颈部解剖

1. 颈部的境界 boundary of the neck
2.颈部分区
• 颈部:分为固有颈部（proper neck）和项部（nape）。 • 固有颈部:又可分为颈前区anterior region、胸锁乳突肌区 sternocleidomastoid region和颈外侧区lateral region。
• 胸骨上间隙、咽后间隙、气管前间隙、椎前间隙
胸 骨 上 间 隙的内容 Contents of the Suprasternal space
Include the: • 颈前筋膜下端 Inferior ends of the anterior jugular veins • 颈静脉弓 Jugular venous arch • 疏松结缔组织 Loose connective tissue • 1~2个淋巴结 One or two deep lymph nodes
• 封套筋膜、 气管前筋膜、椎前筋膜
• 颈动脉鞘、气管前筋膜、甲状腺鞘、甲状腺悬韧带
2. 颈筋膜间隙 Cervical Fascial Spaces
• 胸骨上间隙 Suprasternal space
• 咽后间隙 Retropharyngeal space
• 气管前间隙 Prechacheal space • 椎前间隙 Prevertebral space
•The level at which the vertebral artery enters the transverse foramen of the 6th cervical vertebra. •The site at which the carotid artery can be pressed against the carotid tubercle of the 6th cervical vertebra.
•The level at which the inferior thyroid artery and the middle thyroid vein enter or leave the thyroid gland.
•The level at which the superior belly of the omohyoid muscle crosses the carotid sheath.
1. 颈阔肌 The platysma
• Is a broad, thin sheet of muscle in the subcutaneous tissue. • Covers the anterolateral aspect of the neck. • Aarise in fascia covering superior parts of the deltoid and pectoralis major muscles and sweep superomedially over the clavicle to the inferior border of the mandible, skin, and subcutaneous tissue of lower face. • Is one of the muscles of facial expression. • Is innervated by the cervical branch of the facial nerve.
• 颈前区：被舌骨hyoid分为舌骨上区suprahyoid region（包括2 个下颌下三角和1个颏下三角）和舌骨下区infrahyoid region （包括成对的颈动脉三角和肌三角）。 • 颈外侧区：被肩胛舌骨肌下腹分为枕三角和锁骨上三角。
(Greater) supraclavicular fossa
• 面神经的颈支Cervical branch of facial nerve
三、颈筋膜及筋膜间隙 Cervical Fasciaand Fascial Space
1. 颈筋膜 Cervical Fascia
• 颈深筋膜分为三层
Deep cervical fascia consists of three fascial layers: – 浅层 Superficial layer 封套筋膜 Investing fascia – 中层 Middle layer 气管前筋膜 Prechacheal fascia 内脏筋膜 Visceral fascia – 深层 Deep layer 椎前筋膜 Prevertebral fascia
• 境界和分区 boundary and regions
• 表面解剖 surface anatomy
– 表面标志 surface landmark
– 体表投影 surface projection
上界：为下颌骨下缘、下颌角、乳突、上项线与枕外隆突的连线。 下界：由胸骨上缘、锁骨和肩峰至第7颈椎棘突的连线。Inferiorly： Superiorly：an line linking with the lower border a line by the upper border of sternum, the clavicle and of mandible, the angle of mandible, the mastoid process, the superior extending from the acromion to the spine of 7th cervical nuchal line and the external occipital protubera of submental triangle
颏下三角的内容
Contents of the submental triangle
Include the:
• 几个小的颏下淋巴结 Several small submental lymph nodes. • 几条小静脉，汇合成颈前静脉 Small veins that unite to form the anterior jugular vein.
Middle pharyngeal constrictor Mylohyoid Hyoglossus
•A floor of the submandibular triangle is formed by the mylohyoid, hyoglossus and middle pharyngeal constrictor.
• The superficial cervical veins and nerves are located deep to the platysma.
• The main action of the platysma:①draws corners of mouth inferiorly and widens it as in expressions of sadness and fright; ②draws the skin of neck superiorly when teeth are “clenched”.
五、下 颌 下 三 角 Submandibular Triangle
• 境界 Boundary
• 内容 Contents
1. 下 颌 下 三 角 Boundaris of the submandibular triangle
• A roof of the submandibular triangle is formed by the skin, superficial fascia, platysma and investing fascia.
Lesser supraclavicular fossa
Suprasternal fossa
3.表面标志 surface landmark
表面标志 Surface Landmark
• 舌骨 Hyhoid(H) • 甲状软骨 Thyroid cartilage(T) • 喉结节 Laryngeal prominence(P)
局部解剖学（九）
颈部的局部解剖与操作（1）
颈 部 Neck
• 概述 introduction • 浅层结构 superifical structures • 下颌下三角 submandibular triangle • 颏下三角 submental triangle
一、概述 Introduction
2.
• 颈前静脉或颈前正中静脉、颈外静脉
颈 静 脉 弓
Jugular venous arch
3. 颈浅淋巴结Superficial cervical lymph nodes
4. Superficial cervical nerves
• Cutaneous branches of the cervical plexus • Nerve point of neck • Cervical branch of the facial nerve
• 胸锁乳突胸骨头 Sternal heads of the ternocleidomastoid • 锁骨间韧带 Interclavicular ligament
锁骨上间隙的内容 Contents of the supraclavicular space
Include the: • 颈外静脉 A part of the external jugular vein • 锁骨上神经 Supraclavicular nerves
• 环状软骨
Cricoid cartilage (C) • 第1气管环
The first tracheal ringe(1)
• 甲状腺峡 Isthmus(S)
环状软骨(弓)的意义 •第6颈椎水平 The level of the 6th cervical vertebra. •喉与气管交界 The junction of the larynx with the trachea. •咽与食管交界 The junction of the pharynx with the esophagus.