小圆肌Teresminor下inferior：大圆肌Teresmajor外lateral：肱三头肌长头Longheadofthetriceps内容Contents：旋肩胛血管circumflexscapulara.旋肩胛动、静脉Circumflexscapulara、v.七、局部结构regionalstructure2.四边孔Quadrangularforamen上Superior:小圆肌Teresminor下inferior：大圆肌Ter

8、esmajor内Medial：肱三头肌长头Longheadofthetriceps外Lateral：肱骨Humerus通过内容：腋神经、旋肱后血管Axillaryn