颈部解剖知识分析
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(2) 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
颈深筋膜分为三层 1. 浅层:封套筋膜 2. 中层：气管前筋膜或内脏筋膜 3. 深层：椎前筋膜
2. 被下颌舌骨肌分为浅深两部,下颌下腺管由腺深部的前端发
出，在下颌舌骨肌的深面前行，开口于口底粘膜的舌下阜。
January, 2007
下颌舌骨肌
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
1. 深筋膜浅层 （封套筋膜）
圆桶形环绕颈部
前 左右延续
后 附于项韧带和C7棘突
上 附于下颌体下缘、颧 弓、乳突基底、上项线 及枕外隆凸
下 附于胸骨柄上缘、锁 骨、肩峰
包裹二肌二腺,形成肌鞘和
腺鞘。
二肌:斜方肌 胸锁乳 突肌
二腺：下颌下腺 腮 腺
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
气管前间隙内有
①甲状腺下静脉 ②奇静脉丛 ③头臂干 ④甲状腺最下动脉 ⑤左头臂静脉 ⑥小儿有胸腺上部
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
2 、 颏下三角
境界:两侧二腹肌前腹和舌骨体围成 底：下颌舌骨肌 顶：颈深筋膜浅层 内容：颏下淋巴结,收集下唇、颏部、口 腔底、下颌切牙、舌尖的淋巴，注 入下颌下淋巴结或颈外侧上深淋巴结。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
(3)咽后间隙
位于椎前筋膜与 咽颅底筋膜之间。 内有淋巴结及结 缔组织。咽壁侧 方的部分为咽旁 间隙。
January, 2007
Copyright© Depart. hou University. All right reserved by YP HOU and YF SONG
颈部
一、概述 三、颈部深筋膜 五、胸锁乳突肌区 七、颈根部
二、浅层结构 四、颈前区 六、颈侧区
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
(2)气管前间隙
位于气管前 筋膜与气管 之间。
通向: 向 下通上纵隔。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
1.颈阔肌
起点: 三角肌和胸 大肌表面的筋膜。 止点： 口角
颈动脉鞘内上部 有颈内动脉、下 部有颈总动脉,颈 内静脉位于动脉 的外侧，迷走神 经位于两者之间 的后方。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
五、颈前区
（一） 舌骨上区 1.下颌下三角 周界: 位于下颌骨下缘
与二腹肌前、后腹之 间。
内容：主要为下颌下腺
及其周围的血管神经。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
一、概述
上下•• 界颈颈:前部为由区下胸:分:颌骨被为骨上舌固下缘骨缘、有分、锁为颈下 骨舌部颌和骨和角肩上项、峰区部乳至（。突第包7、括颈上2椎个项棘下线突颌与的下枕连三外线角隆。和突1的个连颏线下。三
•• 固角颈）外有和侧颈舌区部骨：:下被又区肩可（胛分包舌颈为括骨部颈成肌的前对下的腹区境颈分、界动为胸与脉枕锁三三分乳角角区突和和肌锁肌三骨区角上和）三颈。角外。侧区。
3. 深层（椎前筋膜）
上自颅底,下 续前纵韧带 与胸内筋膜， 并向下外包 绕腋血管及 臂丛，形成 腋鞘。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
Cervical branches of facial nerve
1. 在下颌下腺的浅面有:
January, 2007
面静脉、面神经的颈支、下颌下淋巴结
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
(1) 胸骨上间隙
位于胸骨柄上方 深筋膜浅层的二 层之间。
内有颈前静脉 下段、颈静脉弓、 淋巴结、脂肪组 织等。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
深筋膜浅层 （封套筋膜）续
在胸骨颈静脉切迹上方3~5cm处分 两层附于颈静脉切迹前、后缘, 成胸骨上间隙，内含颈静脉弓。
向上分两层包绕下颌下腺，形成 下颌下间隙的顶，内含下颌下 淋巴结、面动脉、面静脉，延 续为腮腺咬肌筋膜。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
（二） 舌骨下区
颈动脉三角 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 境界:
3.下颌下腺深部的结构:
深面有:面动脉 内下方有：舌下神经 舌动脉、舌静脉 内上方有：舌神经 下颌下神经节
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
胸锁乳突肌前缘上份 二腹肌后腹 肩胛舌骨肌上腹
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
主要内容:
颈总动脉及其分支 颈内静脉及其属支 迷走神经 副神经 舌下神经
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
4.颈动脉鞘:
为包绕颈 部大血管 和迷走神 经的筋膜 鞘。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
②颈外静脉 注入锁骨下静 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
(1)为颈丛的皮支: ①颈横神经 ②耳大神经 ③枕小神经 ④锁骨上神经 颈部麻醉点:
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
二、 浅层结构
1. 皮肤 2. 浅筋膜及其内容
颈阔肌 浅静脉 皮神经
(4)椎前间隙
位于脊柱颈段与 椎前筋膜之间。 颈椎结核脓肿多 积于此间隙。向 下通后纵隔。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
四、 颈部的筋膜间隙:
主要有: (1)胸骨上间隙 (2)气管前间隙 (3)咽后间隙 (4)椎前间隙
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
2.深筋膜中层 （气管前筋膜）
在位甲于状舌腺骨与下气肌管群、的食后管方上,上端附邻于接舌处骨,腺，鞘下后续层纤增维厚性形心
成包甲，状分腺二悬层韧包带绕甲状腺，形成甲状腺鞘。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
颈阔肌深面有浅
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
①颈前静脉 注入颈外静脉
