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1、颈静脉孔的应用解剖陈立华CHINA-INI颈静脉孔由颞骨岩部和枕骨颈突围成。颞骨和枕骨向孔内的突起分别被称为颞突和枕突,二者以纤维或骨桥连接,构成孔内神经和血管的分隔。由颞突下方沿颈静脉球内侧缘伸向后方的骨性隆起称为颈内嵴,舌咽神经行于其内侧。颈静脉孔为一自颅后窝通向前、外、下方的骨性管道。颈静脉管(jugularcanal)。osseousrelationships,superiorviewosseousrelationships,posterosuperiorview.Thejugularforamenisbestse
2、eninaposterosuperiorvieworientedperpendiculartotheclivus.thejugularforamenislocatedbetweenthetemporalandoccipitalbonessigmoidgroovedescendsalongthemastoidandcrossestheoccipitomastoidsuture,turnsforwardontheuppersurfaceofthejugularprocess,enterstheforamenfromposter
3、iorandsuperiorshowstheshapeoftheforamenhypoglossalcanalpassesabovethemiddlethirdoftheoccipitalcondyleandopenslaterallyintotheintervalbetweenthejugularforamenandcarotidcanalstylomastoidforamenislocatedlateralandtheanteriorhalfoftheoccipitalcondylemedialtothejugular
4、foramenanteriorandbackwardrevealstheshapeofthejugularforamenlargerlateralpart,thesigmoidpart,whichreceivesthedrainageofthesigmoidsinus,andasmallermedialpart,thepetrosalpart,whichreceivesthedrainageoftheinferiorpetrosalsinusenlargedviewintrajugularprocessprojectsin
5、totheintervalbetweenthesigmoidandpetrosalpartsoftheforamenintrajugularridge,extendsforwardfromtheintrajugularprocessalongthemedialsideofthejugularbulbcochlearaqueductopensabovethepetrosalpartoftheforamen,wheretheglossopharyngealnerveenterstheintrajugularpartofthef
6、oramenonthemedialsideoftheintrajugularprocess.thevestibularaqueductopensontotheposteriorsurfaceofthetemporalbonesuperolateraltothejugularforamenTheinferiorpetrosalsinusextendsalongthepetroclivalfissureandentersthepetrosalpartoftheforamenposterosuperiorviewoftheint
7、rajugularprocessandridge,whichseparatethesigmoidandpetrosalpartsofthejugularforamenRembrandtvanRijn(Dutch,1606-1669).Thispaintingiscalled"TheAnatomyLectureofDr.NicolaesTulp",paintedin1632颈静脉孔的硬膜结构及分部Hovelacque将颈静脉孔分为前内侧的神经部和后外侧的血管部两部分。Katsuta根据通过颈静脉孔的结构将其分为岩部、颈内部(
8、或神经部)和乙状窦部。神经部的硬膜形成舌咽道和迷走道,分别有舌咽神经和迷走神经及副神经穿过。舌咽道和迷走道位于颈内突内侧,二者间隔以0.5-4.9mm宽的硬膜。神经部上外侧缘的硬膜返折增厚并伸向下内覆于舌咽道和迷走道上方,称颈静脉孔硬膜返折,是辨认颅神经的重要标志。sigmoidsinusdescend