颈部局部解剖与操作

颏下三角 Boundaris 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.
nodes the cutaneous branches of the cervical plexus the cervical branch of the facial nerve
1. 颈阔肌
The platysma
• Is a broad, thin sheet of muscle in the subcutaneous tissue.
• Nerve point of neck
• Cervical branch of the facial nerve
• 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
• 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”.
•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.
下 颌 下 三 角 的 底
下 颌 下 三 角 的 顶 与 底
2.下颌下三角的主要结构 Main contents of the submandibular triangle
• 面静脉 Facial vein
• 面神经的颈支 Cervical branch of facial nerve • 下颌下淋巴结 Submandibular lymph nodes
•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。
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.
• 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
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) • 环状软骨 Cricoid cartilage (C) • 第1气管环 The first tracheal ringe(1) • 甲状腺峡 Isthmus(S)
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
• 颈横静脉 Transverse cervical vein
• 肩胛上静脉 Suprascapular vein • 淋巴管 A few lymph vessels
四、颏 下 三 角 Submental Triangle
• 境界 Boundary • 内容 Contents
Body of hyoid bone
• Is one of the muscles of facial expression.
• Is innervated by the cervical branch of the facial nerve.
• The superficial cervical veins and nerves are located deep to the platysma.
• 下颌腺及其导管Submandibular gland and its duct
• 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
• 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
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
Middle pharyngeal constrictor
Mylohyoid Hyoglossus
•A floor of the submandibular triangle is formed by the mylohyoid, hyoglossus and middle pharyngeal constricte sympathetic ganglion.
二、颈部浅层结构 The superficial structures of the neck
• 皮肤 The skin( thin and pliable) • 浅筋膜及其内容The superficial fascia and its contents a thin layer of fat a sheet of platysma the anterior jugular vein the lateral jugular vein the superficial(lateral and anerior)cervical lymph
• 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.
• 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