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
颈深筋膜分为三层 1. 浅层:封套筋膜 2. 中层：气管前筋膜或内脏筋膜 3. 深层：椎前筋膜
2. 被下颌舌骨肌分为浅深两部,下颌下腺管由腺深部的前端发
出，在下颌舌骨肌的深面前行，开口于口底粘膜的舌下阜。
January, 2007
下颌舌骨肌
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
1. 深筋膜浅层 （封套筋膜）
圆桶形环绕颈部
前 左右延续
后 附于项韧带和C7棘突
上 附于下颌体下缘、颧 弓、乳突基底、上项线 及枕外隆凸
下 附于胸骨柄上缘、锁 骨、肩峰
包裹二肌二腺,形成肌鞘和
腺鞘。
二肌:斜方肌 胸锁乳 突肌
二腺：下颌下腺 腮 腺
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
气管前间隙内有
①甲状腺下静脉 ②奇静脉丛 ③头臂干 ④甲状腺最下动脉 ⑤左头臂静脉 ⑥小儿有胸腺上部
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
2 、 颏下三角
境界:两侧二腹肌前腹和舌骨体围成 底：下颌舌骨肌 顶：颈深筋膜浅层 内容：颏下淋巴结,收集下唇、颏部、口 腔底、下颌切牙、舌尖的淋巴，注 入下颌下淋巴结或颈外侧上深淋巴结。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
(3)咽后间隙
位于椎前筋膜与 咽颅底筋膜之间。 内有淋巴结及结 缔组织。咽壁侧 方的部分为咽旁 间隙。
January, 2007
Copyright© Depart. hou University. All right reserved by YP HOU and YF SONG
颈部
一、概述 三、颈部深筋膜 五、胸锁乳突肌区 七、颈根部
二、浅层结构 四、颈前区 六、颈侧区
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
(2)气管前间隙
位于气管前 筋膜与气管 之间。
通向: 向 下通上纵隔。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
1.颈阔肌
起点: 三角肌和胸 大肌表面的筋膜。 止点： 口角
颈动脉鞘内上部 有颈内动脉、下 部有颈总动脉,颈 内静脉位于动脉 的外侧，迷走神 经位于两者之间 的后方。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
五、颈前区
（一） 舌骨上区 1.下颌下三角 周界: 位于下颌骨下缘
与二腹肌前、后腹之 间。
内容：主要为下颌下腺
及其周围的血管神经。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
一、概述
上下•• 界颈颈:前部为由区下胸:分:颌骨被为骨上舌固下缘骨缘、有分、锁为颈下 骨舌部颌和骨和角肩上项、峰区部乳至（。突第包7、括颈上2椎个项棘下线突颌与的下枕连三外线角隆。和突1的个连颏线下。三
•• 固角颈）外有和侧颈舌区部骨：:下被又区肩可（胛分包舌颈为括骨部颈成肌的前对下的腹区境颈分、界动为胸与脉枕锁三三分乳角角区突和和肌锁肌三骨区角上和）三颈。角外。侧区。
3. 深层（椎前筋膜）
上自颅底,下 续前纵韧带 与胸内筋膜， 并向下外包 绕腋血管及 臂丛，形成 腋鞘。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
Cervical branches of facial nerve
1. 在下颌下腺的浅面有:
January, 2007
面静脉、面神经的颈支、下颌下淋巴结
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
(1) 胸骨上间隙
位于胸骨柄上方 深筋膜浅层的二 层之间。
内有颈前静脉 下段、颈静脉弓、 淋巴结、脂肪组 织等。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
深筋膜浅层 （封套筋膜）续
在胸骨颈静脉切迹上方3~5cm处分 两层附于颈静脉切迹前、后缘, 成胸骨上间隙，内含颈静脉弓。
向上分两层包绕下颌下腺，形成 下颌下间隙的顶，内含下颌下 淋巴结、面动脉、面静脉，延 续为腮腺咬肌筋膜。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
（二） 舌骨下区
颈动脉三角 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 境界:
3.下颌下腺深部的结构:
深面有:面动脉 内下方有：舌下神经 舌动脉、舌静脉 内上方有：舌神经 下颌下神经节
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
胸锁乳突肌前缘上份 二腹肌后腹 肩胛舌骨肌上腹
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
主要内容:
颈总动脉及其分支 颈内静脉及其属支 迷走神经 副神经 舌下神经
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
4.颈动脉鞘:
为包绕颈 部大血管 和迷走神 经的筋膜 鞘。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
②颈外静脉 注入锁骨下静 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
(1)为颈丛的皮支: ①颈横神经 ②耳大神经 ③枕小神经 ④锁骨上神经 颈部麻醉点:
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
二、 浅层结构
1. 皮肤 2. 浅筋膜及其内容
颈阔肌 浅静脉 皮神经
(4)椎前间隙
位于脊柱颈段与 椎前筋膜之间。 颈椎结核脓肿多 积于此间隙。向 下通后纵隔。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
四、 颈部的筋膜间隙:
主要有: (1)胸骨上间隙 (2)气管前间隙 (3)咽后间隙 (4)椎前间隙
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
2.深筋膜中层 （气管前筋膜）
在位甲于状舌腺骨与下气肌管群、的食后管方上,上端附邻于接舌处骨,腺，鞘下后续层纤增维厚性形心
成包甲，状分腺二悬层韧包带绕甲状腺，形成甲状腺鞘。
January, 2007
Copyright© Depart. Anatomy, School of Medicine, Lanzhou University. All right reserved by YP HOU and YF SONG
颈阔肌深面有浅
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
①颈前静脉 注入颈外静脉